Miracle-dz/UniFAR-FTUs huggingface dataset:
The Ability of Deep Learning Models to Identify Total Hip and Knee Arthroplasty Implant Design From Plain Radiographs

Introduction: The surgical management of patients with failed total hip or knee arthroplasty (THA and TKA) necessitates the identification of the implant manufacturer and model. Failure to accurately identify implant design leads to delays in care, increased morbidity, and healthcare costs. The automated identification of implant designs has the potential to assist in the surgical management of patients with failed arthroplasty. This study aimed to develop and validate a convolutional neural network deep learning model for the identification of primary and revision hip and knee total joint arthroplasty designs from plain radiographs. Methods: This study trained a convolutional neural network deep learning model to automatically identify 24 THA designs and 14 TKA designs from 11,204 anterior-posterior radiographs obtained from 8,763 patients. From these radiographs, 8,963 radiographs (80%) were used for model training and 2,241 radiographs (20%) were used for model validation. Model performance was assessed through receiver operating curve characteristics. Results: After 1,000 training epochs by the convolutional neural network deep learning model, the computational model discriminated 17 primary THA designs with an area under the receiver operating curve (AUC) of 0.98, sensitivity of 95.8%, and specificity of 98.6%. The deep learning model discriminated eight primary TKA designs with an AUC of 0.97, sensitivity of 94.9%, and specificity of 97.8%. The deep learning model demonstrated an AUC of 0.98 and 0.96 for the identification of seven revision THA and six revision TKA designs, respectively. Discussion: This study developed and validated a convolutional neural network deep learning model for the identification of hip and knee total joint arthroplasty designs from plain radiographs. The study findings demonstrate excellent accuracy of the deep learning model for the identification of 24 THA and 14 TKA designs, illustrating the great potential of the deep learning model to assist in preoperative surgical planning of failed arthroplasty patients.
The Association of Physical Activity with Arterial Stiffness and Inflammation: Insight from the “Corinthia” Study

Diminished physical activity is a frequent phenomenon leading to a higher incidence of cardiovascular morbidity and mortality. Our study aimed to assess the impact of physical activity on arterial stiffness and inflammation. Classification of physical activity was performed in 1945 individuals of the cross-sectional “Corinthia” study using the International Physical Activity Questionnaire. Demographic and clinical characteristics were obtained via a standardized questionnaire. Arterial stiffness was estimated via carotid-femoral pulse wave velocity evaluation, and the inflammatory burden was assessed via high sensitivity C reactive protein (hsCRP) measurement. Participants with low physical activity had the most impaired carotid-femoral pulse wave velocity values while abnormally increased measurements—adjusted for age and blood pressure—were more frequently encountered in individuals with low physical activity. Participants characterized as having vigorous physical activity had the lowest inflammatory burden, as estimated by hsCRP levels. The results remained unaffected even after adjustment for confounders. In a subgroup analysis according to sex, increased arterial stiffness and inflammatory burden were noted similarly in female and male subjects within the lowest percentile of physical activity. In conclusion, a significant association between physical activity, arterial stiffness, and inflammation was observed, even after adjusting for known cardiovascular risk factors.
Neuron-fibrous scaffold interfaces in the peripheral nervous system: a perspective on the structural requirements

The nerves of the peripheral nervous system are not able to effectively regenerate in cases of severe neural injury. This can result in debilitating consequences, including morbidity and lifelong impairments affecting the quality of the patient’s life. Recent findings in neural tissue engineering have opened promising avenues to apply fibrous tissue-engineered scaffolds to promote tissue regeneration and functional recovery. These scaffolds, known as neural scaffolds, are able to improve neural regeneration by playing two major roles, namely, by being a carrier for transplanted peripheral nervous system cells or biological cues and by providing structural support to direct growing nerve fibers towards the target area. However, successful implementation of scaffold-based therapeutic approaches calls for an appropriate design of the neural scaffold structure that is capable of up- and down-regulation of neuron-scaffold interactions in the extracellular matrix environment. This review discusses the main challenges that need to be addressed to develop and apply fibrous tissue-engineered scaffolds in clinical practice. It describes some promising solutions that, so far, have shown to promote neural cell adhesion and growth and a potential to repair peripheral nervous system injuries.
Prolonged cessation of chronic opioid analgesic therapy: a multidisciplinary intervention.

