Miracle-dz/UniFAR-FTUs huggingface dataset:
Tai Chi exercise and functional electrical stimulation of lower limb muscles for rehabilitation in older adults with chronic systolic heart failure: a non-randomized clinical trial

Exercise-based training decreases hospitalizations in heart failure patients but such patients have exercise intolerance. The objectives of the study were to evaluate the effect of 12 weeks of Tai Chi exercise and lower limb muscles' functional electrical stimulation in older chronic heart failure adults. A total of 1,084 older adults with chronic systolic heart failure were included in a non-randomized clinical trial (n=271 per group). The control group did not receive any kind of intervention, one group received functional electrical stimulation of lower limb muscles (FES group), another group practiced Tai Chi exercise (TCE group), and another received functional electrical stimulation of lower limb muscles and practiced Tai Chi exercise (FES & TCE group). Quality of life and cardiorespiratory functions of all patients were evaluated. Compared to the control group, only FES group had increased Kansas City Cardiomyopathy Questionnaire (KCCQ) score (P<0.0001, q=9.06), only the TCE group had decreased heart rate (P<0.0001, q=5.72), and decreased peak oxygen consumption was reported in the TCE group (P<0.0001, q=9.15) and FES & TCE group (P<0.0001, q=10.69). FES of lower limb muscles and Tai Chi exercise can recover the quality of life and cardiorespiratory functions of older chronic heart failure adults (trial registration: Research Registry 4474, January 1, 2015).
Association of pulse pressure with all-cause mortality in young adults

Background Pulse blood pressure was significantly associated with all-cause mortality in middle-aged and elderly populations, but less evidence was known in young adults. Objective To assess the association of pulse pressure (PP) with all-cause mortality in young adults. Methods This cohort from the 1999–2006 National Health and Nutrition Examination Survey included adults aged 18–40 years. All included participants were followed up until the date of death or 31 December 2015. PP was categorised into three groups: <50, 50~60, ≥60 mm Hg. Cox proportional hazards models and subgroup analysis were performed to estimate the adjusted HRs and 95% CIs for all-cause mortality. Results After applying the exclusion criteria, 8356 participants (median age 26.63±7.01 years, 4598 women (55.03%)) were included, of which 265 (3.17%) have died during a median follow-up duration of 152.96±30.45 months. When treating PP as a continuous variable, multivariate Cox analysis showed that PP was an independent risk factor for all-cause mortality (HR 1.94, 95% CI 1.02 to 3.69; p=0.0422). When using PP<50 mm Hg as referent, from the 50~60 mm Hg to the ≥60 mm Hg group, the risks of all-cause mortality for participants with PP ranging 50–60 mm Hg or ≥60 mm Hg were 0.93 (95% CI 0.42 to 2.04) and 1.15 (95% CI 0.32 to 4.07) (P for tend was 0.959). Subgroup analysis showed that PP (HR 2.00, 95% CI 1.05 to 3.82; p=0.0360) was associated with all-cause mortality among non-hypertensive participants. Conclusion Among young adults, higher PP was significantly associated with an increased risk of all-cause mortality, particularly among those without hypertension.
Cytokinin dehydrogenase: a genetic target for yield improvement in wheat

Summary The plant hormone group, the cytokinins, is implicated in both qualitative and quantitative components of yield. Cytokinins have opposing actions in shoot and root growth—actions shown to involve cytokinin dehydrogenase (CKX), the enzyme that inactivates cytokinin. We revise and provide unambiguous names for the CKX gene family members in wheat, based on the most recently released wheat genome database, IWGSC RefSeq v1.0 & v2.0. We review expression data of CKX gene family members in wheat, revealing tissue‐specific gene family member expression as well as sub‐genome‐specific expression. Manipulation of CKX in cereals shows clear impacts on yield, root growth and orientation, and Zn nutrition, but this also emphasizes the necessity to unlink promotive effects on grain yield from negative effects of cytokinin on root growth and uptake of mineral nutrients, particularly Zn and Fe. Wheat is the most widely grown cereal crop globally, yet is under‐research compared with rice and maize. We highlight gaps in our knowledge of the involvement of CKX for wheat. We also highlight the necessity for accurate analysis of endogenous cytokinins, acknowledging why this is challenging, and provide examples where inadequate analyses of endogenous cytokinins have led to unjustified conclusions. We acknowledge that the allohexaploid nature of bread wheat poses challenges in terms of uncovering useful mutations. However, we predict TILLING followed by whole‐exome sequencing will uncover informative mutations and we indicate the potential for stacking mutations within the three genomes to modify yield components. We model a wheat ideotype based on CKX manipulation.
Epstein-Barr virus (EBV) in periodontal sites of human immunodeficiency virus (HIV)-positive individuals in North Brazil: a cross-sectional study.

