Miracle-dz/UniFAR-FTUs huggingface dataset:
Mechanical or chemical and mechanical pleurodesis for spontaneous pneumothorax: what is the most effective approach in preventing recurrence? A systematic review and meta-analysis.

OBJECTIVES Surgical management of spontaneous pneumothorax typically involves wedge resection and mechanical pleurodesis. It is unclear whether combining mechanical and chemical pleurodesis can further reduce the recurrence rate. We have performed a meta-analysis of studies comparing the combined approach with mechanical pleurodesis alone. METHODS A comprehensive search of the existing literature was performed using PubMed, EMBASE and Web of Science for all types of studies that compared combined pleurodesis to a single approach. We used the Cochrane Risk of Bias Tool and Strengthening The Reporting of OBservational Studies in Epidemiology (STROBE) to assess the quality of the studies. Relative risk of pneumothorax recurrence was calculated, and the differences between the studies were examined. The primary outcome was the recurrence of pneumothorax. RESULTS Of 2301 eligible studies, 5 studies were included. Five hundred sixty-one patients who received combined pleurodesis were compared to 286 patients who received mechanical pleurodesis only. Patients treated with combined intervention had a 63% lower risk of developing a recurrent pneumothorax compared to single intervention [relative risk 0.37, 95% confidence interval (CI) 0.18-0.76; P = 0.006]. There were no statistically significant differences in the length of stay (standardized mean difference -0.17, 95% CI -0.39 to 0.05, P = 0.138), the duration of postoperative air leak (standardized mean difference 0.17, 95% CI -1.14 to 1.47, P = 0.804) or the duration of postoperative chest tube drainage (standardized mean difference -0.07, 95% CI -0.27 to 0.12, P = 0.471). CONCLUSIONS This meta-analysis demonstrated that combined intervention with mechanical and chemical pleurodesis for spontaneous pneumothorax may be more effective in preventing recurrence than mechanical pleurodesis alone. These findings will provide some guidance to surgeons in the decision-making process.
Spatial and Temporal Patterns of THM Precursors in a Eutrophic Reservoir

ABSTRACT Temporal and spatial patterns of trihalomethane (THM) precursors (measured as THM formation potential, THMFP) are described and analyzed for eutrophic Cannonsville Reservoir, NY, based on monitoring conducted weekly over the April to November interval of 1995 at three sites along the main axis of the reservoir. Ninety-eight percent of the precursors formed chloroform, and 94% were in a dissolved (0.45-μm filtrate) form. Distinct seasonal, vertical and longitudinal patterns were observed. Progressive increases in THMFP occurred from spring (~170 μg · L−1) through midsummer (~360 μg·L−1) in the epilimnion of the lacustrine zone of die reservoir, followed by subsequent decreases through early fell. Progressive, but smaller, increases in THMFP occurred in the hypolimnion throughout the period of stratification. Vertical patterns in dissolved THMFP within the hypolimnion indicate the sediments were not an important source of precursors to the water column. Summer epilimnetic concentrations of THMFP we.
Systematics and evolution of syllids (Annelida, Syllidae)

A large, combined phylogenetic analysis (including morphological and molecular data from 18S rDNA, 16S rDNA and cytochrome c oxidase subunit I), with the highest number of species and genera of Syllidae studied to date (213 terminals), is examined. The data were explored with different parameters and optimality criteria (parsimony, likelihood, and bayesian inference). The monophyly of Syllidae and most of the traditional subfamilies is supported. The subfamily Eusyllinae is polyphyletic, as currently delineated, but it is herein reorganized and its diagnosis modified to be a valid group. Additional well supported clades arise. The phylogenetic relationships of the well known and established genera, as well as several enigmatic genera (e.g. Anguillosyllis, Paraopisthosyllis and Parahaplosyllis), the position of which in syllid taxonomy was uncertain or dubious to date, are clarified. The results corroborate previous hypotheses about the evolution of the reproductive and brooding modes. Within Syllinae, the nature of the stolon is phylogenetically informative. The classification of the whole family is revised and discussed on the basis of this phylogenetic hypothesis.
Daily and temporal occurrence of Frankliniella spp. (Thysanoptera: Thripidae) on tomato

