Miracle-dz/UniFAR-FTUs huggingface dataset:
Instagram and Spine Fusion: An Analysis of Social Media and Its Relationship to Patient Perception of Surgery

Study Design: Cross sectional study. Objectives: To analyze posts shared on Instagram referencing spinal fusion for tone, gender, activities of daily living (ADLs), rehabilitation, incision, pain, neurological injury, and content of post. Methods: Public instragram posts, which were isolated and evaluated using the hashtags “#spinefusion” and “#spinalfusion. ” All posts were analyzed by the authors for the variables previously listed. In total, 264 posts were included for investigation and analysis of patient perception of spine fusion through social media. Results: Of all included posts, approximately 86% of posts had a positive tone. There was statistical significance between positive tone and activities of daily living (ADLs) (P = 0.047), as well as negative tone and persistent pain (P = 0.008). Adequate return to activities of daily living is perceived by patients as a positive outcome after surgery: odds ratio (OR) (95% CI) of 2.11 (1.01-4.39). Persistent post operative pain results negatively on perceived outcomes after surgery OR = 0.38 (0.18-0.78). Conclusions: Reported outcomes after spine fusion has not been evaluated through social media avenues. This analysis of patients sharing their experience on social media after spinal fusion demonstrates that returning to activities of daily living is of the utmost importance to patients. Additionally, post-operative pain is a strong metric utilized by patients with their satisfaction after surgery.
Effect of force accuracy on hemodynamic response: an fNIRS study using fine visuomotor task

Objective. Despite converging neuroimaging studies investigating how neural activity is modulated by various motor related factors, such as movement velocity and force magnitude, little has been devoted to identifying the effect of force accuracy. This study thus aimed to investigate the effect of task difficulty on cortical neural responses when participants performed a visuomotor task with varying demands on force accuracy. Approach. Fourteen healthy adults performed a set of force generation operations with six levels of force accuracy. The participants held a pen-shaped tool and moved the tool along a planar ring path, meanwhile producing a constant force against the plane under visual guidance. The required force accuracy was modulated by allowable tolerance of the force during the task execution. We employed functional near-infrared spectroscopy to record signals from bilateral prefrontal, sensorimotor and occipital areas, used the hemoglobin concentration as indicators of cortical activation, then calculated the effective connectivity across these regions by Granger causality. Main results. We observed overall stronger activation (oxy-hemoglobin concentration, p = 0.015) and connectivity (p < 0.05) associated with the initial increase in force accuracy, and the diminished trend in activation and connectivity when participants were exposed to excessive demands on accurate force generation. These findings suggested that the increasing task difficulty would be only beneficial for the mental investment up to a certain point, and above that point neural responses would show patterns of lower activation and connections, revealing mental overload at excessive task demands. Significance. Our results provide the first evidence for the inverted U-shaped effect of force accuracy on hemodynamic responses during fine visuomotor tasks. The insights obtained through this study also highlight the essential role of inter-region connectivity alterations for coping with task difficulty, enhance our understanding of the underlying motor neural processes, and provide the groundwork for developing adaptive neurorehabilitation strategies.
The impact of dusk phenomenon on total glucose exposure in Chinese people with type 2 diabetes

