Miracle-dz/UniFAR-FTUs huggingface dataset:
Hypoglycemia in Critically Ill Patients

Dysglycemia is common in critically ill patients. Both hyperglycemia and hypoglycemia are independent risk factors for increased morbidity and mortality. Hypoglycemia severity may even have a ‘dose-response’ relationship with increased mortality(Bagshaw et al., 2009). Acute hypoglycemia induces a systemic, counter-regulatory stress response that leads to an increase in blood norepinephrine, epinephrine, glucagon, growth hormone, and cortisol concentrations. Risk factors that are associated with the occurrence of hypoglycemia in ICU patients include severity of illness, strict glucose control, continuous veno-venous hemodialysis, decrease of nutrition without adjustment for insulin infusion, a prior diagnosis of diabetes mellitus, sepsis, and need for inotropic support (Arabi et al, 2009;Krinsley & Grover, 2007;Vriesendorp et al. ,2006). The association between hyperglycemia and mortality seems population dependent, with the strongest association in patients in the cardiac, cardiothoracic and neurological ICU(Whitcomb et al., 2005). During acute illness, hyperglycemia might exert an even more deleterious effect on ICU patients without diabetes than among patients with diabetes(Capes et al., 2000;Krinsley 2006;Rady et al., 2005). Unlike nondiabetic patients, diabetic patients show no clear association between hyperglycemia during intensive care unit stay and mortality and markedly lower odds ratios of death at all levels of hyperglycemia. These findings suggest that, in critically patients with diabetes mellitus, hyperglycemia may have different biological and/or clinical implications(Egi et al., 2008). Recently, variability of glucose concentrations has been identified as an additional factor that may contribute to the mortality and morbidity of dysglycemia. A retrospective evaluation of over 7000 patients identified glycemic variability, defined as the standard deviation of each patient’s mean glucose level during ICU stay, as a stronger predictor of mortality than hyperglycemia(Egi et al., 2006). High glucose variability during ICU stay was associated with increased mortality in patients without diabetes, even after adjustment for severity of illness and mean glucose concentration(Krinsley 2009). In contrast, there was no independent association of glucose variability with mortality among patients with diabetes. Glucose variability contributes to ICU mortality and in-hospital death by increasing oxidative stress, neuronal damage, mitochondrial damage, and coagulation activation. The relation between glucose concentration and outcome is complex and not linear. The interaction between glucose concentrations and outcome may arise from independent and synergistic domains of glycemic control including central tendency (such as mean and
Rates and Patterns of Lower Extremity Sports Injuries in All Gender-Comparable US High School Sports

Background: High school athletes with lower extremity sports injuries (LESIs) frequently present to the emergency department in the United States. Previous epidemiological studies have presented rates and mechanisms of LESIs in these athletes. No studies, however, have looked at LESIs in gender-comparable sports in an attempt to evaluate what differences exist between LESIs in boys and girls. Purpose: To describe the epidemiology of LESIs among US high school athletes using a large national database of athletes in sports that could be considered gender comparable, given the rules of play and protective equipment. Study Design: Descriptive epidemiology study. Methods: Descriptive data from 2005 to 2016 were collected using the internet-based High School Reporting Information Online (High School RIO), a national high school sports injury surveillance system, for athletes participating in 8 gender-comparable sports (soccer, volleyball, basketball, baseball/softball, swimming and diving, track and field, cross-country, and tennis). Rates and patterns of injury were evaluated, with injury rates calculated as ratio of injuries per 10,000 athlete-exposures. Rate ratios (RRs) were calculated to compare the LESI rates in girls and boys. Results: In both genders, LESI rates (per 10,000 athlete-exposures) were highest in soccer (girls, 15.87; boys, 11.68) followed by basketball (girls, 11.51; boys, 9.35), and were lowest in swimming and diving (girls, 0.70; boys, 0.39). Although injury rates were significantly higher in girls compared with boys in all sports, only in tennis was the RR greater than 2 (RR, 2.03; 95% CI, 1.17-3.54). Girls had a greater proportion of severe LESIs and injuries that received radiographic evaluation, such as magnetic resonance imaging, compared with boys for all sports except volleyball. Consistency in the mechanism of injury was demonstrated between genders within each sport. Conclusion: This study demonstrated that LESIs are common among high school athletes and disproportionately affect girls more than boys, especially when looking at severe injuries and resource utilization. Further studies are needed to elucidate the cause of these findings. We hope that the awareness of gender-based differences in LESIs will lead to improvements in targeted efforts to decrease injury rates and injury severity.
A Tetra-PEG Hydrogel Based Aspirin Sustained Release System Exerts Beneficial Effects on Periodontal Ligament Stem Cells Mediated Bone Regeneration

