Miracle-dz/UniFAR-FTUs huggingface dataset:
Sensitivity, Specificity, and Predictive Values of Laryngopharyngeal Reflux Symptoms and Signs in Clinical Practice.

OBJECTIVE To investigate the sensitivity (SE), specificity (SP), and positive and negative predictive value (PPV and NPV) of symptoms and signs of laryngopharyngeal reflux (LPR). STUDY DESIGN Prospective controlled. SETTING University medical center. METHODS Patients presenting with LPR symptoms and signs were consecutively included after diagnosis confirmation through 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring. Healthy individuals were recruited to compose a control group. Symptoms and signs were evaluated with the reflux symptom score and reflux sign assessment. The SE, SP, PPV, and NPV of symptoms and signs were assessed. RESULTS The study included 403 patients with LPR and 144 healthy individuals. Throat clearing, globus sensation, heartburn, and excess throat mucus were symptoms with the highest SE (67.5%-69.7%), SP (12.5%-20.8%), and NPV (48.3%-49.2%). The combination of throat clearing, heartburn, globus sensation, and excess throat mucus led to a high SE (96.0%) and NPV (85.2%). Anterior pillar erythema, tongue tonsil hypertrophy, and posterior commissure hypertrophy resulted in the highest SE (75.5%-83.5%). The highest SP was found for uvula erythema/edema, epiglottis erythema, and interarytenoid granulatory tissue (97.1%-97.2%). The association of nonendoscopic signs (anterior pillar erythema, uvula erythema/edema, and coated tongue) had an SE and SP of 80.1% and 47.2%, respectively. The association of throat clearing, heartburn, globus, anterior pillar erythema, and uvula erythema/edema had the highest SE (98.8%), SP (33.3%), PPV (94.3%), and NPV (70.6%). CONCLUSION LPR symptoms and signs reported low SP and NPV. The SE, SP, PPV, and NPV may be maximized with the association of throat clearing, heartburn, globus sensation, anterior pillar erythema, and uvula erythema/edema.
Post-fracture rehabilitation pathways and association with mortality among adults with cerebral palsy

Objective Rehabilitation may mitigate the high mortality rates and health declines post-fracture for adults with cerebral palsy, but this is understudied. The objectives were to characterize the post-fracture rehabilitation pathways and identify their association with 1-year survival among adults with cerebral palsy. Methods A retrospective cohort study of adults with cerebral palsy with a fragility fracture with continuous health plan enrollment ≥1-year prior to and ≥1 day after their fracture date was performed using a random 20% Medicare fee-for-service dataset. Participants were categorized as a home discharge or inpatient rehabilitation admission post-fracture. For the home discharge cohort, weekly exposure to outpatient physical/occupational therapy (PT/OT) was examined up to 6-month post-fracture. Cox regression examined the association between time-varying PT/OTuse within 6-month post-fracture and mortality from 30 days to 1-year post-fracture before and after adjusting for confounders (e.g. medical complexity). Results Of 3598 adults with cerebral palsy with an incident fragility fracture, 74% were discharged home without inpatient rehabilitation; they were younger, but more medically complex compared to the 26% admitted to inpatient rehabilitation. Among the home discharge cohort (n = 2662), 43.1% initiated PT/OTwithin 6-month post-fracture, and cumulative PT/OTexposure post-fracture was associated with improved survival; for example, per 3 weeks of PT/OTexposure, the adjusted mortality rate was 40% lower (95% confidence interval (CI) = 0.41–0.89). Conclusions Most adults with cerebral palsy with a fragility fracture were discharged home rather than to inpatient rehabilitation, and only 43.1% of that group initiated outpatient PT/OTwithin 6 months post-fracture. Receiving outpatient PT/OTwas associated with improved 1-year survival.
Nonlinear analysis of postural changes related to the movement interventions during prolonged standing task

