Miracle-dz/UniFAR-FTUs huggingface dataset:
Outcomes and Anticoagulation Use After Catheter Ablation for Atrial Fibrillation.

BACKGROUND Studies evaluating the effects of atrial fibrillation (AF) catheter ablation versus antiarrhythmic therapy on outcomes have shown mixed results. In addition, guidelines recommend continuing oral anticoagulation (OAC) after ablation for those at risk of stroke, but real-world data are lacking. METHODS We evaluated outcomes including death, myocardial infarction, stroke or systemic embolism, intracranial bleeding, major bleeding, and hospitalization in patients undergoing AF ablation compared with a propensity score matched cohort of patients treated with anti-arrhythmic medications only in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation registries. Cox proportional hazards regression was performed to evaluate the association between AF ablation and outcomes. We then evaluated patterns of treatment with OAC among AF ablation patients. RESULTS Among 21 595 patients, 1190 (6%) underwent de novo AF ablation. Our propensity score-matched cohort included 1087 patients who underwent AF ablation matched 1:1 with 1087 patients treated with antiarrhythmic medications only. There were no significant differences in the risk of all-cause and cardiovascular death, and most other major adverse cardiovascular and neurological events. AF catheter ablation was associated with an increased risk of all-cause hospitalization during follow-up (hazard ratio, 1.24 [95% CI, 1.05-1.46]), particularly in the first 3 months (the standard blanking period) after the procedure. Among those who underwent AF ablation with a CHA2DS2 VASc score ≥2 for men and ≥3 for women, 23% had OAC discontinued after ablation. Among those who discontinued OAC, the median time to discontinuation was 6.2 months. CONCLUSIONS In this large US national registry, we found no difference in adjusted rates of cardiovascular or all-cause death between patients treated with AF catheter ablation and antiarrhythmic medications only. Notably, discontinuation of OAC after ablation remains relatively common despite guideline recommendations for continued stroke prevention therapy in patients at risk of stroke.
Transmembrane protease serine 5: a novel Schwann cell plasma marker for CMT1A

Development of biomarkers for Charcot‐Marie‐Tooth (CMT) disease is critical for implementing effective clinical trials. The most common form of CMT, type 1A, is caused by a genomic duplication surrounding the PMP22 gene. A recent report (Neurology 2018;90:e518–3524) showed elevation of neurofilament light (NfL) in plasma of CMT1A disease patients, which correlated with disease severity. However, no plasma/serum biomarker has been identified that is specific to Schwann cells, the most directly affected cells in CMT1A.
Outcome Evaluation of Highly Challenging Balance Training for People With Parkinson Disease: A Multicenter Effectiveness-Implementation Study

Supplemental Digital Content is Available in the Text. Background and Purpose: In order for people with Parkinson disease (PwPD) to benefit from neurorehabilitation research, interventions tested in research settings require assessment in real-world clinical practice. There is little evidence for whether efficacious exercise interventions for PwPD remain effective when transferred to standard clinical settings. The aim of this study was to assess the clinical effectiveness of the adapted HiBalance program on balance control and gait among PwPD. Methods: Participants (n = 117) with mild-moderate Parkinson disease were consecutively included into either the 10-week HiBalance group training (n = 61) or the control (n = 56) group. The main outcome was balance performance (Mini-BESTest). Secondary outcomes were comfortable gait speed (10-m Walk Test); functional mobility (Timed Up and Go [TUG] test) and dual-task interference (cognitive TUG test); physical activity level (steps per day); perceived balance confidence (Activities-specific Balance Confidence scale) and perceived walking difficulty (Walk-12G) and self-rated health (EQ-5D visual analog scale). Results: In total, 98 people completed the trial. Compared with controls, the training group showed significant improvement in balance performance (P < 0.001), gait speed (P = 0.001), and dual-task interference (P = 0.04) following the intervention. No group differences were observed for physical activity level or any patient-reported measures. Discussion and Conclusions: Highly challenging balance training is effective at improving balance, gait, and dual-task performance when delivered at a clinically feasible dose, in a range of rehabilitation settings, without direct involvement of the research group. Video Abstract available for more insights from the authors (see the Video, Supplementary Digital Content 1, available at: http://links.lww.com/JNPT/A299).
Induction of AP-1 by YAP/TAZ contributes to cell proliferation and organ growth

