Miracle-dz/UniFAR-FTUs huggingface dataset:
Early Change in Fecal Calprotectin Predicts One-Year Outcome in Children Newly Diagnosed With Ulcerative Colitis

Supplemental Digital Content is available in the text ABSTRACT Introduction: While fecal calprotectin (FC) is used to assess disease activity in ulcerative colitis (UC) there are little data concerning the role of serial FC levels at diagnosis in predicting clinical course. We sought to determine whether FC at diagnosis or early change following therapy predicts clinical outcomes in pediatric UC. Methods: Children with newly diagnosed UC were treated with standardized regimens of mesalamine or corticosteroids (CS). CS tapering and escalation to additional therapy or colectomy were by protocol. Patients with baseline or week 4 or week 12 FC levels were included in the analysis. Our primary outcome was CS-free remission on mesalamine at week 52. We compared the prognostic value of a baseline FC as well as a change in FC by week 4 or week 12 in predicting clinical outcomes. Results: The study included 352 children (113 initial mesalamine, 239 initial CS, mean age 12.6 years) with UC. At Week 52, 135 (38.3%), 84 (23.8%), and 19 (5.4%) children achieved CS-free remission, needed anti-tumor necrosis factor therapy or had colectomy respectively. Baseline FC was not associated with CS-free remission at week 52. However, both week 4 (odds ratio [OR] 0.95, 95% confidence interval [CI] 0.901.00) and week 12 FC levels (OR 0.91, 95% CI 0.87–0.96) were associated with outcomes, with the latter having a stronger association with CS-free remission. Patients with a >75% decrease by 12 weeks, had a 3-fold increased likelihood of CS-free remission at 1 year. Discussion: Longitudinal changes in FC may predict 1 year outcomes better than values at diagnosis in children with a new diagnosis of UC.
Efficacy of Oral Cryotherapy in the Prevention of Oral Mucositis Associated with Cancer Chemotherapy: Systematic Review with Meta-Analysis and Trial Sequential Analysis

Background: This review aimed to evaluate the efficacy of oral cryotherapy in the prevention of chemotherapy-induced oral mucositis using meta-analysis and trial sequential analysis, as well as to assess the quality of the results by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Methods: A comprehensive search of three databases including Medline, Embase and Central was performed to identify randomized controlled trials that used oral cryotherapy for the prevention of chemotherapy-induced oral mucositis. The primary outcome was the incidence of oral mucositis for trials employing oral cryotherapy as the intervention for the prevention of oral mucositis. The meta-analysis was performed using the random-effects model and random errors of the meta-analyses were detected by trial sequential analysis. Results: A total of 14 RCTs with 1577 participants were included in the present meta-analysis. Patients treated with oral cryotherapy were associated with a significantly lower risk of developing oral mucositis of any grade (risk ratio (RR), 0.67 (95% CI: 0.56–0.81, p < 0.05)). Findings from the subgroup analyses showed that oral cryotherapy significantly reduced the risk of oral mucositis in patients undergoing bone marrow transplantation (RR 0.69, CI: 0.54–0.89, p < 0.05) as well as chemotherapy (RR 0.66, CI: 0.58–0.75, p < 0.05). Findings from the trial sequential analysis suggested that the evidence on oral cryotherapy as a preventive intervention for oral mucositis in patients with solid malignancies receiving conventional chemotherapy was conclusive. Conclusion: Oral cryotherapy is effective in preventing oral mucositis in patients undergoing chemotherapy for the management of solid malignancies. The use of oral cryotherapy in preventing oral mucositis in bone marrow transplantation settings showed promising efficacy, but the evidence is not conclusive and requires more high-quality randomized controlled trials.
Adaptive NN Optimal Consensus Fault-Tolerant Control for Stochastic Nonlinear Multiagent Systems

This article investigates the problem of adaptive neural network (NN) optimal consensus tracking control for nonlinear multiagent systems (MASs) with stochastic disturbances and actuator bias faults. In control design, NN is adopted to approximate the unknown nonlinear dynamic, and a state identifier is constructed. The fault estimator is designed to solve the problem raised by time-varying actuator bias fault. By utilizing adaptive dynamic programming (ADP) in identifier–critic–actor construction, an adaptive NN optimal consensus fault-tolerant control algorithm is presented. It is proven that all signals of the controlled system are uniformly ultimately bounded (UUB) in probability, and all states of the follower agents can remain consensus with the leader’s state. Finally, simulation results are given to illustrate the effectiveness of the developed optimal consensus control scheme and theorem.
Lipid-based and protein-based interactions synergize transmembrane signaling stimulated by antigen clustering of IgE receptors

