Miracle-dz/UniFAR-FTUs huggingface dataset:
Cerebellar White Matter Disruption in Alzheimer's Disease Patients: A Diffusion Tensor Imaging Study.

The cognitive role of the cerebellum has recently gained much attention, and its pivotal role in Alzheimer's disease (AD) has now been widely recognized. Diffusion tensor imaging (DTI) has been used to evaluate the disruption of the microstructural milieu in AD, and though several white matter (WM) tracts such as corpus callosum, inferior and superior longitudinal fasciculus, cingulum, fornix, and uncinate fasciculus have been evaluated in AD, data on cerebellar WM tracts are currently lacking. We performed a tractography-based DTI reconstruction of the middle cerebellar peduncle (MCP), and the left and right superior cerebellar peduncles separately (SCPL and SCPR) and addressed the differences in fractional anisotropy (FA), axial diffusivity (Dax), radial diffusivity (RD), and mean diffusivity (MD) in the three tracts between 50 patients with AD and 25 healthy subjects. We found that AD patients showed a lower FA and a higher RD compared to healthy subjects in MCP, SCPL, and SCPR. Moreover, a higher MD was found in SCPR and SCPL and a higher Dax in SCPL. This result is important as it challenges the traditional view that WM bundles in the cerebellum are unaffected in AD and might identify new targets for therapeutic interventions.
Nighttime Suckling Behavior in Captive Giraffe (Giraffa camelopardalis reticulata)

Suckling behaviors are useful to better understand mother–offspring relationships. However, in many species, knowledge about nighttime suckling behavior is sparse. In the present study, we investigated suckling behavior in four calves of the reticulated giraffe (Giraffa camelopardalis reticulata) and their mother in the Kyoto City Zoo, Japan, by analyzing video clips of 9614 h. The relation between a calf's age and the mean duration and frequency of suckling were consistent with the results of previous daytime studies: the longest duration (80 ± 4 s) and highest frequency (0.41/h) of suckling occurred when the calves were young, and decreased thereafter. Suckling frequency was lower at night than during the day, probably because the mother spent much of the time resting at night. The mother initiated suckling behavior in offspring until six months of age. Most often, the mother terminated suckling except during the first few weeks after birth. Additionally, we reported that the average weaning period was 448 days (n = 5) and that the last born (sixth) continued to suckle for more than 750 days, which is a rare phenomenon. We believe the present report helps to fill the lack of knowledge about nighttime suckling behavior in giraffe.
Vascular endothelial growth factor concentration in vitreous humor of patients with severe proliferative diabetic retinopathy after intravitreal injection of conbercept as an adjunctive therapy for vitrectomy

Abstract Background Proliferative diabetic retinopathy (PDR) is a progressive stage of diabetic retinopathy featured by the formation of neovascular and proliferative membrane. Vascular endothelial growth factor (VEGF) acts as a pivot factor in the development of neovascularization. This study was to investigate the changes of intravitreal VEGF concentrations of severe PDR after intravitreal injection of conbercept (IVC) and its potential advantages to the following vitrectomy. Methods This was a prospective, interventional, randomized controlled study. Sixty eyes (60 patients) with severe PDR and 20 eyes from 20 patients with rhegmatogenous retinal detachment complicated with proliferative vitreoretinopathy were enrolled in this study. PDR eyes were randomly assigned to three groups by sortation randomization method with 20 eyes in each based on the interval of preoperative IVC (group A: 7 days, group B: 14 days, group C: non-IVC). Another 20 eyes without diabetes were enrolled as the non-diabetic control group (group D), receiving PPV directly. Vitreous specimens of all 80 patients were collected and evaluated afterwards. The intravitreal VEGF concentration of the four groups, and the total surgical time and the intraoperative bleeding rate of the PDR groups were recorded. Results The mean intravitreal VEGF concentrations of groups A–D were 66.6 ± 43.3, 93.1 ± 52.3, 161.4 ± 106.1 and 1.8 ± 1.2 pg/mL, respectively. It increased significantly in PDR patients (groups A, B and C) (P = 0.002, <0.001, and <0.001, respectively). PDR patients with preoperative IVC (groups A and B) presented significantly lower VEGF concentrations (P < 0.001 and 0.001), intraoperative bleeding rates (P = 0.004) and total surgical time (P < 0.001, P = 0.003) compared with group C. No statistical differences were presented between groups A and B on the three parameters. Conclusion Seven days and 14 days of preoperative IVC are equally efficient and safe for the vitrectomy of severe PDR patients through decreasing vitreous VEGF concentrations, intraoperative bleeding rate and total surgical times.
SKA3 promotes lung adenocarcinoma metastasis through the EGFR–PI3K–Akt axis