In this study, Koo et al. set out to identify the key downstream target genes of Hippo pathway effectors YAP/TAZ involved in organ size control. Using a battery of genetic experiments in cultured cells and in vivo assays on liver growth the authors identified that YAP/TAZ are directly involved in immediate early gene induction, including AP-1; and this AP-1 induction by YAP is essential for the functions of YAP in organ size control and cancer cell growth.
Self-Assemblies Based on Traditional Medicine Berberine and Cinnamic Acid for Adhesion-induced Inhibiting Multidrug-Resistant Staphylococcus aureus.

Along with S. aureus is being resistant to various first-line antibiotics, seeking multifarious strategies aimed at effective control of antibiotic-resistant behavior is urgent. Here, we report a two-component directed self-assembly mode: phytochemicals berberine and cinnamic acid can directly self-assemble into nanoparticles (NPs) displaying well bacteriostastic activity. Compared with several first-line antibiotics, the obtained nanostructures have better inhibitory effect on multidrug-resistant S. aureus (MRSA) and stronger ability to biofilm removal. These are attributed to that organic assemblies can firstly spontaneously adhere to the surface of bacteria, then infiltrate into cell, and lead to converging attack against MRSA; thereafter, multipath bactericidal mechanisms of NPs on MRSA are found by both transcriptomic analysis and quantitative Polymerase Chain Reaction (qPCR) analysis. Moreover, combining with spectral data and single crystal X-ray diffraction, NPs' self-assemble mechanism governed by hydrogen bonds and π-π stacking interactions is clearly elucidated. These non covalent interactions induce the NPs' formation of butterfly-like one-dimensional self-assembled units and finally layered three-dimensional spatial configuration. In addition, biocompatibility tests display that NPs is non-hemolytic, little toxicity in vitro and in vivo. This directed self-assembly mode can offer a new perspective toward the design of biocompatible antimicrobial nanomedicines for clinical translation.
The YrbE phospholipid transporter of Salmonella enterica serovar Typhi regulates the expression of flagellin and influences motility, adhesion and induction of epithelial inflammatory responses

ABSTRACT Salmonella enterica serovar Typhi is the etiologic agent of typhoid fever, a major public health problem in the developing world. Moving toward and adhering to the intestinal epithelium represents key initial steps of infection by S. Typhi. We examined the role of the S. Typhi yrbE gene, which encodes an inner membrane phospholipid transporter, in these interactions with epithelial cells. Disruption of yrbE resulted in elevated expression of flagellin and a hypermotile phenotype. It also significantly reduced the ability of S. Typhi to adhere to the HeLa epithelial cell line and to polarized primary epithelial cells derived from human ileal organoids. Interestingly, the yrbE-deficient strain of S. Typhi induced higher production of interleukin-8 from the primary human ileal epithelial cell monolayers compared to the wild-type bacteria. Deletion of the flagellin gene (fliC) in the yrbE-deficient S. Typhi inhibited motility and attenuated interleukin-8 production, but it did not correct the defect in adhesion. We also disrupted yrbE in S. Typhimurium. In contrast to the results in S. Typhi, the deficiency of yrbE in S. Typhimurium had no significant effect on flagellin expression, motility or adhesion to HeLa cells. Correspondingly, the lack of yrbE also had no effect on association with the intestine or the severity of intestinal inflammation in the mouse model of S. Typhimurium infection. Thus, our results point to an important and serovar-specific role played by yrbE in the early stages of intestinal infection by S. Typhi.
Sex-specific differences in antithrombotic therapy and prognosis in patients with acute coronary syndrome treated with stent

