Miracle-dz/UniFAR-FTUs huggingface dataset:
Prospective comparison of transient elastography, point shear wave elastography, APRI and FIB‐4 for staging liver fibrosis in chronic viral hepatitis

Ultrasound‐based elastography and serum indexes have been individually validated as noninvasive methods for staging liver fibrosis in chronic viral hepatitis. We aimed to compare the accuracy of transient elastography (TE), shear wave elastography (SWE), aspartate aminotransferase to platelet index (APRI) and Fibrosis‐4 index (FIB‐4) with the METAVIR liver fibrosis staging in viral hepatitis patients. We enrolled 121 treatment‐naïve chronic hepatitis B and C monoinfected patients. All underwent liver biopsy had biochemistry tests and liver stiffness measurements by TE using M and XL probes followed by point SWE performed on the same day. The accuracy of each method for predicting different fibrosis stages was demonstrated as an area under the receiver operating characteristic (AUROC) curves. The AUROCs of TE using M and XL probes, SWE, APRI and FIB‐4 were 0.771, 0.761, 0.700, 0.698 and 0.697, respectively, for significant fibrosis; 0.974, 0.973, 0.929, 0.738 and 0.859, respectively, for advanced fibrosis; and 0.954, 0.949, 0.962, 0.765 and 0.962, respectively, for cirrhosis. TE using the M probe was comparable to the XL probe in detecting all fibrosis stages. TE was superior to SWE for assessing significant fibrosis and advanced fibrosis. For cirrhosis, the performances of TE, SWE and FIB‐4 were similar. APRI was least accurate in liver fibrosis staging. To conclude, for patients with viral hepatitis, TE using either M or XL probe is an effective noninvasive test for assessing liver fibrosis, particularly advanced fibrosis and cirrhosis, while SWE and FIB‐4 possess an excellent accuracy in predicting cirrhosis.
Fluid management in perioperative and critically ill patients

Fluid therapy to restore and/or maintain tissue perfusion may affect patient outcomes in perioperative, emergency, and intensive care. Kinetic analyses and outcome-oriented studies have provided more insight into fluid management. Crystalloids are slowly distributed to the interstitial space, and the efficiency (proportion of infused fluid retained in the bloodstream) is 50%−75% as long as infusion continues and may increase up to 100% when the arterial pressure has decreased. Elimination of the infused fluid during general anesthesia and surgery is very slow, amounting to only 10%–20% compared with that in conscious patients. When the endothelial glycocalyx layer is degraded in sepsis or trauma-induced systemic inflammation, turnover of colloids and crystalloids is accelerated and the efficiency is reduced, which may lead to tissue edema, inflammation, poor wound healing, and organ dysfunction. Balanced crystalloids are pragmatic initial resuscitation fluids and improve patient outcomes compared to saline (0.9% sodium chloride). Albumin may be beneficial, but other synthetic colloids appear to increase the risk of acute kidney injury and death among patients in the intensive care unit. Fluid kinetics is likely to change based on patient physiological conditions (e.g., general anesthesia, surgery, stress, dehydration, blood pressure, or inflammation) and fluid types. To maximize efficacy and minimize iatrogenic side effects, fluids should be prescribed based on individual patient factors, disease states, and other treatment remedies.
Musculoskeletal (MSK) practitioners in primary care: an evaluation of a MSK core capabilities framework and review process

ABSTRACT The General Practice Contract 2019/20 established first contact musculoskeletal (MSK) physiotherapists in primary care. This paper describes an evaluation exploring the feasibility of using the MSK Core Capabilities Framework and a peer review process to evidence capability. It discusses how this process may be developed to ensure MSK practitioners are able to evidence the level of practice required within the complex environment of primary care. MSK practitioners were supported to evidence their capabilities against the MSK Framework. Twenty-two participants took part in the evaluation of this intervention via semi-structured interviews. A robust and iterative process of qualitative data analysis was undertaken. The findings are framed in terms of Davis’ Technology Acceptance Model of evaluation (i.e. user perceptions). There were a range of perceived benefits of the Framework including as a means of quality assurance, career progression, the promotion of knowledge consolidation and reflective practice. There were however, a number of ‘translation into practice’ issues. Given the newness of the MSK Framework, it is perhaps not surprising there is a need for refinement. This evaluation highlights key enablers for reviewing capabilities of MSK practitioners: a curriculum; educational supervision; and accreditation. Learning also applies more widely to other emerging role opportunities.
Adult loss of Cacna1a in mice recapitulates childhood absence epilepsy by distinct thalamic bursting mechanisms.