Abstract The processes that lead to lung adenocarcinoma (LUAD) metastasis are poorly characterized. Spindle and kinetochore associated complex subunit 3 (SKA3) plays a key role in cervical cancer development, but its contribution to LUAD is unknown. Here, we found that SKA3 is overexpressed in LUAD and its expression correlates with lymph node metastasis and poor prognosis. SKA3 silencing experiments identified SKA3 as an oncogene that promotes the metastasis of LUAD cell lines and tissues. SKA3 was found to induce the expression of matrix metalloproteinase (MMP)-2, -7, and -9, which activate PI3K–AKT. SKA3 was also found to bind and activate EGFR to activate PI3K–AKT. In summary, we identify a role for SKA3 in LUAD metastasis through its ability to bind EFGR and activate PI3K–AKT signaling.
Effect of a Machine Learning-Derived Early Warning System for Intraoperative Hypotension vs Standard Care on Depth and Duration of Intraoperative Hypotension During Elective Noncardiac Surgery: The HYPE Randomized Clinical Trial.

Importance Intraoperative hypotension is associated with increased morbidity and mortality. A machine learning-derived early warning system to predict hypotension shortly before it occurs has been developed and validated. Objective To test whether the clinical application of the early warning system in combination with a hemodynamic diagnostic guidance and treatment protocol reduces intraoperative hypotension. Design, Setting, and Participants Preliminary unblinded randomized clinical trial performed in a tertiary center in Amsterdam, the Netherlands, among adult patients scheduled for elective noncardiac surgery under general anesthesia and an indication for continuous invasive blood pressure monitoring, who were enrolled between May 2018 and March 2019. Hypotension was defined as a mean arterial pressure (MAP) below 65 mm Hg for at least 1 minute. Interventions Patients were randomly assigned to receive either the early warning system (n = 34) or standard care (n = 34), with a goal MAP of at least 65 mm Hg in both groups. Main Outcomes and Measures The primary outcome was time-weighted average of hypotension during surgery, with a unit of measure of millimeters of mercury. This was calculated as the depth of hypotension below a MAP of 65 mm Hg (in millimeters of mercury) × time spent below a MAP of 65 mm Hg (in minutes) divided by total duration of operation (in minutes). Results Among 68 randomized patients, 60 (88%) completed the trial (median age, 64 [interquartile range {IQR}, 57-70] years; 26 [43%] women). The median length of surgery was 256 minutes (IQR, 213-430 minutes). The median time-weighted average of hypotension was 0.10 mm Hg (IQR, 0.01-0.43 mm Hg) in the intervention group vs 0.44 mm Hg (IQR, 0.23-0.72 mm Hg) in the control group, for a median difference of 0.38 mm Hg (95% CI, 0.14-0.43 mm Hg; P = .001). The median time of hypotension per patient was 8.0 minutes (IQR, 1.33-26.00 minutes) in the intervention group vs 32.7 minutes (IQR, 11.5-59.7 minutes) in the control group, for a median difference of 16.7 minutes (95% CI, 7.7-31.0 minutes; P < .001). In the intervention group, 0 serious adverse events resulting in death occurred vs 2 (7%) in the control group. Conclusions and Relevance In this single-center preliminary study of patients undergoing elective noncardiac surgery, the use of a machine learning-derived early warning system compared with standard care resulted in less intraoperative hypotension. Further research with larger study populations in diverse settings is needed to understand the effect on additional patient outcomes and to fully assess safety and generalizability. Trial Registration ClinicalTrials.gov Identifier: NCT03376347.
Usefulness of a Nurse-Led Program of Care for Management of Patients with Chronic Heart Failure

