Javtor/biomedical-topic-categorization-cased

An approach to quantify the dependence of economy on resource efficiency: A case study in Beijing-Tianjin-Hebei region of north China. The improvements of resource efficiency are crucial for economic development of a city. Currently, the variations of utilization efficiency of ecological resources have been studied much, but whether the efficiency has been good enough for driving the economy, is still unknown. Here, we introduced an efficiency dependence index (EDI) to assess the effects of utilization efficiency of land, energy and water resources on economy and evaluated the promotion potentials of resource efficiency. The Beijing-Tianjin-Hebei (BTH) region of north China was selected to validate the method. First, a non-collinear index system was built. After that, the EDI and the score of resource efficiency (SRE) index were constructed based on the generalized linear regression method. The main results were: (1) The efficiency contributions to economy in primary industry (4 of 13 cities) were far weaker than those in secondary industry (10 of 13 cities). (2) Water efficiency of primary industry in developed cities need further promotions. Energy efficiency needs more improvements especially in medium and small cities in both primary and secondary industries. (3) The efficiency utilization patterns of effective efficiency (EE), potential efficiency (PE) and no efficiency (NE) were categorized, and there were 26 of 65 (40%) counts of indicators performed EE, 31% counts of indicators presented PE and 29% counts of indicators showed NE. The improvement of water efficiency was the key driver to promote the resource efficiency. (4) By comparing current and ideal resource efficiency levels (via SRE), it showed that only 1 city reached to 80% of the ideal efficiency, 3 cities showed 70%, 4 cities showed 60% and 5 cities reached to less than 50% of the ideal resource efficiency. Policy suggestions of optimizing energy structure and pay attention to the comprehensiveness of resource efficiency were provided. This paper could serve as a reference for resource management.

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Experiences of care coordination among older adults in the United States: Evidence from the Health and Retirement Study. The goal of this study was to examine variation in patient experiences and perceptions of care coordination across sociodemographic and health factors.

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Natural Products for the Treatment of Neurodegenerative Diseases. Neurodegenerative diseases are a heterogeneous group of disorders characterized by the progressive degeneration of the structure and function of the central nervous system or peripheral nervous system. Alzheimer's Disease (AD), Parkinson's Disease (PD) and Spinal Cord Injury (SCI) are the common neurodegenerative diseases, which typically occur in people over the age of 60. With the rapid development of an aged society, over 60 million people worldwide are suffering from these uncurable diseases. Therefore, the search for new drugs and therapeutic methods has become an increasingly important research topic. Natural products especially those from the Traditional Chinese Medicines (TCMs), are the most important sources of drugs, and have received extensive interest among pharmacist. In this review, in order to facilitate further chemical modification of those useful natural products by pharmacists, we will bring together recent studies in single natural compound from TCMs with neuroprotective effect.

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Mechanical dyssynchrony and diastolic dysfunction are common in LVH: a pilot correlation study using Doppler echocardiography and CZT gated-SPECT MPI. Hypertrophic cardiomyopathy (HCM) is an often under-diagnosed cause of left ventricular hypertrophy (LVH). It affects 1/500 of the population, is the most commonly inherited cardiovascular disorder, and can present in apical, concentric, or septal forms. Although most patients are asymptomatic, sudden cardiac death can be the initial presentation of HCM. By retrospectively enrolling patients suspected of having three different types of HCM in the absence of epicardial coronary stenosis, we aimed to examine systolic and diastolic dysfunction and perfusion abnormalities using both Doppler echocardiography and state-of-the-art gated single-photon emission computerized tomography (SPECT) myocardial perfusion imaging (MPI) with a cadmium-zinc-telluride camera and thallium-201. Both regional perfusion and gated SPECT parameters were collected in addition to diastolic parameters from Doppler echocardiography. The results showed that mild ischemia was common in patients suspected of having HCM, with a mean summed stress score of 4.7 ± 4.9 (score 0-4 in 17-segment model). The patients with HCM were associated with discernible left ventricular mechanical dyssynchrony, especially those with the apical form. In addition, diastolic dysfunction was prevalent and early to late ventricular filling velocity ratios were significantly different between groups. By combining gated-MPI and Doppler data, the trivial functional changes in HCM may be identified.

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Removal of methylene blue via bioinspired catecholamine/starch superadsorbent and the efficiency prediction by response surface methodology and artificial neural network-particle swarm optimization. This paper demonstrates coupling of the artificial neural network (ANN) technique with the particle swarm optimization (PSO) method and compares the performance of ANN-PSO with response surface methodology (RSM) in prediction of the adsorption of methylene blue (MB) by a novel bio-superadsorbent. To this, a starch-based superadsorbent was synthesized using acrylic acid and acryl amid polymers and then catecholamine functional groups were combined onto the surface with oxidative polymerization of dopamine. The adsorption of MB was considered as a function of pH, dye concentration, and contact time. The best topology of the ANN was found to be 3-7-1, and prediction model of the adsorption capacity was demonstrated as a matrix of explicit equations. ANN-PSO is more accurate than RSM. The results revealed that the root-mean-square error, correlation coefficient, and normalized standard deviation for the ANN-PSO are 22.46, 0.99, and 16.83, respectively, while for RSM are 82.89, 0.98, and 65.41, respectively.

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Engaging Patients in Decision-Making and Behavior Change to Promote Prevention. Effectively engaging patients in their care is essential to improve health outcomes, improve satisfaction with the care experience, reduce costs, and even benefit the clinician experience. This chapter will address the topic of patient engagement directly and review the relationships between health literacy and patient engagement. While there are many ways to define patient and family engagement, this chapter will consider engagement as "patients, families, their representatives, and health professionals working in active partnership at various levels across the health care system - direct care, organizational design and governance, and policy making - to improve health and health care [1]." We will specifically focus on the patient engagement and health literacy needs for three scenarios (1) decision-making, (2) health behavior change, and (3) chronic disease management; we will include the theoretical underpinnings of engagement, the systems required to better support patient engagement, how social determinants of health influence patient engagement, and practical examples to demonstrate approaches to better engage patients in their health and wellbeing. We will close by describing the future of patient engagement, which extends beyond the traditional domains of decision-making and self-care to describe how patient engagement can influence the design of the healthcare delivery system; local, state, and national health policies; and future research relevant to the needs and experiences of patients.

