Miracle-dz/UniFAR-FTUs huggingface dataset:
Predictors of criticism and emotional over-involvement in relatives of early psychosis patients

Mechanisms underlying the manifestation of relatives’ expressed emotion (EE) in the early stages of psychosis are still not properly understood. The present study aimed to examine whether relatives’ psychological distress and subjective appraisals of the illness predicted EE dimensions over-and-above patients’ poor clinical and functional status. Baseline patient-related variables and relatives attributes comprising criticism, emotional over-involvement (EOI), psychological distress, and illness attributions were assessed in 91 early psychosis patients and their respective relatives. Relatives were reassessed regarding EE dimensions at a 6-month follow-up. Relatives’ psychological distress and illness attributions predicted criticism and EOI over-and-above patients’ illness characteristics at both time points. Relatives’ increased levels of anxiety, attributions of blame toward the patients, an emotional negative representation about the disorder, and decreased levels of self-blame attributions predicted EE-criticism at baseline. Relatives’ anxiety and negative emotional representation of the disorder were the only significant predictors of EE-criticism at follow-up, whereas anxiety, attributions of control by the relative and an emotional negative representation about the disorder predicted EE-EOI both at baseline and follow-up assessments. Understanding the components that comprise and maintain EE attitudes should guide early psychosis caregivers in family interventions, enhancing proper management of psychological distress and reduction of negative appraisals about the illness. The prevention of high-EE attitudes over time in a sensitive period such as early psychosis might be critical in shaping the health of caregivers and the outcome of the affected relatives.
Age, Not Sex, Modifies the Effect of Frailty on Long-term Outcomes After Cardiac Surgery

Objective: To examine the prevalence of frailty in surgical patients and determine whether age and sex modify the relationship between frailty and long-term mortality. Background: Frailty is a complex and prevalent clinical syndrome. The cardiac surgery literature consists mostly of small, single-center studies, and the epidemiology of frailty remains to be fully elucidated in a real-world surgical population. Methods: This retrospective cohort study included patients who underwent coronary artery bypass grafting, and/or aortic, mitral or tricuspid valve surgery in Ontario, Canada, between 2008 and 2016. The primary outcome was all-cause mortality. Survival probabilities were calculated using the Kaplan-Meier method, and the association of covariates with the hazard of death was assessed using multivariable Cox proportional hazard models. Frailty was assessed using the Johns Hopkins Adjusted Clinical Groups frailty-defining diagnoses indicator. Results: Of 72,824 patients, 11,685 (16%) were frail. At median 5 ± 2 years of follow-up, 2921 (25.0%) frail patients and 8637 (14.1%) non-frail patients had died [adjusted hazard ratio 1.60; 95% confidence interval (CI), 1.53–1.68]. The adjusted hazard ratio was highest in patients who underwent isolated mitral (2.18; 95% CI, 1.71–2.77) and mitral + aortic valve surgery (1.85; 95% CI, 1.33–2.58) and lowest after coronary artery bypass grafting + mitral valve surgery (1.38; 95% CI, 1.11–1.70). Age, but not sex, modified the effect of frailty on mortality; such that the rate of death decreased linearly with increasing patient age. Conclusions: We observed a high prevalence of frailty in patients undergoing cardiac surgery, and a statistically significant association between frailty and long-term mortality after cardiac procedures. Importantly, the rate of death was inversely proportional to age, such that frailty had a stronger adverse impact on younger patients. Our findings highlight the need to incorporate frailty into the preoperative risk stratification and investigate strategies to support younger patients who are frail.
Clinical Characteristics and Morbidity Associated With Coronavirus Disease 2019 in a Series of Patients in Metropolitan Detroit

Key Points Question What are the clinical characteristics and outcomes of patients with coronavirus disease 2019 evaluated at Henry Ford Health System in Southeast Michigan during the early phase of the outbreak? Findings In this case series involving 463 consecutive patients with confirmed coronavirus disease 2019 evaluated at a 5-hospital system serving metropolitan Detroit, 72.1% of patients were African American and 94.0% had at least 1 comorbidity. Among the 355 patients who were hospitalized, 39.7% required intensive care unit admission, of whom 80.8% underwent invasive mechanical ventilation and 40.4% died within 30 days. Meaning In this series of patients with coronavirus disease 2019 in metropolitan Detroit, a high proportion were admitted and required intensive care unit admission and invasive mechanical ventilation with a mortality rate of 40.4% among patients in the intensive care unit.
EMI: Exploration with Mutual Information Maximizing State and Action Embeddings

