Miracle-dz/UniFAR-FTUs huggingface dataset:
Gastrointestinal Hemorrhage Is Associated with Mortality after Acute Ischemic Stroke.

OBJECTIVE Gastrointestinal (GI) hemorrhage is serious during the acute phase and reported to be related with an increased risk of death during the acute phase of acute ischemic stroke in particular. Our study was designed to investigate the relationship between GI hemorrhage and the mortality of acute ischemic stroke, assessing the influence of cerebrovascular risk factors, brain herniation and oral anticoagulation on the onset of GI hemorrhage. The identified risk factors for the occurrence of GI hemorrhage help to elucidate their respective roles in the mortality of acute ischemic stroke. METHODS A total of 15993 consecutive patients with acute ischemic stroke, including 216 cases and 15777 controls, were enrolled in the study from October 2010 to December 2018. Basic clinical and examination data were collected at the time of study enrollment. GI hemorrhage was diagnosed according to the presence of clinical features and endoscopy. Chi-square test and multiple logistic regressions were conducted to explore the associations between the GI hemorrhage occurrence and known risk factors. Kaplan-Meier was used to assess the influence of GI hemorrhage on the age of mortality of acute ischemic stroke. RESULTS GI hemorrhage cases among patients with acute ischemic stroke accounted for 1.35%. Male patients with ischemic stroke were more likely to have GI hemorrhage than their female counterparts (odds ratio (OR): 1.79; P = 0.000). Patients with atrial fibrillation (AF) had higher incidence of GI hemorhage than their counterparts without AF (3.03% vs 1.20%; P < 0.05). Use of oral anticoagulants was related to increased risk for GI hemorrhage (OR: 1.96; P = 0.00). After adjusting for age and sex, both AF and oral anticoagulant use maintained associations with increased risk for GI hemorrhage (2.59-times and 2.02-times risk respectively; P = 0.00). Patients with hyperlipidemia had lower incidence of GI hemorrhage than their counterparts without hyperlipidemia (0.62% vs 1.60%; P < 0.05). Hyperlipidemia was associated with reduced risk of GI hemorrhage (OR: 0.38, 95% confidence interval (CI): 0.25-0.58; P = 0.00), even after adjusting for age and sex (OR: 0.41; P = 0.00). Patients with brain herniation had a 6.54-times increased risk for GI hemorrhage (P = 0.00). GI hemorrhage was associated with 10.98-fold risk for mortality of acute ischemic stroke (P = 0.00). There was an interaction between GI hemorrhage and brain herniation and increased 26.91-fold risk for the mortality after acute ischemic stroke (P = 0.00). CONCLUSION AF, oral anticoagulant use, brain herniation and male sex increase GI hemorrhage risk, while hyperlipidemia reduces risk. GI hemorrhage itself increases risk for mortality of acute ischemic stroke. The interaction between GI hemorrhage and brain herniation increased the risk for the mortality after acute ischemic stroke.
Letter: studies of salivary pepsin in patients with gastro‐oesophageal reflux disease. Authors’ reply

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Prognostic markers affecting the early recurrence of hepatocellular carcinoma with liver cirrhosis after curative resection

Background: Early recurrence is associated with poor prognosis after curative resection for hepatocellular carcinoma. Thus, we studied which factors, including this inflammation-based scoring system, affect disease recurrence in single hepatocellular carcinoma patients with liver cirrhosis. Methods: A total of 430 consecutive hepatocellular carcinoma patients were enrolled in our institution between January 2002 and December 2015. Survival rate, univariate, and multivariate analyses were performed to identify the variables associated with recurrence and early recurrence especially. Results: The overall survival rate was significantly lower in the early recurrence group than in the non-early recurrence group (P<0.001). According to the multivariate analysis, protein induced by vitamin K absence or antagonist (PIVKA) greater than 200 (P=0.035), neutrophil-to-lymphocyte ratio greater than 2.0 (P<0.001), elevated Glasgow prognostic score (P=0.003), tumor size greater than 5 cm (P=0.002), and the presence of lymphovascular invasion (P=0.002) were significantly different among the groups and affected the early recurrence of hepatocellular carcinoma. The patients were categorized into five levels of risk for early recurrence according to the number of independent risk factors, and patients with no risk factors were set as the reference group. Conclusion: Neutrophil-to-lymphocyte ratio, Glasgow prognostic score, and serum level of PIVKA offer significant prognostic information associated with early recurrence following single lesion hepatocellular carcinoma patients with liver cirrhosis after curative resection.
Sex differences in executive functioning and latent herpesvirus reactivation among bereaved and non-bereaved individuals.

