Miracle-dz/UniFAR-FTUs huggingface dataset:
The role of brachytherapy in the management of brain metastases: a systematic review

Purpose Brain metastases have a highly variable prognosis depending on the primary tumor and associated prognostic factors. Standard of care for patients with these tumors includes craniotomy, stereotactic radiosurgery (SRS), or whole brain radiotherapy (WBRT) for patients with brain metastases. Brachytherapy shows great promise as a therapy for brain metastases, but its role has not been sufficiently explored in the current literature. Material and methods The PubMed, Cochrane, and Scopus databases were searched using a combination of search terms and synonyms for brachytherapy, brain neoplasms, and brain metastases, for articles published between January 1st, 1990 and January 1st, 2018. Of the 596 articles initially identified, 37 met the inclusion criteria, of which 14 were review articles, while the remaining 23 papers with detailing individual studies were fully analyzed. Results Most data focused on 125I and suggested that it offers rates of local control and overall survival comparable to standard of care modalities such as SRS. However, radiation necrosis and regional recurrence were often high with this isotope. Studies using photon radiosurgery modality of brachytherapy have also been completed, resulting superior regional control as compared to SRS, but worse local control and higher rates of radiation necrosis than 125I. More recently, studies using the 131Cs for brachytherapy offered similar local control and survival benefits to 125I, with low rates of radiation necrosis. Conclusions For a variety of reasons including absence of physician expertise in brachytherapy, lack of published data on treatment outcomes, and rates of radiation necrosis, brachytherapy is not presently a part of standard paradigm for brain metastases. However, our review indicates brachytherapy as a modality that offers excellent local control and quality of life, and suggested that its use should be further studied.
Validation of the Arabic Version of the Epworth Sleepiness Scale among the Yemeni Medical Students

The study was conducted with the aim to assess the psychometric measures of an adapted Arabic version of the Epworth Sleepiness Scale (ESS) among medical students at Sana'a University, Yemen. The cross-sectional study targeted 360 students (males: 176; females: 184) from the preclinical 3rd year (N: 197) and the final clinical year (N: 163). Participants self-filled an Arabic and slightly modified version of the 8-item Epworth Sleepiness Scale. Exploratory Principal Component Analysis (PCA) and Confirmatory Factor Analyses (CFA) were conducted on two equal subsets of the sample (N: 180 each). The PCA yielded a two-dimension model subsequently confirmed by factor analysis. The first dimension was grouped on three items while the second dimension had five items reflecting the respondents' propensity to sleep during “interactive situations” and “sitting and lying,” respectively. The model had an acceptable goodness of fit measures for the overall ESS (CMINDF = 2.362, CFI = 0.91, IFI = 0.92) and acceptable reliability indicators (factor 1 α = 0.65, factor 2 α = 0.62). However, due to weak variance explanation (0.07) of item 6 (sitting and talking) in factor 1, analysis was repeated excluding this item. The 7-item model was also two-dimensional, valid, and reliable. The reliability indicators were acceptable with α = 0.65 for factor 1 (4 items of interactive situations) and 0.62 for factor 2 (3 items of sitting) and overall α = 0.68. Overall, the ESS is a useful tool. Factor analysis produced a two-factor model of 7 items with good validity and reasonable reliability that can be used in diagnosing daytime sleepiness among young Yemeni adults.
Cost-effectiveness of 2-dose human papillomavirus vaccination for 12-year-old girls in Zhejiang Province: implications for China’s expanded program on immunization

ABSTRACT Background The high cost and insufficient supply of HPV vaccines have substantially slowed their implementation in lower-income countries. This study aimed to assess the incremental cost-effectiveness of two doses of human papillomavirus (HPV) vaccination (bivalent 16/18 vaccine; 2vHPV) compared to a no-vaccination scenario and a three-dose scenario in one province in China. Methods A static Markov model was used to model a lifetime cohort of 100,000 girls aged 12 years at the start of vaccination. A two-dose vaccination schedule was assumed to be non-inferior to a three-dose schedule in terms of vaccine efficacy, and both vaccination schemes were assumed to provide lifelong protection. Incremental costs, health effects and incremental cost-effectiveness ratios were used to measure the outcomes when comparing the different strategies. Results Compared to no vaccination, the incremental cost-effectiveness ratio (Chinese yuan per quality-adjusted life year) of the two-dose vaccination strategy is 12,472, and the 2-dose strategy is calculated to be cost saving relative to the 3-dose vaccination strategy. Conclusions Introducing the 2vHPV vaccine would be highly cost effective at a per-dose vaccine price of CNY 500, which has implications for cervical cancer control in China and other resource-limited countries.
Maternal exercise and its beneficial effects on glucose metabolism in offspring

