Miracle-dz/UniFAR-FTUs huggingface dataset:
Coronary artery lesion risk and mediating mechanism in children with complete and incomplete Kawasaki disease

To compare the risk of coronary artery lesions (CAL) in children with complete and incomplete Kawasaki disease (KD) before and after immunoglobulin therapy and explore the mediation mechanisms underlying this association. All patients with KD admitted to the Wenzhou Medical University affiliated Yuying Children’s Hospital were divided into complete and incomplete KD groups. The independent effect of KD type on the risk of CAL and the intermediate effect of admission time on the association between KD type and CAL were assessed. The incidence of CAL in children with incomplete KD was higher than that in children with complete KD (33.9% vs 23.0%, p<0.001), and was also higher before therapy (27.5% vs 14.8%). Among children without CAL before therapy, there was no statistical difference in the incidence of CAL after treatment between the two groups. Mediation analysis found that the mediating effect of admission time was 1.07 (95% C: 1.01 to 1.13), and the direct effect of KD type on CAL was 1.59 (95% CI 1.17 to 2.16); proportion mediated was 15.71%. In conclusion, the risk of CAL among patients with incomplete KD was higher than that for complete KD, especially before therapy. In patients without CAL before treatment, the risk of CAL after treatment was equivalent for the two groups. Delayed admission may be one of the important mediating mechanisms for the higher risk of CAL in incomplete KD children.
Statistical Concerns About Acupressure on Pain in Cancer Patients With Bone Metastasis Trial

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons AttributionNonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Letter to the Editor
Long-term outcomes of completion pneumonectomy for non-small cell lung cancer

Abstract Background: Completion pneumonectomy (CP) is the removal of remaining lung tissue after initial resection. Our aim in this study was to investigate the factors affecting mortality, morbidity, and survival after CP. Methods: Patients who underwent CP in our clinic between January 2000 and December 2015 were evaluated retrospectively. The patients’ demographic information, morbidity, mortality, histopathological characteristics, and 2-, 5-, and 10-year survival were evaluated. Results: Of the 32 non-small cell lung cancer patients in the study, 31 (96.9%) were male and one (3.1%) was female. The postoperative mortality rate was 9.4% and the morbidity rate was 46.9%. The most common complication was atrial fibrillation (31.3%). Median survival time was 67 ± 10.3 months; 5- and 10-year survival rates were 50.3 and 31.2%, respectively. Conclusion: Completion pneumonectomy involves an acceptable mortality rate but high morbidity rate. Based on the results of this study, the interval between initial resection and CP does not affect survival time.
Effects of different pharmacologic smoking cessation treatments on body weight changes and success rates in patients with nicotine dependence: A network meta‐analysis

Smoking cessation is a public health priority to reduce smoking‐related morbidity and mortality. However, weight gain is a known primary reason for not trying to quit smoking. The aim of the current study was to investigate differences in weight gain associated with different pharmacological smoking cessation interventions. Randomized controlled trials (RCTs) that reported weight gain related to pharmacologic treatments for smoking cessation were analysed using network meta‐analysis with a random effects model. Thirty‐one RCTs with 5650 participants were included. Ten drugs and 22 regimens were identified. Nicotine patches plus fluoxetine, topiramate with/without nicotine patches, nicotine patches plus methylphenidate, nicotine spray/gum/lozenges, high‐dose nicotine patches (42 mg/21 mg), naltrexone with/without nicotine patches, or bupropion with/without nicotine patches were associated with less weight gain than the placebo/control arm. Nicotine patches plus fluoxetine were associated with the least weight gain of all smoking cessation treatments. In addition, the nicotine patch plus topiramate and nicotine inhaler was associated with the best success rate and the least dropout rate, respectively. Overall, the nicotine patch 14 mg plus fluoxetine 40 mg, nicotine patch 14 mg plus fluoxetine 20 mg, and topiramate 200 mg would be the three best pharmacologic treatments based upon both weight gain effect and success rate.
Optimal SBP targets in routine clinical care

