Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Features and Complications of Coxiella burnetii Infections From the French National Reference Center for Q Fever

Key Points Question What are the characteristics and clinical presentations of Coxiella burnetii infection using 21st-century–clarified definitions? Finding In a cohort study of 2434 patients with Q fever, the following new critical Q fever foci were identified: acute endocarditis, lymphadenitis, and bone marrow involvement in hemophagocytic syndrome. Lymphadenitis is a risk factor for lymphoma, and the elevation of IgG anticardiolipin antibody titers in acute Q fever is associated with complications. Meaning Screening for anticardiolipin antibodies may help prevent acute Q fever complications; the use of transthoracic echocardiography in acute Q fever and positron emission tomographic scanning in suspected persistent focalized infection is justified to improve the care of patients with Q fever.
Surface Roughness of Glass Ionomer Cements after Application of Different Polishing Techniques

Glass Ionomer Cements (GIC) have been widely used in clinical practice since they have a wide range of positive characteristics: chemical bonding to the tooth surface, fluoride release, a heat-expansion coefficient similar to the tooth, do not require an absolutely dry working area, less volumetric contraction, good color stability. Physical properties can be improved by using external energy such as ultrasound and radiant heat (thermo-curing), which also accelerates chemical curing. Objectives: The aim of this study was to determine the most effective polishing technique and to compare the surface roughness of two Glass Ionomer Cements after treatment with heat (thermo-curing), and without heat treatment during the setting process. Materials and methods: Two polishing systems (Tungsten carbide burs and Sof-Lex discs) were used on two types of GIC (Equia Fil and Ketac Molar Universal). Bluephase 16i LED (Vivadent, Schaan Liechtenstein) light was used for the specimens treated with heat (thermo-curing). Samples without heat treatment are left for 10 minutes to chemically cure. Surface profilometar was used for measuring the mean surface roughness value (Ra). Results: Group with Mylar strip (control group) of each material showed the lowest (Ra) value. The Equia Fil material samples treated with heat (thermo-curing) achieved lower surface roughness values (Ra), and showed lower surface roughness values (Ra) after polishing with a Sof-Lex discs (p<0.05). The results for Ketac Molar Universal samples showed no statistically significant difference (p>0.05) between polishing with Sof-Lex discs and Tungsten carbide burs. Conclusion: Based on the obtained results, it can be concluded that the smoothest surface roughness is achieved by the Mylar strip. Some types of Glass Ionomer Cements can obtain better surface polishing with heat treatment (thermo-curing).
Modulation of the Gut Microbiota in Rats by Hugan Qingzhi Tablets during the Treatment of High-Fat-Diet-Induced Nonalcoholic Fatty Liver Disease

Background Accumulative evidence showed that gut microbiota was important in regulating the development of nonalcoholic fatty liver disease (NAFLD). Hugan Qingzhi tablet (HQT), a lipid-lowering and anti-inflammatory medicinal formula, has been used to prevent and treat NAFLD. However, its mechanism of action is unknown. The aim of this study was to confirm whether HQT reversed the gut microbiota dysbiosis in NAFLD rats. Methods We established an NAFLD model of rats fed with a high-fat diet (HFD), which was given different interventions, and measured the level of liver biochemical indices and inflammatory factors. Liver tissues were stained with hematoxylin-eosin and oil red O. Changes in the gut microbiota composition were analyzed using 16S rRNA sequencing. Results The hepatic histology and biochemical data displayed that HQT exhibited protective effects on HFD-induced rats. Moreover, HQT also reduced the abundance of the Firmicutes/Bacteroidetes ratio in HFD-fed rats and modified the gut microbial species at the genus level, increasing the abundances of gut microbiota which were reported to have an effect on relieving NAFLD, such as Ruminococcaceae, Bacteroidales_S24-7_group, Bifidobacteria, Alistipes, and Anaeroplasma, and significantly inhibiting the relative abundance of Enterobacteriaceae, Streptococcus, Holdemanella, Allobaculum, and Blautia, which were reported to be potentially related to NAFLD. Spearman's correlation analysis found that [Ruminococcus]_gauvreauii_group, Lachnoclostridium, Blautia, Allobaculum, and Holdemanella exhibited significant (p < 0.001) positive correlations with triglyceride, cholesterol, low-density lipoprotein cholesterol, interleukin-6, interleukin-1β, tumor necrosis factor-α, and body weight and negative correlations with high-density lipoprotein cholesterol (p < 0.001). The norank_f__Bacteroidales_S24-7_group and Alistipes showed an opposite trend. Moreover, the HQT could promote flavonoid biosynthesis compared with the HFD group. Conclusion In summary, the HQT has potential applications in the prevention and treatment of NAFLD, which may be closely related to its modulatory effect on the gut microbiota.
Trends in Socioeconomic Inequalities and Prevalence of Anemia Among Children and Nonpregnant Women in Low- and Middle-Income Countries

