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Data from: Patent foramen ovale closure, antiplatelet therapy or anticoagulation in patients with patent foramen ovale and cryptogenic stroke: a systematic review and network meta-analysis incorporating complementary external evidence
Objective: To examine the relative impact of three management options in patients less than 60 years old with cryptogenic stroke and a patent foramen ovale (PFO): PFO closure plus antiplatelet therapy, antiplatelet therapy alone, and anticoagulation alone. Design: Systematic review and network meta-analysis (NMA) supported by complementary external evidence Data sources: Medline, EMBASE, and Cochrane CENTRAL. Study selection: Randomised controlled trials (RCTs) addressing PFO closure and/or medical therapies in patients with PFO and cryptogenic stroke. Review methods: We conducted an NMA complemented with external evidence and rated certainty of evidence using the GRADE system. Results: Ten RCTs in eight studies proved eligible (n=4416). PFO closure versus antiplatelet therapy probably results in substantial reduction in ischaemic stroke recurrence (risk difference per 1000 patients over 5 years [RD]: -87, 95% credible interval [CrI] -100 to -33; moderate certainty). Compared with anticoagulation, PFO closure may confer little or no difference in ischaemic stroke recurrence (low certainty) but probably has a lower risk of major bleeding (RD -20, 95% Crl -27 to -2, moderate certainty). Relative to either medical therapy, PFO closure probably increases the risk of persistent atrial fibrillation (RD 18, CI +5 to +56, moderate certainty) and device-related adverse events (RD +36, 95% CI +23 to +50, high certainty). Anticoagulation, compared to antiplatelet therapy, may reduce the risk of ischaemic stroke recurrence (RD -71, 95% CrI -100 to +17, low certainty), but probably increases the risk of major bleeding (RD +12, CrI -5 to +65, moderate certainty). Conclusions: In patients less than 60 years old, PFO closure probably confers an important reduction in ischaemic stroke recurrence compared to antiplatelet therapy alone but may make no difference compared to anticoagulation. PFO closure incurs a risk of persistent atrial fibrillation and device-related adverse events. Compared to alternatives, anticoagulation probably increases major bleeding.
Data from: Loss of paraplegin drives spasticity rather than ataxia in a cohort of 241 patients with SPG7
Objective: We took advantage of a large multinational recruitment to delineate genotype-phenotype correlations in a large, trans-European multicenter cohort of patients with spastic paraplegia gene 7 (SPG7). Methods: We analyzed clinical and genetic data from 241 patients with SPG7, integrating neurologic follow-up data. One case was examined neuropathologically. Results: Patients with SPG7 had a mean age of 35.5 ± 14.3 years (n = 233) at onset and presented with spasticity (n = 89), ataxia (n = 74), or both (n = 45). At the first visit, patients with a longer disease duration (>20 years, n = 62) showed more cerebellar dysarthria (p < 0.05), deep sensory loss (p < 0.01), muscle wasting (p < 0.01), ophthalmoplegia (p < 0.05), and sphincter dysfunction (p < 0.05) than those with a shorter duration (<10 years, n = 93). Progression, measured by Scale for the Assessment and Rating of Ataxia evaluations, showed a mean annual increase of 1.0 ± 1.4 points in a subgroup of 30 patients. Patients homozygous for loss of function (LOF) variants (n = 65) presented significantly more often with pyramidal signs (p < 0.05), diminished visual acuity due to optic atrophy (p < 0.0001), and deep sensory loss (p < 0.0001) than those with at least 1 missense variant (n = 176). Patients with at least 1 Ala510Val variant (58%) were older (age 37.6 ± 13.7 vs 32.8 ± 14.6 years, p < 0.05) and showed ataxia at onset (p < 0.05). Neuropathologic examination revealed reduction of the pyramidal tract in the medulla oblongata and moderate loss of Purkinje cells and substantia nigra neurons. Conclusions: This is the largest SPG7 cohort study to date and shows a spasticity-predominant phenotype of LOF variants and more frequent cerebellar ataxia and later onset in patients carrying at least 1 Ala510Val variant.
