Miracle-dz/UniFAR-FTUs huggingface dataset:
Fractional CO2 laser treatment as adjunctive therapy to topical steroids for managing vulvar lichen sclerosus

Uncontrolled vulvar lichen sclerosus (VLS) is often associated with distressful symptoms of genital itch, irritation, and pain and can lead to a pathological process including anatomical changes, scarring, and an elevated risk of cancer in the genital area. First‐line topical corticosteroid as monotherapy is frequently not adequate to fully suppress disease activity and control symptoms. This study evaluated the efficacy of fractional CO2 laser treatments as adjunctive therapy where recalcitrant VLS had been improved, but not adequately controlled, with topical corticosteroid treatment. Outcomes were evaluated up to 12 months after a series of CO2 laser treatments delivered via a fractional handpiece.
Highlighting psychological pain avoidance and decision-making bias as key predictors of suicide attempt in major depressive disorder-A novel investigative approach using machine learning.

OBJECTIVE Predicting suicide is notoriously difficult and complex, but a serious public health issue. An innovative approach utilizing machine learning (ML) that incorporates features of psychological mechanisms and decision-making characteristics related to suicidality could create an improved model for identifying suicide risk in patients with major depressive disorder (MDD). METHOD Forty-four patients with MDD and past suicide attempts (MDD_SA, N = 44); 48 patients with MDD but without past suicide attempts (MDD_NS, N = 48-42 of whom with suicide ideation [MDD_SI, N = 42]), and healthy controls (HCs, N = 51) completed seven psychometric assessments including the Three-dimensional Psychological Pain Scale (TDPPS), and one behavioral assessment, the Balloon Analogue Risk Task (BART). Descriptive statistics, group comparisons, logistic regressions, and ML were used to explore and compare the groups and generate predictors of suicidal acts. RESULTS MDD_SA and MDD_NS differed in TDPPS total score, pain arousal and avoidance subscale scores, suicidal ideation scores, and relevant decision-making indicators in BART. Logistic regression tests linked suicide attempts to psychological pain avoidance and a risk decision-making indicator. The resultant key ML model distinguished MDD_SA/MDD_NS with 88.2% accuracy. The model could also distinguish MDD_SA/MDD_SI with 81.25% accuracy. The ML model using hopelessness could classify MDD_SI/HC with 94.4% accuracy. CONCLUSION ML analyses showed that motivation to avoid intolerable psychological pain, coupled with impaired decision-making bias toward under-valuing life's worth are highly predictive of suicide attempts. Analyses also demonstrated that suicidal ideation and attempts differed in potential mechanisms, as suicidal ideation was more related to hopelessness. ML algorithms show useful promises as a predictive instrument.
Supplementary role of left ventricular global longitudinal strain for predicting sudden cardiac death in hypertrophic cardiomyopathy.

AIMS We investigated the prognostic role of left ventricular global longitudinal strain (LV-GLS) and its incremental value to established risk models for predicting sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). METHODS AND RESULTS LV-GLS was measured with vendor-independent software at a core laboratory in a cohort of 835 patients with HCM (aged 56.3 ± 12.2 years) followed-up for a median of 6.4 years. The primary endpoint was SCD events, including appropriate defibrillator therapy, within 5 years after the initial evaluation. The secondary endpoint was a composite of SCD events, heart failure admission, heart transplantation, and all-cause mortality. Twenty (2.4%) and 85 (10.2%) patients experienced the primary and secondary endpoints, respectively. Lower absolute LV-GLS quartiles, especially those worse than the median (-15.0%), were associated with progressively higher SCD event rates (P = 0.004). LV-GLS was associated with an increased risk for the primary endpoint, independent of the LV ejection fraction, apical aneurysm, and 2014 European Society of Cardiology (ESC) risk score [adjusted hazard ratio (aHR) 1.14, 95% confidence interval (CI) 1.02-1.28] or 2011 American College of Cardiology/American Heart Association (ACC/AHA) risk factors (aHR 1.18, 95% CI 1.05-1.32). LV-GLS was also associated with a higher risk for the composite secondary endpoint (aHR 1.06, 95% CI 1.01-1.12). The addition of LV-GLS enhanced the performance of the ESC risk score (C-statistic 0.756 vs. 0.842, P = 0.007) and the 2011 ACC/AHA risk factor strategy (C-statistic 0.743 vs. 0.814, P = 0.007) for predicting SCD. CONCLUSION LV-GLS is an important prognosticator in patients with HCM and provides additional information to established risk stratification strategies for predicting SCD.
Observational management of penetrating occult pneumothoraces: Outcomes and risk factors for interval tube thoracostomy placement