Methods: Hypertensive patients aged 50–90 without diabetes or chronic kidney disease (CKD) were selected in SPRINT and The Health Improvement Network (THIN) database. Patients were enrolled in 2010–2013 and followed-up to 2015 (SPRINT N1⁄44112; THIN N1⁄48631). Cox’s proportional hazards regressions were fitted to estimate the hazard of all-cause mortality or CKD (main adverse effect) associated with intensive treatment, adjusted for sex, age, ethnicity, smoking, blood pressure, cardiovascular disease, aspirin, statin, number of antihypertensive drugs at baseline, change in number of antihypertensive drugs at trial entry, and clinical site.
1H‐NMR Based Metabolomics Profiling of Citrus Juices Produced in Veracruz, México

This study describes the 1H‐NMR‐based metabolomics profiling of juices from citrus fruits harvested in the state of Veracruz, México. The hydrophilic profile of commercial lemons (Agrio and Persian), tangerines (Fremont and Mónica), oranges (Valencia and Washington Navel), and grapefruits (Red Ruby and Rio Red) was determined. According to our results, 35 metabolites were identified in the 1H‐NMR profiling. The statistical differences obtained by PCA and OPLS‐DA revealed that specific amino acids, sugars, and organic acids were differential metabolites in the species and cultivars studied. High endogenous levels of sucrose (10–190 mM), α‐glucose, β‐glucose (α‐ and β‐isomers, 40–205 mm), and fructose (36–170 mm) were detected in the juices of grapefruits, oranges, and tangerines, whereas citric acid (40–530 mm) was the principal organic acid in the juices of lemons. To calculate the specific amounts of metabolites from these species and their cultivars, the results were finely analyzed using the qNMR method. According to these calculations, Valencia oranges had the highest concentration of ascorbic acid (>2 mm). The described 1H‐NMR method is highly reproducible, inexpensive, and highly robust in comparison to other analytical methods used to determine the hydrophilic profile of citrus juices.
The Impact of a Web-Based Course Concerning Patient Education for Mental Health Care Professionals: Quasi-Experimental Study

Background Continuing education has an important role in supporting the competence of health care professionals. Although Web-based education is a growing business in various health sectors, few studies have been conducted in psychiatric settings to show its suitability in demanding work environments. Objective We aimed to describe the impact of a Web-based educational course to increase self-efficacy, self-esteem, and team climate of health care professionals. Possible advantages and disadvantages of the Web-based course are also described. Methods The study used nonrandomized, pre-post intervention design in 1 psychiatric hospital (3 wards). Health care professionals (n=33) were recruited. Self-efficacy, self-esteem, and team climate were measured at 3 assessment points (baseline, 8 weeks, and 6 months). Possible advantages and disadvantages were gathered with open-ended questions at the end of the course. Results Our results of this nonrandomized, pre-post intervention study showed that health care professionals (n=33) had higher self-efficacy after the course, and the difference was statistically significant (mean 30.16, SD 3.31 vs mean 31.77, SD 3.35; P=.02). On the other hand, no differences were found in the self-esteem or team climate of the health care professionals before and after the course. Health care professionals found the Web-based course useful in supporting their work and relationships with patients. The tight schedule of the Web-based course and challenges in recruiting patients to use the patient education program with health care professionals were found to be the disadvantages. Conclusions Web-based education might be a useful tool to improve the self-efficacy of health care professionals even in demanding work environments such as psychiatric hospitals. However, more studies with robust and sufficiently powered data are still needed.
Minimally invasive aortic valve replacement with sutureless and rapid deployment valves: a report from an international registry (Sutureless and Rapid Deployment International Registry)†.

