Miracle-dz/UniFAR-FTUs huggingface dataset:
Executive functioning and emotion recognition in youth with oppositional defiant disorder and/or conduct disorder

Abstract Objectives: Executive functioning and emotion recognition may be impaired in disruptive youth, yet findings in oppositional defiant disorder (ODD) and conduct disorder (CD) are inconsistent. We examined these functions related to ODD and CD, accounting for comorbid attention-deficit/hyperactivity disorder (ADHD) and internalising symptoms. Methods: We compared executive functioning (visual working memory, visual attention, inhibitory control) and emotion recognition between youth (8–18 years old, 123 boys, 55 girls) with ODD (n = 44) or CD (with/without ODD, n = 48), and healthy controls (n = 86). We also related ODD, CD, and ADHD symptom counts and internalising symptomatology to all outcome measures, as well as executive functioning to emotion recognition. Results: Visual working memory and inhibitory control were impaired in the ODD and CD groups versus healthy controls. Anger, disgust, fear, happiness, and sadness recognition were impaired in the CD group; only anger recognition was impaired in the ODD group. Deficits were not explained by comorbid ADHD or internalising symptoms. Visual working memory was associated with recognition of all basic emotions. Conclusions: Our findings challenge the view that neuropsychological impairments in youth with ODD/CD are driven by comorbid ADHD and suggest possible distinct neurocognitive mechanisms in CD versus ODD.
Health Returns to Pharmaceutical Innovation in the Market for Oral Chemotherapy in Response to Insurance Coverage Expansion

We estimated the average returns, in terms of patient survival, to the marginal innovations in the oral chemotherapy market induced by Part D expansion of oral chemotherapy coverage for elderly individuals by mandating inclusion of “all or substantially all” oral anticancer medications on plans’ formularies. We exploited exogenous variation in the age of diagnosis for different cancer sites—and therefore the relative expansion in market size for different cancers under Medicare's prescription drug coverage—to isolate the effect of Part D on innovation and the health benefits that these innovative technologies provide. Using data from the Food and Drug Administration and clinical studies from January 1994 to December 2016, we find that the approval rate for oral chemotherapies increased an additional 5.7 percent (95 percent CI: 1.7, 9.8) after implementation of Part D for every 1 percent relative expansion in the Medicare market. In contrast, the same relative expansion in the Medicare market resulted in a smaller increase in the indication-specific survival gains reported in the drug's label (3.2 percent (95 percent CI: 2.1, 4.3)) and 8.0 percent (95 percent CI: 6.1, 9.8) lower in absolute and relative gains, respectively). Similar trends were not observed for intravenously administered chemotherapy whose coverage was unaffected by Part D. These findings suggest that while increased innovation will generate health benefits, there could be diminishing marginal returns to incentives for pharmaceutical innovation created by broad coverage mandates, and more nuanced coverage policies and targeted treatment uses may help maximize the health benefits provided by future pharmaceutical innovations.
Novel Prognostic Nomograms for Predicting Early and Late Recurrence of Hepatocellular Carcinoma After Curative Hepatectomy

Aim Hepatectomy is the main curative method for patients with hepatocellular carcinoma (HCC) in China. Unfortunately, high recurrence rate after hepatectomy poses negative impact on the prognosis of patients. This study aimed to develop prognostic nomograms to predict early recurrence (ER) and late recurrence (LR) of HCC after curative hepatectomy. Patients and Methods Total of 318 HCC patients undergoing curative hepatectomy from January 2012 to January 2018 were retrospectively recruited. Potential risk factors that were significant for predicting ER and LR in univariate analysis were selected for multivariate survival model analysis using the backward stepwise method. Risk factors identified in multivariate analysis were used to develop nomograms to predict ER and LR. The nomogram was internally validated using 2,000 bootstrap samples from 75% of the original data. Results Among 318 patients, 164 showed postoperative recurrence, of which 140 and 24 had ER (≤2 years) and LR (>2 years), respectively. Multivariate analysis showed that age, Hong Kong Liver Cancer Stage, albumin-bilirubin, METAVIR fibrosis grade, and microvascular invasion were risk factors of ER for HCC after curative hepatectomy. The AUC of the ROC curve for ER in the development set (D-set) was 0.888 while that in the validation set (V-set) was 0.812. Neutrophil/lymphocyte ratio and glypican-3 (+) were risk factors for LR in HCC patients after curative hepatectomy. The AUC of the ROC curve for LR predictive nomogram that integrated all independent predictors was 0.831. The AUC of the ROC curve for LR in the D-set was 0.833, while that for LR in the V-set was 0.733. The C-index and AUC of ROC for the proposed nomograms were more satisfactory than three conventional HCC staging systems used in this study. Conclusion We developed novel nomograms to predict ER and LR of HCC patients after curative hepatectomy for clinical use to individualize follow-up and therapeutic strategies.
Influence of systematic variations of the stimulation profile on responses evoked with a vestibular implant prototype in humans

