Miracle-dz/UniFAR-FTUs huggingface dataset:
Gender differences in the dissection properties of ascending thoracic aortic aneurysms

Abstract OBJECTIVES Presentation, management and outcomes in the aortic dissection (AD) of ascending thoracic aortic aneurysm (ATAA) differ in gender and age. The purpose of this study is to investigate the dissection properties of male and female ATAAs. METHODS Peeling tests were performed to quantitatively determine the delamination strength and dissection energy of 41 fresh ATAA samples (22 males and 19 females) in relatively young (≤65 years) and elderly (>65 years) patients. The delamination strength of the ATAAs was further correlated with patient ages for males and females. The histological investigation was employed to characterize the dissected morphology. RESULTS For elderly patients, circumferential and longitudinal delamination strengths of the female ATAAs were statistically significantly lower than those of the males (circumferential: 31 ± 6 vs 42 ± 6 mN/mm, P < 0.01; longitudinal: 35 ± 7 vs 49 ± 10 mN/mm, P = 0.02). No significant differences were found in the delamination strength between males and females for relatively young patients. The circumferential and longitudinal delamination strengths were significantly decreased and strongly correlated with patient ages for females. However, these correlations were not present in males. Dissection routes propagated in the aortic media to create ruptured surfaces for all specimens. Peeling tests of the male ATAAs generate rougher surfaces than females. CONCLUSIONS There is a higher propensity of AD occurrence for the elderly females as compared to males with matched ages. Surgeons should be cognizant of the risk of AD onset later in life, especially in females.
Comprehensive characterization of firing byproducts generated from small arms firing of lead-free frangible ammunition

Abstract Following the introduction of lead-free frangible ammunition in United States Air Force small arms firing ranges, Combat Arms instructors have routinely reported experiencing adverse health symptoms during live fire training exercises, including sore throat, cough, and headache. Previous studies have found that these symptoms occur despite occupational exposure limits not being exceeded. To better characterize the potential source and mechanisms for health symptoms, a comprehensive characterization of the physicochemical properties of gases and aerosols emitted during the firing of the M9 pistol and M4 rifle using lead-free frangible ammunition was completed. Weapons were fired within a sealed chamber using a remote firing mechanism. A suite of direct-reading instruments and collection-based analytical methods were used to determine the composition of the emissions. Emissions were dominated by carbon monoxide and ultrafine particles. Other prevalent gases included carbon dioxide, ammonia, formaldehyde, hydrogen cyanide, and nitric oxide when measured using Fourier-transform infrared spectroscopy. An electrical, low-pressure impactor showed that, on average, the count median diameter immediately after firing was 36 ± 4 nm (n = 10 rounds) and 32 ± 3 nm (n = 14 rounds) for the M9 pistol and M4 rifle, respectively. Analytical methods were used to determine that emitted particles were primarily composed of soot, copper, and potassium, with trace amounts of calcium, silicon, sodium, sulfur, and zinc. Results from this research confirm prior work and expand upon the characterization of emissions generated from firing lead-free frangible ammunition. By employing multiple methods to measure and analyze data we were able to quantify both total and respirable particle fractions and determine particle morphology and composition. Characterization of the emissions provides insight into potential exposure risks that may lead to the development of adverse health symptoms allowing for the development of strategies for risk mitigation.
Evaluation of Glial and Neuronal Blood Biomarkers Compared With Clinical Decision Rules in Assessing the Need for Computed Tomography in Patients With Mild Traumatic Brain Injury

Key Points Question How does the diagnostic performance of serum glial fibrillary acidic protein (GFAP) and neuronal ubiquitin C-terminal hydrolase (UCH-L1) biomarkers compare with that of validated clinical decision rules for detecting intracranial lesions on computed tomography (CT) of the head in patients with mild traumatic brain injury, and is a combination of biomarkers and clinical decision rules associated with improved performance? Findings In this cohort of 349 patients with mild traumatic brain injury, the Canadian CT Head Rule (CCHR), the New Orleans Criteria (NOC), and GFAP plus UCH-L1 had 100% sensitivity for detecting lesions on CT, but the CCHR had the highest specificity (33%), followed by GFAP plus UCH-L1 (25%) and the NOC (16%). The combination of GFAP level and the CCHR yielded the highest diagnostic performance. Meaning These findings suggest that although GFAP plus UCH-L1 and the clinical decision rules performed similarly in detecting intracranial lesions on CT scans, the diagnostic performance was improved when biomarkers were combined with rules, specifically GFAP with the CCHR.
Predictive Patient Factors for Poor Outcomes Following Stapedotomy for Otosclerosis