Background The aims of the present study were to determine whether a nurse-led program of care can improve medication adherence, quality of life (QoL), rates of rehospitalization, and all-cause mortality for chronic heart failure (CHF) patients. Material/Methods CHF patients were randomly assigned into either a control group or an intervention group. At 12 weeks, patients were followed up to evaluate the rate of medication adherence, QoL (as assessed by SF-12 physical and mental component score [PCS and MCS]), rehospitalization, and all-cause mortality. Results We recruited 152 patients. No significant differences in demographics, comorbidities, CHF severity, or etiology at baseline were observed. At discharge, no significant differences in medications prescription, PCS (46 vs. 45), or MCS (55 vs. 56) were observed. However, at 12-week follow-up, compared to the control group, patients in the intervention group were more likely to keep on medications therapy, with a significantly higher use of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker [73.8% vs. 59.7%], beta-blocker (62.5% vs. 51.4%), and aldosterone receptor antagonist (60% vs. 54.2%). Both PCS (35 vs. 40) and MCS (42 vs. 49) were also significantly lower in the control group versus the intervention groups (P<0.05). Patients in the control group had higher incident rate of rehospitalization (8.0% vs. 5.2% per person-week) than in the intervention group, with an incident rate ratio of 1.54 (95% confidence interval [CI]: 1.06–2.23). Conclusions A nurse-led discharge program of care can be a cost-effective and feasible approach for management of CHF patients in China.
Is Adjuvant Chemotherapy Necessary for Obstructing Stage II Colon Cancer? Results From a Propensity Score Analysis of the French Surgical Association Database

Objective: The aim of this study was to compare the survival of patients with stage II obstructing colon cancer (OCC) who had adjuvant chemotherapy with those who did not. Summary Background Data: The need for adjuvant chemotherapy in stage II colon cancer is still debated. Methods: All consecutive patients treated for a stage II OCC in a curative intent (with primary tumor resection) between January 2000 and December 2015 were included in this retrospective, multicenter cohort study which included a propensity score analysis using an odds of treatment weighting (Average Treatment effect on the Treated, ATT). The endpoint was the comparison between the 2 groups for overall survival (OS) and disease-free survival (DFS) according to whether or not patients received adjuvant chemotherapy. Results: During the study period, 504 patients underwent a curative colectomy for a stage II OCC. Among these patients, 179 (35.5%) had adjuvant chemotherapy and 325 (64.5%) had no adjuvant treatment. Among the 179 patients who received adjuvant chemotherapy, 108 patients (60%) received oxaliplatin based regimen and 99 patients (55%) completed all scheduled cycles. At multivariate analysis, after weighting by the odds (ATT analysis) and adjustment, adjuvant chemotherapy after resection of a stage II OCC was associated with improvements in OS [hazard ratio (HR) = 0.42 (0.17–0.99), P = 0.0498] and DFS [HR = 0.57 (0.37–0.88), P = 0.0116]. Conclusion: This study suggests that adjuvant chemotherapy after curative resection of stage II OCC may improve oncological outcomes.
The clinical and economic burden of community-onset complicated skin and skin structure infections in Korea

Background/Aims To investigate epidemiologic characteristics, clinical and economic burdens, and factors associated with mortality in complicated skin and skin structure infection (cSSSI) patients in Korea. Methods A retrospective, observational, nationwide study was conducted between April to July 2012 at 14 tertiary-hospitals in Korea. Eligible patients were hospitalized adults with community acquired cSSSI, who underwent surgical intervention and completed treatment between November 2009 and October 2011. Data on demography, clinical characteristics, outcomes and medical resource utilization were collected through medical record review. Direct medical costs were calculated by multiplying quantities of resources utilized by each unit price in Korea. Results Of 473 patients enrolled, 449 patients (except 24 patients with no record on surgical intervention) were eligible for analysis. Microbiological testing was performed on 66.1% of patients and 8.2% had multiple pathogens. Among culture confirmed pathogens (n = 297 patients, 340 episodes), 76.2% were gram-positive (Staphylococcus aureus; 41.2%) and 23.8% were gram-negative. The median duration of hospital stay was 16 days. Among treated patients, 3.3% experienced recurrence and 4.2% died in-hospital. The mean direct medical costs amounted to $4,195/ person, with the greatest expenses for hospitalization and antibiotics. The in-hospital mortality and total medical costs were higher in combined antibiotics therapy than monotherapy (p < 0.05). Charlson’s comorbidity index ≥ 3, standardized early warning scoring ≥ 4, sub-fascia infections and combined initial therapy, were all found to be associated with higher mortality. Conclusions Korean patients with community-onset cSSSI suffer from considerable clinical and economic burden. Efforts should be made to reduce this burden through appropriate initial treatment.
The endophytic bacteria Bacillus velezensis Lle-9, isolated from Lilium leucanthum harbors antifungal activity and plant growth-promoting effects.