Abstract It shows that detrimental exposures and conditions in mothers can lead to the development of obesity and type 2 diabetes in offspring. This can lead to a vicious cycle of metabolic dysfunction, where rising rates of obesity, pre-diabetes, and diabetes in individuals of reproductive age, propagating risks to subsequent generations. It is well established that regular exercise has important health benefits for people with obesity and type 2 diabetes. Recently, increasing studies aim to examine the effects of maternal exercise on metabolic health in offspring. This review aims to demonstrate the evidence linking maternal exercise during critical periods of development and its implications for glucose metabolism in offspring, including intervention timing, sexual dimorphism, different exercise type, and intensity. Then we further examine the potential role of epigenetic modifications in this process.
Repair mechanism of astrocytes and non-astrocytes in spinal cord injury.

BACKGROUND Spinal cord injury (SCI) is a destructive disease that incurs huge personal and social costs, and there is no effective treatment. Although the pathogenesis and treatment mechanism of SCI has always been a strong scientific focus, the pathogenesis of SCI is still under investigation. AIM To determine the key genes based on the modularization of in-depth analysis, in order to identify the repair mechanism of astrocytes and non-astrocytes in SCI. METHODS Firstly, the differences between injured and non-injured spinal cord of astrocyte (HA), injured and non-injured spinal cord of non-astrocyte (FLOW), injured spinal cord of non-injured astrocyte (HA) and non-injured spinal cord of non-astrocyte (FLOW), and non-injured spinal cord of astrocyte (HA) and non-astrocyte (FLOW) were analyzed. The total number of differentially expressed genes was obtained by merging the four groups of differential results. Secondly, the genes were co-expressed and clustered. Then, the enrichment of GO function and KEGG pathway of module genes was analyzed. Finally, non-coding RNA, transcription factors and drugs that regulate module genes were predicted using hypergeometric tests. RESULTS In summary, we obtained 19 expression modules involving 5216 differentially expressed genes. Among them, miR-494, XIST and other genes were differentially expressed in SCI patients, and played an active regulatory role in dysfunction module, and these genes were recognized as the driving genes of SCI. Enrichment results showed that module genes were significantly involved in the biological processes of inflammation, oxidation and apoptosis. Signal pathways such as NF-kappa B/A20, AMPK and MAPK were significantly regulated. In addition, non-coding RNA pivot (including miR-136-5p and let-7d-5p, etc.) and transcription factor pivot (including NFKB1, MYC, etc.) were identified as significant regulatory dysfunction modules. CONCLUSION Overall, this study uncovered a co-expression network of key genes involved in astrocyte and non-astrocyte regulation in SCI. These findings helped to reveal the core dysfunction modules, potential regulatory factors and driving genes of the disease, and to improve our understanding of its pathogenesis.
Temporary Abdominal Closure Is Associated with Increased Risk for Fungal Intra-Abdominal Infections in Trauma Patients.