Data from: Management of behavioural change in patients presenting with a diagnosis of dementia: a video vignette study with Australian general practitioners
Objective: To test the impact of feedback on the proposed management of standardised patients presenting with behavioural change with a diagnosis of dementia in Australian primary care. Materials and methods: A video vignette study was performed with Australian general practitioners (GPs) in 2013. Participants viewed six pairs of matched videos depicting people presenting changed behaviour in the context of a dementia diagnosis in two phases. In both phases GPs indicated their diagnosis and management. After phase 1, GPs were offered feedback on management strategies for the patients depicted. Analyses focused on identification of change in management between the two phases of the study. Factors impacting on the intention to coordinate care for such patients were tested in a questionnaire based on the Theory of Planned Behaviour. Results: Forty-five GPs completed the study. There was significant improvement in the proposed management of three of the six scenarios after the intervention. Older GPs were more likely to refer appropriately (OR=1.11 (1.01 to 1.23), p=0.04.). Overall referral to support agencies was more likely after the intervention (OR=2.52 (1.53 to 4.14), p<0.001). Older GPs were less likely to intend to coordinate care for such patients (OR=0.89 (0.81 to 0.98) p=0.02). Participants who felt confident about their ability to coordinate care were more likely to do so (OR=3.79 (1.08 to 13.32) p=0.04). Conclusions: The intervention described in this study promoted multidisciplinary management of patients with behavioural problems with a diagnosis of dementia. Increasing practitioner confidence in their ability to coordinate care may increase the proportion of GPs who will respond to patients and carers in this context. Older GPs may benefit in particular.
Data from: Hepatotoxicity of isotretinoin in patients with acne and Gilbert's syndrome: comparative study
Objectives: The objective of our follow-up study is to evaluate liver function tests (LFTs) and lipid profiles in patients with Gilbert's syndrome treated with isotretinoin because of severe acne. Setting: Dermatology outpatient clinics of three regional hospitals of Jaén (Spain). Participants: Over 4 years, we included all patients diagnosed with severe acne. Only 37 patients were identified, of which 11 had Gilbert's syndrome. Interventions: All patients were treated with isotretinoin and followed-up in our outpatient clinics after 10 and 20 weeks. Patients were subjected to an interview questionnaire which included data on age, gender, complete blood count, coagulation profile, fasting blood glucose, LFTs and lipid profiles. Data and results of patients with severe acne and Gilbert's syndrome were compared with those of 26 patients with only severe acne (control group). Primary: outcome Blood analyses were repeated in the follow-up visits. Results: In patients with Gilbert's syndrome, bilirubin levels showed substantial decrease over the 20-week follow-up, with more decrease after 10 weeks. None of the control group patients had significant increase in total bilirubin levels after 10 and 20 weeks of follow-up. Liver enzymes were maintained within normal levels in both groups. Both study groups did not show significant pathological increase in lipid profile levels. LDL levels were increased in the two study groups, but this increase was less substantial in patients with Gilbert's syndrome. Conclusions: Our preliminary results suggest that oral isotretinoin could be an effective, safe treatment for patients with Gilbert's syndrome, and may lower bilirubin levels in the first 10 weeks of treatment. Limitations of the study include the small numbers of participants and the fact that it is restricted to one region of Spain.
Data from: Exploring health literacy competencies toward patient education program for Chinese-speaking healthcare professionals: a Delphi study
Objectives: To achieve consensus on a set of competencies in health literacy practice based on a literature review and expert consultation. Setting: Hospitals and community health centres in Taiwan. Method: A 2-stage modified Delphi study involving a literature review was conducted, followed by qualitative interviews and 3 rounds of email-based data collection over a 3-month period in 2011. Participants: 15 Chinese healthcare practitioners with more than 6 months' experience in patient education were interviewed to collect data on health literacy practice. 24 experts (12 academic scholars in health literacy and 12 professionals with training related to health literacy practice) were invited to participate in the Delphi process. Results: Qualitative data from the interviews were analysed and summarised to form 99 competency items for health literacy practice, which were categorised into 5 domains of health literacy practice including those pertaining to knowledge and skills. Consensus was reached on 92 of 99 competencies, using a modified Delphi technique. Conclusions: The 92 competencies in health literacy practice embraced core components of patient education in the Chinese healthcare profession.
