Miracle-dz/UniFAR-FTUs huggingface dataset:
Mechanical properties and microstructural organization of common ulnar collateral ligament grafts: Palmaris longus and gracilis tendons

Ulnar collateral ligament (UCL) injuries are becoming increasingly common. The palmaris longus (PL) and gracilis (GR) tendons are the most common grafts used in UCL reconstructions. While clinical studies have demonstrated relatively similar outcomes for either graft, there is little quantitative data describing these grafts from a material perspective, specifically the mechanical and microstructural properties of these tissues and how they respond under dynamic loading. The purpose of this descriptive laboratory study was to quantify and compare the mechanical and microstructural properties of PL and GR tendons. A total of 13 PL and 11 GR cadaveric human tendons were obtained. Each specimen was divided into three subregions and subjected to preconditioning, ramp‐and‐hold stress‐relaxation and ramp‐to‐failure testing. Mechanical parameters were computed for each sample, and a polarized light imaging technique was used to simultaneously evaluate dynamic microstructural properties during testing. The PL had larger toe‐ and linear‐region modulus values than the GR. Within the GR, the distal subregion had stronger collagen alignment than the proximal subregion at the zero, transition and linear portions of the stress‐strain curve. The PL and GR, have similar mechanical properties and similar microstructural alignment under load. The PL graft has similar properties throughout its length whereas the GR properties exhibited slight differences in strength of alignment along its length. The PL and GR exhibit larger moduli values and more strongly/uniformly aligned collagenous microstructure when qualitatively compared to data previously published on the native UCL.
Predictors of perirenal haematoma post-percutaneous ultrasound-guided renal biopsy

Objective To perform a prospective study to determine the risk factors associated with perirenal haematoma development after percutaneous renal biopsy (PRB). Methods This multivariate prospective study collected demographic and clinical data from all consecutive adult patients that underwent real-time ultrasound-guided PRB of native kidneys. All biopsies were performed by two well-trained ultrasound physicians using 16G biopsy needles. Routine renal ultrasounds were performed within 12–24 h after biopsies in order to observe post-biopsy perirenal haematoma formation. Patients were stratified based on the occurrence of post-biopsy haematoma development. Results This prospective study enrolled 218 patients and stratified them into a haematoma group (n = 126) and a non-haematoma group (n = 92). Binary logistic regression analysis identified female patients (odds ratio [OR] 1.990; 95% confidence interval [CI] 1.125, 3.521), patients with a body mass index (BMI) ≥28 kg/m2 (OR 2.660; 95% CI 1.097, 6.449) and patients with immediate post-biopsy active bleeding (IPAB) (OR 2.572; 95% CI 1.422, 4.655) as being more likely to have perirenal haematoma after real-time ultrasound guided PRB of native kidneys. Conclusion Female sex, a BMI ≥28 kg/m2 and IPAB were risk factors for perirenal haematoma after real-time ultrasound-guided PRB of native kidneys.
The prevalence and characteristics of visceral autonomic symptoms among migraineurs: A population-based study

Background There is limited evidence about visceral autonomic symptoms in the different phases of migraine attack. We evaluated the prevalence of these symptoms in migraineurs before, during, and after headache attacks. In addition, the association between migraine characteristics and visceral autonomic symptoms was investigated. Methods A total of 605 participants who met the entry criteria were enrolled prospectively in this cross-sectional study. Participants were 18–60 years old and met the ICHD-3 criteria for migraine with or without aura. Information on the migraine symptoms was gathered from all participants in face-to-face interviews. A structured questionnaire was used to evaluate the related symptoms before, during, and after attacks. Migraine features of frequency, duration, and severity were also assessed. Results Considering all phases, the most commonly present visceral symptom was nausea (52.9%). About half of participants reported at least one visceral symptom before the onset of attacks. While, during and after attacks, 71% and 36% of participants reported such characteristics, respectively. Notably, the migraine headache in participants with visceral symptoms was longer during attacks compared to participants without them (24.4 ± 29.6 vs. 16.8 ± 19.8; P = 0.008). Additionally, subjects with positive visceral symptoms experienced more severe migraine attacks than participants without symptoms for both the premonitory (8 ± 1.7 vs. 7.6 ± 1.8; P = 0.02) and during-attack (8.01 ± 1.7 vs. 7.09 ± 1.9; P = 0.001) phases. Conclusion This study demonstrated that visceral symptoms were common in migraine sufferers not only during attacks but also in the premonitory and postdrome phases. Positive visceral symptoms were also associated with more burdensome headache attacks. Therefore, recognizing the phenotypic presentation of associated symptoms of migraine, especially during the pre-attack phase, could aid in early implementation of optimal management.
3‐Aminopyrazolo[3,4‐b]pyridine: Effective Precursor for Barium Hydroxide‐Mediated Three Components Synthesis of New Mono‐ and Bis(pyrimidines) with Potential Cytotoxic Activity

