Miracle-dz/UniFAR-FTUs huggingface dataset:
Batwing mammoplasty: a safe oncoplastic technique for breast conservation in breast cancer patients with gigantomastia.

BACKGROUND Surgical management of breast cancer with gigantomastia can be challenging when planning breast conservation, as major breast reduction is required. Complex oncoplastic procedures can carry an additional surgical risk in this situation. We suggest batwing mammoplasty as a simple and safe oncoplastic procedure for those patients. MATERIALS AND METHODS Fourteen patients with gigantomastia diagnosed with breast cancer were included in this prospective cohort study. All underwent batwing mammoplasty and contralateral symmetrisation procedure between May 2016 and June 2018. Patient satisfaction assessed by the Breast-Q questionnaire. RESULTS All patients had a body mass index above 30 kg/m2 with a mean of 36.7 kg/m2 (range 31.6-44.9 kg/m2). The mean distance from midclavicular point to nipple was 42 cm (range 38-50 cm). The mean operative time was 83 minutes for procedures done by a single surgeon. Mean specimen weight was 1.2 kg (ranging from 1.035-1.63 kg). Postoperative complications occurred in 14.2% of patients. Nipple-areola complex viability was not compromised nor sensation impaired. The mean Breast-Q score for patient satisfaction with breasts was 68.6 (range 61-74). The mean score for physiological wellbeing was 77.3 (range 64-84) and the mean score for physical wellbeing was 35 (range 31-40). CONCLUSION Batwing mammoplasty is a safe and simple oncoplastic procedure in patients who have breast cancer with gigantomastia. It has short operative time and low complications rate. In our cohort of patients, there was no delay in the delivery of adjuvant treatment. The cosmetic outcome was favourable with a high patient satisfaction.
Mechanically strong, heat resistant, water-induced shape memory polyvinyl alcohol/regenerated cellulose bio-composites via a facile co-precipitation method.

In this work, polyvinyl alcohol (PVA) bio-composites with regenerated cellulose-softwood pulp (RC-SP) as a green reinforcement were prepared via co-precipitation method. Simultaneous precipitation of the two components promotes uniform dispersion of the RC-SP, and constructs strong molecular chain entanglements and hydrogen bonding network inside the composites. This physical cross-linking network reduces the water absorption and improves the water resistance of the composites. The incorporation of RC-SP not only improves the thermal decomposition properties of the composites, but also enhances the mechanical properties and dynamic mechanical properties, attributing to the strong interaction between the filler and the matrix. Moreover, the fabricated PVA/RC-SP composites exhibit good water-induced shape memory effect, and shape recovery rate of 10 % RC-SP reinforced composite reaches 95.3 % after immersing for 35 minutes. This work provides useful information for the implementation of co-precipitation method and the application of renewable cellulose resources.
Human cord blood (hCB)-CD34+ humanized mice fail to reject human acute myeloid leukemia cells

Since their appearance, humanized mice carrying human immune system seemed promising tools to study the crosstalk between cancer and immunity. The NOD-scidIL2Rgammanull (NSG) mice engrafted with human cord blood (hCB)-CD34+ cells have been proposed to be a valuable tool to reproduce human immune system in mouse. However, the lack of solid evidences on the functionality of their human immune components limits their usage in immune-oncology. We report that (hCB)-CD34+ cells lose their ability to propagate and originate bone marrow-derived human immune cells after two serial transplantations in NSG mice. We demonstrate that transplants of bone marrow patient-derived acute myeloid leukemias (hAMLs) grow very similarly in the humanized (hCB)-CD34+ NSG and parental NSG mice. The similar extent of engraftment and development of leukemias in (hCB)-CD34+ NSG and controls suggests a poor human immune response against not compatible hAMLs. Our findings suggest that (hCB)-CD34+ NSG mice are transient and/or incomplete carriers of the human immune system and, therefore, represent a suboptimal tool to study the interaction between tumor and immune cells.
Multiparameter flow cytometry analysis of leukocyte markers for diagnosis in preterm neonatal sepsis

