Miracle-dz/UniFAR-FTUs huggingface dataset:
Detecting Patient Deterioration Using Artificial Intelligence in a Rapid Response System.

OBJECTIVES As the performance of a conventional track and trigger system in a rapid response system has been unsatisfactory, we developed and implemented an artificial intelligence for predicting in-hospital cardiac arrest, denoted the deep learning-based early warning system. The purpose of this study was to compare the performance of an artificial intelligence-based early warning system with that of conventional methods in a real hospital situation. DESIGN Retrospective cohort study. SETTING This study was conducted at a hospital in which deep learning-based early warning system was implemented. PATIENTS We reviewed the records of adult patients who were admitted to the general ward of our hospital from April 2018 to March 2019. INTERVENTIONS The study population included 8,039 adult patients. A total 83 events of deterioration occurred during the study period. The outcome was events of deterioration, defined as cardiac arrest and unexpected ICU admission. We defined a true alarm as an alarm occurring within 0.5-24 hours before a deteriorating event. MEASUREMENTS AND MAIN RESULTS We used the area under the receiver operating characteristic curve, area under the precision-recall curve, number needed to examine, and mean alarm count per day as comparative measures. The deep learning-based early warning system (area under the receiver operating characteristic curve, 0.865; area under the precision-recall curve, 0.066) outperformed the modified early warning score (area under the receiver operating characteristic curve, 0.682; area under the precision-recall curve, 0.010) and reduced the number needed to examine and mean alarm count per day by 69.2% and 59.6%, respectively. At the same specificity, deep learning-based early warning system had up to 257% higher sensitivity than conventional methods. CONCLUSIONS The developed artificial intelligence based on deep-learning, deep learning-based early warning system, accurately predicted deterioration of patients in a general ward and outperformed conventional methods. This study showed the potential and effectiveness of artificial intelligence in an rapid response system, which can be applied together with electronic health records. This will be a useful method to identify patients with deterioration and help with precise decision-making in daily practice.
Awake chronic mouse model of targeted pial vessel occlusion via photothrombosis

Abstract. Animal models of stroke are used extensively to study the mechanisms involved in the acute and chronic phases of recovery following stroke. A translatable animal model that closely mimics the mechanisms of a human stroke is essential in understanding recovery processes as well as developing therapies that improve functional outcomes. We describe a photothrombosis stroke model that is capable of targeting a single distal pial branch of the middle cerebral artery with minimal damage to the surrounding parenchyma in awake head-fixed mice. Mice are implanted with chronic cranial windows above one hemisphere of the brain that allow optical access to study recovery mechanisms for over a month following occlusion. Additionally, we study the effect of laser spot size used for occlusion and demonstrate that a spot size with small axial and lateral resolution has the advantage of minimizing unwanted photodamage while still monitoring macroscopic changes to cerebral blood flow during photothrombosis. We show that temporally guiding illumination using real-time feedback of blood flow dynamics also minimized unwanted photodamage to the vascular network. Finally, through quantifiable behavior deficits and chronic imaging we show that this model can be used to study recovery mechanisms or the effects of therapeutics longitudinally.
Bacterial membrane vesicles from Acinetobacter baumannii induced by ceftazidime are more virulent than those induced by imipenem

ABSTRACT Patients with Acinetobacter baumannii bacteremia treated with antipseudomonal cephalosporins showed higher 14-day mortality than patients treated with antipseudomonal carbapenems. We hypothesized that the bacterial membrane vesicles (BMVs) induced by antipseudomonal cephalosporins are more virulent than BMVs induced by antipseudomonal carbapenems. To simulate the clinical condition with inadequate antimicrobial treatment, carbapenem-resistant A. baumannii was treated with ceftazidime (an antipseudomonal cephalosporin) or imipenem (an antipseudomonal carbapenem) at 1/2 the minimum inhibitory concentration. BMVs and BMV-carried lipopolysaccharide were measured by nanoparticle tracking analysis and western blotting, respectively. Cytokine expression in RAW264.7 macrophages or mice serum induced by the BMVs was determined by ELISA, fluorescent bead-based immunoassay or western blotting. The virulence of the BMVs was assessed in mice. Liquid chromatography tandem-mass spectrometry was used to determine the protein contents of the BMVs. We found that ceftazidime induced a higher number of BMVs (CAZ-BMV), which carried more LPS, and induced higher expression levels of iNOS, IL-1β, and IL-6 in macrophages, higher expression of many cytokines in mice, more neutrophil infiltration in lung interstitium, and higher mortality in mice than imipenem-induced BMVs (IMP-BMV). When adjusted to same amount of LPS, CAZ-BMV still led to higher mortality than IMP-BMV. Proteomic analysis revealed different protein contents in CAZ-BMV and IMP-BMV. In conclusion, A. baumannii BMVs induced by ceftazidime are more virulent than BMVs induced by imipenem.
Synaptotagmin-7 is a key factor for bipolar-like behavioral abnormalities in mice