Key Points Question How did anemia inequalities change over time in low- and middle-income countries? Findings In this cross-sectional study of 163 419 children aged 6 to 59 months and 304 202 nonpregnant girls and women aged 15 to 49 years, the socioeconomic inequalities of anemia did not decrease among children in approximately 80% of low- and middle-income countries. For nonpregnant women, that figure was approximately 60% of low- and middle-income countries. Meaning To reduce the anemia inequalities found in most low- and middle-income countries, future efforts should attend to policies designed to reach vulnerable groups, specifically those with lower socioeconomic status.
LincRNA-p21 Inhibits Cell Viability and Promotes Cell Apoptosis in Parkinson's Disease through Activating α-Synuclein Expression

Long intergenic noncoding RNA-p21 (lincRNA-p21) has been reported to be increased in Parkinson's disease (PD). However, the function and underlying mechanisms of lincRNA-p21 remain not clear. In order to explore the role of lincRNA-p21 in PD, we used 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to induce in vivo PD model (C57BL/6 mice) and utilized N-methyl-4-phenylpyridinium (MPP+) to create in vitro PD model (SH-SY5Y cells). Results showed that the expression level of lincRNA-p21 was increased significantly in PD models. High abundance of lincRNA-p21 inhibited viability and promoted apoptosis markedly in SH-SY5Y cells treated with MPP+. Mechanistically, further experiments demonstrated that upregulation of lincRNA-p21 could sponge miR-1277-5p and indirectly increase the expression of α-synuclein to suppress viability and activate apoptosis in SH-SY5Y cells. In short, our study illustrated that lincRNA-p21/miR-1277-5p axis regulated viability and apoptosis in SH-SY5Y cells treated with MPP+ via targeting α-synuclein. LincRNA-p21 might be a novel target for PD.
Validation of Prediction Models for Critical Care Outcomes Using Natural Language Processing of Electronic Health Record Data

Key Points Question Can a prediction model for mortality in the intensive care unit be improved by using more laboratory values, vital signs, and clinical text in electronic health records? Findings In this cohort study of 101 196 patients in the intensive care unit, a machine learning–based model using all available measurements of vital signs and laboratory values, plus clinical text, exhibited good calibration and discrimination in predicting in-hospital mortality, yielding an area under the receiver operating characteristic curve of 0.922. Meaning Applying methods from machine learning and natural language processing to information already routinely collected in electronic health records, including laboratory test results, vital signs, and clinical free-text notes, significantly improves a prediction model for mortality in the intensive care unit compared with approaches that use only the most abnormal vital sign and laboratory values.
Skin physiology and safety of microfocused ultrasound with visualization for improving skin laxity

