Miracle-dz/UniFAR-FTUs huggingface dataset:
Usability Evaluation of Four Top-Rated Commercially Available Diabetes Apps for Adults With Type 2 Diabetes

Despite the many diabetes applications available, the rate of use is low, which may be associated with design issues. This study examined app usability compliance with heuristic design principles, guided by the Self-determination Theory on motivation. Four top-rated commercially available apps (Glucose Buddy, MyNetDiary, mySugr, and OnTrack) were tested for data recording, blood glucose analysis, and data sharing important for diabetes competence, autonomy, and connection with a healthcare provider. Four clinicians rated each app's compliance with Nielsen's 10 principles and its usability using the System Usability Scale. All four apps lacked one task function related to diabetes care competence or autonomy. Experts ranked app usability rated with the System Usability Scale: OnTrack (61) and Glucose Buddy (60) as a “D” and MyNetDairy (41) and mySugr (15) as an “F. ” A total of 314 heuristic violations were identified. The heuristic principle violated most frequently was “Help and Documentation” (n = 50), followed by “Error Prevention” (n = 45) and “Aesthetic and Minimalist Design” (n = 43). Four top-rated diabetes apps have “marginally acceptable” to “completely unacceptable. ” Future diabetes app design should target patient motivation and incorporate key heuristic design principles by providing tutorials with a help function, eliminating error-prone operations, and providing enhanced graphical or screen views.
Effects of High-Intensity Interval Training in Combat Sports: A Systematic Review with Meta-Analysis.

Vasconcelos, BB, Protzen, GV, Galliano, LM, Kirk, C, and Del Vecchio, FB. Effects of high-intensity interval training in combat sports: A systematic review with meta-analysis. J Strength Cond Res XX(X): 000-000, 2019-Combat sports (CS) are intermittent by nature and high-intensity interval training (HIIT) has been used as a tool to maintain and improve physical fitness among CS athletes. The aim of this study was to perform a systematic review and meta-analysis about chronic effects of HIIT in CS athletes. An electronic search was performed in PubMed, Science Direct, and Google Scholar using the following Boolean criteria: ("CS" OR "martial arts" OR "judo" OR "taekwondo" OR "jiu jitsu" OR "boxing" OR "karate" OR "wrestling" OR "wushu" OR "kung fu") AND ("HIIT" OR "intermittent exercise" OR "sprint interval training" OR "repeated sprint training [RST]"). To be included, the studies needed to be original, involve CS athletes, present HIIT intervention protocol (HIIT, sprint interval training [SIT] or RST), and analyze chronic physiological outcomes. From 2,211 identified studies, after screening and eligibility evaluation, 12 studies were included in this review with meta-analysis. Aerobic (aerobic capacity, heart rate, and maximum oxygen uptake), anaerobic (peak and mean power in single and successive Wingate tests, and blood lactate concentration), and anthropometric outcomes (body mass and body fat percentage) were evaluated. Data of 255 subjects from 12 studies were assessed. Regarding methodological quality, 7 studies obtained 9-10/12 on the TESTEX scale. For the interventions, 5 studies used HIIT, 4 studies used RST protocols, one used SIT protocols, and one used an intermittent protocol that could not be classified. Relating to aerobic power, was found an increase in V[Combining Dot Above]O2max, with a mean difference (MD) of 2.83 ml·kg·min (CI 95% = 0.40-5.25; p < 0.001) for striking and 2.36 ml·kg·min (CI 95% = 1.05-3.66; p < 0.001) for grappling athletes. No differences on anaerobic peak power for striking (MD = 0.67 W; CI 95% = -0.43 to 1.77; p = 0.23) were found, and a statistical improvement for grappling athletes, (MD = 0.51 W; CI 95% = 0.03-0.98; p = 0.04) was found. Seven studies analyzed anthropometric variables, with differences for body mass in striking (MD = -0.93 kg; CI 95% = -1.68 to -0.19; p = 0.01) and no differences for grappling (MD = -0.09 kg; CI 95% = -2.80 to 2.62; p = 0.95). Differences in body fat percentage in striking (MD = 0.50%; CI 95% = 0.30-0.70; p < 0.001) and no differences in grappling (MD = -0.87%; CI 95% = -1.77 to 0.03; p = 0.06) were found. It was concluded that HIIT positively influences maximum oxygen uptake and anaerobic power in combat sport athletes, with a minor impact on body composition.
Management of chronic obstructive pulmonary disease-A position statement of the South African Thoracic Society: 2019 update.

