Miracle-dz/UniFAR-FTUs huggingface dataset:
Relapse prevention for alcohol use disorders: combined acamprosate and cue exposure therapy as aftercare

Abstract Aims Many patients with alcohol use disorders are challenged by cravings leading to repeated relapses. Both cue exposure therapy (CET) and acamprosate target alcohol cravings and are often combined (CET + acamprosate). The main aim of this study was to investigate whether aftercare treatment consisting of CET combined with acamprosate is equivalent to (A) CET as monotherapy, (B) aftercare as usual (AAU) as monotherapy or (C) AAU combined with acamprosate. Methods Patients were randomized to receive either CET with urge-specific coping skills (USCS) as aftercare or AAU. Acamprosate prescription data were extracted from patient case records. Alcohol consumption, cravings, and USCS were assessed at pre-aftercare, post-aftercare, and 6-month follow-up. Results Overall, patients increased their alcohol consumption during and following aftercare treatment, thereby relapsing despite any treatment. However, CET + acamprosate achieved greater abstinence compared to AAU + acamprosate at follow-up (p=.047). CET + acamprosate also reduced number of drinking days (p=.020) and number of days with excessive drinking (p=.020) at post-aftercare, when compared to AAU monotherapy. CET monotherapy increased sensible drinking at post-aftercare compared to AAU monotherapy (p=.045) and AAU + acamprosate (p=.047). Only CET monotherapy showed improvement in cravings, when compared to AAU at follow-up (mean urge level: p=.032; peak urge level: p=.014). Conclusion The study showed that CET both as monotherapy and combined with acamprosate was superior to AAU monotherapy and AAU + acamprosate in reducing alcohol consumption. Only CET + acamprosate was capable of reducing alcohol consumption in the longer term, indicating that anti-craving medication may not impede CET from exerting an effect on alcohol consumption. Trial registration: ClinicalTrials.gov ID: NCT02298751 (24/11-2014).
Effectiveness and Safety of Inelastic Versus Elastic Lumbosacral Orthoses on Low Back Pain Prevention in Healthy Nurses

A machine learning algorithm was developed for the automated identification of 15 types of ACDF plates from smartphone images of AP cervical spine radiographs. The algorithm performed with an overall accuracy of 85.8%. This algorithm will be deployed on a smartphone platform for further evaluation, improvement, and eventual widespread use. Study Design. A randomized controlled trial. Objective. To evaluate the effects of inelastic and elastic lumbosacral orthoses (LSOs) on the prevention of low back pain (LBP) in healthy nurses. Summary of Background Data. Over 80% of people experience LBP during their lifetime. LSOs, as a device used to maintain lumbar stability, were widely used in LBP management. The effects of inelastic LSOs (iLSOs) and elastic LSOs (eLSOs) on the prevention of LBP are controversial. Methods. A randomized clinical trial recruiting healthy nurses was conducted from November 2011 to June 2013 at a tertiary hospital in China. A total of 300 eligible participants aged 20 to 25 years were randomly assigned to iLSO, eLSO, or control groups. The intervention period was 6 months, and follow-ups were continued for an additional 6 months. Participants in both iLSO and eLSO groups were required to wear LSOs daily. Outcomes included the incidence of LBP, changes in trunk muscle endurance, and spinal range of motion assessed at baseline, 6months, and 12 months from the starting date. The incidence of LBP among groups was analyzed by ANOVA. Wilcoxon rank-sum test, Kruskal-Wallis H test, etc. were used for secondary outcomes comparison across groups. Results. Two hundred seventy-eight out of 300 participants (92.7%) completed the trial. No statistically significant differences were observed in LBP incidence among the three groups. No difference was observed in abdominal/back muscle endurance among groups at 6 months. In secondary outcome analysis regarding spinal range of motion, flexion and extension improved in iLSO groups at 12 months compared with that at baseline (flexion, P = 0.01; extension, P = 0.01), whereas only extension motion improved at 12 months in the eLSO group (P = 0.00). Conclusions. Six-month wearing of LSO showed neither a significant difference in preventing LBP nor causing adverse effects to participants. Level of Evidence: 1
Kinetic and thermodynamic investigations of surfactants adsorption from water by carbide-derived carbon