Purpose The efficacy of microfocused ultrasound with visualization (MFU-V; Ultherapy®) has been demonstrated in clinical studies and daily practice. However, data addressing skin physiology after MFU-V treatment are lacking. This observational evaluation was aimed to assess skin physiology before and after MFU-V treatment using noninvasive biophysical measurements. Patients and methods Twenty-two female patients with moderate-to-severe skin sagging at the jawline and submental region on the Merz Aesthetics Scale obtained a single MFU-V treatment according to protocol. Skin function measurements focused on short-term effects up to 3 days and long-term effects up to 24 weeks after treatment. Skin temperature, transepidermal water loss, skin hydration, erythema, elasticity, and skin thickness and density were evaluated under standardized conditions. Pain was assessed using a validated numeric visual analog scale. Results Skin temperature remained in a physiologic range and no significant increase was noted at day 3 after MFU-V treatment. Transepidermal water loss, hydration, and erythema values were fairly stable and showed no significant differences at short- and long-term measurements vs baseline. At week 4 after a single MFU-V treatment, gross and net elasticity values were significantly decreased (P=0.003 and P=0.0001, respectively), followed by significantly increased values at week 12 (P=0.015, P=0.046) and week 24 (P=0.001, P=0.049). Edema due to MFU-V treatment resolved without sequelae. For all patients, pain diminished shortly after treatment. No adverse events occurred during the 24-week follow-up period. Conclusions MFU-V treatment is well tolerated and it does not alter the epidermal barrier function or physiology of skin. Significant increase in the elasticity of skin was observed at 12 and 24 weeks after a single treatment, which reflects improvement in dermal tissue function. These short- and long-term effects are congruous with the mode of action of MFU-V due to a proven intrinsic tissue remodeling process.
Vocal combinations in guenon communication

Il est classiquement admis que les etudes comparatives sur la communication des animaux peuvent permettre de mieux comprendre la coevolution de la vie sociale, de la communication vocale et des capacites cognitives, notamment l’emergence de certaines proprietes du langage humain. De recentes etudes ont suggere la presence de capacites combinatoires chez les primates non humains, capacites qui permettraient a ces animaux de diversifier leurs repertoires ou d’enrichir les messages transmis par leurs vocalisations en depit de capacites articulatoires limitees. Toutefois, les fonctions des cris combines et les informations qui en sont extraites par les receveurs restent meconnues. Cette these porte sur les capacites de combinaison vocale de cercopitheques forestiers sauvages : la mone de Campbell (Cercopithecus Campbelli) et le singe Diane (Cercopithecus Diana). Premierement, a l’aide d’experiences de repasse acoustiques, j’ai etudie la nature combinatoire de cris combines et les informations qui en sont extraites par les receveurs chez ces deux especes. Les resultats ont confirme chez les mâles mone de Campbell la presence d’un mecanisme de suffixation diminuant l’urgence du danger signale par un cri d’alarme ainsi que, chez les femelles singe Diane, la presence de cris complexes combinant lineairement les messages des deux unites qui les composent, signalant respectivement l’emotion et l’identite de l’emetteur. Deuxiemement, une etude observationnelle du contexte d’emission de cris simples et combines par des femelles mones de Campbell sauvages a revele une utilisation flexible de la combinaison en fonction du besoin immediat de rester discret (i.e. cris simples) ou de signaler son identite (i.e. cris combines). Finalement, j’ai compare les systemes de communication des femelles de ces deux especes pour identifier leurs points communs et leurs differences. Leurs repertoires sont bases principalement sur des structures acoustiques homologues, comme predit par leur proximite phylogenetique. Cependant, les femelles de ces deux especes different fortement dans leur utilisation de ces structures. Par exemple, le grand nombre de cris combines chez les singes Diane semble permettre un accroissement considerable de leur repertoire vocal par rapport aux mones de Campbell. Etant donne l’organisation non-aleatoire de ces combinaisons vocales qui font sens pour les receveurs et de leur utilisation flexible en fonction du contexte, je propose un parallele avec une forme simple de morphosyntaxe semantique et discute aussi plus generalement de la possibilite de trouver des capacites similaires chez d’autres especes animales.
Variation in and Hospital Characteristics Associated With the Value of Care for Medicare Beneficiaries With Acute Myocardial Infarction, Heart Failure, and Pneumonia

