Miracle-dz/UniFAR-FTUs huggingface dataset:
real world outcomes of adding rapid-acting insulin versus switching to analog premix insulin among Us patients with type 2 diabetes treated with insulin glargine

Introduction: Patients with type 2 diabetes mellitus (T2DM) often require intensification of basal insulin therapy. This retrospective, observational study compared real-world outcomes in US patients with T2DM treated with insulin glargine who added a rapid-acting insulin (RAI) (basal–bolus approach) with those who switched to premixed insulin (PMX). Methods: The national US IMPACT ® database was used to identify data from adult patients ( $ 18 years of age) with T2DM who added bolus RAI to insulin glargine (GLA + RAI) or who switched from GLA to PMX between 2001 and 2009. A stringent 1:1 propensity score-matching method was used to address the selection bias by matching GLA + RAI patients and PMX patients. Clinical and economic outcomes were determined for 1 year after the initial pharmacy claim for RAI or for PMX. Outcomes included treatment persistence and adherence, average insulin doses, glycated hemoglobin (A1C) levels, the prevalence and incidence of hypoglycemia, and health care costs/utilization. Analysis was carried out using an intent-to-treat approach. Results: The study included data from 746 propensity-matched patients (n = 373 in each cohort). Treatment persistence and adherence were higher in the GLA + RAI cohort. There was no significant difference in A1C reduction from baseline and the number of patients achieving target A1C levels of , 7% in each cohort. The incidence of hypoglycemic events was also similar in both groups. However, during follow-up, many patients (48.8%) who initially switched from insulin glargine to PMX crossed back over to use GLA and/or RAI as part of their regimen. Health care costs and utilization levels were not significantly different. Conclusion: Clinical and economic outcomes were similar in T2DM patients who added RAI to GLA and in those who switched to PMX, but a basal–bolus strategy appears to be associated with better treatment persistence and adherence.
Diagnostic potential of serum HSP90 beta for HNSCC and its therapeutic prognosis after local hyperthermia therapy

The present pilot study aims to investigate the diagnostic and prognostic efficacy of serum HSP90 beta in Head and Neck Squamous Cell Carcinoma (HNSCC) patients subjected to localized hyperthermia therapy (HT). Serum levels of HSP90 beta were measured by ELISA and its diagnostic and prognostic efficacy was determined by receiver operating characteristic curve (ROC) analysis. HNSCC patients showed significantly (P<0.05) higher serum levels of HSP90 beta (65.6±13.08 ng/ml) compared to Healthy Controls (HC: 23.5±3.8 ng/ml). No significant difference was observed in serum HSP90 beta levels between complete responders (CR) and non-responders (NR) in the chemo-radiation therapy (CRT) cohort. However, in CRT+HT cohort, CR showed significantly (P = 0.02) lower serum HSP90 beta levels at 24 h after HT (25.6±9.04 ng/ml) compared to NR (130.5±34.2 ng/ml). Youden’s index values between HNSCC versus HC, CR versus NR (CRT) and CR versus NR (CRT+HT) were found to be 0.47, 0.45 and 0.80, respectively. Thus, alterations in the serum HSP90 beta after HT suggest its potential in prognosis of HT response in HNSCC patients. Elevated levels of HSP90 beta may serve as a promising diagnostic serum bio-marker for HNSCC. However, further validation in larger patient samples is needed for clinical translation of HSP90 beta as diagnostic and prognostic biomarker.
The maluma/takete effect is late: No longitudinal evidence for shape sound symbolism in the first year

