Miracle-dz/UniFAR-FTUs huggingface dataset:
Time-dependence and comparison of regional and overall anthropometric features between Asian and Caucasian populations with obstructive sleep apnea: a cumulative meta-analysis

Background Anthropometric measurements are simple and reachable tools for self-evaluating and screening patients with a high risk of obstructive sleep apnea (OSA). However, the accumulated relationship of obesity on the anthropometric characteristics of OSA is not well understood. The aim of the study was to show the time-dependent trend of OSA patients and compare overall and regional anthropometric between two ethnicities. Methods A cumulative meta-analysis was performed to assess obesity metrics in patients with and without OSA between Asians and Caucasians. We searched PubMed, Web of Science, Embase, and Scopus up to Jun 2020. Included studies used body mass index (BMI), neck circumference (NC), waist circumference (WC) and waist-to-hip ratio (WHR) as measures of anthropometric features in the adult OSA population and controls, utilized in-lab polysomnography or home sleep testing with apnea-hypopnea index (AHI) or respiratory disturbance index (RDI) classification, reported ethnicity/race, and were published in English. Any studies lacking one of these criteria or sufficient data were excluded. Results Forty studies with a total of 19,142 subjects were investigated. Comparison of changes between patients with and without OSA showed that OSA patients had a higher BMI [mean difference (MD) 3.12, 95% confidence interval (CI): 2.51–3.73], NC (MD 3.10, 95% CI: 2.70–3.51), WC (MD 9.84, 95% CI: 8.42–11.26) and waist-hip ratio (MD 0.04, 95% CI: 0.03–0.05) than the control subjects. The accumulated time-dependent increase in population with OSA was significantly apparent with all anthropometric features. BMI increased from 2000 (MD 0.50) to 2012 (MD 3.08–3.48) and remained stable afterwards (MD 2.70–3.17), NC increased from 2000 (MD 0.40) to 2013 (MD 3.09) and remained stable afterwards too (MD 3.06–3.21). WC increased from 2000 (MD 2.00) to 2012 (MD 9.37–10.03) and also remained stable afterwards (MD 8.99–9.84). WHR was stable from 2000 to 2004 with an MD of 0.01 and then stable from 2007 onwards with an increased MD of 0.03–0.04. Compared with Caucasian patients, Asian patients had lower obesity relevant variates. Conclusions BMI, NC, WC and WHR are associated with OSA in both ethnic groups. Anthropometry for overall and regional obesity could facilitate differentiation of patients with OSA from individuals without OSA by ethnicity.
General anesthesia versus monitored anesthesia care during endovascular therapy for vertebrobasilar stroke.

OBJECTIVE The objective is to compare the effect of general anesthesia (GA) and monitored anesthesia care (MAC) on clinical outcomes in patients with endovascular therapy for vertebrobasilar occlusion stroke. METHODS 139 patients undergoing endovascular therapy for vertebrobasilar stroke, were recruited. The patients were randomized into GA group and MAC group (about 1:1 ratio). GA group received general anesthesia and MAC group received monitored anesthesia care during endovascular therapy. The primary outcome measure was the shift in the degree of disability among the 2 groups as measured by the modified Rankin scale score (mRS) at 90 days (80-100 days). Secondary end points included infarct volume and related complications. RESULTS The patients were assigned randomly (about 1:1 allocation) to GA group (n=72) and MAC group (n=67). The primary outcome of functional independence measured by 90-day mRS score was not significantly different between the 2 groups (median (IQR), 2 (1-3) vs. 3 (1-4); P=0.316). Final infarct volume was smaller in the GA group than in the MAC group (median (IQR), 27.60 (13.75-83.52) vs. 33.60 (26.85-92.95); P=0.045). There were no differences with statistical significance in rates of successful reperfusion (modified Thrombolysis in Cerebral Ischemia (mTICI) 2b-3) between 2 groups (73.61% vs. 76.12%; P=0.734). Early neurological outcomes measured by the 24-hour National Institutes of Health Stroke Scale scores (NIHSS) showed that 11 (interquartile range (IQR), 3-22) in GA group and 11 (interquartile range (IQR), 7-25) in MAC group, but were not statistically significant. There was no statistical difference in postoperative complications between the two groups. CONCLUSION For patients who underwent endovascular therapy for vertebrobasilar occlusion strok caused by occlusions in the posterior circulation, MAC appears to be as effective as GA. However, MAC is associated with bigger final infarct volume. Future studies are warranted to confirm our findings.
Nasopharyngeal carcinoma in children and adolescents: The EXPeRT/PARTNER diagnostic and therapeutic recommendations

