Miracle-dz/UniFAR-FTUs huggingface dataset:
Endoscopic submucosal dissection for early esophageal and gastric neoplasia in decompensated cirrhosis with varices

Endoscopic management of gastrointestinal (GI) neoplasia in cirrhosis is challenging. Such patients are often poor candidates for surgery, yet their untreated cancer may preclude them from undergoing liver transplantation. Endoscopic submucosal dissection (ESD) offers curative resection but can be difficult in the setting of portal hypertension. Variceal band ligation may cause scarring that complicates esophageal ESD [1]. Pre-ESD transjugular intrahepatic portosystemic shunting carries procedural and hepatic encephalopathy risks. There are increasing data on the safety of endoscopic resection in patients with cirrhosis [2]. Case 1: A 62-year-old man with decompensated cirrhosis underwent endoscopy demonstrating grade II varices and Barrett’s esophagus (C6M6), with a prominent 2-cm nodule (histology: adenocarcinoma) and multifocal nodularity (high grade dysplasia) with no other medical comorbidities (▶Fig. 1). A 7-cm circumferential ESD was performed. Large varices were encountered in the submucosa during dissection and were obliterated with electrocautery using Coagrasper forceps. Histology revealed intramucosal carcinoma. Case 2: An 80-year-old woman with decompensated cirrhosis underwent upper GI endoscopy with esophageal variceal banding. An irregular area was incidentally noted in the stomach, biopsies of which showed adenocarcinoma. The patient otherwise was in excellent overall health. ESD was performed on a 50-mm well demarcated lesion in the gastric body. Significant intraprocedural bleeding was encountered and was treated successfully with Coagrasper forceps, diluted epinephrine, and hemoclips. Histology revealed intramucosal adenocarcinoma (▶Video 1). There are limited reports on esophageal [3, 4] and gastric ESD [5] in patients with cirrhosis. We present the first case of circumferential esophageal ESD with direct variceal obliteration and the first reported Western case of gastric ESD in decompensated cirrhosis. Both patients underwent curative resections without adverse events, demonstrating the safety and effectiveness of ESD in patients with portal hypertension and varices. E-Videos
Influência do descarte involuntário de matrizes no impacto econômico da mastite em rebanhos leiteiros

Objetivou-se com esta pesquisa, analisar e quantificar a influencia do descarte involuntario de matrizes no impacto economico da mastite em rebanhos leiteiros. A pesquisa foi realizada por meio de simulacao no sistema computacional CU$TO MASTITE, considerando rebanhos leiteiros com taxas de descarte de 2, 4 e 6%. Foram considerados como prevencao as despesas com monitoramento (cultura e antibiograma, contagem de celulas somaticas no tanque e contagem de celulas somaticas individuais), pre e pos dipping, vacinacao, tratamento de vacas secas e manutencao de ordenhadeira. Como medidas curativas consideraram-se os tratamentos de casos clinicos, cuja percentagem foi de 7% das vacas em lactacao. O impacto da mastite foi estimado como sendo o total de perdas acrescido das despesas com prevencao e tratamento de casos clinicos. O aumento da taxa de descarte influenciou diretamente no impacto economico da mastite. O elevado impacto economico evidencia a necessidade de monitoramento da doenca, para diminuirem os prejuizos causados pela mesma. As despesas com tratamento preventivo representaram, no maximo, 9,2% do impacto economico, o que demonstra vantagem em investir nessa pratica, pois ela ira contribuir significativamente para diminuicao da contagem de celulas somaticas no tanque e, consequentemente, para reduzir o impacto economico da mastite.
Utility-Optimized Local Differential Privacy Mechanisms for Distribution Estimation

LDP (Local Differential Privacy) has been widely studied to estimate statistics of personal data (e.g., distribution underlying the data) while protecting users' privacy. Although LDP does not require a trusted third party, it regards all personal data equally sensitive, which causes excessive obfuscation hence the loss of utility. In this paper, we introduce the notion of ULDP (Utility-optimized LDP), which provides a privacy guarantee equivalent to LDP only for sensitive data. We first consider the setting where all users use the same obfuscation mechanism, and propose two mechanisms providing ULDP: utility-optimized randomized response and utility-optimized RAPPOR. We then consider the setting where the distinction between sensitive and non-sensitive data can be different from user to user. For this setting, we propose a personalized ULDP mechanism with semantic tags to estimate the distribution of personal data with high utility while keeping secret what is sensitive for each user. We show theoretically and experimentally that our mechanisms provide much higher utility than the existing LDP mechanisms when there are a lot of non-sensitive data. We also show that when most of the data are non-sensitive, our mechanisms even provide almost the same utility as non-private mechanisms in the low privacy regime.
Outcomes of civilian pediatric craniocerebral gunshot wounds: A systematic review

