Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of foot ulcer incidence in diabetic patients at a diabetic foot ulcer prevention clinic over a 10‐year period

The present study aimed to evaluate diabetes patients over a 10‐year period that visited our outpatient clinic for prevention of diabetic foot ulcers and then investigate the incidence and aetiology of diabetic foot ulcers. The Department of Diabetes and Metabolic Diseases of a university hospital was in charge of the clinic that provided diabetes patients with individual education via the use of visualisation techniques. In this prospective cohort study, a total of 942 diabetes patients who visited the clinic were evaluated for neuropathy, angiopathy and medical history between November 2006 and March 2017. Using the patients' medical records, diabetic foot ulcer development was evaluated between the day of the first visit and December 31, 2018, with 20 out of 942 participants developing these ulcers. Over a period of 12, 60 and 120 months, the diabetic foot ulcer cumulative incidence was 0.2%, 2.4% and 5.8%, respectively. A history of diabetic foot ulcers and the male sex were shown by a Cox regression analysis to be correlated with diabetic foot ulcer development (Hazard Ratio [HR] 11.55, 95%CI 4.600–29.004, p < 0.001; and HR 3.55, 95%CI 1.031–12.196, p = 0.045, respectively). However, only five out of 20 participants with ulceration returned to the clinic for re‐examination. In conclusion, a 12‐month evaluation showed there was a low incidence of diabetic foot ulcers. These results might suggest that patients with a diabetic foot ulcer history need to undergo at least an annual follow‐up in order to further reduce diabetic foot ulcer incidence, although studies involving control groups needs to be conducted, in presenting these as evidence.
Effect of Lymphaticovenous Anastomosis on Muscle Edema, Limb, and Subfascial Volume in Lower Limb Lymphedema: MRI Studies

BACKGROUND: Although satisfactory volume reduction in secondary unilateral lower limb lymphedema after lymphaticovenous anastomosis (LVA) in the affected limb has been well reported, alleviation of muscle edema and the impact of LVA on the contralateral limb have not been investigated. STUDY DESIGN: This retrospective cohort study enrolled patients who underwent supermicrosurgical LVA between November 2015 and January 2017. Pre- and post-LVA muscle edema were assessed using fractional anisotropy (FA) and apparent diffusion coefficient (ADC). The primary endpoint was changes in limb/subfascial volume assessed with magnetic resonance volumetry at least 6 months after LVA. RESULTS: Twenty-one patients were enrolled in this study. Significant percentage reductions in post-LVA muscle edema were found in the affected thigh (83.6% [interquartile range = range of Q1 to Q3; 29.8–137.1] [FA], 53.3% [27.0–78.4] [ADC]) as well as limb (21.7% [4.4–26.5]) and subfascial (18.7% [10.7–39.1]) volumes. Similar findings were noted in the affected lower leg: 71.8% [44.0–100.1] (FA), 59.1% [45.8–91.2] (ADC), 21.2% [6.8–38.2], and 28.2% [8.5–44.8], respectively (all p < 0.001). Significant alleviation of muscle edema was also evident in the contralateral limbs (thigh: 25.1% [20.4–57.5] [FA]; 10.7% [6.6–17.7] [ADC]; lower leg: 47.1% [35.0–62.8] [FA]; 14.6% [6.5–22.1] [ADC]; both p < 0.001), despite no statistically significant difference in limb and subfascial volumes. CONCLUSIONS: Our study found significant reductions in muscle edema and limb/subfascial volumes in the affected limb after LVA. Our findings regarding edema in the contralateral limb were consistent with possible lymphedema-associated systemic influence on the unaffected limb, which could be surgically relieved.
Gene Expression Signatures for the Accurate Diagnosis of Peripheral T-Cell Lymphoma Entities in the Routine Clinical Practice

