Miracle-dz/UniFAR-FTUs huggingface dataset:
Establishment and Evaluation of a Predictive Model for Early Postoperative Recurrence of Hepatocellular Carcinoma in Patients with Microvascular Invasion

Objective The present study aimed to identify the risk factors for early postoperative recurrence of hepatocellular carcinoma (HCC) in patients with microvascular invasion (MVI) and develop a predictive model. Inclusion Population and Methods Patients who underwent surgery for HCC with pathological identification of MVI at the Cancer Hospital of the Chinese Academy of Medical Sciences from January 2014 to June 2019 were consecutively enrolled in this study. A total of 416 patients were included, divided into an early recurrence group (N = 169) and a non-early recurrence group (N = 247), taking 12 months as the cut-off point for early recurrence. Univariate and multivariate Cox analysis was adopted to screen for risk factors for recurrence, and independence of risk factors was determined by logistic regression analysis. All variables were included in the logistic regression analysis. As previous studies have shown that tumor diameter is a risk factor for recurrence, this was also included in the analyses. A predictive model for early recurrence was established and evaluated. Results The results indicate that MVI grouping, preoperative serum AFP, number of tumors, satellite nodules, hepatic capsule invasion, tumor diameter, and lymph node metastasis are independent risk factors for early postoperative recurrence. The above factors were adopted to develop a predictive model. The model had good discrimination and calibration in predicting early postoperative recurrence. Decision curve analysis demonstrated good clinical utility. Conclusion MVI grouping, preoperative serum AFP, number of tumors, satellite nodules, hepatic capsule invasion, tumor diameter, and lymph node metastasis were shown to be independent risk factors for early postoperative recurrence. The predictive model developed by applying the above risk factors had good predictive value in patients with early postoperative recurrence.
Detection of Free Toxin B in the Stool of Asymptomatic Clostridioides difficile Carriers by the Cell Cytotoxicity Neutralization Assay

Abstract Cell cytotoxicity neutralization assay (CCNA) is considered to be a gold standard to diagnose Clostridioides difficile infections. We performed CCNA on 77 consecutive admission screening rectal swabs from asymptomatic toxigenic C. difficile carriers. Thirty-nine percent of specimens from asymptomatic carriers were positive. Thus, CCNA specificity may be lower than previously thought.
Feasibility of a 6-Month Home-Based Fall Prevention Exercise Program in Older Adults with COPD

Purpose Older adults with chronic obstructive pulmonary disease (COPD) have a high risk and rate of falls. Home-based fall prevention exercise programs reduce falls in older adults and may be an alternative approach for people with COPD without access to hospital-based rehabilitation. Therefore, we aimed to determine the feasibility of a home-based fall prevention exercise program in older adults with COPD and to examine the effect of the program on fall-related outcomes at baseline, 3 and 6 months. Patients and Methods Adults ≥60 years with COPD at risk for falls participated in a single group study. The intervention was a 6-month home-based fall prevention program which included 40 minutes of independent exercise three times per week, four physiotherapist home visits, bimonthly phone calls, and an optional booster session post-exacerbation. An independent assessor collected outcome measures at home at baseline, 3- and 6-months. Primary feasibility criteria were recruitment and retention rates (≥70%) and exercise adherence (≥60%). Functional outcomes included the Berg Balance Scale (BBS), the Balance Evaluation Systems Test (BESTest), the Activities-Specific Balance Confidence (ABC) scale, the repeated chair-stand test, self-reported function, and fall history. Results Thirty-six patients (female 63.8%, mean age 74.4 ± 6.1 years; mean FEV1 45.0 ± 13.8% predicted) were enrolled. The recruitment rate was 46.8%, participant retention rate was 69.4%, and exercise adherence rate was 73.6%. Repeated measures ANOVA showed improvements at 3- and 6-months compared to baseline in the BBS (p=0.001) and the BESTest total scores and sub-scores (p=0.001). Conclusion The home-based fall prevention exercise program met one of the three pre-specified feasibility criteria (exercise adherence), and improved balance-related measures of fall risk in older adults with COPD. Our findings highlight important opportunities for refinement of the study design prior to undertaking a full-scale trial.
The crystal structure of franckeite, Pb21.7Sn9.3Fe4.0Sb8.1S56.9