BACKGROUND Pediatric craniocerebral gunshot injuries (CGIs) occur both in the context of accidental and intentional trauma. The incidence and physiology of pediatric CGIs merit reexamination of prognostic factors and treatment priorities. This study characterizes the current understanding of mortality and prognostic factors in this patient population. METHODS A systematic search was conducted. Selection criteria included all studies published since 2000, which described civilian isolated CGIs in pediatric patients. Data were analyzed qualitatively and quantitatively to identify factors prognostic for the primary outcome of mortality. Secondary outcomes included functional outcome status, requirement for surgery, and injury complications. Study quality was assessed with the Newcastle-Ottawa Scale. This study was registered with PROSPERO (CRD42019134231). RESULTS Initial search revealed 349 unique studies. Forty underwent full text screening, and eight studies were included in the final synthesis. The overall mortality rate was 44.8%. Most CGIs occurred in older teenagers. Aggressive surgical treatment was recommended by one author, while remaining studies emphasized clinical judgment. Reported prognostic factors include initial Glasgow Coma Scale, pupil reactivity, involvement of multiple lobes or deep nuclei, and bihemispheric injuries. Reported complications from CGIs included seizure, meningitis, abscess, cerebrospinal fluid leak, bullet migration, focal neurological deficits, endocrine abnormalities, cognitive deficits, and neuropsychological deficits. The Glasgow Outcome Scale was the predominant measure of function and demonstrated a moderate recovery in 17.4% and a good recovery in 27.3% of patients. CONCLUSION This systematic review analyzed the existing evidence for prognostic factors in the context of pediatric CGIs. Significant long-term clinical improvement is possible with interventions including urgent surgical therapy. Fixed bilateral pupils and low initial Glasgow Coma Scale correlate with mortality but do not predict all patient outcomes. Patients younger than 15 years are underreported and may have differences in outcome. The literature on pediatric CGIs is limited and requires further characterization. LEVEL OF EVIDENCE Systematic Review, level IV.
A parasite‐driven wedge: infectious diseases may explain language and other biodiversity

Parasite–host coevolutionary races are spatially variable across species’ or human cultural ranges. Assortative sociality, biased toward local conspecifics, and limited dispersal (philopatry) in humans and other organisms can be adaptive through reduced contact with dangerous contagions harbored by distant/non-local conspecifics. These factors can generate cultural or population divergence. Thus, parasites are like a wedge driving groups apart through their effective creation of anticontagion behaviors. If this proposition is correct, then biological diversity should positively correlate with parasite diversity. Here we show that the worldwide distribution of indigenous human language diversity, a form of biodiversity, is strongly, positively related to human parasite diversity indicative of a legacy of parasite-mediated diversification. The significant pattern remains when potential confounds are removed. The pattern too is seen in each of the six world regions and is not confounded by regional differences in their history of colonization and conquest. We hypothesize that variation in limited dispersal and assortative sociality with conspecifics in response to the worldwide spatial variation in pathogen diversity provides a fundamental mechanism of population divergence explaining many important aspects of the geographic patterns of biodiversity. This hypothesis has broad implications for a diversity of research topics including language diversity, cultural evolution, speciation, phylogeny and biogeography.
Combination Preemptive Peripheral Nerve Block in Limb Surgery. A Prospective Study