Abstract This study was aimed at assessing the impact of the dusk phenomenon on the total glucose exposure in Chinese people with type 2 diabetes. A total of 380 type 2 diabetes who received a retrospective continuous glucose monitoring system (CGMs) for 72 hours were enrolled in our study, 32 of them failed in CGMs. The patients were first divided into 2 groups: dusk phenomenon (n = 95) and non dusk phenomenon group (n = 253). The magnitude of the dusk phenomenon (δDusk) was quantified by pre-dinner glucose minus post-lunch 2 hours glucose. A persistent δDusk ≥ 0 or a once only δDusk < 0 can be diagnosed with the dusk phenomenon. The participants were secondarily matched for the post-lunch 2 hours glucose to assess the impact of the dusk phenomenon on the overall glucose exposure. The impact of the dusk phenomenon was assessed on high-performance liquid chromatography assay (HbA1c) and 24-hour mean glucose. There were 95 of 348 (27.3%) participants with the dusk phenomenon in the overall population, and the median of δDusk level was –0.8 (–1.8, 0.2) mmol/L. The median of glucose differences between the 2 paired groups were 0.4 (–0.4, 1.0)% for HbA1c, 0.9 (0.2, 1.4) mmol/L for 24 hours mean glucose. The correlation analysis showed no relationship between the magnitude of dawn phenomenon and the dusk phenomenon (r = 0.052, P = .472). The incidence of dusk phenomenon is about 27.3% in people with type 2 diabetes. The impacts of dusk phenomenon on HbA1c and 24-hour mean glucose were about 0.4% and 0.9 mmol/L and the dusk phenomenon was not related with the dawn phenomenon.
Frequency of pre-treatment may not increase the immune-related adverse events of RCC patients treated with nivolumab

Abstract Nivolumab has shown good prognosis in renal cell carcinoma (RCC) patients previously treated with targeted therapy. We aimed to study irAE (immune-related adverse event) due to nivolumab and numbers of previous treatment lines in RCC patients. Between October 2016 and November 2019, 114 patients were treated with nivolumab as second- and later-line therapy. Among them, 110 patients with complete data were evaluated in this retrospective observational study. The primary endpoint was the relation between irAE and numbers of previous targeted therapies. Secondary endpoints were the relation of irAE with the duration of nivolumab treatment and with best overall response. For the primary analysis, proportional odds logistic regression was used to assess the effect of the number of prior therapies on the grade of any irAE as the ordinal variable. For the secondary analysis, binomial logistic regression models adjusted for the covariates were prepared to confirm the association between the incidence of irAE and the number of courses, number of nivolumab treatments and best overall response. Overall, 69, 66, 33, 13, 9 and 9 patients were treated with sunitinib, axitinib, pazopanib, sorafenib, temsirolimus and everolimus, respectively, prior to nivolumab. In total, 60 adverse events (Grade 1, 21; Grade 2, 21; Grade 3, 14; Grade 4, 2; not evaluated, 2) were identified in the patients treated with nivolumab. Ordered logistic regression analysis showed that the adjusted odds ratios of numbers of prior treatment for grade of irAE were 1.12 (numbers of prior treatment: 2 to 1) and 1.31 (3 to 1). Odds ratios of the numbers of nivolumab treatments and best overall response for the incidence of irAE were not significant. No statistically significant relations were found between grade of irAE and numbers of treatments prior to nivolumab. Patients treated with nivolumab should be closely monitored for irAE regardless number of previous therapies.
STROBE-sequencing analysis of the vaginal microecology of 4- to 6-year-old girls in Southwest China

Abstract We investigated the vaginal flora diversity of preschool-aged (ie, 4–6-year-old) girls in southwest China. Fourteen preschool-aged girls were enrolled in this study. The statuses and differences in their vaginal flora were evaluated by Gram staining, bacterial culturing, and sequencing analysis. Gram staining and microbial culturing showed that the main vaginal flora of the preschool-aged girls were Gram-negative bacilli, whereas the main vaginal flora of healthy adult controls were large Gram-positive bacilli such as Lactobacillus crispatus. Shannon and Simpson indexes indicated that the bacterial diversity tended to decrease with age. The species abundance heat map showed that the vaginal microecology of the girls differed slightly at different ages but mainly comprised Pseudomonas, Methylobacterium, Sphingomona,s and Escherichia. The functional abundance heat map indicated that the bacterial functions increased with age. The vaginal microecology of preschool-aged girls differs from that of adults. A comprehensive understanding of the vaginal flora diversity of preschool-aged girls will aid in clinically diagnosing vulvovaginitis in preschool-aged girls.
Determining the Prognosis of Bell’s Palsy Based on Severity at Presentation and Electroneuronography