In this study, an efficient one‐pot procedure for preparing a new series of pyrazolo[3,4‐b]pyridine‐fused pyrimidines was described. The target hybrids were developed through a three‐component reaction of 3‐amino‐1H‐pyrazolo[3,4‐b]pyridine, benzaldehydes, and acetophenones (molar ratio 1 : 1 : 1). The best conditions for the previous reaction were 2.5 equivalents of barium hydroxide in DMF at 150 °C for 6 h. New bis(pyrimidines) were synthesized in high yields using a similar one‐pot reaction protocol with some modifications. Thus, two equivalents of each of the appropriate acetophenones and 3‐aminopyrazolopyridine were reacted with one equivalent of the appropriate bis(aldehydes). The reaction was carried out at 150 °C for 8 h using 4.5 equivalents of barium hydroxide in DMF. Repeating the previous reaction with the appropriate bis(acetyl) derivatives and benzaldehydes resulted in good yields of the target bis(pyrimidines). The in vitro cytotoxic activity of new pyrimidines against the MCF‐7, HEPG2, and Caco2 cell lines was evaluated using the reference doxorubicin (IC50 values of 4.34–6.97 μM). Hybrid 6h had the best activity against Caco2 and MCF‐7 cell lines, IC50 values of 12.62 and 14.50 μM, respectively. The IC50 values for hybrids 6c, 6e, and 6f against MCF‐7 and Caco2 cell lines were 23.99–41.69 and 33.14–43.33 μM, respectively. Furthermore, hybrid 6e displayed IC50 value of 20.06 μM HEPG2 cell lines, while the hybrids 6c, 6f and 6h exhibited IC50 values ranging between 26.29–50.51 μM. Furthermore, hybrid 6e had an IC50 value of 20.06 μM for the HEPG2 cell lines, whereas hybrids 6c, 6f, and 6h had IC50 values ranging from 26.29 to 50.51 μM.
Pain thresholds and suprathreshold pain after sleep restriction in migraine – A blinded crossover study

Objective There is an unexplained association between disturbed sleep and migraine. In this blinded crossover study, we investigate if experimental sleep restriction has a different effect on pain thresholds and suprathreshold pain in interictal migraineurs and controls. Methods Forearm heat pain thresholds and tolerance thresholds, and trapezius pressure pain thresholds and suprathreshold pain were measured in 39 interictal migraineurs and 31 healthy controls after two consecutive nights of partial sleep restriction and after habitual sleep. Results The effect of sleep restriction was not significantly different between interictal migraineurs and controls in the primary analyses. Pressure pain thresholds tended to be lower (i.e., increased pain sensitivity) after sleep restriction in interictal migraineurs compared to controls with a 48-hour preictal-interictal cut-off (p = 0.061). We found decreased pain thresholds after sleep restriction in two of seven migraine subgroup comparisons: heat pain thresholds decreased in migraineurs with lower pain intensity during attacks (p = 0.005) and pressure pain thresholds decreased in migraineurs with higher severity of photophobia during attacks (p = 0.031). Heat pain thresholds tended to decrease after sleep restriction in sleep-related migraine (p = 0.060). Sleep restriction did not affect suprathreshold pain measurements in either group. Conclusion This study could not provide strong evidence for an increased effect of sleep restriction on pain sensitivity in migraineurs compared to healthy controls. There might be a slightly increased effect of sleep restriction in migraineurs, detectable using large samples or more pronounced in certain migraine subgroups.
Reliability and Validity of the Traditional Chinese Version of the Advance Care Planning Engagement Survey: A Pilot Evaluation in Taiwanese Outpatients