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New data about the 21st Century Identified Skeletal Collection (University of Coimbra, Portugal). After the publication of the first article in 2014, 21st Century Identified Skeletal Collection, housed in the Laboratory of Forensic Anthropology, Department of Life Sciences at the University of Coimbra, Portugal, has been growing. Currently, the collection is composed of 302 complete adult skeletons of both sexes, which means that in 5 years it has doubled. The collection consists mostly of elderly individuals, with only 12.25% of the individuals aged less than 61 years old. All individuals are Portuguese nationals who died between 1982 and 2012. Ninety individuals exhibit prostheses, other medical devices and signs of surgical procedures. Moreover, a sub-collection of experimentally burned skeletons is under development, and currently includes 56 individuals (18.54% of the collection). The 21st Century Identified Skeletal Collection constitutes a fundamental tool for forensic anthropology research, including the development and validation studies of methods that focus on elderly individuals, as can be ascertained by the numerous scientific publications and academic scholarship that have been produced in previous years.

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Considerable variability in antibiotic use among US children's hospitals in 2017-2018. To characterize the prevalence of and seasonal and regional variation in inpatient antibiotic use among hospitalized US children in 2017-2018.

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[Effects of microbial fertilizer on soil improvement and fruit quality of kiwifruit in old orchard.]. The continuous cropping obstacles caused by the increase of kiwifruit planting period resulted in imbalance of soil microbial community structure, and decrease of soil enzyme activity and physicochemical indicators, which substantially reduced both the quality and yield of kiwifruit. Under the field conditions, the traditional fertilization of fruit farmers was used as a control (CK) to study the effects of two different microbial fertilizers, JF and KF, which had been verified the growth promotion of kiwifruit aseptic seedlings test, on soil microbial community structure, soil enzyme activities, soil physicochemical characters during different growth periods of kiwifruit (germination period, florescence period, fruit enlargement period, fruit ripening period and next year germination period), as well as fruit quality. The results showed that both fertilizers significantly increased the ratio of bacteria with fungi and the ratio of actinomycetes with fungi in the kiwifruit orchard soil, indicating that they could improve and balance the soil microbial community structure. The enzymes activity in kiwifruit orchard soil with the addition of both fertilizers were significantly higher than that in CK, and among which sucrose, urease, phosphatase and polyphenol oxidase were increased by 17.9%-83.5%, 7.9%-83.0%, 7.3%-45.4% and 8.1%-140.3%, respectively. JF and KF increased soil fertility (the concentrations of available nitrogen, phosphorus, potassium, total nitrogen, total phosphorus, total potassium, and organic matter content significantly increased) and decreased soil pH (a decrease of 0.29 to 0.34). After application of microbial ferti-lizer, the content of vitamin C, soluble sugar, soluble protein and other contents of kiwifruit increased, and the titratable acid content decreased. Therefore, the application of both fertilizers could balance soil microbial community structure, enhance soil fertility, and improve the fruit quality of kiwifruit. Our results provide robust theoretical basis for the application of microbial fertilizers in the old-aged kiwifruit orchards.

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Differential effects of working memory load on priming and recognition of real images. Several studies have explored the effects of divided attention on priming, but little is known about the impact of working memory load on implicit visual memory. The aim of this study was to determine whether there are differential effects of working memory load on a visual priming task compared to a recognition task. In the encoding phase, participants were presented with real-object pictures and asked to classify them semantically. At retrieval, 40 studied and 40 new images were presented (partially masked) for 100 ms, and participants had to identify the object. Each trial was immediately followed by a recognition test, in which the unmasked image was shown again, and participants had to indicate whether it had been presented at encoding or not. Regarding working memory load, participants performed a task in which a load was imposed in half of the trials. Twenty-four participants concurrently performed an articulatory suppression task, another group of 24 subjects performed an executive demanding task, and a third group of 24 participants performed a spatial tapping task. Working memory load failed to diminish performance on both priming and recognition tests in the articulatory suppression condition. However, the backward counting and the tapping tasks influenced recognition, rather than priming. The relative pattern of backward counting effects on recognition and priming were then broadly replicated in a follow-up experiment using an adapted priming task (N = 24). Results suggest that a concurrent load has a more robust effect on recognition than on priming, especially when the working memory task is executively demanding.

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What strategies do desk-based workers choose to reduce sitting time and how well do they work? Findings from a cluster randomised controlled trial. Large amounts of sitting at work have been identified as an emerging occupational health risk, and findings from intervention trials have been reported. However, few such reports have examined participant-selected strategies and their relationships with behaviour change.

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Household Food Insecurity in Early Adolescence and Risk of Subsequent Behavior Problems: Does a Connection Persist Over Time? Household food insecurity is common among U.S. families, and adolescents are almost twice as likely as school-aged children to be food insecure. However, little is known about how household food insecurity relates to adolescent behavioral outcomes over time. The purpose of this study was to examine whether food security status in early adolescence is associated with behavioral problems over a 6-year period in an ethnically diverse sample of teenagers from low-income households.

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Influence of Divalent Counterions on the Dynamics in DNA as Probed by Using a Minor-Groove Binder. DNA dynamics, to which water, counterions, and DNA motions contribute, is a topic of considerable interest because it is closely related to the efficiency of biological functions performed by it. Simulation studies and experiments suggest that the counterion dynamics in DNA probed by a minor-groove binder are similar for various monovalent counterions. To date, the influence on DNA dynamics of higher-valence counterions, which are also present around DNA and are known to bind more strongly to it than monovalent ions, has not been studied. Herein we investigated DNA dynamics in the presence of Mg 2+ and Ca 2+ , chosen for their relative abundance in cells, by using minor-groove binder 4',6-diamidino-2-phenylindole (DAPI) as a fluorescence probe. The dynamics, as measured from the time-resolved fluorescence Stokes shifts of DAPI bound to calf thymus DNA on a subpicosecond-to-nanosecond timescale, were found to be very similar in the presence of both the divalent ions and Na + ions. The observation is explained by considering the screening of the electric field of the divalent ion by its hydration shell, preferential binding of the ions to the phosphate groups, and displacement of ions from the minor groove by DAPI due to the stronger binding interaction of the latter. Furthermore, the similarity of our results in the presence of Na + to those reported for smaller oligonucleotides suggests that the chain length of DNA does not influence the DNA dynamics.

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The case of encephalitis in a COVID-19 pediatric patient. The COVID-19 pandemic, induced by the worldwide spreading of the SARS-CoV-2, is well known for its clinical picture consistent with respiratory symptoms. If pulmonary complications are the most common manifestation of the disease, neurological problems are also significantly present, with complications including acute cerebrovascular events, encephalitis, Guillain-Barré and Miller Fisher syndromes, acute necrotizing hemorrhagic encephalopathy and hemophagocytic lymphohistiocytosis. These medical signs can be considered direct effects of the virus on the nervous system, para-infectious or post-infectious immune-mediated diseases, and neurological complications of the systemic effects of the SARS-CoV-2.