Inborn errors of CACNA1A-encoded P/Q-type calcium channels impair synaptic transmission, producing early and lifelong neurological deficits, including childhood absence epilepsy, ataxia and dystonia. Whether these impairments owe their pathologies to defective channel function during the critical period for thalamic network stabilization in immature brain remains unclear. Here we show that mice with tamoxifen-induced adult-onset ablation of P/Q channel alpha subunit (iKOp/q) display identical patterns of dysfunction, replicating the inborn loss of function phenotypes and, therefore demonstrate that these neurological defects do not rely upon developmental abnormality. Unexpectedly, unlike the inborn model, the adult-onset pattern of excitability changes believed to be pathogenic within the thalamic network is non-canonical. Specifically, adult ablation of P/Q channels does not promote Cacna1g-mediated burst firing or T-type calcium current (IT) in the thalamocortical relay neurons; however, burst firing in thalamocortical relay neurons remains essential as iKOp/q mice generated on a Cacna1g deleted background show substantially diminished seizure generation. Moreover, in thalamic reticular nucleus neurons, burst firing is impaired accompanied by attenuated IT. Interestingly, inborn deletion of thalamic reticular nucleus-enriched, human childhood absence epilepsy-linked gene Cacna1h in iKOp/q mice reduces thalamic reticular nucleus burst firing and promotes rather than reduces seizure, indicating an epileptogenic role for loss of function Cacna1h gene variants reported in human childhood absence epilepsy cases. Together, our results demonstrate that P/Q channels remain critical for maintaining normal thalamocortical oscillations and motor control in the adult brain, and suggest that the developmental plasticity of membrane currents regulating pathological rhythmicity is both degenerate and age-dependent.
Comparative efficacy and safety of probiotics for the treatment of irritable bowel syndrome: a systematic review and network meta-analysis protocol

Introduction Irritable bowel syndrome (IBS) is a common chronic functional gastrointestinal disorder affecting approximately 10% to 25% of the adult population. A large number of clinical trials have been conducted to evaluate the efficacy of probiotics for IBS but the results were inconsistent. Previous meta-analyses have shown that probiotics are effective for IBS, but the comparative efficacy of individual species is unclear. In addition, evidence regarding the superiority of combination over single probiotic is still lacking. We, therefore, perform this study to evaluate the comparative efficacy and safety of various species of probiotics, and combination regimens for the treatment of IBS. Methods and analysis This study is a systematic review with network meta-analysis. We will search PubMed, Scopus, The Cochrane Central Register of Controlled Trials and CINAHL for randomised controlled trials comparing probiotics with placebo or comparing different probiotics for IBS, with no language restrictions. The primary outcomes will be treatment response and global IBS-symptom score. We will initially combine included studies with traditional pairwise meta-analysis and then with random-effects network meta-analysis. We will quantify the effect of potential effect modifiers by meta-regression if appropriate. We will check the consistency assumption by testing the absolute difference between direct and indirect estimates for comparisons in closed loops. The quality of evidence will be evaluated according to the GRADE framework. Ethics and dissemination Ethical approval is not required for literature-based studies. We will disseminate the findings through publications in peer-reviewed journals and relevant conferences. PROSPERO registration number CRD42018102101
Proteomic Response of Pseudomonas putida KT2440 to Dual Carbon-Phosphorus Limitation during mcl-PHAs Synthesis