Objective To examine the demographics of Bell’s palsy and determine how House-Brackmann (HB) grade at nadir and electroneuronography (ENoG) results correlate with HB grade after recovery and development of synkinesis. Study Design Retrospective cohort study. Setting Tertiary care military medical center. Methods Patients with acute Bell’s palsy and adequate follow-up, defined as 6 months or return to HB grade I function, were included. Demographic information, HB scores at nadir and recovery, and ENoG results were collected. Results A total of 112 patient records were analyzed. Ages ranged from 8 to 87 years with peaks at 21 to 25 and 61 to 65 years. Among patients, 16.3% reached a nadir at HB II, 41.9% at HB III, 5.4% at HB IV, 16.3% at HB V, and 20.1% at HB VI. The overall recovery rate was 73.2% to HB I function, 17.0% to HB II, and 9.8% to HB III. The chance of recovery to HB I decreased as the severity of paralysis increased (rs = −1.0, P < .0001). Mean time to recovery to HB I was 6 weeks. Greater degeneration on ENoG suggested worse recovery (rs = 0.62, P = .01). Patients with HB V and VI were most likely to develop synkinesis. Conclusion More severe paralysis increased the chance of recovery to HB II or III function. The granularity of this study provides prognostic insights that may inform the counseling of patients with Bell’s palsy with respect to prognosis and recovery timeline.
“SingStrong”: Singing for better lung health in COPD – A pilot study

ABSTRACT Background Chronic Obstructive Pulmonary Disease (COPD) affects up to 440,000 people in Ireland. Multiple domains of biopsychosocial health are affected. Community-based interventions supporting behavioral change and self-management are advocated. The aim of this pilot study was to evaluate the efficacy of an 8-week singing intervention, “SingStrong”, to improve biopsychosocial wellness in persons with COPD. Methods Seventy-eight adults with COPD were recruited from three COPD Support groups in the Irish Mid-west. Pre and post-intervention testing performed by physiotherapy and nursing staff comprised Six-Minute Walk Test (6MWT), COPD Assessment test (CAT), Hospital Anxiety and Depression Scale (HADS), and Spirometry: FEV1, FVC, FEV1/FVC. The intervention was a weekly one-hour group class for eight weeks led by a trained choir leader at each site. This included physical and vocal warm-up, breathing exercises and singing. Participants were given a songbook based on their song preferences and a CD with vocal, breathing exercises and songs, and encouraged to practice daily. Semi-structured focus groups were conducted post intervention. Parametric or non-parametric t-tests were conducted to establish significance. Results Fifty-eight (74%) participants who attended at least 4/8 session were re-tested. There was a statistically significant improvement in 6MWT (p = .02), non-significant improvements in CAT (p = .24) and HADS Depression (p = .238), and non-significant worsening in HADS Anxiety (p = .34). All qualitative feedback was positive, including improvements in breathing, quality of life and intervention enjoyment. Principal Conclusions Singing for lung health has positive implications for persons with COPD. Future longer studies should examine outcomes of exacerbation level, hospitalization and medication use.
The Early Impact of Social Distancing Measures on Drug Use

Abstract Background and Objectives: Social distancing policies have been widely adopted in response to the COVID-19 pandemic. High levels of social connection are positively associated with beneficial health outcomes, while social isolation is associated with poor long-term health outcomes including reduced life expectancy. The present study evaluates the impact of social distancing measures during the early period of COVID-19 on substance use behaviors among those in the United States. Methods: We used an internet-based survey with participants (n = 157; 86 male) reporting a history of problems related to drug use. We relied on ANOVA and logistic regression techniques to assess the associations between social connection and substance use. Results: People with more severe drug use problems reported feeling more socially isolated during social distancing. Those who primarily use alcohol reported higher global feelings of social connection than those who primarily use opioids. During social distancing, participants reported an increase in alcohol and cigarette consumption, and a decrease in cocaine use. Lastly, those who reported using drugs for social reasons were less likely to have decreased substance use during social distancing. Conclusions: The current study provides evidence that social distancing guidelines have impacted both substance use behaviors and feelings of social and physical connection. Further, there are differential impacts based on drug of choice. These results advance delineation of the connection between sociality and drug use.
Focused ultrasound ablation of a large canine oral tumor achieves efficient tumor remission: a case report