Abstract This study assessed the effects of movement-based interventions on the complexity of postural changes during prolonged standing. Twenty participants, equally distributed in gender and standing work experience (SWE), completed three simulated prolonged standing sessions: without movement (control), leg exercise and footrest. The amount and complexity of variability in the centre of pressure (COP) and lumbar curvature angle were quantified using linear and nonlinear tools. Lower leg swelling and back/leg discomfort were also monitored. Participants in the SWE group showed significantly greater postural complexity during the standing. Regular leg exercise resulted in significantly higher postural complexity and lower leg discomfort and swelling. The footrest led to significant changes in amount of COP variability. Both interventions significantly reduced back discomfort. Overall, the nonlinear analysis of postural changes provided different findings compared to linear ones, considering the standing time, interventions and standing job experience. Nonlinear results were consistent with leg discomfort and swelling. Practitioner summary: The effect of movement-based interventions on dynamics of postural alterations over prolonged standing were characterised using nonlinear techniques. The effect of standing work experience was also considered. Previous experience of standing jobs and leg movements increase the complexity of postural behaviour over standing period.
A Dynamic Bayesian Model for Breast Cancer Survival Prediction

Objective: Predicting breast cancer survival and targeting patients at high-risk of mortality is of crucial importance. Methods: We built a Bayesian Dynamic Cox (BDCox) model for predicting 5-year overall survival in breast cancer patients using data of the SEER Cancer Registry with 12,840 women. Four feature selection methods were used to identify predictors and enhance parsimony: fast backward variable selection, elastic net, Bayesian Model Average (BMA), and clinical expertise. All resulting models and a baseline full model containing all features were internally validated via bootstrapping and externally validated in the Shanghai Breast Cancer Survival Study. Results: BMA outperformed other feature selection methods in both internal and external validations. The BDCox model with 12 predictors had the best performance. Several predictors showed time-varying associations with survival that are in agreement with previous studies. Conclusion: The model developed using BDCox outperformed other prognostic models considered in our study. The internal validation results indicate that the BDCox model is capable of achieving high prediction accuracy (C-statistic: 0.802), and the external validation results showed excellent generalizability of the BDCox model (C-statistic: 0.739). Significance: We built a dynamic Bayesian model from the large population-based registry SEER for predicting 5-year breast cancer overall survival. The prediction performance of the BDCox model is significantly better than other survival models.
Multifunctional mRNA-based CAR T cells display promising anti-tumor activity against glioblastoma.

PURPOSE Most chimeric antigen receptor (CAR)-T cell strategies against glioblastoma have demonstrated only modest therapeutic activity and are based on persistent gene modification strategies that have limited transgene capacity, long manufacturing processes and the risk for uncontrollable off-tumor toxicities. mRNA-based T cell modifications are an emerging safe, rapid and cost-effective alternative to overcome these challenges, but are underexplored against glioblastoma. EXPERIMENTAL DESIGN We generated mouse and human mRNA-based multifunctional T cells co-expressing a multitargeting CAR based on the NKG2D receptor and the pro-inflammatory cytokines IL12 and IFNa2 and assessed their anti-glioma activity in vitro and in vivo. RESULTS Compared to T cells that either expressed the CAR or cytokines alone, multifunctional CAR T cells demonstrated increased anti-glioma activity in vitro and in vivo in three orthotopic immunocompetent mouse glioma models without signs of toxicity. Mechanistically, the co-expression of IL12 and IFNa2 in addition to the CAR promoted a pro-inflammatory tumor microenvironment and reduced T cell exhaustion as demonstrated by ex vivo immune phenotyping, cytokine profiling and RNA sequencing. The translational potential was demonstrated by image-based single-cell analyses of mRNA-modified T cells in patient glioblastoma samples with a complex cellular microenvironment. This revealed strong anti-glioma activity of human mRNA-based multifunctional NKG2D CAR T cells co-expressing IL12 and IFNa2 whereas T cells that expressed either the CAR or cytokines alone did not demonstrate comparable anti-glioma activity. CONCLUSION These data provide a robust rationale for future clinical studies with mRNA-based multifunctional CAR T cells to treat malignant brain tumors.
Sonic Textiles for Health and Wellbeing