Nasopharyngeal carcinoma (NPC) is a rare pediatric tumor. Collaborative studies performed over the last decades showed improved results compared to historical data, but standardized guidelines for diagnosis and management of pediatric NPC are still unavailable. This study presents a European consensus guideline for the diagnosis and treatment of pediatric NPC developed by the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT). Main recommendations include induction chemotherapy with cisplatin and 5‐flurouracil, concomitant chemoradiotherapy in advanced disease, and to consider maintenance treatment with interferon beta (IFN‐β) for selected high‐risk patients. Dose adjustments of radiotherapy based on response to induction chemotherapy may decrease the rates of long‐term treatment‐related complications that affect most of the survivors.
Repurposing Licensed Drugs for Use Against Alzheimer’s Disease

Substantial evidence, composed of drug mechanisms of action, in vivo testing, and epidemiological data, exists to support clinical testing of FDA-approved drugs for repurposing to the treatment of Alzheimer’s disease (AD). Licensed compound investigation can often proceed at a faster and more cost-effective manner than un-approved compounds moving through the drug pipeline. As the prevalence of AD increases with life expectancy, the current rise in life expectancy amalgamated with the lack of an effective drug for the treatment of AD unnecessarily burdens our medical system and is an urgent public health concern. The unfounded reluctance to examine repurposing existing drugs for possible AD therapy further impedes the possibility of improving the quality of patient lives with a terminal disease. This review summarizes some evidence which exists to suggest certain already-approved drugs may be considered for the treatment of AD and will perhaps encourage physicians to off-label prescribe these safe therapeutics.
Coronavirus conspiracy suspicions, general vaccine attitudes, trust and coronavirus information source as predictors of vaccine hesitancy among UK residents during the COVID-19 pandemic

Abstract Background Vaccine hesitancy presents an obstacle to the campaign to control COVID-19. It has previously been found to be associated with youth, female gender, low income, low education, low medical trust, minority ethnic group membership, low perceived risk from COVID-19, use of certain social media platforms and conspiracy beliefs. However, it is unclear which of these predictors might explain variance associated with others. Methods An online survey was conducted with a representative sample of 4343 UK residents, aged 18–75, between 21 November and 21 December 2020. Predictors of vaccine hesitancy were assessed using linear rank-order models. Results Coronavirus vaccine hesitancy is associated with youth, female gender, low income, low education, high informational reliance on social media, low informational reliance on print and broadcast media, membership of other than white ethnic groups, low perceived risk from COVID-19 and low trust in scientists and medics, as well as (to a much lesser extent) low trust in government. Coronavirus conspiracy suspicions and general vaccine attitudes appear uniquely predictive, jointly explaining 35% of variance. Following controls for these variables, effects associated with trust, ethnicity and social media reliance largely or completely disappear, whereas the effect associated with education is reversed. Conclusions Strengthening positive attitudes to vaccination and reducing conspiracy suspicions with regards to the coronavirus may have a positive effect on vaccine uptake, especially among ethnic groups with heightened vaccine hesitancy. However, vaccine hesitancy associated with age and gender does not appear to be explained by other predictor variables tested here.
Trends in Food Sources and Diet Quality Among US Children and Adults, 2003-2018

Key Points Question What are the trends in nutritional quality of foods consumed from major US sources? Findings In this survey study of 20 905 children and 39 757 adults from 2003-2004 to 2017-2018, modest improvements were found in diet quality for foods from grocery stores and small improvements for foods from restaurants, each with disparities. Diet quality for foods from schools improved significantly, especially after 2010, and equitably across subgroups; by 2017-2018, food consumed at schools had the highest quality, followed by food from grocery stores, other sources, worksites, and restaurants. Meaning By 2017-2018, foods consumed at schools provided the best mean quality of major sources, without disparities, although further improvements are needed in all sources, especially restaurants, with a focus on reducing disparities.
Combined effects of a ketogenic diet and exercise training alter mitochondrial and peroxisomal substrate oxidative capacity in skeletal muscle.

