Miracle-dz/UniFAR-FTUs huggingface dataset:
Hounsfield units and fractal dimension (test HUFRA) for determining PET positive/negative lymph nodes in pediatric Hodgkin’s lymphoma patients

Objectives We had developed a method that can help detect and identify lymph nodes affected by the neoplastic process. Our group evaluated the fractal dimension (FD) and X-ray attenuation (XRA) of lymph nodes in HL and compared to their metabolic activity as measured by 18F-FDG-PET examination. Methods The training set included 72 lymph nodes from 31 consecutive patients, and the tested set of 71 lymph nodes from next 19 patients. The measurement of FD of each lymph node was performed before the start of therapy using original software. X-ray attenuation (XRA) expressed in HU (Hounsfield Units) from CT scans was compared with the metabolic activity of the lymphatic nodes, measured by 18F-FDG-PET examination. Results Significant differences were observed between XRAmax and FDmax values in assessing the PET(+) and PET(-) nodes. All nodes were scored from 0 to 2. The HUFRA test properly qualified 95% with a score of 2 and 0 points as PET(+) or PET(-). Conclusion The HUFRA test can differentiate about 70–80% of lymph nodes as PET(+) or PET(-) based solely on the CT examination. It can be useful in patients who were not subjected to 18FFDG-PET/CT examination before the treatment, or who had an unreliable result of 18F-FDG-PET/CT with further research requirements.
The level of habitat patchiness influences movement strategy of moose in Eastern Poland

Spatio-temporal variation in resource availability leads to a variety of animal movement strategies. In the case of ungulates, temporally unpredictable landscapes are associated with nomadism, while high predictability in the resource distribution favours migratory or sedentary behaviours depending on the spatial and temporal scale of landscape dynamics. As most of the surveys on moose (Alces alces) movement behaviours in Europe have been conducted on Scandinavian populations, little is known about the movement strategies of moose at the southern edge of the species’ range. We expected that decreasing habitat patchiness in central Europe would be associated with the prevalence of migratory behaviours. To verify this hypothesis, we analysed 32 moose fitted with GPS collars from two study areas in eastern Poland which differed in a level of habitat patchiness. We classified moose movements using the net squared displacement method. As presumed, lower patchiness in the Biebrza study site was associated with the predominance of individuals migrating short-distance, while in more patchy landscape of Polesie, resident moose dominated. At the individual level, the propensity of moose to migrate decreased with increasing abundance of forest habitats in their summer ranges. In addition, the parameters (migration distance, timing and duration) for migratory individuals varied substantially between individuals and years. Yet, in spring individual moose expressed a consistent migration timing across years. There was little synchronization of migration timing between individuals from the same population both in spring and autumn, which may have been related to mild weather conditions. We observed that moose postponed their migrations and started movement toward summer ranges at a similar time window in years when spring was delayed due to harsh weather. Hence, in light of global warming, we presume further changes in animal movements will arise.
Temporal patterns of alterations in obesity index, lipid profile, renal function and blood pressure during the development of hypertension in male, but not female, rats fed a moderately high-fat diet

Abstract Context Male Sprague-Dawley rats consuming a moderately high-fat (MHF)-diet diverge into obesity-prone (OP) with hypertension and obesity-resistant. Objectives To study the temporal inter-relationships between body-weight, obesity-index, plasma lipid-profile, renal functional parameters and systolic-pressure alterations during 10-weeks feeding MHF or normal diet to male and female rats. Methods Body-weight, obesity-index and systolic-pressure were measured weekly, while metabolic-cage and blood-sampling protocols were performed every other week. After 10-weeks, renal excretory responses to acute salt-loading and renal autoregulation were examined. Results The male-OP group had progressively increased body-weight, plasma-triglyceride and systolic-pressure from Weeks 2, 4 and 5, respectively, lower renal sodium-excretion at weeks 4–8 and finally, delayed excretory response to salt-loading and rightward and downward shifts in renal autoregulatory curves compared to all other groups. Conclusion Feeding the MHF-diet in male-OP rats led to a greater weight-gain and adiposity followed by the development of atherogenic-hyperlipidaemia and persistently impaired pressure-natriuresis to induce hypertension.
Design Fluency in Children with ADHD and Comorbid Disorders

