Miracle-dz/UniFAR-FTUs huggingface dataset:
Erdheim–Chester disease and vemurafenib: a review of ophthalmic presentations and clinical outcomes

ABSTRACT Purpose To provide a comprehensive review of ocular and orbital manifestations of Erdheim–Chester Disease (ECD) and compare clinical outcomes with vemurafenib (INN) to historical treatments (HT). Primary outcomes are ophthalmic findings on presentation, changes in visual acuity, and mortality rate. Secondary outcomes include the progression of ocular findings, systemic involvements, and treatment modalities. Methods All published literature from January 1983 to March 2021 was searched for ophthalmic manifestations of ECD. Clinical outcomes following HT were collected and compared with INN. Results Forty-seven patients with ECD and ophthalmic presentations were identified. The mean age was 49.6 years (SD = 15.0). Proptosis (65.6%) and extraocular muscle restrictions (42.5%) were the most common presenting signs. Of 41 (87.2%) patients with orbital masses on radiologic examination, 90.2% were bilateral, and 53.7% were located in the intraconal space. Ophthalmic examination was significant for xanthelasma (27.2%), optic disc edema (34.0%), and subretinal changes (21.3%). Common treatments were systemic steroids (76.6%), interferon-α (17.0%), and cyclophosphamide (14.9%). INN was less commonly used (12.8%). The mean change in logMAR visual acuity declined with HT (29.9%) but improved with INN (79.1%) (p > 0.05). The proportion of eyes with complete vision loss increased after HT (p < 0.05). The overall mortality rate was 27.7% and notably higher in the HT group (29.3%) when compared to the INN group (16.7%) (p > 0.05). Conclusion ECD presents with many ophthalmic manifestations. Although the intraocular treatments remain controversial, INN should be highly considered in treating orbital ECD patients with BRAF-V600E mutations to prevent and reverse vision loss.
Diet, activity patterns, and home range use in forest and cultivated areas for one wild group of endangered crested capuchin monkeys (Sapajus robustus) in Reserva Natural Vale, Espírito Santo, Brazil

Robust capuchin monkeys (Sapajus spp.) are distributed widely in the Neotropics and may be able to survive in modified landscapes because of their omnivorous, opportunistic diet. The poorly known and endangered crested capuchin monkey (Sapajus robustus) is endemic to the Atlantic Forest in Bahia, Minas Gerais and Espírito Santo states, Brazil. We collected data on diet and home range for a crested capuchin group with access to forest and cultivated areas. We hypothesized that with access to cultivated exotic fruit, capuchins would use cultivated areas more for feeding during the season of fruit scarcity in the surrounding forest and have a small home range size because of higher fruit availability. Both the forest and the cultivated areas peaked in fruit availability in the wet season, with a low proportion of trees producing fruit in the dry season; cultivated areas had a higher proportion of trees in fruit compared to the forest throughout the study. While monkeys consumed exotic fruits like jackfruit and oil palm, we recorded more samples of them eating forest fruits than exotic fruits in all but 1 month, and they consumed a more diverse array of forest fruits (56 species) but only six exotic species. Home range size was relatively small compared with other studies: 120.5 ha across the year (wet season 102 ha, dry season 111.5 ha). Natural and human‐intensified fruit sources in a protected area without hunting may have allowed monkeys to maintain a smaller home range size. The group composition changed during the study; this also likely influenced home range use. Studies focused on robust capuchin groups that utilize agricultural or cultivated foods may underestimate home range needs for groups without access to human‐intensified food sources. Studying crested capuchin ecology in additional locations will be important for establishing a sound species conservation program.
Distinct transcriptomic profile of small arteries of hypertensive patients with chronic kidney disease identified miR-338-3p targeting GPX3 and PTPRS