The death of a spouse is a highly stressful event. Better executive functioning has been shown to benefit men to a greater degree than women during stress. We evaluated potential sex differences in stress and immune dysregulation among control and bereaved participants who completed a self-report measure of perceived stress, neuropsychological measures of inhibition and updating/monitoring of information in working memory, and a blood draw to measure Epstein - Barr virus (EBV) antibody titers. Moderation analyses were conducted to test the hypothesis that better inhibition would be associated with less stress and immune dysregulation among male bereaved participants compared to female bereaved participants. Bereaved females demonstrated greater EBV antibody titers than bereaved males. Male bereaved participants benefited from better inhibition, as evidenced by fewer EBV antibody titers, while bereaved female participants did not. In the control group, males with high inhibition reported lower stress than males with low inhibition. Present study results are an important step towards identifying those at greatest risk of stress and poor health.
A Land Use/Land Cover Based Green Development Study for Different Functional Regions in the Jiangsu Province, China

Land use/land cover (LULC) change can strongly affect carbon storage in terrestrial ecosystems. The rapid development of China’s economy has formed different functional regions. These functional regions profoundly affect land use patterns. Thus, assessing the carbon storage induced by LULC changes is significant for green development. Selecting the typical region of the Jiangsu Province as the study area, this study first examines the research associated with the regional functional characteristics and various high accuracy data and methods have been used to greatly improve the research accuracy. The results showed that from 1995 to 2015, approximately 10.26% of the entire land area had LULC type changes. Additionally, decreases in the built-up land expansion and ecological land were the main LULC change characteristics, which are mainly affected by socioeconomic development. The total carbon storage of the Jiangsu Province decreased by 714.03 × 104 t and the four regions all presented decreasing carbon storage levels. The economically developed regions presented a more obvious loss of carbon. The region with small LULC changes had a lower carbon loss. The land transfer of cultivated land to built-up land is the main transfer type causing the carbon storage loss. This study investigates the human-environmental interactions from the new perspective of functional zoning and, thus, it enriches the comparative analysis of carbon storage in functional regions and provides references for the green development of a developing country’s developed areas.
High-Throughput Analysis of Clinical Flow Cytometry Data by Automated Gating

Advancements in flow cytometers with capability to measure 15 or more parameters have enabled us to characterize cell populations at unprecedented levels of detail. Beyond discovery research, there is now a growing demand to dive deeper into evaluating the immune response in clinical trials for immune modulating compounds. However, for high-volume, complex flow cytometry data generated in clinical trials, conventional manual gating remains the standard of practice. Traditional manual gating is resource intense and becomes a bottleneck and an impractical method to complete high volumes of flow cytometry data analysis. Current efforts to automate “manual gating” have shown that computational algorithms can facilitate the analysis of daunting multi-parameter data; however, a greater degree of precision in comparison with traditional manual gating is needed for wide-scale adoption of automated gating methods. In an effort to more closely follow the manual gating process, our automated gating pipeline was created to include negative controls (Fluorescence Minus One [FMO]) to enhance the reliability of gate placement. We demonstrate that use of an automated pipeline, heavily relying on FMO controls for population discrimination, can analyze multi-parameter, large-scale clinical datasets with comparable precision and accuracy to traditional manual gating.
Improving the Methods for Processing Hard Rock Aquifers Boreholes’ Databases. Application to the Hydrodynamic Characterization of Metamorphic Aquifers from Western Côte d’Ivoire

Statistical analysis of a borehole database, linear discharges, and water strikes processing enabled an understanding of the structure, geometry and hydrodynamic properties of the metamorphic hard rock aquifers from the Montagnes District, Western Côte d’Ivoire. The database comprises 1654 boreholes among which 445 only were usable for this research work after its pre-processing. Analysis shows that the structure of the aquifer is similar to that observed in several other areas in the world: it developed due to weathering processes, comprises the capacitive saprolite, 10–20 m thick on average, and an underlying transmissive fractured layer, overlying the unweathered impermeable hard rock. The fractured layer is 80 m thick, the first 40 to 45 metres being its most productive zone, with a 11.3 m3/h median productivity. This research shows that metamorphic aquifers exhibit similar aquifer properties (thickness, hydrodynamic parameters) as plutonic ones and that there is interest in using such databases for research and other purposes. However, a rigorous pre-treatment of the data is mandatory, and geological data from published maps must be used instead of the geological data from the database. A previous methodology aiming at processing the boreholes’ linear discharges was improved. It notably appears that the slope method must be preferred to the percentile method.
Digital Simulation for Buildings’ Outdoor Thermal Comfort in Urban Neighborhoods

