Miracle-dz/UniFAR-FTUs huggingface dataset:
Pneumococcal vaccination in adults at very-high risk or established cardiovascular disease: systematic review and meta-analysis.

BACKGROUND There are several guidelines that recommend pneumococcal vaccination (PPSV23 and/or PCV13) in adults with a history of cardiovascular disease (established heart failure, coronary disease, cerebrovascular disease) or at a very-high risk of cardiovascular disease. However, there is no Randomized Controlled Trial (RCT) systematic review that evaluates the impact of vaccination on all-cause mortality compared to no vaccination in this particular population. OBJECTIVE To conduct a systematic review and meta-analysis of the impact of pneumococcal vaccination in the referred population. METHODS We searched CENTRAL and MEDLINE for relevant RCTs and observational studies. Data were screened, extracted, and appraised by two independent reviewers. We pooled results using a random-effects model, and used Hazard Ratios (HR) with 95% Confidence Intervals (CI) to assess measure of effect. The primary outcome was all-cause mortality and we assessed the confidence in the evidence using the GRADE framework. RESULTS No RCTs were found. Seven observational studies were included for analyses. Pooled results from five studies enrolling a total of 163,756‬ participants showed a significant decrease in all-cause mortality (HR 0.78, 95% CI 0.73 to 0.83, very-low confidence), without statistically significant heterogeneity (Chi2 test P = 0.21; I2 = 32%). CONCLUSIONS Pneumococcal vaccination was associated with a 22% decrease of all-cause mortality in patients with cardiovascular disease or at a very high-cardiovascular risk. However, limitations due to study design and the serious risk of bias in three of the included studies leads to a decreased level of result confidence.
Organisational and individual characteristics associated with glycaemic control among patients with type 2 diabetes: cross-sectional study in China

Objective There is a high prevalence of poor glycaemic control among patients with type 2 diabetes (T2DM) in China. This study aimed to explore both organisational and individual characteristics associated with glycaemic control among patients with T2DM. Design Cross-sectional survey. Setting Shandong Province, China. Participants The participants were 2166 patients with T2DM and 337 healthcare providers from 36 urban communities and 36 rural villages in Shandong Province. Primary and secondary outcome measures Multistage stratified sampling procedures were used to measure demand-side individual demographic, clinical and self-management characteristics, and supply-side organisational characteristics, and the status of glycaemic control. Multilevel logistic regression analysis was performed to assess key determinants of glycaemic control. Results Only 42.8% of the patients with T2DM achieved good glycaemic control. Age, income, hypertension and self-efficacy were significantly positive predictors of optimal glycaemic control, while duration of diabetes, antidiabetic drugs and monitoring of blood glucose were significantly negative predictors of that. Private VCs (OR=0.48, 95% CI 0.29 to 0.82, p<0.01) and lack of healthcare providers (OR=0.69, 95% CI 0.53 to 0.89, p<0.01; OR=0.71, 95% CI 0.52 to 0.98, p<0.05) were significantly negative predictors of optimal glycaemic control, while diabetes knowledge level of healthcare providers (OR=1.36, 95% CI 1.02 to 1.83, p<0.05; OR=1.45, 95% CI 1.00 to 2.10, p<0.05) and kinds of antidiabetic drugs (OR=1.37, 95% CI 0.97 to 1.93, p<0.1; OR=1.46, 95% CI 1.07 to 2.00, p<0.05) were significantly positive predictors of that. Conclusions Glycaemic control was suboptimal among patients with T2DM in China. The determinants of failing to achieve good glycaemic control included both organisational and individual characteristics. Potential interventions that target patients, providers and the healthcare organisations should be taken to improve the glycaemic control and health outcome among patients with T2DM.
Levetiracetam (levebel) Versus Carbamazepine Monotherapy for Focal Epilepsy in Children: A randomized clinical trial