Background: Attention deficit/hyperactivity disorder (ADHD) is often associated with frontal executive impairment in children. Oppositional defiant disorder (ODD) and anxiety disorders (AD) frequently accompany ADHD, but the impact of these comorbid disorders on cognition remains elusive. The five-point test (FPT), a design fluency task, has been shown to be sensitive to neurological damage, specifically to frontal lobe lesions in patients with brain injuries. The purpose of this study was to compare the performances of neurotypical children with that of children with ADHD, ADHD-ODD, and ADHD-AD on the FPT in order to examine whether these groups could be distinguished from one another based on their cognitive profile. Methods: A total of 111 children aged 8 to 11 years old participated in the study. Six measures from the FPT were used to characterize their performance. Results: Statistically significant differences between groups were observed for five of the six FPT measures. Essentially, children with ADHD-ODD made more repeated designs than the three other groups (control p > 0.001, ADHD p = 0.008, ADHD-AD p = 0.008), while children with ADHD-AD produced fewer total and correct designs than the control and ADHD groups (p = 0.009). Conclusions: This suggests that comorbidities have an additive impact on the cognitive profile of children with ADHD. Design fluency may be a sensitive measure for capturing the subtle cognitive deficits that are likely to be involved in these disorders.
Comparison of propensity score methods for pre-specified subgroup analysis with survival data

ABSTRACT Examining medical products’ benefits and risks in different population subsets is often necessary for informing public health decisions. In observational cohort studies, safety analyses by pre-specified subgroup can be powered, and are informative about different population subsets’ risks if the study designs or analyses adequately control for confounding. However, few guidelines exist on how to simultaneously control for confounding and conduct subgroup analyses. In this simulation study, we evaluated the performance, in terms of bias, efficiency and coverage, of six propensity score methods in 24 scenarios by estimating subgroup-specific hazard ratios of average treatment effect in the treated with Cox regression models. The subgroup analysis methods control for confounding either by propensity score matching or by inverse probability treatment weighting. These methods vary as to whether they subset information or borrow it across subgroups to estimate the propensity score. Simulation scenarios varied by size of subgroup, strength of association of subgroup with exposure, strength of association of subgroup with outcome (simulated survival), and outcome incidence. Results indicated that subsetting the data by the subgrouping variable, to estimate the propensity score and hazard ratio, has the smallest bias, far exceeding any penalty in precision. Moreover, weighting methods pay a heavier price in bias than do matching methods when the propensity score model is misspecified and the subgrouping variable is a strong confounder.
Activated STAT3 Could Reduce Survival in Patients with Esophageal Squamous Cell Carcinoma by Up-regulating VEGF and Cyclin D1 Expression

Signal transduction and activators of transcription factor (STAT) 3 is associated with a poor prognosis in certain types of cancer. The purpose of the present study was to investigate the clinical and prognostic significance of STAT3/p-STAT3 expression in esophageal squamous cell cancer (ESCC) patients. A total of 71 patients were enrolled in the study. STAT3 and p-STAT3 expression were detected by Western Blot and immunohistochemistry assays. Stattic, the STAT3 inhibitor, was used to block the activation of STAT3 in ESCC cell lines Eca-109 and Kyse-30, and the CCK8 assay was performed to detect the effect of Stattic on the viability of ESCC cells. The expression of associated genes was assessed by RT-PCR and Western blot at RNA and protein levels, respectively. STAT3 expression was correlated with infiltration degree (pT) and pTNM. And p-STAT3 expression was correlated with pT, lymphatic metastasis (pN) and pTNM. The expression of VEGF, Bcl-xl and Cyclin D1 was up-regulated in ESCC tissues and positively correlated with p-STAT3 level, besides Bcl-xl. In vitro, Stattic inhibited the viability of Eca-109 and Kyse-30 cells in a dose- and time- dependent manner, and significantly inhibited the expression of VEGF, Bcl-xl and CyclinD1 at mRNA and protein level. The 5-year survival rate of the 71 patients was significantly associated with pT, pN, pTNM stage, p-STAT3 level, VEGF expression and Cyclin D1 expression. pN and p-STAT3 expression were independent relevant factors. Our results showed that p-STAT3 might serve as an essential biomarker for tumor invasion and metastasis in ESCC.
Disparities in rural versus urban field triage: Risk and mitigating factors for undertriage