Data from: Logistic regression analysis of factors influencing the effectiveness of intensive sound masking therapy in patients with tinnitus
Objectives: To investigate factors influencing the effectiveness intensive sound masking therapy on tinnitus using Logistic Regression Analysis. Design: The study used a retrospective cross-section analysis. Participants: 102 patients with tinnitus were recruited at the Sun Yat-sen Memorial Hospital of Sun Yat-sen University, China. Intervention: Intensive sound masking therapy was used as an intervention approach for patients with tinnitus. Primary and secondary outcome measures: participants underwent audiological investigations and tinnitus pitch and loudness matching measurements, followed by intensive sound masking therapy. The Tinnitus Handicap Inventory (THI) was used as the outcome measure pre- and post-treatment. Multivariate logistic regression was performed to investigate the association of demographic and audiological factors with effective therapy. Results: According to the THI score changes pre-and post-sound masking intervention, fifty-one participants were categorised into an effective group, the remaining 51 participants were placed in a non-effective group. Those in the effective group were significantly younger than those in the non-effective group (p=0.012). Significantly more participants had flat audiogram configurations in the effective group (p=0.04). Multivariable logistic regression analysis showed that age (OR=0.96, 95% CI: 0.93, 0.99, p=0.007), audiometric configuration (p=0.027) and THI score pre-treatment (OR=1.04, 95% CI: 1.02, 1.07, p<0.001) were significantly associated with therapeutic effectiveness. Further analysis showed that patients with flat audiometric configurations were 5.45 times more likely to respond to intervention than those with high-frequency steeply sloping audiograms (OR=5.45, 95% CI: 1.67, 17.86, p=0.005). Conclusion: Audiometric configuration, age and THI scores appear to be predictive for the effectiveness of sound masking treatment. Gender, tinnitus characteristics and hearing threshold measures seem not to be related to treatment effectiveness. Further randomized control study is needed to provide further evidence of the effectiveness of prognostic factors in tinnitus interventions.
Data from: Differential neural processing during motor imagery of daily activities in chronic low back pain patients
Chronic low back pain (chronic LBP) is both debilitating for patients but also a major burden on the health care system. Previous studies reported various maladaptive structural and functional changes among chronic LBP patients on spine- and supraspinal levels including behavioral alterations. However, evidence for cortical reorganization in the sensorimotor system of chronic LBP patients is scarce. Motor Imagery (MI) is suitable for investigating the cortical sensorimotor network as it serves as a proxy for motor execution. Our aim was to investigate differential MI-driven cortical processing in chronic LBP compared to healthy controls (HC) by means of functional magnetic resonance imaging (fMRI). Twenty-nine subjects (15 chronic LBP patients, 14 HC) were included in the current study. MI stimuli consisted of randomly presented video clips showing every-day activities involving different whole-body movements as well as walking on even ground and walking downstairs and upstairs. Guided by the video clips, subjects had to perform MI of these activities, subsequently rating the vividness of their MI performance. Brain activity analysis revealed that chronic LBP patients exhibited significantly reduced activity compared to HC subjects in MI-related brain regions, namely the left supplementary motor area and right superior temporal sulcus. Furthermore, psycho-physiological-interaction analysis yielded significantly enhanced functional connectivity (FC) between various MI-associated brain regions in chronic LBP patients indicating diffuse and non-specific changes in FC. Current results demonstrate initial findings about differences in MI-driven cortical processing in chronic LBP pointing towards reorganization processes in the sensorimotor network.
Data from: Predictive value of apelin-12 in ST-elevation myocardial infarction patients with different renal function: a prospective observational study
Objectives: To investigate the factors predicting the onset of major adverse cardiovascular events (MACEs) after primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI) patients. Background: apelin-12 has been regarded acting essential role in cardiovascular homeostasis. However, current knowledge of the optimal prognostic predictive value is limited. Methods: 464 STEMI patients (63.0±11.9 years, 355 men) who underwent successful pPCI were enrolled. Patients were followed-up for 2.5 years. Multivariate cox regression analyses and receiver operating characteristic curve analysis were performed to determine the factors predicting MACEs. Results: There were 118 patients (25.4%) who experienced MACEs in the follow-up period. Multivariate cox regression analysis demonstrated that low apelin-12 (HR=0.132, 95% CI=0.060-0.292, p<0.001), low left ventricular ejection fraction (LVEF) (HR=0.965, 95% CI=0.941-0.991, p=0.007), low estimated glomerular filtration rate (eGFR) (HR=0.985, 95% CI=0.977-0.993, p<0.001), Killip's classification>I (HR=0.610, 95% CI=0.408-0.912, p=0.016) and pathological Q-wave (HR=1.536, 95% CI=1.058-2.230, p=0.024) were independent predictors of 2.5 MACEs. Low apelin-12 could also predict worse in-hospital prognosis and showed advantage in predicting 2.5 year MACEs compared with Δapelin-12 (p=0.0115)and eGFR (p=0.0071) among patients with eGFR>90 mL/min1.73m2. Further analysis prompt Δapelin-12<20% was usually associated with MACEs in patients whose apelin-12 admission below 0.76 ng/ml (p=0.0075). Conclusions: STEMI patients receiving pPCI with lower apelin-12 are more likely to suffer MACEs in hospitalization and 2.5-year follow-up, especially for those with normal level of eGFR.