PURPOSE Peripheral T-cell lymphoma (PTCL) includes heterogeneous clinicopathologic entities with numerous diagnostic and treatment challenges. We previously defined robust transcriptomic signatures that distinguish common PTCL entities and identified two novel biologic and prognostic PTCL-not otherwise specified subtypes (PTCL-TBX21 and PTCL-GATA3). We aimed to consolidate a gene expression–based subclassification using formalin-fixed, paraffin-embedded (FFPE) tissues to improve the accuracy and precision in PTCL diagnosis. MATERIALS AND METHODS We assembled a well-characterized PTCL training cohort (n = 105) with gene expression profiling data to derive a diagnostic signature using fresh-frozen tissue on the HG-U133plus2.0 platform (Affymetrix, Inc, Santa Clara, CA) subsequently validated using matched FFPE tissues in a digital gene expression profiling platform (nCounter, NanoString Technologies, Inc, Seattle, WA). Statistical filtering approaches were applied to refine the transcriptomic signatures and then validated in another PTCL cohort (n = 140) with rigorous pathology review and ancillary assays. RESULTS In the training cohort, the refined transcriptomic classifier in FFPE tissues showed high sensitivity (> 80%), specificity (> 95%), and accuracy (> 94%) for PTCL subclassification compared with the fresh-frozen–derived diagnostic model and showed high reproducibility between three independent laboratories. In the validation cohort, the transcriptional classifier matched the pathology diagnosis rendered by three expert hematopathologists in 85% (n = 119) of the cases, showed borderline association with the molecular signatures in 6% (n = 8), and disagreed in 8% (n = 11). The classifier improved the pathology diagnosis in two cases, validated by clinical findings. Of the 11 cases with disagreements, four had a molecular classification that may provide an improvement over pathology diagnosis on the basis of overall transcriptomic and morphological features. The molecular subclassification provided a comprehensive molecular characterization of PTCL subtypes, including viral etiologic factors and translocation partners. CONCLUSION We developed a novel transcriptomic approach for PTCL subclassification that facilitates translation into clinical practice with higher precision and uniformity than conventional pathology diagnosis.
A phenome‐wide association study of polygenic scores for attention deficit hyperactivity disorder across two genetic ancestries in electronic health record data

Testing the association between genetic scores for Attention Deficit Hyperactivity Disorder (ADHD) and health conditions, can help us better understand its complex etiology. Electronic health records linked to genetic data provide an opportunity to test whether genetic scores for ADHD correlate with ADHD and additional health outcomes in a health care context across different age groups. We generated polygenic scores (ADHD‐PGS) trained on summary statistics from the latest genome‐wide association study of ADHD (N = 55,374) and applied them to genome‐wide data from 12,383 unrelated individuals of African‐American ancestry and 66,378 unrelated individuals of European ancestry from the Vanderbilt Biobank. Overall, only Tobacco use disorder (TUD) was associated with ADHD‐PGS in the African‐American ancestry group (Odds ratio [95% confidence intervals] = 1.23[1.16–1.31], p = 9.3 × 10−09). Eighty‐six phenotypes were associated with ADHD‐PGS in the European ancestry individuals, including ADHD (OR[95%CIs] = 1.22[1.16–1.29], p = 3.6 × 10−10), and TUD (OR[95%CIs] = 1.22[1.19–1.25], p = 2.8 × 10−46). We then stratified outcomes by age (ages 0–11, 12–18, 19–25, 26–40, 41–60, and 61–100). Our results suggest that ADHD polygenic scores are associated with ADHD diagnoses early in life and with an increasing number of health conditions throughout the lifespan (even in the absence of ADHD diagnosis). This study reinforces the utility of applying trait‐specific PGSs to biobank data, and performing exploratory sensitivity analyses, to probe relationships among clinical conditions.
Bilinguals Produce Pitch Range Differently in Their Two Languages to Convey Social Meaning

We investigated whether expression of social meaning operationalized as individual gender identitity and politeness moderated pitch range in the two languages of female and male Japanese-English sequential bilinguals. The bilinguals were resident in either London (UK) or Tokyo (Japan) and read sentences to imagined addressees who varied in formality and sex. Results indicated significant differences in the pitch range of the two languages of the bilinguals, and this was confirmed for female and male bilinguals in London and Tokyo, with the language differences being more extreme in the London bilinguals than in the Tokyo bilinguals. Interestingly, self-attribution of masculine gender traits patterned with within-language variation in the English pitch level of the female bilinguals, whereas self-attribution of feminine gender traits patterned with within-language variation in the English pitch level of the male bilinguals. In addition, female and male bilinguals significantly varied their pitch range in Japanese, but not in English, as a function of the imagined addressees. Findings confirmed that bilinguals produce pitch range differently in their languages and suggest that expression of social meaning may affect pitch range of the two languages of female and male bilinguals differently.
Risk factors associated with low birth weight.