BACKGROUND Guidelines for penetrating occult pneumothoraces (OPTXs) are based on blunt injury. Further understanding of penetrating OPTX pathophysiology is needed. In observational management of penetrating OPTX, we hypothesized that specific clinical and radiographic features may be associated with interval tube thoracostomy (TT) placement. Our aims were to (1) describe OPTX occurrence in penetrating chest injury, (2) determine the rate of interval TT placement in observational management and clinical outcomes compared with immediate TT placement, and (3) describe risk factors associated with failure of observational management. METHODS Penetrating OPTX patients presenting to our level 1 trauma center from 2004 to 2019 were reviewed. Occult pneumothorax was defined as a pneumothorax on chest computed tomography but not on chest radiograph. Patient groups included immediate TT placement versus observation. Clinical outcomes compared were TT duration and complications, need for additional thoracic procedures, length of stay (LOS), and disposition. Clinical and radiographic factors associated with interval TT placement were determined by multivariable regression. RESULTS Of 629 penetrating pneumothorax patients, 103 (16%) presented with OPTX. Thirty-eight patients underwent immediate TT placement, and 65 were observed. Twelve observed patients (18%) needed interval TT placement. Regardless of initial management strategy, TT placement was associated with longer LOS and more chest radiographs. Chest injury complications and outcomes were similar. Factors associated with increased odds of interval TT placement included Chest Abbreviated Injury Scale score of ≥4 (adjusted odds ratio [aOR], 7.38 [95% confidence interval, 1.43–37.95), positive pressure ventilation (aOR, 7.74 [1.07–56.06]), concurrent hemothorax (aOR, 6.17 [1.08–35.24]), and retained bullet fragment (aOR, 11.62 [1.40–96.62]) (all p < 0.05). CONCLUSION The majority of patients with penetrating OPTX can be successfully observed with improved clinical outcomes (LOS, avoidance of TT complications, reduced radiation). Interval TT intervention was not associated with risk for adverse outcomes. In patients undergoing observation, specific clinical factors (chest injury severity, ventilation) and imaging features (hemothorax, retained bullet) are associated with increased odds for interval TT placement, suggesting need for heightened awareness in these patients. LEVEL OF EVIDENCE Prognostic, level IV.
Velocity-Monitored Resistance Training in Older Adults: The Effects of Low-Velocity Loss Threshold on Strength and Functional Capacity

Abstract Marques, DL, Neiva, HP, Marinho, DA, and Marques, MC. Velocity-monitored resistance training in older adults: the effects of low-velocity loss threshold on strength and functional capacity. J Strength Cond Res 36(11): 3200–3208, 2022—This study analyzed the effects of velocity-monitored resistance training (RT) with a velocity loss of 10% on strength and functional capacity in older adults. Forty-two subjects (79.7 ± 7.1 years) were allocated into an RT group (n = 21) or a control group (CG; n = 21). Over 10 weeks, the RT group performed 2 sessions per week, whereas the CG maintained their daily routine. During RT sessions, we monitored each repetition's mean velocity in the leg press and chest press exercises at 40–65% of 1 repetition maximum (1RM). The set ended when a velocity loss of 10% was reached. At pretest and post-test, both groups were assessed in the 1RM leg press and chest press, handgrip strength, medicine ball throw (MBT), walking speed (T10), and 5-repetition sit-to-stand (STS). After 10 weeks, the RT group significantly improved the 1RM leg press (p < 0.001; Hedge's g effect size [g] = 0.55), 1RM chest press (p < 0.001; g = 0.72), MBT 1kg (p < 0.01; g = 0.26), T10 (p < 0.05; g = −0.29), and STS (p < 0.05; g = −0.29), whereas the CG significantly increased the T10 (p < 0.05; g = 0.15). Comparisons between groups at post-test demonstrated significant differences in the 1RM leg press (p < 0.001; mean difference [MD] = 14.4 kg), 1RM chest press (p < 0.001; MD = 7.52), MBT 1kg (p < 0.05; MD = 0.40 m), T10 (p < 0.001; MD = −0.60 seconds), and STS (p < 0.001; MD = −1.85 seconds). Our data demonstrate that velocity-monitored RT with velocity loss of 10% results in a few repetitions per set (leg press: 5.1 ± 1.2; chest press: 3.6 ± 0.9) and significantly improves strength and functional capacity in older adults.
CARDIAC FUNCTION DURING MINI-INVASIVE REPAIR OF PECTUS EXCAVATUM WITH THE NUSS PROCEDURE.

