Miracle-dz/UniFAR-FTUs huggingface dataset:
Outpatient versus Inpatient Parotidectomy: A Systematic Review and Meta-analysis

Objective Parotidectomies are commonly performed procedures by head and neck surgeons. Although parotidectomies are historically inpatient procedures, recent observational evidence has highlighted the potential for parotidectomies to be performed on an outpatient basis. This systematic review and meta-analysis sought to compare complications and unplanned health care utilization between patients undergoing outpatient versus inpatient parotidectomy. Data Sources A systematic review was performed using MEDLINE, EMBASE, and the Cochrane Library. Review Methods Studies comparing the outcomes of outpatient parotidectomy with those of inpatient parotidectomy were included. Risk of bias was assessed using the Newcastle-Ottawa Scale. Postoperative complications (hematoma, facial nerve dysfunction, seroma, fistulisation, Frey syndrome, and wound infection) and rates of 30-day readmission, reintervention, and emergency department presentation were compared. Results We screened 1018 nonduplicate articles to include 5 studies, all of which were retrospective cohort studies. There were fewer complications found in the outpatient group (relative risk = 0.61, 95% confidence interval: 0.40-0.93). Outpatient procedures were more commonly performed on patients who lived close to the hospital, had fewer comorbidities, and had less extensive planned surgery. Conclusion Outpatient parotidectomy appears safe in select patients with outcomes comparable with inpatient surgery. However, evidence overall is of low quality, and further work is needed to delineate a satisfactory set of criteria for appropriate patient identification.
Regional Gray Matter Density Associated with Fast-Paced Walking in Older Adults: A Voxel-Based Morphometry Study.

BACKGROUND Walking speed during fast-paced walking task has been associated with cognitive function. It is unclear what underlying brain structures are related to fast-paced walking. We investigated the association of gray matter density with fast-paced walking speed and usual-paced walking speed. METHODS We collected data from 284 older adults from a subset of the Health, Aging, and Body composition study (mean age=83 (SD=2.8), 58% women, 41% black)). Voxel-wise analyses on magnetic resonance imaging data identified regions of the brain where gray matter density was associated with fast-paced walking speed. We then extracted gray matter density for all identified regions and modeled the association with fast-paced walking speed after adjusting for demographic factors, clinical factors, and cognitive function. Analyses were repeated for usual-paced walking. Regions with beta coefficients ≥0.3 m/s were considered to be meaningfully correlated. RESULTS Gray matter density of clusters from cortical regions in the right middle and superior frontal gyrus, right postcentral gyrus, and left superior temporal gyrus were positively correlated with fast-paced walking speed in adjusted models. Adjustment for cognitive function had little impact on the findings. Caudate was correlated with usual paced walking speed at coefficient ≥ 0.3 m/s after adjustment of demographic factors and clinical factors, but not after further adjustment of cognitive function. CONCLUSIONS Fast-paced walking speed was correlated with gray matter density of right middle and superior frontal gyrus, right postcentral gyrus, and left superior temporal gyrus, and could potentially provide evidence about subclinical structural change of brain related to aging.
Impact of early use of long-acting injectable antipsychotics on psychotic relapses and hospitalizations in first-episode psychosis

Early relapse is frequent in the first-episode psychosis (FEP), often because of poor adherence to medication. Previous studies have shown positive impacts of long-acting injectable antipsychotics (LAI-AP) on relapse rates, while others have discerned no differences. This study describes the impact of early LAI-AP utilization on relapse and rehospitalization rates in FEP. A three-year, longitudinal, prospective, naturalistic study of all admissions of psychosis patients for early intervention services was conducted. Four hundred sixteen patients were subdivided into four groups according to the route of antipsychotic administration. Patients who received LAI-AP as their first treatment modality were more likely to exhibit poor prognostic factors at baseline. However, their relapse rate over time was similar to those with good prognostic factors at baseline who only received oral antipsychotics (OAP). Patients who were initially prescribed OAP and eventually switched to LAI-AP were more likely to relapse and to be rehospitalized, even if they manifested better functioning at baseline than those started on LAI-AP. Patients with poor prognosis in the early stage of their disease seem to benefit from early prescription of LAI-AP which can reduce and delay relapses and rehospitalizations. Because they are often still at school or at work at the time of their first episode of psychosis, relapse prevention seems particularly relevant to avoid functional deterioration.
Prosthetic joint infection due to Candida species