Background: Fungal infections are associated with increased morbidity and death. Few studies have examined risk factors associated with post-operative fungal intra-abdominal infections (FIAIs) in trauma patients after exploratory laparotomy. In this study, we evaluated potential risk factors for acquiring post-operative FIAIs and their impact on clinical outcomes. Methods: This was a retrospective analysis of trauma patients admitted from 2005 to 2018 who underwent exploratory laparotomy and subsequently had development of intra-abdominal infection (IAI). Demographics, comorbidities, culture data, antimicrobial usage, Injury Severity Scores (ISS), and clinical outcomes were abstracted. All post-operative IAIs were evaluated and stratified as either bacterial, fungal, combined, and with or without colonization. All groups were compared. Risk factors for the development of post-operative IAI and clinical outcomes were analyzed by Student t test and chi-square test. Multi-variable logistic regression was used to determine independent predictors of post-operative FIAIs. Results: There were 1675 patients identified as having undergone exploratory laparotomy in the setting of traumatic injury, 161 of whom were suspected of having IAI. A total of 105 (6.2%) patients had a diagnosis of IAI. Of these patients, 40 (38%) received a diagnosis of FIAI. The most common fungal pathogens were unspeciated yeast (48.3%), followed by Candida albicans (42.7%), C. glabrata (4.5%), C. dubliniensis (2.25%), and C. tropicalis (2.25%). There were no significant differences in demographics, comorbidities, and percentage of gastric perforations between FIAI and bacterial IAI (BIAI) groups. Patients with FIAIs, however, had a 75% temporary abdominal closure (TAC) rate compared with 51% in BIAIs (p = 0.01). The FIAI group had higher ISS (27 vs. 22, p = 0.03), longer hospital days (34 vs. 25, p = 0.02), and longer intensive care unit (ICU) days (17 vs. 9, p = 0.006) when compared with BIAI. The FIAI group also had a five-fold greater mortality rate. Logistic regression identified TAC as an independent risk factor for the development of post-operative FIAIs (odds ratio [OR] 6.16, confidence interval [CI] 1.14-28.0, p = 0.02). Conclusions: An FIAI after exploratory laparotomy was associated with greater morbidity and death. A TAC was associated independently with increased risk of FIAI after exploratory laparotomy in the setting of traumatic injury. Clinicians should suspect fungal infections in trauma patients in whom post-operative IAI develops after undergoing exploratory laparotomy using TAC techniques.
When awareness gets in the way: Reactivation aversion effects resolve the generality/specificity paradox in sensorimotor interference tasks.

Interference tasks combining different distractor types usually find that between-trial adaptations (congruency sequence effects [CSEs]) do not interact with each other, suggesting that sensorimotor control is domain-specific. However, within each trial, different distractor types often do interact, suggesting that control is domain-general. The present study presents a solution to this apparent paradox. In 3 experiments, testing 130 participants in total, we (a) confirm the simultaneous presence of between-trial domain-specific (noninteracting) CSEs and within-trial "domain-general" interactions in a fully factorial hybrid prime-Simon design free of repetition or contingency confounds; (b) demonstrate that the within-trial interaction occurs with supraliminal, but not with subliminal primes; and (c) show that it is disproportionately enlarged in older adults. Our findings suggest that whereas interference (priming and Simon) effects and CSEs reflect direct sensorimotor control, the within-trial interaction does not reflect sensorimotor control but "confusion" at higher-level processing stages (reactivation aversion effect [RAE]). (PsycINFO Database Record (c) 2020 APA, all rights reserved).
A novel homozygous variant of RYR1 p.Ala3072Asp in a neonate with dusty core disease: A new entity with clinicopathological implications

Dusty core disease (DuCD) is a recently described form of congenital myopathy with clinicopathological implications. The presence of “dusty core fibers” is the defining myopathological feature of DuCD. Most cases have a recessive inheritance and harbor RYR1 mutations. I hereby describe a novel homozygous variant of RYR1 p.Ala3072Asp clinicopathologically compatible with DuCD. To the best of my knowledge, this is the first documented case of DuCD from India.
The ML-Index: A Multidimensional, Learned Index for Point, Range, and Nearest-Neighbor Queries

We present the ML-Index, a memory-efficient Multidimensional Learned (ML) structure for processing point, KNN and range queries. Using data-dependent reference points, the ML-Index partitions the data and transforms it into one-dimensional values relative to the distance to their closest reference point. Once scaled, the ML-Index utilizes a learned model to efficiently approximate the order of the scaled values. We propose a novel offset scaling method, which provides a function which is more easily learnable compared to the existing scaling method of the iDistance approach. We validate the feasibility and show the supremacy of our approach through a thorough experimental performance comparison using two real-world data sets.
The Pharmacological Mechanism of Diabetes Mellitus-Associated Overactive Bladder and Its Treatment with Botulinum Toxin A