Objective To assess patient-related risk factors associated with poor outcomes following stapedotomy for otosclerosis. Study Design Retrospective study. Setting Academic tertiary care center. Methods Retrospective chart review of 107 patients with otosclerosis who underwent stapedotomy between 2013 and 2020. Demographics, comorbidities, and smoking history were obtained. Preoperative and postoperative audiogram data, including air-bone gap (ABG), and complications were collected. Data were analyzed using t test and Fischer’s exact test for continuous and categorical variables, respectively. Results Among 107 patients, 29.5% were smokers and 70.1% non-smokers. Overall, the average ABG-gain 3-months postoperatively was 20.2 dB, and intraoperative and postoperative complications were 3.74 and 13.1%, respectively. Those with a history of otologic procedures had a lower mean ABG gain at 3 months compared with those without previous otologic surgery (14.4 dB versus 20.4 dB, p = 0.018). The average ABG gain at 3-months was not significantly different between those with current, former, or no smoking history, respectively (13.5 versus 18.1 versus 20.6, p = 0.08). Current smokers had 4.5 times greater odds of complications compared with non-smokers, although not statistically significant (95% CI 0.9–22.8, p = 0.1912). Conclusion Age and history of otologic procedures as independent risk factors did impact hearing outcomes among our patient cohort; however, smoking history did not. Future prospective studies are required to further investigate complication rates by various modifiable risk factors, such as smoking status, body mass index (BMI), and obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) use, for stapedotomy surgeries.
Paraspinal Muscle in Chronic Low Back Pain: Comparison Between Standard Parameters and Chemical Shift Encoding-Based Water–Fat MRI

Paraspinal musculature (PSM) is increasingly recognized as a contributor to low back pain (LBP), but with conventional MRI sequences, assessment is limited. Chemical shift encoding‐based water–fat MRI (CSE‐MRI) enables the measurement of PSM fat fraction (FF), which may assist investigations of chronic LBP.
Evaluation of voriconazole related adverse events in pediatric patients with hematological malignancies

Background Despite therapeutic drug monitoring and pharmacogenetic-guided dose selection are recommended for pediatric patients, safety of voriconazole is mostly monitored by clinical assessment. Having comprehensive knowledge of safety profile and distinguishing incidental events from the reactions that are truly related to voriconazole use are crucial for safer and uninterrupted treatment. Objectives This study aimed to address adverse reactions during the first month of voriconazole use by systematically evaluating retrospective records of all adverse events. Patients/Methods: It is a single-center, retrospective analysis of patients who received voriconazole from 1 September 2010 to 1 September 2020. Severity of abnormal findings in medical records were systematically graded. Causality between voriconazole and the events was evaluated by Liverpool Causality Assessment Tool (LCAT), Naranjo Algorithm and World Health Organization Causality Assessment System. The events with possible or probable causal relation to voriconazole are classified as adverse reaction. Results Records of 45 patients included in the study. The overall frequency of adverse reactions was 51.1%. Hepatobiliary laboratory adverse reactions identified in 48.9% of the patients and led to treatment discontinuation in 20.0%. Amylase and lipase elevation (2.2%), ventricular extra systoles (2.2%), hallucination and nightmares (2.2%) were other adverse reactions. Conclusions Hepatobiliary abnormalities were the most common adverse reactions and the most common cause of treatment discontinuation. For safer treatment in critically ill patients, the dose should be personalized. To clearly identify the accurate frequency and the causality of all adverse reactions, prospective studies with much larger sample size are needed.
Intralesional immunotherapy for multiple recalcitrant plantar warts: Candida antigen is superior to intralesional purified protein derivative

