Miracle-dz/UniFAR-FTUs huggingface dataset:
Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography for the Treatment of Common Bile Duct Stones in Patients with Roux-en-Y Gastrectomy: Outcomes and Factors Affecting Complete Stone Extraction

Background: Endoscopic retrograde cholangiopancreatography (ERCP) for extraction of common bile duct (CBD) stones in patients with Roux-en-Y gastrectomy (RYG) remains technically challenging. Methods: Seventy-nine RYG patients (median 79 years old) underwent short-type double-balloon enteroscopy-assisted ERCP (sDBE-ERCP) for CBD stones at three referral hospitals from 2011–2020. We retrospectively investigated the treatment outcomes and potential factors affecting complete stone extraction. Results: The initial success rates of reaching the papilla of Vater, biliary cannulation, and biliary intervention, including complete stone extraction or biliary stent placement, were 92%, 81%, and 78%, respectively. Of 57 patients with attempted stone extraction, complete stone extraction was successful in 74% for the first session and ultimately in 88%. The adverse events rate was 5%. The multivariate analysis indicated that the largest CBD diameter ≥ 14 mm (odds ratio (OR), 0.04; 95% confidence interval (CI), 0.01–0.58; p = 0.018) and retroflex position (OR, 6.43; 95% CI, 1.12–36.81; p = 0.037) were independent predictive factors affecting complete stone extraction achievement. Conclusions: Therapeutic sDBE-ERCP for CBD stones in a relatively elderly RYG cohort, was effective and safe. A larger CBD diameter negatively affected complete stone extraction, but using the retroflex position may be useful for achieving complete stone clearance.
Cardioprotection by SGLT2 Inhibitors—Does It All Come Down to Na+?

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are emerging as a new treatment strategy for heart failure with reduced ejection fraction (HFrEF) and—depending on the wistfully awaited results of two clinical trials (DELIVER and EMPEROR-Preserved)—may be the first drug class to improve cardiovascular outcomes in patients suffering from heart failure with preserved ejection fraction (HFpEF). Proposed mechanisms of action of this class of drugs are diverse and include metabolic and hemodynamic effects as well as effects on inflammation, neurohumoral activation, and intracellular ion homeostasis. In this review we focus on the growing body of evidence for SGLT2i-mediated effects on cardiac intracellular Na+ as an upstream mechanism. Therefore, we will first give a short overview of physiological cardiomyocyte Na+ handling and its deterioration in heart failure. On this basis we discuss the salutary effects of SGLT2i on Na+ homeostasis by influencing NHE1 activity, late INa as well as CaMKII activity. Finally, we highlight the potential relevance of these effects for systolic and diastolic dysfunction as well as arrhythmogenesis.
Effects of Lipidation on a Proline-Rich Antibacterial Peptide

The emergence of multidrug-resistant bacteria is a worldwide health problem. Antimicrobial peptides have been recognized as potential alternatives to conventional antibiotics, but still require optimization. The proline-rich antimicrobial peptide Bac7(1-16) is active against only a limited number of Gram-negative bacteria. It kills bacteria by inhibiting protein synthesis after its internalization, which is mainly supported by the bacterial transporter SbmA. In this study, we tested two different lipidated forms of Bac7(1-16) with the aim of extending its activity against those bacterial species that lack SbmA. We linked a C12-alkyl chain or an ultrashort cationic lipopeptide Lp-I to the C-terminus of Bac7(1-16). Both the lipidated Bac-C12 and Bac-Lp-I forms acquired activity at low micromolar MIC values against several Gram-positive and Gram-negative bacteria. Moreover, unlike Bac7(1-16), Bac-C12, and Bac-Lp-I did not select resistant mutants in E. coli after 14 times of exposure to sub-MIC concentrations of the respective peptide. We demonstrated that the extended spectrum of activity and absence of de novo resistance are likely related to the acquired capability of the peptides to permeabilize cell membranes. These results indicate that C-terminal lipidation of a short proline-rich peptide profoundly alters its function and mode of action and provides useful insights into the design of novel broad-spectrum antibacterial agents.
Evaluation of Two Amendments (Biochar and Acid Mine Drainage Sludge) on Arsenic Contaminated Soil Using Chemical, Biological, and Ecological Assessments