Objective: This study aimed at comparing the effect of a newly approved drug leveitiracetam (LEV) versus carbamazepine (CBZ) in the treatment of childhood focal epilepsy. Methods & Materials The study population included newly diagnosed children with focal epilepsy (1-16 years old) referring to the Pediatric Neurology Ward of Quaem Hospital, Mashhad, Iran from May 2013 to March 2014. The subjects were randomly treated with LEV or CBZ. Patients were followed for seizure control and drug side effects throughout six months. We assessed liver function and complete blood count for all patients through one month and they were asked about significant side effects, such as drowsiness، restlessness, and skin reaction. Eventually, they were assigned in two groups (n=25) receiving LEV and CBZ. Results In our study, two cases in the LEV group were excluded because of severe agitation. Relapsing seizures were observed in 3 (13%) and 10 (40%) patients in LEV and CBZ groups, respectively. The seizure was not repeated in 15 cases (60%) in the CBZ group and 20 cases (87%) in the LEV group. The results of the Chi-squared test showed significant differences in the responses to treatment between the groups (P=0.03). Agitation was the most prevalent complication in the LEV group, whereas drowsiness was more common in the CBZ group. Fortunately, liver enzyme dysfunction and blood cell disturbances were not observed in the subjects. Conclusion According to the findings, there were significant differences in controlling seizures between two groups that indicated the effectiveness of LEV (87%) in the suppression of focal seizure.
A microtubule polymerase is required for microtubule orientation and dendrite pruning in Drosophila

Drosophila class IV ddaC neurons selectively prune all larval dendrites to refine the nervous system during metamorphosis. During dendrite pruning, severing of proximal dendrites is preceded by local microtubule (MT) disassembly. Here, we identify an unexpected role of Mini spindles (Msps), a conserved MT polymerase, in governing dendrite pruning. Msps associates with another MT‐associated protein TACC, and both stabilize each other in ddaC neurons. Moreover, Msps and TACC are required to orient minus‐end‐out MTs in dendrites. We further show that the functions of msps in dendritic MT orientation and dendrite pruning are antagonized by the kinesin‐13 MT depolymerase Klp10A. Excessive MT depolymerization, which is induced by pharmacological treatment and katanin overexpression, also perturbs dendritic MT orientation and dendrite pruning, phenocopying msps mutants. Thus, we demonstrate that the MT polymerase Msps is required to form dendritic minus‐end‐out MTs and thereby promotes dendrite pruning in Drosophila sensory neurons.
Racial Disparities in Positive Airway Pressure Therapy Adherence Among Veterans With Obstructive Sleep Apnea.

STUDY OBJECTIVES Black individuals are disproportionately affected by diabetes, cardiovascular disease, obesity and obstructive sleep apnea (OSA). Adherence to positive airway pressure (PAP) therapy has been reported to be lower among black individuals. This study seeks to examine associations between black race and PAP adherence among veterans with OSA. METHODS This was a retrospective study. All veterans newly-diagnosed with OSA at a single Department of Veterans Affairs sleep center who were prescribed a modem-enabled PAP device between January 2015 and November 2017 were enrolled. PAP adherence was defined as ≥ 4 hours nightly usage for at least 70% of nights measured at 30 days from PAP set-up. We examined the relationship between race and adherence, controlling for gender, marital status, age, socioeconomic status, residual apnea-hypopnea index (AHI), and mask leak. RESULTS Of the 3013 patients identified, 2571 (85%) were newly-started on PAP therapy (95% male, aged 59 ± 14 years, 45% married, 8% with neighborhood socioeconomic disadvantage). Twenty-five percent of participants were black, and 57% were white. PAP adherence at 30 days was 50% overall (42% among blacks, 53% among non-blacks). Black race was associated with reduced 30-day PAP adherence in unadjusted (P < 0.001) and adjusted logistic regression models (OR = 0.64; 95% CI, 0.53 - 0.78; P < 0.001). CONCLUSIONS Among veterans with OSA, black race was associated with reduced PAP adherence. These findings suggest health inequality for black individuals in the treatment of OSA.
Reducing the Stigma of Diabetes in Medical Education: A Contact-Based Educational Approach

IN BRIEF In this feasibility study, we evaluated the impact of a contact-based education patient panel in an Endocrine and Metabolism course on second-year medical students’ diabetes attitudes and diabetes stigma. Prior to the patient panel, some medical students harbored stigma toward people with diabetes, thus confirming patients’ reports in the literature of diabetes stigma on the part of health care professionals. Importantly, the one-time contact-based educational approach improved students’ diabetes attitudes and reduced diabetes stigma.
Regular moderate exercise alleviates gastric oxidative damage in rats via the contribution of oxytocin receptors