OBJECTIVE This study aimed to investigate the Epstein-Barr virus (EBV) prevalence and viral load in subgingival sites of human immunodeficiency virus type 1 (HIV-1) positive (HIV+) individuals, correlating subgingival EBV load to the clinical periodontal condition, HIV systemic load, EBV systemic load, and use of antiretroviral therapy (ART). METHOD AND MATERIALS Ninety individuals were recruited and divided into three categories: those without periodontal disease (G1), with gingivitis (G2), and with periodontitis (G3). Subgingival biofilm and blood samples were analyzed by quantitative polymerase chain reactions (qPCR). A questionnaire was administered to collect general information about patients, and data regarding HIV and use of ART were accessed from their medical records. RESULTS EBV was detected in 85.6% of the samples. Comparing subgingival and systemic load of EBV in G1, G2, and G3, there was a statistical difference only in G3 (3.93 log10 copies/mL and 5.47 log10 copies/mL, respectively; P = .014), where EBV load was higher in periodontal pockets than in the blood. All groups had high EBV loads in subgingival sites (> 2,000 copies/mL). A positive linear correlation between systemic HIV load and EBV subgingival load was found in G1 and G2 (r = 0.647; P < .001), but not in G3. Only G1 individuals using ART had lower subgingival EBV loads than those not using it (5.03 log10 copies/mL, and 7.14 log10 copies/mL, respectively; P = .0348). CONCLUSIONS Subgingival sites, especially the periodontal pockets, are suggested to act as a reservoir of EBV in HIV+ individuals. Therefore, the identification of latent EBV infections in this easily accessible site might help to improve quality of life in patients with HIV by maintaining oral/periodontal health. In addition it might encourage new approaches in investigating EBV-associated disorders in HIV+ patients.
An Fe stabilized metallic phase of NiS2 for the highly efficient oxygen evolution reaction.

This work reports a fundamental study on the relationship of the electronic structure, catalytic activity and surface reconstruction process of Fe doped NiS2 (FexNi1-xS2) for the oxygen evolution reaction (OER). A combined photoemission and X-ray absorption spectroscopic study reveals that Fe doping introduces more occupied Fe 3d6 states at the top of the valence band and thereby induces a metallic phase. Meanwhile, Fe doping also significantly increases the OER activity and results in much better stability with the optimum found for Fe0.1Ni0. 9S2. More importantly, we performed detailed characterization to track the evolution of the structure and composition of the catalysts after different cycles of OER testing. Our results further confirmed that the catalysts gradually transform into amorphous (oxy)hydroxides which are the actual active species for the OER. However, a fast phase transformation in NiS2 is accompanied by a decrease of OER activity, because of the formation of a thick insulating NiOOH layer limiting electron transfer. On the other hand, Fe doping retards the process of transformation, because of a shorter Fe-S bond length (2.259 Å) than Ni-S (2.400 Å), explaining the better electrochemical stability of Fe0.1Ni0. 9S2. These results suggest that the formation of a thin surface layer of NiFe (oxy)hydroxide as an active OER catalyst and the remaining Fe0.1Ni0. 9S2 as a conductive core for fast electron transfer is the base for the high OER activity of FexNi1-xS2. Our work provides important insight and design principle for metal chalcogenides as highly active OER catalysts.
Mental toughness in surgeons: Is there room for improvement?