OBJECTIVES The impact of sutureless and rapid deployment (SURD) valves on the clinical outcomes of patients undergoing minimally invasive aortic valve replacement (MI-AVR) has still to be defined. The aim of this study was to assess clinical characteristics and in-hospital results of patients receiving SURD-AVR through less invasive approaches in the large population of the Sutureless and Rapid Deployment International Registry (SURD-IR). METHODS Of the 1935 patients who received primary isolated SURD-AVR between 2009 and 2018, a total of 1418 (73.3%) underwent MI interventions and were included in this analysis. SURD-AVR was performed using upper ministernotomy in 56.4% (n = 800) of cases and anterior right thoracotomy in 43.6% (n = 618). Perceval S was implanted in 1011 (71.3%) patients and Edwards Intuity or Intuity Elite in 407 (28.7%) patients. RESULTS Overall in-hospital mortality and stroke rates were 1.7% and 2%, respectively. A definitive pacemaker implantation was reported in 9% of cases and significantly decreased over the observational period, from 20.6% to 5.6% (P = 0.002). The Perceval valve was associated with shorter operative times and was more frequently implanted in patients receiving anterior right thoracotomy incision. The Intuity valve was preferred in younger patients and revealed superior postoperative haemodynamic results. CONCLUSIONS SURD-AVR was largely performed through less invasive approaches and can be considered as a primary indication in MI surgery. In the SURD-IR cohort, MI SURD-AVR using both Perceval and Intuity valves appeared a safe and reproducible procedure associated with promising early results.
Serum magnesium and calcium levels in relation to ischemic stroke

Objective To determine whether serum magnesium and calcium concentrations are causally associated with ischemic stroke or any of its subtypes using the mendelian randomization approach. Methods Analyses were conducted using summary statistics data for 13 single-nucleotide polymorphisms robustly associated with serum magnesium (n = 6) or serum calcium (n = 7) concentrations. The corresponding data for ischemic stroke were obtained from the MEGASTROKE consortium (34,217 cases and 404,630 noncases). Results In standard mendelian randomization analysis, the odds ratios for each 0.1 mmol/L (about 1 SD) increase in genetically predicted serum magnesium concentrations were 0.78 (95% confidence interval [CI] 0.69–0.89; p = 1.3 × 10−4) for all ischemic stroke, 0.63 (95% CI 0.50–0.80; p = 1.6 × 10−4) for cardioembolic stroke, and 0.60 (95% CI 0.44–0.82; p = 0.001) for large artery stroke; there was no association with small vessel stroke (odds ratio 0.90, 95% CI 0.67–1.20; p = 0.46). Only the association with cardioembolic stroke was robust in sensitivity analyses. There was no association of genetically predicted serum calcium concentrations with all ischemic stroke (per 0.5 mg/dL [about 1 SD] increase in serum calcium: odds ratio 1.03, 95% CI 0.88–1.21) or with any subtype. Conclusions This study found that genetically higher serum magnesium concentrations are associated with a reduced risk of cardioembolic stroke but found no significant association of genetically higher serum calcium concentrations with any ischemic stroke subtype.
Convolutional neural network initialized active contour model with adaptive ellipse fitting for nuclear segmentation on breast histopathological images

Abstract. Automated detection and segmentation of nuclei from high-resolution histopathological images is a challenging problem owing to the size and complexity of digitized histopathologic images. In the context of breast cancer, the modified Bloom–Richardson Grading system is highly correlated with the morphological and topological nuclear features are highly correlated with Modified Bloom–Richardson grading. Therefore, to develop a computer-aided prognosis system, automated detection and segmentation of nuclei are critical prerequisite steps. We present a method for automated detection and segmentation of breast cancer nuclei named a convolutional neural network initialized active contour model with adaptive ellipse fitting (CoNNACaeF). The CoNNACaeF model is able to detect and segment nuclei simultaneously, which consist of three different modules: convolutional neural network (CNN) for accurate nuclei detection, (2) region-based active contour (RAC) model for subsequent nuclear segmentation based on the initial CNN-based detection of nuclear patches, and (3) adaptive ellipse fitting for overlapping solution of clumped nuclear regions. The performance of the CoNNACaeF model is evaluated on three different breast histological data sets, comprising a total of 257 H&E-stained images. The model is shown to have improved detection accuracy of F-measure 80.18%, 85.71%, and 80.36% and average area under precision-recall curves (AveP) 77%, 82%, and 74% on a total of 3 million nuclei from 204 whole slide images from three different datasets. Additionally, CoNNACaeF yielded an F-measure at 74.01% and 85.36%, respectively, for two different breast cancer datasets. The CoNNACaeF model also outperformed the three other state-of-the-art nuclear detection and segmentation approaches, which are blue ratio initialized local region active contour, iterative radial voting initialized local region active contour, and maximally stable extremal region initialized local region active contour models.
Understanding of proton induced synaptic behaviors in three-terminal synapse device for neuromorphic systems

