Miracle-dz/UniFAR-FTUs huggingface dataset:
Dyadic approach to supervised community rehabilitation participation in an Asian setting post-stroke: exploring the role of caregiver and patient characteristics in a prospective cohort study

Objective To study the association of caregiver factors and stroke survivor factors with supervised community rehabilitation (SCR) participation over the first 3 months and subsequent 3 to 12 months post-stroke in an Asian setting. Design Prospective cohort study. Setting Community setting. Participants We recruited stroke survivors and their caregivers into our yearlong cohort. Caregiver and stroke survivor variables were collected over 3-monthly intervals. We performed logistic regression with the outcome variable being SCR participation post-stroke. Outcome measures SCR participation over the first 3 months and subsequent 3 to 12 months post-stroke Results 251 stroke survivor-caregiver dyads were available for the current analysis. The mean age of caregivers was 50.1 years, with the majority being female, married and co-residing with the stroke survivor. There were 61%, 28%, 4% and 7% of spousal, adult-child, sibling and other caregivers. The odds of SCR participation decreased by about 15% for every unit increase in caregiver-reported stroke survivor’s disruptive behaviour score (OR: 0.845; 95% CI: 0.769 to 0.929). For every 1-unit increase in the caregiver’s positive management strategy score, the odds of using SCR service increased by about 4% (OR: 1.039; 95% CI: 1.011 to 1.068). Conclusion We established that SCR participation is jointly determined by both caregiver and stroke survivor factors, with factors varying over the early and late post-stroke period. Our results support the adoption of a dyadic or more inclusive approach for studying the utilisation of community rehabilitation services, giving due consideration to both the stroke survivors and their caregivers. Adopting a stroke survivor-caregiver dyadic approach in practice settings should include promotion of positive care management strategies, comprehensive caregiving training including both physical and behavioural dimensions, active engagement of caregivers in rehabilitation journey and conducting regular caregiver needs assessments in the community.
Multimodal Photoplethysmography-Based Approaches for Improved Detection of Hypertension

Elevated blood pressure (BP) is a major cause of death, yet hypertension commonly goes undetected. Owing to its nature, it is typically asymptomatic until later in its progression when the vessel or organ structure has already been compromised. Therefore, noninvasive and continuous BP measurement methods are needed to ensure appropriate diagnosis and early management before hypertension leads to irreversible complications. Photoplethysmography (PPG) is a noninvasive technology with waveform morphologies similar to that of arterial BP waveforms, therefore attracting interest regarding its usability in BP estimation. In recent years, wearable devices incorporating PPG sensors have been proposed to improve the early diagnosis and management of hypertension. Additionally, the need for improved accuracy and convenience has led to the development of devices that incorporate multiple different biosignals with PPG. Through the addition of modalities such as an electrocardiogram, a final measure of the pulse wave velocity is derived, which has been proved to be inversely correlated to BP and to yield accurate estimations. This paper reviews and summarizes recent studies within the period 2010–2019 that combined PPG with other biosignals and offers perspectives on the strengths and weaknesses of current developments to guide future advancements in BP measurement. Our literature review reveals promising measurement accuracies and we comment on the effective combinations of modalities and success of this technology.
Management for Medically Unexplained Symptoms (MUS) in Primary Care Medicine

Primary Care (PC), General Practice (GP) and Family Medicine (FM) have been important medical fields and developed for long years. PC has been introduced to Japan by Dr. Shigeaki Hinohara who was eminent physician worldwide lived until 105 years old [1]. He has been called as ‘The Father of PC in Japan’ and respected by medical staffs and people for his supreme Hinohara-ism. He has emphasized the importance of psychosomatic care in PC and also ‘the balance of mind and body’.
Smart Biomimetic Nanocomposites Mediate Mitochondrial Outcome Through Aerobic Glycolysis Reprogramming: a Promising Treatment for Lymphoma.