Bone defects, massive bone defects in particular, is still an issue clinically. Acetylsalicylic acid (ASA), also known as aspirin, has been proven to be conducive for mesenchymal stem cells osteogenic differentiation, which may be benefited for bone regeneration. In order to achieve a more appealing prognosis of bone defect, here we develop a well-defined tetra-PEG hydrogel sealant with rapid gelation speed, strong tissue adhesion, and high mechanical strength. After in-situ encapsulation of aspirin, this drug-loaded tetra-PEG hydrogel possessed a sustained release, anti-inflammation, and osteoinductive properties. In vitro experiments showed that the cell proliferation was slightly facilitated, and the osteogenic differentiation was notably augmented when periodontal ligament stem cells (PDLSCs) were co-incubating with the hydrogel materials. Moreover, in vivo study manifested that the aspirin sustained release system significantly facilitated the PDLSCs mediated bone defect regeneration. Overall, tetra-PEG hydrogel-based aspirin sustained release system is applicable not only for enhancing the osteogenesis capacity of PDLSC but also providing a new thought of bone regenerative therapy.
Lactic Acid Treatment of Cereals and Dietary Phytase Modified Fecal Microbiome Composition Without Affecting Expression of Virulence Factor Genes in Growing Pigs

Besides the major nutrients, phosphorus (P) is an essential mineral for both the host animal and the porcine gut microbiota. Different strategies including phytase supplementation and more recently lactic acid (LA) are used to enhance the P availability from cereals in pig diets; however, their impact on the gut microbiota has been rarely related to fecal shedding of opportunistic pathogens. The present study investigated the effect of phytase supplementation and the treatment of dietary cereals with 2.5% LA on the fecal microbiome composition of metabolic active bacteria and expression of virulence factor genes of enterotoxigenic Escherichia coli and Clostridium perfringens in growing pigs. Phytase supplementation reduced the fecal abundance of the most abundant Lactobacillaceae family, whereas the LA-treatment of cereals had a stronger impact on the bacterial community, reducing amylolytic, pullulanolytic and hemicellulolytic Lactobacillaceae, Lachnospiraceae and Ruminococcaceae as well as the fecal bacterial species richness (Chao1) and diversity (Shannon index). Mainly the family Clostridiaceae benefited from the decline in the aforementioned families, being enriched by both dietary treatments. Multigroup data integration using sparse partial least squares-discriminant analysis showed that among the most discriminative operational taxonomic units (OTU) especially two unclassified Clostridiaceae-OTUs, one Prevotella copri-like OTU and one OTU within the vadinCA11 group were associated with calcium and P levels but were negatively linked with complex carbohydrates in feces. Heat-stable toxin A (Sta) of enterotoxigenic E. coli and Stx2e of Shiga-toxin producing E. coli were expressed in feces but were similar among feeding groups. Without modifying the total bacterial gene copies and virulence factor expression of E. coli, both dietary phytase supplementation and LA-treatment of cereals drastically altered the bacterial community composition in pig feces. Results thereby allowed for the characterization of bacterial nutrient dependencies, indicating a link between fecal P availability, complex carbohydrate composition and alterations in the predominant genera.
Monitoring Silent Spillovers Before Emergence: A Pilot Study at the Tick/Human Interface in Thailand

