Miracle-dz/UniFAR-FTUs huggingface dataset:
CLINICAL APPLICATION OF MULTICOLOR IMAGING IN CENTRAL SEROUS CHORIORETINOPATHY.

PURPOSE To characterize features of central serous chorioretinopathy (CSC) using multicolor (MC) imaging and to compare the efficacy of using MC imaging and traditional color fundus photography (CFP) for detecting features of CSC. METHODS A retrospective review of 75 eyes of 69 participants with CSC from the Eye Center of the Renmin Hospital of Wuhan University. The patients underwent same-day CFP, fundus fluorescein angiography (FFA), spectral domain optical coherence tomography (SD-OCT), and MC imaging (including infrared reflectance (IR), green reflectance (GR), blue reflectance (BR), combined standard MC image, and green-blue-enhanced image). Positive CSC lesions were evaluated using FFA and SD-OCT. Features in images of CFP, standard MC, green-blue-enhanced, IR, GR, and BR were analyzed and calculated. RESULTS Among the 75 eyes of 69 patients, 75 eyes with subretinal fluid (SRF) and retinal pigment epithelial (RPE) leakage point, and 43 eyes with RPE damage were observed by FFA and SD-OCT. The detection rate of SRF was significantly higher with the standard MC image (92.0%), green-blue-enhanced image (92.0%), IR (88.0%), and GR (88.0%) than that with CFP (66.7%) (P < 0.05). Blue reflectance (45.3%) was associated with lower rate of SRF detection compared to CFP (P < 0.05). The standard MC image (84.0%), green-blue-enhanced image (84.0%), IR (78.7%), and GR (80%) delineated the boundaries of SRF more effectively than CFP (44%). The abnormal areas corresponding to RPE leakage points on FFA were observed with the standard MC image, green-blue-enhanced image, and IR at detection rates of 90.7, 82.7, and 90.7%, respectively, which were significantly higher than with CFP (29.3%) (P < 0.05). However, the detection rates of the abnormalities corresponding to leakage on FFA were lower with GR (5.3%) and BR (1.3%) than those with CFP (P < 0.05). Areas of RPE damage on FFA were observed at the same locations with the standard MC image, green-blue-enhanced image, and IR at detection rates of 97.7, 93.0, and 95.3%, respectively, which were significantly higher than with CFP (41.9%) (P < 0.05). Compared with CFP, the detectable rates of RPE damage on GR (14.0%) and BR (9.3%) were lower (P < 0.05). CONCLUSION As an adjunct to SD-OCT, the MC image can delineate the extent or boundaries of SRF more effectively than CFP. As an adjunct to FFA, the MC image can identify foci of leakage more effectively than CFP. The MC image, particularly the IR channel, can identify areas of RPE damage more effectively than CFP. Therefore, the MC image may be a useful adjunct to FFA and OCT for detecting or monitoring CSC.
Therapeutic Ultrasound for Pain Management in Chronic Low Back Pain and Chronic Neck Pain: A Systematic Review.