Key Points Questions What is the variation in the value of care for acute myocardial infarction, heart failure, and pneumonia, and what hospital characteristics are associated with high-value care? Findings Among hospitals and patients in this cross-sectional study, there was substantial variation in 30-day risk-standardized mortality and risk-standardized payments, with significant but weak inverse correlations between them. Approximately 1 in 4 hospitals, including facilities across all characteristics, had both lower than median risk-standardized mortality rates and risk-standardized payments for acute myocardial infarction, heart failure, and pneumonia. Meaning There appears to be significant opportunity to improve the value of acute myocardial infarction, heart failure, and pneumonia care, and high-value care appears attainable across hospital types.
Association Between 5-Year Clinical Outcome in Patients With Nonmedically Evacuated Mild Blast Traumatic Brain Injury and Clinical Measures Collected Within 7 Days Postinjury in Combat

Key Points Question What clinical measures collected acutely in combat are associated with 5-year outcome in patients with concussive blast injury? Findings In this longitudinal cohort study, nonmedically evacuated blast concussion patients had significant and sustained symptoms of neurobehavioral impairment, mental health and global disability, whereas cognitive changes were unremarkable compared with combat-deployed nonconcussed controls. Assessments collected in theater were associated with multiple domains of outcome. Meaning Nonmedically evacuated patients with concussive blast injury, considered the mildest of the mild combat casualties fared poorly 5 years later compared with combat-deployed controls.
Cost-effectiveness of a Brief Structured Intervention Program Aimed at Preventing Repeat Suicide Attempts Among Those Who Previously Attempted Suicide

Key Points Question Is the Attempted Suicide Short Intervention Program, a brief novel therapy for individuals who attempt suicide, cost-effective compared with a suicide risk assessment? Findings In this economic evaluation conducted alongside a randomized clinical trial that included 120 Swiss adults, the intervention group had significantly lower levels of suicide reattempts compared with the control group at lower health care costs, with a 96% chance of being less costly and more effective in a sensitivity analysis. Meaning In the context of the Swiss health care system, the Attempted Suicide Short Intervention Program was found to be cost saving as a follow-up treatment for attempted suicide.
Acute Effects of Smoked and Vaporized Cannabis in Healthy Adults Who Infrequently Use Cannabis

Key Points Question How does smoked and vaporized cannabis acutely influence subjective drug effects, cognitive and psychomotor performance, and cardiovascular measures in healthy adults who infrequently use cannabis (>30 days since last use)? Findings In a crossover trial of 17 healthy adults, inhalation of smoked and vaporized cannabis containing 10 mg of Δ9-tetrahydrocannabinol (THC) produced discriminative drug effects and modest impairment of cognitive functioning, while inhalation of a 25-mg dose of THC was associated with pronounced drug effects, increased incidence of adverse effects, and significant impairment of cognitive and psychomotor ability. Vaporized cannabis produced greater pharmacodynamic effects and higher concentrations of THC in blood compared with equal doses of smoked cannabis. Meaning Significant, sometimes adverse, drug effects can occur at relatively low THC doses in infrequent cannabis users, and accordingly these data should be considered with regard to regulation of retail cannabis products and education for individuals initiating cannabis use.
Fertility Limiting Intention and Contraceptive Use among Currently Married Men in Nepal: Evidence from Nepal Demographic and Health Survey 2016

Introduction Less is known about fertility intention of men and family planning (FP) use pattern among men or their spouses who do not want to have more children in Nepal. The objective of the current research was to assess whether number and sex composition of living children determine contraceptive use and method mix among Nepalese men who expressed not wanting to have more children. Methods We used couple dataset from NDHS 2016 for the analysis. The sample consisted of 1551 (weighted) men aged 20 or older who had at least one living child and said they wanted no more children. Multinomial logistic regression analysis was conducted to identify determinants of sterilization, traditional, temporary contraceptive use. Analysis was conducted considering clustering and stratification in NDHS 2016 survey. Results Of the total respondents, more than 80% mentioned they do not want to have any more children. However, only one-third of the men or their spouses who expressed desire not to have children were using sterilization methods at the time of survey. Contraceptive use showed a strong association with number and sex composition of children with men favouring to have at least 1 or 2 sons. Multinomial logistic regression analysis showed that use of sterilization method (especially female sterilization) was strongly associated with having at least 1 or 2 sons. Men with daughters only and one son with daughters were more likely to use temporary methods. Conclusion Among men who do not want to have more children, FP use was associated with number and sex composition of living children. Use of sterilization methods was associated with having at least 1 or 2 sons. Nepal's family planning program can be further strengthened by joining hands with initiatives aimed at promoting the value of girl child.
Growth orientation mechanism of TiO2 nanotubes fabricated by anodization