Chronic obstructive pulmonary disease (COPD) is a significant cause of death and disability in both developed and developing countries. It is increasing in frequency and demands increasing utilisation of healthcare resources. Objective To revise the South African guideline for the management of COPD based on emerging research that has informed updated recommendations.
HOW BENIGN IS BPPV IN THE ELDERLY

Geriatric population in India is rapidly increasing. According to one estimate the number of persons above the age of 60 years is 76.6 million in India. India as the second most populous country in the world, with elderly people constituting 7.7% of total population. The morbidity in this age group is often due to increased incidence of falls. It is often preceded with spells of dizziness and often associated with vestibular disorders. Peripheral vestibular disorders often difficult to evaluate at the time of fall and only realized after the fall. Peripheral vestibular disorders like Benign Paroxysmal Positional Vertigo (BPPV), Vestibulopathy, Vestibular Neuritis are some of the disorders that affect geriatric population that affect the functional ability in 'activities of daily living (ADL). BPPV has been frequently found to be more common with advancing age. One simple test to assess ADL (Activities of Daily Living) is TUG test (Timed Up and Go). A score of 11.1 seconds or more on TUG test was correlated with 80% chance of a fall in the elderly. Hence a study is undertaken to evaluate peripheral vestibular disorders in elderly with special reference to BPPV along with their performance on TUG (Timed Up and Go) test. Benign Paroxysmal Positional Vertigo (BPPV) has been found to be most common vestibular disorder in the elderly. One out of four elderly with Peripheral vestibular disorder has a risk of 'fall'. BPPV is the most common peripheral vestibular disorder leading to 'risk of fall' three times more among the elderly after 75years.
Hydroxycitric acid inhibits renal calcium oxalate deposition by reducing oxidative stress and inflammation.

OBJECTIVE To evaluate the preventive effects of hydroxycitric acid（HCA） for stone formation in the glyoxylate-induced mouse model. MATERIALS AND METHODS Male C57BL/6J mice were divided into a control group, a glyoxylate(GOX) 100 mg/kg group, a GOX+HCA 100 mg/kg group, and a GOX+HCA 200 mg/kg group. Blood samples and kidney samples were collected on the 8th day. We used Pizzolato staining and polarized light microscope to examine crystal formation and evaluated oxidative stress via the levels of malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px). Quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) was used to detect the expression of monocyte chemotactic protein-1(MCP-1), nuclear factor-kappa B (NF κ B), interleukin-1 β (IL-1 β) and interleukin-6 (IL-6) messenger RNA (mRNA). The expression of osteopontin (OPN) and cluster of differentiation-44(CD44) was detected by immunohistochemistry and qRT-PCR. In addition, periodic acid Schiff (PAS) staining and TUNEL assay were used to evaluate renal tubular injury and apoptosis. RESULTS HCA treatment could reduce markers of renal impairment (Blood Urea Nitrogen and serum creatinine). There was significantly less calcium oxalate crystal deposition in mice treated with HCA. Calcium oxalate crystals induced the production of reactive oxygen species and reduced the activity of antioxidant defense enzymes. HCA attenuated the oxidative stress induced by calcium oxalate crystallization. HCA had inhibitory effects on calcium oxalate-induced inflammatory cytokines, such as MCP-1, IL-1 β, and IL-6. In addition, HCA alleviated tubular injury and apoptosis caused by calcium oxalate crystals. CONCLUSION HCA inhibits renal injury and calcium oxalate crystal deposition in the glyoxylate-induced mouse model through antioxidation and anti-inflammation.
Telomere-related Markers for Cancer