Diabetes mellitus (DM) is an independent risk factor for overactive bladder (OAB). The pathophysiology of DM-associated OAB is multifactorial and time-dependent. Diabetic bladder dysfunction is highly associated with diabetic complications, mainly including diabetic neuropathy and atherosclerosis. Chronic systemic inflammation and bladder urothelial inflammation may contribute to the onset of OAB. Intravesical botulinum toxin A (BoNT-A) injection has proved to be a successful treatment for idiopathic and neurogenic OAB. BoNT-A can inhibit the efferent pathways of the bladder as well as the chronic inflammation and hypersensitivity via the afferent pathways. We conducted a review of the published literature in Pubmed using a combination of two keywords, namely “botulinum toxin A” (BoNT-A) and “overactive bladder”, with or without the additional keywords “detrusor overactivity”, “diabetes mellitus”, “inflammation”, and “urodynamic study”. We also reviewed the experience of our research teams, who have published several studies of the association between DM and OAB. Since limited data support the effectiveness and safety of BoNT-A for treating patients with DM-associated OAB, a comprehensive evaluation of diabetic complications and urodynamic study is needed before treatment. In the future, it is imperative to explore the clinical characteristics and inflammatory biomarkers of diabetes as determining predictors of the treatment efficacy.
Biosimilars

Biological therapies have widened the therapeutic armamentarium for immune-mediated inflammatory diseases, providing in many cases a broad range of treatment options with different mechanisms of action. The widespread use of biological agents in systemic lupus erythematosus is currently limited to belimumab and rituximab, although results of promising larger Phase III clinical trials are awaited or have been recently circulated, especially for anti-cytokine therapies. The loss of exclusivity over the last years for several originator biologics has started the successful introduction of biosimilar products into clinical practice. There is an abbreviated pathway to biosimilar approval, but this is underpinned by the same standards of pharmaceutical quality, safety and efficacy that apply to all biological medicines. Nevertheless, there are unique reasons why development of biosimilars may be particularly challenging in lupus.
A Robust Automated Surface-Matching Registration Method For Neuronavigation.

PURPOSE The surface-matching registration method in the current neuronavigation completes the coarse registration mainly by manually selecting anatomical landmarks, which increases the registration time, makes the automatic registration impossible and sometimes results in mismatch. It may be more practical to use a fast, accurate and automatic spatial registration method for the patient-to-image registration. METHODS A coarse-to-fine spatial registration method to automatically register the patient space to the image space without placing any markers on the head of the patient was proposed. 3D keypoints were extracted by 3D Harris corner detector from the point clouds in the patient and image spaces, and used as input to the 4-points congruent sets (4PCS) algorithm which automatically registered the keypoints in the patient space with the keypoints in the image space without any assumptions about initial alignment. Coarsely aligned point clouds in the patient and image space were then fine-registered with a variant of the iterative closest point (ICP) algorithm. Two experiments were designed based on one phantom and five patients to validate the efficiency and effectiveness of the proposed method. RESULTS Keypoints were extracted within 7.0 s with a minimum threshold 0.001. In the phantom experiment, the mean target registration error (TRE) of 15 targets on the surface of the elastic phantom in the five experiments was 1.17±0.04 mm, and the average registration time was 17.4 s. In the clinical experiments, the mean TRE of the targets on the first, second, third, fourth and fifth patient's head surface were 1.70 ± 0.32 mm, 1.83 ± 0.38 mm, 1.64 ± 0.3 mm, 1.67 ± 0.35 mm and 1.72 ± 0.31 mm, respectively, and the average registration time was 21.4 s. Compared with the method only based on the 4PCS and ICP algorithm and the current clinical method, the proposed method has obvious speed advantage while ensuring the registration accuracy. CONCLUSIONS The proposed method greatly improves the registration speed while guaranteeing the equivalent or higher registration accuracy, and avoids a tedious manual process for the coarse registration.
Latency-intensity function of speech evoked auditory brainstem responses in individuals with moderate sensory neural hearing loss

