Miracle-dz/UniFAR-FTUs huggingface dataset:
A Neurologic Examination for Anesthesiologists: Assessing Arousal Level during Induction, Maintenance, and Emergence

Anesthetics have profound effects on the brain and central nervous system. Vital signs, along with the electroencephalogram and electroencephalogram-based indices, are commonly used to assess the brain states of patients receiving general anesthesia and sedation. Important information about the patient’s arousal state during general anesthesia can also be obtained through use of the neurologic examination. This article reviews the main components of the neurologic examination focusing primarily on the brainstem examination. It details the components of the brainstem examination that are most relevant for patient management during induction, maintenance, and emergence from general anesthesia. The examination is easy to apply and provides important complementary information about the patient’s arousal level that cannot be discerned from vital signs and electroencephalogram measures.
Effects of chronic physical disease and systemic inflammation on suicide risk in patients with depression: a hospital-based case–control study

Abstract Background Few studies have examined the concurrent effects of physical disease and systemic inflammation on suicide risk in patients with depression. The authors investigated the independent contributions of chronic physical disease and systemic inflammation as indexed by C-reactive protein (CRP), on risk of suicide attempt. Methods In this case–control study, 1468 cases of suicide attempters and 14 373 controls, both aged 18–65 years with a diagnosis of depression during 2011–2015, were identified from the hospital-wide database. Regression models were implemented to identify separate effects of physical diseases and systemic inflammation indexed by CRP, on risk of suicide attempt. Results Compared with having no physical disease, having one, two, and three or more physical diseases was associated with a 3.6-, 6.4-, and 14.9-fold increase in odds of making a suicide attempt, respectively, after adjusting for age, sex, and race/ethnicity. In a sub-sample of cases and controls with available CRP values, patients with high CRP (>3 mg/L) had 1.9 times the odds of suicide attempt compared with patients with low CRP (<1 mg/L). This association was no longer significant when controlling for the effect of physical disease. Conclusions The presence of physical disease is an important risk factor for suicide attempt among patients with depression. Systemic inflammation is likewise associated with increased risk for suicide attempt, however, this association appears to be accounted for by the presence of physical disease among patients receiving care in a medical center setting. Healthcare providers should consider the risk of suicide attempt in depressed patients burdened with multiple comorbidities.
Presentation, diagnosis and clinical course of the spectrum of progressive-fibrosing interstitial lung diseases

Although these conditions are rare, a proportion of patients with interstitial lung diseases (ILDs) may develop a progressive-fibrosing phenotype. Progressive fibrosis is associated with worsening respiratory symptoms, lung function decline, limited response to immunomodulatory therapies, decreased quality of life and, potentially, early death. Idiopathic pulmonary fibrosis may be regarded as a model for other progressive-fibrosing ILDs. Here we focus on other ILDs that may present a progressive-fibrosing phenotype, namely idiopathic nonspecific interstitial pneumonia, unclassifiable idiopathic interstitial pneumonia, connective tissue disease-associated ILDs (e.g. rheumatoid arthritis-related ILD), fibrotic chronic hypersensitivity pneumonitis, fibrotic chronic sarcoidosis and ILDs related to other occupational exposures. Differential diagnosis of these ILDs can be challenging, and requires detailed consideration of clinical, radiological and histopathological features. Accurate and early diagnosis is crucial to ensure that patients are treated optimally. Other chronic ILDs with a progressive-fibrosing phenotype may have a clinical course similar to IPF. Although challenging, identification of these patients is crucial, and requires a multidisciplinary approach, to ensure optimal diagnosis and management. http://ow.ly/8q8M30mGDsQ
Functional MRI Task Comparison for Language Mapping in Neurosurgical Patients

Language task‐based functional MRI (fMRI) is increasingly used for presurgical planning in patients with brain lesions. Different paradigms elicit activations of different components of the language network. The aim of this study is to optimize fMRI clinical usage by comparing the effectiveness of three language tasks for language lateralization and localization in a large group of patients with brain lesions.
The Effectiveness of Life Skills Training on the Level of Hope in Recovering Addicts Referring to the Zahedan Psychiatric Center