Toxicity and drug resistance caused by chemotherapeutic drugs have become bottlenecks in treating tumors. The delivery of anticancer drugs based on nano-carriers is regarded as an ideal way to solve the aforementioned problems. In this study, a new anti-lymphoma nanodrug CD20 aptamer-RBCm@Ag-MOFs/PFK15 (A-RAMP) is designed and constructed, and it consists of two parts: 1. metal-organic frameworks Ag-MOFs (AM) loaded with tumor aerobic glycolysis inhibitor PFK15 (P), forming a core part (AMP); 2. targeted molecule CD20 aptamer (A) is inserted into the red blood cell membrane (RBCm) to form the shell part (A-R). A-RAMP under the guidance of CD20 aptamer actively targets B-cell lymphoma both in vitro and in vivo. As a result, A-RAMP not only significantly inhibits the effect on tumor growth, but also shows no obvious side effects on the treated nude mice, indicating that A-RAMP can accurately target tumor cells, reprogram aerobic glycolysis and exert synergistic anti-tumor effect by Ag+ and PFK 15. Furthermore, the anti-tumor mechanism of A-RAMP in vivo by apoptotic pathway and targeting metabonomics are explored. These results suggest that A-RAMP has a promising application prospect as an smart, safe, effective and synergistic anti-lymphoma agent.
Original Research: Exploring the Effects of a Nurse-Initiated Diary Intervention on Post-Critical Care Posttraumatic Stress Disorder.

BACKGROUND Critical illness survivors may develop posttraumatic stress disorder (PTSD) following critical illness and hospitalization. Left untreated, PTSD may result in poor health outcomes. PURPOSE This study sought to examine the effects of a nurse-initiated diary intervention on PTSD development and symptom severity in critical illness survivors with varying levels of mentation. METHODS The study used a pretest-posttest control group design. Patients who were hospitalized in a critical care unit for more than 24 hours were recruited at a single medical center with two such units. All participants completed a pretest on day 2 of critical care hospitalization; the intervention group participants also received a diary. All participants received a posttest one month after critical care discharge. The variables examined were PTSD severity and symptoms of avoidance, intrusion, and hyperarousal. Variables were measured using the Impact of Event Scale-Revised. Diaries were written by the patient, visitors, and interdisciplinary team members, and kept by the patient. RESULTS A total of 134 participants completed the study. The intervention group participants experienced significantly fewer PTSD symptoms than the control group participants. PTSD was found to be of concern in 35 (26%) of all participants: five in the intervention group and 30 in the control group. CONCLUSIONS For critical illness survivors, a collaborative diary-writing intervention during hospitalization and after discharge can mitigate post-critical care PTSD. Participants who received diaries had a lower incidence of PTSD symptoms than controls; and at follow-up, they indicated that the diary intervention was worthwhile. We recommend the use of collaborative diary writing to help critical illness survivors in working through their experiences.
Sculpting Artificial Edges in Monolayer MoS2 for Controlled Formation of Surface Enhanced Raman Hotspots.

Hotspot engineering has the potential to transform the field of Surface-Enhanced Raman Spectroscopy (SERS) by enabling ultra-sensitive and reproducible detection of analytes. However, the ability to controllably generate SERS hotspots, with desired location and geometry, over large-area substrates, has remained elusive. In this study, we sculpt artificial edges in monolayer Molybdenum Disulfide (MoS2) by low-power focused laser-cutting. We find that when gold nanoparticles (AuNPs) are deposited on MoS2 by drop-casting, the AuNPs tend to accumulate predominantly along the artificial edges. First-principles density functional theory (DFT) calculations indicate strong binding of AuNPs with the artificial edges due to dangling bonds that are ubiquitous on the un-passivated (laser-cut) edges. The dense accumulation of AuNPs along the artificial edges intensifies plasmonic effects in these regions creating hot spots exclusively along the artificial edges. DFT further indicates that adsorption of AuNPs along the artificial edges prompts a transition from semiconducting to metallic behavior, which can further intensify the plasmonic effect along the artificial edges. These effects are observed exclusively for the sculpted (i.e., cut) edges and not observed for the MoS2 surface (away from the cut edges) or along the natural (passivated) edges of the MoS2 sheet. To demonstrate the practical utility of this concept, we use our substrate to detect Rhodamine B (RhB) with large SERS enhancement (~104) at the hotspots for RhB concentrations as low as ~10-10 M. The single-step laser etching process reported here can be used to controllably generate arrays of SERS hotspots. As such, this concept offers several advantages over previously reported SERS substrates that rely on electro-chemical deposition, e-beam lithography, nanoimprinting or photolithography. While we have focused our study on MoS2, this concept could in principle, be extended to a variety of 2D material platforms.
A Diagnostic Dilemma of a Subcutaneous Hibernoma: Case Report