The maluma/takete effect refers to an association between certain language sounds (e.g., /m/ and /o/) and round shapes, and other language sounds (e.g., /t/ and /i/) and spiky shapes. This is an example of sound symbolism and stands in opposition to arbitrariness of language. It is still unknown when sensitivity to sound symbolism emerges. In the present series of studies, we first confirmed that the classic maluma/takete effect would be observed in adults using our novel 3-D object stimuli (Experiments 1a and 1b). We then conducted the first longitudinal test of the maluma/takete effect, testing infants at 4-, 8- and 12-months of age (Experiment 2). Sensitivity to sound symbolism was measured with a looking time preference task, in which infants were shown images of a round and a spiky 3-D object while hearing either a round- or spiky-sounding nonword. We did not detect a significant difference in looking time based on nonword type. We also collected a series of individual difference measures including measures of vocabulary, movement ability and babbling. Analyses of these measures revealed that 12-month olds who babbled more showed a greater sensitivity to sound symbolism. Finally, in Experiment 3, we had parents take home round or spiky 3-D printed objects, to present to 7- to 8-month-old infants paired with either congruent or incongruent nonwords. This language experience had no effect on subsequent measures of sound symbolism sensitivity. Taken together these studies demonstrate that sound symbolism is elusive in the first year, and shed light on the mechanisms that may contribute to its eventual emergence.
Comparison of radar/radiometer retrievals of stratus cloud liquid‐water content profiles with in situ measurements by aircraft

In situ sampling of cloud droplets by aircraft in Oklahoma in 1997 is used to evaluate a ground-based remote sensing technique for retrieving profiles of cloud liquid-water content. The technique uses vertically pointing measurements from a high-sensitivity millimeter-wavelength radar and a collocated dual-frequency microwave radiometer to obtain height-resolved estimates of the liquid content of stratiform clouds. Comparisons with the aircraft measurements are made for 16 overpasses through thin cloud layers within a 1.5-km radius of the remote sensor site. Over a range of liquid-water contents from 0.04 to 0.57 g m -3 the mean difference between the aircraft and the radar/radiometer values was 0.02 g m -3 , and the maximum difference was 0.09 g m -3 . Although the number of comparisons is limited, these results suggest that the ground-based estimates may be sufficiently accurate for many scientific purposes.
A Study of Drug Utilization Pattern and Pharmacoeconomic Analysis of Immunosuppressant Drugs in Patients With Skin Disorders in a Tertiary Care Hospital in Bihar

Aims The cost-effective therapy of immunosuppressant drugs in dermatological conditions will not only lead to adherence to rational prescribing but will also increase patient compliance with fewer dropouts due to cost factor. Thus, this study was done to determine and compare the drug utilization pattern, prescribed daily dose/defined daily dose (PDD/DDD) defined by WHO, and the cost-effectiveness ratio of different immunosuppressants. Methods and material Prescriptions for patients with skin disorders prescribed with any one systematic or topical immunosuppressant were collected. The utilization of drugs in different skin disorders was expressed as frequency and percentage. PDD was compared with DDD as per the WHOCC-Anatomical Therapeutic Chemical (ATC)/DDD index. The pharmacoeconomic analysis was done using a cost-effectiveness ratio. Statistical analysis Descriptive statistics were used to calculate percentages, frequency, and 95% CI. The cost-effectiveness ratio in terms of SFDs (symptom-free days) was defined as the total cost of the initial antibiotic during the study period divided by the number of SFDs (cost/ SFD) and was expressed as mean±standard deviation, and the Kruskal-Wallis test was used to determine statistical significance of difference. Results Immunosuppressants were prescribed in 117 (19.12%) prescriptions out of a total of 612 prescriptions. Deflazacort was the most utilized systemic immunosuppressant prescribed in 27.18% of cases and was commonly prescribed for irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD) followed by prednisolone and betamethasone. Tacrolimus was the most utilized topical immunosuppressant prescribed in 15.90% of patients and was commonly used for ICD and vitiligo followed by clobetasol and mometasone. Betamethasone, prednisolone, clobetasol, and mometasone had better cost-effectiveness. PDD/DDD of all immunosuppressants was less than one except prednisolone, which had a PDD/DDD ratio of 3.52. Conclusions The cost-effectiveness of steroids has the advantage of providing better patients’ adherence to pharmacotherapy, but over-prescribing could also lead to long-term adverse effects of steroids. Pharmacovigilance research should also incorporate pharmacoeconomic analysis to determine the relation between these two aspects.
Unified seismic hazard modelling throughout the Mediterranean region