OBJECTIVE The aim of the study was to analyze cardiac function during Nuss procedure under the combination of general anesthesia with dif f erent variants of the regional block. PATIENTS AND METHODS Materials and methods: The observative prospective study included 60 adolescents (boys/girls=47/13) undergone Nuss procedure for pectus excavatum correction under the combination of general anaesthesia and regional blocks. The patients were randomized into three groups (n=20 in each) according to the perioperative regional analgesia technique: standart epidural anaesthesia (SEA), high epidural anaesthesia (HEA) and bilateral paravertebral anaesthesia (PVA). The following parameters of cardiac function were analyzed: heart rate, estimated cardiac output (esCCO), cardiac index (esCCI), stroke volume (esSV) and stroke volume index (esSVI) using non-invasive monitoring. RESULTS Results: Induction of anesthesia and regional blocks led to a signif i cant decrease in esCCO (-9.4%) and esCCI (-9.8%), while esSV and esSVI remained almost unchanged in all groups (H=4.9; p=0.09). At this stage, the decrease in cardiac output was mainly due to decreased heart rate. At the stage of sternal elevation we found an increase in esSV, which was more pronounced in the groups of epidural blocks (+23.1% in HEA and +18.5% in SEA). After awakening from anesthesia and tracheal extubation esSV was by 11% higher than before surgery without ingergroup dif f erence. CONCLUSION Conclusions: The Nuss procedure for pectus excavatum correction lead to improved cardiac function. increase in stroke volume and its index were more informative than cardiac output and cardiac index which are dependent on heart rate that is under the inf l uence of anaesthesia technique.
Repetitive transcranial magnetic stimulation for fibromyalgia patients: A Systematic Review with Meta-Analysis.

OBJECTIVE Fibromyalgia is a poorly understood pain syndrome. Repetitive transcranial magnetic stimulation is a noninvasive brain stimulation therapy and is commonly applied for the management of fibromyalgia. However, controversy regarding its efficacy remains. Therefore, a meta-analysis was conducted to evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for fibromyalgia syndrome. METHOD Four medical databases and one physiotherapy database were screened for randomized controlled trials. A systematic review and meta-analysis was performed. Numerical Pain Rating Scale (NPRS), Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS) anxiety score, Pain Catastrophizing Scale (PCS), Fatigue Severity Scale (FSS), Short Form-36 general health survey mental score, and Fibromyalgia Impact Questionnaire (FIQ) were set as outcome measures. RESULTS Analysis of 14 studies and 433 participants indicated that rTMS exerted more favorable effects on the NPRS than sham rTMS after treatment (standardized mean difference = -0.49, 95% confidence interval = -0.86 to - 0.13, P = 0.008, I2 = 68%) and FIQ (standardized mean difference = -0.50, 95% confidence interval = -0.75 to - 0.25, P = 0.0001, I2 = 28%). However, the BDI, FSS, PCS, mood index, and HADS scores showed no significant difference compared with sham rTMS after treatment. The mean methodological quality of included studies was an acceptable score of 8.5 based on the PEDro scale, suggesting the validity of our conclusions. CONCLUSION This study demonstrated that rTMS relieved pain and enhanced quality of life of patients with fibromyalgia; however, it did not improve anxiety, depression, and other symptoms based on current reports.
Effect of bio-banding on physiological and technical-tactical key performance indicators in youth elite soccer