Abstract Purpose Neonatal sepsis is an important public health concern worldwide due to its immediate lethality and long-term morbidity rates, Clinical evaluation and laboratory analyses are indispensable for diagnosis of neonatal sepsis. However, assessing multiple biomarkers in neonates is difficult due to limited blood availability. The aim is to investigate if the neonatal sepsis in preterm could be identified by multiparameter analysis with flow cytometry. Materials and Methods The expression of activation-related molecules was evaluated by flow cytometry in newborn with or without risk factors for sepsis. Results Our analysis revealed that several markers could be useful for sepsis diagnosis, such as CD45RA, CD45RO, or CD71 on T cells; HLA-DR on NKT or classic monocytes, and TREM-1 on non-classic monocytes or neutrophils. However, ROC analysis shows that the expression of CD45RO on T lymphocytes is the only useful biomarker for diagnosis of neonatal late-onset sepsis. Also, decision tree analyses showed that CD45RO plus CD27 could help differentiate the preterm septic neonates from those with risk factors. Conclusions Our study shows a complementary and practical strategy for biomarker assessment in neonatal sepsis.
Building Risk Prediction Models for Type 2 Diabetes Using Machine Learning Techniques

Introduction As one of the most prevalent chronic diseases in the United States, diabetes, especially type 2 diabetes, affects the health of millions of people and puts an enormous financial burden on the US economy. We aimed to develop predictive models to identify risk factors for type 2 diabetes, which could help facilitate early diagnosis and intervention and also reduce medical costs. Methods We analyzed cross-sectional data on 138,146 participants, including 20,467 with type 2 diabetes, from the 2014 Behavioral Risk Factor Surveillance System. We built several machine learning models for predicting type 2 diabetes, including support vector machine, decision tree, logistic regression, random forest, neural network, and Gaussian Naive Bayes classifiers. We used univariable and multivariable weighted logistic regression models to investigate the associations of potential risk factors with type 2 diabetes. Results All predictive models for type 2 diabetes achieved a high area under the curve (AUC), ranging from 0.7182 to 0.7949. Although the neural network model had the highest accuracy (82.4%), specificity (90.2%), and AUC (0.7949), the decision tree model had the highest sensitivity (51.6%) for type 2 diabetes. We found that people who slept 9 or more hours per day (adjusted odds ratio [aOR] = 1.13, 95% confidence interval [CI], 1.03–1.25) or had checkup frequency of less than 1 year (aOR = 2.31, 95% CI, 1.86–2.85) had higher risk for type 2 diabetes. Conclusion Of the 8 predictive models, the neural network model gave the best model performance with the highest AUC value; however, the decision tree model is preferred for initial screening for type 2 diabetes because it had the highest sensitivity and, therefore, detection rate. We confirmed previously reported risk factors and also identified sleeping time and frequency of checkup as 2 new potential risk factors related to type 2 diabetes.
Severe Combined Dyslipidemia With a Complex Genetic Basis

Background. Familial dysbetalipoproteinemia (also known as type 3 hyperlipoproteinemia) is typically associated with homozygosity for the apolipoprotein E2 isoform, but also sometimes with dominant rare missense variants in the APOE gene. Patients present with roughly equimolar elevations of cholesterol and triglyceride (TG) due to pathologic accumulation of remnant lipoprotein particles. Clinical features include tuberoeruptive xanthomas, palmar xanthomas, and premature vascular disease. Case. A 48-year-old male presented with severe combined dyslipidemia: total cholesterol and TG were 11.5 and 21.4 mmol/L, respectively. He had dyslipidemia since his early 20s, with tuberous xanthomas on his elbows and knees. His body mass index was 42 kg/m2. He also had treated hypertension, mild renal impairment, and a history of gout. He had no history of cardiovascular disease, peripheral arterial disease, or pancreatitis. Multiple medications had been advised including rosuvastatin, ezetimibe, fenofibrate, and alirocumab, but his lipid levels were never adequately controlled. Genetic Analysis. Targeted next-generation sequencing identified (1) the APOE E2/E2 homozygous genotype classically described with familial dysbetalipoproteinemia; (2) in addition, one APOE E2 allele contained the rare heterozygous missense variant p.G145D, previously termed apo E-Bethesda; (3) a rare heterozygous APOC2 nonsense variant p.Q92X; and (4) a high polygenic risk score for TG levels (16 out of 28 TG-raising alleles) at the 82nd percentile for age and sex. Conclusion. The multiple genetic “hits” on top of the classical APOE E2/E2 genotype likely explain the more severe dyslipidemia and refractory clinical phenotype.
Hippocampal connectivity with sensorimotor cortex during volitional finger movements: Laterality and relationship to motor learning