Pseudomonas putida KT2440, one of the best characterized pseudomonads, is a metabolically versatile producer of medium-chain-length polyhydroxyalkanoates (mcl-PHAs) that serves as a model bacterium for molecular studies. The synthesis of mcl-PHAs is of great interest due to their commercial potential. Carbon and phosphorus are the essential nutrients for growth and their limitation can trigger mcl-PHAs’ production in microorganisms. However, the specific molecular mechanisms that drive this synthesis in Pseudomonas species under unfavorable growth conditions remain poorly understood. Therefore, the proteomic responses of Pseudomonas putida KT2440 to the limited carbon and phosphorus levels in the different growth phases during mcl-PHAs synthesis were investigated. The data indicated that biopolymers’ production was associated with the cell growth of P. putida KT2440 under carbon- and phosphorus-limiting conditions. The protein expression pattern changed during mcl-PHAs synthesis and accumulation, and during the different physiological states of the microorganism. The data suggested that the majority of metabolic activities ceased under carbon and phosphorus limitation. The abundance of polyhydroxyalkanoate granule-associated protein (PhaF) involved in PHA synthesis increased significantly at 24 and 48 h of the cultivations. The activation of proteins belonging to the phosphate regulon was also detected. Moreover, these results indicated changes in the protein profiles related to amino acids metabolism, replication, transcription, translation, stress response mechanisms, transport or signal transduction. The presented data allowed the investigation of time-course proteome alterations in response to carbon and phosphorus limitation, and PHAs synthesis. This study provided information about proteins that can be potential targets in improving the efficiency of mcl-PHAs synthesis.
Electrocoagulants characteristics and application of electrocoagulation for micropollutant removal and transformation mechanism.

Predominantly, the removal of dissolved contaminates via the Fe electrocoagulation (EC) process depends on the electrocoagulants stability, specific area, porosity, dissolution rate and phase transformation kinetics. The present investigation elucidates the role of applied currents and electrolyte counter anions on the crystalline phase and surface topography of electrocoagulants generated from Fe EC. Moreover, the dissolved contaminant micropollutant removal efficiency was also evaluated by electrochemically produced coagulants. This study confirms that mixed-phase iron (oxyhydr) oxide nanostructures were consistently produced from Fe EC, with predominant formation of the magnetite phase. The applied current controls the morphology of the coagulants, with flake-like morphology observed with currents at and below 100 mA and spherical morphology observed with currents above 100 mA. The counter anions in the electrolyte also impacted the morphology with spherical, nanosheet and nanorod morphologies produced by Cl‾ or SO42‾, CO32‾ and HCO3‾ counter anions respectively. BET analysis revealed the formation of electrocoagulants with micro-, meso- and macropores. Surface area markedly reduced from 142.85 m2 g-1 to 41.96 m2 g-1 by incident coagulation resulting from increased anodic dissolution. Applicability of the electrocoagulant were examined by different micropollutant (acetaminophen (AC), antipyrine (AT) and atenolol (AT)). Results suggest that >90% and >80% TOC reduction were achieved with Na2CO3 and NaHCO3 as electrolyte media. The lower TOC reduction was rationalized by the identified intermediate products and possible micropollutant degradation pathway were proposed based on LC-MS/MS analysis.
Off-Axis Cavity-Enhanced Absorption Spectroscopy of 14NH3 in Air Using a Gain-Switched Frequency Comb at 1.514 μm

A custom-designed gain-switched frequency comb (GSFC) source was passively coupled to a medium finesse (F ≈ 522) cavity in off-axis configuration for the detection of ammonia (14NH3) in static dry air. The absorption of ammonia was detected in the near infrared spectral region between 6604 and 6607 cm−1 using a Fourier transform detection scheme. More than 30 lines of the GSFC output (free spectral range 2.5 GHz) overlapped with the strongest ro-vibrational ammonia absorption features in that spectral region. With the cavity in off-axis configuration, an NH3 detection limit of ∼3.7 ppmv in 20 s was accomplished in a laboratory environment. The experimental performance of the prototype spectrometer was characterized; advantages, drawbacks and the potential for future applications are discussed.
Effect of Molecular Structure in the Chain Mobility of Dichalcogenide-Based Polymers with Self-Healing Capacity

