Miracle-dz/UniFAR-FTUs huggingface dataset:
Trends and Outcomes of Alcoholic Liver Cirrhosis Hospitalizations in the Last Two Decades: Analysis of the Nationwide Inpatient Sample

Background Liver cirrhosis is a major burden on the health care system. Alcohol is one of the most common etiologies of cirrhosis. The aim of our article is to examine the trends of alcoholic liver cirrhosis (ALC) hospitalizations over the past two decades. Methods This was a retrospective longitudinal study. Using the International Classification of Diseases, Ninth Revision, Clinical Modification/Procedure Coding System (ICD-9-CM/PCS) and the ICD-10-CM/PCS, the Nationwide Inpatient Sample (NIS) database was analyzed. We included 1998, 2003, 2008, 2013, and 2018 NIS databases. Using multivariate regression analysis, we examined trends of ALC hospitalizations including inpatient mortality, mean length of stay (LOS), and mean total hospital charges (THCs). Results We included 261,420 hospitalizations with ALC as the primary diagnosis for admission. There was a trend toward increasing hospitalizations over that period; they increased from 46,186 in 1998 to 69,970 in 2018 (P < 0.001). Moreover, there was a 2.1-fold increase in the mean THC in 2018 compared to 1998 (P < 0.001). On the other hand, inpatient mortality decreased from 12.8% in 1998 to 4.7% in 2018 (P < 0.001), and a trend of decreasing mean LOS was observed. The mean LOS decreased from 7.0 days in 1998 to 5.9 days in 2018 (P < 0.001). Conclusions Over the last two decades, there was a trend of increasing hospitalizations and THC. However, we noticed a trend toward decreasing inpatient mortality and LOS over that period, which might reflect in part an improvement in the medical care provided for these patients.
Tropical wetlands and land use changes: The case of oil palm in neotropical riverine floodplains

Oil palm plantations are expanding in Latin America due to the global demand for food and biofuels, and much of this expansion has occurred at expense of important tropical ecosystems. Nevertheless, there is limited knowledge about effects on aquatic ecosystems near to oil palm-dominated landscapes. In this study, we used Landsat 7 ETM+, Landsat 8 OLI imagery and high-resolution images in Google Earth to map the current extent of oil palm plantations and determined prior land use land cover (LULC) in the Usumacinta River Basin as a case-study site. In addition, we assess the proximity of the crop with aquatic ecosystems distributed in the Usumacinta floodplains and their potential effects. Based on our findings, the most significant change was characterized by the expansion of oil palm crop areas mainly at expenses of regional rainforest and previously intervened lands (e.g. secondary vegetation and agriculture). Although aquatic ecosystem class (e.g. rivers, lagoons and channels) decreased in surface around 3% during the study period (2001–2017), the change was not due to the expansion of oil palm lands. However, we find that more than 50% of oil palm cultivations are near (between 500 and 3000 m) to aquatic ecosystems and this could have significant environmental impacts on sediment and water quality. Oil palm crops tend to spatially concentrate in the Upper Usumacinta ecoregion (Guatemala), which is recognized as an area of important fish endemism. We argue that the basic information generated in this study is essential to have better land use decision-making in a region that is relative newcomer to oil palm boom.
Learning analytics in higher education : a summary of tools and approaches

Higher education institutions recently have been drawing on methods from learning analytics to make decisions about learners’ academic progress, predictions about future performance and to recognise potential issues. As the use of learning analytics in higher education is a relatively new area of practice and research, the intent of this paper is to provide an overview of learning analytics including a summary of some exemplar tools. Finally we conclude the paper with a discussion on challenges and ethical issues.
Optimal sizing and allocation of distributed generation for reliable energy distribution accounting for uncertainty