Various types of organic and inorganic materials are widely examined and applied into the arsenic (As) contaminated soil to stabilize As bioavailability and to enhance soil quality as an amendment. This study deals with two types of amendments: biochar for organic amendment and acid mine drainage sludge (AMDS) for inorganic amendment. Each amendment was applied in two types of As contaminated soils: one showed low contaminated concentration and acid property and the other showed high contaminated concentration and alkali property. In order to comprehensively evaluate the effect of amendments on As contaminated soil, chemical (As bioavailability), biological phytotoxicity (Lactuca sativa), soil respiration activity, dehydrogenase activity, urease activity, ß-glucosidase activity, and acid/alkali phosphomonoesterase activity, an ecological (total bacterial cells and total metagenomics DNA at the phylum level) assessment was conducted. Both amendments increased soil pH and dissolved organic carbon (DOC), which changes the bioavailability of As. In reducing phytotoxicity to As, the AMDS was the most effective regardless of soil types. Although soil enzyme activity results were not consistent with amendments types and soil types, bacterial diversity was increased after amendment application in acid soil. In acid soil, the results of principal component analysis represented that AMDS contributes to improve soil quality through the reduction in As bioavailability and the correction of soil pH from acidic to neutral condition, despite the increases in DOC. However, soil DOC had a negative effect on As bioavailability, phytotoxicity and some enzyme activity in alkali soil. Taken together, it is necessary to comprehensively evaluate the interaction of chemical, biological, and ecological properties according to soil pH in the decision-making stages for the selection of appropriate soil restoration material.
Association between Subclinical Hypothyroidism and Incident Hypertension in Women: A Systematic Review and Meta-Analysis

Subclinical hypothyroidism (SCH) has been found to be associated with an increased risk of cardiovascular diseases. However, there is no clear consensus on the relationship between SCH and hypertension (HTN). We sought to investigate the association between SCH and incident HTN in women. MEDLINE and EMBASE databases were searched for studies that reported the incidence of HTN in females with SCH versus without SCH. Pooled odds ratio (OR) and 95% confidence interval (CI) of the outcome were obtained using a random-effects model. Studies were also divided into the middle-aged (mean age < 65) and the older (mean age ≥ 65) subgroups, and a subgroup analysis was performed to examine the potential age-effect on the association between SCH and HTN. Nine studies with a total of 21,972 subjects met the inclusion criteria. SCH was found to be positively associated with HTN (OR = 1.32, 95% CI = 1.02–1.71). Such association varied depending on the age of women. In the middle-aged subgroup, SCH was more positively associated with HTN (OR = 1.64, 95% CI = 1.18–2.27), while there was no significant association in the older subgroup (OR = 0.97, 95% CI = 0.80–1.16). Our study showed that the middle-aged females with SCH had an increased risk of HTN, while there was no significant association in the older females with SCH.
Efficacy and Cardiovascular Safety of Roxadustat for Treatment of Anemia in Patients with Non–Dialysis-Dependent CKD