Background : Not paying enough attention to psychological issues is one of the factors that can lead to recovering addicts lapsing back to drug use. Paying attention to component of hope can be a motivating factor in maintaining and sustaining the new conditions for those who quit drugs. Therefore, this study was conducted to evaluate the effectiveness of life skills training on the level of hope of the addicts referring to the Zahedan Psychiatric Center to quit their drug use. Methods: In this quasi-experimental study, 90 drug addicts who were referred to the psychiatric center of Zahedan were selected. Forty-five of these addicts were placed in the intervention group and 45 of them were placed in the control group. Data were collected twice (pretest, post-test design) by demographic questionnaire and Miller’s Hope Questionnaire. The intervention group received some life skills training for 4 sessions per week in the group form, while the control group received no intervention. After 8 weeks from the end of the intervention, the questionnaires were completed again by samples. Using SPSS software version 20, this study applied independent t-test, paired t-test and covariance analysis, to address the objective of the study. Results: The mean score of hope before training in intervention and control group was 180.22 ± 22.68 and 170.08 ± 24.82, respectively, while it increased to 199.77 ± 30.53 in the intervention group and decreased to 166.20 ± 21.93 in the control group. Consequently, life skills training brought about significant increase in terms of hope in the intervention group (P <0.05). Conclusion: Findings showed that life skills training can increase the level of hope in addicts quitting drug in addiction recovery. Considering the fact that promotion of hope can lead to favorable behavior changes regarding drug abstinence, it is recommended that life skills training programs be offered for these people in drug rehabilitation centers. Keywords : life skills, hope, drug abuse
Are Sedentary Behaviors Associated with Sleep Duration? A Cross-Sectional Case from Croatia

Although both sedentary behavior and sleep duration are risk factors for obesity, little evidence is provided regarding their mutual associations in young adults, who are at extreme risk of spending more time sitting and having irregular sleeping hygiene. Thus, the main purpose of the present study was to explore the associations between different sedentary behaviors and sleep duration. In this cross-sectional study, we recruited 2100 university students from the city of Zagreb. To assess sedentary behaviors and sleep duration, we used validated questionnaires. The associations between sedentary behaviors and sleep duration were analyzed using logistic regression analyses and were adjusted for sex, body-mass index, self-rated health, socioeconomic status, smoking status, binge drinking, psychological distress and chronic disease/s. Participants being in the third (OR = 1.45; 95% CI 1.05 to 2.01) and fourth (OR = 1.82; 95% CI 1.26 to 2.61) quartile of the screen-time, in the third (OR = 1.49; 95% CI 1.05 to 2.13) and fourth (OR = 1.72; 95% CI 1.22 to 2.42) quartile of the leisure-time sedentary behavior and in the fourth (OR = 1.45; 95% CI 1.04 to 2.02) quartile of the total sedentary behavior were more likely to be ‘short’ sleepers (<7 h). Also, participants being in the third (OR = 1.63; 95% CI 1.16 to 2.30) and fourth (OR = 1.93; 95% CI 1.33 to 2.81) quartile of the screen-time and in the fourth (OR = 1.45; 95% CI 1.05 to 2.00) quartile of the total sedentary behavior were more likely to be ‘long’ sleepers (>9 h). Our study shows that sedentary behavior in screen-time and total sedentary behavior are associated with both ‘short’ and ‘long’ sleep duration.
The effect of legal mandates on substance use disorder treatment completion among older adults

Abstract Objective: This study seeks to determine the relationship between referral type (legally mandated versus non-mandated) and substance use disorder (SUD) treatment completion among older adults and by primary substance used. Method: We used data from the Treatment Episode Data Set - Discharges (TEDS-D) from 2011. Using data for persons age 55 and over (n = 104,747), we used propensity score matching (PSM) to address selection bias and attenuate the likelihood of a type I error. Logistic regression models estimated the effect of referral type on treatment completion based on treatment for a primary substance for five categories of substances. Results: In the matched sample, those who faced treatment mandates had 71% greater odds of completing treatment compared with those who entered treatment voluntarily (OR =1.71, 95% CI [1.64, 1.79]). Based on the primary drug used, odds of treatment completion were highest for alcohol, with 86% greater treatment completion for the mandated individuals compared with those entering treatment without a legal mandate (OR =1.86, 95% CI [1.75, 1.97]). Conclusion: These findings suggest that the motivating influence of treatment mandates may encourage completion of SUD treatment among older adults. Although the legal mandates for treatment are punitive, they may act to keep older adults with SUD engaged in treatment, an important factor as treatment completion is inversely related to relapse of a SUD.
Low Levels of PaO2 after Long-term Noninvasive Ventilation are a Poor Prognostic Factor in Patients with Restrictive Thoracic Disease