Policy optimization struggles when the reward feedback signal is very sparse and essentially becomes a random search algorithm until the agent accidentally stumbles upon a rewarding or the goal state. Recent works utilize intrinsic motivation to guide the exploration via generative models, predictive forward models, or more ad-hoc measures of surprise. We propose EMI, which is an exploration method that constructs embedding representation of states and actions that does not rely on generative decoding of the full observation but extracts predictive signals that can be used to guide exploration based on forward prediction in the representation space. Our experiments show the state of the art performance on challenging locomotion task with continuous control and on image-based exploration tasks with discrete actions on Atari.
Activin B signaling may promote the conversion of normal fibroblasts to scar fibroblasts

Abstract This study is to explore the molecular mechanism of benign bile duct hypertrophic scar formation. Differential proteins between the normal fibroblast (NFB) and scar fibroblast (SCFB) were screened by protein chip assay, and analyzed by pathway-enrichment analysis and function-enrichment analysis. The differential proteins were further tested by ELISA. SiRNA-Act B was transfected to SCFB to down-regulate the expression of Act B. NFB was incubated with rh-Act B. The cell apoptosis and cell cycle were determined by flow cytometry. The expression of Act B, Smad2/3, transforming growth factor-β1 (TGF-β1), endothelin-1 (ET-1), thrombospondin-1 (Tsp-1), and Oncostatin M (OSM) were detected by Western blot. A total of 37 differential proteins were identified in SCFBs by microarray (P < .05), including 27 up-regulated proteins and 10 down-regulated proteins (P < .05). Their function were associated with Activin signaling, synthesis and degradation of extracellular matrix, formation and activation of cytokine, inflammatory reaction, immunoreaction, tissue damage reaction, cell cycle, migration, apoptosis, and secretion, etc. ELISA results showed that the expression of Act B, TGF-β1, ET-1 were higher in SCFBs, while the expression of Tsp-1 and OSM were lower in SCFBs (P < .05). After interfered by siRNA-Act B, the expression of Act B mRNA decreased (P < .05). The percentage of early apoptosis increased (P < .05). The expression of Act B, Smad2/3, TGF-β1 were decreased and Tsp-1, OSM were increased (P < .05). After treatment with rh-Act B, the percentage of G0/G1 phase of NFBs was decreased and that of S phase was increased without significance (P > .05). The expression of Act B, Smad2/3, TGF-β1 were increased (P < .05) and Tsp-1, OSM were decreased (P < .01). There are differentially expressed proteins between SCFBs and NFBs. Activin B signal plays an important role in the process of NFB transforming to SCFB, and TGF-β1, Smad2/3, Tsp-1, and OSM are important participants.
Fabrication of Nanocomposite Complexed with Gold Nanoparticles on Polyaniline and Application to Their Nerve Regeneration.

Electrically conductive materials can stimulate stem cells through electric shock, and thereby contribute to the regulation of cell proliferation and differentiation. Recently, polymer-metal complexes composed of polyaniline and gold nanoparticles have emerged as novel candidates for use in regenerative medicine. By mixing two different materials, such composites maximize the benefits while alleviating the disadvantages of either material alone. Based on their excellent conductivity, these complexes can applied to nerve regeneration using stem cells. In this study, we investigated a method for producing hybrid nanocomposites by complexing gold nanoparticles to polyaniline, and tested the resultant composites in a model of nerve regeneration. We manipulated the shape, size, and electrical conductivity of the hybrid composites by compounding the component materials at various ratios. The most efficient nanocomposite was named conductive reinforced nanocomposites (CRNc). When CRNc was delivered directly to cells, no cytotoxicity was observed. After intracellular delivery of CRNc, the stem cells were electrically stimulated using an electroporator. As a result of performing mRNA-sequencing (Seq) analysis after electrical stimulation (ES) of the CRNc-internalized cells, it was confirmed that the CRNc-internalized cells have a pattern similar to that of the positive group induced induced neuron cells. In particular, MAP2 (microtubule related protein 2) is more than twice that of the control group (NC; negative control), and the nerve fiber (NEFL) protein is strongly expressed as in the positive control group. In addition, we verified that neural differentiation progressed by monitoring the growth of neurites from stem cells. Together, these findings show that CRNc can be used to induce formation of neuron-like cells by applying electrical stimulation to stem cells.
Novel biallelic variants in COL7A1 cause recessive dystrophic epidermolysis bullosa