A moderate level of exercise has beneficial effects for the prevention of gastric ulcers. Although regular aerobic exercise was shown to elevate serum oxytocin levels and exogenously administered oxytocin exerts an anti‐ulcer activity, the role of endogenous oxytocin in the gastroprotective effects of exercise has not yet been elucidated. We showed that increased anxiety and oxidative gastric damage induced by gastric ulcers were reversed in pre‐exercised rats, while reduced hypothalamic oxytocin expression and decreased myenteric oxytocin receptor expression due to gastric ulcers were abolished by exercise. We also reported that the blockade of oxytocin receptors exaggerated gastric damage in exercised rats with ulcers. Our data establish that endogenous oxytocin is the key mediator in the beneficial effects of regular physical activity in alleviating gastric injury.
Investigating the Use of Pretrained Convolutional Neural Network on Cross-Subject and Cross-Dataset EEG Emotion Recognition

The electroencephalogram (EEG) has great attraction in emotion recognition studies due to its resistance to deceptive actions of humans. This is one of the most significant advantages of brain signals in comparison to visual or speech signals in the emotion recognition context. A major challenge in EEG-based emotion recognition is that EEG recordings exhibit varying distributions for different people as well as for the same person at different time instances. This nonstationary nature of EEG limits the accuracy of it when subject independency is the priority. The aim of this study is to increase the subject-independent recognition accuracy by exploiting pretrained state-of-the-art Convolutional Neural Network (CNN) architectures. Unlike similar studies that extract spectral band power features from the EEG readings, raw EEG data is used in our study after applying windowing, pre-adjustments and normalization. Removing manual feature extraction from the training system overcomes the risk of eliminating hidden features in the raw data and helps leverage the deep neural network’s power in uncovering unknown features. To improve the classification accuracy further, a median filter is used to eliminate the false detections along a prediction interval of emotions. This method yields a mean cross-subject accuracy of 86.56% and 78.34% on the Shanghai Jiao Tong University Emotion EEG Dataset (SEED) for two and three emotion classes, respectively. It also yields a mean cross-subject accuracy of 72.81% on the Database for Emotion Analysis using Physiological Signals (DEAP) and 81.8% on the Loughborough University Multimodal Emotion Dataset (LUMED) for two emotion classes. Furthermore, the recognition model that has been trained using the SEED dataset was tested with the DEAP dataset, which yields a mean prediction accuracy of 58.1% across all subjects and emotion classes. Results show that in terms of classification accuracy, the proposed approach is superior to, or on par with, the reference subject-independent EEG emotion recognition studies identified in literature and has limited complexity due to the elimination of the need for feature extraction.
Investigating Novel Syntheses of a Series of Unique Hybrid PLGA-Chitosan Polymers for Potential Therapeutic Delivery Applications

Discovering new materials to aid in the therapeutic delivery of drugs is in high demand. PLGA, a FDA approved polymer, is well known in the literature to form films or nanoparticles that can load, protect, and deliver drug molecules; however, its incompatibility with certain drugs (due to hydrophilicity or charge repulsion interactions) limits its use. Combining PLGA or other polymers such as polycaprolactone with other safe and positively-charged molecules, such as chitosan, has been sought after to make hybrid systems that are more flexible in terms of loading ability, but often the reactions for polymer coupling use harsh conditions, films, unpurified products, or create a single unoptimized product. In this work, we aimed to investigate possible innovative improvements regarding two synthetic procedures. Two methods were attempted and analytically compared using nuclear magnetic resonance (NMR), fourier-transform infrared spectroscopy (FT-IR), and dynamic scanning calorimetry (DSC) to furnish pure, homogenous, and tunable PLGA-chitosan hybrid polymers. These were fully characterized by analytical methods. A series of hybrids was produced that could be used to increase the suitability of PLGA with previously non-compatible drug molecules.
The skin microbiome facilitates adaptive tetrodotoxin production in poisonous newts