Objective. To explore the impact of different electrical stimulation profiles in human recipients of the Geneva-Maastricht vestibular implant prototypes. Approach. Four implanted patients were recruited for this study. We investigated the relative efficacy of systematic variations of the electrical stimulus profile (phase duration, pulse rate, baseline level, modulation depth) in evoking vestibulo-ocular (eVOR) and perceptual responses. Main results. Shorter phase durations and, to a lesser extent, slower pulse rates allowed maximizing the electrical dynamic range available for eliciting a wider range of intensities of vestibular percepts. When either the phase duration or the pulse rate was held constant, current modulation depth was the factor that had the most significant impact on peak velocity of the eVOR. Significance. Our results identified important parametric variations that influence the measured responses. Furthermore, we observed that not all vestibular pathways seem equally sensitive to the electrical stimulus when the electrodes are placed in the semicircular canals and monopolar stimulation is used. This opens the door to evaluating new stimulation strategies for a vestibular implant, and suggests the possibility of selectively activating one vestibular pathway or the other in order to optimize rehabilitation outcomes.
Tc-99m TRODAT-1 SPECT Is a Potential Biomarker for Restless Leg Syndrome in Patients with End-Stage Renal Disease

Rationales: Restless leg syndrome (RLS) is a common complication in patients with end-stage renal disease (ESRD). However, there is a lack of biomarkers linking uremic RLS to dopaminergic neurons. Previous studies demonstrated that Tc-99m TRODAT-1 SPECT was a biomarker for RLS but the correlation between the physiologic parameter was lacking. Methods: Overall, 32 patients were enrolled in the study and divided into the following 3 groups: (1) control (n = 13), (2) ESRD without RLS (n = 8) and (3) ESRD with RLS (n = 11). All patients had a clinical diagnosis of RLS and received Tc-99m TRODAT-1 SPECT. A subgroup analysis was performed to compare differences between the control and ESRD with RLS groups. Tc-99m TRODAT-1 SPECT was performed and activities in the striatum and occipital areas were measured using manually delineated regions of interest (ROIs) by an experienced nuclear medicine radiologist who was blinded to clinical data. Results: The total ratio of Tc-99m TRODAT SPECT was lower in the ESRD with RLS group (p = 0.046). The uptake ratio of TRODAT negatively correlated with serum parathyroid hormone (r = −0.577, p = 0.015) and ferritin (r = −0.464, p = 0.039) concentrations. However, the uptake positively correlated with the hemoglobin concentration (r = 0.531, p = 0.011). The sensitivity and specificity of the total TRODAT ratio for predicting RLS in the overall population were 95.0% and 67.7%, respectively, at a cutoff value of 0.980 (area under the curve of receiver operating characteristic curve was 0.767, p = 0.024). Conclusion: In patients with ESRD and RLS, Tc-99m TRODAT might be a potential biomarker. Dysregulated hemoglobin, serum parathyroid hormone and serum ferritin concentrations might influence the uptake of the TRODAT ratio.
Comparative Structure-Property Characterization of Poly(3-Hydroxybutyrate-Co-3-Hydroxyvalerate)s Films under Hydrolytic and Enzymatic Degradation: Finding a Transition Point in 3-Hydroxyvalerate Content