Ketogenic diets (KD) are reported to improve body weight, fat mass, and exercise performance in humans. Unfortunately, most rodent studies have used a low-protein KD, which does not recapitulate diets used by humans. Since skeletal muscle plays a critical role in responding to macronutrient perturbations induced by diet and exercise, the purpose of this study was to test if a normal-protein KD (NPKD) impacts shifts in skeletal muscle substrate oxidative capacity in response to exercise training (ExTr). A high fat, carbohydrate-deficient NPKD (16.1% protein, 83.9% fat, 0% carbohydrate) was given to C57BL/6J male mice for 6 weeks, while controls received a low fat diet with similar protein (15.9% protein, 11.9% fat, 72.2% carbohydrate). On week four of the diet, mice began treadmill training 5 days/week, 60 min/day for 3 weeks. NPKD-fed mice increased body weight and fat mass, while ExTr negated a continued rise in adiposity. ExTr increased intramuscular glycogen, while the NPKD increased intramuscular triglycerides. Neither the NPKD nor ExTr alone altered mitochondrial content; however, in combination, the NPKD-ExTr group showed increases in PGC-1α, as well as markers of mitochondrial fission and fusion. Pyruvate oxidative capacity was unchanged by either intervention, while ExTr increased leucine oxidation in NPKD-fed mice. Lipid metabolism pathways had the most notable changes as the NPKD and ExTr interventions both enhanced mitochondrial and peroxisomal lipid oxidation and many adaptations were additive or synergistic. Overall these results suggest a combination of a NPKD and ExTr induces additive and/or synergistic adaptations in skeletal muscle oxidative capacity.
Mesenchymal stromal cell therapy for pancreatitis: Progress and challenges

Pancreatitis is a common gastrointestinal disease with no effective therapeutic options, particularly for cases of severe acute and chronic pancreatitis (CP). Mesenchymal stromal cells (MSCs) are multipotent cells with diverse biological properties, including directional migration, paracrine, immunosuppressive, and antiinflammatory effects, which are considered an ideal candidate cell type for repairing tissue damage caused by various pathogenies. Several researchers have reported significant therapeutic efficacy of MSCs in animal models of acute and CP. However, the specific underlying mechanisms are yet to be clarified and clinical application of MSCs as pancreatitis therapy has rarely been reported. This review mainly focuses on the potential and challenges in clinical application of MSCs for treatment of acute and CP, along with discussion of the underlying molecular mechanisms.
MicroRNA-1297 suppressed the Akt/GSK3β signaling pathway and stimulated neural apoptosis in an in vivo sevoflurane exposure model

Objective Common inhalation anesthetics used for clinical anesthesia (such as sevoflurane) may induce nerve cell apoptosis during central nervous system development. Furthermore, anesthetics can produce cognitive impairments, such as learning and memory impairments, that continue into adulthood. However, the precise mechanism remains largely undefined. We aimed to determine the function of microRNA-1297 (miR-1297) in sevoflurane-induced neurotoxicity. Methods Reverse transcription-polymerase chain reaction assays were used to analyze miR-1297 expression in sevoflurane-exposed mice. MTT and lactate dehydrogenase (LDH) assays were used to measure cell growth, and neuronal apoptosis was analyzed using flow cytometry. Western blot analyses were used to measure PTEN, PI3K, Akt, and GSK3β protein expression. Results In sevoflurane-exposed mice, miR-1297 expression was up-regulated compared with the control group. MiR-1297 up-regulation led to neuronal apoptosis, inhibition of cell proliferation, and increased LDH activity in the in vitro model of sevoflurane exposure. MiR-1297 up-regulation also suppressed the Akt/GSK3β signaling pathway and induced PTEN protein expression in the in vitro model. PTEN inhibition (VO-Ohpic trihydrate) reduced PTEN protein expression and decreased the effects of miR-1297 down-regulation on neuronal apoptosis in the in vitro model. Conclusion Collectively, the results indicated that miR-1297 stimulates sevoflurane-induced neurotoxicity via the Akt/GSK3β signaling pathway by regulating PTEN expression.
Multiple inhibitory effects of succinic acid on Microcystis aeruginosa: morphology, metabolomics, and gene expression