BACKGROUND There are well-known disparities for patients injured in rural setting versus urban setting. Many cite access to care; however, the mechanisms are not defined. One potential factor is differences in field triage. Our objective was to evaluate differences in prehospital undertriage (UT) in rural setting versus urban settings. METHODS Adult patients in the Pennsylvania Trauma Outcomes Study (PTOS) registry 2000 to 2017 were included. Rural/urban setting was defined by county according to the Pennsylvania Trauma Systems Foundation. Rural/urban classification was performed for patients and centers. Undertriage was defined as patients meeting physiologic or anatomic triage criteria from the National Field Triage Guidelines who were not initially transported to a Level I or Level II trauma center. Logistic regression determined the association between UT and rural/urban setting, adjusting for transport distance and prehospital time. Models were expanded to evaluate the effect of individual triage criteria, trauma center setting, and transport mode on UT. RESULTS There were 453,112 patients included (26% rural). Undertriage was higher in rural patients (8.6% vs. 3.4%, p < 0.01). Rural setting was associated with UT after adjusting for distance and prehospital time (odds ratio [OR], 3.52; 95% confidence interval [CI], 1.82–6.78; p < 0.01). Different triage criteria were associated with UT in rural/urban settings. Rural setting was associated with UT for patients transferred to an urban center (OR, 3.32; 95% CI, 1.75–6.25; p < 0.01), but not a rural center (OR, 0.68; 95% CI, 0.08–5.53; p = 0.72). Rural setting was associated with UT for ground (OR, 5.01; 95% CI, 2.65–9.46; p < 0.01) but not air transport (OR, 1.18; 95% CI, 0.54–2.55; p = 0.68). CONCLUSION Undertriage is more common in rural settings. Specific triage criteria are associated with UT in rural settings. Lack of a rural trauma center requiring transfer to an urban center is a risk factor for UT of rural patients. Air medical transport mitigated the risk of UT in rural patients. Provider and system interventions may help reduce UT in rural settings. LEVEL OF EVIDENCE Care Management, Level IV.
Sedation, Analgesia, and Neuromuscular Blockade: An Assessment of Practices From 2009 to 2016 in a National Sample of 66,443 Pediatric Patients Cared for in the ICU*

Supplemental Digital Content is available in the text. Objectives: To describe the pharmaceutical management of sedation, analgesia, and neuromuscular blockade medications administered to children in ICUs. Design: A retrospective analysis using data extracted from the national database Health Facts. Setting: One hundred sixty-one ICUs in the United States with pediatric admissions. Patients: Children in ICUs receiving medications from 2009 to 2016. Exposure/Intervention: Frequency and duration of administration of sedation, analgesia, and neuromuscular blockade medications. Measurements and Main Results: Of 66,443 patients with a median age of 1.3 years (interquartile range, 0–14.5), 63.3% (n = 42,070) received nonopioid analgesic, opioid analgesic, sedative, and/or neuromuscular blockade medications consisting of 83 different agents. Opioid and nonopioid analgesics were dispensed to 58.4% (n = 38,776), of which nonopioid analgesics were prescribed to 67.4% (n = 26,149). Median duration of opioid analgesic administration was 32 hours (interquartile range, 7–92). Sedatives were dispensed to 39.8% (n = 26,441) for a median duration of 23 hours (interquartile range, 3–84), of which benzodiazepines were most common (73.4%; n = 19,426). Neuromuscular-blocking agents were dispensed to 17.3% (n = 11,517) for a median duration of 2 hours (interquartile range, 1–15). Younger age was associated with longer durations in all medication classes. A greater proportion of operative patients received these medication classes for a longer duration than nonoperative patients. A greater proportion of patients with musculoskeletal and hematologic/oncologic diseases received these medication classes. Conclusions: Analgesic, sedative, and neuromuscular-blocking medications were prescribed to 63.3% of children in ICUs. The durations of opioid analgesic and sedative medication administration found in this study can be associated with known complications, including tolerance and withdrawal. Several medications dispensed to pediatric patients in this analysis are in conflict with Food and Drug Administration warnings, suggesting that there is potential risk in current sedation and analgesia practice that could be reduced with practice changes to improve efficacy and minimize risks.
The Online Sale of Antibiotics for Veterinary Use

