Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison of wound complications between one‐stage and two‐stage brachiobasilic arteriovenous fistula: A meta‐analysis

Research assessing the outcome of brachiobasilic arteriovenous fistulas (BB‐AVF) after a one‐ and two‐stage technique was conducted. A strict review of the comprehensive literature up to May 2023 was carried out using four databases‐PubMed，Embase, Cochrane Library and web of science. Inclusion and exclusion criteria developed for the study were then applied to assess the quality of the literature, it was decided to review 12 interrelated studies.95% confidence intervals (Cl) and odds ratios (OR) were calculated using fixed effects models. The data were meta‐analysed using RevMan 5.3 software. The results showed that two‐stage technique with BB‐AVF reduced surgical site haematoma (SSH) formation, (OR, 2.28; 95% CI, 1.24–4.17, p = 0.008), and also reduced surgical site wound infection (SSWI) (OR, 1.86; 95% CI, 1.17–2.94, p = 0.008). There are, however, several small sample sizes in the selected studies for this meta‐analysis, so caution should be used when processing their values. There are more high‐quality studies with large sample sizes that should be considered for future meta‐analyses.
Salvianolic acid A diminishes LDHA‐driven aerobic glycolysis to restrain myofibroblasts activation and cardiac fibrosis via blocking Akt/GSK‐3β/HIF‐1α axis

Myofibroblasts activation intensively contributes to cardiac fibrosis with undefined mechanism. Salvianolic acid A (SAA) is a phenolic component derived from Salvia miltiorrhiza with antifibrotic potency. This study aimed to interrogate the inhibitory effects and underlying mechanism of SAA on myofibroblasts activation and cardiac fibrosis. Antifibrotic effects of SAA were evaluated in mouse myocardial infarction (MI) model and in vitro myofibroblasts activation model. Metabolic regulatory effects and mechanism of SAA were determined using bioenergetic analysis and cross‐validated by multiple metabolic inhibitors and siRNA or plasmid targeting Ldha. Finally, Akt/GSK‐3β‐related upstream regulatory mechanisms were investigated by immunoblot, q‐PCR, and cross‐validated by specific inhibitors. SAA inhibited cardiac fibroblasts‐to‐myofibroblasts transition, suppressed collage matrix proteins expression, and effectively attenuated MI‐induced collagen deposition and cardiac fibrosis. SAA attenuated myofibroblasts activation and cardiac fibrosis by inhibiting LDHA‐driven abnormal aerobic glycolysis. Mechanistically, SAA inhibited Akt/GSK‐3β axis and downregulated HIF‐1α expression by promoting its degradation via a noncanonical route, and therefore restrained HIF‐1α‐triggered Ldha gene expression. SAA is an effective component for treating cardiac fibrosis by diminishing LDHA‐driven glycolysis during myofibroblasts activation. Targeting metabolism of myofibroblasts might occupy a potential therapeutic strategy for cardiac fibrosis.
Vaccination with a ZNF2oe Strain of Cryptococcus Provides Long-Lasting Protection against Cryptococcosis and Is Effective in Immunocompromised Hosts

Systemic cryptococcosis is fatal without treatment. Even with the current antifungal therapies, this disease kills 180,000 of 225,000 infected people annually. ABSTRACT Systemic cryptococcosis is fatal without treatment. Even with the current antifungal therapies, this disease kills 180,000 of 225,000 infected people annually. Exposure to the causative environmental fungus Cryptococcus neoformans is universal. Either reactivation of a latent infection or an acute infection after high exposure to cryptococcal cells can result in cryptococcosis. Currently, there is no vaccine to prevent cryptococcosis. Previously, we discovered that Znf2, a transcription factor that directs Cryptococcus yeast-to-hypha transition, profoundly affects cryptococcal interaction with the host. Overexpression of ZNF2 drives filamentous growth, attenuates cryptococcal virulence, and elicits protective host immune responses. Importantly, immunization with cryptococcal cells overexpressing ZNF2, in either live or heat-inactivated form, offers significant protection to the host from a subsequent challenge by the otherwise lethal clinical isolate H99. In this study, we found that the heat-inactivated ZNF2oe vaccine offered long-lasting protection with no relapse upon challenge with the wild-type H99. Vaccination with heat-inactivated ZNF2oe cells provides partial protection in hosts with preexisting asymptomatic cryptococcal infection. Importantly, once animals have been vaccinated with heat-inactivated or live short-lived ZNF2oe cells, they are protected against cryptococcosis even when their CD4+ T cells are depleted at the time of fungal challenge. Remarkably, vaccination with live, short-lived ZNF2oe cells in CD4-depleted hosts still provides strong protection to these hosts with preexisting immunodeficiency at the time of vaccination. This work raises hope for developing effective vaccines with long-lasting protection for individuals who are immunocompromised or could become immunocompromised later in life.
FIGO staging of endometrial cancer: 2023