Introduction: Compared to click evoked auditory brainstem response (ABR), speech evoked ABR holds an additional advantage by providing information on neural encoding of speech sounds. There is limited data available on speech ABR, both in normal and pathological ears. Aim: The present study focused on finding the latency-intensity function of speech evoked ABR in moderate sensorineural hearing loss (SNHL). Materials and Methods: Speech ABR was done using the standardized protocol on 13 ears with moderate SNHL were chosen from 20 participants. Results: Speech ABR recording on these ears produced V Peak till 60 dBnHL which was at the level of 10 dBSL. Results showed that the absolute latency of V Peak at the threshold level, that is, at 60 dBnHL was found to be 8.11 ms; 6.68 ms at 70 dBnHL; 5.96 ms at 80 dBnHL; and 5.41 ms at 90 dBnHL. Conclusion: It can be concluded that using speech as a stimulus in evoked responses, it can result in better estimation of loudness growth pattern in individuals with cochlear pathology. A phenomenon like recruitment can be explored in detail as it gives different results in comparison to click or tone evoked responses.
Determinants of Malnutrition (Overweight and Obesity) in School-Going Children of Coimbatore City, Tamil Nadu

Background & Objectives: Obesity is an emerging problem in India. The author sought to determine prevalence of obesity and malnutrition in school-going children, from grades 5 to 7 of different schools of Coimbatore and assess Socio-Economic Status that affects the weight of the children. Methods: A cross sectional study design with children studying in grades 5 to 7 grade, in different schools of Coimbatore. We visited 23 schools of which 10 consented; five subsidized government schools and five non-government schools. A validated questionnaire was developed. Height and weight were measured on calibrated scales. Results & Interpretation: Of our total population, 17% of children were underweight, 50% of the entire population lay within the normal range. Conclusion: Obesity and under nutrition co-exist in Indian school-children. Our study shows that socio-economic factors are important since obesity and overweight increase with SES. Higher SES groups should be targeted for overweight while underweight is a problem of lower SES.
Gastric Asthma: A Vagally-Mediated Disease

Many evidences show that bronchial asthma may be triggered or enhanced by gastroesophageal reflux (GER) even if standardized methods to detect this particular syndrome defined as “gastric asthma” are not available. The Bernstein test suitably modified was performed in 6 adult asthmatic outpatients when they were symptom-free. These subjects were also suffering from recurrent epigastric pain. The patients resulted positive to ultranebulized fog bronchial challenge and all had a moderate- severe alteration of the competency of the lower esophageal sphincter, shown by endoscopy. Functional lung parameters were significantly reduced after esophageal acidification when they were compared to basal values. Is the linkage between GER and asthma important in clinical practice? In asthmatic patients GER represents an important trigger for broncoconstriction through a vagal mediated reflex. The modified Bernstein test represents a reproducible method and may be well used to identify “gastric asthma”, particularly when this picture is “silent”, less evident, or it is not rightly considered. Moreover, its recognition is very relevant to therapeutic problems, also when it is in a subclinical stage. In fact, many “excellent” drugs used for bronchial asthma treatment may have undesirable effects for the gastric tract causing abnormalities such as GER that is so damaging in the development of “gastric asthma”.
Numerical Investigation of the Accuracy of Particle Image Velocimetry Technique in High-Speed Turbulent Flows

In this study, we investigate the accuracy of Particle Image Velocimetry(PIV) technique for flow-field characterization of high speed homogeneous isotropic turbulence using direct numerical simulations. We carry out synthetic PIV reconstruction of the three-dimensional turbulent flow field at a Reynolds number of 5000, representative of the unburnt reactants side of a premixed CH4-air flame at Karlovitz number ≈ 204. The flow field is uniformly seeded with 300nm monodispersed Al2O3 particles that represent typical PIV particles used in experiments, along with initially co-located massless Lagrangian tracer particles to recover the actual flow pathlines. The effect of the massive particles on the flow field is studied and it is found that turbulent kinetic energy is augmented at high wave numbers and is slightly attenuated at low wave numbers. Secondly, we assess the ability of the massive particles to sample the flow field and it is found that there is irregular sampling due to particle clustering. Finally, we qualitatively assess the accuracy of the PIV reconstruction of the velocity field in comparison with the actual velocity field in the numerical simulations. It is shown that while PIV is generally capable of capturing the bulk flow features, its accuracy is not sufficient to capture small-scale structures and fully characterize the dynamics of the turbulent flow.