Background Low back pain (LBP) and neck pain are major causes of pain and disability that are experienced across all ages. The primary goals of treatment are to improve patient function and facilitate a return to the patient's desired level of daily activity. Therapeutic ultrasound is a noninvasive modality widely utilized in the management of musculoskeletal disorders, but there continues to be controversy regarding its use due to insufficient evidence of effectiveness. The objective of this systematic review was to evaluate the effectiveness of therapeutic ultrasound in the management of patients with chronic LBP and neck pain. Methods Using PRISMA guidelines, a search of the PubMed and CENTRAL (The Cochrane Library) databases was performed to retrieve randomized controlled trials (RCTs) that evaluated therapeutic ultrasound in patients with chronic LBP or neck pain. Results The search strategy identified 10 trials that met the criteria for inclusion. Three studies in LBP reported that both therapeutic and sham (placebo) ultrasound provided significant improvement in pain intensity. In each of these studies, ultrasound was found to be more effective than placebo when using only one of several validated instruments to measure pain. Three of the four studies on neck pain demonstrated significant pain relief with ultrasound in combination with other treatment modalities. However, only one of these studies demonstrated that the use of ultrasound was the cause of the statistically significant improvement in pain intensity. Conclusions Therapeutic ultrasound is frequently used in the treatment of LBP and neck pain and is often combined with other physiotherapeutic modalities. However, given the paucity of trials and conflicting results, we cannot recommend the use of monotherapeutic ultrasound for chronic LBP or neck pain. It does seem that ultrasound may be considered as part of a physical modality treatment plan that may be potentially helpful for short-term pain relief; however, it is undetermined which modality may be superior. In both pain syndromes, further trials are needed to define the true effect of low-intensity ultrasound therapy for axial back pain. No conclusive recommendations may be made for optimal settings or session duration.
Reduce Calibration Time in Motor Imagery Using Spatially Regularized Symmetric Positives-Definite Matrices Based Classification

Electroencephalogram (EEG) based motor imagery brain–computer interface (BCI) requires large number of subject specific training trials to calibrate the system for a new subject. This results in long calibration time that limits the BCI usage in practice. One major challenge in the development of a brain–computer interface is to reduce calibration time or completely eliminate it. To address this problem, existing approaches use covariance matrices of electroencephalography (EEG) trials as descriptors for decoding BCI but do not consider the geometry of the covariance matrices, which lies in the space of Symmetric Positive Definite (SPD) matrices. This inevitably limits their performance. We focus on reducing calibration time by introducing SPD based classification approach. However, SPD-based classification has limited applicability in small training sets because the dimensionality of covariance matrices is large in proportion to the number of trials. To overcome this drawback, our paper proposes a new framework that transforms SPD matrices in lower dimension through spatial filter regularized by prior information of EEG channels. The efficacy of the proposed approach was validated on the small sample scenario through Dataset IVa from BCI Competition III. The proposed approach achieved mean accuracy of 86.13% and mean kappa of 0.72 on Dataset IVa. The proposed method outperformed other approaches in existing studies on Dataset IVa. Finally, to ensure the robustness of the proposed method, we evaluated it on Dataset IIIa from BCI Competition III and Dataset IIa from BCI Competition IV. The proposed method achieved mean accuracy 92.22% and 81.21% on Dataset IIIa and Dataset IIa, respectively.
Implementation of an Evidence-Based, Nurse-Driven Sepsis Protocol to Reduce Acute Care Transfer Readmissions in the Inpatient Rehabilitation Facility Setting.

PURPOSE The aim of this study was to determine if implementing an evidence-based, nurse-driven sepsis protocol would reduce acute care transfer (ACT) readmissions from an inpatient rehabilitation facility compared to nonprotocolized or usual standard of care for adult sepsis patients undergoing physical rehabilitation. DESIGN This study used a preintervention and postintervention model for quality improvement, which involved comparing the nonprotocolized care of adult sepsis patients in the inpatient rehabilitation population to the application of an evidence-based, nurse-driven sepsis protocol to determine its effect on reducing ACT readmissions. METHODS Patients who screened positive for suspected sepsis and received protocolized interventions were analyzed to determine the occurrence of ACT readmission. Compliance with protocol elements was also evaluated. FINDINGS The sepsis-related ACT readmission rate decreased from 36.28% to 25% in 8 weeks, and compliance with protocolized sepsis interventions increased. CONCLUSIONS Nurse-driven, protocolized assessment and treatment can improve the management and care of sepsis patients undergoing physical rehabilitation and can reduce ACT readmissions. CLINICAL RELEVANCE This review provides rehabilitation nurses an evidence-based, nurse-driven approach to the clinical management of sepsis patients in the inpatient rehabilitation setting and discusses how this approach can reduce ACT readmissions and improve clinical outcomes.
PP2C phosphatases promote autophagy by dephosphorylation of the Atg1 complex