The generation of a uniform seismic hazard modelling for the whole Mediterranean basin has been carried out under the coordination of activities of the IUGS-UNESCO IGCP-382 project Seismotectonics and Seismic Hazard Assessment of the Mediterranean Basin (SESAME) and the European Seismological Commission Working Group on Seismic Hazard Assessment. While the final approach for the Mediterranean region in the global hazard map of the Global Seismic Hazard Assessment Program was to assemble independent regional and national hazard maps, main efforts within recent SESAME activities have focused on the development of a unified seismic source model for the whole Mediterranean for homogeneous hazard computations. This unified source model is based on the compilation of existing data on seismogenic models for the region. The individual regional and national zonations have been joined, new seismic sources at border areas between different regions have been redesigned to avoid ambiguities coming from different approaches, and draft source zones have been established in areas where these were not yet availble. For the first time, a unified seismic source model for the whole of the Mediterranean region is presented and a suite of probabilistic hazard maps computed in a homogeneous fashion have been generated.
Comparison and interobserver reliability of three different methods for measuring the amount of the tibial tuberosity advancement in the preoperative planning of TTAT

Introduction The goal of preoperative planning techniques for advancement of the tibial tuberosity is to determine the amount of advancement required to achieve a postoperative patellar tendon angle of 90° and to select the optimal wedge size to achieve this target. Material and methods Three radiographic methods for determining the advancement distance for the tibial tuberosity were evaluated for comparability and interobserver reliability. Among the methods developed, we decided to include the common tangent method, the tibial anatomy-based method, and the Bielecki method. For all techniques, radiographs were taken in mediolateral projection with the knee joint flexed at 135°. Three observers with different levels of experience independently evaluated and scored the degree of osteoarthritis for each stifle, as previously described, and performed measurements of the amount of advancement of the tibial tuberosity on 33 stifles using common tangent method, tibial anatomy-based method, and Bielecki method. Results According to the results, the overall score for osteoarthritis in the mediolateral view was influenced by the experience of the observers, which contradicts the results from a previous study. Regarding the measurement methods used to assess advancement, poor interobserver reliability was found for common tangent method and Bielecki method, while only a slightly moderate interobserver agreement was found for tibial anatomy-based method. Discussion These results are inconsistent with data collected by Bielecki and colleagues. Moreover, measurements from common tangent method and tibial anatomy-based method were overlapping, as confirmed previously. Conversely, Bielecki method showed no agreement with the other methods included in the present study, with a significantly higher mean rank, probably due to its correction formula. Based on the results of the present study, tibial anatomy-based method has better interobserver reliability and is easier to perform according to the observers.
Assessment of the human response to acute mental stress–An overview and a multimodal study

Numerous vital signs are reported in association with stress response assessment, but their application varies widely. This work provides an overview over methods for stress induction and strain assessment, and presents a multimodal experimental study to identify the most important vital signs for effective assessment of the response to acute mental stress. We induced acute mental stress in 65 healthy participants with the Mannheim Multicomponent Stress Test and acquired self-assessment measures (Likert scale, Self-Assessment Manikin), salivary α-amylase and cortisol concentrations as well as 60 vital signs from biosignals, such as heart rate variability parameters, QT variability parameters, skin conductance level, and breath rate. By means of statistical testing and a self-optimizing logistic regression, we identified the most important biosignal vital signs. Fifteen biosignal vital signs related to ventricular repolarization variability, blood pressure, skin conductance, and respiration showed significant results. The logistic regression converged with QT variability index, left ventricular work index, earlobe pulse arrival time, skin conductance level, rise time and number of skin conductance responses, breath rate, and breath rate variability (F1 = 0.82). Self-assessment measures indicated successful stress induction. α-amylase and cortisol showed effect sizes of -0.78 and 0.55, respectively. In summary, the hypothalamic-pituitary-adrenocortical axis and sympathetic nervous system were successfully activated. Our findings facilitate a coherent and integrative understanding of the assessment of the stress response and help to align applications and future research concerning acute mental stress.
Assessing Endoscopic Suture Performance of Gynecology and Obstetrics Residents Following Methodic Training