Treatment of recalcitrant plantar warts represent a highly challenging issue for both patients and physicians. Candida antigen and purified protein derivative (PPD) have shown promising efficacy in the treatment of warts, however no previous studies have compared both antigens for recalcitrant plantar warts. To assess the efficacy and safety of intralesional Candida antigen versus intralesional PPD in the management of recalcitrant plantar warts. The study included 120 adult patients with multiple recalcitrant plantar warts. They were randomly assigned to one of three groups; Candida antigen, PPD, or normal saline. Injections into the largest wart were repeated every 2 weeks until clearance or for a maximum of five sessions. Complete wart clearance was reported in 33 patients (82.5%) of the Candida antigen group, in 22 patients (55.6%) of the PPD group, and in one patient (5%) of the control saline group. A statistically significant difference was found between the studied groups in favor of Candida antigen. Adverse effects were mild and insignificant in the three groups. Intralesional antigen immunotherapy by Candida antigen or PPD is a promising, safe, and cost‐effective therapeutic option for multiple recalcitrant plantar warts, with statistically significant superiority of Candida antigen.
What makes inpatient treatment for PTSD effective? Investigating daily therapy process factors

Abstract Objective Therapeutic process factors including alliance and motivation are considered to play a key role in the treatment of post-traumatic stress disorder (PTSD). Yet, our understanding of change processes in therapy is mostly based on theoretical considerations with limited empirical evidence. In order to identify process characteristics of successful inpatient treatments of PTSD, we investigated the intraindividual, interindividual, and temporal associations of daily assessments of therapy process factors like motivation, alliance, and insight. Method Therapy process questionnaire (TPQ) assessments were collected from 101 inpatients with PTSD over 50 days, resulting in 5050 assessments. Multilevel vector autoregressive (mlVAR) modelling was applied to investigate the networks of the TPQ factors in a subgroup with good outcome regarding PTSD symptomatology and a subgroup with less favourable outcome. Results The two subgroups differed markedly in their network models, suggesting that therapy processes might be different for those with good and those with poor treatment outcomes. Conclusions Our results suggest that good treatment outcome is linked to a specific therapy process dynamic where mindfulness and insight lead to the kind of temporary well-being required to effectively engage with problems and negative emotions, while motivation to change ensures the continuity of confronting negative emotions and problems.
Consumption of a fermented dairy beverage improves hippocampal-dependent relational memory in a randomized, controlled cross-over trial

ABSTRACT Objectives: We aimed to determine whether consumption of a fermented dairy beverage containing probiotic microorganisms influences negative mood states, stress, and hippocampal memory performance in healthy adults. Methods: Adults (25-45 yrs, N = 26) free of gastrointestinal and mental illness were enrolled in a single-blind, randomized, controlled, crossover trial. Participants completed testing prior to and after 4-week consumption, with a 2–4 week washout between treatments of: (1) 8 oz of a dairy-based fermented beverage containing 25–30 billion colony forming units of live and active kefir cultures or (2) 8 oz isocaloric, non-fermented, 1% low-fat lactose-free dairy-based control beverage. Hippocampal-dependent relational memory was assessed using a spatial reconstruction task. Negative mood states of depression and anxiety were assessed using the Depression Anxiety Stress Scales-42 (DASS-42). Pooled 24-hour urine samples were analyzed using an enzyme-linked immunosorbent assay to determine urinary free-cortisol (UFC) concentrations. Fecal microbiota composition was assessed using 16S rRNA gene sequencing. Results: Lactobacillus was increased by 235% following fermented dairy consumption compared to the control (p < .01). Furthermore, the fermented dairy beverage improved performance on two metrics of relational memory, misplacement (p = .04) and object-location binding (p = .03). UFC and DASS-42 scores (all p’s > .08) were not significantly changed by either arm of the intervention. No correlations were observed between the change in Lactobacillus and memory performance. Conclusions: Fermented dairy consumption increased the presence of certain microorganisms in the gut and improved relational memory in healthy adults. However, the benefits observed for relational memory were not related to changes in Lactobacillus. Trial registration: ClinicalTrials.gov identifier: NCT02849275.
Unraveling Hürthle cell lesions of the thyroid using molecular findings