Daily occurrence and flight activity of Frankliniella spp. (Thysanoptera: Thripidae) in tomato fields was studied on five dates in 1990 and four dates in 1992. Higher number of Frankliniella occidentalis (Pergande) were observed on tomato flowers in the morning than in the afternoon on 3 of 5 and 2 of 4 sample dates in 1990 and 1992, respectively. Numbers of Frankliniella tritici (Fitch), Frankliniella fusca (Hinds) and immature thrips on flowers or foliage did not differ among sample hours. On tomato foliage, F. fusca and immature thrips were dominant, while few F. occidentalis or F. tritici were collected. Temperature was an important factor in the flight activity of F. tritici. Populations of F. tritici peaked earlier in the season and declined sooner than those of F. occidentalis. F. occidentalis and F. tritici both inhabited tomato flowers and subdivided this niche temporally, while F. fusca occupied a different niche, tomato foliage.
Seasonal Distribution, Abundance, and Growth of Larval Capelin (Mallotus villosus) in the St. Lawrence Estuary and Northwestern Gulf of St. Lawrence

Capelin (Mallotus villosus) larvae in the St. Lawrence estuary and northwestern Gulf of St. Lawrence were most abundant in 1974 and 1975 in the upper estuary in early June; this coincided with the spring peak in primary production. A spectacular decline (>99%) in larval abundance between June and September resulted principally from their downstream transport by currents. In October and November larval capelin were concentrated in a large counterclockwise gyre located in the northwestern Gulf between Anticosti Island and Pointe des Monts. This region is within the area of maximum primary production in the estuary and Gulf and may serve as an important feeding area for larval capelin. Length of capelin larvae at the end of the first growing season in the estuary and northwestern Gulf was greater than that of capelin from Newfoundland, Labrador, and Greenland. However, this difference may have resulted from sampling biases. Daily growth rates of capelin larvae from these areas were similar. Key words: capeli.
Grading Severity and Bother Using the IPSS and ICIQ-MLUTS Scores in Men Seeking Lower Urinary Tract Symptoms Therapy.

PURPOSE To establish severity banding ranges, bother assessment and key item content in principal patient reported outcomes measures (PROMs) in men seeking therapy for lower urinary tract symptoms (LUTS). MATERIALS AND METHODS Data for International Prostate Symptom Score (IPSS) and International Consultation on Incontinence Questionnaire Male LUTS (ICIQ-MLUTS) were derived from a study evaluating 820 men at 26 UK hospitals. Receiver operating characteristic (ROC) curves were used to establish severity bandings. RESULTS Classification tree showed that thresholds between mild-moderate and moderate-severe severity bands were 15 and 27 respectively for IPSS, 16 and 26 for ICIQ-MLUTS/severity, and 22 and 81 for ICIQ-MLUTS/bother. Highest area under ROC and lowest Akaike's information criteria of univariate logistic regression indicated that ICIQ-MLUTS/bother was more related to global quality of life (QoL) than were IPSS and ICIQ-MLUTS/severity. The symptoms affecting IPSS-QoL were only fully identified by ICIQ-MLUTS, because two key symptoms (urinary incontinence and post-micturition dribble) are not measured by IPSS. ICIQ-MLUTS demonstrated that bother of some LUTS is disproportionate to severity, and that persisting high bother levels following surgery are more likely due to storage (18-25%) and post-voiding (18-28%) LUTS than voiding LUTS (5-13%). Symptom improvement after surgery is uncertain if baseline IPSS-QoL score was <3. CONCLUSIONS The severity threshold scores were measured for the two key LUTS PROMs, and the results indicate suitable categories of symptom severity for use in men referred for urological care. The ICIQ-MLUTS measures all the LUTS affecting QoL, and includes individual symptom bother scores.
Recent advances in the rapid acoustic screening of deoxynivalenol in wheat grains