Overview ‘Sonic Textiles for Health and Wellbeing’ outlines a PhD study using textiles as an interface for sound applied within health and wellbeing. We use textiles for protecting our bodies, helping keep us warm or stay cool in different environments. They are sensory objects that can engage our sight, touch, sense of smell, and even our hearing. In the past, textile designers have considered the sensual aspects of their designs, mainly focusing on the inherent visual and tactile qualities. Over the last few years the addition of sound to textiles within research and design can be seen in the work of Cathy Treadaway and CuteCircuit. Technology is easily integrated within textiles, with components becoming smaller and more sophisticated. Sabine Seymour suggests that audio could become central to the success of smart clothes. This study will investigate adding to the natural qualities of textiles through the addition of sound, creating sonic textiles. The purpose of this study is triple-layered: (1) it looks to encourage and share the making of sensory and sonic textiles, (2) it investigates how making affects our identity, while (3) gaining a better understanding of what affect sensory and sonic textiles can have on health and wellbeing.
Striving for Methodological Integrity in Mixed Methods Research: The Difference Between Mixed Methods and Mixed‐Up Methods

Tacit misconceptions about mixed methods research are evident not only in the way research is conceptualized, executed, and reported but also in the way it is embodied in day-to-day practice. In the name of efficiency, for example, teams are often divided into those with expertise in quantitative research and those who feel more confident of their qualitative expertise, with little thought to the role a mixed methods person might play in bringing the two together. Each group is responsible for a separate stream of publications. For example, researchers in the health fields who are implementing research with an experimental design are encouraged to add a qualitative phase to tap into participants’ views, but there is little evidence that these are integrated into the quantitative phase in a way that has a significant impact on the design of the intervention or the way it is implemented. Each of these practices not only limits the likelihood of leveraging the full potential of mixed methods but also counters some of the most fundamental principles that drive its practice. Much has been written about quality in mixed methods research, most attending to standards of reporting and prioritizing methodological transparency. Advocates of this approach, including my own Mixed Method Evaluation Rubric (Creamer, 2018a), place so much emphasis on this transparency because it reflects a mandate to communicate the results of research with enough precision and clarity to build a case for the credibility of the results and to allow others to build on the results in another study. The recent release of a report from a task force established by the American Psychological Association (Levitt et al., 2018) also prioritizes methodological transparency. Among the most salient standards are the expectation that a report contains explicit language that provides a rationale for the benefits expected to accrue from a mixed methods approach, identification of one of the widely recognized designs (e.g., concurrent, sequential, or multi-phase), and explicit commentary about how the qualitative and quantitative strands, data, and/or analytical procedures were integrated or mixed. Reflecting on these kinds of concerns in a manuscript goes a long way in warranting the conclusions of a study and are very likely to facilitate communication with an audience that extends beyond a single discipline or content area. Guidelines or standards for reporting are not without their detractors who charge that they push a drive for standardization that smothers innovation and that they default to a prescriptive checklist mentality. Although they are not unrelated, adhering to standards for reporting is not the same thing as empirically sound research. Good reporting can camouflage
Posttraumatic Stress Symptoms and the Quality of Maternal-Child Interactions in Mothers of Preterm Infants

This article has supplementary material on the web site: www.jdbp. org. ABSTRACT: Objective: The purpose of this study was to examine associations between maternal trauma exposure, posttraumatic stress symptoms, and directly observed maternal-child interactions among a diverse cohort of mother-preterm infant dyads at 12-month corrected age. Methods: We conducted a retrospective cohort study. Maternal trauma exposure and posttraumatic stress symptoms were measured using the Modified Posttraumatic Stress Disorder Symptom Scale at baseline and 6 and 12 months. The primary outcome was directly observed maternal-child interactions at 12-month corrected age using the Coding Interactive Behavior Manual. We used linear regression models to estimate the associations between trauma exposure, posttraumatic stress symptoms (and symptom clusters), and observer-rated maternal-child interactions. Results: Among the 236 participants, 89 (37.7%) self-reported as Black and 98 (41.5%) as Latina; mean gestational age of the infants was 31.6 weeks (SD 2.6). Mothers with posttraumatic stress symptoms demonstrated greater maternal sensitivity (β = 0.32; 95% confidence interval [CI], 0.06–0.58; standardized effect size = 0.39) and greater dyadic reciprocity (β = 0.39; 95% CI, 0.04–0.73; standardized effect size = 0.36) compared with those not exposed to trauma; however, we did not observe significant differences between trauma-exposed but asymptomatic women and those not exposed to trauma. Across symptom clusters, differences in maternal sensitivity and dyadic reciprocity were most pronounced for mothers with avoidance and re-experiencing symptoms, but not hyperarousal symptoms. Conclusion: Maternal posttraumatic stress symptoms seem to be associated with the quality of maternal-child interactions at age 1 year among a cohort of urban, mother-preterm infant dyads. These findings have implications for strength-based intervention development.
Global Search and Analysis for the Nonconvex Two-Level ℓ₁ Penalty