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Effects of selected rehabilitative exercises on external rotator muscles and trapezius muscles of masonry workers. Masonry workers engaged in occupational work-activities have high risk of shoulder injury that often develops to functional loss and disability. Rehabilitative exercises (REs) have potential for slowing this development.

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Skin concerns in patients with trisomy 21 (Down syndrome): A Mayo Clinic 22-year retrospective review. Trisomy 21 has known associated clinical phenotypes, including skin and soft tissue concerns. However, the overall prevalence and types of findings are largely unclear.

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Arthroscopic and Endoscopic Treatment of Proximal Rectus Femoris Avulsion. Proximal rectus femoris avulsion (PRFA) is an uncommon injury that is poorly reported in the literature. Historically, these injuries have been treated nonoperatively or with open techniques. This is the first study showing endoscopic treatment of this injury. We present a systematic review of PRFA treatment and a case report of a patient whose injury was treated endoscopically. Sixty-four injuries were reported across several sports. Patients underwent nonoperative management, suture repair, suture anchor repair, or excision of the tendon stump. Surgical complications included lateral femoral cutaneous nerve injury and wound complications. The patient who underwent arthroscopic treatment had a good outcome. [ Orthopedics . 2022;45(1):e1-e6.].

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Is feyerabendian philosophy relevant for scientific knowledge development in nursing? To revitalize nursing science, there is a need for a new approach to guide nurse scientists in addressing complex problems in health care. By applying theoretical concepts from a revolutionary philosopher of science, Paul K. Feyerabend, new nursing knowledge can be produced using creativity and pluralistic approaches. Feyerabend proposed that methods within and outside of science can produce knowledge. Despite the recognition of Feyerabendian philosophy within science, there is currently a lack of literature regarding the relevance of Feyerabendian philosophy for nursing science. We aim to (a) describe and critique Feyerabendian concepts, (b) discuss the potential application of Feyerabendian philosophy for knowledge production within gerontological nursing and (c) describe theoretical possibilities for nurse scientists in using Feyerabendian philosophy to guide nursing knowledge development. We begin by introducing Feyerabend's life and his inspirations for his theoretical concepts, epistemological anarchism, theoretical pluralism and humanitarianism, and conclude by offering suggestions of how to apply Feyerabendian philosophy in nursing research.

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Recognition method of construction conflict based on driver's eye movement. Drivers eye movement data in simulated construction conflicts at different speeds were collected and analyzed to find the relationship between the drivers' eye movement and the construction conflict. On the basis of the relationship between the drivers' eye movement and the construction conflict, the peak point of wavelet processed pupil diameter, the first point on the left side of the peak point and the first blink point after the peak point are selected as key points for locating construction conflict periods. On the basis of the key points and the GSA, a construction conflict recognition method so called the CCFRM is proposed. And the construction conflict recognition speed and location accuracy of the CCFRM are verified. The good performance of the CCFRM verified the feasibility of proposed key points in construction conflict recognition.

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Pterins as diagnostic markers of exercise-induced stress: a systematic review. To evaluate pterins as diagnostic biomarkers of exercise-induced stress.

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Changes in socio-economic level and their impact on nutritional status: a follow-up study among young Chilean adults. To verify the association between changes in socio-economic level (SEL) and nutritional status of Chilean adults over a 10-year period.

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A comprehensive review on freshness of fish and assessment: Analytical methods and recent innovations. Fish, a highly nutritious, containing a good amount of protein and fatty acids, has TMA and TVB-N present as major factors responsible for quality deterioration during storage and maintaining of fish freshness. Freshness is one of the most important parameters in the fish market. There are many methods of estimating fish freshness, out of which some are very costly while others are not user-friendly. However, with more technological innovations, there have been efforts to make a more reliable method of calculating and analyzing freshness. Parameters chosen for assessing the freshness are sensory, physical, chemical and microbiological including the recent trends such as SDS-PAGE, fast protein liquid chromatography, hyper Spectral Imaging Technique, etc. focused on reducing time, destruction and labor. Traditional and recent methods of evaluation of freshness along with their comparison based on several parameters are needed to link them and making it convenient for upcoming researchers to have a detailed study for having a universal indicator for assessing the freshness of fish. Information in the present article has all the methods of assessing the fish freshness been discussed in detail. There has also been focus on bringing the readers knowledge about the comprehensive information related to recent developments. The recommended limit for different indicators signifies the time period for which the particular fish can be stored and it depends upon several factors like species, surrounding environment and enzymatic and non-enzymatic actions. Based on these demands, this paper is uniquely worked upon to review the different literature which brought all the discussions from the past including the recent innovations in assessing the freshness of different fishes with the help of various indicators as well as a complete study of spoilage and toxicity mechanism leading to deterioration in quality, making it easy for the reader and researchers to have quick glance over the trends and innovations.

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A High-Fat High-Fructose Diet Dysregulates the Homeostatic Crosstalk Between Gut Microbiome, Metabolome, and Immunity in an Experimental Model of Obesity. Ample evidence supports the prominent role of gut-liver axis in perpetuating pathological networks of high-fat high-fructose (HFF) diet induced metabolic disorders, however, the molecular mechanisms are still not fully understood. Herein, this study aims to present a holistic delineation and scientific explanation for the crosstalk between the gut and liver, including the potential mediators involved in orchestrating the metabolic and immune systems.

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Student evaluations of teaching (SET): implications for medical education in psychiatry and an approach to evaluating SET and student performance. We present reflections on student evaluation of teaching (SET) in the context of recent higher educational research that assesses SET, as well as concurrent and/or subsequent student performance.