Abstract Purpose: Oral cancers are one of the commonly diagnosed tumors worldwide in human and veterinary patients. Most oral cancers are surgically resected; however, obtaining an adequate margin of safety in patients without compromising their quality of life is often challenging. Herein, we investigated the ability of non-invasive focused ultrasound (FUS) to thermally ablate a biopsy confirmed canine oral cancer. Materials and Methods: A male canine patient with a large neurilemmoma (schwannoma) mass on the left maxilla, with evidence of thinning and loss of alveolar bone and pressure necrosis, was treated with FUS ablation instead of the traditional maxillectomy procedure. FUS ablations were performed in three sessions over three weeks. Tumor remission was determined with computed tomography and histopathological examination of the treated site. Additionally, the anti-tumor immune effects of FUS were assessed by flow cytometry analysis of blood and tumor samples. Results: Complete tumor remission was noted at the treated site. Treatment related adverse events were primarily thermal burns of the buccal mucosa, which were managed with periodic hyperbaric oxygen therapy and surgical coverage of the underlying exposed bones with gingival flaps. Enhanced proliferation of adaptive immunity cells (e.g., T-cells) was observed in tumor and blood samples. Conclusion: Our limited investigation in a canine oral cancer patient suggests that FUS may avoid the need for large-scale resection of bony tissues, thus potentially improving quality of life.
Partitioning risk factors for embolic stroke of undetermined source using exploratory factor analysis

Background Embolic stroke of undetermined source (ESUS) accounts for up to 25% of strokes. Understanding risk factors associated with ESUS is important in reducing stroke burden worldwide. However, ESUS patients are younger and present with fewer traditional risk factors. Significant global variation in ESUS populations also exists making the clinical picture of this type of stroke unclear. Methods and results ESUS patients were pair matched for age, sex, and ethnicity with a group of all other strokes (both n = 331). Exploratory factor analysis was applied in both groups to 14 risk and clinical factors to identify latent factors. In ESUS patients, two latent factors emerged consisting primarily of heart-related variables such as left ventricular wall motion abnormalities, reduced ejection fraction, and increased left atrial volume index, as well as aortic arch atherosclerosis. This is in comparison to the all other strokes group, which was dominated by traditional stroke risk factors. Conclusions Our findings support the existence of a unique pattern of risk factors specific to ESUS. We show that LVWMA and corresponding changes in left heart function are a potential source of emboli in these patients. In addition, the clustering of aortic arch atherosclerosis with left heart factors suggests a causal link. Through the application of exploratory factor analysis, this work contributes to a further understanding of stroke mechanisms in ESUS.
In Vivo Efficacy of Tesevatinib in EGFR-Amplified Patient-Derived Xenograft Glioblastoma Models May Be Limited by Tissue Binding and Compensatory Signaling