Background and objectives: Patients often suffer from moderate to severe pain during the early recovery period in orthopedic surgery. We investigated the impact of a single-shot preoperative peripheral nerve block (PNB) on post-anesthesia recovery parameters and interleukin (IL)-6 level during limb surgery. Materials and Methods: A prospective randomized controlled study was conducted, and patients scheduled for limb surgery were recruited. Sixty patients were randomly assigned to either the PNB group or control group, who received morphine as a primary analgesic. The peak verbal numeric rating scale (NRS) score in the post-anesthesia care unit (PACU) was evaluated as a primary outcome. We also recorded rescue analgesics requirement and wake-up time from anesthesia in the PACU. In addition, the change of plasma IL-6 level after incision was measured. Results: Fifty-two patients completed the study, 27 and 25 cases in the PNB and control group, respectively. Preemptive PNB significantly reduced peak NRS score in the PACU compared to control group. Lower rescue analgesics requirement and rapid wake-up from anesthesia were also noted in PNB group. The IL-6 concentration increased less in the PNB group at 2 h after incision. Conclusions: Preemptive PNB attenuates IL-6 expression 2 h after incision and improves pain management in the PACU. PNB was considered as an essential part of pain management in limb surgery.
Sensorized Tip for Monitoring People with Multiple Sclerosis that Require Assistive Devices for Walking

Multiple Sclerosis (MS) is a neurological degenerative disease with high impact on our society. In order to mitigate its effects, proper rehabilitation therapy is mandatory, in which individualisation is a key factor. Technological solutions can provide the information required for this purpose, by monitoring patients and extracting relevant indicators. In this work, a novel Sensorized Tip is proposed for monitoring People with Multiple Sclerosis (PwMS) that require Assistive Devices for Walking (ADW) such as canes or crutches. The developed Sensorized Tip can be adapted to the personal ADW of each patient to reduce its impact, and provides sensor data while naturally walking in the everyday activities. This data that can be processed to obtain relevant indicators that helps assessing the status of the patient. Different from other approaches, a full validation of the proposed processing algorithms is carried out in this work, and a preliminary study-case is carried out with PwMS considering a set of indicators obtained from the Sensorized Tip’s processed data. Results of the preliminary study-case demonstrate the potential of the device to monitor and characterise patient status.
Unraveling the Links Underlying Arterial Stiffness, Bone Demineralization, and Muscle Loss

The effects of elevated arterial stiffness on cardiovascular outcomes are widely studied, whereas the relation to noncardiovascular outcomes relevant to older persons, such as the effect on bones and muscles, is less well established. Arterial stiffness, bone demineralization, and muscle loss are all age-related processes with common risk factors, however, whether these are just parallel age-related alterations or whether these processes share common pathways is not yet understood. In this review, we outline previous literature using different assessments of arterial stiffness in various populations across the world to produce a comprehensive overview. Although there are many studies showing an association between arterial stiffness and loss of bone and muscle, the majority are cross-sectional and there is limited longitudinal evidence to justify causal conclusions. We also give an in-depth review of hypotheses and possible mechanisms which may underlie these associations including hormone dysregulation, impaired glucose metabolism, and inflammation. This narrative review highlights the associations between vessels, bones, and muscles with aging, offering insights into possible shared pathways.
Effect of ascorbic acid supplementation level to diets of indigenous Venda hens on egg production, hatchability and subsequent productivity of chicks

An experiment was conducted to determine the effect of ascorbic acid supplementation level to the diets of indigenous Venda hens on egg production, hatchability and subsequent productivity of the chicks. The first part of the study determined the effect of ascorbic acid supplementation level to the diets of Venda hens on feed intake, egg production, egg weight, egg content, hatchability and chick hatch-weight. Seventy five Venda hens were randomly assigned to five dietary ascorbic acid treatment levels with three replications, each having five hens. A complete randomized design was used. The treatments were A 0 (0 ascorbic acid/kg DM feed), A 200 (200 mg ascorbic acid/kg DM feed), A 500 (500 mg ascorbic acid/kg DM feed), A 1000 (1000 mg ascorbic acid/kg DM feed), A 1500 (1500 mg ascorbic acid/kg DM feed). Ascorbic acid supplementation to the diets of indigenous Venda hens improved (P 0.05) on diet digestibility, metabolisable energy, nitrogen retention and mortality of their chickens. These results have implications on ration formulation for indigenous Venda hens. Keywords: Indigenous Venda chickens, ascorbic acid supplementation, optimum feed intake, feed conversion ratio, growth rate, live weight, mortalit
An in vitro assessment of atrial fibrillation flow types on cardiogenic emboli trajectory paths