Abstract The objective of the study is to investigate the potential of carbide-derived carbon (CDC) for the adsorptive removal of nonionic t-octylphenoxy poly ethoxy ethanol (TX-100), anionic sodium dodecylbenzene sulfonate (SDBS) and cationic 1-hexadecylpyridinium bromide (HDPB) surfactants from water. The CDC was characterized using TEM, SEM, FTIR, BET, EDS, XPS methods and zeta potential measurements. The effects of adsorption parameters included initial surfactant concentration, contact time, temperature, and pH of the feed solution were evaluated. The adsorption capacity and mechanism were determined by modeling the isotherm, kinetic and thermodynamic data. The kinetics results demonstrated that the adsorption of the surfactant by CDC obeys the pseudo 2nd order model. The thermodynamic results have shown that surfactants adsorption by CDC is an endothermic and spontaneous process. The Sips model agreed with the adsorption isotherm data of SDBS with R2 of 0.987, while both Freundlich and Redlich-Peterson models comply well with adsorption data for TX-100 and HDPB. The hydrophobic and electrostatic interactions were found the dominant mechanisms of the adsorption of the surfactant by CDC. The adsorption capacities of CDC were found to be 442.4, 462.0 and 578.4 mg/g for SDBS, HDPB and TX-100, respectively.
The Association of Psychological Well-Being With Sensory and Cognitive Function and Neuronal Health in Aging Adults

Objectives Psychological well-being (PWB) may be a potential modifiable risk factor of age-related diseases. We aimed to determine associations of PWB with sensorineural and cognitive function and neuronal health in middle-aged adults. Methods This study included 2039 Beaver Dam Offspring Study participants. We assessed PWB, hearing, visual acuity, contrast sensitivity impairment, olfactory impairment, cognition, and retinal (macular ganglion cell inner-plexiform layer, mGCIPL) thickness. Age-sex-education-adjusted multivariable linear, logistic regression, and generalized estimating equation models were used and then further adjusted for health-related confounders. Results Individuals with higher PWB had better hearing functions, visual acuity, and thicker mGCIPL and reduced odds for hearing, contrast sensitivity and olfactory impairment in age-sex-education-adjusted models. Effects on mGCIPL and visual and olfactory measures decreased with adjustment. Higher PWB was associated with better cognition, better combined sensorineural-cognitive function, and decreased cognitive impairment. Discussion Psychological well-being was associated with sensorineural-cognitive health indicating a potential of PWB interventions for healthy aging.
Integrated Molecular-Morphologic Meningioma Classification: A Multicenter Retrospective Analysis, Retrospectively and Prospectively Validated

PURPOSE Meningiomas are the most frequent primary intracranial tumors. Patient outcome varies widely from benign to highly aggressive, ultimately fatal courses. Reliable identification of risk of progression for individual patients is of pivotal importance. However, only biomarkers for highly aggressive tumors are established (CDKN2A/B and TERT), whereas no molecularly based stratification exists for the broad spectrum of patients with low- and intermediate-risk meningioma. METHODS DNA methylation data and copy-number information were generated for 3,031 meningiomas (2,868 patients), and mutation data for 858 samples. DNA methylation subgroups, copy-number variations (CNVs), mutations, and WHO grading were analyzed. Prediction power for outcome was assessed in a retrospective cohort of 514 patients, validated on a retrospective cohort of 184, and on a prospective cohort of 287 multicenter cases. RESULTS Both CNV- and methylation family–based subgrouping independently resulted in increased prediction accuracy of risk of recurrence compared with the WHO classification (c-indexes WHO 2016, CNV, and methylation family 0.699, 0.706, and 0.721, respectively). Merging all risk stratification approaches into an integrated molecular-morphologic score resulted in further substantial increase in accuracy (c-index 0.744). This integrated score consistently provided superior accuracy in all three cohorts, significantly outperforming WHO grading (c-index difference P = .005). Besides the overall stratification advantage, the integrated score separates more precisely for risk of progression at the diagnostically challenging interface of WHO grade 1 and grade 2 tumors (hazard ratio 4.34 [2.48-7.57] and 3.34 [1.28-8.72] retrospective and prospective validation cohorts, respectively). CONCLUSION Merging these layers of histologic and molecular data into an integrated, three-tiered score significantly improves the precision in meningioma stratification. Implementation into diagnostic routine informs clinical decision making for patients with meningioma on the basis of robust outcome prediction.
Guidelines for in vivo mouse models of myocardial infarction.