Emerging zoonoses caused by previously unknown agents are one of the most important challenges for human health because of their inherent inability to be predictable, conversely to emergences caused by previously known agents that could be targeted by routine surveillance programs. Emerging zoonotic infections either originate from increasing contacts between wildlife and human populations, or from the geographical expansion of hematophagous arthropods that act as vectors, this latter being more capable to impact large-scale human populations. While characterizing the viral communities from candidate vectors in high-risk geographical areas is a necessary initial step, the need to identify which viruses are able to spill over and those restricted to their hosts has recently emerged. We hypothesized that currently unknown tick-borne arboviruses could silently circulate in specific biotopes where mammals are highly exposed to tick bites, and implemented a strategy that combined high-throughput sequencing with broad-range serological techniques to both identify novel arboviruses and tick-specific viruses in a ticks/mammals interface in Thailand. The virome of Thai ticks belonging to the Rhipicephalus, Amblyomma, Dermacentor, Hyalomma, and Haemaphysalis genera identified numerous viruses, among which several viruses could be candidates for future emergence as regards to their phylogenetic relatedness with known tick-borne arboviruses. Luciferase immunoprecipitation system targeting external viral proteins of viruses identified among the Orthomyxoviridae, Phenuiviridae, Flaviviridae, Rhabdoviridae, and Chuviridae families was used to screen human and cattle Thai populations highly exposed to tick bites. Although no positive serum was detected for any of the six viruses selected, suggesting that these viruses are not infecting these vertebrates, or at very low prevalence (upper estimate 0.017% and 0.047% in humans and cattle, respectively), the virome of Thai ticks presents an extremely rich viral diversity, among which novel tick-borne arboviruses are probably hidden and could pose a public health concern if they emerge. The strategy developed in this pilot study, starting from the inventory of viral communities of hematophagous arthropods to end by the identification of viruses able (or likely unable) to infect vertebrates, is the first step in the prediction of putative new emergences and could easily be transposed to other reservoirs/vectors/susceptible hosts interfaces.
The fastest $\ell_{1,\infty}$ prox in the west

Proximal operators are of particular interest in optimization problems dealing with non-smooth objectives because in many practical cases they lead to optimization algorithms whose updates can be computed in closed form or very efficiently. A well-known example is the proximal operator of the vector $\ell_1$ norm, which is given by the soft-thresholding operator. In this paper we study the proximal operator of the mixed $\ell_{1,\infty}$ matrix norm and show that it can be computed in closed form by applying the well-known soft-thresholding operator to each column of the matrix. However, unlike the vector $\ell_1$ norm case where the threshold is constant, in the mixed $\ell_{1,\infty}$ norm case each column of the matrix might require a different threshold and all thresholds depend on the given matrix. We propose a general iterative algorithm for computing these thresholds, as well as two efficient implementations that further exploit easy to compute lower bounds for the mixed norm of the optimal solution. Experiments on large-scale synthetic and real data indicate that the proposed methods can be orders of magnitude faster than state-of-the-art methods.
Are cerebral veins hounsfield unit and H: H ratio calculating in unenhanced CT eligible to diagnosis of acute cerebral vein thrombosis?

Background: For both the clinician and a radiologist, the diagnosis of cerebral venous sinus thrombosis (CVST), because of the variety of signs and symptoms, remains a challenge. In this study, the role of unenhanced brain computed tomography (CT) in the diagnosis of CVST was assessed. Materials and Methods: In this case–control study, unenhanced CT of 35 patients with acute CVST was compared with 70 normal patients. Hematocrit (HCT), creatinine, and blood urea nitrogen were recorded in all patients. CT images were read, and the attenuation was measured by two independent experienced radiologists. The H:H ratio was calculated for all patients in both case and control groups to normalized densities regarding HCT. Results: The mean of attenuation in patients was 66.95 ± 10.63 Hounsfield unit (HU) and in the controls was 52.51 ± 2.92 HU (P < 0.0001). The mean of H:H ratio in patients was 1.78 ± 0.40 and in controls was 1.46 ± 0.28 (P < 0.0001). Attenuation >60.4 HU was the best optimal cutoff with area under the curve of 0.918 (0.848–0.962) and had 71.4% sensitivity and 100% specificity. H:H ratio >1.42 as the optimal cutoff had 94.3% sensitivity and 54.3% specificity for identifying the CVST. Conclusion: Attenuation value >60.4 HU and H: H ratio >1.42 calculated based on unenhanced CT can be used as reliable methods to detect CVST in the absence of magnetic resonance imaging and magnetic resonance venography in the emergency setting.
Papillary Thyroid Microcarcinoma - Do Classical Staging Systems Need to Be Changed?