Aims and objective: Impact of sex-related differences in patients with the acute coronary syndrome (ACS) undergoing percutaneous coronary intervention and treated with new P2Y12 inhibitors is not adequately characterized. We aimed to analyze gender-based differences in dual antiplatelet therapy, and adverse cardiovascular events. Materials and methods: Prospec-tive-observational study of the consecutive ACS patients treated with stent from July 2015 to January 2016, with a follow-up of 1 year. Results: We examined 283 patients, 75 (26.5%) women and 208 (73.5%) men. Women were older than men (71 ± 13 vs. 66.5 ± 13 years). There were 44% of women and 52% of men presenting with ST-elevation ACS (p = 0.21). Women had a higher bleeding risk (CRUSADE), without differences in the ischemic risk (Global Registry of Acute Coronary Events and thrombolysis in myocardial infarction). More women were treated with drug-eluting stent (88.9 vs. 75.5%, p = 0.04). There was a lower rate of ticagrelor prescription in women (42.6 vs. 50.9%, p = 0.29), in favor of clopidogrel. No differences were observed in the prasugrel prescription. No significant differences were observed after a year of follow-up, but women had a tendency toward lower mortality (1.4 vs. 6.7%, p = 0.19) and higher bleeding rates (23.3 vs. 17.4%, p = 0.27). Conclusions: In our study of patients presenting with ACS treated with stent, clopidogrel was preferred in women, whereas ticagrelor was the most frequent prescription in men. No significant differences were noted in clinical outcomes, but women experienced a tendency toward less mortality and more bleeding events.
Event-Triggered Exponential Synchronization for Complex-Valued Memristive Neural Networks With Time-Varying Delays

This article solves the event-triggered exponential synchronization problem for a class of complex-valued memristive neural networks with time-varying delays. The drive-response complex-valued memristive neural networks are translated into two real-valued memristive neural networks through the method of separating the complex-valued memristive neural networks into real and imaginary parts. In order to reduce the information exchange frequency between the sensor and the controller, a novel event-triggered mechanism with the event-triggering functions is introduced in wireless communication networks. Some sufficient conditions are established to achieve the event-triggered exponential synchronization for drive-response complex-valued memristive neural networks with time-varying delays. In addition, to guarantee that the Zeno behavior cannot occur, a positive lower bound for the interevent times is explicitly derived. Finally, numerical simulations are provided to illustrate the effectiveness and superiority of the obtained theoretical results.
Finite-Horizon H∞ Fault-Tolerant Constrained Consensus for Multiagent Systems With Communication Delays

This article focuses on the fault-tolerant constrained consensus problem for multiagent systems with communication delays. The communication graphs are first assumed to be directed and fixed. Then, a novel delay-dependent fault-tolerant controller is designed such that, in the presence of communication delays and randomly occurring actuator failures, the influence of the projections and the initial states on the closed-loop system can be attenuated with a prespecified level. Based on the provided performance requirement, the initial state of each agent does not need to be identical. The proposed control algorithms ensure that sufficient conditions are met for the fault-tolerant constrained consensus to be achieved according to the prespecified performance index. After this, the controller gains are computed by employing an iterative linear matrix inequality scheme. Finally, a numerical example is provided to show the effectiveness of the proposed method.
Metabolic Imaging Using Hyperpolarized Pyruvate–Lactate Exchange Assesses Response or Resistance to the EGFR Inhibitor Cetuximab in Patient-Derived HNSCC Xenografts

Purpose: Optimal head and neck squamous cell carcinoma (HNSCC) patient selection for anti–EGFR-based therapy remains an unmet need since only a minority of patients derive long-term benefit from cetuximab treatment. We assessed the ability of state-of-the-art noninvasive in vivo metabolic imaging to probe metabolic shift in cetuximab-sensitive and -resistant HNSCC patient-derived tumor xenografts (PDTXs). Experimental Design: Three models selected based on their known sensitivity to cetuximab in patients (cetuximab-sensitive or acquired-resistant HNC007 PDTXs, cetuximab-naïve UCLHN4 PDTXs, and cetuximab-resistant HNC010 PDTXs) were inoculated in athymic nude mice. Results: Cetuximab induced tumor size stabilization in mice for 4 weeks in cetuximab-sensitive and -naïve models treated with weekly injections (30 mg/kg) of cetuximab. Hyperpolarized 13C-pyruvate–13C-lactate exchange was significantly decreased in vivo in cetuximab-sensitive xenograft models 8 days after treatment initiation, whereas it was not modified in cetuximab-resistant xenografts. Ex vivo analysis of sensitive tumors resected at day 8 after treatment highlighted specific metabolic changes, likely to participate in the decrease in the lactate to pyruvate ratio in vivo. Diffusion MRI showed a decrease in tumor cellularity in the HNC007-sensitive tumors, but failed to show sensitivity to cetuximab in the UCLHN4 model. Conclusions: This study constitutes the first in vivo demonstration of cetuximab-induced metabolic changes in cetuximab-sensitive HNSCC PDTXs that were not present in resistant tumors. Using metabolic imaging, we were able to identify hyperpolarized 13C-pyruvate as a potential marker for response and resistance to the EGFR inhibitor in HNSCC.
Correlation between endometrial thickness and perinatal outcome for pregnancies achieved through assisted reproduction technology