Despite significant improvements in reperfusion strategies, acute coronary syndromes all too often culminate in a myocardial infarction (MI). The consequent MI can in turn lead to remodeling of the left ventricle (LV), the development of LV dysfunction, and ultimately progression to heart failure. Accordingly, improved understanding of the underlying mechanisms of MI remodeling and progression to heart failure is necessary. One common approach to examine MI pathology is with murine models that recapitulate components of the clinical context of acute coronary syndrome and subsequent MI. We evaluated the different approaches used to produce MI in mouse models and identified opportunities to consolidate methods, recognizing that reperfused and non-reperfused MI yield different responses. The overall goal in compiling this consensus statement is to unify best practices regarding mouse MI models to improve interpretation and allow comparative examination across studies and laboratories. These guidelines will help to establish rigor and reproducibility and provide increased potential for clinical translation.
The impact of sex, age at onset, recurrence, mode of ascertainment and medical complications on the family genetic risk score profiles for alcohol use disorder

Abstract Background Alcohol use disorder (AUD) is clinically heterogeneous. We examine its potential genetic heterogeneity as a function of sex, age, clinical features and mode of ascertainment. Methods In the Swedish population born 1932–1995 (n = 5 829 952), we examined the genetic risk profiles for AUD, major depression (MD), anxiety disorders, bipolar disorder, drug use disorder (DUD), attention deficit-hyperactivity disorder (ADHD) and criminal behavior (CB) in 361 124 cases of AUD subdivided by sex, age at onset (AAO), recurrence, mode of ascertainment and medical complications. Family genetic risk scores (FGRS), calculated from 1st to 5th-degree relatives controlling of cohabitation, assesses genetic risk from phenotypes in the family, not from DNA variants. Results FGRS profiles differed modestly across sex with all scores higher in females. Differences were more pronounced for AAO and recurrence with the FGRS for AUD, DUD, ADHD and CB substantially higher in cases with early AAO or high recurrence rates. Genetic profiles differed considerably by mode of ascertainment, with higher FGRS for AUD and most other disorders in patients seen in hospital v. primary care settings. Cases of AUD with medical complications had higher FGRS for AUD. AUD cases comorbid with MD and DUD had higher FGRS risk for AUD, but this genetic may be less specific given increases in FGRS for multiple other disorders. Conclusions From a genetic perspective, AUD differs substantially as a function of AAO, recurrence, mode of ascertainment and patterns of comorbidity, suggesting caution in cross-sample comparisons of AUD cohorts that differ in these features.
Induction of Heme Oxygenase‐1 Is Linked to the Severity of Disease in Human Abdominal Aortic Aneurysm

Background Rupture of abdominal aortic aneurysm (rAAA) is associated with high case fatality rates, and risk of rupture increases with the AAA diameter. Heme oxygenase‐1 (gene HMOX1, protein HO‐1) is a stress‐induced protein and induction has protective effects in the vessel wall. HMOX1−/− mice are more susceptible to angiotensin II‐induced AAA formation, but the regulation in human nonruptured and ruptured AAA is only poorly understood. Our hypothesis proposed that HO‐1 is reduced in AAA and lowering is inversely associated with the AAA diameter. Methods and Results AAA walls from patients undergoing elective open repair (eAAA) or surgery because of rupture (rAAA) were analyzed for aortic HMOX1/HO‐1 expression by quantitative real‐time polymerase chain reaction and Western blot. Aortas from patients with aortic occlusive disease served as controls. HMOX1/HO‐1 expression was 1.1‐ to 7.6‐fold upregulated in eAAA and rAAA. HO‐1 expression was 3‐fold higher in eAAA specimen with a diameter >84.4 mm, whereas HO‐1 was not different in rAAA. Other variables that are known for associations with AAA and HO‐1 induction were tested. In eAAA, HO‐1 expression was negatively correlated with aortic collagen content and oxidative stress parameters H2O2 release, oxidized proteins, and thiobarbituric acid reactive substances. Serum HO‐1 concentrations were analyzed in patients with eAAA, and maximum values were found in an aortic diameter of 55 to 70 mm with no further increase >70 mm, compared with <55 mm. Conclusions Aortic HO‐1 expression was increased in eAAA and rAAA. HO‐1 increased with the severity of disease but was additionally connected to less oxidative stress and vasoprotective mechanisms.
Successful follicular unit extraction in a case of inactive, recalcitrant alopecia barbae