Hippocampal interactions with the motor system are often assumed to reflect the role of memory in motor learning. Here, we examine hippocampal connectivity with sensorimotor cortex during two tasks requiring paced movements, one with a mnemonic component (sequence learning) and one without (repetitive tapping). Functional magnetic resonance imaging activity was recorded from thirteen right-handed subjects; connectivity was identified from sensorimotor cortex (SMC) correlations with psychophysiological interactions in hippocampal activity between motor and passive visual tasks. Finger movements in both motor tasks anticipated the timing of the metronome, reflecting cognitive control, yet evidence of motor learning was limited to the sequence learning task; nonetheless, hippocampal connectivity was observed during both tasks. Connectivity from corresponding regions in the left and right hippocampus overlapped extensively, with improved sensitivity resulting from their conjunctive (global) analysis. The cortical laterality of SMC connectivity depended both on the hippocampal source and the task.Functionally-defined seeds produced bilateral connectivity within the hand representation, regardless of whether finger movements were uni- or bimanual; these seeds were located midlateral within the hippocampus, whereas structural seeds were located in the posterior hippocampus and produced unilateral connectivity. Results implicate the hippocampus in volitional finger movements even in the absence of motor learning or recall.
Blood Pressure Variability and Cardiovascular Outcomes in Patients With Prior Stroke: A Secondary Analysis of PRoFESS.

Background and Purpose- Every year in the United States, almost 185 000 ischemic strokes occur in patients with a prior stroke. Recurrent stroke has significantly higher morbidity and mortality. Among modifiable risk factors for recurrent stroke, hypertension is the most prevalent. Reducing systolic blood pressure is standard of care for secondary stroke prevention. Recent literature suggests that increased blood pressure variability (BPV) is associated with primary stroke, although studies have not convincingly shown that it is associated with recurrent stroke, which was the goal of this analysis. Methods- We conducted a secondary analysis of 17 916 patients in the PRoFESS (Prevention Regimen for Effectively Avoiding Second Strokes) trial, which is the largest trial of patients with potential recurrent stroke. We calculated BPV and evaluated its effect on recurrent stroke (composite and stratified by ischemic or hemorrhagic stroke), major cardiovascular events (death from cardiovascular causes, recurrent stroke, myocardial infarction, or new or worsening heart failure), and all-cause death. Results- Both systolic and diastolic BPV were associated with recurrent stroke, major cardiovascular events, and all-cause death. The association with stroke was significant for ischemic, but not hemorrhagic, stroke. For every 10-point increase in BPV (systolic SD, range =0-54.2), the hazard ratio for a recurrent ischemic stroke was 1.15 (95% CI, 1.02-1.32; P=0.02), for major cardiovascular events was 1.19 (95% CI, 1.09-1.31; P<0.001), and for all-cause death was 1.24 (95% CI, 1.10-1.39; P<0.001). Conclusions- Our study adds to the growing body of literature suggesting that BPV is an important and potentially modifiable risk factor for ischemic stroke, cardiovascular events, and all-cause death. Specifically, it is the first study to demonstrate that increased BPV is associated with recurrent ischemic stroke and that diastolic BPV can be as important as systolic BPV. Future work should focus on evaluating whether actively reducing BPV, using widely available and inexpensive antihypertensive medications, reduces the risk of cardiovascular disease.
Dry period heat stress induces microstructural changes in the lactating mammary gland