Abstract Objective To explore the relationship between endometrial thickness and perinatal outcome in assisted reproductive techniques (ART). Methods A retrospective cohort study was conducted in 1139 infertile women who underwent ART treatment from January 2011 to July 2014. Four groups were divided by endometrial thickness on the human chorionic gonadotropin (HCG) trigger day in fresh embryo transfer cycles or on the progesterone administration day in frozen embryo transfer cycles, as group A (<8 mm), group B (8–10 mm), group C (10–14 mm) and group D (≥14 mm). Two other groups were delineated according to whether uterine lesions were present. The incidence of premature rupture of membranes (PROM), postpartum hemorrhage (PPH) and other common perinatal complications were observed subsequently. Results It was found that the highest incidence of PROM and PPH was in group A (P < 0.05). The incidence of PROM in group B was higher than in groups C and D (P < 0.05). The occurrence of mothers entering the intensive care unit (ICU) was significantly higher in group A than in group B (P < 0.05). However, no significant differences were found in other adverse outcomes. There was no difference in the incidence of adverse perinatal outcome when the endometrial thickness of pre-implantation was not attenuated by uterine lesions. Conclusion The incidence of PROM and PPH increased significantly when the thickness of the endometrium was less than 10 mm before implantation. Correspondingly, the number of mothers treated in the ICU was also higher under these circumstances. To reduce such perinatal placenta-related complications, we should maximize the thickness of the endometrium before transplantation of embryos.
Multicenter study on the effect of nonsteroidal anti‐inflammatory drugs on postoperative pain after endoscopic sinus and nasal surgery

The taboo of avoiding nonsteroidal anti‐inflammatory drugs (NSAIDs) after functional endoscopic sinus surgery (FESS) has been waning. The impetus to reduce opioid prescriptions in view of the opioid epidemic led the authors to change their practices to include NSAIDs after sinus surgery. This study's aim was to analyze the differences between patients before and after we began recommending NSAIDs after FESS.
Gender Disparities in Financial Relationships Between Industry and Orthopaedic Surgeons.

BACKGROUND Recent studies in a number of surgical subspecialties have demonstrated that financial relationships with industry differ between men and women. This study aimed to determine if gender disparities exist in industry relationships with orthopaedic surgeons. METHODS This retrospective study utilized publicly available data from the Centers for Medicare & Medicaid Services (CMS) at OpenPayments.cms. gov. Data were extracted for payments made to orthopaedic surgeons from industry for royalties, licensing, or consulting fees from 2016 to 2017. A physician's profile was used to determine name, gender, practice location, and subspecialty. Years of experience were recorded from publicly available websites. Total number of payments and amounts were compared among men and women, subspecialties, and locations. Multivariable linear regression models were used to determine predictors of total payments and number of payments. RESULTS Royalties and consulting fees were paid to 3,418 individual physicians (11% of 29,996 physicians in the American Academy of Orthopaedic Surgeons [AAOS] census) and accounted for 88% of total payments. The majority of the total payment amount (99.6%) was made to men, while only 0.4% went to women. Male gender was a predictor of total number of payments (β = 5.17, p < 0.001), as were years of experience (β = 0.15 [95% confidence interval (CI): 0.10 to 0.20], p < 0.001), Mountain region (β = 2.77 [95% CI: 0.37 to 5.17], p = 0.02), and adult reconstructive subspecialty (β = 4.07 [95% CI: 1.89 to 6.25], p < 0.001). Years of experience (β = 0.046 [95% CI: 0.039 to 0.052], p < 0.001), male gender (β = 1.09 [95% CI: 0.67 to 1.51], p < 0.001), Mountain region (β = 0.35 [95% CI: 0.020 to 0.68], p = 0.04), and adult reconstructive subspecialty (β = 0.33 [95% CI: 0.030 to 0.63], p = 0.03) were associated with higher payments. CONCLUSIONS Male gender, years of experience, Mountain region, and adult reconstructive subspecialty are independent predictors of a higher number of industry payments and payment amount. These disparities in industry payments may contribute to continued inequities in scholarship, academic rank, and leadership opportunities.
A Hospital-Community-Family–Based Telehealth Program for Patients With Chronic Heart Failure: Single-Arm, Prospective Feasibility Study