Abstract Introduction: The increase in the number of patients with prosthetic joints will entail a rise in the absolute number of infections associated with these procedures. Although less frequent, infections by Candida species are also expected to increase, and the clinical and surgical management of these cases is based on case reports and opinion of specialists. The objective of the present study was to review the available literature and describe the cases of prosthetic joint infection caused by Candida species in patients of the Institute of Orthopedics and Trauma of the University of São Paulo Faculty of Medicine Clinics Hospital (IOT-HCFMUSP) between 2007 and 2014. Patient concerns: Eleven patients were diagnosed with prosthetic joint infection due to Candida with mean age of 65 years. The most frequent comorbidities were heart disease and diabetes mellitus, and the main personal antecedent was previous bacterial infection in the prosthetic joint. At least one risk factor for fungal infection was present in 73% of the patients. There was no difference between the prevalence of infections caused by Candida albicans and non-albicans Candida species, and there was bacterial co-infection in 55% of the cases. Diagnosis: For building up the case series, patients with cultures of bone and joint specimens that were positive for Candida species and had a clinical diagnosis of prosthetic joint infection were included in the case series. Interventions: Surgical debridement with removal of the prosthesis was the most frequently used surgical approach (45%). All patients were treated with monotherapy, and the most frequently used antifungal agent was fluconazole. The total duration of antifungal therapy was 6 months in 73% of the cases. Outcomes: After the initial management, 73% of the patients achieved clinical remission. Conclusion: The most indicated initial management was debridement with removal of the prosthesis, and the most used treatment regimen was fluconazole monotherapy. The most prevalent treatment duration was 6 months. The initial management led to a favorable outcome in 73% of the cases. Descriptors: Prosthetic joint infection, Candida, treatment, and diagnosis.
Clinical and sonographic features of nipple lesions

Abstract Background: The aim of this study was to present several cases of benign and malignant nipple lesions and contribute to diagnosis and differential diagnosis. Methods: A retrospective study was conducted on 13 patients. All of the patients were evaluated by ultrasonography, and 11 of them had pathological results. We analyzed the clinical and sonographic features. Results: There were 3 malignant lesions, 7 benign lesions, and 3 congenital nipple dysplasia, listed as follows: Malignant lesions (n = 3, 23%): Paget's disease (PD, n = 3, 23%). All of the patients with PD showed unilateral nipple erosion, discharge, and pain. The ultrasound showed abundant blood flow (n = 3, 23%); 2 patients (n = 2, 15%) had microcalcifications. Benign lesions (n = 7, 54%): Adenoma of the nipple (n = 2, 15%). One patient (n = 1, 8%) had nipple erosion and discharge. Two patients (n = 2, 15%) had a palpable nodule in the nipple. The ultrasound of both patients (n = 2, 15%) showed regular-shaped, clear border nodule with abundant blood flow (n = 2, 15%). Leiomyoma of the nipple (n = 1, 8%): This male patient was characterized by unilateral nipple enlargement and pain. The ultrasound showed a regular nodule with absent blood flow. Plasma cell mastitis (n = 2, 15%): Two patients showed unilateral nipple inversion and pain. One patient (n = 1, 8%) showed swollen and redness. The 2 patients showed a lesion in the gland around the nipple present as an irregular shape and unclear boundary hypoechoic mass. Nipple wart (n = 2, 15%): Two patients showed a unilateral soft exogenous neoplasm. Both of the patients showed a hypoechoic wart; the echo was similar to the nipple, the border was clear, and had no blood flow in the wart. Nipple Dysplasia (n = 3, 23%): Accessory nipple (n = 3, 23%). Two patients (n = 2, 15%) had accessory nipples in the subcoastal area, 1 patient (n = 1, 8%) in the areolar. All of the patients’ sonographic features were the same as the nipple. The positive predict value (PPV) of the clinical symptoms: Erosion and discharge are both 75% (P < 0.05). The PPV of the US manifestations: irregular shape, indictinct margin, abundant blood flow, microcalcification, thicken skin in diagnosing malignant lesions are 60%,60%,60%,100%,100%, respectively (P < 0.05). Conclusions: The characteristic sonographic features together with clinical symptoms contribute to the diagnosis of nipple lesions.
Brain‐Derived Acetylcholine Maintains Peak Bone Mass in Adult Female Mice