Abstract Objective To evaluate the performance of residents in gynecology and obstetrics before and after practicing laparoscopic sutures, to establish when the training shows the best results, in addition to comparing whether being in different years of residency influences this progression. Methods A prospective cohort study involving 32 medical residents evaluated with a pretest to establish their previous knowledge in laparoscopic suture. This test consisted of knotting two wires, one made of polypropylene and the other of polyglactin, with a blocking sequence of five semi-knots. We set a 30-minute limit to complete the task. Then, the residents held four training meetings, focusing on suture, Gladiator rule, knot, and symmetries, in addition to executing blocking sequences. A second test to establish progress was performed. Results Regarding the time spent to make the stiches using polyglactin wire, a statistically significant time improvement ( p < 0.01) was observed, with a 10.67-minute pretraining median (mean 12.24 minutes) and a 2.53-minute posttraining median (mean 3.25 minutes). Regarding the stitches with polypropylene wire, a statistically significant time improvement ( p < 0.05) was also observed, with a 9.38-minute pretraining median (mean 15.43 minutes) and a 3.65-minute posttraining median (mean 4.54 minutes). A total of 64.2% of the residents had been able to make the knot with polypropylene previously. One hundred percent were able to complete the task in the posttest. Conclusion Model training using the Gladiator rule for laparoscopic suture improves the knotting time with statistically similar performance, regardless of the year of residency, after systematic training.
Angular‐Momentum Transfer Mediated by a Vibronic‐Bound‐State

The notion that phonons can carry pseudo‐angular momentum has many major consequences, including topologically protected phonon chirality, Berry curvature of phonon band structure, and the phonon Hall effect. When a phonon is resonantly coupled to an orbital state split by its crystal field environment, a so‐called vibronic bound state forms. Here, a vibronic bound state is observed in NaYbSe2, a quantum spin liquid candidate. In addition, field and polarization dependent Raman microscopy is used to probe an angular momentum transfer of ΔJz = ±ℏ between phonons and the crystalline electric field mediated by the vibronic bound stat. This angular momentum transfer between electronic and lattice subsystems provides new pathways for selective optical addressability of phononic angular momentum via electronic ancillary states.
Carcinogenic Polynuclear Aromatic Hydrocarbons in the Atmosphere in Chiang Mai, Thailand.

Ambient concentrations of 7 mutagenic and/or carcinogenic polycyclic aromatic hydrocarbons (PAHs) were measured in Chiang Mai, Thailand, and compared to those in Tokyo. In Chiang Mai, airborne particulate samples were collected at two sites, i.e., commercial and residential sites (two stations in each site) from July through December in 1989. In Tokyo, sampling was carried out at a commercial/residential site in November 1989. PAHs were extracted by sonication, and analyzed by a multicolumn HPLC/computerized fluorometric detection system. Major observations are as follows ; 1) In both cities, ambient concentrations of PAHs and airborne particulates showed log normal distribution. Geometric mean/standard deviation is appropriate to express the situation of pollution. 2) In Chiang Mai, there was not a large difference in PAH concentrations between commercial and residential sites. This suggested wide-spreaded pollution over the city. On the other hand, concentrations of airborne particulates showed large differences among the sites. PAH concentrations in 1989 were higher than those in 1986. 3) Ambient concentrations of PAHs and airborne particulates concentrations were both low in the rainy season and high in the dry season in Chiang Mai. 4) Ambient concentrations of PAHs (except for rather volatile 4 ring PAHs) and airborne particulates in Chiang Mai were suggested to be higher than those in Tokyo. 5) In Tokyo, a fairly good correlation among concentrations of 7 PAHs and airborne particulates has been observed. In Chiang Mai, there has been good correlation among PAHs concentrations, but a poor correlation between PAHs and airborne particulate concentrations. This suggested that large content of rough particulates in Chiang Mai air may be higher than that in Tokyo. These results suggest that air pollution by PAHs and airborne particulates may be more serious in Chiang Mai than in Tokyo. Size distribution of airborne particulates seems to be different between these two cities.
How Does the Severity of Neuroforaminal Compression in Cervical Radiculopathy Affect Outcomes of Anterior Cervical Discectomy and Fusion