Autosomal recessive dystrophic epidermolysis bullosa (RDEB) is an incurable and severe inherited skin disorder characterized by recurrent blistering at the sublamina densa beneath the cutaneous basement membrane. It is caused by biallelic loss‐of‐function mutation in the gene encoding type VII collagen (COL7A1). This study aimed to identify the causative variants of a Chinese RDEB patient and further provide prenatal diagnosis for the ongoing risk pregnancy of the proband's mother.
Astrocyte Signaling Gates Long-Term Depression at Corticostriatal Synapses of the Direct Pathway

Despite extensive research into understanding synaptic mechanisms of striatal plasticity, the functional role played by astrocytes in this region remains to be fully elucidated. It was recently demonstrated that high-frequency stimulation (HFS) of cortical inputs induced long-term depression (LTD) mediated by adenosine A1 receptor (A1R) activation at corticostriatal synapses of the direct pathway [cortico-striatal projection neuron (dSPN)] in the dorsolateral striatum (DLS). Because astrocyte-derived adenosine has been shown to regulate synaptic transmission in several brain areas, we investigated whether this form of neuron-astrocyte signaling contributes to synaptic plasticity in the DLS of male and female mice. We found that cortical HFS increases calcium (Ca2+) levels in striatal astrocytes through activation of metabotropic glutamate receptor type 5 (mGluR5) signaling and that this astrocyte-mediated response is necessary for A1R-mediated LTD. Consistent with this, astrocyte activation with Gq designer receptors exclusively activated by designer drugs (DREADDs) induced A1R-mediated synaptic depression at cortico-dSPN synapses. Together, these results indicate that astrocytes are integral elements of striatal A1R-mediated LTD. SIGNIFICANCE STATEMENT Abnormal striatal circuit function is implicated in several disorders such as Parkinson's disease and Huntington's disease. Thus, there is a need to better understand the mechanisms supporting proper striatal activity. While extensive work has revealed the many important contributions from neurons in striatal function, far less is known about the role of astrocytes in this brain area. We show that long-term depression (LTD) at corticostriatal synapses of the direct pathway is not strictly a neuronal phenomenon; astrocytes respond to corticostriatal stimulation and this astrocyte response is necessary for LTD. This research adds to the accumulating evidence that astrocytes are active and integral players in synaptic communication, and that neuron-astrocyte interactions are key cellular processes involved in brain function.
Comparison of Therapeutic Results with/without Additional Hyperbaric Oxygen Therapy in Idiopathic Sudden Sensorineural Hearing Loss: A Randomized Prospective Study

Objective: To assess the efficacy of the combination of hyperbaric oxygen (HBO) and pharmacological treatment in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) and define patients amenable for HBO therapy. Methods: Prospective, randomized, trial involving 136 cases with unilateral ISSNHL that were randomly divided into 2 groups: the pharmacological treatment (P) group and HBO + pharmacological treatment (HBO+P) group, which received additional HBO for 14 days besides the pharmacological treatments. Pure tone audiometry gain larger than 15 dBHL was defined as success, and the success rate of each group was calculated. Results: The overall success rate of the HBO+P group and the P group is 60.6% (40/66) and 42.9% (30/70), respectively (p < 0.05). Furthermore, patients with mild-moderate baseline hearing loss, aged ≤50 years, receiving treatment in ≤14 days, or without accompanied dizziness/vertigo in the HBO+P group had higher success rate than the P group (p < 0.05). Conclusions: HBO combined with pharmacological treatments leads to better hearing recovery than pharmacological treatments alone.
[Risks factors for death among COVID-19 patients combined with hypertension, coronary heart disease or diabetes].