OBJECTIVES To contribute to the literature of best-practice approaches to promote full mu agonist chronic opioid analgesic therapy (COAT) cessation in a population with chronic, noncancer pain by describing initial and extended follow-up outcomes from a limited group program that utilized a standardized, multidisciplinary curriculum containing robust complementary care access in a private practice setting. STUDY DESIGN A retrospective review of data from electronic health records and the California Prescription Drug Monitoring Program for program participants between October 2017 and December 2019. METHODS Daily oral morphine milligram equivalent (MME) dose use upon entry, at program graduation, at 6 months post graduation, and at extended follow-up of 7 to 24 months post graduation were compared and reported for program participants. RESULTS A total of 109 program participants with incoming daily COAT use amounts as high as 600 MME (median, 60 MME; 25% quartile, 36.5 MME; 75% quartile, 90 MME; interquartile range, 53.5 MME) had a successful COAT cessation rate of 90% at program graduation, which was maintained at 6 months and extended follow-up at 95% and 97%, respectively. CONCLUSIONS This pilot study contributes to the literature by documenting a successful and potentially generalizable strategy to promote COAT cessation, and by providing unusually lengthy follow-up for postintervention COAT cessation monitoring.
Systematic review of the efficacy, effectiveness and safety of MF59® adjuvanted seasonal influenza vaccines for the prevention of laboratory‐confirmed influenza in individuals ≥18 years of age

The most effective means of preventing seasonal influenza is through vaccination. In this systematic review, we investigated the efficacy, effectiveness and safety of MF59® adjuvanted trivalent and quadrivalent influenza vaccines to prevent laboratory‐confirmed influenza. A systematic literature search was conducted in electronic databases and grey literature sources up to 7 February 2020. Randomised controlled trials and non‐randomised studies of interventions (NRSIs) were eligible for inclusion. The search returned 28,846 records, of which 48 studies on MF59® adjuvanted vaccines met our inclusion criteria. No efficacy trials were identified. In terms of vaccine effectiveness (VE), MF59® adjuvanted trivalent influenza vaccines were effective in preventing laboratory‐confirmed influenza in older adults (aged ≥65 years) compared with no vaccination (VE = 45%, 95% confidence interval (CI) 23%–61%, 5 NRSIs across 3 influenza seasons). By subtype, significant effect was found for influenza A(H1N1) (VE = 61%, 95% CI 44%–73%) and B (VE = 29%, 95% CI 5%–46%), but not for A(H3N2). In terms of relative VE, there was no significant difference comparing MF59® adjuvanted trivalent vaccines with either non‐adjuvanted trivalent or quadrivalent vaccines. Compared with traditional trivalent influenza vaccines, MF59® adjuvanted trivalent influenza vaccines were associated with a greater number of local adverse events (RR = 1.90, 95% CI 1.50–2.39) and systemic reactions (RR = 1.18, 95% CI 1.02–1.38). In conclusion, MF59® adjuvanted trivalent influenza vaccines were found to be more effective than ‘no vaccination’. Based on limited data, there was no significant difference comparing the effectiveness of MF59® adjuvanted vaccines with their non‐adjuvanted counterparts.
DExD/H-box helicase 9 intrinsically controls CD8+ T cell–mediated antiviral response through noncanonical mechanisms

Upon virus infection, CD8+ T cell accumulation is tightly controlled by simultaneous proliferation and apoptosis. However, it remains unclear how TCR signal coordinates these events to achieve expansion and effector cell differentiation. We found that T cell–specific deletion of nuclear helicase Dhx9 led to impaired CD8+ T cell survival, effector differentiation, and viral clearance. Mechanistically, Dhx9 acts as the key regulator to ensure LCK- and CD3ε-mediated ZAP70 phosphorylation and ERK activation to protect CD8+ T cells from apoptosis before proliferative burst. Dhx9 directly regulates Id2 transcription to control effector CD8+ T cell differentiation. The DSRM and OB_Fold domains are required for LCK binding and Id2 transcription, respectively. Dhx9 expression is predominantly increased in effector CD8+ T cells of COVID-19 patients. Therefore, we revealed a previously unknown regulatory mechanism that Dhx9 protects activated CD8+ T cells from apoptosis and ensures effector differentiation to promote antiviral immunity independent of nuclear sensor function.
Effects of life-stage and passive tobacco smoke exposure on pulmonary innate immunity and influenza infection in mice