Recently, it has been shown that the reaction mechanism in self-healing diphenyl dichalcogenide-based polymers involves the formation of sulfenyl and selenyl radicals. These radicals are able to attack a neighbouring dichalcogenide bond via a three-membered transition state, leading to the interchange of chalcogen atoms. Hence, the chain mobility is crucial for the exchange reaction to take place. In this work, molecular dynamics simulations have been performed in a set of disulfide- and diselenide-based materials to analyze the effect of the molecular structure in the chain mobility. First of all, a validation of the computational protocol has been carried out, and different simulation parameters like initial guess, length of the molecular chains, size of the simulation box and simulation time, have been evaluated. This protocol has been used to study the chain mobility and also the self-healing capacity, which depends on the probability to generate radicals (ρ), the barrier of the exchange reaction (ΔG) and the mobility of the chains (ω). The first two parameters have been obtained in previous quantum chemical calculations on the systems under study in this work. After analyzing the self-healing capacity, it is concluded that aromatic diselenides (PD-SeSe) are the best candidates among those studied to show self-healing, due to lower reaction barriers and larger ω values.
Development of an optimized febuxostat self-nanoemulsified loaded transdermal film: in-vitro, ex-vivo and in-vivo evaluation

Abstract Febuxostat (FBX) is used to treat gout and chronic hyperuricemia. However, its bioavailability is moderate (49%) as a result of low solubility and first-pass metabolism. Therefore, the aim of our study is to improve FBX bioavailability by enhancement its solubility using self-nanoemulsifying drug delivery system (SNEDDS) technique in the form of transdermal film to avoid hepatic metabolism. To accomplish this goal, Eight SNEDDS formulae were prepared according to a three-factor, two-level D-Optimal mixture design to evaluate the effect of different ratios of the Lemon oil (X1), the surfactant Tween-20 (X2), and the co-surfactant PEG-400 (X3) on the globule size in order to reach smallest globular size. Results revealed that SNEDDS globule size ranged from 177 to 454 nm. The optimized formula consisted of 20% oil, 40% surfactant and 40% co-surfactant. Diffusion study showed improved enhancement in skin permeation that was confirmed by imaging using fluorescence microscope. In vivo plasma data showed significant (p < 0.05) difference in FBX plasma levels and pharmacokinetic parameters when compared with raw FBX loaded film. In conclusion, FBX-SNEDDS loaded transdermal film could be a successful way to improve solubility and skin permeability that would lead to improvement in patient's compliance.
Acoustic Energy Controlled Nanoparticle Aggregation for Nanotherapy

Patients with unresectable or nonablatable tumors are difficult to cure, but nanotherapy combining targeted nanoparticles has many severe side effects due to the toxicities of anticancer drugs. We found that acoustic energy can produce a local region with high concentration from a low concentration suspended liquid of nano-SiO2 particles at 2.5 MHz. Our calculated results show that the main reason for aggregation is the synthesized effect of the potential well of acoustic energy and streaming to trap them. In addition, the aggregated region can be manipulated to a targeted position in the vessel phantom by moving the ultrasound transducer external to the body. This noninvasive manipulation of suspended nanoparticles can rapidly increase the local drug concentration, but reduce the total dosage of anticancer drugs, which has the potential to be used for patients with advanced tumors by improving the physiological effects and reducing the side effects.
Exploring the interaction between approach-avoidance conflict and memory processing

ABSTRACT The medial temporal lobe (MTL) has been implicated in approach-avoidance (AA) conflict processing, which arises when a stimulus is imbued with both positive and negative valences. Notably, since the MTL has been traditionally viewed as a mnemonic brain region, a pertinent question is how AA conflict and memory processing interact with each other behaviourally. We conducted two behavioural experiments to examine whether increased AA conflict processing has a significant impact on incidental mnemonic encoding and inferential reasoning. In Experiment 1, participants first completed a reward and punishment AA task and were subsequently administered a surprise recognition memory test for stimuli that were presented during high and no AA conflict trials. In Experiment 2, participants completed a reward and punishment task in which they learned the valences of objects presented in pairs (AB, BC pairs). Next, we assessed their ability to integrate information across these pairs (infer A-C relationships) and examined whether inferential reasoning was more challenging across objects with conflicting compared to non-conflicting incentive values. We observed that increased motivational conflict did not significantly impact encoding or inferential reasoning. Potential explanations for these findings are considered, including the possibility that AA conflict and memory processing are not necessarily intertwined behaviourally.
Pre‐migration traumatic experiences, post‐migration perceived discrimination and substance use among Russian and Kurdish migrants—a population‐based study