Imposing suitably designed nonconvex regularization is effective to enhance sparsity, but the corresponding global search algorithm has not been well established. In this article, we propose a global search algorithm for the nonconvex two-level $\ell _{1}$ penalty based on its piecewise linear property and apply it to machine learning tasks. With the search capability, the optimization performance of the proposed algorithm could be improved, resulting in better sparsity and accuracy than most state-of-the-art global and local algorithms. Besides, we also provide an approximation analysis to demonstrate the effectiveness of our global search algorithm in sparse quantile regression.
Tau and amyloid biomarkers modify the degree to which cognitive reserve and brain reserve predict cognitive decline

Abstract Objective: Brain reserve, cognitive reserve, and education are thought to protect against late-life cognitive decline, but these variables have not been directly compared to one another in the same model, using future cognitive and functional decline as outcomes. We sought to determine whether the influence of these protective factors on executive function (EF) and daily function decline was dependent upon Alzheimer’s disease (AD) pathology severity, as measured by the total tau to beta-amyloid (T-τ/Aβ1-42) ratio in cerebrospinal fluid (CSF). Method: Participants were 1201 older adult volunteers in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) study. Brain reserve was defined using a composite index of structural brain volumes (total brain matter, hippocampus, and white matter hyperintensity). Cognitive reserve was defined as the variance in episodic memory performance not explained by brain integrity and demographics. Results: At higher levels of T-τ/Aβ1-42, brain and cognitive reserve predicted slower decline in EF. Only brain reserve attenuated decline at lower levels of T-τ/Aβ1-42. Education had no independent association with cognitive decline. Conclusions: These results point to a hierarchy of protection against aging- and disease-associated cognitive decline. When pathology is low, only structural brain integrity predicts rate of future EF decline. The ability of cognitive reserve to predict future EF decline becomes stronger as CSF biomarker evidence of AD increases. Although education is typically thought of as a proxy for cognitive reserve, it did not show any protective effects on cognition after accounting for brain integrity and the residual cognitive reserve index.
The effect of nutrition on stroke risk: A systematic review

Background: An estimated 33% reduction in cardiovascular events can be achieved when incorporating whole grains, fruits, vegetables, poultry, nuts, and vegetable oils in the diet along with reduced consumption of refined carbohydrates, processed meats, and sugar sweetened beverages. We performed a systematic review to analyze the impact of nutritional intervention on stroke risk, as there is no current consensus concerning dietary recommendation for primary and secondary stroke prevention. Methods: A literature search of the PubMed database from January 2010 to June 2020 was performed using combinations of the following search terms: carotid disease, carotid artery disease, carotid stenosis, carotid intima-media thickness (CIMT), diet, nutrition, micronutrition, embolic stroke, and stroke. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist. Results: 28 studies met our inclusion criteria. Multiple studies showed an inverse relationship between consumption of vegetables and fruits and stroke risk. Vitamin B12 or a combination of B Vitamins was the most common supplement studied in stroke prevention. Only one RCT showed the use of B12 (500 micrograms/day) correlated with lower CIMT at follow up in healthy vegetarians. Discussion: The key findings from this systematic review indicate that adopting a diet rich in fruits and vegetables earlier in life may lower stroke risk compared with meats and fat intake. B vitamins also appear to confer some protection against stroke. However, not enough data exists to support the use of multivitamins, calcium, soy products and other supplements for primary or secondary stroke prevention.
In vitro characterization of tofacitinib loaded novel nanoemulgel for topical delivery for the management of rheumatic arthritis

