Miracle-dz/UniFAR-FTUs huggingface dataset:
Interpretation of Normal and Abnormal Tympanogram Findings in Eustachian Tube Dysfunction

Objective To characterize the relationship between objective tympanogram values and patient-reported symptoms and associations with common comorbid conditions. Study Design Cross-sectional study with prospective data collection. Setting Tertiary medical center. Methods Patients undergoing routine audiometric evaluation between October 2018 and June 2019 were included. Participants with temporomandibular joint dysfunction, inner ear hydrops, and similar conditions were excluded. Symptoms were assessed with the 7-item Eustachian Tube Dysfunction Questionnaire. Demographics and medical comorbidities were recorded from the medical record. Analysis of tympanometric peak pressure (TPP), demographics, and comorbidities was performed to determine associations with clinically significant eustachian tube dysfunction (ETD) symptoms. Results A total of 250 patients were included with similar demographics: 101 (40.4%) in the asymptomatic group and 149 (59.6%) in the symptomatic group. The median (interquartile range) TPP was –10 (20) daPa and –25 (100) daPa in the asymptomatic and symptomatic groups, respectively. A diagnosis of rhinitis was more likely to be associated with significant ETD symptoms (adjusted odds ratio, 2.61; 95% CI, 1.23-5.63). A subgroup analysis revealed that symptomatic patients with normal TPP values were negatively skewed as compared with asymptomatic patients. This symptomatic group had a higher prevalence of rhinitis and chronic rhinosinusitis than the asymptomatic group. Conclusion Patients with symptoms of ETD may have a TPP within a range typically considered normal per conventional standards. This suggests that the currently accepted interpretation of tympanometry findings may be insensitive for the diagnosis of less severe cases of ETD.
Communication Theory Applied to the Reference Encounter: An Analysis of Critical Incidents

Dimensions of interpersonal communication perceived to be integral to success or failure in academic reference interactions are identified through the use of the critical incident technique. Forty-seven critical incidents recalled by twenty-seven library users and nine librarians are analyzed from the theoretical perspective of interpersonal communication developed by Paul Watzlawick, Janet Beavin, and Don Jackson. This study is the first to be published that applies the heuristically rich relational theory from the communication field to library interactions. Content and relational dimensions that have an impact on librarian and user critical incidents are identified, such as attitude, relationship quality, information, knowledge base, and approachability. Interpersonal relationships are major themes in incidents recalled by library users. Librarians give relatively more weight to content dimensions dealing with quality of information given but also perceive relationship qualities to be important. The value of applying communication theory to study of the reference interaction is demonstrated. In addition, this research also illustrates the importance of incorporating the user's point of view. Evidence presented argues for a new model of the librarian-user reference interaction that recognizes the vital importance of relational messages that are communicated in the reference encounters along with the information transfered.
AN EMPIRICAL COMPARISON OF BLOCK BOOTSTRAP METHODS: TRADITIONAL AND NEWER ONES

In this study, we compared various block bootstrap methods in terms of parameter estimation, biases and mean squared errors (MSE) of the bootstrap estimators. Comparison is based on four real-world examples and an extensive simulation study with various sample sizes, parameters and block lengths. Our results reveal that ordered and sufficient ordered non-overlapping block bootstrap methods proposed by Beyaztas et al. (2016) provide better results in terms of parameter estimation and its MSE compared to conventional methods. Also, sufficient non-overlapping block bootstrap method and its ordered version have the smallest MSE for the sample mean among the others.
Association between Kawasaki Disease and Prenatal Exposure to Ambient and Industrial Air Pollution: A Population-Based Cohort Study