In this study, we investigate a proton-based three-terminal (3-T) synapse device to realize linear weight-update and I–V linearity characteristics for neuromorphic systems. The conductance states of the 3-T synapse device can be controlled by modulating the proton concentration in the WOx channel. Therefore, we estimate the dynamic change of proton concentration in the channel region, which directly affects synaptic behaviors. Our findings indicate that the supply of an excess number of protons from the SiO2–H electrolyte and low proton diffusivity in the WOx channel result in asymmetric and non-linear weight-update characteristics. In addition, though the linear I–V characteristics can be obtained using non-stoichiometric WOx, we observe that significant oxygen deficiency in the channel region increases the operating current levels. Thus, based on this information, we introduce optimized conditions of each component in the 3-T synapse device and shape of the gate voltage pulses. As a result, an excellent classification accuracy is achieved using linear weight-update and I–V linearity characteristics under optimized device and pulse conditions.
Can systematic reviews facilitate the communication of scientific uncertainty?

Communicating uncertainty is one of the major challenges scientists face when disseminating experimental results, not only to audiences of nonscientists, but also to other scientists. Uncertainty is multifaceted and takes on different meanings in different fields, and its communication operates on the background of complex science–society relationships. However, clear and responsible communication of uncertainty is necessary to adequately present results to the scientific community, for policy making, and for public engagement, which, in turn, may influence policy.
Vitamin C Activates Osteoblastogenesis and Inhibits Osteoclastogenesis via Wnt/β-Catenin/ATF4 Signaling Pathways

This study evaluated the effects of vitamin C on osteogenic differentiation and osteoclast formation, and the effects of vitamin C concentration on bone microstructure in ovariectomized (OVX) Wistar rats. Micro-computed tomography analysis revealed the recovery of bone mineral density and bone separation in OVX rats treated with vitamin C. Histomorphometrical analysis revealed improvements in the number of osteoblasts, osteoclasts, and osteocytes; the osteoblast and osteoclast surface per bone surface; and bone volume in vitamin C-treated OVX rats. The vitamin C-treated group additionally displayed an increase in the expression of osteoblast differentiation genes, including bone morphogenetic protein-2, small mothers against decapentaplegic 1/5/8, runt-related transcription factor 2, osteocalcin, and type I collagen. Vitamin C reduced the expression of osteoclast differentiation genes, such as receptor activator of nuclear factor kappa-B, receptor activator of nuclear factor kappa-B ligand, tartrate-resistant acid phosphatase, and cathepsin K. This study is the first to show that vitamin C can inhibit osteoporosis by promoting osteoblast formation and blocking osteoclastogenesis through the activation of wingless-type MMTV integration site family/β-catenin/activating transcription factor 4 signaling, which is achieved through the serine/threonine kinase and mitogen-activated protein kinase signaling pathways. Therefore, our results suggest that vitamin C improves bone regeneration.
Societal Marketing in the Treatment of Type 2 Diabetes Mellitus: A Longitudinal Questionnaire Survey for Michelin-Starred Restaurants in Japan