Rough-skinned newts (Taricha granulosa) use tetrodotoxin (TTX) to block voltage-gated sodium (Nav) channels as a chemical defense against predation. Interestingly, newts exhibit extreme population-level variation in toxicity attributed to a coevolutionary arms race with TTX-resistant predatory snakes, but the source of TTX in newts is unknown. Here, we investigated whether symbiotic bacteria isolated from toxic newts could produce TTX. We characterized the skin-associated microbiota from a toxic and non-toxic population of newts and established pure cultures of isolated bacterial symbionts from toxic newts. We then screened bacterial culture media for TTX using LC-MS/MS and identified TTX-producing bacterial strains from four genera, including Aeromonas, Pseudomonas, Shewanella, and Sphingopyxis. Additionally, we sequenced the Nav channel gene family in toxic newts and found that newts expressed Nav channels with modified TTX binding sites, conferring extreme physiological resistance to TTX. This study highlights the complex interactions among adaptive physiology, animal-bacterial symbiosis, and ecological context.
Tongue Mass Arising after Hematopoietic Cell Transplantation and Leukemia Relapse

Acute lymphoblastic leukemia (ALL) is a hematopoietic malignancy of lymphoid progenitor cells. Malignant lymphoid cells proliferation accumulated the bone marrow, peripheral blood and extramedullary regions with a rapid progression, including the oral cavity. ALL mainly arises in children and is the most threatful type of cancer under the age 20. Advances in multiagent chemotherapy has increased the survival rate up to 90% in children, with less achievements of 30-40% in adult ALL. Patients, especially those with disease relapse, are considered for allogeneic hematopoietic cell transplantation (HCT). Acute and chronic graft-versushost disease (GVHD) are representative complications that may follow HCT. Patients with a medical history of ALL are possible of experiencing various treatment levels of chemotherapy or HCT and are at risk for leukemia relapse which gives a wide range of considerations for dentists during oral examination. In this report, we discussed a case of a large pedunculated tongue mass in a patient with history of ALL and HCT. 조혈세포이식 후 재발한 백혈병 환자의 혀 종물
Impairment but not abolishment of express saccades after unilateral or bilateral inactivation of the frontal eye fields.

Express saccades are a manifestation of a visual grasp reflex triggered when visual information arrives in the intermediate layers of the superior colliculus (SCi), which in turn orchestrates the lower level brainstem saccade generator to evoke a saccade with a very short latency (~100ms or less). A prominent theory regarding express saccades generation is that they are facilitated by preparatory signals, presumably from cortical areas, which prime the SCi prior to the arrival of visual information. Here, we test this theory by reversibly inactivating a key cortical input to the SCi, the frontal eye fields (FEF), while monkeys perform an oculomotor task that promotes express saccades. Across three tasks with a different combination of potential target locations and uni- or bilateral FEF inactivation, we found a spared ability for monkeys to generate express saccades, despite decreases in express saccade frequency during FEF inactivation. This result is consistent with the FEF having a facilitatory but not critical role in express saccade generation, likely because other cortical areas compensate for the loss of preparatory input to the SCi. However, we also found decreases in the accuracy and peak velocity of express saccades generated during FEF inactivation, which argues for an influence of the FEF on the saccadic burst generator even during express saccades. Overall, our results shed further light on the role of the FEF in the shortest-latency visually-guided eye movements.
Normothermic Machine Perfusion Combined with Bone Marrow Mesenchymal Stem Cells Improves the Oxidative Stress Response and Mitochondrial Function in Rat Donation After Circulatory Death Livers