Abstract The purpose of the current study is to prepare the tofacitinib (TFB) nanoemulgel (NEG) for topical administration with optimized particle size, high loading efficiency, and better penetration through the skin for the treatment of rheumatic arthritis. The topical delivery of this drug avoids the hazards associated with oral delivery like upper respiratory tract infections and neutropenia. The formulations were prepared using the high-energy ultrasonication method. Oleic acid, tween 80, and propylene glycol were used to prepare TFB nanoemulsion (NE) which is then homogenized with carbopol-934 hydrogel to get the NEG loaded with TFB. The concentration of independent variables such as X 1 (oil phase), X 2 (surfactant), and X 3 (cosurfactant) was optimized using the Box–Behnken design to check its impact on dependent variables such as Y 1 (particle size) and Y 2 (loading efficiency) of the NE. The minimum particle size of 106.3 ± 2.8 nm and maximum loading efficiency of 19.3 ± 1.8% were obtained for NE. The NEGs were evaluated for different organoleptic and physicochemical stability which were found within the normal range. The in vitro release studies showed 89.64 ± 0.97% cumulative release of TFB from NEG over the period of 24 h. The drug release data were fitted in different kinetic models and it followed Higuchi and Korsmeyer-Peppas model clearly showing the non-Fickian drug release from matrix system. As a result, the TFB NEG that have been produced could be a viable delivery mechanism for topical route. Graphical Abstract
Ionospheric outflow and cross polar cap potential: What is the role of magnetospheric inflation?

Reductions of the ionospheric cross polar cap potential in magnetohydrodynamic models that include polar wind‐like heavy ion outflow have become a ubiquitous observation in recent studies. The underlying mechanisms for these reductions, which are not to be confused with the problem of potential saturation, remain in question. A possible explanation is that such outflow inflates the magnetosphere, creating a blunter obstacle to the solar wind and reducing the upstream geoeffective length. Such an explanation is attractive because it describes the outflow‐related potential drop in clear, model‐independent terms. This study uses three separate magnetohydrodynamic simulations to test this hypothesis: one coupled to a polar wind outflow model, one coupled to an inner magnetosphere code in order to reproduce the effect without explicit outflow, and a stand‐alone baseline simulation. It is found that this hypothesis cannot explain the total reduction. Results suggest that other mechanisms, such as a change to the dayside reconnection rate, may be important, but further investigation is required.
Biosynthesis of silver nanoparticles using Lawsonia inermis and their biomedical application

Abstract Developing biosynthesis of silver nanoparticles (Ag‐NPs) using plant extract is an environmentally friendly method to reduce the use of harmful chemical substances. The green synthesis of Ag‐NPs by Lawsonia inermis extract and its cellular toxicity and the antimicrobial effect was studied. The physical and chemical properties of synthesised Ag‐NPs were investigated using UV‐visible spectroscopy, infrared spectroscopy, X‐ray diffraction (XRD), scanning, and transmission electron microscopy. The average size of Ag‐NPs was 40 nm. The XRD result shows peaks at 2θ = 38.07°, 44.26°, 64.43°, and 77.35° are related to the FCC structure of Ag‐NPs. Cytotoxicity of synthesised nanoparticles was evaluated by MTT toxicity test on breast cancer MCF7 cell line. Observations showed that the effect of cytotoxicity of nanoparticles on the studied cell line depended on concentration and time. The obtained IC50 was considered for cells at a dose of 250 μg/ml. Growth and survival rates decreased exponentially with the dose. Antimicrobial properties of Ag‐NPs synthesised with extract were investigated against Escherichia coli, Salmonella typhimurium, Bacillus cereus, and Staphylococcus aureus to calculate the minimum inhibitory concentration and the minimum bactericidal concentration of (MBC). The results showed that the synthesised Ag‐NPs and the plant extract have antimicrobial properties. The lowest concentration of Ag‐NPs that can inhibit the growth of bacterial strains was 25 μg/ml.