Miracle-dz/UniFAR-FTUs huggingface dataset:
T'ai Chi for Chronic Low Back Pain in Older Adults: A Feasibility Trial.

Objectives: T'ai chi (TC) has been found effective for improving chronic low back pain (cLBP). However, such studies did not include adults over 65 years of age. This study was designed to evaluate the feasibility and acceptability of TC in this population compared with Health Education (HE) and with Usual Care (UC). Design: Feasibility randomized controlled trial. Settings/Location: Participants were recruited from Kaiser Permanente Washington and classes took place in a Kaiser facility. Patients: Adults 65 years of age and older with cLBP. Interventions: Twenty-eight participants were randomized to 12 weeks of TC followed by a 24-week tapered TC program, 12 were assigned to a 12-week HE intervention and 17 were assigned to UC only. Outcome Measures: Feasibility and acceptability were determined by recruitment, retention and 12-, 26-, and 52-week follow-up rates, instructor adherence to protocol, class attendance, TC home practice, class satisfaction, and adverse events. Results: Fifty-seven participants were enrolled in two cohorts of 28 and 29 during two 4-month recruitment periods. Questionnaire follow-up completion rates ranged between 88% and 93%. Two major class protocol deviations were noted in TC and none in HE. Sixty-two percent of TC participants versus 50% of HE participants attended at least 70% of the classes during the 12-week initial intervention period. Weekly rates of TC home practice were high among class attendees (median of 4.2 days) at 12 weeks, with fewer people practicing at 26 and 52 weeks. By 52 weeks, 70% of TC participants reported practicing the week before, with a median of 3 days per week and 15 min/session. TC participants rated the helpfulness of their classes significantly higher than did HE participants, but the groups were similarly likely to recommend the classes. Conclusion: The TC intervention is feasible in this population, while the HE group requires modifications in delivery.
Cucurbitacin E Inhibits Huh7 Hepatoma Carcinoma Cell Proliferation and Metastasis via Suppressing MAPKs and JAK/STAT3 Pathways

Cucurbitacin E (CuE), a highly oxygenated tetracyclic triterpene from Cucurbitaceae, has shown to exhibit potent cytotoxic and anti-proliferative properties against several human cancer cells. However, the underlying effects and mechanisms of CuE regarding hepatocellular carcinoma (HCC) have not been well understood. In the current study, unbiased RNA-sequencing (RNA-seq) and bioinformatics analysis was applied to elucidate the underlying molecular mechanism. CuE could significantly inhibit cell proliferation and migration of Huh7 cells, meanwhile CuE exhibited potent anti-angiogenic activity. RNA-seq analysis revealed that CuE negatively regulated 241 differentially expressed genes (DEGs) involved in multiple processes including cytoskeleton formation, angiogenesis and focal adhesion. Further analysis revealed that CuE effectually regulated diversified pharmacological signaling pathways such as MAPKs and JAK-STAT3. Our findings demonstrated the role of CuE in inhibiting proliferation and migration, providing an insight into the regulation of multiple signaling pathways as a new paradigm for anti-cancer treatment strategy.
Regional Epidemiology, Burden, and Management of Hepatitis B Virus in the Middle East

Roughly a quarter of the world’s population, or 2 billion people, has serological evidence of past or present hepatitis B virus (HBV) infection. A total of 250 million people are estimated to have chronic hepatitis B (CHB) infection. It is further estimated that almost 700,000 die of HBV per year, with 300,000 because of the development of HBV-induced hepatocellular carcinoma, the second most common cause of death from cancer. This is true despite the presence of a safe and effective vaccine and the availability of efficient therapy. In industrialized Western countries, including the United States, immigrants from hepatitis B–endemic areas represent an important source of new HBV infections. This group represents a much greater risk than, for example, the intravenous drug user population, which is estimated to account worldwide for slightly more than a million CHB infections, whereas the immigrant HBV population in the United States alone is estimated at 1.6 million. HBVendemic countries are defined as countries hyperendemic for HBV where more than 8% of the population is HBV infected, as well as countries displaying intermediate endemicity with an HBV prevalence rate between 2% and 8%. Countries in the Middle Eastern region belong to the latter group and, because of their political instability, have recently become an important source of migration. The discussion of the current HBV epidemiology and in general the burden of HBV in this area is thus timely and is the aim of this review.
Clinical and Esthetic Outcomes of two different Prosthetic Workflows for Implant- supported All-Ceramic Single Crowns - 3 year results of a Randomized Multicenter Clinical Trail.