It has been broadly demonstrated that there has been a dramatic, worldwide, increase in the incidence of papillary thyroid carcinoma (PTC). Leenhardt et al. [2004] showed that there was approximately a 10-fold increase in the ratio of thyroid cancer for the cohort born in 1978 compared to those born in 1928. Davies & Welch [2006] found that the incidence of thyroid cancer in the United States had more than doubled from 1973 to 2002 and that this augmentation was virtually entirely due to an increase in PTC. However, it is uncertain whether this increase is a real phenomenon, or whether it is simply due to an increased rate of detection. Practices for management of thyroid diseases were deeply modified over the past few decades. The wide availability of ultrasonography (US) and fine needle aspiration biopsy (FNAB), as well as the improved accuracy of histopathological examination of surgical samples (that is the thinness of the anatomical slice of the thyroid specimen) are indicated as causes of this so-called spreading of the epidemic [Grodski & Delbridge, 2008]. Furthermore, the characteristics of PTCs, especially its size at diagnosis, have changed over time.
Subspace Estimation from Unbalanced and Incomplete Data Matrices: 𝓁2, ∞ Statistical Guarantees

This paper is concerned with estimating the column space of an unknown low-rank matrix A ∈Rd1×d2 , given noisy and partial observations of its entries. There is no shortage of scenarios where the observations—while being too noisy to support faithful recovery of the entire matrix—still convey sufficient information to enable reliable estimation of the column space of interest. This is particularly evident and crucial for the highly unbalanced case where the column dimension d2 far exceeds the row dimension d1, which is the focal point of the current paper. We investigate an efficient spectral method, which operates upon the sample Gram matrix with diagonal deletion. While this algorithmic idea has been studied before, we establish new statistical guarantees for this method in terms of both 2 and 2,∞ estimation accuracy, which improve upon prior results if d2 is substantially larger than d1. To illustrate the effectiveness of our findings, we derive matching minimax lower bounds with respect to the noise levels, and develop consequences of our general theory for three applications of practical importance: (1) tensor completion from noisy data, (2) covariance estimation/principal component analysis with missing data and (3) community recovery in bipartite graphs. Our theory leads to improved performance guarantees for all three cases.
Synergistic effects between glycopyrronium bromide and indacaterol on a muscarinic agonist-induced contraction in airway smooth muscle

Rationale: Bronchodilators play an important role in therapy for stable chronic obstructive pulmonary disease (COPD). Anticholinergics and beta 2 -adrenoceotor agonists are widely used to improve lung function, symptoms, and QOL of patients with COPD. This study was designed to investigate whether combination of anticholinergics and beta 2 -adrenoceptor agonists is beneficial. Combined effects on airway smooth muscle contraction were examined using glycopyrronium bromide (GB), a long-acting muscarinic antagonist (LAMA), and indacaterol, a long-acting beta 2 -adrenoceptor agonist (LABA). Methods: For record of isometric tension, the strips of tracheal smooth muscle of guinea pigs were placed in the organ bath and were perfused with the physiological solution at a constant flow rate of 2 ml/min. Results: One nM indacaterol caused a modest (7.9%, n=18) inhibition of 1 μM methacholine (MCh)-induced contraction of tracheal smooth muscle. GB at 3, 10, and 30 nM caused a concentration-dependent inhibition of 1 μM MCh-induced contraction with values of percent inhibition of 11.1, 21.9, and 52.2%, respectively (each n=6). However, when equi-molars of GB were applied in the presence of 1 nM indacaterol, the inhibitory effects of GB (3, 10, and 30 nM) / indacaterol (1 nM) combination were markedly enhanced, with values of percent inhibition of 25.6 ( p p p Conclusions: Indacaterol synergistically potentiated GB-induced relaxation against cholinergic stimulation in airway smooth muscle. These results may underlie the clinical benefit of combination therapy of LABA and LAMA for patients with COPD.
Proper nutrition for athletes: the missing link.