ABSTRACT Limited data are available on the effects of perinatal environmental tobacco smoke (ETS) exposure for early childhood influenza infection. The aim of the present study was to examine whether perinatal versus adult ETS exposure might provoke more severe systemic and pulmonary innate immune responses in mice inoculated with influenza A/Puerto Rico/8/34 virus (IAV) compared to phosphate-buffered saline (PBS). BALB/c mice were exposed to filtered air (FA) or ETS for 6 weeks during the perinatal or adult period of life. Immediately following the final exposure, mice were intranasally inoculated with IAV or PBS. Significant inflammatory effects were observed in bronchoalveolar lavage fluid of neonates inoculated with IAV (FA+IAV or ETS+IAV) compared to PBS (ETS+PBS or FA+PBS), and in the lung parenchyma of neonates administered ETS+IAV versus FA+IAV. Type I and III interferons were also elevated in the spleens of neonates, but not adults with ETS+IAV versus FA+IAV exposure. Both IAV-inoculated neonate groups exhibited significantly more CD4 T cells and increasing numbers of CD8 and CD25 T cells in lungs relative to their adult counterparts. Taken together, these results suggest perinatal ETS exposure induces an exaggerated innate immune response, which may overwhelm protective anti-inflammatory defenses against IAV, and enhances severity of infection at early life stages (e.g., in infants and young children).
Sustained delivery of vascular endothelial growth factor mediated by bioactive methacrylic anhydride hydrogel accelerates peripheral nerve regeneration after crush injury

Neurotrophic factors, currently administered orally or by intravenous drip or intramuscular injection, are the main method for the treatment of peripheral nerve crush injury. However, the low effective drug concentration arriving at the injury site results in unsatisfactory outcomes. Therefore, there is an urgent need for a treatment method that can increase the effective drug concentration in the injured area. In this study, we first fabricated a gelatin modified by methacrylic anhydride hydrogel and loaded it with vascular endothelial growth factor that allowed the controlled release of the neurotrophic factor. This modified gelatin exhibited good physical and chemical properties, biocompatibility and supported the adhesion and proliferation of RSC96 cells and human umbilical vein endothelial cells. When injected into the epineurium of crushed nerves, the composite hydrogel in the rat sciatic nerve crush injury model promoted nerve regeneration, functional recovery and vascularization. The results showed that the modified gelatin gave sustained delivery of vascular endothelial growth factors and accelerated the repair of crushed peripheral nerves.
The ScHARR LMIC filter: Adapting a low‐ and middle‐income countries geographic search filter to identify studies on preterm birth prevention and management

Search filters are used to find evidence on specific subjects. Performance of filters can be varied and may need adapting to meet the needs of research topics. There are limited geographic search filters available, and only one pertaining to low‐ and middle‐income countries (LMICs). When searching for literature on preterm birth prevention and management in LMICs for a research project at the School of Health and Related Research (ScHARR), we made use of the Cochrane Effective Practice and Organisation of Care (EPOC) LMIC geographic search filter for the databases; Ovid MEDLINE, Ovid Embase, Cochrane Library. During screening following a broad scoping search in Ovid MEDLINE, it was found that the EPOC LMIC filter did not identify a relevant study. Adaptations were made to the LMIC geographic search filter to maximise retrieval and identify the missing study. Institution was included as a search field, and the search terms high burden or countdown countries were added. The filter was translated for the databases; Ovid Embase, Cochrane Library, Ovid PsycINFO, and CINAHL via EBSCO. The adapted ScHARR LMIC filter is a non‐validated 1st generation filter which increases the sensitivity of the EPOC LMIC search filter. Validating the filter would confirm its retrieval performance and benefit information professionals, researchers, and health professionals. We recommend that the ScHARR LMIC filter is used to improve sensitivity of the Cochrane EPOC LMIC filter and reduce the risk of missing relevant studies.
Mid-Term Review of the Implementation of AEC Blueprint: Executive Summary