Significance Under starvation conditions, cells activate macroautophagy to recycle nutrients. A kinase complex that consists of Atg1 kinase, Atg13, and Atg17 is essential for macroautophagy function. This kinase complex is regulated extensively by phosphorylation events. However, the phosphatases that counteract these phosphorylations have remained elusive. Our results show that two redundant PP2C-type phosphatases, Ptc2 and Ptc3, promote autophagy by interacting with Atg1 and Atg13 and dephosphorylating them. In the absence of these phosphatases, macroautophagy, as well as selective autophagy pathways such as cytoplasm-to-vacuole targeting and genotoxin-induced targeted autophagy, are inhibited. These results suggest that PP2C-type phosphatases play a previously uncharacterized and central role in the regulation of core autophagy proteins. Macroautophagy is orchestrated by the Atg1-Atg13 complex in budding yeast. Under nutrient-rich conditions, Atg13 is maintained in a hyperphosphorylated state by the TORC1 kinase. After nutrient starvation, Atg13 is dephosphorylated, triggering Atg1 kinase activity and macroautophagy induction. The phosphatases that dephosphorylate Atg13 remain uncharacterized. Here, we show that two redundant PP2C phosphatases, Ptc2 and Ptc3, regulate macroautophagy by dephosphorylating Atg13 and Atg1. In the absence of these phosphatases, starvation-induced macroautophagy and the cytoplasm-to-vacuole targeting pathway are inhibited, and the recruitment of the essential autophagy machinery to the phagophore assembly site is impaired. Expressing a genomic ATG13-8SA allele lacking key TORC1 phosphorylation sites partially bypasses the macroautophagy defect in ptc2Δ ptc3Δ strains. Moreover, Ptc2 and Ptc3 interact with the Atg1-Atg13 complex. Taken together, these results suggest that PP2C-type phosphatases promote macroautophagy by regulating the Atg1 complex.
Hospital Volume, In-Hospital Mortality, and Failure to Rescue in Esophageal Surgery.

BACKGROUND In Germany, complex esophageal surgery is often performed in hospitals with low case numbers. For these procedures, an association exists between hospital case numbers and treatment outcomes, possibly because of differences in complication management. This aspect of the association between volume and outcome in esophageal surgery has not yet been studied in Germany. METHODS On the basis of nationwide hospital discharge data (DRG statistics) from the years 2010 to 2015, the association between volume and outcome was analyzed in relation to in-hospital mortality, the frequency of complications, and the mortality of patients who had complications. RESULTS 22 700 cases of complex esophageal surgery were identified. The probability of dying after esophageal surgery was much lower in hospitals with very high case numbers (median, 62 per year) than in those with very low case numbers (median, two per year), with an odds ratio (OR) of 0.50 (95% confidence interval, [0.42; 0.60]). At least one complication was documented for more than half of all patients; no association was found between the frequency of complications and the hospital case volume. The in-hospital mortality among patients who had complications was 12.3% [11.1; 13.7] in hospitals with very high case numbers and 20.0% [18.5; 21.6] in hospitals with very low case numbers. Of the 4032 procedures performed in 2015, 83% were for cancer of the esophagus. CONCLUSION These findings indicate that the quality of care for patients undergoing esophageal surgery in Germany could be improved if more patients were treated in hospitals with high case numbers. The observed association between case numbers and outcomes is tightly linked to failure to rescue.
Undaria pinnatifida a Rich Marine Reservoir of Nutritional and Pharmacological Potential: Insights into Growth Signaling and Apoptosis Mechanisms in Cancer