Many advances in the understanding of the pathologic and molecular features of endometrial cancer have occurred since the FIGO staging was last updated in 2009. Substantially more outcome and biological behavior data are now available regarding the several histological types. Molecular and genetic findings have accelerated since the publication of The Cancer Genome Atlas (TCGA) data and provide improved clarity on the diverse biological nature of this collection of endometrial cancers and their differing prognostic outcomes. The goals of the new staging system are to better define these prognostic groups and create substages that indicate more appropriate surgical, radiation, and systemic therapies.
A Chemically Defined Medium That Supports Mycotoxin Production by Stachybotrys chartarum Enabled Analysis of the Impact of Nitrogen and Carbon Sources on the Biosynthesis of Macrocyclic Trichothecenes and Stachybotrylactam

Macrocyclic trichothecenes (MTs) are highly toxic secondary metabolites that are produced by certain Stachybotrys chartarum strains, which consequently pose a risk for animals and humans. To identify hazardous, toxin-producing strains by analytical means, it is important to grow them under conditions that support MT production. ABSTRACT Stachybotrys chartarum (Hypocreales, Ascomycota) is a toxigenic fungus that is frequently isolated from water-damaged buildings or improperly stored feed. The secondary metabolites formed by this mold have been associated with health problems in humans and animals. Several authors have studied the influence of environmental conditions on the production of mycotoxins, but these studies focused on undefined or complex substrates, such as building materials and media that impeded investigations of the influence of specific nutrients. In this study, a chemically defined cultivation medium was used to investigate the impact of several nitrogen and carbon sources on growth of S. chartarum and its production of macrocyclic trichothecenes (MTs) and stachybotrylactam (STLAC). Increasing concentrations of sodium nitrate were found to positively affect mycelial growth, the level of sporulation, and MT production, while ammonium nitrate and ammonium chloride had an inhibitory effect. Potato starch was the superior and most reliable carbon source tested. Additionally, we observed that the level of sporulation was correlated with the production of MTs but not with that of STLAC. In this study, we provide a chemically well-defined cultivation medium suitable for standardized in vitro testing of the capacity of S. chartarum isolates to produce macrocyclic trichothecenes. IMPORTANCE Macrocyclic trichothecenes (MTs) are highly toxic secondary metabolites that are produced by certain Stachybotrys chartarum strains, which consequently pose a risk for animals and humans. To identify hazardous, toxin-producing strains by analytical means, it is important to grow them under conditions that support MT production. Nutrients determine growth and development and thus the synthesis of secondary metabolites. Complex rich media are commonly used for diagnostics, but batch differences of supplements pose a risk for inconsistent data. We have established a chemically defined medium for S. chartarum and used it to analyze the impact of nitrogen and carbon sources. A key finding is that nitrate stimulates MT production, whereas ammonium suppresses it. Defining nutrients that support MT production will enable a more reliable identification of hazardous S. chartarum isolates. The new medium will also be instrumental in analyzing the biosynthetic pathways and regulatory mechanisms that control mycotoxin production in S. chartarum.
Association between blood pressure and different antihypertensive drugs with outcome after ischemic stroke: A Mendelian randomization study