Significance The key molecular mechanisms underlying the etiology of bipolar disorder (BD) have remained enigmatic. As BD patients often show comorbidity with insulin/glucose metabolic syndrome, we hypothesized that the central and peripheral abnormalities might share some identical molecular mechanism. Through investigating the expression of insulin/synapse dual functioning genes in patient induced pluripotent stem cell-derived neurons and their effects on mouse behaviors, as well as testing the mRNA level in BD patient plasma samples, we demonstrated that Syt7 is likely a key factor involved in neuropsychiatric-like behaviors. Our work helps explain the molecular mechanism involved in the pathogenesis of BD. The pathogenesis of bipolar disorder (BD) has remained enigmatic, largely because genetic animal models based on identified susceptible genes have often failed to show core symptoms of spontaneous mood cycling. However, pedigree and induced pluripotent stem cell (iPSC)-based analyses have implicated that dysfunction in some key signaling cascades might be crucial for the disease pathogenesis in a subpopulation of BD patients. We hypothesized that the behavioral abnormalities of patients and the comorbid metabolic abnormalities might share some identical molecular mechanism. Hence, we investigated the expression of insulin/synapse dually functioning genes in neurons derived from the iPSCs of BD patients and the behavioral phenotype of mice with these genes silenced in the hippocampus. By these means, we identified synaptotagmin-7 (Syt7) as a candidate risk factor for behavioral abnormalities. We then investigated Syt7 knockout (KO) mice and observed nocturnal manic-like and diurnal depressive-like behavioral fluctuations in a majority of these animals, analogous to the mood cycling symptoms of BD. We treated the Syt7 KO mice with clinical BD drugs including olanzapine and lithium, and found that the drug treatments could efficiently regulate the behavioral abnormalities of the Syt7 KO mice. To further verify whether Syt7 deficits existed in BD patients, we investigated the plasma samples of 20 BD patients and found that the Syt7 mRNA level was significantly attenuated in the patient plasma compared to the healthy controls. We therefore concluded that Syt7 is likely a key factor for the bipolar-like behavioral abnormalities.
Post-marketing surveillance of adverse events following measles, mumps, rubella and varicella (MMRV) vaccine: retrospecive study in apulia region (ITALY), 2009-2017

ABSTRACT Since 2006, some Italian Regions introduced the active offer of measles, mumps, rubella, and varicella (MMRV) vaccine for all newborns during the second years of life. In 2011, Italian Drug Authority (AIFA) recommended the discontinuation of the MMRV use for an increased risk of febrile seizures following vaccination; furthermore, some Regions (such as Apulia, that introduced MMRV offer in 2009) chose to continue the use of MMRV and Ministry of Health recommended to guarantee supplemental monitoring of safety of the vaccine. In Italy, the surveillance of Adverse Events following immunization (AEFIs) is currently carried out by AIFA and Regional Health Authorities; this paper aims to summarize the results of MMRV-vaccine surveillance of AEFIs program carried out in Apulia. From the AIFA database, we selected MMRV AEFIs that occurred in Apulia (about 4,000,000 inhabitants) from 2009 to 2017. For serious AEFIs, we applied the WHO causality assessment algorithm, using for cases hospitalized information from individual medical records. In the 8 years of observation, 155 MMRV-AEFIs (reporting rate: 37.9×100,000 doses) occurred of which 26 were classified as serious (6.3×100,000 doses) and 22 led to hospitalization. Performing causality assessment, for 10 the classification was “consistent causal association to immunization” (reporting rate: 2.4×100000 doses), for 2 indeterminate, for 13 “inconsistent causal association to immunization” and for 1 not-classifiable. No case of febrile seizure resulted consistent to vaccination. All consistent serious AEFIs were completely resolved at subsequent follow-up.
Characterization of antibiogram fingerprints in Listeria monocytogenes recovered from irrigation water and agricultural soil samples