Background Mental toughness is crucial to high-level performance in stressful situations. However, there is no formal evaluation or training in mental toughness in surgery. Our objective was to examine differences in mental toughness between staff and resident surgeons, and whether there is an interest in improving this attribute. Methods We distributed a survey containing the Mental Toughness Index (domains of self-belief, attention regulation, emotion regulation, success mindset, context knowledge, buoyancy, optimism and adversity capacity) among general surgery residents and staff at 3 Canadian academic institutions. Responses were recorded on a 7-point Likert scale. Participants were also asked about techniques they used to help them perform under pressure and interest in further developing mental toughness. Results Eighty-three of 193 surgeons participated: 56/105 (52.8%) residents and 27/87 (31.0%) staff. The average age was 29 (standard deviation 5) years and 42 (standard deviation 8) years, respectively. Residents scored significantly lower than staff in all mental toughness domains. Men scored significantly higher than women in attention regulation and emotion regulation. Age, staff experience and resident postgraduate year were not significantly associated with mental toughness scores. Twenty residents (36%) and 17 staff (63%) reported using specific techniques to deal with stressful situations; 49 (88%) and 15 (56%), respectively, were interested in further developing mental toughness. Conclusion Staff surgeons scored significantly higher than residents in all mental toughness domains measured. Both groups expressed a desire to improve mental toughness. There are many techniques to improve mental toughness, and further research is needed to assess their effectiveness in surgical training.
Snapping Hip Syndrome: Result of Partial Release and Anterior Transposition of Iliotibial Band

Objectives Snapping hip syndrome has been a known entity for long, but has only recently been studied in detail. It however remains poorly understood and infrequently diagnosed due to the paucity of the condition. As a result, the literature remains scarce and scattered about the management, with most series limited to less than 15 patients. We present our experience in operative and conservative management of this condition in a series of 20 patients. We describe an out patient operative approach involving release and anterior transposition of the posterior half of the iliotibial band. Methods Review of results in 20 patients [25 hips] treated operatively over last 12 years after failed conservative treatment. Results Dramatic reduction in average visual analog scale and clicking score from 6 and 9 to 0.7 and 0.6, respectively. Significant improvement in quality of life score from 5 to 9 postoperatively [out of a maximum of 10]. All the patients reported good to excellent relief in symptoms postoperatively and walking distance was no longer limited by hip pain or clicking. Five patients had bilateral surgery and the rest replied in affirmative when asked if they would prefer this procedure in future if the other hip became symptomatic. Conclusions We did not have any major complications after the procedure and had a high satisfaction rate of 95 percent. None of the patients have needed a repeat surgery yet. Most patients reported impressive relief in their snapping symptoms, but pain relief was variable. This approach has yielded satisfactory and reproducible results and we would recommend this approach in snapping hip refractory to conservative treatment.
Percutaneous coronary intervention assisted by invasive mechanical ventilation and intra-aortic balloon pump for acute myocardial infarction with cardiogenic shock: Retrospective cohort study and meta-analyses

There is little evidence to recommend the optimal invasive mechanical ventilation (IMV) modes and ideal positive end-expiratory pressure stress levels for acute myocardial infarction-cardiogenic shock (AMI-CS) patients. The aim of this study was to compare the mortality outcome in patients with AMI-CS who were treated with percutaneous coronary intervention (PCI) assisted by intra-aortic balloon pump (IABP) + IMV with historical controls. From January 1, 2016 to June 1, 2017, 60 patients were retrospectively enrolled at Tianjin Chest Hospital. Out of these, 88.3% of patients achieved thrombolysis in myocardial infarction (TIMI) flow 3 after PCI. The all-cause mortality rate in-hospital and at 1 year was 25% (95% CI: 0.14–0.36) and 33.9% (0.22–0.46), respectively. A systematic review followed by meta-analysis was performed with four historical studies of patients treated by PCI + IMV with partial IABP, which found an in-hospital mortality rate of 66.0% (95% CI: 0.62–0.71). Recently, a meta-analysis of patients receiving PCI + IABP with partial IMV showed that the 1 year mortality rate was 52.2% (95% CI: 0.47–0.58). In Cox regression analysis of patient data from the current study, lactic acid level ≥4.5 mmol/L, hyperuricemia, and TIMI flow <3 were independent predictors of death at 1 year. All-cause mortality, in-hospital and at 1 year, in patients with AMI-CS treated with PCI + IABP and IMV was lower than in those treated with PCI + partial IABP or IMV. Larger, longer-term direct comparisons are warranted.
Influence of age on the efficacy of immune checkpoint inhibitors in advanced cancers: a systematic review and meta-analysis