Background: Observational studies suggest an association between blood pressure (BP) and functional outcomes in ischemic stroke patients but whether this is causal or due to confounding is uncertain. We used Mendelian randomization (MR) to assess causality, and also explore whether particular classes of anti-hypertensives were associated with a better outcome after ischemic stroke. Methods: We selected genetic variants associated with systolic and diastolic BP and BP-lowering variants in genes encoding antihypertensive drugs from genome-wide association studies (GWAS) on 757,601 individuals. The primary outcome was 3-month dependence or death defined as a modified Rankin Scale (mRS) of 3–6. The secondary outcome was disability or death after 90 days defined as mRS 2–6. Cochran’s Q statistic in the inverse variance weighted (IVW) model, the weighted median, MR-Egger regression, leave-one-single-nucleotide polymorphism (SNP)-out analysis, MR-Pleiotropy Residual Sum and Outlier methods were adopted as sensitivity analyses. To validate our primary results, we performed independent repeat analyses and Bi-directional MR analyses. Results: Genetic predisposition to higher systolic and diastolic BP was associated with disability or death after ischemic stroke in univariable IVW MR analysis (odds ratio (OR) 1.29, 95% confidence interval (CI): 1.05–1.59, p = 0.014; OR 1.27, 95% CI: 1.07–1.51, p = 0.006, respectively). Pulse pressure was associated with both dependence or death and disability or death after ischemic stroke (OR = 1.05, 95% CI: 1.02–1.08, p = 0.002; OR = 1.04, 95% CI = 1.01–1.07, p = 0.009, respectively). Angiotensin-converting enzyme inhibitor (ACEI) and calcium channel blocker (CCB) were significantly associated with improved functional outcomes (dependence or death, OR 0.76, 95% CI: 0.62–0.94, p = 0.009; OR 0.89, 95% CI: 0.83–0.97, p = 0.005). Proxies for β-blockers, angiotensin receptor blockers (ARB), and thiazides failed to show associations with functional outcomes (p > 0.05). Conclusion: We provide evidence for an association of genetic predisposition to higher BP with a higher risk of 3-month functional dependence after ischemic stroke. Our findings support ACEI and CCB as promising antihypertensive drugs for improving functional outcomes in ischemic stroke.
Assessment of the patient with heart failure symptoms and risk factors: A guide for the non‐cardiologist

Although the prevalence of heart failure has been increasing over time, the presentation of heart failure has been shifting, with a greater proportion of preserved ejection fraction and more slowly progressive symptoms that require recognition in the outpatient setting. These shifts have placed more of the diagnostic responsibility onto primary care physicians, who often are challenged to determine the etiology of common symptoms in patients who often have several other potential reasons for these symptoms. Establishing a diagnosis of heart failure requires a step‐wise approach that includes physical exam (looking for multiple signs of hypervolemia), labs (B‐type natriuretic peptide levels), and echocardiography (structural and functional measures). Diagnostic algorithms are particularly challenging in patients with obesity, which limits the assessment of intravascular volume on exam, the quality of cardiac imaging, and the diagnostic accuracy of B‐type natriuretic peptide levels, which may be falsely low. In these challenging patients, the use of risk scores, invasive testing of intravascular volume, or empiric treatment of hypervolemia may be needed to determine whether symptoms are due to heart failure. Once a diagnosis of heart failure is established, several treatments can be beneficial, from diuretics to relieve congestion to various aspects of guideline‐directed medical therapy, some of which vary according to the ejection fraction of the patient. In addition, a diagnosis of heart failure may alter the treatment plan for comorbidities, including selection of anti‐hypertensive and glucose‐lowering medications, and medical or surgical treatments for obesity. While a diagnosis of heart failure may be challenging in many patients with slowly progressive and non‐specific symptoms, early recognition and treatment can be extremely effective at preventing hospitalizations, prolonging survival, and improving quality of life.
Grouping by Time and Pitch Facilitates Free but Not Cued Recall for Word Lists in Normally-Hearing Listeners

Auditory memory is an important everyday skill evaluated more and more frequently in clinical settings as there is recently a greater recognition of the cost of hearing loss to cognitive systems. Testing often involves reading a list of unrelated items aloud; but prosodic variations in pitch and timing across the list can affect the number of items remembered. Here, we ran a series of online studies on normally-hearing participants to provide normative data (with a larger and more diverse population than the typical student sample) on a novel protocol characterizing the effects of suprasegmental properties in speech, namely investigating pitch patterns, fast and slow pacing, and interactions between pitch and time grouping. In addition to free recall, and in line with our desire to work eventually with individuals exhibiting more limited cognitive capacity, we included a cued recall task to help participants recover specifically the words forgotten during the free recall part. We replicated key findings from previous research, demonstrating the benefits of slower pacing and of grouping on free recall. However, only slower pacing led to better performance on cued recall, indicating that grouping effects may decay surprisingly fast (over a matter of one minute) compared to the effect of slowed pacing. These results provide a benchmark for future comparisons of short-term recall performance in hearing-impaired listeners and users of cochlear implants.
Survival Analysis of Transplant-Associated Thrombotic Microangiopathy Under Different Diagnostic Criteria and Efficacy of Plasma Exchange