Objective The effects of partial pressure of arterial oxygen (PaO2) after introducing long-term noninvasive ventilation (NIV) on the prognosis of patients with restrictive thoracic disease and chronic respiratory failure are not exactly known. Methods Data from 141 patients with restrictive thoracic disease under long-term nocturnal NIV were retrospectively examined. We divided the patients into 2 groups according to the daytime PaO2 value while breathing spontaneously with prescribed oxygen at 12 months after introducing NIV: PaO2≥80 Torr group (n=76) and PaO2<80 Torr group (n=65). Results During the 4-year follow-up, the mortality was significantly higher in the PaO2<80 Torr group than in the PaO2≥80 Torr group (50.8% vs. 32.9%, p=0.03). Independent factors associated with the 4-year mortality after introducing NIV determined by a multivariate logistic regression analysis were a low body mass index [odds ratio (OR) 0.87; 95% confidence interval (CI) 0.77 to 0.97; p=0.01], assisted mode with NIV (OR 4.11; 95% CI, 1.79 to 9.45; p=0.0009), hospitalization during the first year of introducing NIV (OR 1.72; 95% CI, 1.06 to 2.79; p=0.03), and daytime PaO2<80 Torr at 12 months after introducing NIV (OR 2.30; 95% CI, 1.03 to 5.10; p=0.04). Conclusion A low daytime PaO2 at 12 months after introducing NIV was an independent risk factor for mortality. Keeping the daytime PaO2≥80 Torr through the adjustment of the nocturnal NIV settings or increased diurnal supplemental oxygen may help improve the prognosis in patients with restrictive thoracic disease who are under NIV.
Interleukin-32: Frenemy in cancer?

Interleukin-32 (IL-32) was originally identified in natural killer (NK) cells activated by IL-2 in 1992. Thus, it was named NK cell transcript 4 (NK4) because of its unknown function at that time. The function of IL-32 has been elucidated over the last decade. IL-32 is primarily considered to be a booster of inflammatory reactions because it is induced by pro-inflammatory cytokines and stimulates the production of those cytokines and vice versa. Therefore, many studies have been devoted to studying the roles of IL-32 in inflammation-associated cancers, including gastric, colon cancer, and hepatocellular carcinoma. At the same time, roles of IL-32 have also been discovered in other cancers. Collectively, IL-32 fosters the tumor progression by nuclear factor-κB (NF-κB)-mediated cytokines and metalloproteinase production, as well as stimulation of differentiation into immunosuppressive cell types in some cancer types. However, it is also able to induce tumor cell apoptosis and enhance NK and cytotoxic T cell sensitivity in other cancer types. In this review, we will address the function of each IL-32 isoform in different cancer types studied to date, and suggest further strategies to comprehensively elucidate the roles of IL-32 in a context-dependent manner.
Effects of Developmental Arsenic Exposure on the Social Behavior and Related Gene Expression in C3H Adult Male Mice