Deoxynivalenol (DON) is a natural and ubiquitous toxic metabolite produced by filamentous fungi of the genus Fusarium. Approximately one quarter of the world's food crops (mainly cereals) are affected by mycotoxins such as DON. A rapid and non-destructive method to evaluate the quality and safety of grains is therefore required to eliminate these toxins from the food chain. The first portable acoustic device that predicts the concentration of DON in cereal grains has been developed using a broadband capacitive ultrasonic transducer. An acoustic method was optimised for the rapid prediction of DON in wheat. To measure the performance of this method, a model system comprising 0-100% scabby wheat grains was prepared and a single laboratory validation was carried out. The best regression model between DON concentrations determined by the reference ELISA method and the acoustic technique was obtained at an acoustic frequency of 32.2 kHz, with a correlation coefficient of 0.9852 and a repeatability coefficient .
An Infant Presenting With Fever and Thrombocytopenia.

The Pediatric Infectious Disease Journal • Volume 39, Number 8, August 2020 www.pidj. com | 771 Accepted for publication May 12, 2020. From the Department of Pediatrics, DartmouthHitchcock Medical Center, Lebanon, New Hampshire. The authors have no funding or conflicts of interest to disclose. Address for correspondence: Meghan E. Reynolds, MD, Department of Pediatrics, 1 Medical Center Dr, Lebanon, NH 03756. E-mail: meghan.e. reynolds@hitchcock.org. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. Your Diagnosis, Please
Drug cost savings in phase III hematological oncology clinical trials in a university hospital

The rapid emergence of expensive anticancer therapies is leading to exponential growth in healthcare expenses. In clinical trials, most investigational drugs are provided free of charge by industrial and academic sponsors. This results in drug cost savings for healthcare payers, who are no longer charged with the cost of the standard‐of‐care treatment, which would have been administered outside the trial. This study aims to estimate drug cost savings resulting from patient enrolment in hematological oncology clinical trials, from a public payer perspective. Retrospective screening identified all patients with hematological malignancies included from 2011 to 2016 in a phase III trial and having received at least one sponsor‐provided cycle. Drug cost savings were defined as the standard treatment costs not charged to the payer due to sponsor provision of treatment. For each patient, cost savings were determined by the number of cycles received in the trial and the cost of standard (control arm) treatment. Of the 345 patients included in eligible trials during study period, 272 received sponsor‐provided drugs. Drug cost savings could be estimated for 177 patients (65.1%) included in 27 trials. Total cost savings were €5218 million (US$ 6804 million) for 1720 sponsor‐provided cycles. Mean cost saving per patient was €19 182.7 ± 29 865.7 ($25 015.24 ± 39 478.25). Most cost‐saving trials were industry‐sponsored (77.8%), although academic trials generated 40.15% of total cost savings. Enrolling patients in clinical trials, whether industry‐sponsored or academic, leads to substantial drug cost savings for payers. Implications are significant for public payers facing increasing financial constraints, as savings can be reallocated to patient care.
Mental Health Problems during the COVID-19 Pandemics and the Mitigation Effects of Exercise: A Longitudinal Study of College Students in China

(1) Background: The novel coronavirus disease 2019 (COVID-19) is a global public health emergency that has caused worldwide concern. Vast resources have been allocated to control the pandemic and treat patients. However, little attention has been paid to the adverse impact on mental health or effective mitigation strategies to improve mental health. (2) Purpose: The aim of this study was to assess the adverse impact of the COVID-19 outbreak on Chinese college students’ mental health, understand the underlying mechanisms, and explore feasible mitigation strategies. (3) Methods: During the peak time of the COVID-19 outbreak in China, we conducted longitudinal surveys of sixty-six college students. Structured questionnaires collected information on demographics, physical activity, negative emotions, sleep quality, and aggressiveness level. A mixed-effect model was used to evaluate associations between variables, and the mediating effect of sleep quality was further explored. A generalized additive model was used to determine the dose-response relationships between the COVID-19 death count, physical activity, and negative emotions. (4) Results: The COVID-19 death count showed a direct negative impact on general sleep quality (β = 1.37, 95% confidence interval [95% CI]: 0.55, 2.19) and reduced aggressiveness (β = −6.57, 95% CI: −12.78, −0.36). In contrast, the COVID-19 death count imposed not a direct but an indirect impact on general negative emotions (indirect effect (IE) = 0.81, p = 0.012), stress (IE = 0.40, p < 0.001), and anxiety (IE = 0.27, p = 0.004) with sleep quality as a mediator. Moreover, physical activity directly alleviated general negative emotions (β = −0.12, 95% CI: −0.22, −0.01), and the maximal mitigation effect occurred when weekly physical activity was about 2500 METs. (5) Conclusions: (a) The severity of the COVID-19 outbreak has an indirect effect on negative emotions by affecting sleep quality. (b) A possible mitigation strategy for improving mental health includes taking suitable amounts of daily physical activity and sleeping well. (c) The COVID-19 outbreak has reduced people’s aggressiveness, probably by making people realize the fragility and preciousness of life.
Association between olive colobus (Procolobus verus), Diana guenons (Cercopithecus diana), and other forest monkeys in Sierra Leone