OBJECTIVES Low birth weight (LBW) is one of the major factors affecting child morbidity and mortality worldwide. Every day, approximately 800 women die from causes related to pregnancy and childbirth worldwide. Maternal ill health increases the risk of LBW. This study seeks to investigate determinants and incidence of LBW. METHODS This study was conducted based on the medical records of mothers and their 1,946 infants born in 2016-2019 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Košice. Data on mothers and newborn infants were obtained from the Reports on mothers at childbirth. The inclusion criteria were singleton births and birth weight > 500 g. The exclusion criteria were twins or multiple births, congenital anomalies and stillbirths, birth weight ≥ 4,000 g or ≤ 500 g, and Roma ethnicity. Roma children are more likely to be born prematurely, with low birth weight. Roma mothers have different lifestyle. Univariate analysis was employed to evaluate the association between the independent variables and LBW. Variables that were found to be statistically significant were then further analysed using multivariable logistic analysis for each dependent variable. The implementation of the research was approved by the Ethics Committee. RESULTS Of 1,946 newborns, 271 (13.90%) have low birth weight. The mean of birth weight at delivery was 3,068.62 (SD 671.16) grams. Factors that were associated with LBW were primary maternal education (OR = 2.98, 95% CI: 1.08-8.21, p = 0.034), marital status single (OR = 2.88, 95% CI: 1.68-4.94, p < 0.001), number of prenatal care visits less than 8 (OR = 1.62, 95% CI: 1.01-2.61, p = 0.047), and preterm birth (OR = 74.94, 95% CI: 45.44-123.61, p < 0.001). CONCLUSION The reducing of LBW requires strategies to improve maternal lifestyle, maternal care before, during and after birth and to strengthen social support.
Exercise and nutritional interventions on sarcopenia and frailty in heart failure: a narrative review of systematic reviews and meta‐analyses

The purpose of this review is to describe the present evidence for exercise and nutritional interventions as potential contributors in the treatment of sarcopenia and frailty (i.e. muscle mass and physical function decline) and the risk of cardiorenal metabolic comorbidity in people with heart failure (HF). Evidence primarily from cross‐sectional studies suggests that the prevalence of sarcopenia in people with HF is 37% for men and 33% for women, which contributes to cardiac cachexia, frailty, lower quality of life, and increased mortality rate. We explored the impact of resistance and aerobic exercise, and nutrition on measures of sarcopenia and frailty, and quality of life following the assessment of 35 systematic reviews and meta‐analyses. The majority of clinical trials have focused on resistance, aerobic, and concurrent exercise to counteract the progressive loss of muscle mass and strength in people with HF, while promising effects have also been shown via utilization of vitamin D and iron supplementation by reducing tumour necrosis factor‐alpha (TNF‐a), c‐reactive protein (CRP), and interleukin‐6 (IL‐6) levels. Experimental studies combining the concomitant effect of exercise and nutrition on measures of sarcopenia and frailty in people with HF are scarce. There is a pressing need for further research and well‐designed clinical trials incorporating the anabolic and anti‐catabolic effects of concurrent exercise and nutrition strategies in people with HF.
Examination of the effect of the perceived stress in the coronavirus‐19 pandemic on marital adjustment, sexual life and intimate partner violence