OBJECTIVE The pathogenesis of myocardial injury upon corona virus disease 2019 (COVID-19) infection remain unknown,evidence of impact on outcome is insufficient, therefore, we aim to investigate the risk factors for death among COVID-19 patients combined with hypertension, coronary heart disease or diabetes in this study. METHODS This was a single-centered, retrospective, observational study. Patients of Sino-French Eco-City section of Tongji Hospital, Wuhan, China attended by Peking University Supporting Medical Team and admitted from Jan. 29, 2020 to Mar. 20, 2020 were included. The positive nucleic acid of COVID-19 virus and combination with hypertension, coronary heart disease or diabetes were in the standard. We collected the clinical data and laboratory examination results of the eligible patients to evaluate the related factors of death. RESULTS In the study, 94 COVID-19 patients enrolled were divided into the group of death (13 cases) and the group of survivors (81 cases), the average age was 66.7 years. Compared with the survival group, the death group had faster basal heart rate(103.2 beats/min vs. 88.4 beats /min, P=0.004), shortness of breath(29.0 beats /min vs. 20.0 beats /min, P<0.001), higher neutrophil count(9.2×109/L vs. 3.8×109/L, P<0.001), lower lymphocyte count(0.5×109/L vs. 1.1×109/L, P<0.001), creatine kinase MB(CK-MB, 3.2 μg/L vs. 0.8 μg/L, P<0.001), high sensitivity cardiac troponin Ⅰ(hs-cTnⅠ, 217.2 ng/L vs. 4.9 ng/L, P<0.001), N-terminal pro brain natriuretic peptide(NT-proBNP; 945.0 μg/L vs. 154.0 μg/L, P<0.001), inflammatory factor ferritin(770.2 μg/L vs. 622.8 μg/L , P=0.050), interleukin-2 recepter(IL-2R, 1 586.0 U/mL vs. 694.0 U/mL, P<0.001), interleukin-6(IL-6, 82.3 ng/L vs. 13.0 ng/L, P<0.001), interleukin-10(IL-10, 9.8 ng/L vs. 5.0 ng/L, P<0.001)were higher than those in the survival group. Univariate logistic regression analysis showed that the risk factors for death were old age, low non oxygen saturation, low lymphocyte count, myocardial injury, abnormal increase of IL 2R, IL-6, and IL-10. Multivariate regression showed that old age (OR=1.11, 95%CI=1.03-1.19, P=0.026), low non oxygen saturation(OR=0.85, 95%CI=0.72-0.99, P=0.041), and abnormal increase of IL-10(＞9.1 ng/L, OR=101.93, 95%CI=4.74-2190.71, P=0.003)were independent risk factors for COVID-19 patients combined with hypertension, coronary heart disease or diabetes. CONCLUSION In COVID-19 patients combined with hypertension, coronary heart disease or diabetes, the risk factors for death were old age, low non oxygen saturation, low lymphocyte count, myocardial injury, and abnormal increase of IL-2R, IL-6, and IL-10. Old age, low non oxygen saturation and abnormal increase of IL-10 were independent risk factors.
The Sources of Belief in Personal Capability: Antecedents of Self‐Efficacy in Private Adaptation to Flood Risk

Self‐efficacy is one of the strongest and most consistent drivers of private flood mitigation behavior; however, the factors influencing self‐efficacy in the context of flooding remain unclear. The present study examines three potential antecedents of self‐efficacy: personal and vicarious experiences of floods or building‐related events, social norms for private flood preparedness, and personal competencies such as technical abilities and social skills. While controlling for other drivers in a protection motivation theory (PMT) framework, these antecedents are tested as precursors of self‐efficacy and intentions to improve flood resilience. Structural equation modeling is applied to conduct mediation analyses with survey data of 381 flood‐prone households in Austria. Contrary to theoretical expectations, personal and vicarious experiences do not predict self‐efficacy, presumably because rare flood events and changing hazard characteristics do not facilitate generalizable performance accomplishments. Social norms strongly and consistently influence self‐efficacy, especially for actions observable by others, and also directly influence protective responses. Personal competencies increase self‐efficacy and support protective action, particularly with regard to preventive and structural measures. The strength and direction of the antecedents of self‐efficacy as well as of other PMT determinants vary between general and specific protective responses. This study provides important insights for risk managers, suggesting that interventions involving social norms and personal competencies can be effective in stimulating self‐efficacy and, in turn, private flood mitigation. Interventions and research should clearly differentiate between general intention and the implementation of specific measures, and should address cumulative, synergistic, or tradeoff interrelations between multiple measures.
The Metabolomic study of Calotropis procera Ait. from Burkina Faso, based on chemical functional groups profiling using FTIR