Abstract The layer-like crystal structure of franckeite from the mine of San José, Bolivia, exhibits a pronounced one-dimensional transversal wave-like modulation and a non-commensurate layer match in two dimensions. It consists of alternating pseudohexagonal (H) layers and pseudotetragonal (Q) slabs and forms a homologous pair with cylindrite, which has thinner Q slabs. The Q slabs in franckeite are four atomic layers thick. The two components have their own lattices and a common modulation. The Q slab of the refined franckeite structure, Pb21.74Sn9. 34Fe3.95Sb8. 08S56.87, is an MS layer (M = Pb2+, Sn2+, Sb3+) four atomic planes thick, with a = 5.805(8), b = 5.856(16) Å, and the layer-stacking vector c = 17.338(5) Å. The lattice angles are α = 94.97(2)°, β = 88.45(2)°, γ = 89.94(2)°; the modulation vector q = -0.00129(8) a* + 0.128436(10) b* - 0.0299(3) c*. The H layer is a single-octahedron MS2 layer (M = Sn4+, Fe2+) with a = 3.665(8), b = 6.2575(16), c = 17.419(5) Å, α = 95.25(2)°, β = 95.45(2)°, γ = 89.97(2)°; the modulation vector is q = -0.00087(8) a* + 0.13725(16) b* - 0.0314(4) c*. The a and b vectors of both subsystems are parallel; the c vectors diverge. (3+2)D superspace refinement was performed in the superspace group C1, using 7397 observed reflections. It resulted in the overall R(obs) value equal to 0.094. The Q slabs are composed of two tightly bonded double-layers, separated by an interspace hosting non-bonding electron pairs. Average composition of cations on the outer surface was refined as Pb0.74(Sn,Sb)0.26, whereas that of cations, which are adjacent to the interspace with lone electron pairs, with a configuration analogous to that observed in orthorhombic SnS, corresponds to (Sn,Sb)0.73Pb0. 27. Iron is dispersed over the octahedral Sn4+ sites in the H layer. Transversal modulation of the Q slab is achieved by local variations in the Pb:(Sn,Sb) ratios at its surface and interior. Its purpose is to re-establish a one-dimensional commensurate contact along [010] between the curved Q and H surfaces to the greatest extent possible. Layer-stacking disorder and divergence of the Q and H stacking directions, and the divergence between modulation wave-front and these stacking directions are typical for the composite structures of franckeite and cylindrite. Because of the increased rigidity of the Q component, franckeite usually forms masses of curved crystals rather than cylindrical aggregates. The existence of this family depends critically on the radius ratios of the cations involved, especially those involving (Pb2+, Sn2+) and Sn4+. Their replacement by a Pb2+:Bi3+ combination leads to misfit layer structures of a very different type, typified by cannizzarite.
Adolescent autism and autoimmune diagnoses linked to infant gut bacteria whose prevalence is associated with at-risk genetics and/or diet

The earliest predictors of future autoimmune diseases are a series of autoantibodies that are rarely evaluated and very within and between diseases. In addition, autoantibodies often appear just prior to disease onset. All of these factors make it difficult to apply interventions that might prevent disease. Earlier predictors of disease are needed. Here, a general population cohort was used to assess whether gut bacterial biomarkers could be identified prior to disease. Gut microbiome analysis on 1,741 one-year old Swedish children was performed on samples collected in the late 1990s. These children were then followed for 18 years for the incidence of five autoimmune diseases and autism. Specific bacterial strains in the gut microbiome of one-year-old children have been identified as exclusive to the 96 subjects (cases) who acquired type 1 diabetes, celiac disease, hypothyroidism, Crohns disease, juvenile idiopathic arthritis, or autism over their next 18 years. None of these strains were found in the 1,645 children (controls) who did not acquire any of these diseases. Ten other strains were exclusive to those who remained disease-free. In most cases, the presence or absence of these bacteria were strongly associated with: 1) high-risk class II human leukocyte antigen (HLA) alleles; 2) dietary factors; or 3) a combination of HLA genetics and diet. These results have three significant implications: 1) certain class II HLA haplotypes may serve as bacterial gatekeepers early in life, altering microbiome composition thereby creating the potential for dysbiosis and inflammation; 2) the gut microbiome dysbiosis and inflammation during infancy, largely derived from host HLA genetics and diet, may be a common precedent to all five autoimmune diseases and autism; and 3) HLA gatekeeping may prevent gut colonization of beneficial bacteria in those genetically at-risk individuals who could most benefit from probiotic therapy.
Revision periarterial sympathectomy for recurrent digital ischaemia: a report with 11 patients