Objective: Hypertension is associated with vascular injury, which contributes to end-organ damage. MicroRNAs regulating mRNAs have been shown to play a role in vascular injury in hypertensive mice. We aimed to identify differentially expressed microRNAs and their mRNA targets in small arteries of hypertensive patients with/without chronic kidney disease (CKD) to shed light on the pathophysiological molecular mechanisms of vascular remodeling. Methods and results: Normotensive individuals and hypertensive patients with/without CKD were recruited (n = 15–16 per group). Differentially expressed microRNAs and mRNAs were identified uniquely associated with hypertension (microRNAs: 10, mRNAs: 68) or CKD (microRNAs: 68, mRNAs: 395), and in both groups (microRNAs: 2, mRNAs: 32) with a P less than 0.05 and a fold change less than or greater than 1.3 in subcutaneous small arteries (n = 14–15). One of the top three differentially expressed microRNAs, miR-338-3p that was down-regulated in CKD, presented the best correlation between RNA sequencing and reverse transcription-quantitative PCR (RT-qPCR, R2 = 0.328, P < 0.001). Profiling of human aortic vascular cells showed that miR-338-3p was mostly expressed in endothelial cells. Two of the selected top nine up-regulated miR-338-3p predicted targets, glutathione peroxidase 3 (GPX3) and protein tyrosine phosphatase receptor type S (PTPRS), were validated with mimics by RT-qPCR in human aortic endothelial cells (P < 0.05) and by a luciferase assay in HEK293T cells (P < 0.05). Conclusion: A distinct transcriptomic profile was observed in gluteal subcutaneous small arteries of hypertensive patients with CKD. Down-regulated miR-338-3p could contribute to GPX3 and PTPRS up-regulation via the canonical microRNA targeting machinery in hypertensive patients with CKD. Graphical abstract: http://links.lww. com/HJH/C27
A Dual-Hormone Multicontroller for Artificial Pancreas Systems

Artificial pancreas (AP) algorithms can be divided into single-hormone (SH) and dual-hormone (DH). SH algorithms regulate glycemia using insulin as their control input. On the other hand, DH algorithms also use glucagon to counteract insulin. While SH-AP systems are already commercially available, DH-AP systems are still in an earlier research phase. DH-AP systems have been questioned since the added complexity of glucagon infusion does not always guarantee hypoglycemia prevention and might significantly raise insulin delivery. In this work, a DH multicontroller is proposed based on a SH linear quadratic gaussian (LQG) algorithm with an additional LQG controller to deliver glucagon. This strategy has a switched structure that allows activating one of the following three controllers when necessary: a conservative insulin LQG controller to modulate basal delivery (<inline-formula><tex-math notation="LaTeX">$K_{1}$</tex-math></inline-formula>), an aggressive insulin LQG controller to counteract meals (<inline-formula><tex-math notation="LaTeX">$K_{2}$</tex-math></inline-formula>), or a glucagon LQG controller to avoid imminent hypoglycemia (<inline-formula><tex-math notation="LaTeX">$K_{3}$</tex-math></inline-formula>). Here, an <italic>in silico</italic> study of the benefits of incorporating controller <inline-formula><tex-math notation="LaTeX">$K_{3}$</tex-math></inline-formula> is carried out. Intra-patient variability and mixed meals are considered. Results indicate that the proposed switched, dual-hormone strategy yields to a reduction in hypoglycemia without increasing hyperglycemia, with no significant rise in insulin delivery.
Hybridizing Basic Variable Neighborhood Search With Particle Swarm Optimization for Solving Sustainable Ship Routing and Bunker Management Problem

This paper studies a novel sustainable ship routing problem considering a time window concept and bunker fuel management. Ship routing involves the decisions corresponding to the deployment of vessels to multiple ports and time window concept helps to maintain the service level of the port. Reducing carbon emissions within the maritime transportation domain remains one of the most significant challenges as it addresses the sustainability aspect. Bunker fuel management deals with the fuel bunkering issues faced by different ships, such as selection of bunkering ports and total bunkered amount at a port. A novel mathematical model is developed capturing the intricacies of the problem. A hybrid particle swarm optimization with a basic variable neighborhood search algorithm is proposed to solve the model and compared with the exact solutions obtained using Cplex and other popular algorithms for several problem instances. The proposed algorithm outperforms other popular algorithms in all the instances in terms of the solution quality and provides good quality solutions with an average cost deviation of 5.99% from the optimal solution.
Multisensory Rather than Unisensory Representations Contribute to Statistical Context Learning in Tactile Search