The bovine dry period is a non-lactating period between consecutive lactations characterized by mammary gland involution and redevelopment phases to replace senescent mammary epithelial cells with active cells primed for the next lactation. Dairy cows exposed to heat stress during the dry period experience milk yield reductions between 3–7.5 kg/d in the next lactation, partially attributed to processes associated with mammary cell growth and turnover during the dry period. However, the carry-over impact of dry period heat stress on mammary morphology during lactation has yet to be determined. In the current study, we hypothesized that exposure to heat stress during the dry period would alter alveolar microstructure and cellular turnover (i.e. proliferation and apoptosis) during lactation. Cows were either subjected to heat stress (HT, access to shade; n = 12) or cooling (CL, access to shade, fans, and soakers; n = 12) for a 46 d dry period. Upon calving, all cows were treated similarly with access to cooling for their entire lactation. Six cows per treatment were randomly selected for mammary gland biopsies at 14, 42, and 84 days in milk. Tissues were sectioned and stained for histological analysis. During lactation, HT cows produced 4 kg less colostrum and 3.7 kg less milk compared with CL cows. Lactating mammary gland microstructure was impacted after exposure to dry period heat stress; HT cows had fewer alveoli and a higher proportion of connective tissue in the mammary gland relative to CL cows, however alveolar area was similar between treatments. Rates of mammary epithelial cell proliferation and apoptosis were similar between treatment groups. This suggests that heat stress exposure during the dry period leads to reductions in milk yield that could be caused, in part, by a reduction in alveoli number in the lactating mammary gland but not to dynamic alterations in cellular turnover once lactation is established.
Radical Formation by Fine Particulate Matter Associated with Highly Oxygenated Molecules.

Highly oxygenated molecules (HOMs) play an important role in the formation and evo-lution of secondary organic aerosols (SOA). However, the abundance of HOMs in differ-ent environments and their relation to the oxidative potential of fine particulate matter (PM) are largely unknown. Here, we investigated the relative HOM abundance and radi-cal yield of laboratory-generated SOA and fine PM in ambient air ranging from remote forest areas to highly polluted megacities. By electron paramagnetic resonance and mass spectrometric investigations, we found that the relative abundance of HOMs especially the dimer and low volatile types in ambient fine PM was positively correlated with the formation of radicals in aqueous PM extracts. SOA from photooxidation of isoprene, ozonolysis of α- and β-pinene as well as fine PM from tropical (central Amazon) and boreal (Hyytiälä, Finland) forests exhibited a higher HOM abundance and radical yield than SOA from photooxidation of naphthalene and fine PM from urban sites (Beijing, Guangzhou, Mainz, Shanghai, and Xi'an), confirming that HOMs are important constit-uents of biogenic SOA to generate radicals. Our study provides new insights into the chemical relationship of HOM abundance, composition, and sources with the yield of radicals by laboratory and ambient aerosols, enabling better quantification of compo-nent-specific contribution of source- or site-specific fine PM to its climate and health effects.
Uneven Access to Smoke-Free Laws and Policies and Its Effect on Health Equity in the United States: 2000-2019.

Tobacco control measures have played an important role in the reduction of the cigarette smoking prevalence among US adults.However, although overall smoking prevalence has declined, it remains high among many subpopulations that are disproportionately burdened by tobacco use, resulting in tobacco-related health disparities. Slow diffusion of smoke-free laws to rural regions, particularly in the South and Southeast, and uneven adoption of voluntary policies in single-family homes and multiunit housing are key policy variables associated with the disproportionate burden of tobacco-related health disparities in these subpopulations.Developing policies that expand the reach of comprehensive smoke-free laws not only will facilitate the decline in smoking prevalence among subpopulations disproportionately burdened by tobacco use but will also decrease exposure to secondhand smoke and further reduce tobacco-caused health disparities in the United States. (Am J Public Health. Published online ahead of print September 19, 2019: e1-e8. doi:10.2105/AJPH.2019.305289).
Levetiracetam and non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation and epilepsy: a reasonable combination

Department of Neurology 1, Kepler Universitätsklinikum, Wagner-JureggWeg 15, 4020 Linz, Austria, and European Academy of Neurology (EAN), Scientific Panel Epilepsy; Department of Neurology, Christian Doppler Klinik, University Hospital Paracelsus Medical University, Ignaz-Harrer-Straße 79, 5020 Salzburg, Austria, International League Against Epilepsy Europe (ILAE-EUROPE) and EAN Scientific Panel Epilepsy; and Shaarei Zedek Medical Center, 12 Shmuel Bait St., Jerusalem 9103102, Israel and EAN Scientific Panel Stroke
LINC01096 knockdown inhibits progression of triple-negative breast cancer by increasing miR-3130-3p.