Background Transplant-associated thrombotic microangiopathy (TA-TMA) is a serious complication of hematopoietic stem cell transplantation (HSCT). The efficacy and survival of plasma exchange (PE) for TA-TM have not been fully clarified. In addition, there is a lack of consensus on diagnostic criteria for TA-TMA. Material/Methods We retrospectively analyzed 32 patients diagnosed with TA-TMA by different diagnostic criteria from January 2018 to February 2022 at the First Medical Center of the PLA General Hospital. Results (1) The patients with TA-TMA treated with PE in this study had a remission rate of 42.8%, a 100-day OS of 47.6%, and a 6-month OS of 38.1%. The only factor affecting the response to PE treatment was the number of PE sessions (P=0.047). (2) III–IV aGVHD prior to TA-TMA diagnosis (P=0.002), renal or neurological dysfunction (P=0.021), and the time to onset of TA-TMA (P=0.002) were independent risk factors for overall survival with TA-TMA. (3) Probable TA-TMA had the highest survival rate, but the Jodele criteria are expected to diagnose earlier and provide the greatest benefit to patients. Conclusions PE can temporarily alleviate TA-TMA patients’ clinical symptoms and laboratory indicators. It does not, however, significantly increase overall survival. In addition, probable TA-TMA improved survival prognosis through early detection of patients with TA-TMA. There is a need for further large prospective trials to identify the population more suitable for PE treatment of TA-TMA and more valid diagnostic criteria.
Clinical Recommendations for Augmentation Agents in Obsessive-Compulsive Disorder Partially Responsive to Serotonin Reuptake Inhibitors

Abstract Background Obsessive-compulsive disorder (OCD) affects 2% to 3% of adults worldwide. Although serotonin reuptake inhibitors (SRIs) reliably demonstrate efficacy for this condition, 40% to 60% of patients only achieve partial recovery. The purpose of this systematic review was to assess the efficacy of other agents that may be used as augmentation agents for patients who are partial responders to SRI monotherapy. Methods Using PRISMA-P guidelines, PubMed and Embase were searched using the randomized controlled trial (RCT) filter and the key word “obsessive-compulsive disorder. ” To be considered for analysis, a potential augmentation agent needed to have at least 2 RCTs. This review specifically analyzes the effect of each augmentation agent on OCD symptoms as measured by the Yale-Brown Obsessive-Compulsive Scale. Results The augmentation agents analyzed in this review are d-cycloserine (2 RCTs), memantine (4 RCTs), N-acetylcysteine (5 RCTs), lamotrigine (2 RCTs), topiramate (3 RCTs), riluzole (2 RCTs), ondansetron (2 RCTs), celecoxib (2 RCTs), aripiprazole (5 RCTs), risperidone (7 RCTs), quetiapine (9 RCTs), and olanzapine (3 RCTs). Implications The augmentation agents most supported by this review for OCD that is only a partial response to SRI monotherapy are lamotrigine, memantine, and aripiprazole. If an antipsychotic must be used and aripiprazole is not tolerated, risperidone may be considered as an alternative. Unlike the SRI class effect for OCD symptom reduction, augmentation agents demonstrate considerable intraclass variability.
The association between eveningness and autistic traits: Mediating effects of depression and insomnia

ABSTRACT There is a lack of research on the relationships between autistic traits and morningness-eveningness. The current research explored associations between autistic traits (preferences for routine, difficulties with imagination, difficulties with social skills, fixations with numbers and patterns, and difficulties with attention switching) and morningness-eveningness, including the component of Morning Affect (alertness/energy upon awakening). The potential mediation effects of depression and insomnia were also tested. 163 adults (university students and general population) completed an online survey including questionnaire measures of autistic traits, morningness-eveningness, depression, and insomnia. Positive correlations were found between most autistic trait subcomponents, depression, and insomnia. The autistic trait of difficulties in attention switching was correlated with more eveningness and with less Morning Affect, but significant correlations were not observed with any other autistic trait. Depression mediated the relationship between eveningness and difficulties in attention switching. Although insomnia alone was not a significant mediator, when combined with depression in a serial mediator model, a significant mediation effect was shown. The current results suggest that greater eveningness may be related with the autistic trait of difficulties in attention switching possibly through the mechanism of increased insomnia and elevated risk for depression. These findings may potentially inform interventions.
HPV16 status might correlate to increasing tumor-infiltrating lymphocytes in hypopharyngeal cancer