Visual Abstract Background and objectives We evaluated the efficacy and cardiovascular safety of roxadustat versus placebo by analyzing data pooled from three phase 3 studies of roxadustat in patients with non–dialysis-dependent CKD and CKD-related anemia. Design, setting, participants, & measurements In the three phase 3, double-blind studies of roxadustat versus placebo evaluating the treatment of CKD-related anemia in patients not requiring dialysis, the primary efficacy end point was mean change from baseline in hemoglobin averaged over weeks 28–52, regardless of rescue therapy. The primary cardiovascular safety end point was a composite measure of major adverse cardiovascular events (MACE; all-cause mortality, myocardial infarction, stroke). MACE plus (MACE+; MACE plus unstable angina and heart failure requiring hospitalization) and all-cause mortality were key secondary safety end points. These safety end points were adjudicated. Results A total of 4277 patients with non–dialysis-dependent CKD were randomized (roxadustat, n=2391; placebo, n=1886). Baseline characteristics were comparable between groups; the mean (SD) hemoglobin was 9.1 (0.7) g/dl and mean eGFR was 20 (12) ml/min per 1.73 m2. Patients treated with roxadustat versus those treated with placebo showed a mean change from baseline in hemoglobin averaged over weeks 28–52, regardless of rescue therapy, of 1.9 versus 0.2 g/dl, a treatment difference of 1.7 (95% confidence interval [95% CI], 1.7 to 1.8). Roxadustat reduced the need for red blood cell transfusion in the first 52 weeks versus placebo (6.1 versus 20.4 per 100 patient-exposure years, respectively; hazard ratio [HR], 0.26; 95% CI, 0.21 to 0.32). There were no increased risks of MACE (HR, 1.10; 95% CI, 0.96 to 1.27), MACE+ (HR, 1.07; 95% CI, 0.94 to 1.21), all-cause mortality (HR, 1.08; 95% CI, 0.93 to 1.26), or individual MACE+ components in patients treated with roxadustat versus those treated with placebo. Conclusions Roxadustat was more effective than placebo at increasing hemoglobin in patients with non–dialysis-dependent CKD and anemia, while decreasing transfusion rate and being noninferior to placebo with respect to risk of MACE. Clinical Trial registry name and registration number: A Study of FG-4592 for the Treatment of Anemia in Chronic Kidney Disease Patients Not Receiving Dialysis, NCT01750190; Roxadustat in the Treatment of Anemia in Chronic Kidney Disease Patients Not Requiring Dialysis (ALPS), NCT01887600; Safety and Efficacy Study of Roxadustat to Treat Anemia in Patients With Chronic Kidney Disease (CKD), Not on Dialysis, NCT02174627
Gastric Microenvironment—A Partnership between Innate Immunity and Gastric Microbiota Tricks Helicobacter pylori

Helicobacter pylori (H. pylori) carcinogenicity depends on three major factors: bacterial virulence constituents, environmental factors and host’s genetic susceptibility. The relationship between microenvironmental factors and H. pylori virulence factors are incontestable. H. pylori infection has a major impact on both gastric and colonic microbiota. The presence of non-H. pylori bacteria within the gastric ecosystem is particularly important since they might persistently act as an antigenic stimulus or establish a partnership with H. pylori in order to augment the subsequent inflammatory responses. The gastric ecosystem, i.e., microbiota composition in children with H. pylori infection is dominated by Streptoccocus, Neisseria, Rothia and Staphylococcus. The impairment of this ecosystem enhances growth and invasion of different pathogenic bacteria, further impairing the balance between the immune system and mucosal barrier. Moreover, altered microbiota due to H. pylori infection is involved in increasing the gastric T regulatory cells response in children. Since gastric homeostasis is defined by the partnership between commensal bacteria and host’s immune system, this review is focused on how pathogen recognition through toll-like receptors (TLRs—an essential class of pathogen recognition receptors—PRRs) on the surface of macrophages and dendritic cells impact the immune response in the setting of H. pylori infection. Further studies are required for delineate precise role of bacterial community features and of immune system components.
Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation

Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI involvement despite the presence of metastases to the lateral cervical stations in PTC. Eighty-eight patients operated for PTC with level II–V metastases were retrospectively enrolled in the study. Demographics, thyroid function, autoimmunity, nodule size and site, cancer variant, multifocality, Bethesda and EU-TIRADS, number of central and lateral lymph nodes removed, number of positive lymph nodes and outcome were recorded. At univariate analysis, PTC location and number of positive lateral lymph nodes were risk criteria for failure to cure. ROC curves demonstrated the association of the number of positive lateral lymph nodes and failure to cure. On multivariate analysis, the protective factors were PTC located in lobe center and number of positive lateral lymph nodes < 4. Kaplan–Meier curves confirmed the absence of central lymph nodes as a positive prognostic factor. In the selected cases, Central Neck Dissection (CND) could be avoided even in the presence of positive Lateralcervical Lymph Nodes (LLN+).
Diagnostic Performance of Extracellular Volume Quantified by Dual-Layer Dual-Energy CT for Detection of Acute Myocarditis