Simple Summary Access to antibiotics online endangers its responsible use, increasing the risk of bacterial resistance emergence. The objective of this study was to assess the possibility of purchasing antibiotics for veterinary use on the internet, evaluating the availability of those classified as highest priority critically important antimicrobials (HP-CIA), and if a prescription is required. The Google and Bing search engines and both simple and complex search strings in Spanish and in English were used. The simple search string was “buy veterinary antibiotics”. Complex searches used wildcards and specific syntax. The searches carried out in Spanish revealed that 50% of websites operated in South America and 65% of websites did not require a valid prescription. For the searches in English, 57% of websites operated in the United States of America (USA) and 55% of them did not require a prescription. Our study shows that veterinary antibiotics are easily available for purchase online without a prescription. Abstract Antibiotics are essential medicines against infectious diseases in both humans and animals. An inappropriate use of antibiotics can impair animal health and enhance the risk of bacterial resistance, as well as its transfer from animals to humans. The objective of this study was to assess the possibility of purchasing antibiotics for veterinary use on the internet, to evaluate if a prescription is required, and to determine the availability of drugs classified as the highest priority critically important antimicrobials (HP-CIA). The Google and Bing search engines and both simple and complex search strings in Spanish and in English were used. The simple search string was “buy veterinary antibiotics”. Complex searches used wildcards and specific syntax. The searches carried out in Spanish revealed that 50% of websites operated in South America, and 65% of websites did not require a valid prescription. Fluoroquinolones were offered in 84% of these websites (45% without prescription), macrolides were offered in 63% of these websites (43% without prescription), and 3rd– and 4th–generation cephalosporins in 54% of these websites (38% without prescription). For the searches in English, 57% of these websites operated in the United States of America (USA), and 55% of them did not require a prescription. Fluoroquinolones were offered in 79% of these websites (49% without prescription), macrolides were offered in 72% of these websites (45% without prescription), and 3rd– and 4th–generation cephalosporins were offered in 49% of these websites (27% without prescription). Therefore, it is easy to illegally access antibiotics via the internet.
PREVALENCE AND RISK FACTORS OF HYPERTENSION AMONG ADULT CIVIL SERVANTS IN YOBE STATE, NORTHEAST NIGERIA

ABSTRACT Background: Hypertension is the third leading independent risk factor for global burden of diseases. Its prevalence and risk factors remain undocumented in parts of Nigeria. The objective of this study was to determine the prevalence of hypertension and its risk factors among adult civil servants in Yobe State, Nigeria. Materials and Methods: An analytical cross sectional study was carried out using self-administered validated questionnaire. Weight was measured with a digital bathroom scale (TANITA model) and height was measured using SECA body meter. Blood pressure was measured using an Omron digital sphygmomanometer. Result: The response rate was 89%. The Overall mean (±SD) systolic blood pressure and diastolic blood pressure were 122.5 mmHg ±15.9, 95% CI (121.0-124.0) and 77.7 mmHg ± 11.2, 95% CI (76.6-78.7) respectively. The overall prevalence of hypertension was 39.3%. It was more prevalent (41.4%) in females than males (38.2%) and increased with age (p<0.16). Respondents aged ≥50 were twice more likely to be hypertensive (OR= 1.72; 95%CI (0.98 – 3.00), p=0.057) than those less than 34 years of age. Similarly, there was more than two-fold chance of hypertension in respondents with positive family history OR= 2.25; 95%CI (1.53-3.33), p<0.001. Also, tobacco users were almost twice likely to be hypertensive OR= 1.83; 95%CI (1.48-4.90), p<0.001. Alcohol consumption increased the risk of hypertension more than two-folds OR= 2.69; 95%CI (1.48-4.90), p<0.001. Finally, low level of physical activity was associated with more than 3 times the likelihood of hypertension OR= 3.36; 95%CI (1.82-6.22), p< 0.001). Conclusions: Hypertension is highly prevalent among civil servants in Yobe state. Early detection and further epidemiological studies are essential to understand the impact of hypertension at regional and national levels. Keyword: Hypertension, obesity, risk factors, prevalence, Nigeria
Expanding the utility of the dextran sulfate sodium (DSS) mouse model to induce a clinically relevant loss of intestinal barrier function