Abstract Background Human papillomavirus (HPV) plays a major etiological role in the increasing number of patients with head and neck squamous cell carcinoma (HNSCC). Objectives This study aimed at exploring the relationship between HPV infection and prognosis in patients with hypopharyngeal carcinoma (HPSCC). Methods We retrospectively analyzed 108 consecutive patients diagnosed with HPSCC from 2015 to 2018. Real-time fluorescent quantitative PCR and P16 immunohistochemistry were used to detect HPV infection in tissues of patients with hypopharyngeal carcinoma. The numbers of CD8, CD4 and Foxp3 cells in tumor parenchyma were obtained by immunohistochemical counting. Finally, the analysis was performed according to the clinicopathological variables and prognosis of the patients. Results Among 108 patients with HPSCC, 18 cases were detected by qPCR, and 16 subtypes accounted for the majority (77.8%). Kaplan–Meier analysis showed that HPV16+, higher CD8+, higher CD4+ and higher FoxP3+ TIL infiltration was strongly associated with superior three-year disease-free survival (DFS), cancer-specific survival (CSS) and overall survival (OS). Univariate analysis showed that HPV and CD4+ TIL had higher predictive value for prognosis. Conclusions HPV16 infection is significantly related to tumor immune infiltrating cells (TILs).
Root coverage with apical tunnel approach using propolis as a root conditioning agent: A case report with 2‐year follow‐up and review of the literature

One of the main challenges in performing root coverage is patient discomfort and donor site morbidity. This case report presents a minimally invasive apical tunnel surgical technique, with propolis for root conditioning, to correct gingival recession defects without harvesting donor grafts, flap elevation, or sutures. Propolis is a natural anti‐infective, anti‐inflammatory, and antioxidant agent.
High-risk Prescribing Following Surgery Among Payer Types for Patients on Chronic Opioids

Objective: Among those on chronic opioids, to determine whether patients with Medicaid coverage have higher rates of high-risk opioid prescribing following surgery compared with patients on private insurance. Background: Following surgery, patients on chronic opioids experience gaps in transitions of care back to their usual opioid prescriber, but differences by payer type are not well understood. This study aimed to analyze how new high-risk opioid prescribing following surgery compares between Medicaid and private insurance. Methods: In this retrospective cohort study through the Michigan Surgical Quality Collaborative, perioperative data from 70 hospitals across Michigan were linked to prescription drug monitoring program data. Patients with either Medicaid or private insurance were compared. The outcome of interest was new high-risk prescribing, defined as a new occurrence of: overlapping opioids or benzodiazepines, multiple prescribers, high daily doses, or long-acting opioids. Data were analyzed using multivariable regressions and a Cox regression model for return to usual prescriber. Results: Among 1435 patients, 23.6% (95% CI: 20.3%–26.8%) with Medicaid and 22.7% (95% CI: 19.8%–25.6%) with private insurance experienced new, postoperative high-risk prescribing. New multiple prescribers was the greatest contributing factor for both payer types. Medicaid insurance was not associated with higher odds of high-risk prescribing (odds ratio: 1.067, 95% CI: 0.813–1.402). Conclusions: Among patients on chronic opioids, new high-risk prescribing following surgery was high across payer types. This highlights the need for future policies to curb high-risk prescribing patterns, particularly in vulnerable populations that are at risk of greater morbidity and mortality.
Sex‐based differences in the association between loneliness and polypharmacy among older adults in Ontario, Canada

Emerging evidence shows loneliness is associated with polypharmacy and high‐risk medications in older adults. Despite notable sex‐based differences in the prevalence in each of loneliness and polypharmacy, the role of sex in the relationship between loneliness and polypharmacy is unclear. We explored the relationship between loneliness and polypharmacy in older female and male respondents and described sex‐related variations in prescribed medication subclasses.