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Probing prodrug metabolism and reciprocal toxicity with an integrated and humanized multi-tissue organ-on-a-chip platform. Current drug development techniques are expensive and inefficient, partially due to the use of preclinical models that do not accurately recapitulate in vivo drug efficacy and cytotoxicity. To address this challenge, we report on an integrated, in vitro multi-organoid system that enables parallel assessment of drug efficiency and toxicity on multiple 3D tissue organoids. Built in a low-cost, adhesive film-based microfluidic device, these miniaturized structures require less than 200 µL fluid volume and are amenable to both matrix-based 3D cell culture and spheroid aggregate integration, each supported with an in situ photocrosslinkable hyaluronic acid hydrogel. Here, we demonstrate this technology first with a three-organoid device consisting of liver, cardiac, and lung constructs. We show that these multiple tissue types can be kept in common circulation with high viability for 21 days and validate the platform by investigating liver metabolism of the prodrug capecitabine into 5-fluorouracil (5-FU) and observing downstream toxicity in lung and cardiac organoids. Then we expand the integrated system to accommodate six humanized constructs, including liver, cardiac, lung, endothelium, brain, and testes organoids. Following a 14-day incubation in common media, we demonstrate multi-tissue interactions by metabolizing the alkylating prodrug ifosfamide in the liver organoid to produce chloroacetaldehyde and induce downstream neurotoxicity. Our results establish an expandable, multi-organoid body-on-a-chip system that can be fabricated easily and used for the accurate characterization of drug interactions in vitro. STATEMENT OF SIGNIFICANCE: The use of 3-dimensional (3D) in vitro models in drug development has advanced over the past decade. However, with several exceptions, the majority of research studies using 3D in vitro models, such as organoids, employ single tissue types, in isolated environments with no "communication" between different tissues. This is a significant limiting factor because in the human body there is significant signaling between different cells, tissues, and organs. Here we employ a low-cost, adhesive film-based microfluidic device approach, paired with a versatile extracellular matrix-derived hyaluronic acid hydrogel to support integrated systems of 3 and 6 3D organoid and cell constructs. Moreover, we demonstrate an integrated response to drugs, in which downstream toxicity is dependent on the presence of liver organoids.

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Signaling-to-chromatin pathways in the immune system. Complex organisms are able to respond to diverse environmental cues by rapidly inducing specific transcriptional programs comprising a few dozen genes among thousands. The highly complex environment within the nucleus-a crowded milieu containing large genomes tightly condensed with histone proteins in the form of chromatin-makes inducible transcription a challenge for the cell, akin to the proverbial needle in a haystack. The different signaling pathways and transcription factors involved in the transmission of information from the cell surface to the nucleus have been readily explored, but not so much the specific mechanisms employed by the cell to ultimately instruct the chromatin changes necessary for a fast and robust transcription activation. Signaling pathways rely on cascades of protein kinases that, in addition to activating transcription factors can also activate the chromatin template by phosphorylating histone proteins, what we refer to as "signaling-to-chromatin." These pathways appear to be selectively employed and especially critical for driving inducible transcription in macrophages and likely in diverse other immune cell populations. Here, we discuss signaling-to-chromatin pathways with potential relevance in diverse immune cell populations together with chromatin related mechanisms that help to "solve" the needle in a haystack challenge of robust chromatin activation and inducible transcription.

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Improved efficacy and safety of low-dose oxaliplatin/pegylated liposomal doxorubicin/S-1 regimen in advanced gastric cancer: a cohort study. Dose-limiting neurotoxicity is the major side effect caused by oxaliplatin treatment. Optimization of oxaliplatin-containing chemotherapeutic regimens may potentially benefit advanced gastric cancer (AGC) patients. We tried to reduce the dose of oxaliplatin and add a drug to compensate for the efficacy. This cohort study evaluated the efficacy and side effects of low-dose oxaliplatin combined with pegylated liposomal doxorubicin and S-1 (D-SOX) as first-line treatment for AGC.

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Anatomic study of fibrous structures attached to the volar ulnar corner of the radius: implications in the volar rim fracture. This study aimed to clarify the bone and soft tissue morphological features at the volar ulnar corner of the radius. Micro-computed tomography, macroscopic and histological analyses were conducted using 12 cadaveric wrists, and in vivo MRI studies of the wrist were evaluated in five healthy volunteers. The volar ulnar corner of the distal radius has a protrusion volar to the sigmoid notch. The capsule elements of the radiolunate and radioulnar joints merge and this conjoined capsule attaches to the radius at the ulnar protrusion. Histologically, this capsule attaches to the radius via fibrocartilage, with fibres running in the radioulnar direction. In-vivo MRI studies showed that the capsule attaching to the volar ulnar corner could be traced to the dorsal side of the ulnar styloid. Our findings indicate that, given the direction of the fibres, an avulsion force in the radioulnar direction could be a cause for volar rim fractures.

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The effect of speed limit reductions in urban areas on cyclists' injuries in collisions with cars. Objective: Impact speed is one of the most important factors explaining the severity of injuries to cyclists when they collide with passenger cars. To reduce injury severity (especially for vulnerable road users), since 2008, Swedish municipalities have the authority to lower the speed limit to 30 or 40 km/h in urban areas as appropriate. The aim of this study was to evaluate how this speed limit reduction has influenced the injury severity for cyclists in this type of collision. Method : Data from 1,953 collisions between bicycles and passenger cars were collected using information from third-party-liability insurance claims from 2005 to 2017. The change of speed limit distribution, influenced by the reduction of speed limits in urban areas, where car-to-cyclist collisions occurred was studied. Following that, injury severity for cyclists was evaluated regarding collisions occurring in areas with different speed limits. Results: The results show that, in collisions with cars, cyclists have a significantly lower risk of a moderate-to-fatal (MAIS 2+) injury when the speed limit is 30-40 km/h compared to 50-60 km/h. During the last decade, while the speed-limit has been lowered on many road-sections in urban areas from 50-60 km/h to 30-40 km/h the risk of a cyclist getting a MAIS 2+ injury decreased by 25%. In 2005 to 2011, 16% of the crashes happened on a road with a speed limit of 30-40 km/h; in 2016-2017, this percentage had increased to approximately 50%. Thus, in recent years more crashes occurred on roads with lower speed limits, and in these crashes, there was a lower risk of severe injuries to cyclists. Unfortunately, it was not possible to evaluate the risk of a crash for specific speed limits; since one limitation of this study was the lack of exposure data, nor do we know the impact speed or the actual speed of the vehicles. Conclusions: This study is an important follow-up on the implementation of measures that can influence bicycle safety. The insurance data used, made it possible to quantify a positive effect on injury severity for cyclists in passenger car-to-cyclist collisions when the speed limit was reduced in urban areas. Insurance claims cover collisions of all crash severity, so they include data covering all types of injuries-not just the most severe/fatal ones. This aspect is especially important in the speed intervals evaluated here, since moderate (MAIS 2) injuries are very frequent in lower-speed crashes and even these injuries can result in long-term consequences.

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Surgery Versus Endoscopic Mucosal Resection Versus Endoscopic Submucosal Dissection for Large Polyps: Making Sense of When to Use Which Approach. Endoscopic resection for large colorectal lesion is effective and cost-saving than surgery. Piecemeal resections are often effective if applied meticulously but endoscopic submucosal dissection (ESD) allows meritorious removal of large lesions in one piece. For rectal lesions, transanal endoscopic microsurgery or transanal minimally invasive surgery offers more radical transmural resection but ESD is also effective for removal of complex rectal lesions. Surgical resection with lymph node dissection is the gold standard for invasive cancer; however, the management of low-risk early-stage colorectal cancer is worth debating. Treatment selection for large colorectal lesions is discussed based on lesion factor and treatment outcomes.