TiO2 nanotubes (TNTs) fabricated by anodization have been extensively researched in recent years. However, the mechanism that controls the growth orientation of anodic TNTs is still not clear. Here, we firstly examine their growth orientation systematically. Combined with the previous literature, the results of anodization on rotated Ti foil and thin Ti wire confirm that almost all of the TNTs grow vertically to the local Ti substrate surface. Their growth orientation predominantly depends on the local electric field around the bottom of the nanotube. The distribution of the local electric field is regulated by the shape of the initial nano-scale local Ti substrate surface (INLTSS). Most of the INLTSS is nearly flat, which leaves vertical, circular, and straight TNTs. In terms of the evolution of TNTs fabricated on a micron-scale convex surface, the vertical growth of TNTs leads to a continuous decrease in the oxide/substrate (O/S) interface area, and a few TNTs are periodically crushed and detached from the O/S interface. For a micron-scale concave surface, due to the ever-increasing O/S interface area, Y-branched TNTs occurred periodically as a response to avoid a vacancy on the oxide/substrate interface.
Healthcare-service utilization and direct costs throughout ten years following acute myocardial infarction: Soroka Acute Myocardial Infarction II (SAMI II) project

Abstract Objective: Acute myocardial infarction (AMI) is associated with significant risk for long-term morbidity and healthcare expenditure. We investigated healthcare utilization and direct costs throughout 10 years following AMI. Methods: A retrospective study included AMI patients hospitalized in a tertiary medical center throughout 2002–2012. Data was obtained from computerized medical records. Hospitalizations, emergency department (ED), primary care and outpatient consulting clinic visits and other ambulatory services, following the AMI and their costs, were compared with the year preceding the AMI. Results: Overall 9548 patients were analyzed (age 66.6 ± 13.9 years, 67.8% men, 48.1% ST-elevation AMI). A significant increase in the utilization of all the evaluated services was observed in the first year following the AMI compared with the preceding year (p < .001 for each) and followed by a decline thereafter (p-for trend < .001 for each) except increased number of ED visits (p-for trend = .014). Annual per-patient costs throughout the first year following AMI (5592€) were significantly greater compared with the preceding year (3120€) and declined subsequently to 3216€ and 2760€ for years 2–5 and 6–10, respectively. Multivariate analysis showed that throughout the first half of the follow-up total costs were slightly higher and in the second half similar to the year preceding the AMI. Analysis of the relative costs showed that ambulatory services make up most of the expenditure. Conclusions: Healthcare utilization and economic expenditure peak throughout the first year and decline afterwards. For several services it remains higher for up to 10 years compared with the year preceding the AMI.
Dabigatran as an alternative for atrial thrombosis resistant to rivaroxaban

Rationale: Anti-thrombosis therapy for atrial fibrillation (AF) management and stroke prevention is an important aspect of disease management. Novel oral anticoagulants (NOACs) are recommended by guidelines for AF management. However, if one can switch one NOAC to another when the former showed a poor effect has not been fully determined. Patient concerns: A 52-year-old man was admitted to our center for heart failure and AF with a thrombus in the left atrium. Diagnoses: Cardiomyopathy was diagnosed by cardiac magnetic resonance (CMR) and echocardiography. Interventions: He was prescribed rivaroxaban (20 mg daily) as treatment, and dabigatran (150 mg twice daily) was used when the thrombus was found to be non-response to rivaroxaban. Outcomes: The rivaroxaban did not diminish the atrial thrombus, and dabigatran was given instead which finally eliminated the thrombus. Lessons: Individualized responsiveness to NOACs should be considered and paid more attention to during clinical practice.