Background Inflammatory bowel disease (IBD) is a family of debilitating disorders that affects more than 1 million people in the United States. Many animal studies of IBD use a dextran sulfate sodium (DSS) mouse model of colitis that induces rapid and severe colitis symptoms. Although the typical seven-day DSS model is appropriate for many studies, it destroys intestinal barrier function and results in intestinal permeability that is substantially higher than what is typically observed in patients. As such, therapies that enhance or restore barrier integrity are difficult or impossible to evaluate. Methods We identify administration conditions that result in more physiologically relevant intestinal damage by systematically varying the duration of DSS administration. We administered 3.0% DSS for four to seven days and assessed disease metrics including weight, fecal consistency, intestinal permeability, spleen weight, and colon length. Histology was performed to assess the structural integrity of the intestinal epithelium. Results Extended exposure (seven days) to DSS resulted in substantial, unrecoverable loss of intestinal structure and intestinal permeability increases of greater than 600-fold. Attenuated DSS administration durations (four days) produced less severe symptoms by all metrics. Intestinal permeability increased only 8-fold compared to healthy mice, better recapitulating the 2–18 fold increases in permeability observed in patients. The attenuated model retains the hallmark properties of colitis against which to compare therapeutic candidates. Our results demonstrate that an attenuated DSS colitis model obtains clinically relevant increases in intestinal permeability, enabling the effective evaluation of therapeutic candidates that promote barrier function.
Widefield optical coherence tomography angiography for early detection and objective evaluation of proliferative diabetic retinopathy

Purpose To evaluate the utility of widefield optical coherence tomography angiography (WF-OCTA) compared with clinical examination in grading diabetic retinopathy in patients diagnosed clinically with proliferative diabetic retinopathy (PDR) or severe non-proliferative diabetic retinopathy (NPDR). Design This retrospective observational case series included patients diagnosed clinically with PDR or severe NPDR. Patients underwent standard clinical examination and WF-OCTA imaging (PLEX Elite 9000, Carl Zeiss Meditec AG) using 12×12 montage scans between August 2018 and January 2019. Two trained graders identified neovascularisation at the disc (NVD) and neovascularisation elsewhere (NVE) on WF-OCTA which were compared with the clinical examination, and to ultra-widefield fluorescein angiography (UWFA) when available. Results Seventy-nine eyes of 46 patients were evaluated. Of those, 57 eyes were diagnosed clinically with PDR, and 22 with severe NPDR. NVD was detected on OCTA-B scan as preretinal hyperreflective material (PRHM) in 39 eyes (100%) with evident flow signals in 79.5% compared with 51.3% detected clinically. We further classified NVD on OCTA into four subtypes and found that subtypes 1 and 2 could not be seen on clinical examination alone. WF-OCTA detected NVE in 81% of the cases compared with 55.7% detected clinically. Using WF-OCTA resulted in a higher percentage of PDR grading (88.6%) than on clinical examination (72.2%). When available, UWFA confirmed the WF-OCTA diagnosis in the majority of cases. Conclusion This study demonstrates that WF-OCTA has a higher detection rate of PDR than clinical examination. This suggests that this modality could be used non-invasively for the purpose of early detection and characterisation of neovascularisation.