Miracle-dz/UniFAR-FTUs huggingface dataset:
Provider Perspectives on the Use of Evidence-based Risk Stratification Tools in the Evaluation of Pulmonary Embolism: A Qualitative Study.

OBJECTIVES Providers often pursue imaging in patients at low risk of pulmonary embolism (PE), resulting in imaging yields <10% and false-positive imaging rates of 10% to 25%. Attempts to curb overtesting have had only modest success and no interventions have used implementation science frameworks. The objective of this study was to identify barriers and facilitators to the adoption of evidence-based diagnostic testing for PE. METHODS We conducted semistructured interviews with a purposeful sample of providers. An interview guide was developed using the implementation science frameworks, consolidated framework for implementation research, and theoretical domains framework. Interviews were recorded, transcribed, and analyzed in an iterative process. Emergent themes were identified, discussed, and organized. RESULTS We interviewed 23 providers from four hospital systems, and participants were diverse with regard to years in practice and practice setting. Barriers were predominately at the provider level and included lack of knowledge of the tools, particularly misunderstanding of the validated scoring systems in Wells, as well as risk avoidance and need for certainty. Barriers to prior implementation strategies included the perception of a clinical decision support (CDS) tool for PE as adding steps with little value; most participants reported that they overrode CDS interventions because they had already made the decision. All providers identified institution-level strategies as facilitators to use, including endorsed guidelines, audit feedback with peer comparison about imaging yield, and peer pressure. CONCLUSIONS This exploration of the use of risk stratification tools in the evaluation of PE found that barriers to use primarily exist at the provider level, whereas facilitators to the use of these tools are largely perceived at the level of the institution. Future efforts to promote the evidence-based diagnosis of PE should be informed by these determinants.
Does dietary modification and/or physical activity reduce the progression from impaired glucose tolerance to type 2 diabetes?

Interventions: The arms were control, diet only, physical activity only, and diet plus physical activity. For people who were not overweight (BMI < 25 kg/m2), the diet was much the same as the Australian dietary guidelines (10%–15% energy from protein, 25%– 30% energy from fat, 55%–60% energy from carbohydrate, reduce simple sugar intake, eat more vegetables, control alcohol intake). People in the diet groups (BMI > 25 kg/m2) who were overweight were encouraged to lose weight gradually but details of the diet were not specified. Patients received individual counselling and also attended group sessions. The exercise intervention was to increase physical activity by one unit, and preferably two units, per day (eg, 1 unit was 30 minutes of slow walking or five minutes of swimming). The control group was given general information about diabetes and IGT and a pamphlet about diet and exercise. Main outcome measure: Diabetes (glucose level > 11.1 mmol/L), determined by biennial two-hour GTT and confirmed by a repeat GTT. Patients also had three-monthly urine tests; if results were positive, plasma glucose was tested after a standard breakfast (100 g steamed bread). If plasma glucose was > 11.1 mmol/dL, or if the doctor suspected diabetes, a 75 g GTT was performed. Subjects also received a GTT if they had signs of diabetes at any time. Main results: Compared with the control group (six-year incidence, 15.7/100 person-years [py]) the incidence of diabetes was significantly reduced in all three intervention groups: 10.0/100py in the diet group, 8.3/100py in the exercise group and 9.6/100py in the combined group. The interventions also reduced the incidence of diabetes within subgroups of those who were overweight and not overweight at baseline. Among those who were not overweight, all groups gained a small amount of weight, whereas among those overweight at baseline all groups lost weight, with the control and exercise groups both losing an average of 0.9kg/m2. There was no significant difference in the proportion of dietary energy derived from fat between the groups at follow-up.The two exercise groups significantly increased their exercise by 0.6units/day (exercise only) and 0.8 units/day (exercise and diet), compared with 0.1units/day in the control group.
Parecoxib exhibits anti-inflammatory and neuroprotective effects in a rat model of transient global cerebral ischemia