Significance Lipid organization of the plasma membrane is known to be important for facilitating protein interactions in transmembrane signaling. However, the orchestration of these interactions in live cells remains elusive. We employed imaging fluorescence correlation spectroscopy (ImFCS) to systemically investigate the interplay of lipids and proteins during mast cell signaling, initiated as phosphorylation of antigen-crosslinked immunoglobulin E–receptor (IgE-FcεRI) complexes by lipid-anchored Lyn kinase. We found that stabilized liquid ordered-like nanodomains around clustered FcεRI—which can be accessed by Lyn kinase but not by transmembrane phosphatase—provide essential spatial filtering that augments Lyn’s binding and phosphorylating FcεRI while suppressing dephosphorylation by phosphatase. ImFCS provides quantitative evidence of the functional link between lipid-based membrane organization and transmembrane signaling in live cells. Antigen (Ag) crosslinking of immunoglobulin E–receptor (IgE-FcεRI) complexes in mast cells stimulates transmembrane (TM) signaling, requiring phosphorylation of the clustered FcεRI by lipid-anchored Lyn tyrosine kinase. Previous studies showed that this stimulated coupling between Lyn and FcεRI occurs in liquid ordered (Lo)-like nanodomains of the plasma membrane and that Lyn binds directly to cytosolic segments of FcεRI that it initially phosphorylates for amplified activity. Net phosphorylation above a nonfunctional threshold is achieved in the stimulated state but not in the resting state, and current evidence supports the hypothesis that this relies on Ag crosslinking to disrupt a balance between Lyn and tyrosine phosphatase activities. However, the structural interactions that underlie the stimulation process remain poorly defined. This study evaluates the relative contributions and functional importance of different types of interactions leading to suprathreshold phosphorylation of Ag-crosslinked IgE-FcεRI in live rat basophilic leukemia mast cells. Our high-precision diffusion measurements by imaging fluorescence correlation spectroscopy on multiple structural variants of Lyn and other lipid-anchored probes confirm subtle, stimulated stabilization of the Lo-like nanodomains in the membrane inner leaflet and concomitant sharpening of segregation from liquid disordered (Ld)-like regions. With other structural variants, we determine that lipid-based interactions are essential for access by Lyn, leading to phosphorylation of and protein-based binding to clustered FcεRI. By contrast, TM tyrosine phosphatase, PTPα, is excluded from these regions due to its Ld-preference and steric exclusion of TM segments. Overall, we establish a synergy of lipid-based, protein-based, and steric interactions underlying functional TM signaling in mast cells.
Association between pain and gait instability in patients with lumbar disc herniation

Objective To determine whether pain is associated with gait instability in patients with lumbar disc herniation (LDH). Methods This retrospective cross-sectional study used data from electronic medical records. Among patients with lumbar back pain caused by LDH between January 2017 and July 2019, patients that underwent gait analysis were included. LDH was diagnosed using magnetic resonance imaging. An OptoGait photoelectric cell system was used for gait evaluation. Instability was measured using a gait symmetry index. Multivariate linear regression analysis was performed to determine the association between lumbar pain and gait instability. Results A total of 29 patients (12 females [41.4%] and 17 males [58.6%]; mean ± SD age, 40.6 ± 12.0 years) with LDH were enrolled in the study. With each 1-point increase in lumbar pain on the numeric rating scale, the symmetry index of the stance phase (0.33; 95% confidence interval [CI] 0.04, 0.62), swing phase (0.78; 95% CI 0.14, 1.43) and single support (0.79; 95% CI 0.15, 1.43) increased. Conclusions Gait instability in patients with LDH may occur due to an increase in pain.
Modulation of Synthetic Tracheal Grafts with Extracellular Matrix Coatings