Background: Environmental factors may contribute to the development of Kawasaki disease in children, but prenatal environmental exposures are understudied. Objective: We used a population-based cohort to investigate whether prenatal exposure to outdoor air pollution is associated with the incidence of Kawasaki disease in childhood. Methods: We performed a longitudinal cohort study of all children born in Quebec, Canada, between 2006 and 2012. Children were followed for Kawasaki disease from birth until 31 March 2018. We assigned prenatal air pollutant exposure according to the residential postal code at birth. The main exposure was annual average concentration of ambient fine particulate matter [PM ≤2. 5μm in aerodynamic diameter (PM2.5) and nitrogen dioxide (NO2) from satellite-based estimates and land-use regression models. As secondary exposures, we considered industrial PM2.5, NO2, and sulfur dioxide (SO2) emissions estimated from dispersion models. We estimated hazard ratios (HRs) using Cox proportional hazards models, adjusted for maternal age, parity, sex, multiple birth, maternal smoking during pregnancy, socioeconomic status, birth year, and rural residence. We considered single and multipollutant models. We performed several sensitivity analyses, including assessing modifying effects of maternal comorbidities (e.g., diabetes, preeclampsia). Results: The cohort comprised 505,336 children, including 539 with Kawasaki disease. HRs for each interquartile range increase in ambient air pollution were 1.16 (95% CI: 0.96, 1.39) for PM2.5 and 1.12 (95% CI: 0.96, 1.31) for NO2. For industrial air pollution, HRs were 1.07 (95% CI: 1.01, 1.13) for SO2, 1.09 (95% CI: 0.99, 1.20) for NO2, and 1.01 (95% CI: 0.97, 1.05) for PM2.5. In multipollutant models, associations for ambient PM2.5 and NO2 (i.e., from all sources) were robust to adjustment for industrial pollution, and vice versa. Discussion: In this population-based cohort study, both prenatal exposure to ambient and industrial air pollution were associated with the incidence of Kawasaki disease in childhood. Further studies are needed to consolidate the observed associations. https://doi.org/10.1289/EHP6920
The Impact of Diet and Body Size on the Mating Competitiveness and Longevity of the Malaria Mosquito Anopheles gambiae s.s.

Malaria kills over half a million people worldwide. Some promising malaria control approaches focus on producing genetically modified (GM) mosquito vectors that are either unable to transmit malaria parasites or to reproduce. Only male mosquitoes would be released in such programmes as they do not bite, however, they should be sexually competitive to mate with wild females in order to spread their genes into wild populations. Thus a thorough understanding of the determinants of male mosquito mating success is required. The present study consisted in analyzing pre-collected data on lab-reared mosquitoes from two experiments that were carried out in 2005. This work aimed to assess how male body size, diet and mating history of the African malaria vector, An. gambiae s.s. influence their mating competitiveness and survival. In the first experiment, male mosquitoes were given for three days after emergence one of the three sugar treatments that differed in glucose availability (Low, Medium and High). During dusk of the third day, individuals were given the opportunity to mate and their body size was recorded. Analyses were done by carrying out Generalized Linear Mixed Models and model selection was done by Akaike Information Criterion (AIC) and significance testing by Log Likelihood Ratio
Long-Term Clinical Outcomes With the Activ-L Lumbar Arthroplasty System

ABSTRACT Background: Low back pain (LBP) due to degenerative disc disease (DDD) is the most common occupational disorder worldwide. Lumbar total disc replacement (LTDR) has provided an alternative to rigid fusion to relieve pain with less motion restriction. We present clinical results with long-term follow-up from a single-center, single-surgeon series of patients treated with the Activ-L artificial disc. Methods: Thirty-three patients with symptomatic single-level DDD who failed nonsurgical therapy for a minimum of 6 months underwent single-level arthroplasty with the Activ-L system between 2007 and 2012. Demographic, preoperative, and postoperative data were collected prospectively. Clinical factors reviewed included occupational status, sensory deficits, functional status determined by Oswestry Disability Index (ODI), back pain, leg pain, pain medication consumption, and radiographic imaging. Results: Average age at surgery was 38.0 ± 7.8 years, and the majority of patients were male (60.6%). Average follow-up was 2.7 ± 1.7 years. Average ODI at preoperative baseline was 54.6 ± 13.5, with scores significantly improved at 6 weeks (28.6 ± 17.4, P < .0001), 3 months (24.1 ± 16.8, P < .0001), 6 months (22.3 ± 16.3, P < .0001), 1 year (18.8 ± 15.3, P < .0001), and final follow-up (15.6 ± 16.4, P < .0001). Most patients (87.8%) reported pain medication usage within 14 days of baseline evaluation, with consumption decreasing significantly at 1-year (34.5%, P < .0001) and long-term follow-up (21.2%, P < .0001). One patient experienced mild unilateral graft subsidence at 1 year, which remained stable on radiographs at 5 years. None of the prostheses required revision surgery. Conclusions: The Activ-L disc replacement system is safe and effective for treating single-level lumbar DDD. Patients reported significant improvement in functional outcomes and decreases in pain medication consumption. Further investigation of the Activ-L system in larger populations is warranted. Clinical Relevance: LBP is a common cause of disability worldwide, and better treatment options are needed to improve outcomes, including pain and mobility. Spine surgeons may choose the Activ-L disc replacement as a safe and effective treatment for LBP caused by single-level lumbar DDD.
Helicoidally Arranged Polyacrylonitrile Fiber-Reinforced Strong and Impact-Resistant Thin Polyvinyl Alcohol Film Enabled by Electrospinning-Based Additive Manufacturing