ABSTRACT Transient global cerebral ischemia (tGCI) induces inflammation leading to secondary brain injury. Data suggested that cyclooxygenase-2 (COX-2) is involved in the occurrence and development of inflammatory reaction after reperfusion; however, the effectiveness of a highly selective COX-2 inhibitor, parecoxib, to counteract tGCI remains to be determined. Thus, the aim of this study was to investigate the potential protective actions of parecoxib in a rat model of tGCI and the role inflammation plays in this disorder. Adult male Sprague-Dawley rats were administered parecoxib 10 or 20 mg/kg intraperitoneally (ip) at 5 min, 24 or 48 hr after tGCI. Control rats received an equal volume of 0.9% saline. The rat model of tGCI was established using the method of bilateral common carotid artery occlusion combined with arterial hypotension. The following parameters were measured: Neurological Severity Score, morphological changes in the hippocampal CA1 region, Evans blue (EB) extravasation, brain water content, levels of matrix metalloproteinase-9 (MMP-9), zonula occludens-1 (ZO-1), neuronal apoptosis, the protein expression of Bcl-2, Bax, COX-2, prostaglandin E2 (PGE2), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α). Parecoxib treatment significantly improved neurological function and morphological defects in the hippocampal CA1 region, reduced levels of COX-2, PGE2, IL-1β, and TNF-α. In addition, parecoxib attenuated brain edema and BBB destruction as evidenced by increased ZO-1 expression and decreased MMP-9 expression. Further, parecoxib reduced neuronal apoptosis via diminished protein expression of Bax and enhanced expression of Bcl-2.
A photocaged, water-oxidizing, and nucleolus-targeted Pt(IV) complex with a distinct anticancer mechanism.

Targeted anticancer prodrugs that can be controllably activated are highly desired for personalized precision medicine of cancer therapy. Such prodrugs with unique action modes are also promising to overcome drug resistance. Herein, we report coumaplatin, an oxaliplatin-based and photocaged Pt(IV) prodrug, to realize nuclear accumulation along with "on-demand" activation. This prodrug is based on a Pt(IV) complex that can be efficiently photoactivated via water oxidation without the requirement of a reducing agent. Coumaplatin accumulates very efficiently in the nucleoli and upon photoactivation, this prodrug exhibits a level of photocytotoxicity up to two orders of magnitude higher than that of oxaliplatin. Unexpectedly, this prodrug presents strikingly enhanced tumor penetration ability and utilizes a distinct action mode to overcome drug resistance, i.e., coumaplatin but not oxaliplatin induces cell senescence, p53-independent cell death, and immunogenic cell death along with T cell activation. Our findings not only provide a novel strategy for the rational design of controllably-activated and nucleolus-targeted Pt(IV) anticancer prodrugs but also demonstrate that accumu-lating conventional platinum drugs to the nucleus is a practical way to change its canonical mechanism of action and to achieve re-duced resistance.
Versican G1 Fragment Establishes a Strongly Stabilized Interaction with Hyaluronan-Rich Expanding Matrix during Oocyte Maturation

In the mammalian ovary, the hyaluronan (HA)-rich cumulus extracellular matrix (ECM) organized during the gonadotropin-induced process of oocyte maturation is essential for ovulation of the oocyte-cumulus complex (OCC) and fertilization. Versican is an HA-binding proteoglycan that regulates cell function and ECM assembly. Versican cleavage and function remain to be determined in ovarian follicle. We investigated versican expression in porcine ovarian follicles by real-time (RT)-PCR and western blotting. The aims of the present work were to determine whether 1) versican was produced and cleaved by porcine OCCs during gonadotropin stimulation; 2) these processes were autonomous or required the participation of mural granulosa cells (MGCs); and 3) versican cleavage was involved in the formation or degradation of expanded cumulus ECM. We demonstrate two cleavage products of G1 domain of versican (V1) accumulated in the HA-rich cumulus ECM. One of them, a G1-DPEAAE N-terminal fragment (VG1) of ~70 kDa, was generated from V1 during organization of HA in in vivo and in vitro expanded porcine OCCs. Second, the V1-cleaved DPEAAE-positive form of ~65 kDa was the only species detected in MGCs. No versican cleavage products were detected in OCCs cultured without follicular fluid. In summary, porcine OCCs are autonomous in producing and cleaving V1; the cleaved fragment of ~70 kDa VG1 is specific for formation of the expanded cumulus HA-rich ECM.
[Oxidative stress induces damage to epididymal epithelial tight junction protein ZO-1 and impairs epididymal function in varicocele rats].