Hürthle cell– predominant fineneedle aspiration (FNA) biopsies remain a challenging area within thyroid cytology. Hürthle cells can be found frequently in the thyroid in association with both nonneoplastic and neoplastic conditions. Although there are limitations to the cytomorphologic evaluation of these lesions, an indeterminate FNA result no longer necessitates a diagnostic lobectomy. This is due in large part to an evolution in the management of thyroid nodules with indeterminate cytology in the last decade. Molecular testing after an indeterminate FNA diagnosis has become widely practiced, if not the standard of care, in many institutions and has helped to more accurately categorize nodules as likely benign or requiring additional intervention. Examples of commercially available molecular platforms include the Afirma Genomic Sequencing Classifier/ Xpression Atlas (Veracyte), ThyGeNEXT/ThyraMIR (Interpace Diagnostics), and ThyroSeq (CBLPath/Sonic Healthcare). These molecular tests use nextgeneration sequencing to assess expression profiles, point mutations, gene fusions, and/or copy number variants (CNVs). In general, the primary goal of these tests is to distinguish nodules that are at higher risk for malignancy from those that are likely benign. Although the initial versions of some of these molecular tests performed well among indeterminate nodules as a whole, performance in Hürthle cell– predominant FNA was questionable. However, more recent iterations of these tests have shown improved performance in Hürthle cell lesions. The increased specificity of these tests has paralleled our understanding of the molecular biology and pathogenesis of Hürthle cell neoplasms (HCNs). For example, recent studies have demonstrated more clearly that Hürthle cell carcinomas appear molecularly distinct from other differentiated thyroid carcinomas, with frequent mitochondrial DNA alterations and CNVs. Specifically, largescale chromosomal changes leading to a near haploid state (with or without subsequent chromosomal duplication) are found in a subset of tumors. Additionally, driver mutations associated with follicular carcinoma (ie, RAS or PAX8/PPARγ) and papillary carcinoma (ie, BRAF V600E) are less commonly or only rarely (if at all) seen in Hürthle cell carcinomas. In this issue of Cancer Cytopathology, AbiRaad and colleagues evaluate a cohort of 324 thyroid FNAs that had been classified as follicular lesion of undetermined significance (which were further classified as follicular lesion of undetermined significance– Hürthle cell type [FLUSHCT] or follicular lesion of undetermined significance– nonHürthle cell type) or follicular neoplasm/HCN. All cases from this cohort had the ThyroSeq version 3 genomic classifier (ThyroSeq v3 GC) test performed, and a subset (105 cases) also had histopathologic followup. The ThyroSeq v3 GC uses targeted nextgeneration sequencing to assess mutations and fusions in 112 genes and CNV analysis across 10 genomic regions in FNA samples.
OCA‐B does not act as a transcriptional coactivator in T cells

Pou2af1 encodes for OCA‐B, a coactivator of OCT‐1/2 transcription factors, which plays a key role in B‐cell maturation. The function of OCA‐B has also been studied in T cells, where T cells from Pou2af1−/− mice have impaired functions, such as cytokine production and T follicular helper (Tfh) differentiation. Arguably, some of these T‐cell phenotypes may result from impaired T–B interactions, secondary to the well‐documented B‐cell defects in Pou2af1−/− mice. Yet, Pou2af1 is actively transcribed in activated T cells, suggesting a T‐cell‐intrinsic role. To isolate the T‐cell‐intrinsic impact of Pou2af1, we generated Pou2af1fl/fl mice with specific genetic disruption of Pou2af1 either in all hematopoietic cells or exclusively in T cells. While we confirm that Pou2af1 is expressed in activated T cells, we surprisingly find that T‐cell cytokine production is not impaired in Pou2af1‐deficient T cells. Moreover, Pou2af1‐sufficient and Pou2af1‐deficient T cells have comparable transcriptome profiles, arguing against a T‐cell‐intrinsic role for Pou2af1. In line with these observations, we demonstrate that Tfh maturation is influenced by T‐cell‐extrinsic deletion of Pou2af1, as observed both in competitive bone marrow chimeras and in Pou2af1fl/fl mice with specific deletion in B cells. Overall, this study provides strong evidence that Pou2af1 does not act as a transcriptional coactivator in T cells, and conclusively demonstrates that loss of OCA‐B in B cells indirectly impacts Tfh differentiation, clarifying the role of OCA‐B in the immune system.
The Relationship Between Self-reported Cognitive Abilities and Psychological Symptoms in Breast Cancer Survivors