ABSTRACT The cell membrane permeability, morphology, metabolomics, and gene expression of Microcystis aeruginosa under various concentrations of succinic acid (SA) were evaluated to clarify the mechanism of SA inhibition of M. aeruginosa. The results showed that SA caused intracellular protein and nucleic acid extravasation by increasing the cell membrane permeability. Scanning electron microscopy suggested that a high dose of SA (60 mg L−1) could damage the cell membrane and even cause lysis in some cells. Metabolomics result demonstrated that change in intracellular lipids content was the main reason for the increase of cell membrane permeability. In addition, SA could negatively affect amino acids metabolism, inhibit the biosynthesis of nucleotides, and interfere with the tricarboxylic acid (TCA) cycle of algal cells. Furthermore, SA also affected N assimilation and caused oxidative damage to Microcystis. In conclusion, SA inhibits the growth of M. aeruginosa through multisite action. GRAPHICAL ABSTRACT
Comparative Effectiveness of Multiple Different First-Line Treatment Regimens for Helicobacter pylori Infection: a Network Meta-Analysis.

BACKGROUND & AIMS A number of double, triple and quadruple therapies have been proposed as first line H. pylori infection empiric treatments. However, knowledge of their worldwide and regional comparative efficacy is lacking. We examined the comparative effectiveness of all empirically used first line regimens tested against standard triple treatment, using a network meta-analysis (NWM) of published RCTs. METHODS Data extracted from eligible RCTs were entered into a Bayesian NWM to investigate the comparative efficacy of H. pylori infection empiric first line regimens and to explore their effectiveness rank order. The ranking probability for each regimen, was evaluated by means of SUCRA (surfaces under cumulative ranking) values. RESULTS Sixty-eight eligible RCTs were included, giving a total of 92 paired comparisons with 22,975 patients, randomized to 8 first line regimens. The overall results showed that only vonoprazan triple therapy and reverse hybrid therapy achieved cure rates of more than 90%. Levofloxacin triple therapy performed best in Western countries (eradication rate 88.5%). The comparative effectiveness ranking showed that vonoprazan triple therapy had the best results, whereas standard triple therapy was the least efficacious regimen [SUCRA 92.4% vs 4.7% respectively, ORs (95% CrI 3.80(1.62-8.94)]. CONCLUSIONS For first line empiric H. pylori infection treatment, vonoprazan triple therapy and reverse hybrid therapy achieved high eradication rates of more than 90%. Levofloxacin triple therapy achieved the highest eradication rates in Western countries. Standard triple therapy was the least efficacious regimen in this NWM.
The influence of time of day on the performance of adolescent swimmers

ABSTRACT The study aimed to investigate the eﬀects of time-of-day, chronotype, and sex differences on the relationships between anxiety, depression, sleep quality, and swimming performance of normally diurnally active adolescent athletes. Thirty-three competitive swimmers, 20 boys (14.8 ± 1.60 y) and 13 girls (14.4 ± 1.51 y) from two different swimming centers participate in the study. They performed 50 m and 400 m front crawl trials twice, at 08:00 h and 18:00 h, with an interval of 48 h in a 50 m swimming pool. Chronotype, depression, anxiety levels, and sleep quality were accessed by questionnaires. No effect of time-of-day was observed in girls for the 50 and 400 m trials. The swimming performance of boys was similar in the 50 m trials independent of time-of-day, but in the 400 m trial the performance time was better in the evening compared to morning. The best evening performance was observed among N-types. Linear regression analysis of the data of all participants revealed a positive correlation between sleep quality and anxiety level (p = .016; R2 = 0.1769) and sleep quality and depression level (p = .006; R2 = 0.2192). There was no correlation between chronotype and sleep quality in either sex (p = .4044; R2 = 0.0232). We conclude that time-of-day can influence the performance of adolescent swimmers that differs with the distance of the trial and by sex. We also demonstrated the importance of sleep quality among adolescents swimmers as a factor that can influence anxiety and depression and thus consequently affect their performance.
Live Well, Die Well: The Development of an Online, Arts-Based Palliative Care Programme in the Shadow of the COVID-19 Pandemic