Objective: The Advance Care Planning Engagement Survey (ACP-ES) has proven effective in evaluating individuals’ engagement in advance care planning (ACP). However, a Traditional Chinese version of ACP-ES (ACPES-TC) has not yet been developed. Therefore, this study aimed to translate and preliminarily validate the ACPES-TC in the Taiwanese context. Material and Methods: A forward and backward translation process was conducted. The translated questionnaire was confirmed by clinical and academic experts. The ACPES-TC was then evaluated for its reliability and validity with participants in the community and from an outpatient clinic in a medical center in Northern Taiwan. The participants comprised healthy people aged 20 to 30 years and patients ≥55 years old, recruited from September 17 to October 28, 2019. Results: Seventy people were recruited, including 20 people aged 20 to 30 years in the community and 50 patients ≥ 55 years old from clinics. The ACPES-TC scores are significantly higher among those of older age, having financial independence, and under long-term medication (p < .05). The patients’ preference for health-related decision-making is significantly correlated with the ACPES-TC score; the point-biserial correlation coefficient is 0.46 (p < .001). The discriminant and criterion-related validities are verified. The ACPES-TC demonstrated a good internal consistency (Cronbach's α .97), acceptable one-week test-retest reliability (overall intraclass correlation coefficient 0.86), and low practice effect between the test and retest (Cohen's d .43). Conclusion: The overall reliability and validity of the ACPES-TC are fair, which could be used to evaluate the patients’ engagement in ACP in Taiwan. However, further studies with a full-scale psychometric evaluation are needed.
In vitro and in silico antioxidant and anti-inflammatory potential of essential oil of Cymbopogon citratus (DC.) Stapf. of North-Western Himalaya

Abstract Cymbopogon citratus (DC.) Stapf is an aromatic perennial herb of Gramineae (Poaceae) family and is known for its application in food and healthcare industry. The present study aimed to evaluate anti-inflammatory and antioxidant potential of C. citratus essential oil (CEO) through in vitro and in silico studies. Chemical characterization of CEO was done using Gas chromatography-mass spectrophotometry (GC-MS) method. In vitro antioxidant activity was evaluated by 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2, 2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid (ABTS) and ferric ion reducing antioxidant power (FRAP) assays, while egg albumin denaturation method was used to evaluate in vitro anti-inflammatory activity of CEO. Molecular docking investigation of major phytocompounds of CEO was done using Autodock vina software against human peroxiredoxin 5 (PDB ID: 1HD2) and human cyclooxygenase 2 (PDB ID: 5IKQ) proteins, which were further analyzed through molecular dynamics (MD) simulation using YASARA. GC-MS analysis of CEO showed the presence of geranial (48%) neral (34.04%), β-myrcene (9.77%), geraniol (1.88%), linalool (0.84%), isogeranial (0.81%), β-caryophyllene (0.80%), D-limonene (0.51%) as major constituents. CEO showed significant antioxidant activity with DPPH (IC50-47.53 ± 2.16 µg/ml), FRAP (IC50-30.7 ± 0.31 µM), and ABTS assays (IC50-27.87 ± 0.09 µg/ml). CEO also exhibited significant in-vitro anti-inflammatory activity with IC50-29.71 ± 1.95 µg/ml as compared to that of Diclofenac sodium (IC50-36.52 ± 1.95 µg/ml). Molecular docking revealed that β-caryophyllene showed considerable binding potential with human peroxiredoxin 5 receptor (-6.0 kcal/mol) and human cyclooxygenase 2 receptor (-10.1 kcal/mol). Further, MD simulations demonstrated considerable and stable interactions of β-caryophyllene with 1HD2 and 5IKQ proteins up to 100 ns. Drug-likeness and ADME/T features also showed that β-caryophyllene can be used as a potential candidate to replace the synthetic anti-inflammatory drugs with side effects and also act as natural antioxidants. Communicated by Ramaswamy H. Sarma
Clinical Effectiveness of Elexacaftor/Tezacaftor/Ivacaftor in People with Cystic Fibrosis: A Clinical Trial