In this study, we demonstrate the use of parallel plate far field electrospinning (pp-FFES) based manufacturing system for the fabrication of polyacrylonitrile (PAN) fiber reinforced polyvinyl alcohol (PVA) strong polymer thin films (PVA SPTF). Parallel plate far field electrospinning (also known as the gap electrospinning) is generally used to produce uniaxially aligned fibers between the two parallel collector plates. In the first step, a disc containing PVA/H2O solution/bath (matrix material) was placed in between the two parallel plate collectors. Next, a layer of uniaxially aligned sub-micron PAN fibers (filler material) produced by pp-FFES was directly collected/embedded in the PVA/H2O solution by bringing the fibers in contact with the matrix. Next, the disc containing the matrix solution was rotated at 45° angular offset and then the next layer of the uniaxial fibers was collected/stacked on top of the previous layer with now 45° rotation between the two layers. This process was continued progressively by stacking the layers of uniaxially aligned arrays of fibers at 45° angular offsets, until a periodic pattern was achieved. In total, 13 such layers were laid within the matrix solution to make a helicoidal geometry with three pitches. The results demonstrate that embedding the helicoidal PAN fibers within the PVA enables efficient load transfer during high rate loading such as impact. The fabricated PVA strong polymer thin films with helicoidally arranged PAN fiber reinforcement (PVA SPTF-HA) show specific tensile strength 5 MPa·cm3·g−1 and can sustain specific impact energy (8 ± 0.9) mJ·cm3·g−1, which is superior to that of the pure PVA thin film (PVA TF) and PVA SPTF with randomly oriented PAN fiber reinforcement (PVA SPTF-RO). The novel fabrication methodology enables the further capability to produce even further smaller fibers (sub-micron down to even nanometer scales) and by the virtue of its layer-by-layer processing (in the manner of an additive manufacturing methodology) allowing further modulation of interfacial and inter-fiber adherence with the matrix materials. These parameters allow greater control and tunability of impact performances of the synthetic materials for various applications from army combat wear to sports and biomedical/wearable applications.
Antimicrobial Activity of an Extract of Hermetia illucens Larvae Immunized with Lactobacillus casei against Salmonella Species