Bacillus velezensis is an important plant-growth promoting rhizobacterium with immense potential in agriculture development. In the present study, Bacillus velezensis, Lle-9 was isolated from the bulbs of Lilium leucanthum. The isolated strain showed antifungal activities against plant pathogens like Botryosphaeria dothidea, Fusarium oxysporum, Botrytis cinerea and Fusarium fujikuroi. Highest percentage of growth inhibition i.e., 68.56±2.35% was observed against Fusarium oxysporum followed by 63.12 ± 2.83%, 61.67 ± 3.39% and 55.82 ± 2.76% against Botrytis cinerea, Botryosphaeria dothidea, and Fusarium fujikuroi, respectively. The ethyl acetate fraction revealed a number of bioactive compounds and several were identified as antimicrobial agents such as diketopiperazines, cyclo-peptides, linear peptides, latrunculin A, 5α. -hydroxy-6-ketocholesterol, (R)-S-lactoylglutathione, triamtrene, rubiadin, moxifloxacin, 9-hydroxy-5Z,7E,11Z,14Z-eicosatetraenoic acid, D-erythro-C18-Sphingosine, citrinin, and 2-arachidonoyllysophosphatidylcholine. The presence of these antimicrobial compounds in the bacterial culture might have contributed to the antifungal activities of the isolated B. velezensis Lle-9. The strain showed plant growth promoting traits such as production of organic acids, ACC deaminase, indole-3-acetic acid (IAA), siderophores, and nitrogen fixation and phosphate solubilization. IAA production was accelerated with application of exogenous tryptophan concentrations in the medium. Further, the lily plants upon inoculation with Lle-9 exhibited improved vegetative growth, more flowering shoots and longer roots than control plants under greenhouse condition. The isolated B. velezensis strain Lle-9 possessed broad spectrum antifungal activities and multiple plant growth promoting traits and thus may play an important role in promoting sustainable agriculture. This strain could be developed and applied in field experiments in order to promote plant growth and control disease pathogens.
Sound rhythm effects on cardiac parameters

The aim of this study was to find out effects of simple sound rhythms on cardiac parameters of listeners. The rhythms used differed in tempo and intensity, while changes in cardiac parameters (R-R intervals and their variability) were used to assess the effects on the subjects. Experimental design was 3 x 2 within group factorial experiment. Three different levels of tempo (60, 200 and 400 BPMs), and two intensity levels (40 and 80 dB) were used. Eleven subjects participated in the experiment, which consisted of six experimental situations, interpolated with silence situations. Complex effects of different situations were found on cardiac parameters. When sequential effects were eliminated by the use of linear regression, rhythm effects on cardiac parameters were obtained, with a tendency of a decrease in heartbeat frequency, which was more prominent during listening to more intensive and slower rhythms. Heartbeat variability tended to decrease during listening to any rhythm.
Knowledge, Attitude and Practices on Antimicrobial Resistance and Usage Among Medical Students in A Malaysian Medical University