Preclinical and clinical data support a role of the sympathetic nervous system in the regulation of bone remodeling, but the contribution of parasympathetic arm of the autonomic nervous system to bone homeostasis remains less studied. In this study, we sought to determine whether acetylcholine (ACh) contributes to the regulation of bone remodeling after peak bone mass acquisition. We show that reduced central ACh synthesis in mice heterozygous for the choline transporter (ChT) leads to a decrease in bone mass in young female mice, thus independently confirming the previously reported beneficial effect of ACh signaling on bone mass accrual. Increasing brain ACh levels through the use of the blood brain barrier (BBB)‐permeable acetylcholinesterase inhibitor (AChEI) galantamine increased trabecular bone mass in adult female mice, whereas a peripheral increase in ACh levels induced by the BBB‐impermeable AChEI pyridostigmine caused trabecular bone loss. AChEIs did not alter skeletal norepinephrine level, and induced an overall increase in osteoblast and osteoclast densities, two findings that do not support a reduction in sympathetic outflow as the mechanism involved in the pro‐anabolic effect of galantamine on the skeleton. In addition, we did not detect changes in the commitment of skeletal progenitor cells to the osteoblast lineage in vivo in AChEI‐treated mice, nor a direct impact of these drugs in vitro on the survival and differentiation of osteoblast and osteoclast progenitors. Last, ChT heterozygosity and galantamine treatment triggered bone changes in female mice only, thus revealing the existence of a gender‐specific skeletal response to brain ACh level. In conclusion, this study supports the stimulatory effect of central ACh on bone mass accrual, shows that it also promotes peak bone mass maintenance in adult mice, and suggests that central ACh regulates bone mass via different mechanisms in growing versus sexually mature mice. © 2020 American Society for Bone and Mineral Research.
Maternal perinatal depression and infant sleep problems at 1 year of age: Subjective and actigraphy data from a population‐based birth cohort study

This study used data from 2,222 mothers and infants participating in a population‐based birth cohort to verify whether maternal depression in the perinatal period was associated with poor infant sleep. Mothers who scored ≥13 points on the Edinburgh Postnatal Depression Scale at 16–24 weeks of gestation and/or 3 months after delivery were considered perinatally depressed. The main outcome variable was poor infant sleep at 12 months of age, defined as >3 night wakings, nocturnal wakefulness >1 hr or total sleep duration <9 hr. Infant sleep data were obtained with the Brief Infant Sleep Questionnaire (BISQ) and 24‐hr actigraphy monitoring. Prevalence of perinatal depression in the sample was 22.3% (95% confidence interval [CI], 20.5–24.0). After Poisson regression, infants of depressed mothers showed an adjusted relative risk (RR) of 1.44 (95% CI, 1.00–2.08; p = .04) for >3 night wakings with questionnaire‐derived data. When actigraphy data were analysed, no association was found between perinatal depression and poor infant sleep (adjusted RR, 1.20; 95% CI, 0.82–1.74; p = .35). In conclusion, although mothers in the depressed group were more likely to report more night wakings, objective data from actigraphy did not replicate this finding. Dysfunctional cognition, maternal behavioural factors and sleep impairment associated with perinatal depression may affect the mother's impression of her infant's sleep.
Mortality in Patients With Gout Treated With Allopurinol: A Systematic Review and Meta‐Analysis