Following periarterial sympathectomy, patients with recurrent digital ischemia due to vasospastic or vaso-occlusive disease have few remaining treatment options. We performed a retrospective review from 1997 to 2019 to determine the safety and efficacy of revision periarterial sympathectomy. Eleven patients were identified who underwent revision periarterial sympathectomy, performed on average 84 months after their initial procedure. Preoperatively, all patients had worsening ischemic pain and five had non-healing digital ulcers. Revision digital periarterial sympathectomy alone was performed in seven patients, while four had a more extensive sympathectomy. Mean follow-up after revision was 23 months (range 3 to 76). Eight patients had symptomatic improvement and four healed their digital ulcers. Three patients developed new ulcers during follow-up, of which two healed with conservative management and one required three digital amputations. Revision periarterial sympathectomy is effective in providing symptomatic improvement and digital ulcer healing with minimal postoperative complications. Level of evidence: IV
Impact of revascularisation on outcomes in chronic coronary syndromes: a new meta-analysis with the same old biases?

The opinions expressed in this article are not necessarily those of the Editors of the European Heart Journal or of the European Society of Cardiology. * Corresponding author. David L. Brown, MD, Department of Medicine (Cardiovascular Medicine), Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8086, St. Louis, MO 63110, Phone: 314-362-1291, Fax: 314-996-3268, Email: d.brown@wustl.edu Published on behalf of the European Society of Cardiology. All rights reserved. VC The Author(s) 2021. For permissions, please email: journals.permissions@oup.com. European Heart Journal (2021) 00, 1–4 EDITORIAL
Outcome predictors of platelet‐rich plasma injection for moderate carpal tunnel syndrome

Platelet‐rich plasma (PRP) injection is effective for mild‐to‐moderate carpal tunnel syndrome (CTS), and physicians have been using PRP injections to treat CTS. However, the predictive factors of PRP injections have not been evaluated. This retrospective study sought to identify the predictive factors of PRP injections in patients with moderate CTS.
Certification in endovascular hemostasis for trauma surgeons: Possible and practical?

BACKGROUND Endovascular hemostasis is commonplace with many practitioners providing services. Accruing sufficient experience during training could allow acute care surgeons (ACSs) to expand their practice. We quantified case load and training opportunities at our center, where dedicated dual-trained ACS/vascular surgery faculty perform these cases. Our aim was to assess whether ACS fellows could obtain sufficient experience in 6 months of their fellowship in order to certify in these techniques, per the requirements of other specialties. METHODS We performed a retrospective case series where we reviewed 6 years (2013–2018) of endovascular activity at an academic, level I trauma center quantifying arterial access, angiography, embolization, stent and stent graft placement, and IVC filter procedures. This was compared with the certification requirements for interventional radiology, vascular surgery, cardiothoracic surgery, and interventional cardiology. RESULTS Between 2013 and 2018, 1,179 patients with a mean ± SD Injury Severity Score of 22.47 ± 13.24, underwent 4960 procedures. Annual rates per procedure, expressed as median (interquartile range), were arterial access 193.5 (181–195.5), diagnostic angiography 352 (321.5–364.5), embolization 90.5 (89.25–93.25), stent placement 24 (13.5–29.25), and IVC filter procedures 16.5 (10–23.75). Our 6-month case volume exceeded or was within 85% of the required number of cases for vascular surgery and interventional radiology training, with the exception of stent-graft deployment for both specialties, and therapeutic procedures for vascular surgery. CONCLUSION The case volume at a large trauma center with a dedicated endovascular trauma service is sufficient to satisfy the case requirements for endovascular certification. Our trainees are already acquiring this experience informally. An endovascular trauma curriculum should now be developed to support certification within ACS fellowship training.
Trigeminal neuralgia: a practical guide