Buildings’ outdoor thermal comfort influences environment quality and human behavior in urban neighborhoods. The Universal Thermal Climate Index (UTCI) has been broadly applied to the study of buildings’ outdoor thermal comfort in urban areas. However, complex environmental conditions in climate-sensitive urban areas can make UTCI assessment complicated and ineffective. This paper introduces digital techniques into buildings’ outdoor thermal comfort analysis for the improvement of the urban habitant environment. A digital simulation system is generated to facilitate the analysis procedure for buildings’ outdoor thermal comfort assessment in urban neighborhoods. The analysis addresses the research question: “Can digital simulation techniques provide a modeling system to assess buildings’ outdoor thermal comfort continuously and effectively? ” Methods include a case study of neighborhoods in Beijing, qualitative and quantitative analysis based on digital processes, and parametric modeling. The results indicate that digital simulation techniques and tools have the capability to support the analysis of buildings’ outdoor thermal comfort by providing three-dimensional models, algorithm-based analysis, and visual simulation. The findings include a critique of digital simulation as applied to architecture study and insights on potentially improving buildings’ outdoor thermal comfort through human–computer interactions.
Night Shift and Decreased Brain Activity of ICU Nurses: A Near-Infrared Spectroscopy Study

Background: Shift working is associated with a profound desynchronization of circadian rhythm and in particular, night-shift work disrupts normal circadian physiology. Sleep deprivation affects the functioning of certain brain areas and thus impairs cognitive performance. The purpose of this study was to investigate the effects of the night shift on cognitive performance and cerebral oxygenation/haemodynamics. Methods: A prospective, observational, comparative, randomized and cross-over study was carried out. A total of 74 intensive care unit nurses in Spain were included in the study. The following variables were measured: sociodemographic, burnout, anxiety, baseline cerebral oxygenation levels on night and day shift using a near-infrared spectroscopy system and cognitive task performance during a verbal fluency task to evaluate the alterations in the prefrontal cortex, assessed as changes in regional saturation index. Results: The average regional saturation index decreased significantly in the night shift (r = 0.560, p < 0.001). The ICU nurses showed a significant decrease in the verbal fluency test on average (8.53 ± 8.49, p < 0.001) and, in general, there was also a significant increase in anxiety score (3.17 ± 7.56, p = 0.001). Conclusions: Sleep deprivation during the night shift was considered to be related to decreased dorsolateral PFC reactivity. After the night shift, the nurses showed a decrease in prefrontal cortex activity and in cognitive performance.
Ebastine in the treatment of allergic rhinitis and urticaria: 30 years of clinical studies and real-world experience.

Histamine, acting predominantly via the H1-receptor, is an important mediator of the symptoms of allergy, and H1-antihistamines, which stabilise the receptor in its inactive form, are the treatment of choice for some chronic allergic conditions. Ebastine is a well-established oral second-generation H1-antihistamine. It is administered once daily at a dose of 10-20 mg and is available as a standard tablet and also as a fast-dissolving tablet that disintegrates in the mouth. Ebastine has demonstrated to be efficacious at relieving symptoms in patients with allergic rhinitis or urticaria in multiple clinical trials. Ebastine has modulating effects on the allergic inflammatory process in addition to its antihistamine effects, which may help explain the beneficial effect it has on nasal obstruction in some patients. Ebastine is generally well tolerated at recommended doses and is one of the lowest-risk antihistamines with respect to adverse cognitive/psychomotor effects, confirmed after decades of pharmacovigilance. New long-term data confirm its efficacy and tolerability during up to 1 year of treatment in patients with chronic urticaria.
Comparing PTSD treatment retention among survivors of military sexual trauma utilizing clinical video technology and in-person approaches

Introduction Interventions such as Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) have demonstrated efficacy for the treatment of post-traumatic stress disorder (PTSD) following military sexual trauma (MST). However, MST survivors report a number of logistical and social barriers that impede treatment engagement. In an effort to address these barriers, the Veterans Health Administration offers remote delivery of services using clinical video technology (CVT). Evidence suggests PE and CPT can be delivered effectively via CVT. However, it is unclear whether rates of veteran retention in PTSD treatment for MST delivered remotely is comparable to in-person delivery in standard care. Methods Data were drawn from veterans (N = 171, 18.1% CVT-enrolled) with PTSD following MST who were engaged in either PE or CPT delivered either via CVT or in person. Veterans chose their preferred treatment modality and delivery format in collaboration with providers. Data were analysed to evaluate full completion (FP) of the protocol and completion of a minimally adequate care (MAC) number of sessions. Results FP treatment completion rates did not differ significantly by treatment delivery format. When evaluating receipt of MAC care, CVT utilizers were significantly less likely to complete. Kaplan–Meier analyses of both survival periods detected significant differences in attrition speed, with the CVT group having higher per-session attrition earlier in treatment. Discussion Disengagement from CVT-delivered treatment generally coincided with early imaginal exposures and writing of trauma narratives. CVT providers may have to take special care to develop rapport and problem-solve anticipated barriers to completion to retain survivors in effective trauma-focused interventions.
Co-delivery of sorafenib and VEGF-siRNA via pH-sensitive liposomes for the synergistic treatment of hepatocellular carcinoma