There is a need to improve the quality of donor liver from donation after circulatory death (DCD). The purpose of this study was to investigate the effects and mechanism of normothermic machine perfusion (NMP) combined with bone marrow mesenchymal stem cells (BMMSCs) on the oxidative stress and mitochondrial function in DCD livers. DCD livers were obtained, a rat NMP system was established, and BMMSCs were extracted and identified. The DCD livers were grouped by their preservation method: Normal, static cold storage (SCS), NMP (P), and NMP combined with BMMSCs (PB), and the preservation time was up to 8 h. An IAR20 cell oxidative stress injury model was established in vitro by simulating DCD oxidative stress injury and coculturing with BMMSCs for 6 h. Compared with SCS group, after 6 h in vitro, the PB and P groups had significantly improved liver function and liver histological damage, reduced hepatocyte apoptosis and oxidative stress, improved hepatocyte mitochondrial damage, and increased mitochondrial membrane potential. These indicators were significantly better in the PB group than in the P group. BMMSCs significantly inhibited reactive oxygen species release from the IAR20 cell oxidative stress model in vitro, ameliorated mitochondrial damage, and increased mitochondrial membrane potential level. BMMSCs also downregulated the JUN N-terminal kinase-nuclear factor kappa B (JNK-NF-κB) signaling pathway significantly in the IAR20 cell oxidative stress model and promoted AMP-activated protein kinase (AMPK) activation. We verified that NMP combined with BMMSCs also played the same role in the PB group. NMP combined with BMMSCs could improve liver quality by relieving oxidative stress injury and improving mitochondrial function in rat DCD livers. The mechanism of protective role might involve inhibiting the JNK-NF-κB pathway to reduce oxidative stress and promote AMPK activation, thereby reducing mitochondrial damage and increase mitochondrial function.
Blood transfusions in mass casualty events: recent trends

The US AABB disaster task force recommends estimating 3 RBC units per admission (UPA) for mass casualty events (MCEs). In a previous analysis, median MCE UPA were 2·7 RBCs, 1·2 plasmas and 0·27 platelet doses (Vox Sang 2017; 112:648). Additional recent data were sought from the current era of balanced massive transfusion protocols (bMTPs).
HECT E3 ubiquitin ligases – emerging insights into their biological roles and disease relevance

ABSTRACT Homologous to E6AP C-terminus (HECT) E3 ubiquitin ligases play a critical role in various cellular pathways, including but not limited to protein trafficking, subcellular localization, innate immune response, viral infections, DNA damage responses and apoptosis. To date, 28 HECT E3 ubiquitin ligases have been identified in humans, and recent studies have begun to reveal how these enzymes control various cellular pathways by catalyzing the post-translational attachment of ubiquitin to their respective substrates. New studies have identified substrates and/or interactors with different members of the HECT E3 ubiquitin ligase family, particularly for E6AP and members of the neuronal precursor cell-expressed developmentally downregulated 4 (NEDD4) family. However, there still remains many unanswered questions about the specific roles that each of the HECT E3 ubiquitin ligases have in maintaining cellular homeostasis. The present Review discusses our current understanding on the biological roles of the HECT E3 ubiquitin ligases in the cell and how they contribute to disease development. Expanded investigations on the molecular basis for how and why the HECT E3 ubiquitin ligases recognize and regulate their intracellular substrates will help to clarify the biochemical mechanisms employed by these important enzymes in ubiquitin biology. Summary: This comprehensive Review discusses our current understanding on the biological roles of the HECT E3 ubiquitin ligases in the cell and how they contribute to disease development.
Everolimus-Eluting Second-Generation Stents for Treatment of De Novo Lesions in Patients with Cardiac Allograft Vasculopathy

Background Cardiac allograft vasculopathy is a major cause of cardiac allograft rejection. Percutaneous coronary intervention has become the main form of treatment of significant focal lesions. Despite the significance of the problem, data remain scarce. With a large population of transplant recipients undergoing coronary angiography at our center, we decided to analyze the implications of the use of everolimus-eluting second-generation stents by performing 6-month clinical and angiographic follow-up. Material/Methods From December 2012 and August 2019, 319 patients after heart transplantation undergoing coronary angiography at our institution were analyzed. Subsequently, 22 patients underwent de novo angioplasty with second-generation everolimus-eluting stents. The primary study endpoint was angiographic restenosis as evaluated by quantitative coronary angiography. Secondary outcomes included binary restenosis, target lesion revascularization, and cardiac death during the follow-up period (6 months). Results Patient comorbidities included hypertension (77.3%), type 2 diabetes mellitus (68.2%), dyslipidemia (68.2%), and obesity (31.8%). Primary success was obtained in all of the treated lesions. The analysis of quantitative coronary angiography after 6-month follow-up revealed low late lumen loss (0.22±0.40). Significant restenosis was observed in 1 of the cases. There were no deaths in the 6-month observation period. Conclusions In the analyzed population, invasive strategy with second-generation everolimus-eluting stents for de novo lesions in cardiac allograft vasculopathy resulted in a low rate of binary restenosis, low late lumen loss, and no deaths during the 6-month follow-up.