OBJECTIVE The aim of this randomized multicenter clinical trial was to evaluate and compare the performance of anterior all-ceramic implant crowns based either on prefabricated zirconia abutments veneered with pressed ceramics or on CAD/CAM zirconia abutments veneered with the hand build-up technique. The null hypothesis was that there is no statistically significant difference between the two study groups. MATERIAL AND METHODS Forty implants were inserted in sites 14-24 (World Dental Federation (FDI)) in two centers, the Universities of Bern and Geneva, Switzerland. 20 patients each were randomized into either Group A and restored with one piece single crown made of a prefabricated zirconia abutment with pressed ceramic, or Group B using an individualized CAD/CAM zirconia abutment with the hand layered technique. After 3 years clinical, esthetic and radiographic parameters were assessed. RESULTS Group A exhibited one drop-out patient and one failure resulting in a survival rate of 89% after three years and two failures for Group B (90%). Clinical parameters presented healthy peri-implant soft tissues. Overall, no crestal bone level changes were observed (mean DIB of 0.13 mm (Group A) and 0.24 mm (Group B)). There were no significant differences at baseline, 6 months and 1 and 3 years for DIB values between the two groups. PES and WES values evaluated at all three time points indicated stability over time for both groups and pleasing esthetic outcomes. CONCLUSIONS Both implant supported prosthetic pathways represent a valuable treatment option for the restoration of implant crowns in the anterior maxilla. (ClinicalTrials.gov # NCT02905838).
Programmed cell death protein 1/programmed death ligand-1 checkpoint blockade meets patient-derived organoids.

Tumor immunotherapy, particularly programmed cell death protein 1 (PD-1)/programmed death ligand-1 (PD-L1) immune checkpoint blockade, has been instrumental in the successful treatment of cancer. Anti-PD-1/PD-L1 immunotherapy has been approved for many types of cancer (1,2); however, it is generally understood that only a fraction of cancer patients benefit from the therapy, which limits the application of immune checkpoint inhibitors (3). Predicting the therapeutic responses to immune checkpoint inhibitors is a focus of many studies.
A meta-analysis of poststroke depression risk factors comparing depressive-related factors versus others

ABSTRACT Objectives: Poststroke depression (PSD) is a public health issue, affecting one-third of stroke survivors, and is associated with multiple negative consequences. Reviews tried to identify PSD risk factors with discrepant results, highlighting the lack of comparability of the analyzed studies. We carried out a meta-analysis in order to identify clinical risk factors that can predict PSD. Design: PubMed and Web of Science were searched for papers. Only papers with a strictly defined Diagnostic and Statistical Manual of Mental Disorders depression assessment, at least 2 weeks after stroke, were selected. Two authors independently evaluated potentially eligible studies that were identified by our search and independently extracted data using standardized spreadsheets. Analyses were performed using MetaWin®, the role of each variable being given as a risk ratio (RR). Results: Eighteen studies were included in the meta-analysis. Identified risk factors for PSD with RR significantly above 1 were previous history of depression (RR 2.19, confidence interval (CI) 1.52–3.15), disability (RR 2.00, CI 1.58–2.52), previous history of stroke (RR 1.68, CI 1.06–2.66), aphasia (RR 1.47, CI 1.13–1.91), and female gender (RR 1.35, CI 1.14–1.61). Fixed effects model leads to identification of two more risk factors: early depressive symptoms with an RR of 2.32 (CI 1.43–3.79) and tobacco consumption (RR 1.40, CI 1.09–1.81). Time bias was found for alcohol consumption. Sample size was significantly involved to explain the role of “alcohol consumption” and “cognitive impairment. ” Conclusion: Five items were significantly predictive of PSD. It might be of clinical interest that depressive-related risk factors (such as past depressive episodes) were having the largest impact.
Prognostic Value of p16 Protein in Patients With Surgically Treated Non-small Cell Lung Cancer; Relationship With Ki-67 and PD-L1