Abstract Seaweeds are an important part of diet consumed in a different part of the world such as New Zealand, Ireland, Wales, and Asian countries including Korea, China, and Japan. In addition, seaweed is nutritious sources possessing health improving effects and therapeutic potential. Recently, one of the widely eaten seaweed species Undaria pinnatifida (U. pinnatifida) has got much attention because of its pharmacological properties for the prevention of various ailments, including cancer, inflammation, and other diseases. It is rich in all essential amino acids, physiologically significant fatty acids, vitamins, minerals, and has a variety of bioactive constituents which include fucoidan, carotenoids, and fucoxanthin. The present study reviews the nutritional aspects, key bioactivities specifically focusing on anticancer potential along with apoptosis and growth signaling mechanisms of U. pinnatifida or its constituents. It exhibited anticancer effects both in vitro and in vivo studies in a variety of experimental models. Due to a variety of pharmacological properties of U. pinnatifida can not only fulfilling nutritional necessities, but it can be used for treating, curing and preventing cancer.
Multi-energy computed tomography reconstruction using a nonlocal spectral similarity model

Multi-energy computed tomography (MECT) is able to acquire simultaneous multi-energy measurements from one scan. In addition, it allows material differentiation and quantification effectively. However, due to the limited energy bin width, the number of photons detected in an energy-specific channel is smaller than that in traditional CT, which results in image quality degradation. To address this issue, in this work, we develop a statistical iterative reconstruction algorithm to acquire high-quality MECT images and high-accuracy material-specific images. Specifically, this algorithm fully incorporates redundant self-similarities within nonlocal regions in the MECT image at one bin and rich spectral similarities among MECT images at all bins. For simplicity, the presented algorithm is referred to as ‘MECT-NSS’. Moreover, an efficient optimization algorithm is developed to solve the MECT-NSS objective function. Then, a comprehensive evaluation of parameter selection for the MECT-NSS algorithm is conducted. In the experiment, the datasets include images from three phantoms and one patient to validate and evaluate the MECT-NSS reconstruction performance. The qualitative and quantitative results demonstrate that the presented MECT-NSS can successfully yield better MECT image quality and more accurate material estimation than the competing algorithms.
Risk of Alcohol-Related Injury: Does Societal Drinking Context Make a Difference?

OBJECTIVE The aim of this study is to examine whether country-level frequency of drinking in a public context and in a private context is associated with rates of alcohol-related injury in emergency department studies from those same countries. METHOD Emergency department data on 5,104 injured patients in 10 countries from the International Collaborative Alcohol and Injury Study (ICAIS) and aggregate level drinking context data from the Gender, Alcohol and Culture: An International Study (GENACIS) are analyzed. The association of societal drinking context (public and private) with variation in the rate of self-reported drinking before injury is examined using multilevel modeling. RESULTS Controlling for demographic characteristics, individual-level volume and drinking pattern, study-level volume, and country-level drinking pattern and alcohol control policy, societal public drinking context was significantly predictive of an alcohol-related injury (odds ratio [OR] = 1.08, CI [1.02, 1.13]), whereas societal private drinking context was not. Public drinking context was predictive of violence-related injury (OR = 1.09, CI [1.01, 1.17]), whereas private drinking context was predictive of injuries from falls (OR = 1.01, CI [1.01, 1.02]). Neither societal drinking context was significantly predictive of traffic-related injuries whereas both public (OR = 1.06, CI [1.01, 1.12]) and private (OR = 1.01, CI [1.01, 1.03]) contexts were predictive of injuries from other causes. CONCLUSIONS These data suggest that societal drinking context does make a difference in the likelihood of an alcohol-related injury, which is important for a better understanding of the role of drinking context in a country in the occurrence of an alcohol-related injury and may inform future recommendations for reducing this harmful consequence.
The OMERACT-OARSI Core Domain Set for Measurement in Clinical Trials of Hip and/or Knee Osteoarthritis