Abstract Background and aims The associations between traumatic events, substance use and perceived discrimination have been rarely studied among migrants in host countries. We examined whether pre‐migration potentially traumatic experiences (PTEs) or perceived discrimination (PD) are associated with substance use among migrants with voluntary (Russians) and forced (Kurds) migration backgrounds. Design Cross‐sectional interview and health examination data from the Finnish Migrant Health and Wellbeing Study were used. The target sample (n = 1000 for each group) was drawn from the national population register using stratified random sampling by participants’ country of birth and native language. Setting Population‐based data were collected from six cities in Finland during 2010–12. Participants The participation rates were 68% (Russians) and 59% (Kurds). The analytical sample size varied (Russians n = 442–687, Kurds n = 459–613), as some participants completed only interview, health examination or short interview. The majority of Kurds had a refugee background (75%) while Russians had mainly migrated for other reasons (99%). Measurements The three main outcomes were self‐reported binge drinking, daily smoking and life‐time cannabis use. PTEs and PD were self‐reported in the interview. Socio‐demographic background, migration‐related factors and current affective symptoms were adjusted for. Findings Among Kurds, PTEs were associated with binge drinking [adjusted odds ratio (aOR) = 2.65, 95% confidence interval (CI) = 1.30–5.42] and PD was associated with life‐time cannabis use (aOR = 3.89, 95% CI = 1.38–10.97) after adjusting for contextual factors. Among Russians, PTEs were associated with life‐time cannabis use adjusting for contextual factors (aOR = 2.17, 95% CI = 1.12–4.18). Conclusions In Finland, pre‐migration traumatic experiences appear to be associated with life‐time cannabis use among the Russian migrant population (voluntary migration) and binge drinking among the Kurdish migrant population (forced migration). Perceived discrimination in Finland appears to be associated with life‐time cannabis use among Kurdish migrants.
Faith-Assisted Cognitive Therapy of Obsessive—Compulsive Disorder

Objective: The aim of this paper is to report the rapid resolution of obsessions when the patient invoked Christ to treat her obsessions. Clinical picture: A 25–year-old female presented with obsessions (doubts) that: (i) while driving she will knock down a pedestrian; and (ii) she will be charged with sex abuse. Treatment and Outcome: Cognitive therapy (cognitive restructuring and thought-stopping) was offered. After a single session a complete remission was reported when she replaced her doubts with firm convictions that “Christ will help me drive safely” and “Christ will not let me do anything wrong”. She was reported to have remained well at the end of 5 months at which time she relocated and was then lost to follow-up. Conclusion: Religious faith can have a healing effect, and cognitive therapy is not incompatible with religion. Although unusual in standard clinical practice, rapid resolution of obsessions is possible.
Learning No-Reference Quality Assessment of Multiply and Singly Distorted Images With Big Data

Previous research on no-reference (NR) quality assessment of multiply-distorted images focused mainly on three distortion types (white noise, Gaussian blur, and JPEG compression), while in practice images can be contaminated by many other common distortions due to the various stages of processing. Although MUSIQUE (MUltiply- and Singly-distorted Image QUality Estimator) [Zhang et al., TIP 2018] is a successful NR algorithm, this approach is still limited to the three distortion types. In this paper, we extend MUSIQUE to MUSIQUE-II to blindly assess the quality of images corrupted by five distortion types (white noise, Gaussian blur, JPEG compression, JPEG2000 compression, and contrast change) and their combinations. The proposed MUSIQUE-II algorithm builds upon the classification and parameter-estimation framework of its predecessor by using more advanced models and a more comprehensive set of distortion-sensitive features. Specifically, MUSIQUE-II relies on a three-layer classification model to identify 19 distortion types. To predict the five distortion parameter values, MUSIQUE-II extracts an additional 14 contrast features and employs a multi-layer probability-weighting rule. Finally, MUSIQUE-II employs a new most-apparent-distortion strategy to adaptively combine five quality scores based on outputs of three classification models. Experimental results tested on three multiply-distorted and six singly-distorted image quality databases show that MUSIQUE-II yields not only a substantial improvement in quality predictive performance as compared with its predecessor, but also highly competitive performance relative to other state-of-the-art FR/NR IQA algorithms.