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Correlation between osteoarthritis of the atlantoaxial facet joint and a high-riding vertebral artery. A high-riding vertebral artery (HRVA) is an intraosseous anomaly that narrows the trajectory for C2 pedicle screws. The prevalence of a HRVA is high in patients who need surgery at the craniovertebral junction, but reports about HRVAs in subaxial cervical spine disorders are limited. We sought to determine the prevalence of HRVAs among patients with subaxial cervical spine disorders to elucidate the potential risk for VA injury in subaxial cervical spine surgery.

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Esophageal Button Battery in the Pediatric Population: Experience from a Tertiary Care Center. To highlight different patterns of clinical presentation, share authors' experience in the management of children following button battery ingestion and their outcomes.

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Versatility of buccinator flaps for the treatment of palatal defects: a series of cases. The buccinator flap is currently one of the best techniques for the reconstruction of defects in the oral cavity and other sites. Reconstruction of the palate is a major challenge because of the functional consequences of the excision of lesions in this area. The main goal is to maintain separation between the mouth and the nose. We have done a cross-sectional retrospective descriptive study of a series of cases reconstruction of palatal defects with buccinator flap at the University Hospital Miguel Servet in Zaragoza during a six-year period and compared our results, morbidity, and mortality with those of published series. The main complication was partial loss of the flap. We have analysed the reasons for this and report the steps needed to avoid it.

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Nanoparticle-mediated histotripsy (NMH) using perfluorohexane 'nanocones'. Nanoparticle-mediated histotripsy (NMH) is an ultrasound treatment strategy that combines acoustically sensitive nanoparticles with histotripsy. Previous NMH studies using perfluorocarbon (PFC) nanodroplets (ND's), ~200 nm in diameter, demonstrated that NMH can selectively generate cavitation by reducing the cavitation threshold from ~25-30 MPa to ~10-15 MPa. Recent studies have also shown that cavitation nucleation in NMH is directly caused by the incident negative pressure (p-) exposed to the PFC, as predicted by classical nucleation theory (CNT), suggesting that the NMH cavitation threshold is dependent on the total volume of PFC present in the focal region. In this study, we investigate the use of a newly developed NMH nanoparticle synthesized using an inclusion complex of methylated β-cyclodextrin and perfluorohexane (PFH). These 'nanocones' (NCs) have advantages compared to previously used ND's due to their smaller size (~50 nm), simple synthesis method, higher stability and information of definite PFH amount carried by the NC. To test the hypothesis that NCs can reduce the NMH cavitation threshold similar to ND's, and that the NMH cavitation threshold is dependent upon the total PFH concentration, tissue phantoms containing concentrations of NCs ranging from 10 -5 to 10 -10 (ml PFH/ml water) were exposed to single cycle ultrasound pulses using a 500 kHz focused transducer where high speed imaging captured cavitation data. Results showed that NCs significantly reduced the histotripsy cavitation threshold to 11.0 MPa for a concentration of 10 -5 (ml PFH/ml water), with the threshold increasing at lower concentrations. Finally, the ability of NCs to be used for effective NMH ablation was demonstrated in tissue phantoms containing red blood cells (RBCs). Overall, the results of the study support our hypotheses that NCs can be used for effective NMH therapy and that NC concentration has a predictable threshold-reducing effect.

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Properties of natural rubber reinforced with cellulose nanofibers based on fiber diameter distribution as estimated by differential centrifugal sedimentation. Cellulose nanofibers (CNFs) with different degrees of fibrillation are prepared by the mechanical fibrillation of kraft pulp using wet disk milling, and dispersions of the prepared CNFs were subjected to differential centrifugal sedimentation (DCS) in order to estimate the diameter distributions of the CNFs. The low-fibrillated CNFs (fiber diameter (d): >10 μm) had a weak reinforcing effect on natural rubber (NR), while the medium-fibrillated CNFs (d: 0.1-10 μm) dramatically improve the initial modulus and decrease the elongation at break. The high-fibrillated CNFs (d: <0.1 μm) enhanced the tensile strength even further while maintaining the elongation at break. The reinforcing mechanism of the NR composites reinforced by the CNFs (NR-CNFs) was confirmed by field-emission scanning electron microscopy imaging, dynamic mechanical analysis, and toluene uptake measurements. It was concluded that these characteristic mechanical properties of the NR-CNFs were determined by the morphologies of the CNFs. The branching structure of the medium-fibrillated CNFs affected high improvement of the initial modulus, and the network formed by the high-fibrillated CNFs were involved in enhancement of the tensile strength without compromising viscoelastic properties. Understanding the effect of their diameter distribution can potentially reduce the production cost of CNFs and thus expand their applicability.

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[Stress Echocardiography in the Assessment of Long-Term Outcomes After Percutaneous Coronary Intervention in Patients With Stable Coronary Heart Disease]. To study the possibilities of stress echocardiography (EchoCG) in the assessment of clinical state of patients after percutaneous coronary intervention (PCI).

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Characterization of Thrombospondin Type 1 Repeat in Haliotis diversicolor and Its Possible Role in Osteoinduction. Thrombospondin repeats (TSR) are important peptide domains present in the sequences of many extracellular and transmembrane proteins with which a variety of ligands interact. In this study, we characterized HdTSR domains in the ADAMTS3 protein of Thai abalone, Haliotis diversicolor, based on the transcriptomic analysis of its mantle tissues. PCR amplification and localization studies demonstrated the existence of HdTSR transcript and protein in H. diversicolor tissues, particularly in both the inner and outer mantle epithelial folds. We, therefore, generated a short recombinant protein, termed HdTSR1/2, based on the existence of the WxxWxxW or WxxxxW motif (which binds to TGF-β, a known signaling in bone formation/repair) in HdTSR1 and HdTSR2 sequences and used it to test the osteoinduction function in the pre-osteoblastic cell line, MC3T3-E1. This recombinant protein demonstrated the ability to induce the differentiation of MC3T3-E1 cells by the concentration- and time-dependent upregulation of many known osteogenic markers, including RUNX2, COL1A1, OCN, and OPN. We also demonstrated the upregulation of the SMAD2 gene after cell treatment with HdTSR1/2 proteinindicating its possible interaction through TGF-β, which thus activates its downstream signaling cascade and triggers the biomineralization process in the differentiated osteoblastic cells. Together, HdTSR domains existed in an extracellular ADAMTS3 protein in the mantle epithelium of H. diversicolor and played a role in osteoinduction as similar to the other nacreous proteins, opening up its possibility to be developed as an inducing agent of bone repair.