Simple Summary In this investigation, we found antimicrobial activity of the extract of Lactobacillus casei–infected Hermetia illucens larvae (HIL) against Salmonella species. The result demonstrates that the extract is a powerful natural antibiotic and preservative. Abstract The expressions of antimicrobial peptides (AMPs) in the larvae of the black soldier fly, Hermetia illucens, were significantly increased by pathogen or stimulant induced innate immunity activation. We immunized H. illucens fifth instar larvae with five different Lactobacillus species, that is, Lactobacillus acidophilus, L. brevis, L. casei, L. fermentum, or L. delbrueckii, to induce the mass production of AMPs and selected optimal immune inducers. Antimicrobial activities in hemolymph and H. illucens larvae (HIL) extract were evaluated against three salmonella species (Salmonella pullorum, Salmonella typhimurium, and Salmonella enteritidis). Highest antimicrobial activity was shown by the hemolymph of HIL immunized by L. casei and its activity was closely linked with the inductions of cecropin 1 (HiCec1) and defensin 1 (HiDef1) gene expressions. Furthermore, antimicrobial activity in hemolymph was stable to heat and pH and the growth of three Salmonella species were dramatically suppressed by HIL hemolymph and extract after immunization with L. casei. The minimal inhibitory concentration (MICs) of L. casei-immunized HIL extract against Staphylococcus aureus, Escherichia coli, and Salmonella species ranged from 100~200 µg/100 µL and no cytotoxicity to CaCo-2 and L929 cells were observed in the concentration range 100~40,000 µg/100 µL. Taken together, the present investigation demonstrates that L. casei-immunized HIL extract is a powerful natural antibiotic and preservative that can prevent contamination by Salmonella species.
Nuclear and kinetoplast DNA analyses reveal genetically complex Leishmania strains with hybrid and mito-nuclear discordance in Peru

Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis of the mannose phosphate isomerase (mpi) gene was applied to 134 skin samples collected from patients with cutaneous leishmaniasis (CL) in Peru for identification of the infecting parasite at the species level, and the results were compared with those of cytochrome b (cyt b) gene sequencing obtained in previous studies. Although most results (121/134) including 4 hybrids of Leishmania (Viannia) braziliensis and L. (V.) peruviana corresponded to those obtained in the previous study, PCR-RFLP analyses revealed the distribution of putative hybrid strains between L. (V.) peruviana and L. (V.) lainsoni in two samples, which has never been reported. Moreover, parasite strains showing discordance between kinetoplast and nuclear genes (kDNA and nDNA), so-called mito-nuclear discordance, were identified in 11 samples. Of these, six strains had the kDNAs of L. (V.) braziliensis or L. (V.) peruviana and nDNAs of L. (V.) guyanensis, and three strains had the kDNAs of L. (V.) shawi and nDNAs of L. (V.) braziliensis. The rest were identified as mito-nuclear discordance strains having kDNAs of L. (V.) braziliensis or L. (V.) peruviana and nDNAs of L. (V.) lainsoni, and kDNAs of L. (V.) lainsoni and nDNAs of L. (V.) braziliensis. The results demonstrate that Leishmania strains in Peru are genetically more complex than previously considered.
Randomized control trial of oral arginine therapy for children with sickle cell anemia hospitalized for pain in Nigeria

Low arginine bioavailability is associated with vaso‐occlusive painful crisis (VOC) severity in sickle cell anemia (SCA) and predicts need for pediatric hospitalization. Intravenous arginine therapy has opioid‐sparing effects and was found to significantly decrease pain scores in children hospitalized with SCA‐VOC in a phase‐two randomized placebo‐controlled trial (RCT). Efficacy of oral arginine is unknown. Our objective was to determine the safety and efficacy of oral arginine therapy in Nigerian children with SCA. A double‐blind RCT of oral L‐arginine‐hydrochloride (100 mg/kg TID) was conducted in children with SCA‐VOC, aged 5‐17 years, hospitalized at two Nigerian sites. The primary outcome measure was analgesic usage, quantified by difference in the mean Analgesic Medication Quantification Scale (MQS). Secondary outcomes included daily pain scores, time‐to‐crisis‐resolution and length‐of‐hospital‐stay. An intention‐to‐treat analysis was performed. Sixty‐eight children (age 5‐17 years, mean 10.6 ± 0.4 years; 56% male), were randomized to receive L‐arginine (35 patients) or placebo (33 patients). The mean total MQS for the arginine group was 73.4 (95% CI, 62.4‐84.3) vs 120.0 (96.7‐143.3) for placebo (P < .001). The mean rate of decline in worst pain scores was faster in the arginine arm vs placebo (1.50 [1.23‐1.77] vs 1.09 [0.94‐1.24] point/d, P = .009). Children receiving arginine had a shorter time‐to‐crisis‐resolution (P = .02), shorter hospital‐stay (P = .002) and experienced no serious adverse event. Pain control was more rapid, total analgesic requirement was significantly reduced, and most notably, time‐to‐crisis‐resolution and length‐of‐hospital‐stay were shorter in children with SCA‐VOC receiving arginine vs placebo. Given the established safety and low cost, oral arginine is a promising adjuvant therapy for SCA‐VOC management.
Liver Resection Versus Local Ablation Therapies for Hepatocellular Carcinoma Within the Milan Criteria: A Systemic Review and Meta-analysis.