Background Many breast cancer survivors (BCSs) report numerous symptoms following cancer treatment, including cognitive concerns and psychological symptoms (anxiety and depression). However, the association among these symptoms is not well understood. Objectives The objectives were to, primarily, examine the relationship between self-reported cognitive ability and psychological symptoms (anxiety and depressive symptoms) controlling for potential confounders of age, education, and time posttreatment and, secondarily, examine the relationship between self-reported cognitive domains (attention, language, visuoperception, visual memory, and verbal memory) and psychological symptoms. Methods This secondary data analysis pooled data from 2 theoretically and conceptually congruent, institutional review board–approved studies of BCSs. Breast cancer survivors completed the Multiple Ability Self-report Questionnaire (cognitive ability), Spielberger State Trait Anxiety Inventory—State (anxiety), and Center for Epidemiological Studies—Depression Scale (depressive symptoms). Data were analyzed using descriptive statistics, Pearson correlations, and separate linear regression. Results One hundred fifty-five BCSs who were on average 54.8 (SD, 8.9) years of age, approximately 5 years (mean, 5.2 [SD, 3.8] years) posttreatment, and well-educated (mean, 15.2 [SD, 2.2] years) completed questionnaires. In bivariate correlations, higher anxiety and depressive symptoms were significantly related to cognitive abilities in all domains (P = <.01). In the regression model, increased anxiety was associated with poorer cognitive abilities in all domains (P < .01). Conclusions Anxiety and depressive symptoms were associated with decrements in self-reported cognitive abilities among BCSs. Implications for Practice With increasing numbers of BCSs, more research is needed to address psychological symptoms, which correlate with cognitive function. Findings from this analysis can inform clinical BCS survivorship care planning and future interventional research, focused on comprehensive symptom management.
Neighborhood built environments and cognition in later life

Abstract Objectives: Maintaining good cognition is crucial in later life. However, most existing research has focused on individual factors impacting cognition, and few studies have investigated the association between neighborhood built environment and older adults’ cognition. This study examined the association between neighborhood built environment and cognition among community-dwelling older adults and identified variations in this association between different age groups in the older population. Methods: Data were derived from a cross-sectional survey of 1873 people aged 65 years and above in Hong Kong. We merged individual data from the survey with neighborhood built environment data based on community auditing and geographical information system. After controlling for individual covariates, we used multivariable linear regression to examine the association between neighborhood built environment and cognition. Results: Residents aged 80 and younger in neighborhoods with a higher land-use mix and more public transport terminals exhibited better cognition. Only the number of community centers in a neighborhood was positively associated with cognition for people older than 80. Conclusion: The built environment creates diverse impacts on different age groups among older adults. Our findings provide useful information for urban planners and policymakers for planning community facilities and built environments that consider the needs of different age groups within the older population.
The impact of group ownership on memory

Abstract The influence of the self on memory processes has been extensively investigated (the self-reference effect) both explicitly (trait-rating paradigm) and implicitly (ownership paradigm). The groups that are closely related to the self are an important part of self-concept, and group-reference facilitated recall to the same extent as self-referencing using trait-rating paradigm. The current research employed an ownership procedure to investigate the impact of group ownership on memory using the participants’ family served as the reference group. In both experiments, participants were asked to sort items into baskets that belonged to their family or a fictitious family. A subsequent recognition test showed that there was a significant memory advantage for objects that owned by their family, and the ownership effect was found in remember, but not know, responses. This finding suggests that transient ingroup-ownership of items had a significant memory dominance effect, and the enhancing effect of ownership leads to recollective experience.