Objective To investigate oxidative stress-mediated damage to the epididymal epithelial tight junction protein ZO-1 and its impact on epididymal function in varicocele rats. METHODS We randomly divided 45 male adolescent SD rats into three groups of equal number: sham operation (left renal vein exposed and isolated), experimental (left renal vein constricted and collaterals of the left spermatic vein fully ligated), and treatment (60-day intragastric administration of vitamin E at 150 mg/kg/d after modeling). At 60 days after modeling, we observed the histological changes in the left epididymis, detected the expressions of ZO-1 and other tight junction-related proteins by real-time quantitative PCR, immunohistochemistry, immunofluorescence staining and Western blotting, determined sperm motility, and measured the levels of superoxide dismutase (SOD), total antioxidant capacity (T-AOC), methylene dioxyamphetamine (MDA) and α-glucosidase (α-Glu) in the epididymal tissue of the rats. RESULTS Compared with the rats of the sham operation group, those of the experimental group showed disorganized epithelial structure and decreased number of epithelial cells in the left epididymis, with some epithelial cells desquamated into the lumen. The expression of ZO-1 was significantly lower in the experimental than in the sham operation group (P < 0.05) but markedly upregulated after VE treatment (P < 0.05). In comparison with the sham operation group, the animals in the experimental group exhibited remarkably increased content of MDA in the epididymal tissue (［0.41 ± 0.05］ vs ［1.21 ± 0.18］ nmol/mg prot, P < 0.05) but decreased levels of SOD (［814.65 ± 73.64］ vs ［298.62 ± 67.84］ U/mg prot, P < 0.05), T-AOC (［0.84 ± 0.07］ vs ［0.24 ± 0.04］ nmol/mg prot, P < 0.05) and α-Glu (［11.72 ± 2.72］ vs ［5.82 ± 1.24］ U/mg prot, P < 0.05). VE treatment, however, remarkably reduced the content of MDA (［0.69 ± 0.12］ nmol/mg prot) and elevated the levels of SOD (［497.73 ± 48.03］ U/mg prot), T-AOC (［0.42 ± 0.06］ nmol/mg prot) and α-Glu (［9.11 ± 1.91］ U/mg prot) as compared with those in the experimental group (all P < 0.05). The percentage of progressively motile sperm was significantly lower in the experimental than in the sham operation group (［31.33 ± 6.32］% vs ［71.21 ± 5.21］%, P < 0.05), but markedly increased after VE treatment (［60.68 ± 5.31］%, P < 0.05). CONCLUSIONS Varicocele reduces the expression of the EETJ protein ZO-1 and impairs epididymal function via oxidative stress, while vitamin E can effectively upregulate the ZO-1 expression and improve epididymal function by decreasing oxidative stress in the epididymis of varicocele rats.
A systematic review of the effectiveness of cohorting to reduce transmission of healthcare-associated C. difficile and multidrug-resistant organisms

Abstract Background: Cohorting of patients and staff is a control strategy often used to prevent the spread of infection in healthcare institutions. However, a comprehensive evaluation of cohorting as a prevention approach is lacking. Methods: We performed a systematic review of studies that used cohorting as part of an infection control strategy to reduce hospital-acquired infections. We included studies published between 1966 and November 30, 2019, on adult populations hospitalized in acute-care hospitals. Results: In total, 87 studies met inclusion criteria. Study types were quasi-experimental “before and after” (n = 35), retrospective (n = 49), and prospective (n = 3). Case-control analysis was performed in 7 studies. Cohorting was performed with other infection control strategies in the setting of methicillin-resistant Staphylococcus aureus (MRSA, n = 22), Clostridioides difficile infection (CDI, n = 6), vancomycin-resistant Enterococcus (VRE, n = 17), carbapenem-resistant Enterobacteriaceae infections (CRE, n = 22), A. baumannii (n = 15), and other gram-negative infections (n = 5). Cohorting was performed either simultaneously (56 of 87, 64.4%) or in phases (31 of 87, 35.6%) to help contain transmission. In 60 studies, both patients and staff were cohorted. Most studies (77 of 87, 88.5%) showed a decline in infection or colonization rates after a multifaceted approach that included cohorting as part of the intervention bundle. Hand hygiene compliance improved in approximately half of the studies (8 of 15) during the respective intervention. Conclusion: Cohorting of staff, patients, or both is a frequently used and reasonable component of an enhanced infection control strategy. However, determining the effectiveness of cohorting as a strategy to reduce transmission of MDRO and C. difficile infections is difficult, particularly in endemic situations.
2D linear array device as a quality assurance tool in brachytherapy applications