Abstract Background: Immune checkpoint inhibitors (ICIs) represent a paradigm shift in the development of cancer treatment. However, it remains to be clarified whether the benefits that they confer differ according to patient age. We conducted a systematic review and meta-analysis to assess age differences in the benefits of ICI treatment. Methods: We systematically searched the PubMed database for randomised controlled trials of ICIs, including PD-1, PD-L1 and CTLA-4 inhibitors across multiple cancer types, such as melanoma, lung cancer and gastric cancer. We extracted trials including hazard ratios (HRs) for death stratified by patient age (cut-off age, 65 years). The primary objective of this study was to assess the difference in ICI efficacy between younger and older patients. We calculated pooled HRs and 95% confidence intervals (CIs) for younger and older cancer patients, and assessed data heterogeneity. Results: We identified 3999 studies in our search. Of these, 24 eligible randomised trials, including a total of 8157 (57%) younger and 6104 (43%) older cancer patients, fulfilled the criteria for our study and were thus further analysed. The pooled HRs of the younger and older patients were 0.76 (95% CI: 0.69–0.84) and 0.80 (95% CI: 0.71–0.86), respectively; the difference in ICI efficacy between younger and older cancer patients was not significant (p = .82). Regarding the PD-1 and PD-L1 inhibitors, the survival benefit was similar in both age groups (HR: 0.74; p = .96), whereas for the CTLA-4 inhibitors, there tended to be less survival benefit for older versus younger patients (HR: 0.90 and 0.77, respectively; p = .26). Conclusions: The survival benefit conferred by ICI was not age-dependent, amongst patients aged 65 years or younger. However, age-dependent benefits may vary amongst different types of ICIs.
Prediction of acute kidney injury using artificial intelligence: are we there yet?

Management of acute kidney injury (AKI) is suboptimal and often opportunities for AKI prevention are missed [1]. AKI is frequently associated with other underlying conditions and will, in most cases, be handled by non-nephrologists in the hospital setting who are less experienced in diagnosing AKI. This has made the development of detection or prediction models of AKI a hot topic. Most of these models are restricted to estimating the risk for AKI at baseline, e.g. on admission or preoperatively, and/or in specific settings, e.g. cardiac surgery or sepsis, thus hampering their generalizability [2]. Recently a machine learning-based algorithm was shown to perform as well as physicians in predicting AKI stages 2–3 on the day of admission, albeit in the restricted setting of the intensive care unit (ICU), on the basis of which the algorithm was developed [3]. More advanced prediction models have shown increased clinical usefulness by allowing continuous, and nearly real-time, risk prediction, taking into account longitudinal patient data, and thereby the dynamic status of the patient, thus making implementation of an (automated) electronic alert system highly attractive [4]. In addition, many models predict only advanced stages of AKI or the need for renal replacement therapy, thus missing the opportunity to prevent or mitigate AKI.
Validación de dos modelos de predicción de mortalidad, PRISM y PIM2, en una Unidad de Cuidados Intensivos Pediátricos

Aclaración de intereses: Ninguno para declarar. RESUMEN Introducción. Pediatric Index of Mortality 2 (PIM2) y Pediatric Risk of Mortality (PRISM) son puntajes para predecir la probabilidad de mortalidad en unidades de cuidados intensivos pediátricos. El objetivo fue validar ambos modelos en la Unidad del Hospital Italiano de Buenos Aires. Población, material y métodos. En forma prospectiva se recogió la información para obtener los puntajes de predicción de mortalidad para cada uno de los pacientes ingresados consecutivamente a la unidad entre 1/1 y 31/12 de 2004. Se emplearon en el cálculo las ecuaciones originales de cada modelo. La calibración se evaluó con la prueba de Hosmer y Lemeshow (HL) y los Índices de Mortalidad Estandarizados [Standardized Mortality Ratio, (SMR)] para la población completa; la discriminación con el área bajo la curva ROC (Receiver Operating Characteristics). Resultados. Se incluyeron 765 pacientes. 53,6% fueron varones. La mediana de edad fue 4,1 años (1 mes-20 años). La mediana de la estadía en UCIP fue 2 días (1-154 días). Murieron en UCIP 22 pacientes (2,9%). La mortalidad estimada por PIM2 fue de 3,3%; SMR= 0,87 (IC 95% 0,54-1,21); HL x2= 15,16 (p= 0,01) y el área bajo la curva ROC fue de 0,92 (IC 95% 0,90-0,94). La mortalidad estimada por PRISM fue de 5,5%; SMR= 0,50 (IC 95% 0,280,73); HL x2= 22 (p= 0,0005) y el área bajo la curva ROC fue de 0,94 (IC 95% 0,92-0,96). Conclusiones. PIM2 tuvo una mejor adecuación que PRISM en la población heterogénea de nuestra UCIP. Aunque la discriminación de ambos modelos fue muy buena, PRISM sobrestimó claramente la mortalidad. Palabras clave: PIM2, PRISM, puntajes, mortalidad, cuidados intensivos pediátricos.
Oral narrative structure and coherence of children with attention deficit hyperactivity disorder.