Listeria monocytogenes (L. monocytogenes) is a foodborne pathogen and the etiologic agent of listeriosis, which can be disseminated within the agricultural environment particularly soil and irrigation water, contaminate farm produce and cause high mortality and morbidity among vulnerable individuals. This study assessed the incidence and antibiogram of L. monocytogenes recovered from irrigation water and agricultural soil samples collected from Chris Hani and Amathole District Municipalities (DMs) in Eastern Cape Province, South Africa. The distribution of presumptive L. monocytogenes in irrigation water and agricultural soil samples was done using the standard plate count method, while polymerase chain reaction (PCR) was used to identify the isolates. The confirmed isolates were screened for 9 key virulence markers using PCR after which they were subjected to antibiotic susceptibility testing against 18 antibiotics used for the alleviation of listeriosis using the disk diffusion method. Relevant putative antibiotic resistance genes in the resistant variants were screened for using PCR. The distribution of L. monocytogenes in irrigation water samples was statistically significant (P ≤ 0.05) and ranged from log10 1.00 CFU/100ml to log10 3.75 CFU/100 ml. In agricultural soil samples, the distribution ranged significantly (P ≤ 0.05) from log10 2.10 CFU/g to log10 3.51 CFU/g. Of the 117 presumptive L. monocytogenes recovered from irrigation water samples and 183 presumptive L. monocytogenes isolated from agricultural soil samples, 8 (6.8%) and 12 (6.6%) isolates were confirmed respectively. Nine virulence genes including inlA, inlB, inlC, inlJ, actA, hlyA, plcA, plcB, and iap were detected in all the isolates. The proportion of the isolates exhibiting phenotypic resistance against the test antimicrobials followed the order: tetracycline (90%), doxycycline (85%), cefotaxime (80%), penicillin (80%), chloramphenicol (70%), linezolid (65%), erythromycin (60%) and trimethoprim/sulfamethoxazole (55%). The isolates exhibited multiple antibiotic resistance against 3 or more antibiotics and the MAR indices of all the multidrug isolates were ≥0.2. The isolates harboured antibiotic resistance genes including tetA, tetB, tetC, sulI, sulII, aadA, aac(3)-IIa and ESBLs including blaTEM, blaCTX-M group 9, blaVEB as well as AmpC. None of the isolates harboured the carbapenemases. We conclude that irrigation water and agricultural soil collected from Chris Hani and Amathole District Municipalities (DMs) in Eastern Cape Province of South Africa are reservoirs and potential transmission routes of multidrug-resistant L. monocytogenes to the food web and consequently threat to public health.
Short implants (<8mm) versus longer implants (≥8mm) with lateral sinus floor augmentation in posterior atrophic maxilla: A meta-analysis of RCT`s in humans

Background One of the greatest challenges that dentists face today is to rehabilitate severe atrophied alveolar ridges in partially and completely edentulous patients with implants. Despite the high survival rate of implants placed next to sinus elevation, this technique presents complications that can be avoided by placing short implants, an option that also presents high survival rates. For this reason, the aim of this study is to compare the survival rate, marginal bone loss and complications associated with short implants (<8 mm) versus longer implants (≥8mm) placed with lateral sinus floor elevation in posterior atrophic maxillae. Material and Methods A literature search was conducted by two independent reviewers in the PubMed/Medline (National Library of Medicine, Washington, DC) electronic database for articles published from January 2007 to July 2018. Seven qualified articles were selected for the meta-analysis. Results The test for overall effect did not find statistical significance in the survival rates, overall complications, intra-operative complications, post-operative complications and prosthetic complications. However, the test showed statistically significant differences in biological complications in favor of standard implants, and marginal bone loss between control and test groups in favor of short implants (<8mm) was found. Conclusions Within the limitations of the present study, prosthetic rehabilitations with short implants (<8mm) in posterior maxilla is a reliable treatment option as an alternative to lateral wall sinus floor augmentation. Key words:Short implant, lateral sinus floor augmentation, Randomized controlled trial, Survival rate, Complications, Marginal bone loss.
The Metabolic Rainbow: Deep Learning Phase I Metabolism in Five Colors