Alopecia areata (AA) is a non‐scarring autoimmune type of alopecia. Hair transplantation in AA is not practiced as the implanted follicular grafts might be destroyed due to underlying autoimmune pathology. A biopsy proven 28 year old male patient of AA presented to us with an 8‐year history of a hairless patch over the beard area. He underwent many treatments by other dermatologist with oral, topical, and intralesional immunosuppressants, which curtailed his disease progression but failed to re‐grow hair. Biopsy during his visit revealed absence of inflammatory infiltrates and empty hair tracts replaced by fibrotic tracts. Follicular unit extraction (FUE) was done successfully after counseling the patient about the controversial role of hair transplant surgery in AA. Hair growth was achieved within 6 months with no recurrence during 1‐year follow up. FUE can be opted for long‐standing and clinically stable cases of AA; histopathology and dermoscopy being the guiding lights in determining the disease inactivity.
Changes in rumen microbial community composition in yak in response to seasonal variations

Yak is a dominant ruminant, well adapted to grazing on pasture year around in the harsh climate of the 3000‐meter‐high Qinghai‐Tibetan Plateau. The complex microbial community that resides within the yak rumen is responsible for fermentation and contributes to its climatic adaptation. This study aimed to characterize the rumen microbiota responses to wide seasonal variations, especially those necessary for survival in the cold seasons.
Distributed Adaptive Nash Equilibrium Solution for Differential Graphical Games

This article investigates differential graphical games for linear multiagent systems with a leader on fixed communication graphs. The objective is to make each agent synchronize to the leader and, meanwhile, optimize a performance index, which depends on the control policies of its own and its neighbors. To this end, a distributed adaptive Nash equilibrium solution is proposed for the differential graphical games. This solution, in contrast to the existing ones, is not only Nash but also fully distributed in the sense that each agent only uses local information of its own and its immediate neighbors without using any global information of the communication graph. Moreover, the asymptotic stability and global Nash equilibrium properties are analyzed for the proposed distributed adaptive Nash equilibrium solution. As an illustrative example, the differential graphical game solution is applied to the microgrid secondary control problem to achieve fully distributed voltage synchronization with optimized performance.
GALAD demonstrates high sensitivity for HCC surveillance in a cohort of patients with cirrhosis

Most patients with HCC are diagnosed at a late stage, highlighting the need for more accurate surveillance tests. Although biomarkers for HCC early detection have promising data in Phase 2 case–control studies, evaluation in cohort studies is critical prior to adoption in practice. We leveraged a prospective cohort of patients with Child‐Pugh A or B cirrhosis who were followed until incident HCC, liver transplantation, death, or loss to follow‐up. We used a prospective specimen collection, retrospective, blinded evaluation design for biomarker evaluation of GALAD (gender × age × log alpha‐fetoprotein [AFP] × des‐gamma‐carboxy prothrombin), longitudinal GALAD, and the HCC Early Detection Screening (HES) algorithm—compared to AFP—using patient‐level sensitivity and screening‐level specificity.
Preoperative Paravertebral Block and Chronic Pain after Breast Cancer Surgery: A Double-blind Randomized Trial