Patient: Male, 33-year-old Final Diagnosis: Hibernoma Symptoms: Mass in the thigh • increasing in size Medication: — Clinical Procedure: — Specialty: Surgery Objective: Rare disease Background: Subcutaneous lipomatous lesions are commonly encountered in clinical practice. Hibernoma is a rare subtype of the benign lipomatous tumor, representing 1% of all types. It poses a challenge due to the difficulty of differentiating it from atypical lipomatous lesions and liposarcomas, which may lead to possible inappropriate diagnosis and management. Case Report: We report a case of a 33-year-old male who presented with a right upper thigh swelling noticed some time prior to presentation that had started increasing in size prior to his presentation. The magnetic resonance imaging (MRI) was unable to rule out atypical lipomatous tumor and liposarcoma. An ultrasound-guided biopsy gave a diagnosis of hibernoma. The patient underwent a wide local excision, which confirmed the diagnosis of hibernoma. At the 3-year follow-up, there was no evidence of local recurrence. Conclusions: Hibernoma has been reported in the literature to be discovered incidentally by radiological imaging done for other causes. However, hibernomas raise a diagnostic challenge because in most imaging modalities they are indistinguishable from other malignant tumors. A wide local excision with negative margins is key to resolving the diagnostic dilemma that a hibernoma presents, as it will provide a definitive diagnosis differentiating it from other lipomatous lesions and prevent any future recurrence. Caution is advised when dealing with lipomatous lesions, as they often overlap with malignancy. Furthermore, an MRI should be done for any subcutaneous lesion that is larger than 5 cm or shows recent growth. A biopsy can resolve the diagnostic dilemma with caution to the hypervascularity of such tumors.
[Effect of moxibustion on cardiac function and expression of autophagy-related proteins of cardiomyocytes in chronic heart failure rats].

OBJECTIVE To observe the effect of moxibustion on cardiac function and expression of myocardial tumor suppressor protein p53, mammalian target of rapamycin (mTOR) and phosphorylated(p)-mTOR (excessive autophagy-associated proteins of cardiomyocytes) in rats with chronic heart failure (CHF), so as to explore its mechanisms underlying improvement of CHF. METHODS SD rats were divided into blank control (n＝11), model(n＝8), autophagy activator (n＝8), autophagy inhibitor (n＝9) and moxibustion(n＝9) groups. The CHF model was established by i．p. injection of Doxorubicin Hydrochloride (DOX, 1 mg/mL, 1-4 mg/kg) every other day. Moxibustion was applied to bilateral "Feishu" (BL13) and "Xinshu" (BL15) for 20 min, 5 times a week for 3 weeks. Rats of the autophagy activator group received gavage of Rapamycin (RAPA, 2 mg/kg) and those of the autophagy inhibitor group received i．p. injection of Methyladenine (3-MA, 15 mg/kg) 5 times a week for 3 weeks after successful modeling. The heart weight and body weight were measured to calculate heart mass index (HW/BW＝heart weight ÷ body weight). Cardiac output (CO) and heart rate (HR) were measured by using a cardiac function meter. Serum N-terminal pro-brain natriuretic peptide (NT-pro BNP) content was assayed by using ELISA, and the expression of myocardial p53, p-mTOR and mTOR proteins was examined by Western blot. RESULTS (1) Compared with the blank control group, the HR, HW/BW, NT-pro BNP content and p53 expression levels were significantly increased (P<0.01), and the CO and ratio of p-mTOR/mTOR were significantly decreased in the model group (P<0.01). (2) Compared with the model group, the HR, HW/BW and NT-pro BNP content of the autophagy inhibitor and moxibustion groups were significantly decreased (P<0.01, P<0.05), and CO and p-mTOR/mTOR ratio were significantly increased in both autophagy inhibitor and moxibustion groups (P<0.01). (3) Compared with the autophagy activator group, the levels of HR, HW/BW, NT-pro BNP and p53 in the autophagy inhibitor and moxibustion groups were significantly lower (P<0.01), and those of CO and p-mTOR/mTOR levels were significantly higher (P<0.01). CONCLUSION Moxibustion, similar to the autophagy inhibitor, has a protective action on myocardium in CHF rats, which is possible by preventing over expression of myocardial autophagy-associated proteins during CHF.
Cryogenic Correlative Single-Particle Photoluminescence Spectroscopy and Electron Tomography for Investigation of Nanomaterials.