Nutrition should be an integral part of an athlete’s training program. Yet, in the United States, American athletes and fitness exercisers alike commonly report that they do not eat as well as they should; they admit that nutrition is their missing link. Consequently, they may fail to attain the most benefits from their training programs and their competitive efforts. The purpose of this paper is to highlight the sports nutrition errors commonly made by American athletes who live in a culture where food is considered “fattening”, eatingon-the-run is the norm, and fast foods are a common alternative to home-cooked meals. Given the rapidly changing food culture in China, this information may help Chinese athletes avoid making the same nutritional mistakes. Common missing links in the sports diet of American athletes include: (1) respect for the power of a proper sports diet; (2) sufficient calories during the active part of the day; (3) equal-sized and regularly scheduled meals; (4) beneficial amount of dietary fat; (5) pre-exercise fuel; (6) optimal protein intake; (7) iron to prevent anemia; (8) post-exercise recovery food; (9) carbohydrates combined with protein for recovery food; (10) rest days for muscles to refuel; (11) adequate fluids; (12) sodium before exercise in the heat; and (13) the sports dietitian. [ J Exerc Sci Fit • Vol 6 • No 2 • 130–134 • 2008]
NR4A Expression by Human Marginal Zone B-Cells

We have previously characterized a human blood CD19+CD1c+IgM+CD27+CD21loCD10+ innate-like B-cell population, which presents features shared by both transitional immature and marginal zone (MZ) B-cells, named herein “precursor-like” MZ B-cells. B-cells with similar attributes have been associated with regulatory potential (Breg). In order to clarify this issue and better characterize this population, we have proceeded to RNA-Seq transcriptome profiling of mature MZ and precursor-like MZ B-cells taken from the blood of healthy donors. We report that ex vivo mature MZ and precursor-like MZ B-cells express transcripts for the immunoregulatory marker CD83 and nuclear receptors NR4A1, 2, and 3, known to be associated with T-cell regulatory (Treg) maintenance and function. Breg associated markers such as CD39 and CD73 were also expressed by both populations. We also show that human blood and tonsillar precursor-like MZ B-cells were the main B-cell population to express elevated levels of CD83 and NR4A1-3 proteins ex vivo and without stimulation. Sorted tonsillar precursor-like MZ B-cells exerted regulatory activity on autologous activated CD4+ T-cells, and this was affected by a CD83 blocking reagent. We believe these observations shed light on the Breg potential of MZ populations, and identify NR4A1-3 as potential Breg markers, which as for Tregs, may be involved in stabilization of a regulatory status. Since expression and activity of these molecules can be modulated therapeutically, our findings may be useful in strategies aiming at modulation of Breg responses.
Identification of Dietary Patterns Related to Metabolic Diseases and Their Association with Cardiovascular Disease: From the Korean Genome and Epidemiology Study

Using data from the community-based cohort of the Korean Genome and Epidemiology Study (KoGES), we evaluated the dietary patterns (DPs) related to metabolic diseases and their associations with the incidence of non-fatal cardiovascular disease (CVD). After excluding those with a history of CVD or cancer, we analyzed the data of 8352 subjects aged 40–69 years. Based on their daily intake of 26 food groups at baseline, the DPs of the subjects with metabolic diseases (n = 1679, 20.1%) were analyzed using principal component analysis. Due to regional differences in the effect of DPs on CVD, we performed analyses stratified by region. The association between DPs and the incidence of non-fatal CVD was evaluated by calculating the hazard ratio (HR) and 95% confidence interval (CI) using the Cox proportional hazards model. During the 12-year follow-up, the incidence of non-fatal CVD was 5.4 per 1000 person-years (n = 431). An animal-based DP made the greatest contribution to the total variance and was characterized by a high intake of pork, beef, chicken, fish, and shellfish. The effect of DP on CVD differed by region (industrial/rural regions, p < 0.05) and was dominant in industrial regions, irrespective of metabolic disease status. In industrial regions, subjects in the top quintile of DP had a 0.42-fold (95% CI = 0.24–0.74) lower risk of incident CVD than those in the bottom quintile, even after adjusting for various covariates. In addition, the risk of CVD was high in individuals with a history of metabolic disease in both regions (HR = 1.74, 95% CI = 1.24–2.43 in industrial regions; HR = 1.88, 95% CI = 1.42–2.48 in rural regions). DP and a history of metabolic diseases, but not their interaction, were independently associated with incident CVD. In our study, an animal-based DP related to metabolic disease was independently associated with incident CVD, and this effect was noticeable only in industrial regions.