Atrial fibrillation is the most significant contributor to thrombus formation within the heart and is responsible for 45% of all cardio embolic strokes, which account for approximately 15% of acute ischemic strokes cases worldwide. Atrial fibrillation can result in a reduction of normal cardiac output and cycle length of up to 30% and 40%, respectively. A total of 240 embolus analogues were released into a thin-walled, patient-specific aortic arch under normal (60 embolus analogues) and varying atrial fibrillation (180 embolus analogues) pulsatile flow conditions. Under healthy flow conditions (n = 60), the embolus analogues tended to follow the flow rate split through each outlet vessel. There was an increase in clot trajectories along the common carotid arteries under atrial fibrillation flow conditions. A shorter pulse period (0.3 s) displayed the highest percentage of clots travelling to the brain (24%), with a greater percentage of clots travelling through the left common carotid artery (17%). This study provides an experimental insight into the effect varying cardiac output and cycle length can have on the trajectory of a cardiac source blood clots travelling to the cerebral vasculature and possibly causing a stroke.
Feasibility Study of Drowsiness Detection Using Hybrid Brain-Computer Interface

In this study, we developed a hybrid brain--computer interface for drowsiness detection using electroencephalography (EEG) and electrooculography (EOG). Measurement was done with a single-channel EEG amplifier. A simple responsive task performed in a drowsy environment was used to experimentally demonstrate the advantages of the proposed system. Additionally, we performed the first investigation of hybrid EEG/EOG indices for drowsiness detection. Pearson's correlation analysis revealed that hybrid EEG/EOG indices were better correlated with the Karolinska Sleepiness Scale---the standard subjective measure---than were conventional EEG or EOG indices. Our investigation could contribute to both sleep research and the development of realtime drowsiness detection in the near future.
Spiritual Growth

“Have faith in God. I tell you the truth, if anyone says to this mountain, ‘Go, throw yourself into the sea’, and does not doubt in his heart but believes that what he says will happen, it will be done for him. Therefore I tell you, whatever you ask for in prayer, believe that you have received it and it will be yours. And when you stand praying, if you hold anything against anyone forgive him so that your Father in heaven may forgive you your sins. ”
Analysis of Economic Outcomes of Methicillin-Resistant Staphylococcus Aureus (MRSA) Bacteremia Using Retrospective Case-control Study

Eun Ja Park, Su Mi Chae, Nam Joong Kim, Jae Hoon Song, Jun Hee Woo, Hae Suk Cheong, and Eui Kyung Lee Pharmaceutical policy team, Korea Institute for Health and Social Affairs, Seoul, Korea Division of Infection, Seoul National University Hospital, Seoul, Korea Division of Infection, Samsung Medical Center, Seoul, Korea Division of Infection, Asan Medical Center, Seoul, Korea Graduate School of Clinical Pharmacy, Sookmyung Women’s University, Seoul, Korea
Presence of highly conserved idiotypic determinants in a family of antibodies that constitute an intrastrain cross-reactive idiotype

It has been shown that A/J anti-p-azophenylarsonate antibodies that share a major cross-reactive idiotype (CRI) comprise a family of closely related, but nonidentical, molecules. Our results demonstrate that 12 of 14 monoclonal hybridoma products that express the CRI have in common at least one highly conserved idiotypic determinant. It is proposed that this reflects conservation of a portion of the amino acid sequence, presumably in hypervariable regions. That the conserved determinant(s0 are located in the region of the hapten-binding site is indicated by the ability of haptens to inhibit idiotype-anti-idiotype interactions involving the conserved, or public determinants.
The N-Terminal Region of Soybean PM1 Protein Protects Liposomes during Freeze-Thaw

Late embryogenesis abundant (LEA) group 1 (LEA_1) proteins are intrinsically disordered proteins (IDPs) that play important roles in protecting plants from abiotic stress. Their protective function, at a molecular level, has not yet been fully elucidated, but several studies suggest their involvement in membrane stabilization under stress conditions. In this paper, the soybean LEA_1 protein PM1 and its truncated forms (PM1-N: N-terminal half; PM1-C: C-terminal half) were tested for the ability to protect liposomes against damage induced by freeze-thaw stress. Turbidity measurement and light microscopy showed that full-length PM1 and PM1-N, but not PM1-C, can prevent freeze-thaw-induced aggregation of POPC (1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine) liposomes and native thylakoid membranes, isolated from spinach leaves (Spinacia oleracea). Particle size distribution analysis by dynamic light scattering (DLS) further confirmed that PM1 and PM1-N can prevent liposome aggregation during freeze-thaw. Furthermore, PM1 or PM1-N could significantly inhibit membrane fusion of liposomes, but not reduce the leakage of their contents following freezing stress. The results of proteolytic digestion and circular dichroism experiments suggest that PM1 and PM1-N proteins bind mainly on the surface of the POPC liposome. We propose that, through its N-terminal region, PM1 functions as a membrane-stabilizing protein during abiotic stress, and might inhibit membrane fusion and aggregation of vesicles or other endomembrane structures within the plant cell.
Inhaled vitamin A is more effective than intramuscular dosing in mitigating hyperoxia-induced lung injury in a neonatal rat model of bronchopulmonary dysplasia.