Background: External beam radiotherapy and brachytherapy plays a vital role in the management of cancer cervix. High dose rate brachytherapy is being presently used worldwide for the brachytherapy applica ons. At present, 2Dimensional linear array detectors are the most common QA tool used for pretreatment pa ent specific quality assurance in external beam radiotherapy alone and ll date no dedicated brachytherapy tool is available. An a$empt has been made to explore the feasibility of using 2 dimensional linear array, Imatrixx as a QA tool for brachytherapy. Materials and Methods: Reference treatment plans are generated by Plato treatment planning system using the images of Imatrix acquired with Siemens CT simulator. The efficacy of Imatrixx as a QA tool for intracavitary treatment plan verifica on, dwell posi on and dwell me accuracy verifica on are studied. Results: The length and the widths along with the area of the reference isodose curves of the intracavitary treatment plans generated by Plato Planning system and measured with Imatrixx is compared. The difference in area of the reference isodose curve is found to vary from -0.59 cm2 to 4.59 cm 2 . The es mated user correc on factor for Iridium-192 energy, 0.38 MeV is 1.090 with a standard devia on of ±0.0211. Machine related QA such as dwell posi on and dwell me were measured with Imatrixx with an accuracy of 0.5 mm and 0.02 s respec vely. Conclusion: Results shows that the 2-Dimensional linear array, Imatrixx can be used with accepted accuracy for both machine and pa ent specific quality assurance in brachytherapy treatments.
High-Intensity 10-s Work: 5-s Recovery Intermittent Training Improves Anaerobic and Aerobic Performances

ABSTRACT Purpose and Methods: To compare the effects of a set of 12–30 min, maximal effort, constant load cycle bouts (HICT) to 12 short work: shorter rest (10 s: 5 s) interval sessions (INT) of similar duration and effort, performed on alternate days over 4 weeks, on performance and V̇O2 l.min−1. INT sessions consisted of repeated cycles of 10 s work followed by 5 s of recovery for 30 min. Fourteen male athletes (83 kg ± 6, 24year ± 2) were randomly assigned to HICT (n = 7) or INT (n = 7) training. Pre- and post-power output (PO), V̇O2 and V̇O2peak, during 60s, 3 min, and ramp (RAMP) tests were collected Results: Between group comparisons showed increased mean PO, pre- to post-INT training (p = .026) over the last min of the 3-min test whereas PO post-HICT training declined. INT showed greater training effects on the 60 s test than HCIT (INT 506 ± 45 to 535 ± 55 W; p = .002, Cd = .57; HCIT 513 ± 78 to 548 ± 83 W; p = .02, Cd = 27). RAMP peak PO and V̇O2peak increased within both groups (INT 341 ± 63 to 370 ± 48 W, p = .002, Cd = 0.52; HICT 332 ± 45 to 353 ± 44 W, p = .006, Cd = .53; 3.73 ± 0.68 to 4.06 ± 0.63 L·min−1, p = .001, Cd = .50; 3.75 ± 0.62 to 4.09 ± 0.52 L·min−1, p = .002, Cd = .59). Conclusion(s): These results show that utilizing this novel short work: shorter rest (10 s: 5 s) interval training paradigm will elicit better performances in moderate duration performances compared to continuous training of the same duration, effort, and frequency.
Quantification of contrast-uptake as imaging biomarker for disease progression of renal cell carcinoma after tumor ablation

Background The prognosis of patients with renal cell carcinoma (RCC) depends greatly on the presence of extra-renal metastases. Purpose To investigate the value of total tumor volume (TTV) and enhancing tumor volume (ETV) as three-dimensional (3D) quantitative imaging biomarkers for disease aggressiveness in patients with RCC. Material and Methods Retrospective, HIPAA-compliant, IRB-approved study including 37 patients with RCC treated with image-guided thermal ablation during 2007–2015. TNM stage, RENAL Nephrometry Score, largest tumor diameter, TTV, and ETV were assessed on cross-sectional imaging at baseline and correlated with outcome measurements. The primary outcome was time-to-occurrence of extra-renal metastases and the secondary outcome was progression-free survival (PFS). Correlation was assessed using a Cox regression model and differences in outcomes were shown by Kaplan–Meier plots with significance and odds ratios (OR) calculated by Log-rank test/generalized Wilcoxon and continuity-corrected Woolf logit method. Results Patients with a TTV or ETV > 5 cm3 were more likely to develop distant metastases compared to patients with TTV (OR 6.69, 95% confidence interval [CI] 0.33–134.4, P=0.022) or ETV (OR 8.48, 95% CI 0.42–170.1, P=0.016) < 5 cm3. Additionally, PFS was significantly worse in patients with larger ETV (P = 0.039; median PFS 51.87 months vs. 69.97 months). In contrast, stratification by median value of the established, caliper-based measurements showed no significant correlation with outcome parameters. Conclusion ETV, as surrogate of lesion vascularity, is a sensitive imaging biomarker for occurrence of extra-renal metastatic disease and PFS in patients with RCC.
The essential of inflammatory bowel disease— from ultrasound to MRI in pediatric imaging