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Knockdown of LncRNA MALAT1 contributes to cell apoptosis via regulating NF-κB/CD80 axis in neonatal respiratory distress syndrome. Neonatal respiratory distress syndrome (NRDS) is a leading cause of morbidity in premature newborns and is a common reason for admission to the neonatal intensive care unit (NICU). Recent studies found that the pathogenesis of NRDS is not simply lung immaturity. Apoptosis is an essential process for the development and maturation of the lungs. In this study, we report a critical role of lncRNA MALAT1 in regulating CD80 transcription in the NRDS-associated apoptosis via binding with NF-κB. We first showed MALAT1 and CD80 were highly expressed in the peripheral blood mononuclear cells of NRDS with infection exposure. Then we found MALAT1 expressions were significantly increased by the treatment of LPS. We confirmed knockdown of MALAT1 promoted cell viability by CCK-8 assays, cell apoptosis by flow cytometric assays and cytoskeleton destruction by immunocytochemistry. We confirmed CD80 expression level was associated with cell apoptosis by affecting PARP and caspase-3. Then we demonstrated knockdown of MALAT1 promoted CD80 transcription in A549 cells. Furthermore, we confirmed that MALAT1 downregulated transcriptional expression of CD80 by interfering with NF-κB activation and disrupting its binding efficiency with the CD80 promoter in the cell nucleus. In conclusion, we first identified lncRNA MALAT1 as an important prognosis maker for NRDS patients. Most significantly, this study then demonstrated a novel regulatory function of knocked-down MALAT1 on the transcriptional level of CD80 by enhancing the binding of NF-κB to CD80 promoter. Since the interaction between MALAT1 and CD80 plays an essential role in the cell apoptosis of NRDS, our findings demonstrate the possibility of using MALAT1 as therapeutic target for treatment of NRDS, and extend existing knowledge about the molecular mechanism that underlies NRDS pathogensis.

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Biomarkers to Predict Cardiovascular Death. This article reviews biomarkers that have been shown to identify subjects at increased risk for cardiovascular death within the general population, in those with established coronary artery disease, and in those with heart failure. Use of biomarkers for risk stratification for sudden cardiac death continues to evolve. It seems that a multimarker strategy for risk stratification using simple measures of circulating proteins and usual clinical risk factors, particularly in patients with known coronary artery disease, can be used to identify patients at near-term risk of death. Whether similar strategies in the general population will prove to be cost-effective needs to be investigated.

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[DICER1 mutated, solid/trabecular thyroid papillary carcinoma in an 11-year-old child]. We report the case of an 11-year-old patient diagnosed with a solid variant of papillary thyroid carcinoma. Papillary thyroid carcinoma (PTC) is the most common thyroid cancer, representing 80-90% of all newly diagnosed thyroid cancers. Among the many variants described, solid/trabecular variant of papillary thyroid carcinoma is a rare entity and account for 3% of thyroid cancers. It is more common in children and young adults, and it is seen in higher proportion in post radiation papillary thyroid carcinoma cases. Histologically, solid variant papillary carcinoma is characterized by a predominantly solid, trabecular or insular growth pattern, and the presence of cytological features typical of PTC. Its main differential diagnosis is poorly differentiated thyroid carcinoma. It has a less favorable prognosis than the classical papillary type, with a higher risk of distant metastasis, extrathyroidal extension and lympho-vascular invasion. It is associated with a slightly lower long-term survival in adult cases, but not in children. The management of solid variant PTC includes surgery, associated or not with postoperative radioiodine ablation, according to the aggressiveness criteria. Our patient had a DICER1 somatic mutation. Carriers of germline DICER1 mutations are predisposed to a rare cancer syndrome, the DICER1 syndrome, with a higher risk of numerous tumors and infrequently differentiated thyroid carcinomas.

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Unusual mechanical processing of sounds at the apex of the Guinea pig cochlea. One of the tenets of mammalian auditory physiology is that the frequency selectivity at the cochlear base decreases as a function of stimulus level. Changes in frequency selectivity have been shown to be accompanied by changes in response phases as a function of stimulus level. The existence of such nonlinear properties has been revealed by the analysis of either direct or indirect recordings of mechanical vibrations of the cochlea. Direct measurements of cochlear mechanical vibrations, however, have been carried out with success primarily in cochlear regions that are tuned to frequencies >7 kHz, but not in regions sensitive to lower frequencies. In this paper we continue to analyze recently published data from measurements of sound-induced vibrations at four locations near the apex of the intact guinea pig cochlea, in a region encompassing approximately 25% of its total length. Analysis of the responses at all locations reveal level-dependent phase properties that are rather different from those usually reported at the base of the cochlea of laboratory animals such as the chinchilla. Cochlear group delays, for example, increase or remain constant with increasing stimulus. Similarly, frequency selectivity at all the regions increases as a function of stimulus level.

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Lymphoscintigraphy of Chylous Anomalies: Chylothorax, Chyloperitoneum, Chyluria, and Lymphangiomatosis-15-Year Experience in a Pediatric Setting and Review of the Literature. In the pediatric setting, lymphoscintigraphy is used mostly for the evaluation of lymphedema. Only a few cases of chylous anomalies and lymphatic malformations imaged with lymphoscintigraphy have been reported in the literature. The aim of this study was to review the use of lymphoscintigraphy in those pathologies. Methods: All lymphoscintigraphy studies performed for chylous anomalies between 2001 and 2017 in our hospital were retrospectively reviewed. The results were correlated to clinical and radiologic findings. Lymphoscintigraphy consisted of sequential imaging after injection of 3.7-9.25 MBq (100-250 μCi) of 99m Tc-filtered sulfur colloid at the level of the feet or hands. Results: Twenty-five studies were performed on 21 patients. Fourteen studies were obtained for the evaluation of chylothorax. Eleven were performed for chyloperitoneum, chyluria, chylopericardium, exudative enteropathy, or lymphangiomatosis. Ten studies were positive for lymphatic leakage, and 1 had uncertain results. After correlation with radiologic findings and follow-up, there were 7 true-negative and 5 false-negative results (previous 67 Ga-interfering activity in 1, injection in only the hands in 3, and a low-fat diet in 1). One study became positive after injection in the feet, and another became positive after a switch to a high-fat diet. Conclusion: Lymphoscintigraphy is a useful tool for imaging lymphatic anomalies in children. Suggestions to optimize results include placing the patient on a high-fat diet, withholding octreotide, injecting the 4 extremities, and imaging with SPECT/CT.

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Expanding Palliative Medicine across Care Settings: One Health System Experience. The success of our hospital-based Palliative Care program stimulated requests to duplicate the program across the health system continuum of care.