Prevention of bronchopulmonary dysplasia (BPD) in premature-birth babies continues to be an unmet medical need. Intramuscular Vitamin A is currently employed in preterm neonates to prevent BPD but requires intramuscular (IM) injections in fragile neonates. We hypothesized that non-invasive inhaled delivery of vitamin A, targeted to lung, would be a more effective and tolerable strategy. We employed our well-established hyperoxia-injury neonatal rat model, exposing newborn rats to 7 days of constant extreme (95% O2) hyperoxia, comparing vitamin A dosed every 48 hours via either aerosol inhalation or IM injection, with normoxic untreated healthy animals and vehicle-inhalation hyperoxia groups as positive and negative controls, respectively. Separately, similar vitamin A dosing of normoxia-dwelling animals was performed. Analyses after day 7 included characterization of alveolar histomorphology, and protein biomarkers of alveolar maturation [surfactant protein C (SP-C), peroxisome proliferator-activated receptor (PPAR) g, cholinephosphate cytidylyl transferase, vascular endothelial growth factor and its receptor, FLK-1, and retinoid X receptors (RXR-α, -β, and -γ], apoptosis [Bcl2 and Bax] key injury repair pathway data including protein markers [ALK-5 and β-catenin] and neutrophil infiltration, and serum vitamin A levels. Compared with IM dosing, inhaled vitamin A significantly enhanced biomarkers of alveolar maturation, mitigated hyperoxia-induced lung damage, and enhanced surfactant protein levels, suggesting that it may be more efficacious in preventing BPD in extremely premature infants than the traditionally used IM dosing regimen. We speculate lung-targeted inhaled vitamin A may also be an effective therapy against other lung damaging conditions leading to BPD or, more generally, to acute lung injury.
HYDROLYSIS OF ISOFLAVONE GLYCOSIDES IN SOY MILK BY β-GALACTOSIDASE AND β-GLUCOSIDASE

The objective of this study was to assess the potential of pure β-galactosidase and β-glucosidase for hydrolyzing isoflavone glycosides to aglycones in soy milk. Both pure β-galactosidase and β-glucosidase were added at various concentrations (0.5, 1.0, 2.0 and 4.0 U/mL) to soy milk made from 4% soy protein isolate and incubated at 37C for up to 240 min. Isoflavones were quantified using high-performance liquid chromatography. The isoflavone contents of soy milk before and after autoclaving were also compared. β-Glucosidase and β-galactosidase were both able to hydrolyze the β-glucosidic linkages in isoflavone glycosides. A range of 43.3 to 77.2% of the total isoflavone glycosides was hydrolyzed at various β-galactosidase concentrations. The β-glucosidase hydrolyzed isoflavone glycosides more efficiently than β-galactosidase. At the most diluted β-glucosidase concentration (0.5 U/mL), 86.6% of isoflavone glycosides were hydrolyzed to aglycones at 240 min. PRACTICAL APPLICATIONS Isoflavone glycosides, which are mainly found in the bean family, are the inactive forms of isoflavones. However, aglycones, which are the nonsugar component of a glycoside molecule that results from hydrolysis of the isoflavone glycosides, are the biologically active forms. Because of their similarity to female hormone, they are considered a “natural way” to relieve the menopausal symptoms as they prevent certain cancers and improve bone health. Only a small amount of the total isoflavones, however, exists in the aglycone forms in nature. A novel method to produce aglycones from natural isoflavones is highly important. β-Glucosidase has been claimed to be the only enzyme which is able to hydrolyze isoflavone glycosides to aglycones. However, other enzymes could hydrolyze isoflavone glycosides more efficiently and could be easier to produce. This paper investigates the ability of β-galactosidase to biotransform isoflavone glycosides to aglycones, as the source of the enzyme is abundant.