ABSTRACT Bio-banding has been introduced to reduce the impact of inter-individual differences due to biological maturation among youth athletes. Existing studies in youth soccer have generally examined the pilot-testing application of bio-banding. This is the first study that investigated whether bio-banded (BB) versus chronological age (CA) competition affects reliable physiological and technical-tactical in-game key performance indicators (KPIs) using a randomized cross-over repeated measures design. Sixty-five youth elite soccer players from the under-13 (U13) and under-14 (U14) age category and with maturity offsets (MO) between −2.5 and 0.5 years, competed in both a BB and CA game. For statistical analysis, players were divided into four sub-groups according to CA and MO: U13MOlow (CA ≤ 12.7, MO ≤ −1.4), U13MOhigh (CA ≤ 12.7, MO > −1.4), U14MOlow (CA > 12.7, MO ≤ −1.4), U14MOhigh (CA > 12.7, MO > −1.4). The two-factor mixed ANOVA revealed significant (p < .05) interactions between competition format and sub-group for the KPIs high accelerations ( = .176), conquered balls ( = .227) and attack balls ( = .146). Especially, U13MOhigh (i.e. early maturing players) faced a higher physiological challenge by having more high accelerations (|d| = 0.6) in BB games. Notably, U14MOlow (i.e. late maturing players) had more opportunities to show their technical-tactical abilities during BB games with more conquered balls (|d| = 1.1) and attack balls (|d| = 1.6). Affected KPIs indicate new challenges and learning opportunities during BB competition depending on a player’s individual maturity status. Bio-banding can beneficially be applied to enhance the talent development of youth elite soccer players.
Unravel the Active Site in Nitrogen‐Doped Double‐Walled Carbon Nanotubes for Nitrogen Dioxide Gas Sensor

In this paper, a nitrogen dioxide (NO2) gas sensor using nitrogen‐doped double‐walled carbon nanotubes (N‐DWCNTs) with different types of nitrogen is demonstrated, and the sensor performance to the pyridinic nitrogen is related. The ratio of nitrogen is controlled by the temperature applied for the synthesis. It is found that the fabricated sensor from N‐DWCNTs enable an approximately threefold improvement in NO2 detection compared to the sensor from DWCNTs. Also, the improvement of sensor response of N‐DWCNTs more depends on the pyridinic site than the other types of nitrogen, because it can strongly interact with the NO2 molecule. The sensing mechanism is attributed to the charge transfer between the NO2 molecule and the sensing materials (especially with pyridinic site), which shifts the Fermi level, resulting in a decrease of the electrical resistance. Furthermore, the relation between the sensor response and the concentration of NO2 is derived based on Langmuir adsorption isotherm, and the calculated detection limit can be down to 0.14 ppm, which suggests that the N‐DWCNTs‐based sensor is a promising approach for low concentration NO2 detection at room temperature.
THE EFFECTIVENESS OF THERAPY BY CRYOPRESERVED HUMAN PLASMA IN PATIENTS WITH DEFICIENCY OF MANNOSE BINDING LECTIN SUFFERING FROM HERPES VIRUS INFECTION.

OBJECTIVE The aim: To research the ef f ectiveness of cryopreserved blood plasma replacement therapy in patients with primary mannose binding lectin (MBL) def i ciency, suf f ering from chronic active herpes virus infections. PATIENTS AND METHODS Materials and methods: Patients of the study group (SG) n= 36 additionally received cryopreserved blood plasma therapy Octaplas (Octapharma, Switzerland). Patients of the control group (CG) n=36 received only chemotherapy with Valganciclovir 450 mg 2/day per os for 1-3 months. The diagnosis of active herpes virus infection was established by PCR of blood leukocytes. Statistical analysis of the obtained information was processed by the calculation of the chi-square (χ2) Pearson criterion, the odds ratio and the associated 95% conf i dence interval (95% CI). RESULTS Results: The adding cryopreserved blood plasma substitute to standard therapy with valganciclovir for the treatment of chronic active herpes virus infection in patients with total serum MBL def i ciency below 50 ng/ml, allowed to get more negative PCR results. The ef f ectiveness of combination therapy was 50% higher in carrier of HHV-6 (χ2=8,533 and р=0,004; Yeats correction 6,533 and signif i cance 0,011; OR=11,667 and 95% CI=1,939-70,180) and 43% in carrier of HHV-7 (χ2=8,846 and р=0,003; Yeats correction 7,165 and signif i cance 0,008; OR=6,375 and 95% CI=1,711-23,758), compared with monotherapy. The close association between def i cit MBL compensation and the results of antiviral treatment is also reported. The ef f ect of such treatment in patients with chronic EBV infection was less (27%). CONCLUSION Conclusions: We assumed, that virostatic ef f ect of valganciclovir is increased by MBL-mediated clearance of blood serum from viral particles.
Renal Deafferentation Prevents Progression of Hypertension and Changes to Sympathetic Reflexes in a Rabbit Model of Chronic Kidney Disease