OBJECTIVE Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer. Long noncoding RNAs (lncRNAs) have been reported to be involved in the development of TNBC. However, the role and mechanism of LINC01096 in TNBC are largely unclear. This work aims to investigate the effect of LINC01096 on cell viability, apoptosis, migration, and invasion of TNBC cells, as well as explore the interaction between LINC01096 and microRNA (miR)-3130-3p. PATIENTS AND METHODS Sixty TNBC patients were recruited. T47-D and BT-549 cells were cultured for experiments in vitro. The expression levels of LINC01096 and miR-3130-3p were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Cell viability, apoptosis, migration, and invasion were determined by MTT, flow cytometry, and trans-well assays. The target association between LINC01096 and miR-3130-3p was confirmed by the luciferase reporter assay. RESULTS The expression of LINC01096 was enhanced in TNBC tissues and cells. High expression of LINC01096 predicted poor outcomes of patients with TNBC. Silence of LINC01096 led to the suppression of cell viability, migration, and invasion, as well as the promotion of apoptosis in TNBC cells. MiR-3130-3p was targeted by LINC01096 and lowly expressed in TNBC. Overexpression of miR-3130-3p repressed cell viability, migration, and invasion, while it induced apoptosis. However, the knockdown of miR-3130-3p induced the opposite effect. This was weakened by inhibiting LINC01096. CONCLUSIONS Knockdown of LINC01096 inhibited cell viability, migration, and invasion; however, it promoted apoptosis in TNBC by up-regulating miR-3130-3p, indicating a novel target for the treatment of TNBC.
Impacts of Financial Coverage on Long-Term Outcome of Intensive Care Unit Survivors in South Korea

Purpose The objective of this study was to investigate whether financial coverage by the national insurance system for patients with lower economic conditions can improve their 1-year mortality after intensive care unit (ICU) discharge. Materials and Methods This study, conducted in a single tertiary hospital, used a retrospective cohort design to investigate discharged ICU survivors between January 2012 and December 2016. ICU survivors were classified into two groups according to the National Health Insurance (NHI) system in Korea: medical aid program (MAP) group, including people who have difficulty paying their insurance premium or receive medical aid from the government due to a poor economic status; and NHI group consisting of people who receive government subsidy for approximately 2/3 of their medical expenses. Results After propensity score (PS) matching, a total of 2495 ICU survivors (1859 in NHI group and 636 in MAP group) were included in the analysis. Stratified Cox regression analysis of PS-matched cohorts showed that 1-year mortality was 1.31-fold higher in MAP group than in NHI group (hazard ratio: 1.31, 95% confidence interval, 1.06 to 1.61; p=0.012). According to Kaplan-Meir estimation, MAP group also showed significantly poorer survival probability than NHI group after PS matching (p=0.011). Conclusion This study showed that 1-year mortality was higher in ICU survivors with low economic status, even if financial coverage was provided by the government. Our result suggests the necessity of a more nuanced and multifaceted approach to policy for ICU survivors with low economic status.
Next-generation sequencing-based BRCA testing on cytological specimens from ovarian cancer ascites reveals high concordance with tumour tissue analysis

Background With the approval of the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib for newly diagnosed, breast cancer gene (BRCA)1/2 mutated, ovarian cancer women, the assessment of BRCA1/2 tumour status will be shortly required at the time of diagnosis. Aim To investigate the feasibility of next-generation sequencing (NGS)-based BRCA tumour test on cytological specimens from ovarian cancer ascites. Methods We evaluated the BRCA1/2 status on neoplastic ascites and corresponding tumour tissue of 11 patients with ovarian cancer, using the NGS ‘Oncomine BRCA Research Assay’. Results The NGS-based BRCA test on cytological samples had a success rate of 100%, with 11 of 11 concordant BRCA1/2 results between ascites and tumour tissues analyses, including two wild type samples and nine cases harbouring somatic or germline variants. Conclusion BRCA test may be performed on ovarian cancer ascites, reproducing BRCA1/2 tumour status and representing a useful tool for clinical decision-making.