Synthetic scaffolds for the repair of long-segment tracheal defects are hindered by insufficient biocompatibility and poor graft epithelialization. In this study, we determined if extracellular matrix (ECM) coatings improved the biocompatibility and epithelialization of synthetic tracheal grafts (syn-TG). Porcine and human ECM substrates (pECM and hECM) were created through the decellularization and lyophilization of lung tissue. Four concentrations of pECM and hECM coatings on syn-TG were characterized for their effects on scaffold morphologies and on in vitro cell viability and growth. Uncoated and ECM-coated syn-TG were subsequently evaluated in vivo through the orthotopic implantation of segmental grafts or patches. These studies demonstrated that ECM coatings were not cytotoxic and, enhanced the in vitro cell viability and growth on syn-TG in a dose-dependent manner. Mass spectrometry demonstrated that fibrillin, collagen, laminin, and nephronectin were the predominant ECM components transferred onto scaffolds. The in vivo results exhibited similar robust epithelialization of uncoated and coated syn-TG patches; however, the epithelialization remained poor with either uncoated or coated scaffolds in the segmental replacement models. Overall, these findings demonstrated that ECM coatings improve the seeded cell biocompatibility of synthetic scaffolds in vitro; however, they do not improve graft epithelialization in vivo.
Analyzing Predictors of Control Measures and Psychosocial Problems Associated with COVID-19 Pandemic: Evidence from Eight Countries

COVID-19 has harshly impacted communities globally. This study provides relevant information for creating equitable policy interventions to combat the spread of COVID-19. This study aims to predict the knowledge, attitude, and practice (KAP) of the COVID-19 pandemic at a global level to determine control measures and psychosocial problems. A cross-sectional survey was conducted from July to October 2020 using an online questionnaire. Questionnaires were initially distributed to academicians worldwide. These participants distributed the survey among their social, professional, and personal groups. Responses were collected and analyzed from 67 countries, with a sample size of 3031. Finally, based on the number of respondents, eight countries, including Bangladesh, China, Japan, Malaysia, Mexico, Pakistan, the United States, and Zambia were rigorously analyzed. Specifically, questionnaire responses related to COVID-19 accessibility, behavior, knowledge, opinion, psychological health, and susceptibility were collected and analyzed. As per our analysis, age groups were found to be a primary determinant of behavior, knowledge, opinion, psychological health, and susceptibility scores. Gender was the second most influential determinant for all metrics except information about COVID-19 accessibility, for which education was the second most important determinant. Respondent profession was the third most important metric for all scores. Our findings suggest that health authorities must promote health educations, implement related policies to disseminate COVID-19-awareness that can prevent and control the spread of COVID-19 infection.
Solid self nano-emulsifying system for the enhancement of dissolution and bioavailability of Prasugrel HCl: in vitro and in vivo studies

Abstract Prasugrel Hydrochloride (PHCl) is an antiplatelet drug. It is a class II drug with variable bioavailability. The objective of this work was to enhance the solubility and hence the bioavailability and efficacy of PHCl. A Self Nano-Emulsifying Drug Delivery System (SNEDDS) was prepared using Kolliphor El, Maisine 35-1, and Transcutol P as surfactant, oil, and co-surfactant, respectively in a ratio 10:72:18 v/v%. The SNEDDS was converted into solid by adsorption onto Neusilin. In vitro release of the drug from SNEDDS in (pH = 4) at 37 °C and 75 rpm for 45 min was studied. The results were compared to those from the unprocessed PHCl and Lexar® (the commercial drug). In-vivo studies (platelet Aggregation and bleeding time) were conducted using rats as animal models. It was found that the particle size of the SNEDDS ranged between 80 and 155 nm and EE% was in the range of 90.2% ± 0.4. The release from SNEDDS was about 84% compared to around 25% from unprocessed PHCl and 65% from Lexar® after 15 min. The platelet aggregation of the formula was lower than the PHCl, and Lexar® indicating higher bioavailability. In conclusion, SNEDDS with high EE% was prepared and was successful in enhancing the solubility, dissolution rate, and the bioavailability.
Subsize Pt-based intermetallic compound enables long-term cyclic mass activity for fuel-cell oxygen reduction

