Miracle-dz/UniFAR-FTUs huggingface dataset:
EEG to detect early recovery of consciousness in amantadine-treated acute brain injury patients

Disorder of consciousness (DOC) is common in patients with acute brain injury (ABI) and it weighs heavily in goals of care discussion.1 Dopaminergic agents to support recovery have shown encouraging results in chronic DOC following traumatic brain injury (TBI) and are currently the most promising candidates to also support recovery during the acute post injury phase.2 Amantadine is a neurohormonal modulator that increases the concentration of dopamine at the synaptic cleft. Behavioural assessments of consciousness alone are often operator dependent, time consuming to obtain and may miss patients with covert consciousness.3 Our hypothesis is that resting Electroencephalogram (EEG) features follow a predictable course preceding behavioural recovery in patients with acute non-hypoxic-ischaemic brain injury receiving amantadine and may serve as biomarkers for recovery of consciousness. We studied 44 patients with ABI that were not following commands and were on EEG monitoring before and after the start of amantadine. A full description of the methods is available in the online supplementary file. ### Supplementary data [jnnp-2019-322645supp001.pdf] ### Study cohort From a cohort of 44 patients, 30 (68%) recovered consciousness prior to hospital discharge (online supplementary tables S1, S2). ### Baseline predictors of recovery Age, focal versus diffuse brain injury and admission Glasgow Coma Score were not associated with recovery of command following. Presence of sleep structures in the EEG (spindles and K-complexes) prior to starting amantadine was independently associated with recovery of command following (online supplementary table S3). Average spectrogram plots for each EEG recording classified according to the ‘ABCD’ model representing thalamocortical integrity were generated (figure 1A, online supplementary figure). 4 The percent of patients that recovered command following did not increase hierarchically with higher ‘ABCD’ levels (figure 1B). Power spectral density analysis …
Nucleotide sequence and analysis of pRC12 and pRC18, two theta-replicating plasmids harbored by Lactobacillus curvatus CRL 705

The nucleotide sequences of plasmids pRC12 (12,342 bp; GC 43.99%) and pRC18 (18,664 bp; GC 34.33%), harbored by the bacteriocin-producer Lactobacillus curvatus CRL 705, were determined and analyzed. Plasmids pRC12 and pRC18 share a region with high DNA identity (> 83% identity between RepA, a Type II toxin-antitoxin system and a tyrosine integrase genes) and are stably maintained in their natural host L. curvatus CRL 705. Both plasmids are low copy number and belong to the theta-type replicating group. While pRC12 is a pUCL287-like plasmid that possesses iterons and the repA and repB genes for replication, pRC18 harbors a 168 amino acid replication protein affiliated to RepB, which was named RepB’. Plasmid pRC18 also possesses a pUCL287-like repA gene but it was disrupted by an 11 kb insertion element that contains RepB’, several transposases/IS elements, and the lactocin Lac705 operon. An Escherichia coli / Lactobacillus shuttle vector, named plasmid p3B1, carrying the pRC18 replicon (i.e. repB’ and replication origin), a chloramphenicol resistance gene and a pBluescript backbone, was constructed and used to define the host range of RepB’. Chloramphenicol-resistant transformants were obtained after electroporation of Lactobacillus plantarum CRL 691, Lactobacillus sakei 23K and a plasmid-cured derivative of L. curvatus CRL 705, but not of L. curvatus DSM 20019 or Lactococcus lactis NZ9000. Depending on the host, transformation efficiency ranged from 102 to 107 per μg of DNA; in the new hosts, the plasmid was relatively stable as 29–53% of recombinants kept it after cell growth for 100 generations in the absence of selective pressure. Plasmid p3B1 could therefore be used for cloning and functional studies in several Lactobacillus species.
A CpG Methylation Classifier to Predict Relapse in Adults with T-Cell Lymphoblastic Lymphoma

Purpose: Adults with T-cell lymphoblastic lymphoma (T-LBL) generally benefit from treatment with acute lymphoblastic leukemia (ALL)-like regimens, but approximately 40% will relapse after such treatment. We evaluated the value of CpG methylation in predicting relapse for adults with T-LBL treated with ALL-like regimens. Experimental Design: A total of 549 adults with T-LBL from 27 medical centers were included in the analysis. Using the Illumina Methylation 850K Beadchip, 44 relapse-related CpGs were identified from 49 T-LBL samples by two algorithms: least absolute shrinkage and selector operation (LASSO) and support vector machine–recursive feature elimination (SVM-RFE). We built a four-CpG classifier using LASSO Cox regression based on association between the methylation level of CpGs and relapse-free survival in the training cohort (n = 160). The four-CpG classifier was validated in the internal testing cohort (n = 68) and independent validation cohort (n = 321). Results: The four-CpG–based classifier discriminated patients with T-LBL at high risk of relapse in the training cohort from those at low risk (P < 0.001). This classifier also showed good predictive value in the internal testing cohort (P < 0.001) and the independent validation cohort (P < 0.001). A nomogram incorporating five independent prognostic factors including the CpG-based classifier, lactate dehydrogenase levels, Eastern Cooperative Oncology Group performance status, central nervous system involvement, and NOTCH1/FBXW7 status showed a significantly higher predictive accuracy than each single variable. Stratification into different subgroups by the nomogram helped identify the subset of patients who most benefited from more intensive chemotherapy and/or sequential hematopoietic stem cell transplantation. Conclusions: Our four-CpG–based classifier could predict disease relapse in patients with T-LBL, and could be used to guide treatment decision.
Pharmacological evaluation of Ashwagandha highlighting its healthcare claims, safety, and toxicity aspects