Abstract Aims The aim of the study was to explore the effects of perceived stress during the pandemic on marital adjustment, sexual life and intimate partner violence. Design A cross‐sectional design was employed in this study. Methods The data were collected with an online survey between October and December 2020 from 901 participants in Turkey. Participants completed the Descriptive Information Form, the Marital Adjustment Scale and the Perceived Stress Scale. Multivariate analysis of variance and moderation analysis were used in the analysis of the data. Results The pre‐pandemic marital adjustment scores of the participants significantly decreased during the pandemic. The marital adjustment and sexual life of those with high perceived stress levels were found to be negatively affected, and they were exposed to violence during the pandemic. In the moderation analysis, a non‐standardized coefficient of the marital adjustment variable in the model turned out to be significant, and the perceived stress decreased as marital adjustment increased. The marital adjustment was low, and the stress level was high in individuals exposed to violence. Besides, perceived stress was found to be effective in being exposed to intimate partner violence. Conclusion The stress perceived by individuals during the COVID‐19 pandemic negatively affected their marital adjustment and sexual life. Besides, perceived stress was found to be effective in being exposed to intimate partner violence, and marital adjustment decreased during the pandemic compared to the pre‐pandemic period. Impact During the pandemic period, health care providers should routinely screen the psychosocial health of individuals. Continuous, accessible, free psychosocial support services should be available in order to increase the psychosocial health and marital adjustment of people with high‐stress levels and prevent exposure to violence. Patient or Public Contribution The conduct of this study is based on an online survey with participants living in the same house with their spouses during the pandemic.
A systematic review of patient‐reported dignity and dignified care during acute hospital admission

Abstract Aims To synthesize quantitative evidence on levels of dignity during acute hospital admission and identify barriers and facilitators to patients' dignity or dignified care from the perspective of hospitalized patients. The secondary aim was to examine the relationship between dignity and demographic, clinical and psychological characteristics of patients. Design A systematic review based on the protocol of the Preferred Reporting Items for Systematic reviews and Meta‐Analyses guideline for reporting systematic reviews. Data Sources Five electronic databases (PubMed, CINAHL, Embase, PsycINFO, AgeLine) were searched in February 2021, followed by backward‐forward searching using Web of Science and Scopus databases. Review Methods Potentially eligible articles were scrutinized by two reviewers. Articles that met the eligibility criteria were appraised for quality using the Critical Appraisal Tool for Cross‐Sectional Studies. Two reviewers extracted data for the review and resolved differences by consensus. Results Out of 3052 potentially eligible studies, 25 met the inclusion criteria. Levels of dignity for hospitalized patients vary widely across geographic locations. Patients' dignity is upheld when healthcare professionals communicate effectively, maintain their privacy, and provide dignity therapy. Patients' perceptions of dignity were, in some studies, reported to be associated with demographic (e.g. age, marital status, gender, employment, educational status), clinical (e.g. hospitalization, functional impairment, physical symptoms) and psychological (e.g. depression, anxiety, demoralization, coping mechanisms) variables whilst other studies did not observe such associations. Conclusion Patients in acute care settings experience mild to a severe loss of dignity across different geographic locations. Patients' dignity is influenced by several demographic, clinical and psychological characteristics of patients. Impact The findings of the review support impetus for improvement in dignified care for hospitalized patients, addressing factors that facilitate or impede patients' dignity. Measures aimed at alleviating suffering, fostering functional independence and addressing patients' psychosocial needs can be used to promote dignity.
Agroforestry perennials reduce nitrous oxide emissions and their live and dead trees increase ecosystem carbon storage

Agroforestry systems (AFS) contribute to carbon (C) sequestration and reduction in greenhouse gas emissions from agricultural lands. However, previously understudied differences among AFS may underestimate their climate change mitigation potential. In this 3‐year field study, we assessed various C stocks and greenhouse gas emissions across two common AFS (hedgerows and shelterbelts) and their component land uses: perennial vegetated areas with and without trees (woodland and grassland, respectively), newly planted saplings in grassland, and adjacent annual cropland in central Alberta, Canada. Between 2018 and 2020 (~April–October), nitrous oxide emissions were 89% lower under perennial vegetation relative to the cropland (0.02 and 0.18 g N m−2 year−1, respectively). In 2020, heterotrophic respiration in the woodland was 53% lower in shelterbelts relative to hedgerows (279 and 600 g C m−2 year−1, respectively). Within the woodland, deadwood C stock was particularly important in hedgerows (35 Mg C ha−1 or 7% of ecosystem C) relative to shelterbelts (2 Mg C ha−1 or <1% of ecosystem C), and likely affected C cycling differences between the woodland types by enhancing soil labile C and microbial biomass in hedgerows. Deadwood C stock was positively correlated with annual heterotrophic respiration and total (to ~100 cm depth) soil organic C, water‐soluble organic C, and microbial biomass C. Total ecosystem C was 1.90–2.55 times greater within the woodland than all other land uses, with 176, 234, 237, and 449 Mg C ha−1 found in the cropland, grassland, planted saplings treatment, and woodland, respectively. Shelterbelt and hedgerow woodlands contained 2.09 and 3.03 times more C, respectively, than adjacent cropland. Our findings emphasize the importance of AFS for fostering C sequestration and reducing greenhouse gas emissions and, in particular, retaining hedgerows (legacy woodland) and their associated deadwood across temperate agroecosystems will help mitigate climate change.
An energy-efficient rescheduling approach under delay perturbations for metro systems