This paper presents a computational framework for the integration of renewable generators DG into an electrical power distribution network. Reliability of power supply is targeted, taking into account the uncertainty of loads and renewable energy sources and, in addition to the failure behavior of the system components. The computational framework developed integrates Monte Carlo simulation for the generation of the uncertain scenarios of operation and Optimal Power Flow (MCS-OPF) into a multi-objective NSGA-II search engine. NSGA-II searches for Pareto optimal (non-dominated) solutions of allocation of DG in the electrical power network. Optimality is sought with respect to power service reliability and cost performance indicators, and is evaluated by MCS-OPF, for each allocation proposed by NSGA-II. A case study is presented to discuss the implications of the new framework and propose further challenges.
Equivalent-circuit modeling of quantum-well lasers and fibre-optic communications channels

Lasers, photodetectors, optical amplifiers, and optical fibres are the key components in lightwave communications systems. The availability of accurate models for these devices allows designers to predict the performance of lightwave communications systems prior to their implementation. Since many of the components in such communications systems are still purely electronic in nature, the development of equivalent-circuit models for the optical devices enables the entire telecommunications link to be simulated using one of the well-developed circuit simulators from the electronic industry, e.g., SPICE. Suitable models for quantum-well lasers, optical fibres, and erbium-doped fibre amplifiers (EDFA's) are developed here, and then used with equivalent-circuit models of a photodiode, a transimpedance amplifier, and an electric filter to produce a complete equivalent-circuit model for a lightwave communications channel. The main contribution of the thesis is a SPICE model for the quantum-well laser, which takes into account, for the first time, dynamical carrier effects due to the presence of gateway states at the quantum well. These states play important roles when considering carrier transport through a long separate-confinement heterostructure (SCH) and carrier capture and release via these states at the quantum well. Coulomb-enhanced gain due to many-body effects is extended beyond the usual treatment by accounting for transitions between multiple sub-bands. This correction to the free-carrier gain improves the fit between simulated and experimental data of the 3dB modulation response as a function of optical power. A compact analytical expression for the material gain, as a function of carrier density in the quantum well, is proposed for use in the model for self-consistent calculation in SPICE. The laser model is validated by comparing results for the small-
A single-stage high power factor electronic ballast with duty-ratio controlled series resonant inverter

A single-stage high power factor electronic ballast is developed by making integration of an active filter and a series resonant inverter. The function of power factor correction is performed by adjusting the duty-ratio of inverter power switches with a simple control circuit. A prototype unit designed for a 36-W compact fluorescent lamp is built and tested to verify the predicted results.
The Genetic Traces of Expansion

The Turkic peoples represent a diverse collection of ethnic groups defined by the Turkic languages. 3 These groups have dispersed across a vast area, including Siberia, Northwest China, Central Asia, 4 East Europe, the Caucasus, Anatolia, the Middle East, and Afghanistan. The origin and early 5 dispersal history of the Turkic peoples is disputed, with candidates for their ancient homeland 6 ranging from the Transcaspian steppe to Manchuria in Northeast Asia. Previous genetic studies have 7 not identified a clear-cut unifying genetic signal for the Turkic peoples, which lends support for 8 language replacement rather than demic diffusion as the model for the Turkic language’s expansion. 9 We addressed the genetic origin of 373 individuals from 22 Turkic-speaking populations, 10 representing their current geographic range, by analyzing genome-wide high-density genotype data. left genetic trace. In this study, we show that Turkic-speaking peoples sampled across the East, Caucasus, East Europe, and Central Asia share varying proportions of Asian ancestry that originate in a single area, southern Siberia and Mongolia. Mongolic- and Turkic-speaking populations from this area bear an unusually high number of long chromosomal tracts that are identical by descent with Turkic peoples from across west Eurasia. Admixture induced linkage disequilibrium decay across chromosomes in these indicates admixture occurred during the later Mongol our findings reveal traces of and
The effects of macronutrients composition on hormones and substrates during a meal tolerance test in drug-naive and sitagliptin-treated individuals with type 2 diabetes: a randomized crossover study