Close association between olive colobus (Procolous verus) and other monkeys (especially Cercopithecus species) has been observed throughout the range of P. verus in the forest zone of West Africa. To investigate the basis of this association, we made new observations in Sierra Leone, concentrated at Tiwai Island. We obtained data on the association patterns of monkeys over a large area of the island from line‐transect samples, and studied association behavior via long‐term observational sampling of habituated groups of olive colobus and Diana monkeys (C. diana). During transect sampling, olive colobus always were seen less than 50 m from monkeys of other species, especially Cercopithecus. In studies of habituated groups, we found that one groups of olive colobus associated closely with a larger groups of Diana monkeys for more than 3 years. Members of the two groups were within 50 m of each other on over 80% of scan samples; the two groups shared the same range, but foraged in different parts of the canopy and had little dietary overlap; association was maintained by the behavior of the colobus. The olive colobus was the only Tiwai monkey species seen less than 50 m from members of a secon Diana study group more frequently than expected, although in this case the two species were associated during less than 12% of samples. In both cases, we detected month‐to‐month variation in association frequency. We suggest that olive colobus has a strong tendency to associate with other monkeys as part of an evolved strategy; that observed association patterns depend on the ranging habits and group dispersion patterns of the other species in the area; and that this strategy evolved because it reduces predation risk for a small‐bodied monkey that forages in small, dispersed groups.
Enzalutamide and Survival in Nonmetastatic, Castration-Resistant Prostate Cancer.

BACKGROUND Preliminary trial results showed that enzalutamide significantly improved metastasis-free survival among men who had nonmetastatic, castration-resistant prostate cancer and rapidly increasing prostate-specific antigen (PSA) levels while taking androgen-deprivation therapy. Results from the final analysis of overall survival have not yet been reported. METHODS In this double-blind, phase 3 trial, men with nonmetastatic, castration-resistant prostate cancer (defined on the basis of conventional imaging and a PSA doubling time of ≤10 months) who were continuing to receive androgen-deprivation therapy were randomly assigned (in a 2:1 ratio) to receive enzalutamide at a dose of 160 mg or placebo once daily. Overall survival was assessed with a group sequential testing procedure and an O'Brien-Fleming-type alpha-spending function. RESULTS As of October 15, 2019, a total of 288 of 933 patients (31%) in the enzalutamide group and 178 of 468 (38%) in the placebo group had died. Median overall survival was 67.0 months (95% confidence interval [CI], 64.0 to not reached) in the enzalutamide group and 56.3 months (95% CI, 54.4 to 63.0) in the placebo group (hazard ratio for death, 0.73; 95% CI, 0.61 to 0.89; P = 0.001). The exposure-adjusted rate of adverse events of grade 3 or higher was 17 per 100 patient-years in the enzalutamide group and 20 per 100 patient-years in the placebo group. Adverse events in the enzalutamide group were consistent with those previously reported for enzalutamide; the most frequently reported events were fatigue and musculoskeletal events. CONCLUSIONS Enzalutamide plus androgen-deprivation therapy resulted in longer median overall survival than placebo plus androgen-deprivation therapy among men with nonmetastatic, castration-resistant prostate cancer and a rapidly rising PSA level. The risk of death associated with enzalutamide was 27% lower than with placebo. Adverse events were consistent with the established safety profile of enzalutamide. (Funded by Pfizer and Astellas Pharma; PROSPER ClinicalTrials.gov number, NCT02003924.).
Blood Oxidative Stress Modulates Alveolar Bone Loss in Chronically Stressed Rats