Arsenic is carcinogenic and teratogenic. In addition, it is also a developmental neurotoxicant. Little is known however about the effect of arsenic exposure during brain development on social behavior. This study aimed to detect the effect of developmental arsenic exposure on social behavior and related gene expression in C3H adult male mice. Pregnant C3H mice were exposed to sodium arsenite (NaAsO2, 85 ppm in the drinking water) from gestational day (GD) 8 to 18. The F1 generation male pups from different mothers were taken and social behavior tasks were examined. Social behavioral-related gene expression in the prefrontal cortex was determined by the real-time RT-PCR method. The mice with developmental arsenic exposure showed poor sociability and poor social novelty preference. Glutamate receptor expression (NMDA and AMPA receptor subunits) showed no significant difference, but gene expressions of serotonin receptor 5B (5-HT 5B) and brain-derived neurotrophic factor (BDNF) were significantly decreased (p < 0.05) in the arsenic-exposed group compared to control group. The heme oxygenase-1 (HO-1) and cyclooxygenase-2 (COX-2) gene expressions were not significantly different. Our findings indicate that developmental arsenic exposure might affect social behavior by modulating serotonin receptors and reducing BDNF. Some oxidative stress markers and inflammatory markers were not affected.
Postconvulsive central apnea as a biomarker for sudden unexpected death in epilepsy (SUDEP)

Objective To characterize peri-ictal apnea and postictal asystole in generalized convulsive seizures (GCS) of intractable epilepsy. Methods This was a prospective, multicenter epilepsy monitoring study of autonomic and breathing biomarkers of sudden unexpected death in epilepsy (SUDEP) in patients ≥18 years old with intractable epilepsy and monitored GCS. Video-EEG, thoracoabdominal excursions, nasal airflow, capillary oxygen saturation, and ECG were analyzed. Results We studied 148 GCS in 87 patients. Nineteen patients had generalized epilepsy; 65 had focal epilepsy; 1 had both; and the epileptogenic zone was unknown in 2. Ictal central apnea (ICA) preceded GCS in 49 of 121 (40.4%) seizures in 23 patients, all with focal epilepsy. Postconvulsive central apnea (PCCA) occurred in 31 of 140 (22.1%) seizures in 22 patients, with generalized, focal, or unknown epileptogenic zones. In 2 patients, PCCA occurred concurrently with asystole (near-SUDEP), with an incidence rate of 10.2 per 1,000 patient-years. One patient with PCCA died of probable SUDEP during follow-up, suggesting a SUDEP incidence rate 5.1 per 1,000 patient-years. No cases of laryngospasm were detected. Rhythmic muscle artifact synchronous with breathing was present in 75 of 147 seizures and related to stertorous breathing (odds ratio 3.856, 95% confidence interval 1.395–10.663, p = 0.009). Conclusions PCCA occurred in both focal and generalized epilepsies, suggesting a different pathophysiology from ICA, which occurred only in focal epilepsy. PCCA was seen in 2 near-SUDEP cases and 1 probable SUDEP case, suggesting that this phenomenon may serve as a clinical biomarker of SUDEP. Larger studies are needed to validate this observation. Rhythmic postictal muscle artifact is suggestive of post-GCS breathing effort rather than a specific biomarker of laryngospasm.
Automatic Pathological Lung Segmentation in Low-Dose CT Image Using Eigenspace Sparse Shape Composition

The segmentation of lungs with severe pathology is a nontrivial problem in the clinical application. Due to complex structures, pathological changes, individual differences, and low image quality, accurate lung segmentation in clinical 3-D computed tomography (CT) images is still a challenging task. To overcome these problems, a novel dictionary-based approach is introduced to automatically segment pathological lungs in 3-D low-dose CT images. Sparse shape composition is integrated with the eigenvector space shape prior model, called eigenspace sparse shape composition, to reduce local shape reconstruction error caused by the weak and misleading appearance prior information. To initialize the shape model, a landmark recognition method based on discriminative appearance dictionary is introduced to handle lesions and local details. Furthermore, a new vertex search strategy based on the gradient vector flow field is also proposed to drive the shape deformation to the target boundary. The proposed algorithm is tested on 78 3-D low-dose CT images with lung tumors. Compared to the state-of-the-art methods, the proposed approach can robustly and accurately detect pathological lung surface.
Multimodal Object Classification Models Inspired by Multisensory Integration in the Brain