Abstract Withania somnifera, commonly known as “Ashwagandha” or “Indian ginseng” is an essential therapeutic plant of Indian subcontinent regions. It is regularly used, alone or in combination with other plants for the treatment of various illnesses in Indian Systems of Medicine over the period of 3,000 years. Ashwagandha (W. somnifera) belongs to the genus Withania and family Solanaceae. It comprises a broad spectrum of phytochemicals having wide range of biological effects. W. somnifera has demonstrated various biological actions such as anti-cancer, anti-inflammatory, anti-diabetic, anti-microbial, anti-arthritic, anti-stress/adaptogenic, neuro-protective, cardio-protective, hepato-protective, immunomodulatory properties. Furthermore, W. somnifera has revealed the capability to decrease reactive oxygen species and inflammation, modulation of mitochondrial function, apoptosis regulation and improve endothelial function. Withaferin-A is an important phytoconstituents of W. somnifera belonging to the category of withanolides been used in the traditional system of medicine for the treatment of various disorders. In this review, we have summarized the active phytoconstituents, pharmacologic activities (preclinical and clinical), mechanisms of action, potential beneficial applications, marketed formulations and safety and toxicity profile of W. somnifera. Graphical Abstract
The Present and Future of eHealth in Spain From a Health Management Perspective

eHealth has grown significantly over the last decade. The aim of this study was to determine the level of use of information and communication technologies for health care in Spain and identify the main barriers to development. We used a qualitative study based on data obtained from 8 Spanish autonomous communities through semi-structured, in-depth interviews with key informants in eHealth management and planning. Programs present varying degrees of implementation. Services such as electronic prescriptions, digital medical records, and appointment requests via the Internet are advanced and widespread; others, such as digital imaging, are advanced but not fully deployed; and some, such as telecare programs, are experimental. The study also revealed diverse levels of interoperability and barriers to the expansion of these technologies, which can be classified into 4 fields: technological, organizational, human, and economic. eHealth might evolve more slowly in the coming years. Unless the payoff is clearly seen, major budget cuts in the current economic climate will prevent the implementation of new projects. Programs that help reduce health spending are more likely to be implemented, to the detriment of projects involving simple techniques or even clear health care improvements.
Does Cannabis Use Predict More Severe Types of Alcohol Consequences? Longitudinal Associations in a 3-Year Study of College Students.

BACKGROUND Prior research shows that negative drinking outcomes among young adults may be exacerbated by cannabis use. However, to date, there have been few longitudinal studies of associations between cannabis use and negative alcohol-related consequences. This study examined longitudinal within-person associations between cannabis use and several domains of negative alcohol consequences among young adults and explored the moderating role of sex. METHOD We analyzed data from N = 997 students assessed 4 times per year over the first 3 years of university. At each time point, participants completed measures of past-month cannabis use frequency, typical weekly number of drinks, and 8 domains of negative alcohol consequences. Longitudinal associations were examined in multilevel models. RESULTS Within-person changes in frequency of cannabis use were not uniquely associated with changes in total alcohol consequences aggregated across several alcohol consequence domains. However, when examining alcohol consequence domains separately, within-person increases in cannabis use frequency were specifically associated with increases in some (but not all) of the more severe types of alcohol consequences, including risky behaviors, poor self-care, and alcohol dependence symptoms. No support was observed for the moderating role of sex in the longitudinal within-person associations between cannabis use and alcohol consequence domains. CONCLUSIONS Findings suggest that within-person changes in cannabis use frequency among young adults are associated with corresponding changes in some domains of alcohol consequences (but not others) when examined over the course of several years. Results may inform targeted harm reduction interventions for young adult drinkers who use cannabis, although future research is needed to clarify the mechanisms of the observed associations.
Arms Open Wide: Library Outreach to Customers with Print Impairments