Telomeres are structurally nucleoprotein complexes at termini of linear chromosomes and essential to chromosome stability/integrity. In normal human cells, telomere length erodes progressively with each round of cell divisions, which serves as an important barrier to uncontrolled proliferation and malignant transformation. In sharp contrast, telomere maintenance is a key feature of human malignant cells and required for their infinite proliferation and maintenance of other cancer hallmarks as well. Thus, a telomere-based anti-cancer strategy has long been suggested. However, clinically efficient and specific drugs targeting cancer telomere-maintenance have still been in their infancy thus far. To achieve this goal, it is highly necessary to elucidate how exactly cancer cells maintain functional telomeres. In the last two decades, numerous studies have provided profound mechanistic insights, and the identified mechanisms include the aberrant activation of telomerase or the alternative lengthening of telomere pathway responsible for telomere elongation, dysregulation and mutation of telomere-associated factors, and other telomere homeostasis-related signaling nodes. In the present review, these various strategies employed by malignant cells to regulate their telomere length, structure and function have been summarized, and potential implications of these findings in the rational development of telomere-based cancer therapy and other clinical applications for precision oncology have been discussed.
Morphological Profiling of Schizophrenia: Cluster Analysis of MRI-Based Cortical Thickness Data

Abstract The diagnosis of schizophrenia is thought to embrace several distinct subgroups. The manifold entities in a single clinical patient group increase the variance of biological measures, deflate the group-level estimates of causal factors, and mask the presence of treatment effects. However, reliable neurobiological boundaries to differentiate these subgroups remain elusive. Since cortical thinning is a well-established feature in schizophrenia, we investigated if individuals (patients and healthy controls) with similar patterns of regional cortical thickness form naturally occurring morphological subtypes. K-means algorithm clustering was applied to regional cortical thickness values obtained from 256 structural MRI scans (179 patients with schizophrenia and 77 healthy controls [HCs]). GAP statistics revealed three clusters with distinct regional thickness patterns. The specific patterns of cortical thinning, clinical characteristics, and cognitive function of each clustered subgroup were assessed. The three clusters based on thickness patterns comprised of a morphologically impoverished subgroup (25% patients, 1% HCs), an intermediate subgroup (47% patients, 46% HCs), and an intact subgroup (28% patients, 53% HCs). The differences of clinical features among three clusters pertained to age-of-onset, N-back performance, duration exposure to treatment, total burden of positive symptoms, and severity of delusions. Particularly, the morphologically impoverished group had deficits in N-back performance and less severe positive symptom burden. The data-driven neuroimaging approach illustrates the occurrence of morphologically separable subgroups in schizophrenia, with distinct clinical characteristics. We infer that the anatomical heterogeneity of schizophrenia arises from both pathological deviance and physiological variance. We advocate using MRI-guided stratification for clinical trials as well as case–control investigations in schizophrenia.
Differential Diagnosis of Sluggish Cognitive Tempo Symptoms in College Students

Objective: Sluggish cognitive tempo (SCT) refers to a set of symptoms that prior research has found to be related to several different psychological disorders, especially the predominantly inattentive presentation of ADHD. This study collected evidence relevant to the question of whether SCT is a distinct disorder. Method: College students (N = 910) completed measures of SCT, ADHD, depression, anxiety, sleep quality, and substance misuse. Results: Students reporting clinically high SCT (reporting at least five symptoms often or very often) had significantly higher levels and rates of other types of psychopathology. Moreover, when students reporting clinically significant levels of ADHD, depression, and anxiety symptoms, poor sleep quality, or hazardous levels of alcohol or cannabis use were removed, very few students reporting high SCT remained (only 4.8% of the original high-SCT group). Conclusion: SCT may be best thought of as a symptom set common to many types of psychopathology, and it may be caused by sleep problems or substance misuse as well.
Association between adverse perinatal outcomes and sleep disturbances during pregnancy: a systematic review and meta-analysis

Abstract Background Due to physiological and hormonal factors, sleep disturbances are prevalent in the obstetric population. Multiple studies have evaluated the relationship between sleep disturbances and perinatal outcomes, with inconsistent results. The purpose of this systematic review and meta-analysis was to further assess the overall relationship between four types of sleep disturbances (snoring, obstructive sleep apnea, extreme sleep duration, and poor sleep quality) and adverse perinatal outcomes. Methods We performed electronic searches in PubMed, Embase, the Cochrane Library, CNKI, VIP, and Wanfang Data in February 2019 to identify studies that assessed adverse perinatal outcomes among expectant mothers with sleep disturbances. Results In total, 5044 studies were identified in the initial search and 65 met the defined criteria. Pooled analysis showed that sleep disturbances were associated with an increased risk for preeclampsia (aOR: 2.77; 95% CI: 1.81–4.24), gestational diabetes mellitus (aOR: 1.96; 95% CI: 1.62–2.38), cesarean delivery (aOR: 1.99; 95% CI: 1.70–2.33), depression (aOR: 3.98; 95% CI: 2.74–5.77) and preterm birth (aOR: 1.95; 95% CI: 1.55–2.45). Conclusions The four studied sleep disturbances (OSA, snoring, extreme sleep duration and poor sleep quality) during pregnancy were associated with adverse perinatal outcomes. Expectant mothers should be advised to practice healthy sleep hygiene measures.
Malignant mixed müllerian tumor with a lung metastasis: Fine needle aspiration cytology and histology correlation