Study Design This study is a retrospective cohort study. Purpose This study aims to determine whether preoperative neuroforaminal stenosis (FS) severity is associated with motor function patient-reported outcome measures (PROMs) following anterior cervical discectomy and fusion (ACDF). Overview of Literature Cervical FS can significantly contribute to patient symptoms. While magnetic resonance imaging (MRI) has been used to classify FS, there has been limited research into the impact of FS severity on patient outcomes. Methods Patients undergoing primary, elective 1–3 level ACDF for radiculopathy at a single academic center between 2015 and 2021 were identified retrospectively. Cervical FS was evaluated using axial T2-weighted MRI images via a validated grading scale. The maximum degree of stenosis was used for multilevel disease. Motor symptoms were classified using encounters at their final preoperative and first postoperative visits, with examinations ≤3/5 indicating weakness. PROMs were obtained preoperatively and at 1-year follow-up. Bivariate analysis was used to compare outcomes based on stenosis severity, followed by multivariable analysis. Results This study included 354 patients, 157 with moderate stenosis and 197 with severe stenosis. Overall, 58 patients (16.4%) presented with upper extremity weakness ≤3/5. A similar number of patients in both groups presented with baseline motor weakness (13.5% vs. 16.55, p=0.431). Postoperatively, 97.1% and 87.0% of patients with severe and moderate FS, respectively, experienced full motor recovery (p=0.134). At 1-year, patients with severe neuroforaminal stenosis presented with significantly worse 12-item Short Form Survey Physical Component Score (PCS-12) (33.3 vs. 37.3, p=0.049) but demonstrated a greater magnitude of improvement (ΔPCS-12: 5.43 vs. 0.87, p=0.048). Worse stenosis was independently associated with greater ΔPCS-12 at 1-year (β=5.59, p=0.022). Conclusions Patients with severe FS presented with worse preoperative physical health. While ACDF improved outcomes and conferred similar motor recovery in all patients, those with severe FS reported much better improvement in physical function.
New perspectives in cancer immunotherapy: targeting IL-6 cytokine family

Chronic inflammation has been recognized as a canonical cancer hallmark. It is orchestrated by cytokines, which are master regulators of the tumor microenvironment (TME) as they represent the main communication bridge between cancer cells, the tumor stroma, and the immune system. Interleukin (IL)-6 represents a keystone cytokine in the link between inflammation and cancer. Many cytokines from the IL-6 family, which includes IL-6, oncostatin M, leukemia inhibitory factor, IL-11, IL-27, IL-31, ciliary neurotrophic factor, cardiotrophin 1, and cardiotrophin-like cytokine factor 1, have been shown to elicit tumor-promoting roles by modulating the TME, making them attractive therapeutic targets for cancer treatment. The development of immune checkpoint blockade (ICB) immunotherapies has radically changed the outcome of some cancers including melanoma, lung, and renal, although not without hurdles. However, ICB shows limited efficacy in other solid tumors. Recent reports support that chronic inflammation and IL-6 cytokine signaling are involved in resistance to immunotherapy. This review summarizes the available preclinical and clinical data regarding the implication of IL-6-related cytokines in regulating the immune TME and the response to ICB. Moreover, the potential clinical benefit of combining ICB with therapies targeting IL-6 cytokine members for cancer treatment is discussed.
Enhancing myocardial function with cardiac contractility modulation: potential and challenges

Abstract Cardiac contractility modulation (CCM) offers a novel therapeutic avenue for heart failure patients, particularly those unresponsive to cardiac resynchronization therapy within specific QRS duration ranges. This review elucidates CCM's mechanistic underpinnings, its impact on myocardial function, and utility across patient demographics. However, CCM is limited by insufficient data on mortality and hospitalization rate reductions, as well as the need for specialized device implantation skills. While prevailing research has concentrated on left ventricular effects, a knowledge gap persists for other patient subsets. Future inquiries should address combinatory treatment strategies, extended usage and the impact of atrial fibrillation on device implantation. Such expanded studies could refine therapeutic outcomes and widen the scope of beneficiaries.