Metabolism of drugs affects their absorption, distribution, efficacy, excretion, and toxicity profiles. Metabolism is routinely assessed experimentally using recombinant enzymes, human liver microsome, and animal models. Unfortunately, these experiments are expensive, time-consuming, and often extrapolate poorly to humans because they fail to capture the full breadth of metabolic reactions observed in vivo. As a result, metabolic pathways leading to the formation of toxic metabolites are often missed during drug development, giving rise to costly failures. To address some of these limitations, computational metabolism models can rapidly and cost-effectively predict sites of metabolism-the atoms or bonds which undergo enzymatic modifications-on thousands of drug candidates, thereby improving the likelihood of discovering metabolic transformations forming toxic metabolites. However, current computational metabolism models are often unable to predict the specific metabolites formed by metabolism at certain sites. Identification of reaction type is a key step towards metabolite prediction. Phase I enzymes, which are responsible for the metabolism of more than 90% of FDA approved drugs, catalyze highly diverse types of reactions and produce metabolites with substantial structural variability. Without knowledge of potential metabolite structures, medicinal chemists cannot differentiate harmful metabolic transformations from beneficial ones. To address this shortcoming, we propose a system for simultaneously labeling sites of metabolism and reaction types, by classifying them into five key reaction classes: stable and unstable oxidations, dehydrogenation, hydrolysis, and reduction. These classes unambiguously identify 21 types of phase I reactions, which cover 92.3% of known reactions in our database. We used this labeling system to train a neural network model of phase I metabolism on a literature-derived dataset encompassing 20,736 human phase I metabolic reactions. Our model, Rainbow XenoSite, was able to identify reaction-type specific sites of metabolism with a cross-validated accuracy of 97.1% area under the receiver operator curve. Rainbow XenoSite with five-color and combined output is available for use free and online through our secure server at http://swami.wustl. edu/xenosite/p/phase1_rainbow.
Middle to long-term results of distal femoral tension band hemiepiphysiodesis in the treatment of idiopathic genu valgum

Idiopathic genu valgum is a common deformity in children. Guided growth is the treatment of choice in severe or symptomatic cases, although long-term results are mostly unknown. The purpose of this study was to determine the middle- to long-term results and complications of tension band plating in the treatment of idiopathic genu valgum, and the association between obesity and idiopathic genu valgum. A retrospective review of patients with idiopathic genu valgum treated by tension band plating between January 2007 and September 2017 was performed. Data from 99 patients (198 limbs) were reviewed. All underwent bilateral medial distal femoral tension band plating and subsequent plate removal and were followed by a mean of 56.1 months (12–120 months) after surgery. Full correction was achieved in all patients, with a mean correction rate of 0.52° per month. No cases of infection or premature physeal closure were recorded. Screw breakage at the time of removal occurred in five limbs (2.5%). Fifteen limbs (7.5%) developed a minor overcorrection. 44.4% of our patients were either overweight or obese, which is higher than the national average. A third of our patients complained of an unsightly scar at the latest follow-up. Tension band plating is an effective, well tolerated, and reproducible technique in the treatment of idiopathic genu valgum. The risk of premature physeal closure is minimal. We recommend achieving a minor overcorrection before plate removal in patients with more than a year of expected growth. Also, predicting correction based on the mean correction rate is discouraged.
The DSM’s Reconnection to Psychoanalytic Theory through the Alternative Model for Personality Disorders