Supplemental Digital Content is available in the text. There is increasing evidence that renal denervation is effective in alleviating hypertension associated with elevation of renal sympathetic nerve activity (RSNA) in chronic kidney disease (CKD), but whether this is due to reduction in renal afferent signaling is unclear. We determined the cardiovascular and sympathetic effects of total renal denervation or afferent renal denervation (topical capsaicin) on CKD induced by glomerular layer lesioning of the left kidney and right nephrectomy in conscious rabbits. CKD increased blood pressure by 18±2 mmHg and plasma creatinine by 40% over 2 to 4 weeks (both P<0.001), while RSNA (43%) and total norepinephrine spillover (28%) were elevated in CKD compared with sham (both P=0.04). After total or afferent renal denervation blood pressure, RSNA and norepinephrine spillover were similar or lower than non-CKD (sham) rabbits. While plasma creatinine in CKD rabbits was not affected by total renal denervation, deafferented rabbits had lower levels (P=0.017). The greater hypotensive response to pentolinium in CKD was also normalized after total or afferent denervation. Heart rate and RSNA baroreflex gain were similar in all groups. The RSNA response to airjet stress was greater in CKD compared with sham but not after total or afferent renal denervation. By contrast, the sympathetic response to hypoxia was similar in sham and CKD intact or deafferented groups but elevated in total denervated CKD animals. We conclude that the elevated sympathetic activity and blood pressure in this model of CKD is predominantly driven by renal afferents.
Sleepy drivers on a slippery road: A pilot study using a driving simulator

Sleepy drivers have problems with keeping the vehicle within the lines, and might often need to apply a sudden or hard corrective steering wheel movement. Such movements, if they occur while driving on a slippery road, might increase the risk of ending off road due to the unforgiving nature of slippery roads. We tested this hypothesis. Twelve young men participated in a driving simulator experiment with two counterbalanced conditions; dry versus slippery road × day (alert) versus night (sleepy) driving. The participants drove 52.5 km on a monotonous two‐lane highway and rated their sleepiness seven times using the Karolinska Sleepiness Scale. Blink durations were extracted from an electrooculogram. The standard deviation of lateral position and the smoothness of steering events were measures of driving performance. Each outcome variable was analysed with mixed‐effect models with road condition, time‐of‐day and time‐on‐task as predictors. The Karolinska Sleepiness Scale increased with time‐on‐task (p < 0.001) and was higher during night drives (p < 0.001), with a three‐way interaction suggesting a small increased sleepiness with driving time at night with slippery road conditions (p = 0.012). Blink durations increased with time‐on‐task (p < 0.01) with an interaction between time‐of‐day and road condition (p = 0.040) such that physiological sleepiness was lower for sleep‐deprived participants in demanding road conditions. The standard deviation of lateral position increased with time‐on‐task (p = 0.026); however, during night driving it was lower on a slippery road (p = 0.025). The results indicate that driving in demanding road condition (i.e. slippery road) might further exhaust already sleepy drivers, although this is not clearly reflected in driving performance.
Mindfulness-Based Training Does Not Improve Neuropsychological Outcomes in Mild Cognitive Impairment More Than Spontaneous Reversion Rates: A Randomized Controlled Trial.

BACKGROUND Current pharmacological and behavioral treatment options for mild cognitive impairment (MCI) are limited, motivating a search for alternative therapies that might slow the progression of cognitive decline. OBJECTIVE We investigated the effectiveness of a cognition-focused mindfulness-based intervention. METHODS An open-label, three arm randomized controlled trial was conducted at a public tertiary medical center. Older persons (ages 45-75; N = 76) diagnosed with MCI were recruited and randomized into either Mindfulness-based training (MBT), cognitive rehabilitation therapy (CRT), or treatment as usual (TAU). Participants in the intervention arms received 8 weekly 2-h sessions delivered in a group setting and engaged in home practice. Primary outcomes measures included changes in index scores for attention, immediate memory, and delayed memory as measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Depression was a secondary outcome. RESULTS Using intent-to-treat analysis, we found that participants receiving MBT showed significant improvements in global cognition (d = 0.26; [95%CI 0.03-0.56]) and delayed memory (d = 0.36; [95%CI 0.17-0.57]), with significantly greater improvements in delayed memory than CRT (ηp2 = 0.10). However, there was no benefit of MBT over TAU. No change in depression was observed in the MBT group. Reductions in depression were associated with improvements in cognitive functioning in the MBT group only. CONCLUSION Our results suggest that a cognition-focused MBT did not improve cognitive functioning in MCI patients substantially more than spontaneous reversion rates, possibly as mood symptoms were not significantly alleviated in this group.