Background An increasing number of patients with chronic heart failure (CHF) are demanding more convenient and efficient modern health care systems, especially in remote areas away from central cities. Telehealth is receiving increasing attention, which may be useful to patients with CHF. Objective This study aimed to evaluate the feasibility of a hospital-community-family (HCF)–based telehealth program, which was designed to implement remote hierarchical management in patients with CHF. Methods This was a single-arm prospective study in which 70 patients with CHF participated in the HCF-based telehealth program for remote intervention for at least 4 months. The participants were recruited from the clinic and educated on the use of smart health tracking devices and mobile apps to collect and manually upload comprehensive data elements related to the risk of CHF self-care management. They were also instructed on how to use the remote platform and mobile app to send text messages, check notifications, and open video channels. The general practitioners viewed the index of each participant on the mobile app and provided primary care periodically, and cardiologists in the regional central hospital offered remote guidance, if necessary. The assessed outcomes included accomplishments of the program, usability and satisfaction, engagement with the intervention, and changes of heart failure–related health behaviors. Results As of February 2018, a total of 66 individuals, aged 40-79 years, completed the 4-month study. Throughout the study period, 294 electronic medical records were formed on the remote monitoring service platform. In addition, a total of 89 remote consultations and 196 remote ward rounds were conducted. Participants indicated that they were generally satisfied with the intervention for its ease of use and usefulness. More than 91% (21/23) of physicians believed the program was effective, and 87% (20/23) of physicians stated that their professional knowledge could always be refreshed and enhanced through a library hosted on the platform and remote consultation. More than 60% (40/66) of participants showed good adherence to the care plan in the study period, and 79% (52/66) of patients maintained a consistent pattern of reporting and viewing their data over the course of the 4-month follow-up period. The program showed a positive effect on self-management for patients (healthy diet: P=.046, more fruit and vegetable intake: P=.02, weight monitoring: P=.002, blood pressure: P<.001, correct time: P=.049, and daily dosages of medicine taken: P=.006). Conclusions The HCF-based telehealth program is feasible and provided researchers with evidence of remote hierarchical management for patients with CHF, which can enhance participants’ and their families’ access and motivation to engage in self-management. Further prospective studies with a larger sample size are necessary to confirm the program’s effectiveness.
Language Appropriation Practices of Gay Men after the Legalization of Same-Sex Marriage

ABSTRACT In the United States, legal marriage has found itself simultaneously serving as a pact made by two individuals, an agreement under the state’s control, and a legal status with social implications. The influences of legal marriage on social levels are not monolithic, as a result, there is not a comprehensive definition of marriage that supports the diverse relationships that exist, including same-sex marriage. Moreover, explicit attention to verbal communication in reference to these relationships has rarely been documented. Utilizing a qualitative framework and semi-structured interviews, this study investigated the relationship between marriage equality and its impact on language appropriation for 28 gay men living in various parts of the United States. Results of analysis situated in grounded theory via the constant comparative method indicated that for many in this sample, access to legal marriage facilitated unapologetic use of language associated with marriage, irrespective of one’s own marital status. These findings are in stark contrast to studies exploring adoption of marriage language by lesbian women. Implications across private and public arenas are discussed.