ABSTRACT Objectives: To evaluate the effect of sitagliptin treatment in early type 2 diabetes mellitus (T2DM) and the impact of different macronutrient compositions on hormones and substrates during meal tolerance tests (MTT). Materials and methods: Half of the drug-naive patients with T2DM were randomly assigned for treatment with 100 mg of sitagliptin, q.d. , or placebo for 4 weeks and then submitted to 3 consecutive MTT intercalated every 48 h. The MTTs differed in terms of macronutrient composition, with 70% of total energy from carbohydrates, proteins, or lipids. After 4 weeks of washout, a crossover treatment design was repeated. Both patients and researchers were blinded, and a repeated-measures ANOVA was employed for statistical analysis. Results: Sitagliptin treatment reduced but did not normalize fasting and post-meal glucose values in the three MTTs, with lowered area-under-glucose-curve values varying from 7% to 15%. The sitagliptin treatment also improved the insulinogenic index (+86%) and the insulin/glucose (+25%), glucagon-like peptide-1/glucose (+46%) incremental area under the curves. Patients with early T2DM maintained the lowest glucose excursion after a protein- or lipid-rich meal without any major change in insulin, C-peptide, glucagon, or NEFA levels. Conclusion: We conclude that sitagliptin treatment is tolerable and contributes to better control of glucose homeostasis in early T2DM, irrespective of macronutrient composition. The blood glucose excursion during meal ingestion is minimal in protein- or fat-rich meals, which can be a positive ally for the management of T2DM. Clinical trial no: NCT00881543
Actigraphically measured psychomotor slowing in depression: systematic review and meta-analysis

Abstract Psychomotor slowing is a key feature of depressive disorders. Despite its great clinical importance, the pathophysiology and prevalence across different diagnoses and mood states are still poorly understood. Actigraphy allows unbiased, objective, and naturalistic assessment of physical activity as a marker of psychomotor slowing. Yet, the true effect-sizes remain unclear as recent, large systematic reviews are missing. We conducted a novel meta-analysis on actigraphically measured slowing in depression with strict inclusion and exclusion criteria for diagnosis ascertainment and sample duplications. Medline/PubMed and Web-of-Science were searched with terms combining mood-keywords and actigraphy-keywords until September 2021. Original research measuring actigraphy for ⩾24 h in at least two groups of depressed, remitted, or healthy participants and applying operationalized diagnosis was included. Studies in somatically ill patients, N < 10 participants/group, and studies using consumer-devices were excluded. Activity-levels between groups were compared using random-effects models with standardized-mean-differences and several moderators were examined. In total, 34 studies (n = 1804 patients) were included. Patients had lower activity than controls [standardized mean difference (s.m.d.) = −0.78, 95% confidence interval (CI) −0.99 to −0.57]. Compared to controls, patients with unipolar and bipolar disorder had lower activity than controls whether in depressed (unipolar: s.m.d. = −0.82, 95% CI −1.07 to −0.56; bipolar: s.m.d. = −0.94, 95% CI −1.41 to −0.46), or remitted/euthymic mood (unipolar: s.m.d. = −0.28, 95% CI −0.56 to 0.0; bipolar: s.m.d. = −0.92, 95% CI −1.36 to −0.47). None of the examined moderators had any significant effect. To date, this is the largest meta-analysis on actigraphically measured slowing in mood disorders. They are associated with lower activity, even in the remitted/euthymic mood-state. Studying objective motor behavior via actigraphy holds promise for informing screening and staging of affective disorders.
Periodontitis pathogen Porphyromonas gingivalis promotes pancreatic tumorigenesis via neutrophil elastase from tumor-associated neutrophils

ABSTRACT Intratumor microbiome shapes the immune system and influences the outcome of various tumors. Porphyromonas gingivalis (P. gingivalis), the keystone periodontal pathogen, is highly epidemically connected with pancreatic cancer (PC). However, its causative role and the underlining mechanism in promoting PC oncogenesis remain unclear. Here, we illustrated the landscape of intratumor microbiome and its bacterial correlation with oral cavity in PC patients, where P. gingivalis presented both in the oral cavity and tumor tissues. When exposed to P. gingivalis, tumor development was accelerated in orthotopic and subcutaneous PC mouse model, and the cancerous pancreas exhibited a neutrophils-dominated proinflammatory tumor microenvironment. Mechanistically, the intratumoral P. gingivalis promoted PC progression via elevating the secretion of neutrophilic chemokines and neutrophil elastase (NE). Collectively, our study disclosed the bacterial link between periodontitis and PC, and revealed a previously unrecognized mechanism of P. gingivalis in PC pathophysiology, hinting at therapeutic implications.
The Wider Considerations in Closing Chronic Disease Gaps – Focus on Heart Failure and Implementation