Abstract Non-viral nanocarrier affords a platform for drug and siRNA combination, the focus of which is to load drug and siRNA into a single carrier, allowing for co-delivery and a synergistic effect at tumour site. In our previous study, pH-sensitive carboxymethyl chitosan-modified liposomes (CMCS-SiSf-CL) were assembled for sorafenib (Sf) and Cy3-siRNA co-loaded. The present study evaluated in vitro and in vivo co-delivery of the co-loaded liposomes. Further, in vitro inhibiting hepatocellular carcinoma of the pH-sensitive sorafenib (Sf) and VEGF-siRNA co-loaded liposomes was discussed. The experimental results demonstrated co-delivery and penetration into 2-dimensional (2D) cultured HepG2 cells, 3-dimensional (3D) cultured HepG2 tumour spheroids and tumour regions of H22 tumour-bearing mice. Compared with free siRNA and single loaded carrier, co-delivery liposomes exhibited enhanced VEGF downregulating effect, inducing cell early apoptosis. Therefore, the CMCS-SiSf-CL delivery system can lay the foundation for the co-delivery systems development and provide new area for HCC therapy.
Estimating the Attributable Disease Burden and Effects of Interhospital Patient Sharing on Clostridium difficile Infections

Abstract Objective: To estimate the burden of Clostridium difficile infections (CDIs) due to interfacility patient sharing at regional and hospital levels. Design: Retrospective observational study. Methods: We used data from the Healthcare Cost and Utilization Project California State Inpatient Database (2005–2011) to identify 26,878,498 admissions and 532,925 patient transfers. We constructed a weighted, directed network among the hospitals by defining an edge between 2 hospitals to be the monthly average number of patients discharged from one hospital and admitted to another on the same day. We then used a network autocorrelation model to study the effect of the patient sharing network on the monthly average number of CDI cases per hospital, and we estimated the proportion of CDI cases attributable to the network. Results: We found that 13% (95% confidence interval [CI], 7.6%–18%) of CDI cases were due to diffusion through the patient-sharing network. The network autocorrelation parameter was estimated at 5.0 (95% CI, 3.0–6.9). An increase in the number of patients transferred into and/or an increased CDI rate at the hospitals from which those patients originated led to an increase in the number of CDIs in the receiving hospital. Conclusions: A minority but substantial burden of CDI infections are attributable to hospital transfers. A hospital’s infection control may thus be nontrivially influenced by its neighboring hospitals. This work adds to the growing body of evidence that intervention strategies designed to minimize HAIs should be done at the regional rather than local level.
Prognostic Nutritional Index after Chemoradiotherapy Was the Strongest Prognostic Predictor among Biological and Conditional Factors in Localized Pancreatic Ductal Adenocarcinoma Patients

Background: In many malignancies, including pancreatic ductal adenocarcinoma (PDAC), host-related inflammatory/immunonutritional markers, such as the prognostic nutritional index (PNI), modified Glasgow prognostic score (mGPS), and C-reactive protein (CRP)/albumin ratio are reported to be prognostic factors. However, the prognostic influence of these factors before and after chemoradiotherapy (CRT) has not been studied in PDAC patients. Methods: Of 261 consecutive PDAC patients who were scheduled for CRT with gemcitabine or S1 plus gemcitabine between February 2005 and December 2015, participants in this study were 176 who completed CRT and had full data available on inflammatory/immunonutritional markers as well as on anatomical and biological factors for the investigation of prognostic/predictive factors. Results: In multivariate analysis, the significant prognostic factors were RECIST classification, cT category, performance status, post-CRT carcinoembryonic antigen, post-CRT C-reactive protein/albumin ratio, post-CRT mGPS, and post-CRT PNI. Post-CRT PNI (cut-off value, 39) was the strongest host-related prognostic factor according to the p-value. In the patients who underwent resection after CRT, median survival time (MST) was significantly shorter in the 12 patients with low PNI (<39) than in the 97 with high PNI (≥39), at 15.5 months versus 27.2 months, respectively (p = 0.0016). In the patients who did not undergo resection, MST was only 8.9 months in those with low PNI and 12.3 months in those with high PNI (p < 0.0001), and thus was similar to that of the resected patients with low PNI. Conclusions: Post-CRT PNI was the strongest prognostic/predictive indicator among the independent biological and conditional prognostic factors in PDAC patients who underwent CRT.