Rationale The cystic fibrosis (CF) modulator drug, elexacaftor/tezacaftor/ivacaftor (ETI), proved highly effective in controlled clinical trials for individuals with at least one F508del allele, which occurs in at least 85% of people with CF. Objectives PROMISE is a postapproval study to understand the broad effects of ETI through 30 months’ clinical use in a more diverse U.S. patient population with planned analyses after 6 months. Methods Prospective, observational study in 487 people with CF age 12 years or older with at least one F508del allele starting ETI for the first time. Assessments occurred before and 1, 3, and 6 months into ETI therapy. Outcomes included change in percent predicted FEV1 (ppFEV1), sweat chloride concentration, body mass index (BMI), and self-reported respiratory symptoms. Measurements and Main Results Average age was 25.1 years, and 44.1% entered the study using tezacaftor/ivacaftor or lumacaftor/ivacaftor, whereas 6.7% were using ivacaftor, consistent with F508del homozygosity and G551D allele, respectively. At 6 months into ETI therapy, ppFEV1 improved 9.76 percentage points (95% confidence interval [CI], 8.76 to 10.76) from baseline, cystic fibrosis questionnaire–revised respiratory domain score improved 20.4 points (95% CI, 18.3 to 22.5), and sweat chloride decreased −41.7 mmol/L (95% CI, −43.8 to −39.6). BMI also significantly increased. Changes were larger in those naive to modulators but substantial in all groups, including those treated with ivacaftor at baseline. Conclusions ETI by clinical prescription provided large improvements in lung function, respiratory symptoms, and BMI in a diverse population naive to modulator drug therapy, using existing two-drug combinations, or using ivacaftor alone. Each group also experienced significant reductions in sweat chloride concentration, which correlated with improved ppFEV1 in the overall study population. Clinical trial registered with www.clinicaltrials. gov (NCT NCT04038047).
Serum lactate levels in cirrhosis and non-cirrhosis patients with septic shock

Background In septic shock patients with cirrhosis, impaired liver function might decrease lactate elimination and produce a higher lactate level. This study investigated differences in initial lactate, lactate clearance, and lactate utility between cirrhotic and non-cirrhotic septic shock patients. Methods This is a retrospective cohort study conducted at a referral, university-affiliated medical center. We enrolled adults admitted during 2012–2018 who satisfied the septic shock diagnostic criteria of the Surviving Sepsis Campaign: 2012. Patients previously diagnosed with cirrhosis by an imaging modality were classified into the cirrhosis group. The initial lactate levels and levels 6 hours after resuscitation were measured and used to calculate lactate clearance. We compared initial lactate, lactate at 6 hours, and lactate clearance between the cirrhosis and non-cirrhosis groups. The primary outcome was in-hospital mortality. Results Overall 777 patients were enrolled, of whom 91 had previously been diagnosed with cirrhosis. Initial lactate and lactate at 6 hours were both significantly higher in cirrhosis patients, but there was no difference between the groups in lactate clearance. A receiver operating characteristic curve analysis for predictors of in-hospital mortality revealed cut-off values for initial lactate, lactate at 6 hours, and lactate clearance of >4 mmol/L, >2 mmol/L, and <10%, respectively, among non-cirrhosis patients. Among patients with cirrhosis, the cut-off values predicting in-hospital mortality were >5 mmol/L, >5 mmol/L, and <20%, respectively. Neither lactate level nor lactate clearance was an independent risk factor for in-hospital mortality among cirrhotic and non-cirrhotic septic shock patients. Conclusions The initial lactate level and lactate at 6 hours were significantly higher in cirrhosis patients than in non-cirrhosis patients.
Spiking Characteristics of Network-Mediated Responses Arising in Direction-Selective Ganglion Cells of Rabbit and Mouse Retinas to Electric Stimulation for Retinal Prostheses

To restore the sight of individuals blinded by outer retinal degeneration, numerous retinal prostheses have been developed. However, the performance of those implants is still hampered by some factors including the lack of comprehensive understanding of the electrically-evoked responses arising in various retinal ganglion cell (RGC) types. In this study, we characterized the electrically-evoked network-mediated responses (hereafter referred to as electric responses) of ON-OFF direction-selective (DS) RGCs in rabbit and mouse retinas for the first time. Interestingly, both species in common demonstrated strong negative correlations between spike counts of electric responses and direction selective indices (DSIs), suggesting electric stimulation activates inhibitory presynaptic neurons that suppress null direction responses for high direction tuning in their light responses. The DS cells of the two species showed several differences including different numbers of bursts. Also, spiking patterns were more heterogeneous across DS RGCs of rabbits than those of mice. The electric response magnitudes of rabbit DS cells showed positive and negative correlations with ON and OFF light response magnitudes to preferred direction motion, respectively. But the mouse DS cells showed positive correlations in both comparisons. Our Fano Factor (FF) and spike time tiling coefficient (STTC) analyses revealed that spiking consistencies across repeats were reduced in late electric responses in both species. Moreover, the response consistencies of DS RGCs were lower than those of non-DS RGCs. Our results indicate the species-dependent retinal circuits may result in different electric response features and therefore suggest a proper animal model may be crucial in prosthetic researches.
Variations in Guidelines for Diagnosis of Child Physical Abuse in High-Income Countries