This paper will address how librarians and library staff can reach out in their communities to find patrons with print impairments, how to communicate effectively with this group of customers, how to partner with other agencies, and how to ensure that their library offers quality accessible services. With the population aging, the number of people with print-impairments is on the rise. Oftentimes, these individuals are homebound which can lead to isolation and depression. It is therefore increasingly important for libraries to reach these patrons. Many library staff lack knowledge and experience in how to conduct outreach to individuals with print-impairments. Too often, outreach is viewed as something that will use staff time and resources that could be better utilized elsewhere. The purpose of this paper is to provide a framework on how to get started in outreach, it will justify the importance of reaching all patrons with print-impairments in the community, and offer practical suggestions for accessible services to offer that cost little or are free. The outreach toolkit for public libraries, included as a link, is an extremely helpful resource.
Convergent Evolution, Evolving Evolvability, and the Origins of Lethal Cancer

Advances in curative treatment to remove the primary tumor have increased survival of localized cancers for most solid tumor types, yet cancers that have spread are typically incurable and account for >90% of cancer-related deaths. Metastatic disease remains incurable because, somehow, tumors evolve resistance to all known compounds, including therapies. In all of these incurable patients, de novo lethal cancer evolves capacities for both metastasis and resistance. Therefore, cancers in different patients appear to follow the same eco-evolutionary path that independently manifests in affected patients. This convergent outcome, that always includes the ability to metastasize and exhibit resistance, demands an explanation beyond the slow and steady accrual of stochastic mutations. The common denominator may be that cancer starts as a speciation event when a unicellular protist breaks away from its multicellular host and initiates a cancer clade within the patient. As the cancer cells speciate and diversify further, some evolve the capacity to evolve: evolvability. Evolvability becomes a heritable trait that influences the available variation of other phenotypes that can then be acted upon by natural selection. Evolving evolvability may be an adaptation for cancer cells. By generating and maintaining considerable heritable variation, the cancer clade can, with high certainty, serendipitously produce cells resistant to therapy and cells capable of metastasizing. Understanding that cancer cells can swiftly evolve responses to novel and varied stressors create opportunities for adaptive therapy, double-bind therapies, and extinction therapies; all involving strategic decision making that steers and anticipates the convergent coevolutionary responses of the cancers.
Gene signatures associated with genomic aberrations predict prognosis in neuroblastoma

Neuroblastoma (NB) is a heterogeneous disease with respect to genomic abnormalities and clinical behaviors. Despite recent advances in our understanding of the association between the genetic aberrations and clinical features, it remains one of the major challenges to predict prognosis and stratify patients for determining personalized therapy in this disease. The aim of this study was to develop an effective prognosis prediction model for NB patients.
The Effects of Home Health Visit Length on Hospital Readmission

Home health care has experienced significant growth as an industry and is viewed as one of the avenues for achieving reductions in the cost and utilization of expensive downstream health care services. Using a novel dataset on home health care visits, this study quantifies the effects of reduced time spent with patients during a post-acute home health visit on hospital readmissions. We focus in particular on the subset of patients with conditions that are subject to penalty under the Hospital Readmission Reduction Program. Since both visit length and readmission risk are likely to be correlated with unobserved illness severity, we use the daily sequence of provider visits and deviation from the provider’s average daily workload as instruments for visit length. We find that patients who are visited later in the provider’s day as well as those who are visited by a provider who has a higher than usual workload experience home health visits that are shorter than usual. Using our instruments and controlling for patient, visit, and provider characteristics, we find that home health visits that are longer than usual by one minute reduce the risk of hospital readmission by approximately 8 percent. These effects seem to be driven by providers with higher levels of discretion in their time management and care provision. We suggest several approaches that managers could take to attain reductions in readmissions without incurring significant additional costs.
Investigating the effect of uterine artery embolisation on the uterus of women with fibroids and heavy menstrual bleeding

Uterine fibroids are common benign tumours in women. The effect they have can range from pressure symptoms and heavy menstrual bleeding to denying a woman a successful pregnancy. Despite the overall benign classification of fibroid, it is undeniable that the reduced quality of life these tumours cause may exceed the effect that some early stage gynecological cancers have on a suffering woman. There has been extensive research into treatments for fibroids however this has only resulted in a handful of worthy advances which are not proportionate to the impact these “benign” tumours have on a suffering woman. The mechanism for how fibroids affect the endometrium and cause heavy menstrual bleeding is understudied. Some of this research has pointed towards vascular endothelial growth factor and cyclooxygenase as potential mediators that change the perceived heaviness –amount and length- of a menstrual period in a woman with fibroids. Uterine artery embolisation (UAE) has emerged as a lesser invasive option and an alternative to surgery. The reported high technical success of the procedure independent of BMI and the short hospital stay and quick recovery has made it an attractive treatment modality. However, the mechanism of how it works is still not understood. Women with large variation in uterine size and fibroid number and size are undergoing this procedure without the full knowledge of how they will individually respond. This thesis aims to explore the mechanism of how UAE works by looking at the change in expression of VEGF, COX-2 & Ki67 and also the change in microvascular density of the endometrium post UAE. Our aim was to investigate how women with different sized fibroid uteri would respond to UAE and if DWI MRI had any advantages above standard MRI in predicting the outcome of UAE.
Serious Motion-Based Exercise Games for Older Adults: Evaluation of Usability, Performance, and Pain Mitigation