Data from: Implementation of an automated early warning scoring system in a surgical ward: practical use and effects on patient outcomes
Introduction: Early warning scores (EWS) are being increasingly embedded in hospitals over the world due to their promise to reduce adverse events and improve the outcomes of clinical patients. The aim of this study was to evaluate the clinical use of an automated modified EWS (MEWS) for patients after surgery. Methods: This study conducted retrospective before-and-after comparative analysis of non-automated and automated MEWS for patients admitted to the surgical high-dependency unit in a tertiary hospital. Operational outcomes included number of recorded assessments of the individual MEWS elements, number of complete MEWS assessments, as well as adherence rate to related protocols. Clinical outcomes included hospital length of stay, in-hospital and 28-day mortality, and ICU readmission rate. Results: Recordings in the electronic medical record from the control period contained 7929 assessments of MEWS elements and were performed in 320 patients. Recordings from the intervention period contained 8781 assessments of MEWS elements in 273 patients, of which 3418 were performed with the automated EWS system. During the control period, 199 (2.5%) complete MEWS were recorded versus 3991 (45.5%) during intervention period. With the automated MEWS systems, the percentage of missing assessments and the time until the next assessment for patients with a MEWS of ≥2 decreased significantly. The protocol adherence improved from 1.1% during the control period to 25.4% when the automated MEWS system was involved. There were no significant differences in clinical outcomes. Conclusion: Implementation of an automated EWS system on a surgical high dependency unit improves the number of complete MEWS assessments, registered vital signs, and adherence to the EWS hospital protocol. However, this positive effect did not translate into a significant decrease in mortality, hospital length of stay, or ICU readmissions. Future research and development on automated EWS systems should focus on data management and technology interoperability.
Data from: Preclinical toxicity and pharmacokinetics of a new orally bioavailable flubendazole formulation and the impact for clinical trials and risk/benefit to patients.
Background: Flubendazole, originally developed to treat infections with intestinal nematodes, has been shown to be efficacious in animal models of filarial infections. For treatment of filarial nematodes, systemic exposure is needed. For this purpose, an orally bioavailable amorphous solid dispersion (ASD) formulation was developed. As this formulation results in improved systemic absorption, the pharmacokinetic and toxicological profile of flubendazole administered with this formulation have been assessed to ensure human safety before clinical trials could be initiated. Methods & Findings: Safety pharmacology, toxicity and genotoxicity studies have been conducted with the flubendazole ASD formulation. In animals, flubendazole has good oral bioavailability from an ASD formulation ranging from 15 % in dogs, 276 % in rats to more than 100% in jirds. In in vivo toxicity studies with the ASD formulation, high systemic exposure to flubendazole and its main metabolites was reached. Flubendazole, up to high peak plasma concentrations, does not induce Cmax related effects in the CNS or cardiovascular system. In repeated dose toxicity studies in rats and dogs, flubendazole-induced changes were observed in haematological, lymphoid and gastrointestinal systems and in testes. In dog, the liver was an additional target organ. Upon treatment cessation, at least partial recovery was observed for these changes in the dog. In rat, the low dose was the No Observed Adverse Effect Level (NOAEL) was , i.e. 5 mg (as base)/kg body weight/day (mg eq./kg/day)mg eq./kg/day in males and 2.5 mg eq./kg/day in females. In dog, the NOAEL was lower than the low dose, 20 mg eq./kg/day. Regarding genotoxicity, flubendazole was negative in the Ames test but positive in the in vivo micronucleus test. Conclusions: Based on these results, in combination with previously described genotoxicity and reproductive toxicity data and the outcome of the preclinical efficacy studies, it was concluded that no flubendazole treatment regimen can be selected that would provide efficacy in humans at safe exposure.