Background Heart failure (HF) is predominately a chronic disease. There are overlaps in HF and chronic disease research and care. Chronic disease and HF research are conducted with multiple goals. The overarching goal is “optimized patient outcomes at maximum cost-effectiveness”. However, observations on patients can come with many variables; thus, we see differences in clinical translation. This document discusses an argument for three important gaps common to HF and chronic disease, i.e., screening, self-management, and patient-reported outcomes (PRO), and provides a glance of how it could fit into the evidence tree. Pertinent arguments for a framework for health services and models of care are provided as a prelude to future consensus. Methodology 1) A preliminary literature review to identify a taxonomy for cardiovascular research, and 2) a review of the published literature describing the translation of research studies into clinical practice for cardiovascular disorders. A spectrum from observational to large randomized controlled trials to post-marketing studies were identified. Discussion A brief discussion on traditional research and differences focusing on screening, mixed methods research concepts, and chronic diseases models of care. Six steps to facilitate this: 1) Research design; 2) Research application (translation) i. routine ii. challenges; 3. Transforming research to translational level; 4. Funding and infrastructure; 5. Clinical Centres of Research Excellence (CCRE) and collaboration; 6. Governance and cost-effectiveness. Conclusion Implementation research that aims to link research findings to improved patient outcomes in an efficient and effective way is a neglected area. Skills required to perform implementation research are complex. Ways to maximize translational impacts for chronic disease research to clinical practice are described in a HF context.
Shotgun Proteomics for the Identification and Profiling of the Tear Proteome of Keratoconus Patients

Purpose The qualitative approach followed in this study aims to obtain an extensive view of the keratoconus (KC) tear proteome, which could highlight proteins previously undetected and enlarge our knowledge of the disease's pathophysiology. Methods Twenty-five patients diagnosed with KC and 25 control subjects were studied in a prospective, cross-sectional study. KC screening examinations, including clinical and tomographic examinations, were performed on all participants. Tear samples were collected using Schirmer strips and analyzed by liquid chromatography-tandem mass spectrometry in a data-dependent workflow. A spectral count was used as a semiquantification tool. The tear proteomes of both groups were identified and profiled, and the functional interactions and biological characterization of differential proteins were analyzed using in silico tools. Results We identified a total of 232 proteins, of whom 133 were expressed in both groups’ samples; 41 were observed only in control samples and 58 were identified just in tears of patients with KC. A semiquantitative analysis showed the dysregulation of 17 proteins in the KC samples. An in silico analysis linked proteins only expressed in KC samples to oxidative stress, skin development, and apoptosis. The dysregulation of proteins involved in iron transport, inflammation, oxidative stress, and protease inhibition was observed in the semiquantitative results. Conclusions A shotgun analysis showed that the tear proteome of patients with KC differed from controls by more than one-third of the total proteins identified, highlighting the relationship of the proteins only expressed in KC tears with processes of cell death, oxidative damage, and inflammation. The underexpression of proteins involved in iron pathways might support the iron imbalance as a contributing factor to cellular damage and death in KC disease.
Effectiveness of pre-anaesthetic assessment clinic: a systematic review of randomised and non-randomised prospective controlled studies