Cryogenic single-particle photoluminescence (PL) spectroscopy has been used with great success to directly observe the heterogeneous photophysical states present in a population of luminescent particles. Cryogenic electron tomography provides complimentary nanometer scale structural information to PL spectroscopy, but the two techniques have not been correlated due to technical challenges. Here, we present a method for correlating single-particle information from these two powerful microscopy modalities. We simultaneously observe PL brightness, emission spectrum, and in-plane excitation dipole orientation of CdSSe/ZnS quantum dots suspended in vitreous ice. Stable and fluctuating emitters were observed, as well as a surprising splitting of the PL spectrum into two bands with an average energy separation of 80 meV. In some cases the onset of the splitting corresponded to changes in the in-plane excitation dipole orientation. These dynamics were assigned to structures of individual quantum dots and the excitation dipoles were visualized in the context of structural features.
Two-Electrode ECG for Ambulatory Monitoring with Minimal Hardware Complexity

This article introduces a two-electrode ground-free electrocardiogram (ECG) with minimal hardware complexity, which is ideal for wearable battery-powered devices. The main issue of ground-free measurements is the presence of noise. Therefore, noise suppression methods that can be employed for a two-electrode ECG acquisition system are discussed in detail. Experimental measurements of a living subject and patient simulator are used to investigate and compare the performance of the three proposed methods utilizing the ADS1191 analogue front-end for biopotential measurements. The resulting signals recorded for the simulator indicate that all three methods should be suitable for suppressing power-line noise. The Power Spectral Density (PSD) of the signals measured for a subject exhibits differences across methods; the signal power at 50 Hz is −28, −24.8, and −26 dB for the first, second, and third method, respectively. The digital postprocessing of measured signals acquired a high-quality ECG signal comparable to that of three-electrode sensing. The current consumption measurements demonstrate that all proposed two-electrode ECG solutions are appropriate as a battery-powered device (current consumption < 1.5 mA; sampling rate of 500 SPS). The first method, according to the results, is considered the most effective method in the suppression of power-line noise, current consumption, and hardware complexity.
A Local Neighborhood Robust Fuzzy Clustering Image Segmentation Algorithm Based on an Adaptive Feature Selection Gaussian Mixture Model

Since the fuzzy local information C-means (FLICM) segmentation algorithm cannot take into account the impact of different features on clustering segmentation results, a local fuzzy clustering segmentation algorithm based on a feature selection Gaussian mixture model was proposed. First, the constraints of the membership degree on the spatial distance were added to the local information function. Second, the feature saliency was introduced into the objective function. By using the Lagrange multiplier method, the optimal expression of the objective function was solved. Neighborhood weighting information was added to the iteration expression of the classification membership degree to obtain a local feature selection based on feature selection. Each of the improved FLICM algorithm, the fuzzy C-means with spatial constraints (FCM_S) algorithm, and the original FLICM algorithm were then used to cluster and segment the interference images of Gaussian noise, salt-and-pepper noise, multiplicative noise, and mixed noise. The performances of the peak signal-to-noise ratio and error rate of the segmentation results were compared with each other. At the same time, the iteration time and number of iterations used to converge the objective function of the algorithm were compared. In summary, the improved algorithm significantly improved the ability of image noise suppression under strong noise interference, improved the efficiency of operation, facilitated remote sensing image capture under strong noise interference, and promoted the development of a robust anti-noise fuzzy clustering algorithm.
Long Non-Coding RNAs in Biliary Tract Cancer—An Up-to-Date Review