Abstract Using a combination of behavioral and EEG measures in a tactile odd-one-out search task with collocated visual items, we investigated the mechanisms underlying facilitation of search by repeated (vs. nonrepeated) spatial distractor–target configurations (“contextual cueing”) when either the tactile (same-modality) or the visual array (different-modality) context was predictive of the location of the tactile singleton target. Importantly, in both conditions, the stimulation was multisensory, consisting of tactile plus visual items, although the target was singled out in the tactile modality and so the visual items were task-irrelevant. We found that when the predictive context was tactile, facilitation of search RTs by repeated configurations was accompanied by, and correlated with, enhanced lateralized ERP markers of pre-attentive (N1, N2) and, respectively focal-attentional processing (contralateral delay activity) not only over central (“somatosensory”), but also posterior (“visual”) electrode sites, although the ERP effects were less marked over visual cortex. A similar pattern—of facilitated RTs and enhanced lateralized (N2 and contralateral delay activity) ERP components—was found when the predictive context was visual, although the ERP effects were less marked over somatosensory cortex. These findings indicate that both somatosensory and visual cortical regions contribute to the more efficient processing of the tactile target in repeated stimulus arrays, although their involvement is differentially weighted depending on the sensory modality that contains the predictive information.
Comparison between surgery and fibrinolytic therapy in prosthetic valve thrombosis: A systematic review and meta‐analysis

Prosthetic valve thrombosis (PVT) is a rare but life‐threatening complication. Surgery and fibrinolytic therapy (FT) are the two main treatment options for PVT. The choice between surgery and FT has always been a matter of debate. Previous studies have shown that although the mortality rate is higher in surgery, complications are less frequent than in FT. We aimed to perform a systematic review and meta‐analysis to compare the results of surgery and FT in PVT.
Blood pressure variability and structural brain changes: a systematic review

Background: Blood pressure variability (BPV) has been linked with cognitive impairment and dementia. However, the pathophysiological mechanisms by which BPV affects cognition are unclear. This systematic review aims to assess the links between different BPV measures and white and grey matter structures. Methods and results: The following databases were searched from inception through to January 2021; EMBASE, MEDLINE, EMCARE and SCOPUS. Studies that reported on the relationship between within-individual BPV (short, medium or long-term variability) or a circadian blood pressure (BP) measurement and MRI assessed brain structures were included. Overall, 20 studies met the criteria and were included, of which 11 studies looked at short-term BPV, eight articles investigated visit-to-visit BPV and one study looked at a compositional BPV measurement. Due to heterogeneity in study samples, meta-analysis was not possible. Across the included studies, associations between MRI indices and BP dipping patterns were mixed; higher long-term BPV and higher sleep systolic BPV was found to be associated with lower whole brain volume and hippocampal volume. Conclusion: Increased BPV, in particular systolic long-term and systolic night-time BPV, appears to be associated with lower brain volume and hippocampal volume. This highlights the adverse effect that increased BPV has upon the brain, potentially contributing to cognitive decline, including dementia, in late-life.
Informing behaviour change intervention design using systematic review with Bayesian meta-analysis: physical activity in heart failure

ABSTRACT Embracing the Bayesian approach, we aimed to synthesise evidence regarding barriers and enablers to physical activity in adults with heart failure (HF) to inform behaviour change intervention. This approach helps estimate and quantify the uncertainty in the evidence and facilitates the synthesis of qualitative and quantitative studies. Qualitative evidence was annotated using the Theoretical Domains Framework and represented as a prior distribution using an expert elicitation task. The maximum a posteriori probability (MAP) for the probability distribution for the log OR was used to estimate the relationship between physical activity and each determinant according to qualitative, quantitative, and qualitative and quantitative evidence combined. The probability distribution dispersion (SD) was used to evaluate uncertainty in the evidence. Three qualitative and 16 quantitative studies were included (N = 2739). High pro-b-type natriuretic peptide (MAP = −1.16; 95%CrI: [−1.21; −1.11]) and self-reported symptoms (MAP = − 0.48; 95%CrI: [ −0.40; −0.55]) were suggested as barriers to physical activity with low uncertainty (SD = 0.18 and 0.19, respectively). Modifiable barriers were symptom distress (MAP = −0.46; 95%CrI: [−0.68; −0.24], SD = 0.36), and negative attitude (MAP = −0.40; 95%CrI: [−0.49; −0.31], SD = 0.26). Modifiable enablers were social support (MAP = 0.56; 95%CrI: [0.48; 0.63], SD = 0.26), self-efficacy (MAP = 0.43; 95%CrI: [0.32; 0.54], SD = 0.37), positive physical activity attitude (MAP = 0.92; 95%CrI: [0.77; 1.06], SD = 0.36).
The short-term effect of weather variables on heart rate variability in patients after open-heart surgery