Two multimodal classification models aimed at enhancing object classification through the integration of semantically congruent unimodal stimuli are introduced. The feature-integrating model, inspired by multisensory integration in the subcortical superior colliculus, combines unimodal features which are subsequently classified by a multimodal classifier. The decision-integrating model, inspired by integration in primary cortical areas, classifies unimodal stimuli independently using unimodal classifiers and classifies the combined decisions using a multimodal classifier. The multimodal classifier models are implemented using multilayer perceptrons and multivariate statistical classifiers. Experiments involving the classification of noisy and attenuated auditory and visual representations of ten digits are designed to demonstrate the properties of the multimodal classifiers and to compare the performances of multimodal and unimodal classifiers. The experimental results show that the multimodal classification systems exhibit an important aspect of the “inverse effectiveness principle” by yielding significantly higher classification accuracies when compared with those of the unimodal classifiers. Furthermore, the flexibility offered by the generalized models enables the simulations and evaluations of various combinations of multimodal stimuli and classifiers under varying uncertainty conditions.
Melanopsin for precise optogenetic activation of astrocyte‐neuron networks

Optogenetics has been widely expanded to enhance or suppress neuronal activity and it has been recently applied to glial cells. Here, we have used a new approach based on selective expression of melanopsin, a G‐protein‐coupled photopigment, in astrocytes to trigger Ca2+ signaling. Using the genetically encoded Ca2+ indicator GCaMP6f and two‐photon imaging, we show that melanopsin is both competent to stimulate robust IP3‐dependent Ca2+ signals in astrocyte fine processes, and to evoke an ATP/Adenosine‐dependent transient boost of hippocampal excitatory synaptic transmission. Additionally, under low‐frequency light stimulation conditions, melanopsin‐transfected astrocytes can trigger long‐term synaptic changes. In vivo, melanopsin‐astrocyte activation enhances episodic‐like memory, suggesting melanopsin as an optical tool that could recapitulate the wide range of regulatory actions of astrocytes on neuronal networks in behaving animals. These results describe a novel approach using melanopsin as a precise trigger for astrocytes that mimics their endogenous G‐protein signaling pathways, and present melanopsin as a valuable optical tool for neuron–glia studies.
Burkholderia cenocepacia utilizes a type VI secretion system for bacterial competition

Burkholderia cenocepacia is an opportunistic bacterial pathogen that poses a significant threat to individuals with cystic fibrosis by provoking a strong inflammatory response within the lung. It possesses a type VI secretion system (T6SS), a secretory apparatus that can perforate the cellular membrane of other bacterial species and/or eukaryotic targets, to deliver an arsenal of effector proteins. The B. cenocepacia T6SS (T6SS‐1) has been shown to be implicated in virulence in rats and contributes toward actin rearrangements and inflammasome activation in B. cenocepacia‐infected macrophages. Here, we present bioinformatics evidence to suggest that T6SS‐1 is the archetype T6SS in the Burkholderia genus. We show that B. cenocepacia T6SS‐1 is active under normal laboratory growth conditions and displays antibacterial activity against other Gram‐negative bacterial species. Moreover, B. cenocepacia T6SS‐1 is not required for virulence in three eukaryotic infection models. Bioinformatics analysis identified several candidate T6SS‐dependent effectors that may play a role in the antibacterial activity of B. cenocepacia T6SS‐1. We conclude that B. cenocepacia T6SS‐1 plays an important role in bacterial competition for this organism, and probably in all Burkholderia species that possess this system, thereby broadening the range of species that utilize the T6SS for this purpose.
Architecture to Embed Software Agents in Resource Constrained Internet of Things Devices

Sensing systems in combination with treatment tools and intelligent information management are the basis on which the cities and urban environments of the future will be built. Progress in the research and development of these new and intelligent scenarios is essential to achieve the objectives of efficiency, integration, sustainability, and quality of life for people who live in cities. To achieve these objectives, it is essential to investigate the development of cheaper, more accurate, and smarter hardware devices, which will form the basis of the intelligent environments of the future. This article focuses on an approach based on intelligent multi-agent systems that are integrated into basic hardware devices for the Internet of Things (IoT). A multi-agent architecture is proposed for the fast, efficient, and intelligent management of the generated data. A layer of services adapted to the needs of the new intelligent environments is built on this architecture. With the aim of validating this architecture, a case study based on electric vehicles of the e-bike type is proposed.