The term long non-coding RNA (lncRNA) describes non protein-coding transcripts with a length greater than 200 base pairs. The ongoing discovery, characterization and functional categorization of lncRNAs has led to a better understanding of the involvement of lncRNAs in diverse biological and pathological processes including cancer. Aberrant expression of specific lncRNA species was demonstrated in various cancer types and associated with unfavorable clinical characteristics. Recent studies suggest that lncRNAs are also involved in the development and progression of biliary tract cancer, a rare disease with high mortality and limited therapeutic options. In this review, we summarize current findings regarding the manifold roles of lncRNAs in biliary tract cancer and give an overview of the clinical and molecular consequences of aberrant lncRNA expression as well as of underlying regulatory functions of selected lncRNA species in the context of biliary tract cancer.
Association between Occupational Noise and Vibration Exposure and Insomnia among Workers in Korea

Background: The effect of noise and vibration exposure on disturbed sleep has been investigated in the past. However, this study was carried out to investigate the relationship between workplace noise and vibration exposure with insomnia amongst representative Korean workers, both simultaneously and separately. Methods: Our research analyzed an overall population of 30,837 workers aged 15 years or older using data derived from the 5th Korean Working Conditions Survey (KWCS) conducted in 2017. Chi-squared tests and logistic regression were performed to investigate baseline characteristics and to quantify the association between workplace exposure to noise and vibration with insomnia. Relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S) were calculated to measure interactions between simultaneous noise and vibration exposure with insomnia. Results: The prevalence of those who reported insomnia was 18.3% of the general population. Among men and women, insomnia in those who were exposed to noise only was 13.9% and 18.3%, respectively, and in those who were exposed to vibration only, it was 23.9% in males and 26.4% in females. Insomnia in those who were exposed to both noise and vibration simultaneously was 20.5% and 41.2% in men and women, respectively. The odds ratio (OR) of insomnia due to noise exposure was 1.10 and 1.07 in men and women, respectively. OR of vibration exposure was 1.84 in men and 1.58 in women. For noise plus vibration exposure OR was 1.83 in men and 3.14 in female workers, where the synergistic effect of noise and vibration exposure could be seen. The association between the varying degree of simultaneous noise plus vibration exposure with insomnia showed a dose–response relationship. The interaction measures showed a synergistic effect of simultaneous exposure in women but not in men. Conclusion: Our study revealed an association between occupational noise and vibration exposure and insomnia, both individually and simultaneously. Additional studies and research are required to further comprehend this relationship.
G2M Cell Cycle Pathway Score as a Prognostic Biomarker of Metastasis in Estrogen Receptor (ER)-Positive Breast Cancer

The vast majority of breast cancer death is a result of metastasis. Thus, accurate identification of patients who are likely to have metastasis is expected to improve survival. The G2M checkpoint plays a critical role in cell cycle. We hypothesized that breast cancer tumors with high activity of G2M pathway genes are more aggressive and likely to metastasize. To test this, we used the single-sample gene set variation analysis method to calculate the score for the Hallmark G2M checkpoint pathway using gene expression data of a total of 4626 samples from 12 human breast cancer cohorts. As expected, a high G2M pathway score correlated with enriched tumor expression of other cell proliferation-related gene sets. The score was significantly associated with clinical aggressive features of tumors and patient survival in estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Interestingly, a high G2M score of metastasis tumors was also significantly associated with worse survival. In primary as well as metastasis tumors with high scores, the infiltration of both pro- and anti-cancerous immune cells increased. Tumor G2M score was also associated with treatment response to systemic chemotherapy in ER-positive/HER2-negative cancer, and was predictive of response to cyclin-dependent kinase inhibition therapy.