ABSTRACT The aim of the study was to detect the associations between heart rate variability (HRV) and weather variables in patients who underwent coronary artery bypass grafting or valve surgery. The study was performed in Kaunas, Lithuania, during 2008–2012. We used data of 220 patients. HRV was assessed by a 5-minute electrocardiogram. The data were collected at 1.5 months, 1 year, and 2 years after the surgery (495 measurements). A negative association of standard deviation of beat-to-beat interval (SDNN), very low frequency (VLF), low frequency, and high frequency (HF) powers with a decrease in air temperature (T) during a 3-day period in the range of T < 1°C wind speed >2.75 knots 2 days before, and the daily North Atlantic Oscillation indices were observed. The effect of wind speed on SDNN and VLF power was stronger in males. Two days after relative humidity >89%, a lower mean VLF and higher HF in normalized units were found; in females, this effect was stronger 1.5 months after the surgery. Among patients after open-heart surgery, the HRV variables may be related to specific weather changes and the effect of weather was different for males and females and at different times after the surgery.
Are Graph Convolutional Networks With Random Weights Feasible?

Graph Convolutional Networks (GCNs), as a prominent example of graph neural networks, are receiving extensive attention for their powerful capability in learning node representations on graphs. There are various extensions, either in sampling and/or node feature aggregation, to further improve GCNs’ performance, scalability and applicability in various domains. Still, there is room for further improvements on learning efficiency because performing batch gradient descent using the full dataset for every training iteration, as unavoidable for training (vanilla) GCNs, is not a viable option for large graphs. The good potential of random features in speeding up the training phase in large-scale problems motivates us to consider carefully whether GCNs with random weights are feasible. To investigate theoretically and empirically this issue, we propose a novel model termed Graph Convolutional Networks with Random Weights (GCN-RW) by revising the convolutional layer with random filters and simultaneously adjusting the learning objective with regularized least squares loss. Theoretical analyses on the model's approximation upper bound, structure complexity, stability and generalization, are provided with rigorous mathematical proofs. The effectiveness and efficiency of GCN-RW are verified on semi-supervised node classification task with several benchmark datasets. Experimental results demonstrate that, in comparison with some state-of-the-art approaches, GCN-RW can achieve better or matched accuracies with less training time cost.
The structure of spectral problems and geometry: hyperbolic surfaces in E3

Working in the framework of Sym's soliton surfaces approach we point out that some simple assumptions about the structure of linear (spectral) problems of the theory of solitons lead uniquely to the geometry of some special immersions. In this paper we consider general su(2) spectral problems. Under some very weak assumptions they turn out to be associated with hyperbolic surfaces (surfaces of negative Gaussian curvature) immersed in three-dimensional Euclidean space, and especially with the so-called Bianchi surfaces.
Hard collar immobilisation following elective surgery on the cervical spine: a cross-sectional survey of UK spinal surgeons