Background/Aim: Non-small cell lung cancer (NSCLC) is the leading cause of cancer death. Patients eligible for surgery have better overall survival rate than patients who are not eligible. We investigated the prognostic value of p16 in patients who underwent surgery for lung cancer, in association with other factors such as PD-L1 and Ki-67. Materials and Methods: Expression of p16 was evaluated along with the presence of Ki-67 and PD-L1 in 256 NSCLC patients treated only surgically. Results: Adenocarcinoma was the prevalent histotype (56%) followed by squamous cell (29%) and differentiation grade of 3 was the most common (60%). p16 was detected in 83 patients (30%): low positivity (<10% cells) was observed in 30 samples (11%) and high positivity (>10 % cells) in 53 patients (20%). Ki-67 was detected in 89 patients (34%) with mild positivity in 46 patients (10-25% cells), moderate positivity (26-75% cells) in 30 patients (11%), and high positivity (>75% cells) in 13 patients (5%). An influence of p16 expression (p<0.05) along with grading and staging on overall survival (OS) was found. The average OS was 36 months, but the OS increased up to 54 months when patients were stratified according to p16 expression levels. The stratification by staging showed a significant prognostic value for p16 at an early stage (p<0.014). Conclusion: p16 significantly influences prognosis, notably at an early stage, along with other variables such as grading and staging.
Activity of a Long-Acting Echinocandin, Rezafungin, and Comparator Antifungal Agents Tested against Contemporary Invasive Fungal Isolates (SENTRY Program, 2016 to 2018)

We evaluated the activity of rezafungin and comparators, using Clinical and Laboratory Standards Institute (CLSI) broth microdilution methods, against a worldwide collection of 2,205 invasive fungal isolates recovered from 2016 to 2018. Candida (n = 1,904 isolates; 6 species), Cryptococcus neoformans (n = 73), Aspergillus fumigatus (n = 183), and Aspergillus flavus (n = 45) isolates were tested for their susceptibility (S) to rezafungin as well as the comparators caspofungin, anidulafungin, micafungin, and azoles. ABSTRACT We evaluated the activity of rezafungin and comparators, using Clinical and Laboratory Standards Institute (CLSI) broth microdilution methods, against a worldwide collection of 2,205 invasive fungal isolates recovered from 2016 to 2018. Candida (n = 1,904 isolates; 6 species), Cryptococcus neoformans (n = 73), Aspergillus fumigatus (n = 183), and Aspergillus flavus (n = 45) isolates were tested for their susceptibility (S) to rezafungin as well as the comparators caspofungin, anidulafungin, micafungin, and azoles. Interpretive criteria were applied following CLSI published clinical breakpoints (CBPs) and epidemiological cutoff values (ECVs). Isolates displaying non-wild-type (non-WT) echinocandin MIC values were sequenced for hot spot (HS) mutations. Rezafungin inhibited 99.8% of Candida albicans isolates (MIC50/90, 0.03/0.06 μg/ml), 95.7% of Candida glabrata isolates (MIC50/90, 0.06/0.12 μg/ml), 97.4% of Candida tropicalis isolates (MIC50/90, 0.03/0.06 μg/ml), 100.0% of Candida krusei isolates (MIC50/90, 0.03/0.06 μg/ml), and 100.0% of Candida dubliniensis isolates (MIC50/90, 0.06/0.12 μg/ml) at ≤0.12 μg/ml. All (329/329 [100.0%]) Candida parapsilosis isolates (MIC50/90,1/2 μg/ml) were inhibited by rezafungin at ≤4 μg/ml. Fluconazole resistance was detected among 8.6% of C. glabrata isolates, 12.5% of C. parapsilosis isolates, 3.2% of C. dubliniensis isolates, and 2.6% of C. tropicalis isolates. The activity of rezafungin against these 6 Candida spp. was similar to the activity of the other echinocandins. Detection of the HS mutation was performed by sequencing echinocandin-resistant or non-WT Candida isolates. Good activity against C. neoformans was observed for fluconazole and the other azoles, whereas the echinocandins, including rezafungin, displayed limited activity. Rezafungin displayed activity similar to that of the other echinocandins against A. fumigatus and A. flavus. These in vitro data contribute to accumulating research demonstrating the potential of rezafungin for preventing and treating invasive fungal infections.
Effect of space diffuser on flow characteristics of a centrifugal pump by computational fluid dynamic analysis