Background: Myocardial extracellular volume (ECV) is a marker of the myocarditis inflammation burden and can be used for acute myocarditis diagnosis. Dual-energy computed tomography (DECT) enables its quantification with high concordance with cardiac magnetic resonance (CMR). Purpose: To investigate the diagnostic performance of myocardial ECV quantified on a cardiac dual-layer DECT in a population of patients with suspected myocarditis, in comparison to CMR. Methods: 78 patients were included in this retrospective monocenter study, 60 were diagnosed with acute myocarditis and 18 patients were considered as a control population, based on the 2009 Lake and Louise criteria. All subjects underwent a cardiac DECT in acute phase consisted in an arterial phase followed by a late iodine enhancement phase at 10 min after injection (1.2 mL/kg, iodinated contrast agent). ECV was calculated using the hematocrit level measured the day of DECT examinations. Non-parametric analyses have been used to test the differences between groups and the correlations between the variables. A ROC curve has been used to identify the optimal ECV cut-off discriminating value allowing the detection of acute myocarditis cases. A p value < 0.05 has been considered as significant. Results: The mean ECV was significantly higher (p < 0.001) for the myocarditis group compared to the control (34.18 ± 0.43 vs. 30.04 ± 0.53%). A cut-off value of ECV = 31.60% (ROC AUC = 0.835, p < 0.001) allows to discriminate the myocarditis with a sensitivity of 80% and a specificity of 78% (positive predictive value = 92.3%, negative predictive value = 53.8% and accuracy = 79.5%). Conclusion: Myocardial ECV enabled by DECT allows to diagnose the acute myocarditis with a cut-off at 31.60% for a sensitivity of 80% and specificity of 78%.
Factors Associated with Neonatal Mortality among Newborns Admitted in the Special Care Baby Unit of a Nigerian Hospital.

BACKGROUND With Nigeria being one of the countries with the highest neonatal mortality rate globally, identifying the risk factors associated with neonatal mortality is essential as we strive to proffer sustainable solutions. AIM This retrospective hospital-based survey aimed to bridge this gap by evaluating the trends and risk factors associated with neonatal mortality in a teaching hospital in Southwestern Nigeria. METHODS Records of newborns admitted at the special care baby unit from January 2018 to December 2019 (n = 1098) were accessed, and available data were extracted. Descriptive analysis and inferential statistics were performed at 0.05 level of significance. RESULTS The mortality rate was determined to be 16.9% (inborn babies- 12.9% and out-born babies- 22.3%), with 83.3% of the newborns dying within the first week. Some of the factors associated with neonatal mortality were proximity of newborns' mothers home to the hospital [p = 0.041; Odds Ratio (OR) = 0.670; 95% Confidence Interval (CI) = 0.455-0.985], maturity of the baby at delivery (p < 0.001; OR = 0.514; CI = 0.358-0.738), place of delivery-inborn or out-born (p < 0.001; OR = 0.515; CI = 0.375-0.709), place of delivery-in a hospital or a non-hospital setting (p = 0.048; OR = 0.633; CI = 0.401-0.999), and baby's weight (p < 0.001; CI = -0.684 to -0.411). CONCLUSION Findings from the study indicate that newborns delivered at home, traditional birth attendant centres or hospitals without essential healthcare facilities have a higher mortality risk. This suggests that measures to improve the accessibility of pregnant women to essential healthcare services are a prerequisite to reducing the neonatal mortality rate in Nigeria.
Bactericidal and Fungistatic Properties of LDPE Modified with a Biocide Containing Metal Nanoparticles

The aim of this study was to ascertain whether the combined action of metal nanoparticles (silver, copper, zinc oxide, iron oxide) would ensure the appropriate biocidal properties oflow-density polyethylene (LDPE) against pathogenic microorganisms. According to the research hypothesis, appropriately selected concentrations of the applied metal nanoparticles allow for a high level of biocidal activity of polymeric materials against both model and pathogenic bacterial strains (Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Legionella pneumophila, Salmonella enterica subsp. enterica) and fungi (Aspergillus brasiliensis, Saccharomyces cerevisiae, Candida albicans, Penicilium expansum), whilst ensuring the safety of use due to the lack of migration of particles to the surrounding environment. Studies have shown that adding 4% of a biocide containing Ag, Cu, ZnO, and Fe2O3 nanoparticles is the most optimal solution to reduce the number of S. aureus, S. enterica and P. aeruginosa by over 99%. The lowest effectiveness was observed against L. pneumophila bacteria. As for E. coli, a higher biocide content did not significantly increase the antibacterial activity. The results showed a high efficiency of the applied biocide at a concentration of 2% against fungal strains. The high efficiency of the obtained biocidal results was influenced by the uniform dispersion of nanoparticles in the material and their low degree of agglomeration. Furthermore, a slight migration of components to the environment is the basis for further research in the field of the application of the developed materials in industry.
The Temporal Mechanisms Guiding Interneuron Differentiation in the Spinal Cord