Abstract Introduction Although mostly used in the management of spinal trauma, hard collar immobilisation is also used as an adjunct to recovery after elective cervical spine surgery. Many surgeons believe that bracing reduces the risk of non-union and pain and provides a subjective sense of security for patients. There is little if any, evidence for this practice and immobilisation can be a direct cause of adverse events. The primary aim of this study was to provide an updated assessment of post-operative bracing practice in UK spinal surgeons, including the indications, rationale and perspectives on compliance and complications. Methods Neurosurgeons and spinal orthopaedic surgeons completed a web-based survey distributed by email to members of the Society of British Neurological Surgeons (SBNS) and the British Association of Spinal Surgeons (BASS). Professional information captured included level of experience and whether surgeons had a specialist interest in spinal surgery. Questions first focused on the frequency and duration of hard collar immobilisation for common decompressive procedures. Later questions captured surgeon rationale, perceptions of patient compliance, complications, and collar removal. Results A total of 86 surgeons completed the survey, of whom 83% were spinal specialists. In total, 33 (38%) surgeons recommend a hard collar following at least one of the elective procedures listed. Collars were most commonly recommended following cervical corpectomy (30%). The support of fusion and bone healing was the most common rationale (82%), with post-operative pain (45%) and limiting patient activity (39%) also considered. Most surgeons (69%) believed that their patients were compliant. All listed types of complications were reported, with impaired activities of daily living (41%) and impaired sleep (34%) the most frequently cited. Conclusions Current post-operative use of hard collars is much lower in the United Kingdom than previously reported in the United States. Surgeon decision-making is inconsistent and may benefit from greater standardisation. Future work is needed to help develop guidelines as a move away from arbitrary to evidence-based practice.
SGLT2 Inhibition via Empagliflozin Improves Endothelial Function and Reduces Mitochondrial Oxidative Stress: Insights From Frail Hypertensive and Diabetic Patients

Background: Frailty is a multidimensional condition often diagnosed in older adults with hypertension and diabetes, and both these conditions are associated with endothelial dysfunction and oxidative stress. We investigated the functional role of the SGLT2 (sodium glucose cotransporter 2) inhibitor empagliflozin in frail diabetic and hypertensive older adults. Methods: We studied the effects of empagliflozin in consecutive hypertensive and diabetic older patients with frailty presenting at the ASL (local health unit of the Italian Ministry of Health) of Avellino, Italy, from March 2021 to January 2022. Moreover, we performed in vitro experiments in human endothelial cells to measure cell viability, permeability, mitochondrial Ca2+, and oxidative stress. Results: We evaluated 407 patients; 325 frail elders with diabetes successfully completed the study. We propensity-score matched 75 patients treated with empagliflozin and 75 with no empagliflozin. We observed a correlation between glycemia and Montreal Cognitive Assessment (MoCA) score and between glycemia and 5-meter gait speed (5mGS). At 3-month follow-up, we detected a significant improvement in the MoCA score and in the 5mGS in patients receiving empagliflozin compared with non-treated subjects. Mechanistically, we demonstrate that empagliflozin significantly reduces mitochondrial Ca2+ overload and reactive oxygen species production triggered by high glucose in human endothelial cells, attenuates cellular permeability, and improves cell viability in response to oxidative stress. Conclusions: Taken together, our data indicate that empagliflozin reduces frailty in diabetic and hypertensive patients, most likely by decreasing the mitochondrial generation of reactive oxygen species in endothelial cells.
EDR-Net: Lightweight Deep Neural Network Architecture for Detecting Referable Diabetic Retinopathy

Present architecture of convolution neural network for diabetic retinopathy (DR-Net) is based on normal convolution (NC). It incurs high computational cost as NC uses a multiplicative weight that measures a combined correlation in both cross-channel and spatial dimension of layer’s inputs. This might cause the overall DR-Net architecture to be over-parameterised and computationally inefficient. This paper proposes EDR-Net – a new end-to-end, DR-Net architecture with depth-wise separable convolution module. The EDR-Net architecture was trained with DRKaggle-train dataset (35,126 images), and tested on two datasets, i.e. DRKaggle-test (53,576 images) and Messidor-2 (1,748 images). Results showed that the proposed EDR-Net achieved predictive performance comparable with current state-of-the-arts in detecting referable diabetic retinopathy (rDR) from fundus images and outperformed other light weight architectures, with at least two times less computation cost. This makes it more amenable for mobile device based computer-assisted rDR screening applications.