Abstract Background C. procera is an important wild medicinal plant used in different area of Burkina Faso for the neuropsychiatric disorders treatment. It was reported to possess many pharmacological properties because of its phytochemical diversity. This study was carried out to identify possible specific chemical characteristics form C. procera leaves and root-bark samples, harvested in two regions of Burkina Faso, for a better selective use of specimens in traditional medicine. Methods Plant materials (leaves and root-bark) were collected from five sites in each region. Samples powders and extracts were mixed with potassium bromide for the Fourier Transform Infrared Spectroscopy (FTIR) analysis. A multivariate data analysis was performed to highlight differences in the FTIR spectral profile of samples. Therefore, phytochemical contents such as phenolics, flavonoids and terpenoids were evaluated with aqueous and methanolic extracts, using UV/visible light spectrophotometer method. Results Results of principal component analysis (PCA) showed a significant difference between leaves and root-bark spectral profile, independently to the region of collection. These profiles possess characteristic signals which could be exploited as biomarkers for plant organ discrimination. The phytochemical contents evaluation showed that C. procera leaves contain more significant phenolics, and root-bark possess more terpenoid compounds. This study of C. procera Ait. based on FTIR spectral characteristic and phytochemical content, suggest that terpenoids, notably cardenolide-type could be a good biomarkers for C. procera samples characterization and to explain root-bark therapeutic potential.
Daily received support and relational functioning in HCT survivors and their caregivers

Numerous authors have expressed their interest in adjustment and social support in the context of cancer. However, none of the previous studies has directly examined the models describing the links between daily social support and adjustment fluctuation, particularly at the relational level. This study aimed to verify the additive and buffering models of daily received support regarding the relational level of patient‐caregiver relationship, that is, the relationship‐related stress and relationship satisfaction following hematopoietic cell transplantation (HCT).
Using negative control outcomes to assess the comparability of treatment groups among women with osteoporosis in the United States.

PURPOSE In contrast to randomized clinical trials, comparative safety and effectiveness assessments of osteoporosis medications in clinical practice may be subject to confounding by indication. We used negative control outcomes to detect residual confounding when comparing osteoporosis medications. METHODS Using MarketScan Commercial and Supplemental claims, we identified women aged ≥55 years who initiated an oral bisphosphonate (BP) (risedronate, alendronate, or ibandronate), denosumab (an injected biologic), or intravenous zoledronic acid (ZA) from October 1, 2010 to September 30, 2015. Women with Paget's disease or cancer were excluded. We compared individual oral BPs to each other, denosumab to ZA, denosumab to oral BPs, and ZA to oral BPs, with respect to 11 negative control outcomes identified by subject matter experts. We estimated the 12-month cumulative risk difference (RD) using inverse probability of treatment and censoring weights. RESULTS Among 148 587 women, most initiated alendronate (57%), followed by ibandronate (12%), ZA (11%), risedronate (10%), and denosumab (10%). Compared with denosumab, patients initiating ZA had similar risks of all negative control outcomes. Compared with oral BPs, patients initiating denosumab had a higher risk of a wellness visit (RD = 1.2%, 95% CI: 0.4, 1.9) and a lower risk of receiving herpes zoster vaccine (RD = -0.6%, 95% CI: -1.1, -0.2). Comparing ZA with oral BP initiators resulted in two outcomes with positive associations. CONCLUSIONS Caution is warranted when comparing injectable vs oral osteoporosis medications, given the potential for unmeasured confounding. Evaluating negative control outcomes could be a standard validity check prior to conducting comparative studies.