Background Many societies are facing demographic changes that challenge the viability of health and welfare systems. Serious games for health care and ambient assisted living (AAL) offer health benefits and support for older adults and may mitigate some of the negative effects of the demographic shift. Objective This study aimed to examine the acceptance of serious games to promote physical health in AAL environments. Since AAL environments are designed specifically to support independent living in older adults, we studied the relationship among age and user diversity, performance in the game, and overall usability and acceptance evaluation. Methods We developed a motion-based serious exercise game for prototypical AAL environments. In two evaluations, outside (n=71) and within (n=64) the AAL environment, we investigated the influence of age, gender, self-efficacy in interacting with technology, need for achievement on performance, effect of the game, usability evaluation of the game, and overall acceptance. Results Both games were evaluated as easy to use and fun to play. Both game interventions had a strong pain-mitigating effect in older adults (game 1: −55%, P=.002; game 2: −66%, P=.01). Conclusions Serious exercise games outside and inside AAL environments can contribute to individuals’ health and well-being and to the stability of health care systems.
Introductory Chapter: Ruminants—The Husbandry, Economic, and Health Aspects

Ruminants have a valuable role in sustainable agricultural systems and provision of food to human beings. They play a pivotal role in converting vast renewable resources from rangeland, pasture, and crop residues and/or other by-products into food edible for humans. Grazing ruminant animals is an efficient way to produce food for humans. The need to maintain ruminants to utilize these humanly inedible foodstuffs and alter them into high-quality foods for human consumption has been a characteristic for several thousand years. In fact, dairy cattle and goats are quite exceptional in being extremely efficient in converting plantbased protein/energy sources into high-quality animal fats and proteins. It is convincing that ruminants are essential components in food production systems now and in the future.
Glut1 expression is increased by p53 reduction to switch metabolism to glycolysis during osteoblast differentiation.

The glycolytic system is selected for ATP synthesis not only in tumor cells but also in differentiated cells. Differentiated osteoblasts also switch dominant metabolic pathway to aerobic glycolysis. We found that primary osteoblasts increased expressions of glycolysis-related enzymes such as Glut1, hexokinase 1 and 2, lactate dehydrogenase A and pyruvate kinase M2 during their differentiation. Osteoblast differentiation decreased expression of tumor suppressor p53, which negatively regulates Glut1 expression, and enhanced phosphorylation of AKT, which is regulated by phosphoinositol-3 kinase (PI3K). An inhibitor of PI3K enhanced p53 expression and repressed Glut1 expression. Luciferase reporter assay showed that p53 negatively regulated transcriptional activity of solute carrier family 2 member 1 (Slc2a1) gene promoter region. Inhibition of glycolysis in osteoblasts reduced ATP contents more significantly than inhibition of oxidative phosphorylation by carbonyl cyanide m-chlorophenyl hydrazine. These results have indicated that osteoblasts increase Glut1 expression through downregulation of p53 to switch their metabolic pathway to glycolysis during differentiation.
Suicidal ideation and associated factors among high school adolescents

ABSTRACT OBJECTIVE To analyze the prevalence of suicidal ideation and its associated factors in school adolescents. METHODS Cross-sectional school-based study with 674 students from public and private schools in Teresina, Piauí, in 2016. Bivariate analysis was performed with the chi-square test and multiple analysis by the Poisson regression model to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS The study participants were mostly female (56.7%), black (77.4%), who lived with their parents (85%), whose mothers had schooling greater than or equal to 8 years of schooling (68.8%), with family income greater than a minimum wage (58.3%), practitioners of some religion (86.8%) and coming from public school (64.7%). The prevalence of suicidal ideation was 7.9%. Higher frequency of suicidal ideation was reported among female students (10.2%). Suicidal ideation was statistically associated with students who reported not living with their parents (adjusted PR = 2.27; 95%CI 1.26–4.10; p < 0.05) and those who reported having suffered sexual violence by other students, teachers or school staff (adjusted PR = 3.40; 95%CI 1.80–6.44; p < 0.05), among which the prevalence of suicidal ideation was more than three times that observed among those who did not mention this type of violence. CONCLUSION The prevalence of suicidal ideation in school adolescents was associated with female students, who did not live with parents and have been victim of sexual violence at school. We recommend advising the school community and health professionals to identify signs of suicidal behavior, especially in those with suspicion or proof of the occurrence of sexual violence at school.
Postoperative Critical Care for Cardiac Surgical Patients

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