Urate‐lowering therapy (predominantly allopurinol) is highly effective as a treatment for gout, but its wider long‐term effects remain unclear. This systematic review and meta‐analysis aimed to ascertain the association between mortality and the use of allopurinol in patients with gout.
Association of thyroid hormones with metabolic syndrome and its components in postmenopausal Chinese women

Abstract To evaluate the association between thyroid hormones (TH) and metabolic syndrome (MS) in postmenopausal women (PmW), a cross-sectional study was conducted with a sample of 1000 participants of PmW (40–65 years). Thyroid stimulating hormone (TSH) and free thyroxine (fT4) were evaluated. The MS was defined using the International Diabetes Federation (IDF) ethnicity-specific definitions for Asian. Participants were classified into three groups according to the TSH reference range: high-TSH (≥4.2 mU/L), low-TSH (<0.1mU/L), and normal-TSH (0.1–4.2 mU/L) group. Serum triglycerides (TG) levels were higher in low-TSH group and high-TSH group compared with normal-TSH group (p < .05). The whole sample was stratified into <60 and ≥60 years subgroups. In the ≥60 years group, fT4 was negatively correlated with waist circumference (WC) (p = .028) and positively correlated with fasting blood glucose (FBG) (p = .043), meanwhile TSH was positively correlated with WC only in the control subjects (p = .014). No difference was found between TH and the number of MS components. It was demonstrated that serum fT4 levels were associated with FBG and WC, while TSH was associated with WC in elderly PmW without MS.
The Roles of Bacterial DNA Double-Strand Break Repair Proteins in Chromosomal DNA Replication

ABSTRACT It is well established that DNA double-strand break (DSB) repair is required to underpin chromosomal DNA replication. Because DNA replication forks are prone to breakage, faithful DSB repair and correct replication fork restart are critically important. Cells, where the proteins required for DSB repair are absent or altered, display characteristic disturbances to genome replication. In this review, we analyze how bacterial DNA replication is perturbed in DSB repair mutant strains and explore the consequences of these perturbations for bacterial chromosome segregation and cell viability. Importantly, we look at how DNA replication and DSB repair processes are implicated in the striking recent observations of DNA amplification and DNA loss in the chromosome terminus of various mutant Escherichia coli strains. We also address the mutant conditions required for the remarkable ability to copy the entire E. coli genome, and to maintain cell viability, even in the absence of replication initiation from oriC, the unique origin of DNA replication in wild type cells. Furthermore, we discuss the models that have been proposed to explain these phenomena and assess how these models fit with the observed data, provide new insights and enhance our understanding of chromosomal replication and termination in bacteria.
Study on Retrofitted Masonry Elements under Shear Using Digital Image Correlation

Architectural heritage is usually built with masonry structures, which present problems under lateral in-plane loading conditions, such as wind pressure or earthquakes. In order to improve the shear behavior of masonry, the use of a fabric-reinforced cementitious matrix (FRCM) has become an interesting solution because of its synergy of mechanical properties and compatibility with masonry substrates. For a proper structural evaluation, the mechanical behavior of reinforced masonry and the FRCM itself needs to be characterized. Hence, a numerical model to evaluate the FRCM reinforcement requires some mechanical parameters that may be difficult to obtain. In this sense, the shear behavior of masonry can be evaluated by means of diagonal tension tests on small specimens (71 × 71 cm). In this work, a digital image correlation (DIC) monitoring system was used to control displacements and cracking patterns of masonry specimens under shear stress (induced by diagonal tension with FRCM layers) applied to one or two sides. In addition, the mechanical behavior of FRCM coupons under uniaxial tensile tests was also registered with DIC. The displacement measurements obtained by DIC were validated with the measurements registered with LVDT. Unlike LVDT-based techniques, DIC monitoring allowed us to measure deformations in masonry during the full test, detecting crack initiation even before it was visible to the eye.
Medical Student Mobilization During a Crisis: Lessons From a COVID-19 Medical Student Response Team