Objectives The aim of this systematic review was to examine the effectiveness of pre-anaesthesia assessment clinics (PACs) in improving the quality and safety of perioperative patient care. Design Systematic review. Data sources The electronic databases CINAHL Plus with Full Text (EBSCOhost), Medline and Embase (OvidSP) were systematically searched on 11 September 2018 and updated on 3 February 2020 and 4 February 2021. Eligibility criteria The inclusion criteria for this study were studies published in English or Scandinavian language and scientific original research that included randomised or non-randomised prospective controlled studies. Additionally, studies that reported the outcomes from a PAC consultation with the patient present were included. Data extraction and synthesis Titles, abstracts and full texts were screened by a team of three authors. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies. Data extraction was performed by one author and checked by four other authors. Results were synthesised narratively owing to the heterogeneity of the included studies. Results Seven prospective controlled studies on the effectiveness of PACs were included. Three studies reported a significant reduction in the length of hospital stay and two studies reported a significant reduction in cancellation of surgery for medical reasons when patients were seen in the PAC. In addition, the included studies presented mixed results regarding anxiety in patients. Most studies had a high risk of bias. Conclusion This systematic review demonstrated a reduction in the length of hospital stay and cancellation of surgery when the patients had been assessed in the PAC. There is a need for high-quality prospective studies to gain a deeper understanding of the effectiveness of PACs. PROSPERO registration number CRD42019137724.
Synergistic immunosuppressive effect of hispidulin and nepetin mixtures on human T lymphocytes

Abstract Background Clerodendrum petasites S. Moore predominantly contains hispidulin (His) and nepetin (Nep) which are immunosuppressive potentials. Although the effect of individual compounds was previously confirmed, a cumulative suppression of these flavonoid mixtures is unknown. This study thus investigated their inhibitory effects and cytotoxicity on T cells by using His:Nep ratios following a naturally occurring dose (3:1) and optimized doses (1:1 and 1:3). Materials and methods Anti-CD3/28 stimulated peripheral blood mononuclear cells were treated with individual compounds and their mixtures. Changes in early cell activation markers in activated T cells and apoptosis were analyzed by a flow cytometer. Results Mixtures at 3:1 suppressed CD69 and CD25 expression in CD4+ and CD8+ T cells in a dose-dependent manner. At the highest concentration of 200 µM His + 66.7 µM Nep, over 90% inhibition was observed for CD25 expression in CD4+ and CD8+ T cells, whereas a lesser effect was observed for CD69 expression. A dose-dependent inhibition was still observed when using 1:1 and 1:3 ratios. Interestingly, 80–97% inhibition were observed in CD69 and CD25 expression without inducing cell death after treated with the highest doses of each ratio (66.7 µM His + 200 µM Nep and 200 µM His + 200 µM Nep). These mixtures were also exhibited a better suppression than individual compounds. Conclusions The optimized mixture of His and Nep at 66.7:200 µM is suggested for further study due to a greater suppressive effect than a single compound or a naturally-occurring dose.
The serotype a-EmaA adhesin of Aggregatibacter actinomycetemcomitans does not require O-PS synthesis for collagen binding activity

Aggregatibacter actinomycetemcomitans , a causative agent of periodontitis and non-oral diseases, synthesizes a trimeric extracellular matrix protein adhesin A (EmaA) that mediates collagen binding and biofilm formation. EmaA is found as two molecular forms, which correlate with the serotype of the bacterium. The canonical protein (b-EmaA), associated with serotypes b and c, has a monomeric molecular mass of 202 kDa. The collagen binding activity of b-EmaA is dependent on the presence of O-polysaccharide (O-PS), whereas biofilm activity is independent of O-PS synthesis. The EmaA associated with serotype a strains (a-EmaA) has a monomeric molecular mass of 173 kDa and differs in the amino acid sequence of the functional domain of the protein. In this study, a-emaA was confirmed to encode a protein that forms antenna-like appendages on the surface of the bacterium, which were found to be important for both collagen binding and biofilm formation. In an O-PS-deficient talose biosynthetic (tld) mutant strain, the electrophoretic mobility of the a-EmaA monomers was altered and the amount of membrane-associated EmaA was decreased when compared to the parent strain. The mass of biofilm formed remained unchanged. Interestingly, the collagen binding activity of the mutant strain was similar to the activity associated with the parent strain, which differs from that observed with the canonical b-EmaA isoform. These data suggest that the properties of the a-EmaA isoform are like those of b-EmaA, with the exception that collagen binding activity is independent of the presence or absence of the O-PS.