Malignant mixed müllerian tumors (MMMTs), better referred to as carcinosarcomas, are rare but highly aggressive tumors. They are histologically characterized by a biphasic pattern, having both a malignant epithelial (carcinomatous) and a malignant stromal (sarcomatous) component. Malignant mixed müllerian tumors usually affect postmenopausal women and most commonly arise from the uterus. Patients often present at an advanced stage of disease and have poor clinical outcomes. Fine needle aspiration (FNA) cytology of these tumors has rarely been reported in the literature. We herein report a uterine MMMT that metastasized to the lung in a 36-year-old woman. Cytologic analysis of the lung mass sampled by means of FNA revealed components of both endometrioid adenocarcinoma and sarcoma, features similar to the histologic findings of her primary tumor. We review the literature and discuss potential pitfalls that can affect the cytologic diagnosis of metastatic MMMTs on FNA samples.
The year in cardiology: arrhythmias and pacing.

During this last year, there has been much progress with regard to anticoagulant and ablation therapy for atrial fibrillation (AF). Apart from recently issued European Society of Cardiology Guidelines for the management of patients with supraventricular arrhythmias, there has been little progress in research in this field. Ventricular arrhythmias and device therapy have seen modest progress.
Prognostic significance of large diameter proximal aortic neck in endovascular aneurysm repair.

Background: Adverse morphological features of the proximal aortic neck have been identified as culprits for late failure after endovascular aneurysm repair (EVAR). Our objective was to investigate the prognostic role of wide proximal aortic neck in EVAR. Methods: We conducted a review of the literature in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies comparing outcomes of EVAR in patients with large versus small proximal aortic neck. A meta-analysis of time-to-event data was performed with the inverse-variance method and the results were reported as summary hazard ratio (HR) and 95 % CI. We applied random-effects models of meta-analysis. Results: We identified 9 observational studies reporting on a total of 7,682 patients (1,961 with large diameter and 5,721 with small diameter neck). The hazard of death (HR 1.57, 95 % CI 1.23-2.01; P = 0.0003), aneurysm-related reintervention (HR 2.06, 95 % CI 1.23-3.45; P = 0.006), type Ia endoleak (HR 6.69, 95 % CI 4.39-10.20; P < 0.001), sac expansion (HR 10.07, 95 % CI 1.80-56.53; P = 0.009), aneurysm rupture (HR 2.96, 95 % CI 2.00-4.38; P < 0.0001), and neck-related adverse events (HR 10.33, 95 % CI 4.95-21.56; P < 0.0001) was higher in patients with large diameter proximal aortic neck than in those with small neck. Conclusions: Patients with a large proximal aortic neck were found to have poorer outcomes than those with small neck. This finding has implications in decision making when selecting methods for aneurysm treatment and in EVAR surveillance for aneurysm-related complications in this cohort of patients.
Gomori Methenamine Silver Stain on Bronchoalveolar Lavage Fluid Is Poorly Sensitive for Diagnosis of Pneumocystis jiroveci Pneumonia in HIV-Negative Immunocompromised Patients and May Lead to Missed or Delayed Diagnoses.