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Kinesio Taping in Dysphonic Patients. Kinesio taping (KT) is a method of elastic bandaging that produces a biomechanical effect on the organism. This study aims to evaluate its use in dysphonic patients tratment, as integrated part of speech therapy.

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Non-coding cancer driver candidates identified with a sample- and position-specific model of the somatic mutation rate. Non-coding mutations may drive cancer development. Statistical detection of non-coding driver regions is challenged by a varying mutation rate and uncertainty of functional impact. Here, we develop a statistically founded non-coding driver-detection method, ncdDetect, which includes sample-specific mutational signatures, long-range mutation rate variation, and position-specific impact measures. Using ncdDetect, we screened non-coding regulatory regions of protein-coding genes across a pan-cancer set of whole-genomes (n = 505), which top-ranked known drivers and identified new candidates. For individual candidates, presence of non-coding mutations associates with altered expression or decreased patient survival across an independent pan-cancer sample set (n = 5454). This includes an antigen-presenting gene ( CD1A ), where 5'UTR mutations correlate significantly with decreased survival in melanoma. Additionally, mutations in a base-excision-repair gene ( SMUG1 ) correlate with a C-to-T mutational-signature. Overall, we find that a rich model of mutational heterogeneity facilitates non-coding driver identification and integrative analysis points to candidates of potential clinical relevance.

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A worldwide epidemiological database for COVID-19 at fine-grained spatial resolution. This database provides the daily time-series of COVID-19 cases, deaths, recovered people, tests, vaccinations, and hospitalizations, for more than 230 countries, 760 regions, and 12,000 lower-level administrative divisions. The geographical entities are associated with identifiers to match with hydrometeorological, geospatial, and mobility data. The database includes policy measures at the national and, when available, sub-national levels. The data acquisition pipeline is open-source and fully automated. As most governments revise the data retrospectively, the database always updates the complete time-series to mirror the original source. Vintage data, immutable snapshots of the data taken each day, are provided to ensure research reproducibility. The latest data are updated on an hourly basis, and the vintage data are available since April 14, 2020. All the data are available in CSV files or SQLite format. By unifying the access to the data, this work makes it possible to study the pandemic on a global scale with high resolution, taking into account within-country variations, nonpharmaceutical interventions, and environmental and exogenous variables.

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Value of CT to detect radiographically occult injuries of the proximal femur in elderly patients after low-energy trauma: determination of non-inferiority margins of CT in comparison with MRI. To determine the margins of non-inferiority of the sensitivity of CT and the sample size needed to test the non-inferiority of CT in comparison with MRI.

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Mapping Risk of Malaria as a Function of Anthropic and Environmental Conditions in Sussundenga Village, Mozambique. Mozambique is a country in Southern Africa with around 30 million inhabitants. Malaria is the leading cause of mortality in the country. According to the WHO, Mozambique has the third highest number of malaria cases in the world, representing approximately 5% of the world total cases. Sussundenga District has the highest incidence in the Manica province and environmental conditions are the major contributor to malaria transmission. There is a lack of malaria risk maps to inform transmission dynamics in Sussundenga village. This study develops a malaria risk map for Sussundenga Village in Mozambique and identifies high risk areas to inform on appropriate malaria control and eradication efforts. One hundred houses were randomly sampled and tested for malaria in Sussundenga Rural Municipality. To construct the map, a spatial conceptual model was used to estimate risk areas using ten environmental and anthropic factors. Data from Worldclim, 30 × 30 Landsat images were used, and layers were produced in a raster data set. Layers between class values were compared by assigning numerical values to the classes within each layer of the map with equal rank. Data set input was classified, using diverse weights depending on their appropriateness. The reclassified data outputs were combined after reclassification. The map indicated a high risk for malaria in the northeast and southeast, that is, the neighborhoods of Nhamazara, Nhamarenza, and Unidade. The central eastern areas, that is, 25 de Junho, 1 and 2, 7 de Abril, and Chicueu presented a moderate risk. In Sussundenga village there was 92% moderate and 8% high risk. High malaria risk areas are most often located in densely populated areas and areas close to water bodies. The relevant findings of this study can inform on effective malaria interventions.

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Effects of ethnicity on proximal femoral intramedullary nail protrusion-a 3D computer graphical analysis. Antegrade nailing of proximal femur or femoral shaft fractures is a proven treatment with good to excellent results. Nonetheless, clinical evidence from Asia indicates that proximal femur nails can be too proud at the greater trochanter (GT) causing irritation for some Asian patients. This study aimed to identify any significant differences in proximal nail misfit for a set of Asian and Caucasian femora.

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Physician death by suicide in the United States: 2012-2016. Reports of incidence of physician suicide in the United States (US) are outdated. The aims of this research were to assess incidence, methods, and associated risk factors of physicians compared to non-physicians in the general US population. Retrospective suicide data (victim age 25 and over) from the 2012-2016 National Violent Death Reporting System were analyzed to test for differences in rates, methods, and risk factors of male and female physicians to non-physicians. The dataset included 498 physician suicides (403 males and 95 females) and 74,420 non-physicians (57,188 males and 17,232 females). No significant difference was found in suicide incidence between gender and age-adjusted physicians vs. non-physicians, though the female physician rate of suicide appeared higher than female non-physicians. The male to female physician ratio of suicide was about 2:1, whereas the ratio in non-physicians was closer to 4:1. Female physicians used poisoning and hanging most often as a method of suicide, where males used firearms. Depressed mood (as perceived by self or others), mental health problems (defined by a diagnosis of depression, a prescribed antidepressants or toxicology report of antidepressants), poor general medical health, and work-related stressors were more frequently associated with physician than with non-physician suicides. In conclusion, results suggest a possible heightened risk to female physicians, which warrants further investigation. Several physician-specific modifiable suicide risk factors present opportunities for prevention.

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[Habitat suitability index of larval Japanese Halfbeak (Hyporhamphus sajori) in Bohai Sea based on geographically weighted regression.]. To investigate the early supplementary processes of fishre sources in the Bohai Sea, the geographically weighted regression (GWR) was introduced to the habitat suitability index (HSI) model. The Bohai Sea larval Japanese Halfbeak HSI GWR model was established with four environmental variables, including sea surface temperature (SST), sea surface salinity (SSS), water depth (DEP), and chlorophyll a concentration (Chl a). Results of the simulation showed that the four variables had different performances in August 2015. SST and Chl a were global variables, and had little impacts on HSI, with the regression coefficients of -0.027 and 0.006, respectively. SSS and DEP were local variables, and had larger impacts on HSI, while the average values of absolute values of their regression coefficients were 0.075 and 0.129, respectively. In the central Bohai Sea, SSS showed a negative correlation with HSI, and the most negative correlation coefficient was -0.3. In contrast, SSS was correlated positively but weakly with HSI in the three bays of Bohai Sea, and the largest correlation coefficient was 0.1. In particular, DEP and HSI were negatively correlated in the entire Bohai Sea, while they were more negatively correlated in the three bays of Bohai than in the central Bohai Sea, and the most negative correlation coefficient was -0.16 in the three bays. The Poisson regression coefficient of the HSI GWR model was 0.705, consistent with field measurements. Therefore, it could provide a new method for the research on fish habitats in the future.