ABSTRACT Due to the increasing energy prices and environmental issues, energy conservation for metro trains has become an important research topic in recent years. The static timetable optimization approach can reduce the trains’ energy consumption to a certain degree by scheduling multiple trains’ movements. However, this optimization approach is prone to fail when one or some trains are delayed at stations. This paper develops an energy-efficient rescheduling approach under delay perturbations for metro trains, which aims to minimize the net energy consumption under the premise of reducing or eliminating the delay altogether. Firstly, we provide an illustrative example to describe the rescheduling problem. Furthermore, we formulate an integer programming model and design an allocation algorithm to obtain the optimal schedule. Finally, a numerical example based on the Beijing Metro Yizhuang Line shows that the developed approach can reduce the net energy consumption by 8.19% in comparison with the traditional rescheduling approach.
Differentially Expressed Inflammation-Regulating MicroRNAs in Oligoarticular Juvenile Idiopathic Arthritis

Objective To evaluate microRNA expression in synovial fluid (SF), plasma, and leukocytes from patients with juvenile idiopathic arthritis (JIA). Methods MicroRNA expression in pooled JIA plasma and SF was assessed by absolute quantitative droplet digital PCR array. The results were validated in individual patient samples. MicroRNA content in leukocytes and extracellular vesicles was evaluated by real-time PCR in JIA blood and SF. Blood microRNA expression was compared with healthy controls (HCs). Principal component analysis was used to profile JIA plasma and SF microRNAs, and the potential biological consequences of microRNA dysregulation were investigated by pathway analysis. Results MiR-15a-5p and miR-409-3p levels were higher in JIA plasma than in HC plasma. JIA SF contained elevated levels of miR-21-5p, miR-27a-3p, miR-146b-5p, miR-155-5p, and miR-423-5p, and decreased miR-192-5p and miR-451a, compared to JIA plasma. Extracellular vesicle analysis demonstrated variable encapsulation among selected microRNAs, with only miR-155-5p being represented substantially in extracellular vesicles. SF leukocytes also had higher expression of miR-21-5p, miR-27a-3p, miR-146b-5p, and miR-155-5p, and lower expression of miR-409-3p and miR-451a, relative to blood. No differences were observed between JIA and HC blood leukocytes. Clusters of microRNAs were commonly altered in JIA joint fluid and leukocytes compared to JIA blood samples. In silico analysis predicted that differentially expressed microRNAs in JIA target the transforming growth factor (TGF)-β pathway. Conclusion The expression of multiple microRNAs is dysregulated in JIA both locally and systemically, which may inhibit the TGF-β pathway. These findings advance our knowledge of JIA immunopathogenesis and may lead to the development of targeted therapies.
Simulation of turning vehicles’ behaviors at mixed-flow intersections based on potential field theory

ABSTRACT The classical lane-based one-dimensional simulation models cannot describe the complex features of turning vehicles including variation of trajectories and shared-priority at mixed-flow intersection (MFI). This paper proposes a quasi-two-dimensional model to simulate turning vehicles’ behaviors at MFI. The proposed model consists of three layers: decision layer, plan layer and action layer. The decision layer firstly employs discrete choice model to decide whether to turn or not. The plan layer plans the desired path to destination considering interactive objects by using distance potential field. The action layer implements movement of turning vehicles under the impact of the artificial potential field. The proposed model is tested by reproducing trajectories of left-turn vehicles at a two-phase MFI in Shanghai. As a result, the simulation reproduces the variation of trajectories, while the overlapping ratio of trajectory is 75.02%. Meanwhile, the travel time of simulation and empirical data do not show statistically significant difference.