OBJECTIVE To compare the oncologic outcomes of liver resection (LR) and local ablation therapies for HCC. SUMMARY OF BACKGROUND DATA Although several studies have compared LR and local ablation therapies, the optimal treatment of choice for HCC within the Milan criteria remains controversial. METHODS We systemically searched the MEDLINE, Embase, and Cochrane Library databases for randomized control trials (RCTs) and matched nonrandomized trials (NRTs) that compared LR and local ablation therapies for HCC within the Milan criteria. The primary outcome was overall survival (OS). Secondary outcomes were recurrence free survival (RFS) and recurrence pattern. RESULTS A total of 7 RCTs and 18 matched NRTs, involving 2865 patients in the LR group and 2764 patients in the local ablation therapy group [RFA, MWA, RFA plus trans-arterial chemoembolization (TACE)], were included. Although there was no significant difference in OS between LR and RFA, LR showed a significantly better 5-year RFS than RFA in the analysis of RCTs (hazards ratio: 0.75; 95% confidence interval: 0.62-0.92; P = 0.006). The RFA group showed a significantly higher local recurrence than the LR group in both analyses of RCTs and NRTs. Additionally, the LR group showed better OS and RFS than the MWA or RFA plus TACE groups. CONCLUSION Our meta-analysis showed that LR was superior to RFA in terms of RFS and incidence of local recurrence. Moreover, LR showed better oncologic outcomes than MWA or RFA plus TACE.
The Concerns, Difficulties, and Stressors of Caring for Pets during COVID-19: Results from a Large Survey of U.S. Pet Owners

Simple Summary Relationships between pets and their owners vary greatly. The popular media portrayal of the human benefits of pet ownership is often biased and overstated, oftentimes creating unrealistic expectations for pet owners. There is evidence that pets can be beneficial to the health and well-being of their owners in certain circumstances; however, there is also evidence that negative or ambivalent relationships between owners and pets can be a detriment to owner well-being, as well as a risk for shelter relinquishment (i.e., surrender) of the pet. Relinquishment due to adverse scenarios like the Coronavirus Disease 2019 (COVID-19) pandemic may increase rates of shelter euthanasia of adoptable pets. In this study we identify the unique difficulties related to caring for pets during the COVID-19 pandemic. Pet owners reported concerns related to pets, humans, and the entire household or family, inclusive of people and pets. Data from this study indicate that strength of the owner’s attachment to their pet, as well as their economic resources, and the characteristics of their household are associated with the types of concerns expressed. We discuss implications for human well-being and pet welfare, and the need to address these issues in order to prevent shelter relinquishment. Abstract Pets may be a positive presence for their owners during the Coronavirus Disease 2019 (COVID-19) pandemic. However, it is pertinent to identify the hardships associated with pet ownership. We conducted a large-scale survey of U.S. pet owners (n = 2254) in spring and summer 2020 to assess the ways that relationships with pets impacted life during COVID-19. We used thematic analysis to analyze 3671 open-ended responses to three prompts. Reported concerns fell into three major categories: (1) pet-focused (meeting needs of pets; procuring supplies; accessing veterinary care; new and emerging behavioral issues; fate of the pet if owner becomes ill; general safety and well-being), (2) human-focused (issues with working from home; well-being and mental health; balancing responsibilities), and (3) household-focused (disease spread; economic issues). Quantitative analyses showed that the owner’s strength of attachment to their pet, economic resources, and relationship status were associated with the types of concerns expressed. Results from this study indicate that pet owners experienced unique hardships related to changes in everyday life from the COVID-19 pandemic. These hardships should be considered alongside the potential benefits found in other studies in order to manage pet owner expectations, prevent pet relinquishment, and more fully understand multifaceted human-companion animal relationships.