The hydrolytic and enzymatic degradation of polymer films of poly(3-hydroxybutyrate) (PHB) of different molecular mass and its copolymers with 3-hydroxyvalerate (PHBV) of different 3-hydroxyvalerate (3-HV) content and molecular mass, 3-hydroxy-4-methylvalerate (PHB4MV), and polyethylene glycol (PHBV-PEG) produced by the Azotobacter chroococcum 7B by controlled biosynthesis technique were studied under in vitro model conditions. The changes in the physicochemical properties of the polymers during their in vitro degradation in the pancreatic lipase solution and in phosphate-buffered saline for a long time (183 days) were investigated using different analytical techniques. A mathematical model was used to analyze the kinetics of hydrolytic degradation of poly(3-hydroxyaklannoate)s by not autocatalytic and autocatalytic hydrolysis mechanisms. It was also shown that the degree of crystallinity of some polymers changes differently during degradation in vitro. The total mass of the films decreased slightly up to 8–9% (for the high-molecular weight PHBV with the 3-HV content 17.6% and 9%), in contrast to the copolymer molecular mass, the decrease of which reached 80%. The contact angle for all copolymers after the enzymatic degradation decreased by an average value of 23% compared to 17% after the hydrolytic degradation. Young’s modulus increased up to 2-fold. It was shown that the effect of autocatalysis was observed during enzymatic degradation, while autocatalysis was not available during hydrolytic degradation. During hydrolytic and enzymatic degradation in vitro, it was found that PHBV, containing 5.7–5.9 mol. % 3-HV and having about 50% crystallinity degree, presents critical content, beyond which the structural and mechanical properties of the copolymer have essentially changed. The obtained results could be applicable to biomedical polymer systems and food packaging materials.
Pre-Operative Imaging can Reduce Negative Appendectomy Rate in Acute Appendicitis

ABSTRACT Introduction Acute appendicitis is a common surgical emergency, with a prevalence of 112 per 100,000 people per year in Europe. Negative appendicectomy is defined as a pathologically normal appendix removed from patient suspected with appendicitis. Negative appendectomy rate (NAR) has been reported to be around 15-25%. We aimed to evaluate our unit's negative appendectomy rate and the effect of pre-operative imaging on NAR. Method A retrospective study including all patients who underwent both open and laparoscopic emergency appendicectomy in a single district general hospital from 2017-2018. Clinical information including cost was calculated based on the 2017/18 national tariff payment system. Patients under 18 years old were excluded from this study. Results Two hundred thirty-two patients were included in this study, of which 69 (29.74%) had a pre-operative CT scan. The mean length of stay was 2.57 days. The sensitivity, specificity, positive predictive value and negative predictive value for CT were 77.8%, 100%, 87.5% and 100%. The negative appendicectomy rate with and without pre-operative CT scan were 7.25% and 22.09% respectively. Based on the 2017/18 national tariff payment system, a CT abdomen and pelvis with contrast and emergency appendicectomy with CC score of 0 cost 92 and 2370 pounds respectively. The total cost of patients who underwent appendicectomy without imaging was £ 322,320. If all patients undergo pre-operative CT, with a reduction of 15% in negative appendicectomy rate, the overall total cost would significantly lower to £ 36,212. Conclusion Our study demonstrated that the negative appendicectomy rate could be improved by preoperative imaging. The study also showed that implementation of preoperative imaging for suspected appendicitis cases could save costs, allowing better allocation of resources.
Controversial treatments: An updated understanding of the coronavirus disease 2019

Abstract An outbreak of severe acute respiratory syndrome‐related coronavirus 2 infection has posed significant threats to international health and the economy. In the absence of specific treatment for this virus, there is an urgent need to learn from the experience and lessons in China. To reduce the case‐fatality rate among coronavirus disease 2019 patients, we should not ignore the complications, such as RNAaemia, acute respiratory distress syndrome, and multiple organ dysfunction. To help understand the advantages and limitations of differential treatments, we provide a timely review and discuss the complications and corresponding major treatments, especially controversial ones such as antiviral therapy (remdesivir, ribavirin, and chloroquine), glucocorticoid therapy, extracorporeal support including an artificial liver system, and extracorporeal membrane oxygenation based on available evidence. As a result, we suggest that antiviral therapy and organ function support are vital to reduce mortality for mild patients and critical patients, respectively.
Does body mass index affect the rate of adverse outcomes in total hip and knee arthroplasty? A retrospective review of a total joint replacement database