Often believed to have Kraepelinian origins, the Diagnostic and Statistical Manual of Mental Disorders—5th Edition (DSM-5) defines personality disorders using a categorical, hierarchical taxonomic system. This system possesses many long-standing problems for clinical practice, including a large assortment of symptom combinations that contribute to problematic heterogeneity and likely impair diagnostic validity. The DSM diagnostic system was at one time heavily influenced by psychoanalytic theory (Shorter 2005). A desire for greater theoretical neutrality then encouraged a shift away from psychoanalytic theory, resulting in the problematic atheoretical model of personality pathology introduced in DSM-III (1980) and still used today. The Alternative Model for Personality Disorders (AMPD), introduced in DSM-5 (2013), is an attempt to reconcile many of the categorical model’s issues and directly parallels primary themes that characterize psychoanalytic models of personality. After a review of the historical development of DSM, three current systems for diagnosing personality pathology—the DSM-5’s categorical model (2013), its AMPD (2013), and the Psychodynamic Diagnostic Manual (2nd ed.; Alliance of Psychoanalytic Organizations 2017) are compared. The comparison illustrates how the AMPD brings psychoanalytic theory back into the DSM system and acknowledges the implications of a more psychoanalytic DSM.
Food Behaviors, Health, and Bean Nutrition Awareness among Low-Income Men: A Pilot Study

Bean consumption is known to lower blood cholesterol and postprandial blood glucose. With higher chronic disease risk, low-income men could theoretically benefit from increased bean intakes. The study objective was to explore low-income men’s food behaviors, bean health benefit awareness, and bean consumption practices and preferences. Seventy-one low-income men aged 18–65 years (µ 41 ± 12.7; 53% white, 16% black, 31% Hispanic) completed a survey on health risks, food behaviors, bean health knowledge, attitudes toward dry and canned beans, and bean preferences. Eighty-seven percent had one or more health risk factors of physical inactivity, smoking, or obesity. Most men compared food prices, and thought about healthy food choices for their families, but few planned meals or read nutrition facts labels. White men had significantly higher bean health benefit knowledge than black or Hispanic men (p < 0.01). Most men liked the taste of beans, disagreed dry beans took too long to prepare, and 79% ate them at least 2–3 times per month. Forty-nine percent agreed beans caused intestinal gas. Improving men’s awareness of the health benefits of beans as well as leveraging existing positive attitudes may be useful approaches to increase bean consumption among low-income and minority male populations.
Inactivation of L. monocytogenes and S. typhimurium Biofilms by Means of an Air-Based Cold Atmospheric Plasma (CAP) System

Previous (biofilm) inactivation studies using Cold Atmospheric Plasma (CAP) focused on helium (with or without the addition of oxygen) as feeding gas since this proved to result in a stable and uniform plasma. In industry, the use of helium gas is expensive and unsafe for employees. Ambient air is a possible substitute, provided that similar inactivation efficacies can be obtained. In this research, 1 and 7 day-old (single/dual-species) model biofilms containing L. monocytogenes and/or S. typhimurium cells were treated with an air-based Surface Barrier Discharge (SBD) plasma set-up for treatment times between 0 and 30 min. Afterwards, cell densities were quantified via viable plate counts, and predictive models were applied to determine the inactivation kinetics and the efficacy. Finally, the results were compared to previously obtained results using a helium-based SBD and DBD (Dielectric Barrier Discharge) system. This study has demonstrated that the efficacy of the air-based CAP treatment depended on the biofilm and population type, with log-reductions ranging between 1.5 and 2.5 log10(CFU/cm2). The inactivation efficacy was not significantly influenced by the working gas, although the values were generally higher for the air-based system. Finally, this study has demonstrated that the electrode configuration was more important than the working gas composition, with the DBD electrode being the most efficient.
The Antioxidant Activity of Prenylflavonoids

Prenylated flavonoids combine the flavonoid moiety and the lipophilic prenyl side-chain. A great number of derivatives belonging to the class of chalcones, flavones, flavanones, isoflavones and other complex structures possessing different prenylation patterns have been studied in the past two decades for their potential as antioxidant agents. In this review, current knowledge on the natural occurrence and structural characteristics of both natural and synthetic derivatives was compiled. An exhaustive survey on the methods used to evaluate the antioxidant potential of these prenylflavonoids and the main results obtained were also presented and discussed. Whenever possible, structure-activity relationships were explored.