Abstract—Drug resistance is a fast mounting crisis. Many factors, like the inappropriate use of antimicrobials by prescribing physician, unregulated sale of drugs and self-medication, have been attributed to the increase in the incidence of antimicrobial resistance. Health care professionals are a significant determinant in this regard their in-depth knowledge is essential for rationale antimicrobial usage. The objective of this study is to analyze the knowledge, attitude, and practice of antimicrobial usage and resistance among different years of medical students. This is a cross-sectional questionnaire-based study that was conducted among yr. 1 to yr.5 students. A validated Questionnaire was obtained. The questionnaire assesses the students on their attitude, practice, and knowledge of antimicrobial resistance and usage. The data were analyzed using descriptive statistics. A total of 543 students participated in the study. Antimicrobial resistance was recognized as an essential and serious public health issue in today’s era by 92.16% Year 5 respondents, which was highest among all the years (Year 1-5). The awareness regarding the etiology of cold and flu was observed to be the highest among Year 4 respondents (65.74%). Only 2.8% of the total respondents strongly agreed that skipping one or two doses of antimicrobials does not lead to the development of resistance. 49.02% of the year five respondents always consulted a physician before starting an antimicrobial, indicating a good practice. However, when it came to checking the expiry date of antimicrobials before taking it, the Year 1 respondents (53.95%) were more particular. The study revealed that some aspects of knowledge regarding antimicrobial resistance and usage were found to be significantly higher among the respondents in the clinical years. The said knowledge was well-reflected in some, but not all of the facets of the respondent’s attitude and practice.
Does contingent payment enhance foreign target acquirer’s value? The optimal entry mode

This paper presents new evidence on the workings and wealth effects of earnouts in international changes of corporate control. It offers compelling evidence suggesting that firms choosing to join a multinational network via the acquisition of a foreign target firm outperform (a) their domestic counterparts and (b) the remaining foreign target acquirers only when they use earnouts in the deal’s financing process. This is further explored by relying on a quasi-experimental design through which the earnout effect is evaluated in isolation. The findings offer direct evidence on the superiority of deferred payments in the form of earnouts in foreign target deals announced by acquirers without any international business experience. The results reflect the ability of earnouts to (a) reduce the excessive valuation risk faced by acquirers that attempt to access a foreign market for the first time and, (b) enhance the benefits of operating within a multinational network by securing higher merger payoffs. The results extend existing debate on the wealth effects of foreign acquirers, especially when entering a market for the first time, which provides further support for the Multinational Network Hypothesis introduced by Doukas and Travlos (1988).
Incidental finding of bifid cardiac apex in a case of sudden death due to sickle cell disease

Bifid cardiac apex represents an infrequent anomaly within human anatomy. When encountered in clinical or forensic practice it has been commonly associated to other cardiovascular malformations. We report an autopsy case of bifid cardiac apex, which was an incidental discovery, in a 29-year-old African male who died suddenly. After histopathological examination death was ascribed to sickle cell crisis. A coronary anatomic variant was also noted. This case is highlighted as a rare representation of bifid cardiac apex and a review of the relevant literature is also presented.
Vegetation of Frequently Burned Old-Growth Longleaf Pine ( Pinus palustris Mill . ) Savannas on Choccolocco Mountain , Alabama , USA

Volume 23 (1),2003 ABSTRACT: Fire-maintained longleaf pine (Pinus palustris Mill.) savannas are imperiled throughout their range in the United States, reduced in extent by 97% since European settlement. Only half of extant stands show evidence of fire; fire suppression has led to dramatic changes in composition an.d declines iIl plaIlt diversity. Examples of pristine vegetation are kIlown for most of 'I()ngleaf pine's distinct regions-a notable exception being mountainous communities in Alabama and Georgia, USA, collectively termed the mountain longleaf pine savannas. We sampled overand understory vegetation in two frequently burned old-growth mountain longleaf pine stands at Fort McClellan, a U.S. Army garrison in the Blue Ridge Physiographic Province of Alabama. Over the spring, summer, and fall 1999 study period, 82 native plant species were encountered in plots, representing 60 genera and 35 families. Overstory composition was dominated by longleaf pine, with blackjack oak (Quercus marilandica Muenchh.) and sand hickory (Cwya pallida [Ashe] Eng! . & Graeb.) as co-dominants in both stands. Understory communities were species-rich, dominated by grasses (principally Andropogon ternarius Michx.), asters (Coreopsis major Walt., Chlysopsis graminifolia [Michx.] Elliott, Helianthus microcephallus Torrey & Gray, Solidago odora Ait., and others), and many legumes. Non-native species were not encountered in sampling plots. Evidence suggests that historic fires in mountain longleaf pine . savannas were frequent (1-to 5-y return interval) and frequent fire is needed to maintain this ecosystem in the contemporary southeastern landscape.