Background Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are reliable surgical options to treat pain and disability resulting from degenerative conditions around the hip and knee. Obesity is a modifiable risk factor that contributes to significant morbidity. The purpose of this study was to retrospectively compare outcomes in primary hip and knee arthroplasty for patients with increased body mass index (BMI) and those with normal BMI, using data from the registry of the Alberta Bone and Joint Health Institute (ABJHI). Methods We retrospectively reviewed the data compiled in the ABJHI registry between March 2010 and July 2016. We reviewed outcomes with respect to length of stay, discharge destination, 30-day readmission, postoperative infection, postoperative transfusion requirements, postoperative adverse events and in-hospital postoperative mechanical complications. Results A total of 10 902 patients (6076 women, 4826 men) who underwent THA and 16 485 patients (10 057 women, 6428 men) who underwent TKA were included in the study. For both THA and TKA, patients with increased BMI had an increased number of in-hospital medical events, had an increased rate of deep infection, were less likely to be discharged home (p < 0.001) and had decreased transfusion requirements (p < 0.001) than patients whose weight was in the normal range. Increased BMI increased the rate of 30-day readmission and length of stay in the THA cohort but not in the TKA cohort. Increased BMI had no effect on acute postoperative dislocation or periprosthetic fractures. Patients with a BMI of 30 kg/m2 or greater required a THA 1.7 years earlier than patients of normal weight, patients whose BMI was 35 kg/m2 or greater required a THA 3.4 years earlier, and patients whose BMI was 40 kg/m2 or greater required a THA 5.8 years earlier. In the TKA cohort, patients with a BMI of 30 kg/m2 or greater required a TKA 2.7 years earlier than patients whose weight was in the normal range, patients with a BMI of 35 kg/m2 or greater required a TKA 4.6 years earlier, and patients whose BMI was 40 kg/m2 or greater required a TKA 7.6 years earlier. Conclusion Our study quantifies the effects of obesity in primary hip and knee arthroplasty. It provides a greater understanding of the risks in the obese population when contemplating joint arthroplasty.
The oral health of patients with acute coronary syndrome confirmed by means of coronary angiography.

AIM The aim of the study was analyses the relationship between oral health and acute coronary syndrome confirmed by coronary angiography. MATERIALS AND METHODS The participants were recruited from patients who had undergone coronary angiography in the Cardiology Department. The study included 128 patients: 68 in a study group - with acute coronary syndrome (ACS-group) and 60 in a control group - no changes in coronary vessels detected by coronary angiography (H-group). A detailed clinical dental examination was performed. The following symptoms of periodontal pathologies were assessed: gingival bleeding, tooth mobility, gingival swelling, changes in gingival colour, a burning sensation in the oral mucosa, the presence of pus, and the need for antibiotic therapy. Moreover, the patients' oral health was assessed on the basis of the following dental indices: Plaque Index (PlI), Approximal Plaque Index (API), their periodontal health on the basis of the following indices - Gingival Index (GI), Community Periodontal Index of Treatment Needs (CPITN), and their dental health on the basis of the following components of the DMF-T index: (D-T) - decayed, missing and filled teeth, (F-T) - filled teeth and (M-T) - missing teeth. RESULTS Oral health in the study group was worse to a degree that was statistically significant in all the indices examined, excluding the filled teeth index (F-T), where there was no statistical significance compared to the control group. CONCLUSIONS The oral health of patients from the ACS group was significantly worse compared to the H-group.
Antimicrobial activity of RP-1 peptide conjugate with ferrocene group