Trigeminal neuralgia (TN) is a highly disabling disorder characterised by very severe, brief and electric shock like recurrent episodes of facial pain. New diagnostic criteria, which subclassify TN on the basis of presence of trigeminal neurovascular conflict or an underlying neurological disorder, should be used as they allow better characterisation of patients and help in decision-making regarding medical and surgical treatments. MR imaging, including high-resolution trigeminal sequences, should be performed as part of the diagnostic work-up. Carbamazepine and oxcarbazepine are drugs of first choice. Lamotrigine, gabapentin, pregabalin, botulinum toxin type A and baclofen can be used either alone or as add-on therapy. Surgery should be considered if the pain is poorly controlled or the medical treatments are poorly tolerated. Trigeminal microvascular decompression is the first-line surgery in patients with trigeminal neurovascular conflict while neuroablative surgical treatments can be offered if MR imaging does not show any neurovascular contact or where patients are considered too frail for microvascular decompression or do not wish to take the risk.
Presence of ipsilateral acoustic reflex artifact may result in clinical misidentification

Abstract Objective Upon calibration of a specific commercially available immittance device, an artifact was consistently measured in a calibration cavity when in ipsilateral acoustic reflex mode. These results were replicated in a controlled fashion, raising concerns about how clinical results might potentially be misinterpreted. Design Responses were measured from an Interacoustics Titan and Grason-Stadler Tympstar Pro immittance device coupled to a 0.2 cc and, separately, to a 1.0 cc calibration cavity when in ipsilateral acoustic reflex mode. The procedure was repeated with the same outcomes. Results Clinically significant responses ordinarily associated with presence of an ipsilateral acoustic reflex were obtained in a 0.2 cc and 1 cc coupler with stimuli presented at 0.5 kHz, 1 kHz, and 2 kHz with one of the Interacoustics Titan, but were not obtained in the same conditions with the Grason-Stadler Tympstar Pro. Conclusions A commercially available immittance device yielded clinically-significant responses to ipsilateral acoustic reflex stimuli within calibration cavities of various sizes. Results suggest that false-positive responses may be obtained when certain immittance devices are used clinically, producing possible misleading or incorrect clinical impressions and assessment.
Readmission following both cardiac and non‐cardiac acute dyspnoea is associated with a striking risk of death

Readmission and mortality are the most common and often combined endpoints in acute heart failure (AHF) trials, but an association between these two outcomes is poorly investigated. The aim of this study was to determine whether unplanned readmission is associated with a greater subsequent risk of death in patients with acute dyspnoea due to cardiac and non‐cardiac causes.
An analysis of distinct navigational domains and topographical disorientation syndromes in ABI: A meta-analysis

ABSTRACT Topographical disorientation is the impairment or inability to successfully navigate in three-dimensional space. Differing topographical disorientation syndromes have been associated with distinct lesion sites in the acquired brain injury (ABI) literature. This meta-analysis attempted to investigate the relationship between lesion location and dysfunctions in specific navigational abilities resulting in topographical disorientation in individuals with ABI, as measured by their performance on experimental and neuropsychological tests. It was expected that focal lesions would be associated with a specific navigational deficit in one ability, with relative sparing of other navigational abilities. Twenty-six papers met the inclusion criteria for the analysis. Results indicated that ABI populations performed worse on all measures of navigation, with moderate to large effect sizes. Dysfunctions in three core navigational skills were consistent with the available lesion studies: a feature/landmark processing unit, a spatial processing unit, and a spatial/feature binding and associative learning unit. A sequential processing model was created to attempt to best represent the transfer of information between these units and the process by which navigational knowledge is generated. The model was then used to assess the validity of existing models of navigation and topographical disorientation.
Baicalin relieves Mycoplasma pneumoniae infection-induced lung injury through regulating microRNA-221 to inhibit the TLR4/NF-κB signaling pathway