Poster: "ECR 2018 / C-2657 / The essential of inflammatory bowel disease— from ultrasound to MRI in pediatric imaging" by: "A. C. Nicolae, O. Rizea, R. G. Nicolaescu, I. G. Lupescu; Bucharest/RO"
The natural history of progressive fibrosing interstitial lung diseases

We used data from the INBUILD and INPULSIS trials to investigate the natural history of progressive fibrosing interstitial lung diseases (ILDs). Subjects in the two INPULSIS trials had a clinical diagnosis of idiopathic pulmonary fibrosis (IPF) while subjects in the INBUILD trial had a progressive fibrosing ILD other than IPF and met protocol-defined criteria for ILD progression despite management. Using data from the placebo groups, we compared the rate of decline in forced vital capacity (FVC) (mL·year−1) and mortality over 52 weeks in the INBUILD trial with pooled data from the INPULSIS trials. The adjusted mean annual rate of decline in FVC in the INBUILD trial (n=331) was similar to that observed in the INPULSIS trials (n=423) (−192.9 mL·year−1 and −221.0 mL·year−1, respectively; nominal p-value=0.19). The proportion of subjects who had a relative decline in FVC >10% predicted at Week 52 was 48.9% in the INBUILD trial and 48.7% in the INPULSIS trials, and the proportion who died over 52 weeks was 5.1% in the INBUILD trial and 7.8% in the INPULSIS trials. A relative decline in FVC >10% predicted was associated with an increased risk of death in the INBUILD trial (hazard ratio 3.64) and the INPULSIS trials (hazard ratio 3.95). These findings indicate that patients with fibrosing ILDs other than IPF, who are progressing despite management, have a subsequent clinical course similar to patients with untreated IPF, with a high risk of further ILD progression and early mortality. Analyses of data from the INBUILD and INPULSIS trials suggest that progressive fibrosing ILDs other than IPF have a clinical course similar to IPF, irrespective of underlying ILD diagnosis or the fibrotic pattern on HRCT http://bit.ly/3apG0Q5
Role of cytoplasmic dynein and kinesins in adenovirus transport

Following receptor‐mediated uptake into endocytic vesicles and subsequent escape, adenovirus particles are transported along microtubules. The microtubule motor proteins dynein and one or more kinesins are involved in this behavior. Dynein is implicated in adenovirus transport toward the nucleus. The kinesin Kif5B has now been found to move the adenovirus (AdV) toward microtubule plus ends, though a kinesin role in adenovirus‐induced nuclear pore disruption has also been reported. In undifferentiated cells, dynein‐mediated transport predominates early in infection, but motility becomes bidirectional with time. The latter behavior can be modeled as a novel assisted diffusion mechanism, which may allow virus particles to explore the cytoplasm more efficiently. Cytoplasmic dynein and Kif5B have both been found to bind AdV through direct interactions with the capsid proteins hexon and penton base, respectively. We review here the roles of the microtubule motor proteins in AdV infection, the relationship between motor protein recruitment to pathogenic vs. physiological cargoes, the evolutionary origins of microtubule‐mediated AdV transport, and a role for the motor proteins in a novel host‐defense mechanism.
Synopsis on Human Babesiosis and Health Implication: A Commentary

Copyright: © 2017 Sanyaolu A. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. *Corresponding author: Adekunle Sanyaolu, Department of Microbiology & Immunology, Saint James School of Medicine Anguilla campus, Park Ridge, Illinois, USA E-mail: sanyakunle@gmail.com