Problem On March 17, 2020, the Association of American Medical Colleges recommended the suspension of all direct patient contact responsibilities for medical students because of the COVID-19 pandemic. Given this change, medical students nationwide had to grapple with how and where they could fill the evolving needs of their schools’ affiliated clinical sites, physicians, and patients and the community. Approach At Harvard Medical School (HMS), student leaders created a COVID-19 Medical Student Response Team to: (1) develop a student-led organizational structure that would optimize students’ ability to efficiently mobilize interested peers in the COVID-19 response, both clinically and in the community, in a strategic, safe, smart, and resource-conscious way; and (2) serve as a liaison with the administration and hospital leaders to identify evolving needs and rapidly engage students in those efforts. Outcomes Within a week of its inception, the COVID-19 Medical Student Response Team had more than 500 medical student volunteers from HMS and had shared the organizational framework of the response team with multiple medical schools across the country. The HMS student volunteers joined any of the 4 virtual committees to complete this work: Education for the Medical Community, Education for the Broader Community, Activism for Clinical Support, and Community Activism. Next Steps The COVID-19 Medical Student Response Team helped to quickly mobilize hundreds of students and has been integrated into HMS’s daily workflow. It may serve as a useful model for other schools and hospitals seeking medical student assistance during the COVID-19 pandemic. Next steps include expanding the initiative further, working with the leaders of response teams at other medical schools to coordinate efforts, and identifying new areas of need at local hospitals and within nearby communities that might benefit from medical student involvement as the pandemic evolves.
Effects of curcumin supplementation on sport and physical exercise: a systematic review

Abstract Curcumin is the main phenolic compound in turmeric. It has been investigated recently due to its numerous medicinal properties and health benefits. However, few studies assessed the effects of curcumin supplementation on physical activity practice. Therefore, the purpose of this review is to assess the available evidences with human beings about the potential effects of curcumin supplementation on sport and physical exercise. This systematic review was conducted within the period from January to February, 2019, following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. The LILACS, Medline, SciELO and PubMed databases were used for the search, with no publication date limit. The following terms, with the respective Boolean operators, were searched: “curcumin” AND sports; “curcumin” AND exercise; curcumin AND “aerobic exercise”; “curcumin” AND “resistance exercise”; “curcumin” AND “endurance exercise”; “curcumin” AND “strength exercise”. Eleven papers were selected for this review. Most of the studies displayed positive effects of the curcumin supplementation for athletes and physical exercise practitioners, and no side effects were reported. Participants supplemented with curcumin displayed reduced inflammation and oxidative stress, decreased pain and muscle damage, superior recovery and muscle performance, better psychological and physiological responses (thermal and cardiovascular) during training and improved gastrointestinal function. Curcumin supplementation appears to be safe and beneficial for sport and physical exercise in human beings. PROSPERO (CRD42019126763).
Effect of Tooth Types on the Accuracy of Dental 3D Scanners: An In Vitro Study

The purpose of this study was to evaluate the accuracy of dental three-dimensional (3D) scanners according to the types of teeth. A computer-aided design (CAD) reference model (CRM) was obtained by scanning the reference typodont model using a high-precision industrial scanner (Solutionix C500, MEDIT). In addition, a CAD test model (CTM) was obtained using seven types of dental 3D scanners (desktop scanners (E1 and DOF Freedom HD) and intraoral scanners (CS3500, CS3600, Trios2, Trios3, and i500)). The 3D inspection software (Geomagic control X, 3DSystems) was used to segment the CRM according to the types of teeth and to superimpose the CTM based on the segmented teeth. The 3D accuracy of the scanner was then analyzed according to the types of teeth. One-way analysis of variance (ANOVA) was used to compare the differences according to the types of teeth in statistical analysis, and the Tukey HSD test was used for post hoc testing (α = 0.05). Both desktop and intraoral scanners showed significant differences in accuracy according to the types of teeth (P < 0.001), and the accuracy of intraoral scanners tended to get worse from anterior to posterior. Therefore, when scanning a complete arch using an intraoral scanner, the clinician should consider the tendency for the accuracy to decrease from anterior to posterior.