Mycoplasma pneumoniae (MP) is a common pathogen that can cause respiratory infections. MP pneumonia (MPP) leads to numerous complications, including lung injury and even death. The present study aimed to investigate the protective effects of Baicalin treatment on MP infection-induced lung injury and the molecular mechanism underlying these effects. Briefly, after mice were infected intranasally by MP and treated with Baicalin (80 mg/kg), serum levels of MP-immunoglobulin M (IgM) were detected by ELISA. The expression levels of C-reactive protein (CRP) in lung tissue were detected by immunohistochemistry and the bronchoalveolar lavage fluid (BALF) was examined by ELISA. Inflammatory factors and inflammatory cells in the BALF were assessed. The expression levels of microRNA (miR)-221 in lung tissue were examined by reverse transcription-quantitative PCR and pathological changes in lung tissue were detected by H&E staining. Cell apoptosis was evaluated by TUNEL assay and the protein expression levels of TLR4, MyD88 and NF-κB were detected by western blotting. Baicalin treatment significantly reduced serum levels of MP-IgM and CRP expression in lung tissue during MP infection. In addition, Baicalin decreased the levels of IL-1β, IL-6, IL-18 and TNF-α in the BALF, and the number of inflammatory cells. Baicalin also reduced the inflammatory infiltration in lung tissue induced by MP infection, improved the pathological changes detected in lung tissue, reduced apoptosis, and downregulated the protein expression levels of TLR4, MyD88 and NF-κB. Furthermore, Baicalin treatment downregulated the expression of miR-221 and the protective effects of Baicalin were attenuated by miR-221 overexpression. In conclusion, Baicalin has a therapeutic effect on mice with MP infection-induced lung injury, which may be related to inhibition of miR-221 expression and regulation of the TLR4/NF-κB signaling pathway.
Facing the challenges of multidrug-resistant Acinetobacter baumannii: progress and prospects in the vaccine development

ABSTRACT In 2017, the World Health Organization (WHO) named A. baumannii as one of the three antibiotic-resistant bacterial species on its list of global priority pathogens in dire need of novel and effective treatment. With only polymyxin and tigecycline antibiotics left as last-resort treatments, the need for novel alternative approaches to the control of this bacterium becomes imperative. Vaccines against numerous bacteria have had impressive records in reducing the burden of the respective diseases and addressing antimicrobial resistance; as in the case of Haemophilus influenzae type b . A similar approach could be appropriate for A. baumannii. Toward this end, several potentially protective antigens against A. baumannii were identified and evaluated as vaccine antigen candidates. A licensed vaccine for the bacteria, however, is still not in sight. Here we explore and discuss challenges in vaccine development against A. baumannii and the promising approaches for improving the vaccine development process.
Molecular epidemiology of Microsporidia among HIV-positive and HIV-negative patients in the Limpopo province, South Africa.

INTRODUCTION Human microsporidiosis represents an important and rapidly emerging opportunistic disease. The present study investigated the prevalence of microsporidia among HIV positive and HIV negative patients with or without diarrhoea in Vhembe and Mopani Districts in the Limpopo Province. METHODOLOGY A total of 170 stool samples were collected from these patients and microsporidia species was detected using a Real-Time PCR targeting a conserved region of the small ribosomal subunit rRNA (SSU-rRNA) gene of Enterocytozoon bieneusi, Encephalitozoon intestinalis, Encephalitozoon hellem, and Encephalitozoon cuniculi. RESULTS Fifty six (32.9%) were positive for microsporidia. The prevalence was higher in HIV negative patients (36.6%) while 24.1% of patients who were HIV positive had microsporidia. Microsporidia was more common among patients aged between 1 and 10 years (52.6%). However among the HIV positive patients, microsporidia prevalence was higher among those that were not taking antiretrovirals (ARVs) compared to those who were on ARVs, (36.6%) and (24.1%), respectively. Microsporidia was also noted to be significantly associated with diarrheal and stomach pains; p = 0.02 and p = 0.048, respectively. Furthermore, microsporidia infections was more prevalent among patients who had animals at home (p = 0.037). CONCLUSIONS Study has shown a high prevalence of microsporidia among patients attending primary health centers in the Mopani District for the first time. Prevalence of microsporidia was higher among HIV negative and HIV positive patients who were not on ARV treatment. Keeping animals in the household appeared to be a risk of getting infected with microsporidia. Further studies are needed to determine the genetic characteristics of these organisms in the study population.