Objective. To update the 1997 OMERACT-OARSI (Outcome Measures in Rheumatology-Osteoarthritis Research Society International) core domain set for clinical trials in hip and/or knee osteoarthritis (OA). Methods. An initial review of the COMET database of core outcome sets (COS) was undertaken to identify all domains reported in previous COS including individuals with hip and/or knee OA. These were presented during 5 patient and health professionals/researcher meetings in 3 continents (Europe, Australasia, North America). A 3-round international Delphi survey was then undertaken among patients, healthcare professionals, researchers, and industry representatives to gain consensus on key domains to be included in a core domain set for hip and/or knee OA. Findings were presented and discussed in small groups at OMERACT 2018, where consensus was obtained in the final plenary. Results. Four previous COS were identified. Using these, and the patient and health professionals/researcher meetings, 50 potential domains formed the Delphi survey. There were 426 individuals from 25 different countries who contributed to the Delphi exercise. OMERACT 2018 delegates (n = 129) voted on candidate domains. Six domains gained agreement as mandatory to be measured and reported in all hip and/or knee OA clinical trials: pain, physical function, quality of life, and patient’s global assessment of the target joint, in addition to the mandated core domain of adverse events including mortality. Joint structure was agreed as mandatory in specific circumstances, i.e., depending on the intervention. Conclusion. The updated core domain set for hip and/or knee OA has been agreed upon. Work will commence to determine which outcome measurement instrument should be recommended to cover each core domain.
Future Directions in Affirmative Psychological Interventions with Transgender Children and Adolescents

Transgender children and adolescents experience a gender identity that is incongruent with their sex assigned at birth, often resulting in gender dysphoria. Emerging literature has explored the etiology of transgender identities, documented transgender youths’ risk for psychopathology, and evaluated whether social and medical gender transition processes are appropriate and effective for transgender youth. However, there is a dearth of empirical data on gender-affirmative psychological interventions designed to reduce the forms of psychological distress experienced by many transgender youths. This is surprising given the elevated rates of psychological distress among transgender youth and the broad recommendation for psychotherapy for youth going through a gender transition. To identify future directions in psychological interventions for transgender youth, we first review key background information on transgender youths’ identity development and the role of psychological support in affirmative care. Next, we present future directions in this literature, which emphasizes the need for theory-driven empirical research that incorporates the developmental context of transgender youth to understand the mechanisms underlying group-specific psychological distress. Finally, we lay out the application of these future directions by exploring 3 domains relevant to transgender youth’s psychological distress: gender dysphoria, parent and peer interactions, and co-occurring psychopathology. Within each domain, we review extant empirical research, present the current state of affirmative psychological interventions, and discuss implications for future directions. Future research on affirmative psychological care for transgender youth is urgently needed and must focus on clearly articulating which youth could benefit from psychological interventions and why those interventions might be effective.
Multiple Parameters Beyond Lipid Binding Affinity Drive Cytotoxicity of Cholesterol-Dependent Cytolysins

The largest superfamily of bacterial virulence factors is pore-forming toxins (PFTs). PFTs are secreted by both pathogenic and non-pathogenic bacteria. PFTs sometimes kill or induce pro-pathogen signaling in mammalian cells, all primarily through plasma membrane perforation, though the parameters that determine these outcomes are unclear. Membrane binding, calcium influx, pore size, and membrane repair are factors that influence PFT cytotoxicity. To test the contribution of membrane binding to cytotoxicity and repair, we compared the closely related, similarly-sized PFTs Perfringolysin O (PFO) from Clostridium perfringens and Streptolysin O (SLO) from Streptococcus pyogenes. Cell death kinetics for PFO and SLO were different because PFO increased in cytotoxicity over time. We introduced known L3 loop mutations that swap binding affinity between toxins and measured hemolytic activity, nucleated cell death kinetics and membrane repair using viability assays, and live cell imaging. Altered hemolytic activity was directly proportional to toxin binding affinity. In contrast, L3 loop alterations reduced nucleated cell death, and they had limited effects on cytotoxicity kinetics and membrane repair. This suggests other toxin structural features, like oligomerization, drives these parameters. Overall, these findings suggest that repair mechanisms and toxin oligomerization add constraints beyond membrane binding on toxin evolution and activity against nucleated cells.