The 41st ASEAN Economic Ministers (AEM) held in Bangkok in 2009, as conveyed by the AEM 2011 Chair, H.E. Mari Elka Pangestu’s 15 April 2011 letter to the Economic Research Institute for ASEAN and East Asia (ERIA) together with the Terms of Reference, requested ERIA to assist ASEAN in undertaking the Comprehensive Mid-Term Review (MTR) of the ASEAN Economic Community (AEC) Blueprint and in providing policy analyses/recommendations to the AEM in order to (a) assess the effectiveness of the adopted measures of the AEC Blueprint as well as the contribution of the AEC Blueprint measures to economic growth, employment, competitiveness and social welfare within ASEAN, and to (b) provide recommendations to enhance the implementation of the AEC Blueprint. The Terms of Reference of the MTR can be broken down into three (3) major tasks; namely: (a) implementation performance of the ASEAN Member States (AMSs) on the AEC measures; (b) the outcomes and impacts or contributions to the economy, actual or potential; and (c) way forward toward accelerated implementation of the AEC measures toward AEC 2015. The MTR covered most of the key measures in the AEC Blueprint. The analysis of the implementation performance of the AMSs is based on the results of the ERIA AEC Scorecard Phase 2 as well as on updates undertaken by the MTR Study Team. For outcomes and outputs, the MTR Study Team developed a number of questionnaires for small surveys or interviews of concerned officials or the private sector; the MTR Study Team also used secondary data where relevant. The analysis of economy wide effects relied on simulation analyses based on computable general equilibrium models. Three such models were used in the Study to examine the economy wide effects of services liberalization, regional integration in ASEAN and various FTA options, and the household impact of agriculture trade liberalization. In addition, two gravity models were also used to examine impact of CEPT tariff elimination on intra-ASEAN trade as well as bilateral investment flows. Finally, the MTR Study also made extensive use of the IDE-ERIA Geographic Simulation Model to examine the economic implications of transport and trade facilitation initiatives at a more spatially disaggregated level.
One Bout of Resistance Training Does Not Enhance Metformin Actions in Prediabetic and Diabetic Individuals

ABSTRACT Purpose This study aimed to determine the separated and combined effects of metformin and resistance exercise on glycemic control, insulin sensitivity, and insulin-like growth factor 1 (IGF-1) in overweight/obese individuals with prediabetes and type 2 diabetes mellitus. Methods Fourteen adults with a body mass index of 32.1 ± 4.1 kg·m−2, insulin resistance (HOMA-2 1.6 ± 0.6), and poor glycemic control (glycated hemoglobin, 6.9% ± 0.9%; 51.9 ± 10.7 mmol·mol−1) while taking metformin (1561 ± 470 g·d−1) were recruited. Participants underwent four 72-h long experimental trials in a randomized counterbalanced order, either 1) taking metformin (MET), 2) replacing metformin by placebo pills (PLAC), 3) taking placebo and undergoing a resistance training bout (RT + PLAC), and 4) taking metformin and undergoing the same RT bout (RT + MET). Interstitial fluid glucose concentration was frequently sampled to obtain 72-h glucose area under the curve (GAUC) and the percentage hyperglycemic glucose readings (>180 mg·dL−1; GPEAKS). Insulin sensitivity (i.e., HOMA-2) and IGF-1 were also assessed. Results HOMA-2 was not affected by treatments. GAUC and GPEAKS were similarly reduced below PLAC during RT + MET and MET (all P < 0.05). In contrast, RT + PLAC did not affect glucose concentration. Metformin decreased serum IGF-1 concentrations (P = 0.006), and RT did not reverse this reduction. Conclusions A bout of full-body RT does not interfere or aid on metformin’s blood glucose–lowering actions in individuals with prediabetes and type 2 diabetes mellitus.
The dual-process perspective and the benefits of retrieval practice in younger and older adults