Significance Pt-based alloys are regarded as the oxygen-reduction electrocatalysts with the most potential to replace commercial Pt/C in proton exchange membrane fuel cells as long as their durability reaches the required standard. We demonstrated a series of Pt-based intermetallic compounds with ultrathin Pt skin and an average particle size down to about 2.3 nm that bring sustainable cyclic mass activity in fuel cells. Moreover, the subsize scale of Pt-based intermetallic compounds benefits the design of the confined structure for membrane electrode assembly, which further enhanced the stability under humid fuel-cell operations. Our work highlights advanced electrocatalysts for fuel cells and offers insight into the correlation between the structure and performance for membrane cathode electrode structures. Pt-based alloy catalysts may promise considerable mass activity (MA) for oxygen reduction but are generally unsustainable over long-term cycles, particularly in practical proton exchange membrane fuel cells (PEMFCs). Herein, we report a series of Pt-based intermetallic compounds (Pt3Co, PtCo, and Pt3Ti) enclosed by ultrathin Pt skin with an average particle size down to about 2.3 nm, which deliver outstanding cyclic MA and durability for oxygen reduction. By breaking size limitation during ordered atomic transformation in Pt alloy systems, the MA and durability of subsize Pt-based intermetallic compounds can be simultaneously optimized. The subsize scale was also found to enhance the stability of the membrane electrode through preventing the poisoning of catalysts by ionomers in humid fuel-cell conditions. We anticipate that subsize Pt-based intermetallic compounds set a good example for the rational design of high-performance oxygen reduction electrocatalysts for PEMFCs. Furthermore, the prevention of ionomer poisoning was identified as the critical parameter for assembling robust commercial membrane electrodes in PEMFCs.
A Machine Learning Approach to Predict Stress Hormones and Inflammatory Markers Using Illness Perception and Quality of Life in Breast Cancer Patients

Psychosocial factors have become central concepts in oncology research. However, their role in the prognosis of the disease is not yet well established. Studies on this subject report contradictory findings. We examine if illness perception and quality of life reports measured at baseline could predict the stress hormones and inflammatory markers in breast cancer survivors, one year later. We use statistics and machine learning methods to analyze our data and find the best prediction model. Patients with stage I to III breast cancer (N = 70) were assessed twice, at baseline and one year later, and completed scales assessing quality of life and illness perception. Blood and urine samples were obtained to measure stress hormones (cortisol and adrenocorticotropic hormone (ACTH) and inflammatory markers (c-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and fibrinogen). Family quality of life is a strong predictor for ACTH. Women who perceive their illness as being more chronic at baseline have higher ESR and fibrinogen values one year later. The artificial intelligence (AI) data analysis yields the highest prediction score of 81.2% for the ACTH stress hormone, and 70% for the inflammatory marker ESR. A chronic timeline, illness control, health and family quality of life were important features associated with the best predictive results.
FORMULATION, STABILITY TFORMULATION, STABILITY TEST AND IN VITRO PENETRATION STUDY OF TRANSETHOSOMAL GEL CONTAINING GREEN TEA (CAMELLIA SINENSIS L. KUNTZE) LEAVES EXTRACTEST AND IN VITRO PENETRATION STUDY OF TRANSETHOSOMAL GEL CONTAINING GREEN TEA(CAMELLIA SINENSIS L. KUNTZE) LEAVES EXTRACT

Objective: The aim of this study was to increase penetration of epigallocatechin gallate (EGCG) from the extract using transethosomal gel. Methods: Transethosomes (TE) formulae were made using thin layer hydration method with different concentration of green tea extract which was equivalent to 1% (F1), 1.5% (F2), and 2% (F3) of EGCG. F1 was the chosen formula to be incorporated into a gel as a transethosomal gel (TEG). A gel containing green tea extract was also made as a control called as non-transethosomal gel (NTEG). A stability test and in vitro penetration study of gels using Franz diffusion cell were performed. Results: F1 was the chosen formula because it had a spherical shape, a particle size of 112.14±2.19 nm, PDI of 0.166±0.03, a zeta potential of-52.05±1.34 mV, and %EE of 58.06±0.08%. Stability test results showed that TEG more stable than NTEG. The amount of EGCG penetrated from TEG and NTEG were 1391.16±34.89 µg/cm 2 and 485.29±14.49 µg/cm 2 , respectively ( p <0.05). The lag time for TEG was around 0.99±0.2 h, while NTEG was 8.69±0.2 h ( p< 0.05). Conclusion: It can be concluded that transethosomes can improve gel stability and increase the amount of EGCG penetrated through the skin.
Kidney Allograft Function Is a Confounder of Urine Metabolite Profiles in Kidney Allograft Recipients