Numerous dietary recommendations have been made for the prevention and treatment of diabetes. However, many people with diabetes regard healthy dietary behavior as wearisome and have difficulty adhering to nutrition therapy. We, therefore, conducted a questionnaire survey concerning the restaurants that serve meals suitable for people with diabetes. We first aimed to determine the number of restaurants that were aware of the need to create special menus for people with diabetes. Second, we aimed to encourage restaurants’ serving of tasty, healthy food and promote easier social living for people with diabetes. We conducted our questionnaire survey every year from 2008 to 2013 on the availability of special menus for people with diabetes at restaurants listed in Michelin Guide Tokyo. We succeeded in increasing the proportion of restaurants offering special meals for people with diabetes from 6.7% (10 of 150 restaurants) in 2008 to 13.2% (32 of 242 restaurants) in 2013. As a result of the diabetes pandemic, the market for goods and services catering to people with diabetes is increasing. Diabetologists need to inform and support the food industry to produce foods that are suitable for people with diabetes and promote the serving of such foods by restaurants. This represents a new approach in the prevention and treatment of type 2 diabetes.
Sowing the Seeds of a Pandemic? Mammalian Pathogenicity and Transmissibility of H1 Variant Influenza Viruses from the Swine Reservoir

Emergence of genetically and antigenically diverse strains of influenza to which the human population has no or limited immunity necessitates continuous risk assessments to determine the likelihood of these viruses acquiring adaptations that facilitate sustained human-to-human transmission. As the North American swine H1 virus population has diversified over the last century by means of both antigenic drift and shift, in vivo assessments to study multifactorial traits like mammalian pathogenicity and transmissibility of these emerging influenza viruses are critical. In this review, we examine genetic, molecular, and pathogenicity and transmissibility data from a panel of contemporary North American H1 subtype swine-origin viruses isolated from humans, as compared to H1N1 seasonal and pandemic viruses, including the reconstructed 1918 virus. We present side-by-side analyses of experiments performed in the mouse and ferret models using consistent experimental protocols to facilitate enhanced interpretation of in vivo data. Contextualizing these analyses in a broader context permits a greater appreciation of the role that in vivo risk assessment experiments play in pandemic preparedness. Collectively, we find that despite strain-specific heterogeneity among swine-origin H1 viruses, contemporary swine viruses isolated from humans possess many attributes shared by prior pandemic strains, warranting heightened surveillance and evaluation of these zoonotic viruses.
Serum folate and vitamin B12 status in young Brazilian children

Abstract Objective To assess the nutritional status of folate and vitamin B12 with anaemia in young children. Design A cross-sectional study was conducted at the primary health-care centres of four Brazilian cities. Folate and vitamin B12 were assessed by fluoroimmunoassay. Multilevel Poisson regression models were used to explore the association of folate and vitamin B12 status in relation to anaemia in young children. Setting Brazil. Participants Children (n 460) aged 11 to 15 months. Results The median (interquartile range) of serum folate was 39·7 (28·8–55·3) nmol/l and only four children presented with folate deficiency (<10 nmol/l). Surprisingly, 30·9 % of children presented with serum folate concentrations above the upper limit of detectable values by the commercial kit used for analysis. The frequency of vitamin B12 deficiency (<148 pmol/l) was 15 % and it was inversely associated with the highest tertile of serum folate concentrations (P<0·001). Having high serum folate concentration (≥50·1 nmol/l) and vitamin B12≥148 pmol/l was associated with lower frequency of anaemia in these children (prevalence ratio=0·53; 95% CI 0·30, 0·92). Conclusions High frequency of elevated serum concentration of folate was found among young Brazilian children and 15 % of them had vitamin B12 deficiency. The combination of high serum folate and normal vitamin B12 status was associated with a lower frequency of anaemia in these children. Improvements in the current strategies to promote healthy food-based complementary feeding along with prevention and control of micronutrient deficiencies are recommended to improve children’s health.