Key Points Question Are clinical guidelines for the early detection and diagnostic workup of child physical abuse complete, clear, and consistent across high-income countries? Findings In this systematic review that included 20 clinical guidelines issued in 15 countries, guidelines were clear but incomplete and discrepant, particularly in the definition of sentinel injuries and in recommendations for exploratory laboratory testing and advanced imaging. Meaning This systematic review found a lack of standardized guidelines for the identification and management of child physical abuse, which may contribute to practice variation.
The effect of stigma on social participation in community-dwelling Chinese patients with stroke sequelae: A cross-sectional study

Objective To explore the effect of stigma on social participation in community-dwelling Chinese patients with stroke sequelae. Design A cross-sectional survey study. Setting The study was conducted in two community centres in Tianjin, China. Subjects Community-dwelling Chinese patients with stroke sequelae. Measures Chinese version of Stigma Scale for Chronic Illness, Chinese version of Impact on Participation and Autonomy, Modified Barthel index, Self-Rating Depression Scale, Social Support Rating Scale, Medical Coping Modes Questionnaire, background and disease-related questions. Pearson’s correlation coefficients were computed between stigma and social participation. The impact of stigma on social participation was estimated by hierarchical multiple regression analysis after controlling for demographic, physical and psychosocial characteristics. Results In total, 136 patients with stroke sequelae were included in this study, with a mean age of 67.8 years. The Chinese version of the Stigma Scale for Chronic Illness had a mean score of 48.4 (SD 16.9), and the Chinese version of the Impact on Participation and Autonomy was 67.1 (SD 21.1). Significant correlations were found between stigma and social participation. Pearson’s correlation coefficient ranged from 0.354 to 0.605 (P < 0.01). Enacted stigma provided a significant explanation for the variance of social participation by 1.1% (P < 0.05). Felt stigma provided a significant explanation for the variance of social participation by 2.9% (P < 0.001). Conclusion Felt stigma and enacted stigma have independent associations with social participation. Patients with stroke sequelae who reported higher stigma experienced a lower level of social participation.
A severe case of Bosch–Boonstra–Schaaf optic atrophy syndrome with a novel description of coloboma and septo‐optic dysplasia, owing to a start codon variant in the NR2F1 gene

Bosch–Boonstra–Schaaf optic atrophy syndrome (BBSOAS) is a rare congenital syndrome characterized by a range of phenotypes including optic atrophy and intellectual disability among other features. Pathogenic variants in the NR2F1 (nuclear receptor subfamily 2 group F member 1) gene have been linked to this condition. A recent report has shown that pathogenic variants in the start codon lead to decreased expression of the NR2F1 protein and a relatively mild phenotype, similar to that seen in whole gene deletions, and due to the lack of the dominant negative effect. Here we describe a severe case of BBSOAS with an initiation codon missense variant. The developmental delay, seizures, optic atrophy are in keeping with features observed in this condition, however this is the first report to describe colobomas and septo‐optic dysplasia as associated features potentially extending the phenotype linked to BBSOAS. In addition, this is the first description of a severe phenotype linked to a de novo missense variant in the start codon of the NR2F1 gene.
Span of a Graph: Keeping the Safety Distance

Inspired by Lelek's idea from [Disjoint mappings and the span of spaces, Fund. Math. 55 (1964), 199 -- 214], we introduce the novel notion of the span of graphs. Using this, we solve the problem of determining the \emph{maximal safety distance} two players can keep at all times while traversing a graph. Moreover, their moves must be made with respect to certain move rules. For this purpose, we introduce different variants of a span of a given connected graph. All the variants model the maximum safety distance kept by two players in a graph traversal, where the players may only move with accordance to a specific set of rules, and their goal: visit either all vertices, or all edges. For each variant, we show that the solution can be obtained by considering only connected subgraphs of a graph product and the projections to the factors. We characterise graphs in which it is impossible to keep a positive safety distance at all moments in time. Finally, we present a polynomial time algorithm that determines the chosen span variant of a given graph.