ABSTRACT The testing effect is often considered a recollection-related phenomenon. However, recent work has observed a benefit of testing to both recollection and familiarity on immediate and delayed final tests. Further, although aging populations show marked declines in recollection, older and younger adults often benefit similarly from testing. This finding suggests that the testing effect in older adults may function via relatively preserved familiarity and lends further support to the hypothesis that the testing effect does not function solely via recollection-related processes. The current study builds on this work to better understand the mechanisms from the dual-process perspective that underlie the testing effect in both younger and older adults. To this end, younger (18–22 year old) and older (65–82 year old) adults studied words, took cued-recall tests on half of the words, and took a final Remember-Know recognition test on all words immediately or after a 1-day delay. At both delays, older and younger adults exhibited a testing effect in both recollection and familiarity, although the magnitude of the testing effect in recollection was reduced for older relative to younger adults. Implications for theories of the testing effect and its application in older adult populations are explored.
Potential of the CRISPR‐Cas system for improved parasite diagnosis

CRISPR‐Cas technology accelerates development of fast, accurate, and portable diagnostic tools, typified by recent applications in COVID‐19 diagnosis. Parasitic helminths cause devastating diseases afflicting 1.5 billion people globally, representing a significant public health and economic burden, especially in developing countries. Currently available diagnostic tests for worm infection are neither sufficiently sensitive nor field‐friendly for use in low‐endemic or resource‐poor settings, leading to underestimation of true prevalence rates. Mass drug administration programs are unsustainable long‐term, and diagnostic tools – required to be rapid, specific, sensitive, cost‐effective, and user‐friendly without specialized equipment and expertise – are urgently needed for rapid mapping of helminthic diseases and monitoring control programs. We describe the key features of the CRISPR‐Cas12/13 system and emphasise its potential for the development of effective tools for the diagnosis of parasitic and other neglected tropical diseases (NTDs), a key recommendation of the NTDs 2021–2030 roadmap released by the World Health Organization.
Depression and a lack of socialization are associated with high levels of boredom during stroke rehabilitation: An exploratory study using a new conceptual framework

ABSTRACT This exploratory sub-study aimed to develop a framework to conceptualize boredom in stroke survivors during inpatient rehabilitation, establish the effect of an activity promotion intervention on boredom, and to investigate factors that are associated with boredom. A framework was developed and explored within a cluster non-randomised controlled trial. Self-reported boredom was measured in 160 stroke survivors 13 (±5) days after rehabilitation admission; 91 participants received usual-care (control) and 69 had access to a patient-driven model of activity promotion (intervention). Individuals with pre-existing dementia or unable to participate in standard rehabilitation were excluded. Hierarchical logistic regression analysis was used to identify demographic, health and activity measures associated with boredom. Results indicated 39% of participants were highly bored. There was no statistically significant difference in boredom levels between treatment groups (difference −11%, 95% CI −26% to 4%). The presence of depression (OR 6.17, 95% CI 2.57–14.79) and lower levels of socialization (OR 0.96, 95% CI 0.92–0.99) predicted high boredom levels. This comprehensive framework provides a foundation for understanding the many interacting factors associated with boredom. Results suggest managing depression and improving opportunities for socialization may support meaningful engagement in rehabilitation to optimize recovery following stroke.
Stigma in Consultation Liaison Psychiatry: A Qualitative Study of Trainee Psychiatrists

Objective Stigma related to mental illness can impact service-user care and clinician wellbeing. The aim of this study was to explore experiences of stigma in consultation-liaison psychiatry from the perspectives of trainee psychiatrists and suggest interventions to tackle stigma within a hospital environment. Method Ethics approval and consent were obtained for the study. In-depth interviews were conducted by telephone with six participants in four New Zealand district health boards. De-identified data was analysed using thematic analysis. An independent co-coder was employed to enhance analytic rigour. Results Participants experienced stigma during their consultation-liaison rotations. Some felt isolated and undervalued. Education, intergration and role clarification within the hospital environment were identified as ways to reduce stigma. Conclusions Stigma experienced by trainee psychiatrists completing consultation-liaison rotations may lead to them feeling devalued and perceiving service-users to experience poorer care. Multidisciplinary education may potentially combat stigma and contribute to improved integration of services.