Parasitic diseases are a neglected and serious problem, especially in underdeveloped countries. Among the major parasitic diseases, Leishmaniasis figures as an urgent challenge due to its high incidence and severity. At the same time, the indiscriminate use of antibiotics by the population is increasing together with resistance to medicines. To address this problem, new antibiotic-like molecules that directly kill or inhibit the growth of microorganisms are necessary, where antimicrobial peptides (AMPs) can be of great help. In this work, the ferrocene molecule, one active compound with low levels of in vivo toxicity, was coupled to the N-terminus of the RP1 peptide (derived from the human chemokine CXCL4), aiming to evaluate how this change modifies the structure, biological activity, and toxicity of the peptide. The peptide and the conjugate were synthesized using the solid phase peptide synthesis (SPPS). Circular dichroism assays in PBS showed that the RP1 peptide and its conjugate had a typical spectrum for disordered structures. The Fc-RP1 presented anti-amastigote activity against Leishmania amazonensis (IC50 = 0.25 μmol L–1). In comparison with amphotericin B, a second-line drug approved for leishmaniasis treatment, (IC50 = 0.63 μmol L-1), Fc-RP1 was more active and showed a 2.5-fold higher selectivity index. The RP1 peptide presented a MIC of 4.3 μmol L-1 against S. agalactiae, whilst Fc-RP1 was four times more active (MIC = 0.96 μmol L-1), indicating that ferrocene improved the antimicrobial activity against Gram-positive bacteria. The Fc-RP1 peptide also decreased the minimum inhibitory concentration (MIC) in the assays against E. faecalis (MIC = 7.9 μmol L-1), E. coli (MIC = 3.9 μmol L-1) and S. aureus (MIC = 3.9 μmol L-1). The cytotoxicity of the compounds was tested against HaCaT cells, and no significant activity at the highest concentration tested (500 μg. mL-1) was observed, showing the high potential of this new compound as a possible new drug. The coupling of ferrocene also increased the vesicle permeabilization of the peptide, showing a direct relation between high peptide concentration and high carboxyfluorescein release, which indicates the action mechanism by pore formation on the vesicles. Several studies have shown that ferrocene destabilizes cell membranes through lipid peroxidation, leading to cell lysis. It is noteworthy that the Fc-RP1 peptide synthesized here is a prototype of a bioconjugation strategy, but it still is a compound with great biological activity against neglected and fish diseases.
The effect of β-carotene on the mortality of male smokers is modified by smoking and by vitamins C and E: evidence against a uniform effect of nutrient

A previous analysis of the Alpha-Tocopherol Beta-Carotene (ATBC) Study on male smokers found that β-carotene supplementation increased the risk of pneumonia 4-fold in those who started smoking at the age of ≥21 years and smoked ≥21 cigarettes/d (a subgroup of 7 % of the study population). The present study hypothesised that β-carotene increases mortality in the same subgroup. The ATBC Study (1985–1993) recruited 29 133 Finnish male smokers (≥5 cigarettes/d) aged 50–69 years. Cox regression models were constructed to estimate the effect of β-carotene supplementation in subgroups. β-Carotene increased mortality (risk ratio 1·56; 95 % CI 1·06, 2·3) in those who started to smoke at ≥21 years and smoked ≥21 cigarettes/d. Within this subgroup, there was strong evidence of further heterogeneity. The effect of β-carotene supplementation was further modified by dietary vitamin C intake, fruit and vegetable intake (P = 0·0004), and by vitamin E supplementation (P = 0·011). Thus, harm from β-carotene was not uniform within the study population. Interactions between β-carotene and vitamins C and E were seen only within a subgroup of 7 % of the ATBC participants, and therefore should not be extrapolated to the general population. Heterogeneity of the β-carotene effect on mortality challenges the validity of previous meta-analyses that have pooled many diverse antioxidants for one single estimate of effect using the assumption that a single estimate equally applies to all antioxidants and all people. Trial registration: ClinicalTrials.gov NCT00342992.
Pre-adult aggression and its long-term behavioural consequences in crickets

Social experience, particularly aggression, is considered a major determinant of consistent inter-individual behavioural differences between animals of the same species and sex. We investigated the influence of pre-adult aggressive experience on future behaviour in male, last instar nymphs of the cricket Gryllus bimaculatus. We found that aggressive interactions between male nymphs are far less fierce than for adults in terms of duration and escalation. This appears to reflect immaturity of the sensory apparatus for releasing aggression, rather than the motor system controlling it. First, a comparison of the behavioural responses of nymphs and adults to mechanical antennal stimulation using freshly excised, untreated and hexane-washed antennae taken from nymphs and adults, indicate that nymphs neither respond to nor produce sex-specific cuticular semiochemicals important for releasing aggressive behaviour in adults. Second, treatment with the octopamine agonist chlordimeform could at least partially compensate for this deficit. In further contrast to adults, which become hyper-aggressive after victory, but submissive after defeat, such winner and loser effects are not apparent in nymphs. Aggressive competition between nymphs thus appears to have no consequence for future behaviour in crickets. Male nymphs are often attacked by adult males, but not by adult females. Furthermore, observations of nymphs raised in the presence, or absence of adult males, revealed that social subjugation by adult males leads to reduced aggressiveness and depressed exploratory behaviour when the nymphs become adult. We conclude that social subjugation by adults during pre-adult development of nymphs is a major determinant of consistent inter-individual behavioural differences in adult crickets.