Achieving an optimal configuration of the diffuser is indispensable for high pump performances. In this work, a numerical study on diffuser configuration is conducted for a high pump performance using a computational fluid dynamics code, and the effects of the wrap angle and the relative position of the diffuser vane to the impeller on pump performances are included. The results indicate that the modified diffuser with a suitable wrap angle may improve the pump hydraulic efficiency and the head by approximately 4% and 8%, respectively, while a suitable position of the diffuser vane can enhance the pump head by more than 4%. Meanwhile, the pressure recovery coefficient and the local Euler head of the diffuser are adopted to evaluate the diffuser performance. For a high pump performance, the local Euler head of the diffuser has a peak value at the leading edge with the change rate of zero along the meridian streamline, meaning that no blade loading at the leading edge of the diffuser guarantees a better match between the impeller and the diffuser.
Automatic Tunnel Crack Detection Based on U-Net and a Convolutional Neural Network with Alternately Updated Clique

Regular crack inspection of tunnels is essential to guarantee their safe operation. At present, the manual detection method is time-consuming, subjective and even dangerous, while the automatic detection method is relatively inaccurate. Detecting tunnel cracks is a challenging task since cracks are tiny, and there are many noise patterns in the tunnel images. This study proposes a deep learning algorithm based on U-Net and a convolutional neural network with alternately updated clique (CliqueNet), called U-CliqueNet, to separate cracks from background in the tunnel images. A consumer-grade DSC-WX700 camera (SONY, Wuxi, China) was used to collect 200 original images, then cracks are manually marked and divided into sub-images with a resolution of 496 × 496 pixels. A total of 60,000 sub-images were obtained in the dataset of tunnel cracks, among which 50,000 were used for training and 10,000 were used for testing. The proposed framework conducted training and testing on this dataset, the mean pixel accuracy (MPA), mean intersection over union (MIoU), precision and F1-score are 92.25%, 86.96%, 86.32% and 83.40%, respectively. We compared the U-CliqueNet with fully convolutional networks (FCN), U-net, Encoder–decoder network (SegNet) and the multi-scale fusion crack detection (MFCD) algorithm using hypothesis testing, and it’s proved that the MIoU predicted by U-CliqueNet was significantly higher than that of the other four algorithms. The area, length and mean width of cracks can be calculated, and the relative error between the detected mean crack width and the actual mean crack width ranges from −11.20% to 18.57%. The results show that this framework can be used for fast and accurate crack semantic segmentation of tunnel images.
Arresting visuospatial stimulation is insufficient to disrupt analogue traumatic intrusions

Intrusive memories are a core symptom of Post-Traumatic Stress Disorder (PTSD). A growing body of analogue studies using trauma films suggest that carrying out specific demanding tasks (e.g., playing the video game Tetris, pattern tapping) after the analogue trauma can reduce intrusive memories. To examine the mechanism behind this effect, we tested whether mere engagement with attention-grabbing and interesting visual stimuli disrupts intrusive memories, and whether this depends on working memory resources and/or the concurrent activation of trauma film memories. In a total sample of 234 healthy participants, we compared no-task control conditions to a perceptual rating task with visually arresting video clips (i.e., non-emotional, complex, moving displays), to a less arresting task with non-moving, blurred pictures (Study 1), and to more demanding imagery tasks with and without repetitive reminders of the trauma film (Study 2). Generally, we found moderate to strong evidence that none of the conditions lead to differences in intrusion frequency. Moreover, our data suggest that intrusive memories were neither related to individual differences in working memory capacity (i.e., operation span performance; Study 1), nor to the degree of engagement with a visuospatial task (i.e., one-week recognition performance; Study 2). Taken together, our findings suggest that the boundary conditions for successful interference with traumatic intrusions may be more complex and subtle than assumed. Future studies may want to test the role of prediction errors during (re-)consolidation, deliberate efforts to suppress thoughts, or the compatibility of the task demands with the individual’s skills.
Human MutLγ, the MLH1–MLH3 heterodimer, is an endonuclease that promotes DNA expansion