Neurogenesis timing is an essential developmental mechanism for neuronal diversity and organization throughout the central nervous system. In the mouse spinal cord, growing evidence is beginning to reveal that neurogenesis timing acts in tandem with spatial molecular controls to diversify molecularly and functionally distinct post-mitotic interneuron subpopulations. Particularly, in some cases, this temporal ordering of interneuron differentiation has been shown to instruct specific sensorimotor circuit wirings. In zebrafish, in vivo preparations have revealed that sequential neurogenesis waves of interneurons and motor neurons form speed-dependent locomotor circuits throughout the spinal cord and brainstem. In the present review, we discuss temporal principals of interneuron diversity taken from both mouse and zebrafish systems highlighting how each can lend illuminating insights to the other. Moving forward, it is important to combine the collective knowledge from different systems to eventually understand how temporally regulated subpopulation function differentially across speed- and/or state-dependent sensorimotor movement tasks.
Imaging of C-fos Activity in Neurons of the Mouse Parietal Association Cortex during Acquisition and Retrieval of Associative Fear Memory

The parietal cortex of rodents participates in sensory and spatial processing, movement planning, and decision-making, but much less is known about its role in associative learning and memory formation. The present study aims to examine the involvement of the parietal association cortex (PtA) in associative fear memory acquisition and retrieval in mice. Using ex vivo c-Fos immunohistochemical mapping and in vivo Fos-EGFP two-photon imaging, we show that PtA neurons were specifically activated both during acquisition and retrieval of cued fear memory. Fos immunohistochemistry revealed specific activation of the PtA neurons during retrieval of the 1-day-old fear memory. In vivo two-photon Fos-EGFP imaging confirmed this result and in addition detected specific c-Fos responses of the PtA neurons during acquisition of cued fear memory. To allow a more detailed study of the long-term activity of such PtA engram neurons, we generated a Fos-Cre-GCaMP transgenic mouse line that employs the Targeted Recombination in Active Populations (TRAP) technique to detect calcium events specifically in cells that were Fos-active during conditioning. We show that gradual accumulation of GCaMP3 in the PtA neurons of Fos-Cre-GCaMP mice peaks at the 4th day after fear learning. We also describe calcium transients in the cell bodies and dendrites of the TRAPed neurons. This provides a proof-of-principle for TRAP-based calcium imaging of PtA functions during memory processes as well as in experimental models of fear- and anxiety-related psychiatric disorders and their specific therapies.
Comparative Life Cycle Analysis of Concrete and Composite Bridges Varying Steel Recycling Ratio

Achieving sustainability is currently one of the main objectives, so a consensus between different environmental, social, and economic aspects is necessary. The construction sector is one of the main sectors responsible for environmental impacts worldwide. This paper proposes the life cycle assessment (LCA) and comparison of four bridge deck alternatives for different span lengths to determine which ones are the most sustainable solutions. The ReCiPe method is used to conduct the life cycle analysis, by means of which the impact value is obtained for every alternative and span length. The Ecoinvent 3.3 database has been used. The life cycle has been divided into four phases: manufacturing, construction, use and maintenance, and end of life. The associated uncertainties are considered, and the results are shown in both midpoint and endpoint approaches. The results of our research show that for span lengths less than 17 m, the best alternative is the prestressed concrete solid slab. For span lengths between 17 and 25 m, since the box-girder solution is not used, then the prestressed concrete lightened slab is the best alternative. For span lengths between 25 and 40 m, the best solution depends on the percentage of recycled structural steel. If this percentage is greater than 90%, then the best alternative is the composite box-girder bridge deck. However, if the percentage is lower, the cleanest alternative is the prestressed concrete box-girder deck. Therefore, the results show the importance of recycling and reusing structural steel in bridge deck designs.