Background: The effectiveness of paravertebral block in preventing chronic pain after breast surgery remains controversial. The primary hypothesis of this study was that paravertebral block reduces the incidence of chronic pain 3 months after breast cancer surgery. Methods: In this prospective, multicenter, randomized, double-blind, parallel-group, placebo-controlled study, 380 women undergoing partial or complete mastectomy with or without lymph node dissection were randomized to receive preoperative paravertebral block with either 0.35 ml/kg 0.75% ropivacaine (paravertebral group) or saline (control group). Systemic multimodal analgesia was administered in both groups. The primary endpoint was the incidence of chronic pain with a visual analogue scale (VAS) score greater than or equal to 3 out of 10, 3 months after surgery. The secondary outcomes were acute pain, analgesic consumption, nausea and vomiting, chronic pain at 6 and 12 months, neuropathic pain, pain interference, anxiety, and depression. Results: Overall, 178 patients received ropivacaine, and 174 received saline. At 3 months, chronic pain was reported in 93 of 178 (52.2%) and 83 of 174 (47.7%) patients in the paravertebral and control groups, respectively (odds ratio, 1.20 [95% CI, 0.79 to 1.82], P = 0.394). At 6 and 12 months, chronic pain occurred in 104 of 178 (58.4%) versus 79 of 174 (45.4%) and 105 of 178 (59.0%) versus 93 of 174 (53.4%) patients in the paravertebral and control groups, respectively. Greater acute postoperative pain was observed in the control group 0 to 2 h (area under the receiver operating characteristics curve at rest, 4.3 ± 2.8 vs. 2.9 ± 2.8 VAS score units × hours, P < 0.001) and when maximal in this interval (3.8 ± 2.1 vs. 2.5 ± 2.5, P < 0.001) but not during any other interval. Postoperative morphine use was 73% less in the paravertebral group (odds ratio, 0.272 [95% CI, 0.171 to 0.429]; P < 0.001). Conclusions: Paravertebral block did not reduce the incidence of chronic pain after breast surgery. Paravertebral block did result in less immediate postoperative pain, but there were no other significant differences in postoperative outcomes. More than 350 study participants undergoing mastectomy were randomized to either paravertebral blocks with ropivacaine or saline injections. Both groups received multimodal analgesia. Although paravertebral block using ropivacaine had a small analgesic effect in the immediate postoperative period, no differences in pain 3, 6, and 12 months after surgery were detected.
The dominance of item learning in the location-specific proportion congruence paradigm

Prior research has shown that various cues are exploited to reactively adjust attention, and such adjustments depend on learning associations between cues and proportion congruence. This raises the intriguing question of what will be learned when more than one cue is available, a question that has implications for understanding which cue(s) will dominate in guiding reactive adjustments. Evidence from a picture-word Stroop task demonstrated that item learning dominated over location learning in a location-specific proportion congruence (LSPC) paradigm, a pattern that may explain the difficulty researchers have faced in replicating and reproducing the LSPC effect. One goal was to reproduce this pattern using a non-overlapping two-item set design that more closely matched prior studies, and another goal was to examine generalisability of the pattern to two other tasks. Using a prime-probe, colour–word Stroop task (Experiment 1), and a flanker task (Experiment 2), we again found clear dominance of item learning. In Experiment 3, we attempted to disrupt item learning and promote location learning by using a counting procedure that directed participants’ attention to location. Once again, we found the same pattern of item dominance. In addition, in none of the experiments did we find evidence for conjunctive (location–item) learning. Collectively, the findings suggest item learning is neither design- or task-specific; rather, it is robust, reliable, and not easily disrupted. Discussion centres on factors dictating dominance of item- over location-based adjustments and implications for the broader literature on LSPC effects.
Level of hM4D(Gi) DREADD Expression Determines Inhibitory and Neurotoxic Effects in the Hippocampus

Abstract Selective neuromodulation using designer receptors exclusively activated by designer drugs (DREADDs) has become an increasingly important research tool, as well as an emerging therapeutic approach. However, the safety profile of DREADD expression is unknown. Here, different titers of adeno-associated viral (AAV) vector were administered in an attempt to vary total expression levels of the inhibitory DREADD hM4D(Gi) in excitatory hippocampal neurons. Male Sprague Dawley rats were injected with AAV2/7 encoding DREADD-mCherry, DREADD, or mCherry. Pronounced neuronal loss and neuroinflammatory reactions were observed after transduction with the high titer DREADD AAV, which also resulted in the highest DREADD expression levels. No such effects were observed in the mCherry control group, despite an equally high titer, nor in conditions where lower viral vector titers were injected. In the high titer DREADD conditions, dentate gyrus (DG) evoked potentials were inhibited on clozapine-induced activation of hM4D(Gi), while in low titer conditions DG evoked potentials were enhanced. Recordings of single neuronal activity nevertheless indicated a reduction in spontaneous firing of granule cell layer neurons. Our results indicate that prolonged, high levels of DREADD expression can have neurotoxic effects and that chemogenetic suppression of excitatory hippocampal neurons can paradoxically enhance DG evoked potentials.