Significance Triplet repeat expansion causes multiple neurological disorders, but the mechanisms of triplet repeat expansion are not well understood. Growing evidence indicates that DNA loops, MutSβ (MSH2–MSH3 heterodimer), and MutLγ (MLH1–MLH3 heterodimer) play important roles in triplet repeat expansion. We demonstrate here that human MutLγ is an endonuclease that nicks DNA in a MutSβ- and loop-dependent manner. Incision of loop-containing DNA by MutLγ endonuclease initiates events that lead to DNA expansion. Surprisingly, cleavage of loop-containing DNAs by MutSβ-dependent endonuclease activity of MutLγ is strongly biased to the strand that lacks the loop. These findings document an endonuclease activity and mechanism that may be important for triplet repeat expansion. MutL proteins are ubiquitous and play important roles in DNA metabolism. MutLγ (MLH1–MLH3 heterodimer) is a poorly understood member of the eukaryotic family of MutL proteins that has been implicated in triplet repeat expansion, but its action in this deleterious process has remained unknown. In humans, triplet repeat expansion is the molecular basis for ∼40 neurological disorders. In addition to MutLγ, triplet repeat expansion involves the mismatch recognition factor MutSβ (MSH2–MSH3 heterodimer). We show here that human MutLγ is an endonuclease that nicks DNA. Strikingly, incision of covalently closed, relaxed loop-containing DNA by human MutLγ is promoted by MutSβ and targeted to the strand opposite the loop. The resulting strand break licenses downstream events that lead to a DNA expansion event in human cell extracts. Our data imply that the mammalian MutLγ is a unique endonuclease that can initiate triplet repeat DNA expansions.
Guidelines for the management of glucocorticoids during the peri‐operative period for patients with adrenal insufficiency

These guidelines aim to ensure that patients with adrenal insufficiency are identified and adequately supplemented with glucocorticoids during the peri‐operative period. There are two major categories of adrenal insufficiency. Primary adrenal insufficiency is due to diseases of the adrenal gland (failure of the hormone‐producing gland), and secondary adrenal insufficiency is due to deficient adrenocorticotropin hormone secretion by the pituitary gland, or deficient corticotropin‐releasing hormone secretion by the hypothalamus (failure of the regulatory centres). Patients taking physiological replacement doses of corticosteroids for either primary or secondary adrenal insufficiency are at significant risk of adrenal crisis and must be given stress doses of hydrocortisone during the peri‐operative period. Many more patients other than those with adrenal and hypothalamic–pituitary causes of adrenal failure are receiving glucocorticoids as treatment for other medical conditions. Daily doses of prednisolone of 5 mg or greater in adults and 10–15 mg.m−2 hydrocortisone equivalent or greater in children may result in hypothalamo–pituitary–adrenal axis suppression if administered for 1 month or more by oral, inhaled, intranasal, intra‐articular or topical routes; this chronic administration of glucocorticoids is the most common cause of secondary adrenal suppression, sometimes referred to as tertiary adrenal insufficiency. A pragmatic approach to adrenal replacement during major stress is required; considering the evidence available, blanket recommendations would not be appropriate, and it is essential for the clinician to remember that adrenal replacement dosing following surgical stress or illness is in addition to usual steroid treatment. Patients with previously undiagnosed adrenal insufficiency sometimes present for the first time following the stress of surgery. Anaesthetists must be familiar with the symptoms and signs of acute adrenal insufficiency so that inadequate supplementation or undiagnosed adrenal insufficiency can be detected and treated promptly. Delays may prove fatal.
Concurrent binding to DNA and RNA facilitates the pluripotency reprogramming activity of Sox2

Abstract Some transcription factors that specifically bind double-stranded DNA appear to also function as RNA-binding proteins. Here, we demonstrate that the transcription factor Sox2 is able to directly bind RNA in vitro as well as in mouse and human cells. Sox2 targets RNA via a 60-amino-acid RNA binding motif (RBM) positioned C-terminally of the DNA binding high mobility group (HMG) box. Sox2 can associate with RNA and DNA simultaneously to form ternary RNA/Sox2/DNA complexes. Deletion of the RBM does not affect selection of target genes but mitigates binding to pluripotency related transcripts, switches exon usage and impairs the reprogramming of somatic cells to a pluripotent state. Our findings designate Sox2 as a multi-functional factor that associates with RNA whilst binding to cognate DNA sequences, suggesting that it may co-transcriptionally regulate RNA metabolism during somatic cell reprogramming.