We aimed to investigate the effects of chronic stress (CS) on experimental periodontitis (EP) in rats. For this, 28 Wistar rats were divided into four groups: control, ligature-induced experimental periodontitis (EP), chronic stress (CS; by physical restraint model) and CS+EP (association of chronic stress and ligature-induced periodontitis). The experimental period lasted 30 days, including exposure to CS every day and ligature was performed on the 15th experimental day. After 30 days, the animals were submitted to the behavioral test of the elevated plus maze (EPM). Next, rats were euthanized for blood and mandible collection in order to evaluate the oxidative biochemistry (by nitric oxide (NO), reduced-glutathione activity (GSH), and thiobarbituric acid reactive substance levels (TBARS)) and alveolar bone characterization (by morphometric, micro-CT, and immunohistochemistry), respectively. The behavioral parameters evaluated in EPM indicated higher anxiogenic activity in the CS and CS+EP, groups, which is a behavioral reflex of CS. The results showed that CS was able to change the blood oxidative biochemistry in CS and CS+EP groups, decrease GSH activity in the blood, and increase the NO and TBARS concentrations. Thus, CS induces oxidative blood imbalance, which can potentialize or generate morphological, structural, and metabolic damages to the alveolar bone.
Benefits of antiretroviral therapy initiation during acute HIV infection

ABSTRACT Objectives: In the last decade, there has been increasing scientific and legislative focus on antiretroviral treatment (ART) for all people living with HIV. Especially early ART initiation, preferably during acute HIV infection, has been named as a promising strategy, both for the individual and for the society. This article will review the benefits and possible future applications of immediate ART initiation during acute HIV infection and explore the remaining hurdles towards this strategy. Results: On an individual level, initiation of ART during acute HIV infection limits the viral reservoir, preserves immune function, and decreases systemic inflammation. In addition, obtaining viral suppression soon after infection can be beneficial for the society by decreasing the chance of onward HIV transmission. Reducing the transmission will reduce HIV incidence and can curtail HIV-related health expenditure. Furthermore, the favorable immunological and virological profile obtained by treating during acute HIV infection will form an ideal starting point for several HIV cure strategies. Conclusions: Initiation of ART during acute HIV infection has shown distinct benefits for the individual, for the society, and for future research on HIV cure. In order to implement this strategy, equal focus should be placed on early diagnosis.
Low-level viremia and cirrhotic complications in patients with chronic hepatitis B according to adherence to entecavir

Background/Aims Low-level viremia (LLV) after nucleos(t)ide analog treatment was presented as a possible cause of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). However, detailed information on patients’ adherence in the real world was lacking. This study aimed to evaluate the effects of LLV on HCC development, mortality, and cirrhotic complications among patients according to their adherence to entecavir (ETV) treatment. Methods We performed a retrospective observational analysis of data from 894 consecutive adult patients with treatment-naïve CHB undergoing ETV treatment. LLV was defined according to either persistent or intermittent episodes of <2,000 IU/mL detectable hepatitis B virus DNA during the follow-up period. Good adherence to medication was defined as a cumulative adherence ≥90% per study period. Results Without considering adherence in the entire cohort (n=894), multivariate analysis of the HCC incidence showed that LLV was an independent prognostic factor in addition to other traditional risk factors in the entire cohort (P=0.031). Good adherence group comprised 617 patients (69.0%). No significant difference was found between maintained virologic response and LLV groups in terms of the incidence of liver-related death or transplantation, HCC, and hepatic decompensation in good adherence group, according to multivariate analyses. Conclusions In patients with treatment-naïve CHB and good adherence to ETV treatment in the real world, LLV during treatment is not a predictive factor for HCC and cirrhotic complications. It may be unnecessary to adjust their antiviral agent for patients with good adherence who experience LLV during ETV treatment.