PURPOSE This study aimed to characterize and compare the use of typical story grammar elements and global coherence level in the oral narrative of children with Attention Deficit Hyperactivity Disorder with the narrative of children without the disorder and with typical development. METHODS A total of 40 children of both sexes aged 5 to 10 years who attended elementary school participated in the study, 20 of whom were diagnosed with Attention Deficit Hyperactivity Disorder (ADHD Group), and 20 with typical development (TD Group). Participants from each group were similar in sex, chronological age, schooling and socioeconomic status. The wordless picture book Frog, Where Are You? was used to elicit the oral narrative analyzed for the presence of the main typical elements of the story schema (character, theme/topic, event/plot and outcome), and afterwards their narration was classified according to four different levels of organization corresponding to the global story coherence level. RESULTS The ADHD Group presented lower scores on the structural elements "theme/ topic" and "outcome" and a narrative with lower degree of coherence compared to the TD Group. CONCLUSION The children with ADHD included in this study presented difficulties to use typical story grammar elements, mainly related to the maintenance of the central theme and outcome of the story. These elements are considered fundamental for construction of narrative coherence, which justifies the lower levels of global coherence found in the oral narrative of the ADHD Group.
Comparing Morphology and Hemodynamics of Stable-versus-Growing and Grown Intracranial Aneurysms

BACKGROUND AND PURPOSE: Aneurysm growth has been related to higher rupture risk. A better understanding of the characteristics related to growth may assist in the treatment decisions of unruptured intracranial aneurysms. This study aimed to identify morphologic and hemodynamic characteristics associated with aneurysm growth and to determine whether these characteristics deviate further from those of stable aneurysms after growth. MATERIALS AND METHODS: We included 81 stable and 56 growing aneurysms. 3D vascular models were segmented on CTA, MRA, or 3D rotational angiographic images. With these models, we performed computational fluid dynamics simulations. Morphologic (size, size ratios, and shape) and hemodynamic (inflow, vorticity, shear stress, oscillatory shear index, flow instability) characteristics were automatically calculated. We compared the characteristics between aneurysms that were stable and those that had grown at baseline and final imaging. The significance level after Bonferroni correction was P < . 002. RESULTS: At baseline, no significant differences between aneurysms that were stable and those that had grown were detected (P > .002). Significant differences between aneurysms that were stable and those that had grown were seen at the final imaging for shear rate, aneurysm velocity, vorticity, and mean wall shear stress (P < .002). The latter was 11.5 (interquartile range, 5.4–18.8 dyne/cm2) compared with 17.5 (interquartile range, 11.2–29.9 dyne/cm2) in stable aneurysms (P = .001). Additionally, a trend toward lower area weighted average Gaussian curvature in aneurysms that had grown was observed with a median of 6.0 (interquartile range, 3.2–10.7 cm−2) compared with 10.4 (interquartile range, 5.0–21.2 cm−2) in stable aneurysms (P = .004). CONCLUSIONS: Morphologic and hemodynamic characteristics at baseline were not associated with aneurysm growth in our population. After growth, almost all indices increase toward values associated with higher rupture risks. Therefore, we stress the importance of longitudinal imaging and repeat risk assessment in unruptured aneurysms.