CONTEXT. — Direct visualization of Pneumocystis jiroveci organisms, using Gomori methenamine silver (GMS) staining in bronchoalveolar lavage fluid (BAL), is a historical gold standard that has been widely used for the diagnosis of P jiroveci pneumonia (PJP). However, the stain may be less sensitive in human immunodeficiency virus (HIV)-negative immunocompromised patients owing to a lower burden of organisms. OBJECTIVES. — To assess the sensitivity of the GMS stain on BAL fluid for the diagnosis of PJP in HIV-negative immunocompromised patients as compared to HIV-positive patients. DESIGN. — We conducted a retrospective review from 2012 to 2018 to identify immunocompromised patients (≥18 years old) who underwent bronchoscopy with BAL GMS staining for the diagnosis of PJP. To assess for sensitivity, we sought to identify BAL GMS-positive cases and BAL GMS-negative cases of PJP. The BAL GMS-negative cases were categorized into proven and probable PJP. RESULTS. — We identified 45 adult immunocompromised patients with proven and probable PJP, including 24 HIV-negative (11 BAL GMS-positive and 13 BAL GMS-negative) and 21 HIV-positive cases (all were BAL GMS-positive). The sensitivity of BAL GMS for the diagnosis of PJP in HIV-negative immunocompromised patients was 11 of 24 (46%) versus 21 of 21 (100%) in HIV-positive patients (CD4: median, 10 cells/mL; range, 3-300 cells/mL). Delayed or missed diagnoses were seen in 3 cases of BAL GMS-negative PJP. Re-examination of BAL GMS slides showed rare P jiroveci cysts in 1 case. CONCLUSIONS. — BAL GMS has poor sensitivity for PJP in HIV-negative immunocompromised patients. Using BAL GMS as a sole method for PJP may result in missed or delayed diagnoses in this population.
Increased frequency of CD4+CD25highCD127low T cells early after lung transplant is associated with improved graft survival – a retrospective study

In this retrospective study, we analyzed the presence of any association of three CD4+CD25high regulatory T‐cell subpopulations at 3 weeks after lung transplantation with the later incidence of chronic lung allograft dysfunction and graft survival. Among lung‐transplanted patients between January 2009 and April 2018, only patients with sufficient T‐cell measurements at 3 weeks after transplantation were included into the study. Putative regulatory T cells were defined as CD4+CD25high T cells, detected in peripheral blood and further analyzed for CD127low, FoxP3+, and CD152+ using fluorescence‐activated cell sorting (FACS) analysis. Associations of regulatory T cells with chronic lung allograft dysfunction (CLAD) and graft survival were evaluated using Cox analysis. During the study period, 724 (71%) patients were included into the study. Freedom from chronic lung allograft dysfunction (CLAD) and graft survival amounted to 66% and 68% at 5 years. At the multivariable analysis, increasing frequencies of CD127low were associated with better freedom from CLAD (hazard ratio for each 1% increase of %CD127low, HR = 0.989, 95% CI = 0.981–0.996, P = 0.003) and better graft survival (HR = 0.991, 95% CI = 0.984–0.999, P = 0.026). A higher frequency of CD127low regulatory T cells in peripheral blood early after lung transplantation estimated a protective effect against chronic lung allograft dysfunction, mortality, and re‐transplantation.
The Molecular Signatures of Acute-immobilization-induced Antinociception and Chronic-immobilization-induced Antinociceptive Tolerance

In the present study, the productions of antinociception induced by acute and chronic immobilization stress were compared in several animal pain models. In the acute immobilization stress model (up to 1 hr immobilization), the antinociception was produced in writhing, tail-flick, and formalin-induced pain models. In chronic immobilization stress experiment, the mouse was enforced into immobilization for 1 hr/day for 3, 7, or 14 days, then analgesic tests were performed. The antinociceptive effect was gradually reduced after 3, 7 and 14 days of immobilization stress. To delineate the molecular mechanism involved in the antinociceptive tolerance development in the chronic stress model, the expressions of some signal molecules in dorsal root ganglia (DRG), spinal cord, hippocampus, and the hypothalamus were observed in acute and chronic immobilization models. The COX-2 in DRG, p-JNK, p-AMPKα1, and p-mTOR in the spinal cord, p-P38 in the hippocampus, and p-AMPKα1 in the hypothalamus were elevated in acute immobilization stress, but were reduced gradually after 3, 7 and 14 days of immobilization stress. Our results suggest that the chronic immobilization stress causes development of tolerance to the antinociception induced by acute immobilization stress. In addition, the COX-2 in DRG, p-JNK, p-AMPKα1, and p-mTOR in the spinal cord, p-P38 in the hippocampus, and p-AMPKα1 in the hypothalamus may play important roles in the regulation of antinociception induced by acute immobilization stress and the tolerance development induced by chronic immobilization stress.