Data from: Patient and impatient punishers of free-riders
Costly punishment of cheaters who contribute little or nothing to a cooperating group has been extensively studied as an effective means to enforce cooperation. The prevailing view is that individuals use punishment to retaliate against transgressions of moral standards like fairness or equity. However, there is much debate regarding the psychological underpinnings of costly punishment. Some authors suggest that costly punishment must be a product of humans' capacity for reasoning, self-control, and long-term planning, while others argue that it is the result of an impulsive, present oriented, emotional drive. Here we explore the inter-temporal preferences of punishers in a multilateral cooperation game and show that both interpretations might be right as we can identify two different types of punishment: punishment of free-riders by cooperators, which is predicted by patience (future orientation) and free-riders' punishment of other free-riders, which is predicted by impatience (present orientation). Therefore, the picture is more complex as punishment by free-riders unlikely comes from a reaction against a moral transgression, but instead from a competitive, spiteful drive. Thus, punishment grounded on morals may be related to lasting or delayed psychological incentives, while punishment triggered by competitive desires may be linked to short-run aspirations. These results indicate that the individual's time horizon is relevant for the type of social behaviour she opts for. Integrating such differences in inter-temporal preferences and the social behaviour of agents might help to achieve a better understanding of how human cooperation and punishment behaviour has evolved.
Denoising Autoencoders for Phenotype Stratification (DAPS) Sample Trained Simulated Patient Data
<p>DAPS Trained data</p>
Denoising Autoencoders for Phenotype Stratification (DAPS) Sample Trained Patient Data
<p>Data for: https://github.com/greenelab/DAPS</p>
Article data of The Impact of MDR-1 Gene Polymorphism (rs1128503) on Response to Imatinib and nilotinib Treatment in A Sample of Iraqi Chronic Myeloid Leukemia-Chronic Phase Patients
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Underlying data for (Hepatitis G Viremia as a Predictor of Liver Disease Prognosis in High-Risk Populations and chronic liver patients)
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Article data of The Impact of MDR-1 Gene Polymorphism (rs1128503) on Response to Imatinib and nilotinib Treatment in A Sample of Iraqi Chronic Myeloid Leukemia-Chronic Phase Patients
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LDA_NEURAL_NETWORK_PATIENT_DATA
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RNAseq expression data FADD/BID gene in MM patients
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Detection of PatIent-Level distances from single cell genomics and pathomics data with Optimal Transport (PILOT)
<p><strong>Datasets for PILOT</strong></p> <p>Although clinical applications represent the next challenge in single-cell genomics and digital pathology, we are still lacking computational methods for the analysis of single-cell and pathomics data at a patient level for finding patient trajectories associated with diseases. This is challenging as a single-cell/pathomics data is represented by clusters of cells/structures, which cannot be compared with other samples. We propose here patient Level analysis with Optimal Transport (PILOT). PILOT uses optimal transport to compute the Wasserstein distance between two single single-cell experiments. This allows us to perform unsupervised analysis at the sample level and to uncover trajectories associated with disease progression. Moreover, PILOT provides a statistical approach to delineate non-linear changes in cell populations, gene expression and tissues structures related to the disease trajectories. We evaluate PILOT and competing approaches in disease single-cell genomics and pathomics studies with up to 1.000 patients/donors and millions of cells or structures. Results demonstrate that PILOT detects disease-associated samples, cells, and genes from large and complex single-cell and pathomics data.</p>
Raw Data_Bioenergetics of human spermatozoa in patients with testicular germ cell tumour
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Allen Brain Atlas
Allen Brain Atlas is an Allen Institute collection of brain map atlases, datasets, APIs, and analysis tools covering mouse, human, and non-human primate brain resources.
Annotated Behaviour and Observability Dataset (ABODe)
ABODe is a University of Edinburgh DataShare dataset for behavior classification in group-housed mice using home-cage video, identities, bounding boxes, ground-plate positions, and annotator labels.
DANDI Archive for NWB datasets
DANDI is a BRAIN Initiative archive for publishing and sharing neurophysiology data, including electrophysiology, optophysiology, and behavioral data packaged as NWB and related standards.
International Brain Laboratory public data
The International Brain Laboratory public data releases expose standardized mouse decision-making experiments, including Neuropixels recordings, widefield calcium imaging, behavior, and session metadata accessed through the ONE API.
OpenNeuro
OpenNeuro is a free, open platform for sharing neuroimaging datasets, with public search, dataset pages, and download paths for web, S3, DataLad, and the OpenNeuro CLI.