Noninvasive biomarkers of kidney allograft status can help minimize the need for standard of care kidney allograft biopsies. Metabolites that are measured in the urine may inform about kidney function and health status, and potentially identify rejection events. To test these hypotheses, we conducted a metabolomics study of biopsy-matched urine cell-free supernatants from kidney allograft recipients who were diagnosed with two major types of acute rejections and no-rejection controls. Non-targeted metabolomics data for 674 metabolites and 577 unidentified molecules, for 192 biopsy-matched urine samples, were analyzed. Univariate and multivariate analyses identified metabolite signatures for kidney allograft rejection. The replicability of a previously developed urine metabolite signature was examined. Our study showed that metabolite profiles can serve as biomarkers for discriminating rejection biopsies from biopsies without rejection features, but also revealed a role of estimated Glomerular Filtration Rate (eGFR) as a major confounder of the metabolite signal.
Detection of Major and Mild Neurocognitive Disorder with the Verbal Naming Test

Abstract Objective: The Verbal Naming Test (VNT) is an auditory-based measure of naming or word finding. The current multisite study sought to evaluate the reliability and validity of the VNT in the detection of major and mild neurocognitive disorder (NCD). Method: This study analyzed clinical data from two outpatient neuropsychology clinics (N = 188 and N = 77) and a geriatric primary care clinic (N = 104). Cronbach’s alpha and Spearman correlations with other measures were calculated. ROC analyses were used to calculate sensitivity, specificity, positive predictive power, and negative predictive power for the detection of major and mild NCD per DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) criteria. Results: The VNT was found to have strong reliability (Cronbach’s alpha = .90) and high convergent validity with a commonly used picture-naming task (NAB Naming, Spearman’s rho = .65, p < .001). The VNT showed good sensitivity and specificity for the detection of NCDs, particularly major NCD, with an area under the curve of . 85, sensitivity of . 80, and specificity of . 75. A possible discontinue rule is also suggested for clinicians to use. Conclusions: These findings provide compelling evidence for the use of the VNT to detect neurocognitive impairment in a clinical setting. The VNT provides a reliable alternative to picture-naming tasks, which may be advantageous when working with visually impaired patients or conducting evaluations over telehealth.
Do health infrastructure and services, aging, and environmental quality influence public health expenditures? Empirical evidence from Pakistan

ABSTRACT Rapidly growing health expenditure is a matter of grave concern for households and governments. Every government is compelled to allocate a sufficient budget to improve people’s health. This study, therefore, identifies some major factors that influence the trajectory of public health care expenditure (HCE) in Pakistan for the period 1974–2017. The ARDL-bounds test and Bayer-Hanck cointegration test consistently reveal that HCE and its specified determinants are cointegrated. Long-term estimates show that healthcare infrastructure and services, income, and environmental degradation exert a positive influence on HCE. Elderly population size has a negative association with HCE. Income elasticity is inelastic, showing that healthcare is a necessity. The findings suggest that the government must pay due attention to the fair distribution of health-related infrastructure and personnel in all regions of Pakistan.
Device profile of the sapphire XTM anterior cervical plate system: overview of its safety and efficacy

ABSTRACT Introduction:The Sapphire X Anterior Cervical Plate System is a new medical device designed to provide stability after anterior discectomy and fusion procedures. It has unique benefits over many of the more established plates on the market. It is manufactured predominantly from titanium alloy and was first launched in late 2020. Areas covered:The structure and unique features of the Sapphire X are described. The indications for its use are discussed. The delivery system designed for the plate is reviewed in detail. Research outlining the shortcomings of current plate technologies and alternative technologies in this market space are reviewed. Expert Opinion:The evidence in this article demonstrates the risk of adjacent-level ossification development (ALOD) with current cervical plate designs. The industry is saturated with cervical plate technologies, yet there are very few plates small enough to avoid encroaching upon adjacent levels of disc space, particularly in the upper subaxial cervical segments and in patients with small vertebrae. This device review demonstrates the successful application of a cervical plate device that is small enough to avoid encroachment on the adjacent-level disc spaces while providing immediate stability after discectomy and fusion in the cervical spine.