Tesevatinib is a potent oral brain penetrant EGFR inhibitor currently being evaluated for glioblastoma therapy. Tesevatinib distribution was assessed in wild-type (WT) and Mdr1a/b(-/-)Bcrp(-/-) triple knockout (TKO) FVB mice after dosing orally or via osmotic minipump; drug–tissue binding was assessed by rapid equilibrium dialysis. Two hours after tesevatinib dosing, brain concentrations in WT and TKO mice were 0.72 and 10.03 μg/g, respectively. Brain-to-plasma ratios (Kp) were 0.53 and 5.73, respectively. With intraperitoneal infusion, brain concentrations were 1.46 and 30.6 μg/g (Kp 1.16 and 25.10), respectively. The brain-to-plasma unbound drug concentration ratios were substantially lower (WT mice, 0.03–0.08; TKO mice, 0.40–1.75). Unbound drug concentrations in brains of WT mice were 0.78 to 1.59 ng/g. In vitro cytotoxicity and EGFR pathway signaling were evaluated using EGFR-amplified patient-derived glioblastoma xenograft models (GBM12, GBM6). In vivo pharmacodynamics and efficacy were assessed using athymic nude mice bearing either intracranial or flank tumors treated by oral gavage. Tesevatinib potently reduced cell viability [IC50 GBM12 = 11 nmol/L (5.5 ng/mL), GBM6 = 102 nmol/L] and suppressed EGFR signaling in vitro. However, tesevatinib efficacy compared with vehicle in intracranial (GBM12, median survival: 23 vs. 18 days, P = 0.003) and flank models (GBM12, median time to outcome: 41 vs. 33 days, P = 0.007; GBM6, 44 vs. 33 days, P = 0.007) was modest and associated with partial inhibition of EGFR signaling. Overall, tesevatinib efficacy in EGFR-amplified PDX GBM models is robust in vitro but relatively modest in vivo, despite a high brain-to-plasma ratio. This discrepancy may be explained by drug-tissue binding and compensatory signaling.
A longitudinal study shows stress proliferation effects from early childhood adversity and recent stress on risk for depressive symptoms among older adults

Abstract Objectives: We evaluated whether the effects of recent stressful life events (SLEs) and early childhood adversities (ECAs) on depressive symptoms are consistent between men and women and across older age, and whether there was evidence for the following: stress sensitization, whereby the psychological impact of SLEs is greater for individuals with ECAs compared with those without; or stress proliferation effect, whereby those with ECAs are more likely to report more SLEs than those without ECAs to effect depressive symptoms. Method: ECAs, SLEs in the past two years, and current depressive symptoms through a modified CES-D were obtained from 11,873 individuals participating in a population representative study of older adults, yielding 82,764 observations. Mixed-effects regression models on depressive symptoms were constructed to control for multiple observations per participant and evaluate within-person effects over time, thereby reducing bias from reverse causation. Results: Results suggest a stress proliferation effect and do not support stress sensitization. ECAs contribute to vulnerability for depressive symptoms, with a dosage effect for each additional ECA. Recent SLEs result in greater depressive symptom risk, with stable effects over age and dosage effects for each additional SLE that were smaller than the effects of ECAs among men, but not women. Belonging to an ethnic minority group, having less education, and less household income at baseline were associated with greater depressive symptom risk. Conclusions: Findings suggest the importance of addressing early childhood adversity and sociodemographic factors, among at-risk older adults to mitigate life-course stress proliferative processes and thereby reduce disparate risk for depression in older age.
Urea analysis in coastal waters: comparison of enzymatic and direct methods

This study presents a comparison of two existing methods for the determination of urea concentration in seawater. These methods are referred to here as the enzymatic method, which is based on the use of the enzyme urease, and the direct method, which is based on the reaction of urea with diacetylmonoxime. A room temperature modification of the direct method was adapted for a single reagent and both the enzymatic and the direct method were tested in artificially prepared solutions and in natural samples from estuaries and shelf waters. We were particularly interested in the effects of salinity and humic acids on the accuracy of both methods. The effect of humic acids was negligible. In contrast, salinity ~34 caused a 15% to 40% underestimation in the urea concentrations measured by the enzymatic method and the degree of underestimation varied among enzyme batches. Urea concentrations corrected for the salt effect should, however, be considered estimations, as other factors also interfered with the enzymatic method in natural samples. The direct method as modified in this study presented a low detection limit (0.04 µM urea‐N) and high precision (standard deviation: 0.02 µM urea‐N; coefficient of variation: 1.1%) comparable to those of the enzymatic method. The direct method was more accurate and less salinity dependent than the enzymatic method. As urea levels could have been underestimated by the enzymatic method, our findings support previous conclusions regarding the important role of urea in the nitrogen cycle and its link with some harmful algal bloom phenomena.