The Covid-19 crisis led to an increase in the ‘total pain’ of many terminally ill patients who faced a reduction in support, due to the temporary closure of front-line palliative day therapy services. A hospice volunteer, I instigated an online day therapy programme for patients previously attending face-to-face day therapy. Participant feedback revealed the importance of providing a space for ongoing peer support for participants’ changing sense of identity, an issue for time-limited day therapy programmes. An exploration of key concepts associated with palliative care established the multiple connections between such changing identity and arts-based approaches to living well. This article charts how I used this understanding to develop an alternative, online arts-based support programme, Live well, die well. It explores the links between ongoing mutual support, arts-based activity and the reactions to a shifting identity in patients with a life-limiting illness.
The Effects of Video Instruction on Neuroscience Intensive Care Unit Nursing Skills in Case Presentations and Neurological Examinations

Supplemental digital content is available in the text. ABSTRACT BACKGROUND: The emergence of neuroscience intensive care units (NSICUs) for the past decades has led to growing interest in targeted training for NSICU nurses. We sought to evaluate the use of video instruction on NSICU nurses' skills in case presentations and neurological examinations, which has timely advantages as an asynchronous and distanced learning modality. METHODS: We enrolled NSICU and surgical intensive care unit nurses who took shifts in the NSICU at our institution. Participants were observed by a neurocritical care attending physician presenting the clinical details of an admitted patient and conducting a neurological examination, with both parties completing a 10-item evaluation on NSICU nursing presentation and examination skills. Participants randomized to an intervention group were given access to an instructional video on NSICU nursing skills. A median of 21 days later, participants were observed by a physician blinded to study randomization, with both parties recompleting the evaluation. Differences between day 1 and day 21 scores were analyzed using paired sample t tests. RESULTS: Fifteen NSICU and 55 surgical intensive care unit nurses were enrolled. Surgical intensive care unit nurses in both the intervention and control groups had statistically significant improvement between day 1 and day 21 physician-rated scores, with a greater increase in the intervention group; self-rated scores did not change. For NSICU nurses, there were no differences in physician-rated or self-rated scores for either group. CONCLUSIONS: Surgical intensive care unit nurses who underwent direct observation and self-evaluation had improvement in physician-rated NSICU nursing skills, likely as these activities allowed for reflective observation in Kolb's experiential learning cycle. Greater improvement in participants who viewed an instructional video highlights its value as a teaching modality for nurses.
Identification of key immune-related genes and immune infiltration in atrial fibrillation with valvular heart disease based on bioinformatics analysis

Background Atrial fibrillation (AF) is the most common persistent arrhythmia. Valvular heart disease (VHD) and AF frequently coexist. In our study, from performing bioinformatics analysis, we sought to identify immune-related genes (IRGs) and explore the role of immune cell infiltration in AF-VHD in depth, aiming at investigating the potential molecular mechanism and developing new therapeutic targets for AF, including AF-VHD. Methods The gene expression of the GSE41177 and GSE79768 datasets were downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were analyzed via the limma package in Bioconductor with R software. Differentially expressed immune-related genes (DEIRGs) were selected via combination ImmPort database with DEGs, and the enrichment function and pathway analysis were explored. A protein-protein interaction (PPI) network was built with a Search Tool for the Retrieval of Interacting Genes/Proteins plugin in Cytoscape. The CIBERSORT algorithm was used to evaluate immune infiltration in the left atrial (LA) tissues between AF-VHD and sinus rhythm (SR) patients. Finally, a correlation analysis between key DEIRGs and infiltrating immune cells was performed. Results A total of 130 DEIRGs were detected. Enrichment function of DEIRGs demonstrated that they are significant in immune and inflammatory responses. The key DEIRGs assessed by the PPI network and involved in both the immune and inflammatory responses were the C-X-C motif chemokine ligand (CXCL) 1, pro-platelet basic protein (PPBP), CXCL12, and C-C motif chemokine ligand 4 (CCL4). The immune infiltration findings indicated that, compared with the LA tissues from SR patients, the tissues from AF-VHD patients contained a higher proportion of gamma delta T cells, but a lower proportion of CD8 and regulatory T cells. The results of correlation analysis demonstrated that CXCL1 was positively correlated with activated mast cells and significantly negatively correlated with resting mast cells. PPBP, CXCL12, and CCL4 were positively correlated with the infiltration of various immune cells, such as neutrophils, plasma cells, and resting dendritic cells. Conclusions The key immune-related genes and the differences in immune infiltration in LA tissues play an essential role in the occurrence and progression of AF-VHD.