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The decoy SNARE Tomosyn sets tonic versus phasic release properties and is required for homeostatic synaptic plasticity. Synaptic vesicle (SV) release probability ( P r ) is a key presynaptic determinant of synaptic strength established by cell-intrinsic properties and further refined by plasticity. To characterize mechanisms that generate P r heterogeneity between distinct neuronal populations, we examined glutamatergic tonic (Ib) and phasic (Is) motoneurons in Drosophila with stereotyped differences in P r and synaptic plasticity. We found the decoy soluble N-ethylmaleimide sensitive factor attachment protein receptor (SNARE) Tomosyn is differentially expressed between these motoneuron subclasses and contributes to intrinsic differences in their synaptic output. Tomosyn expression enables tonic release in Ib motoneurons by reducing SNARE complex formation and suppressing P r to generate decreased levels of SV fusion and enhanced resistance to synaptic fatigue. In contrast, phasic release dominates when Tomosyn expression is low, enabling high intrinsic P r at Is terminals at the expense of sustained release and robust presynaptic potentiation. In addition, loss of Tomosyn disrupts the ability of tonic synapses to undergo presynaptic homeostatic potentiation.

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Lung Cancer Screening Eligibility and Utilization Among Transgender Patients: An Analysis of the 2017-2018 United States Behavioral Risk Factor Surveillance System Survey. Transgender and gender diverse (TGD) persons disproportionately face many health disparities including a higher risk of lung cancer. Lung cancer screening (LCS) using low-dose chest computed tomography has reduced lung cancer mortality in eligible high-risk smokers across several large trials, yet utilization of LCS remains low. TGD persons may be less likely to receive recommended cancer screening compared with cisgender populations. We sought to compare eligibility for and utilization of LCS between TGD and cisgender persons in the United States. We also examined if the utilization of LCS varied by smoking status within each gender identity group.

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Wastewater treatment nexus: Carbon nanomaterials towards potential aquatic ecotoxicity. Carbon nanomaterials (CNMs) provide an effective solution and a novel advancement for wastewater treatment. In this review, a total of 3823 bibliographic records derived from recent 10 years are visualized based on scientometric analysis. The results indicate metal-free CNMs-mediated advanced oxidation processes (AOPs) might be a motive force to develop CNMs application for wastewater treatment; however, corresponding evaluations of aquatic toxicity still lack sufficient attention. Therefore, recent breakthroughs and topical innovations related to prevalent wastewater treatment technologies (i.e., adsorption, catalysis and membrane separation) using three typical dimensional CNMs (nanodiamonds, carbon nanotubes, and graphene-based nanomaterials) are comprehensively summarized in-depth, along with a compendious introduction to some novel techniques (e.g., computational simulation) for identifying reaction mechanisms. Then, current research focusing on CNMs-associated aquatic toxicity is discussed thoroughly, mainly demonstrating: (1) the adverse effects on aquatic organisms should not be overlooked prior to large-scale CNMs application; (2) divergent consequences can be further reduced if the ecological niche of aquatic organisms is emphasized; and (3) further investigations on joint toxicity can provide greater beneficial insight into realistic exposure scenarios. Finally, ongoing challenges and developmental directions of CNMs-based wastewater treatment and evaluation of its aquatic toxicity are pinpointed and shaped in terms of future research.

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Skill acquisition is enhanced by reducing trial-to-trial repetition. Developing approaches to improve motor skill learning is of considerable interest across multiple disciplines. Previous research has typically shown that repeating the same action on consecutive trials enhances short-term performance but has detrimental effects on longer term skill acquisition. However, most prior research has contrasted the effects of repetition only at the block level; in the current study we examined the effects of repeating individual trials embedded in a larger randomized block, a feature that is often overlooked when random trial orders are generated in learning tasks. With 4 days of practice, a "Minimal Repeats" group, who rarely experienced repeating stimuli on consecutive trials during training, improved to a greater extent than a "Frequent Repeats" group, who were frequently presented with repeating stimuli on consecutive trials during training. Our results extend the previous finding of the beneficial effects of random compared with blocked practice on performance, showing that reduced trial-to-trial repetition during training is favorable with regard to skill learning. This research highlights that limiting the number of repeats on consecutive trials is a simple behavioral manipulation that can enhance the process of skill learning. Data/analysis code and Supplemental Material are available at https://osf.io/p3278/. NEW & NOTEWORTHY Numerous studies have shown that performing different subtasks across consecutive blocks of trials enhances learning. We examined whether the same effect would occur on a trial-to-trial level. Our Minimal Repeats group, who primarily responded to different stimuli on consecutive trials, learned more than our Frequent Repeats group, who frequently responded to the same stimulus on consecutive trials. This shows that minimizing trial-to-trial repetition is a simple and easily applicable manipulation that can enhance learning.

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Safety and efficacy of plasma exchange via direct femoral vein puncture in autoimmune blistering diseases. Plasma exchange (PE) is performed for patients with autoimmune blistering diseases by using multiple vascular access routes. We retrospectively examined the safety and the efficacy of PE using direct femoral vein puncture (FVP) technique, by comparing with that using double-lumen catheter (DLC). The troubles related to vascular route, such as catheter occlusion, insufficient blood flow and hematoma, were not different between the FVP group (4.6%) and the DLC group (6.7%), whereas access-related infections occurred more frequently in the DLC group (6.7%) than the FVP group (0.4%). Regarding the efficacy, the removal rate of autoantibodies in PE using the FVP technique was similar or lower, as compared with that using the DLC. These results suggest that PE with the FVP technique is able to be performed safely in patients with autoimmune blistering diseases, although the removal of autoantibodies is not superior to that using the DLC.

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Tolerance induction in hemophilia: innovation and accomplishments. Hemophilia is an X-linked blood coagulation genetic disorder, which can cause significant disability. Replacement therapy for coagulation factor VIII (hemophilia A) or factor IX (hemophilia B) may result in the development of high-affinity alloantibodies ('inhibitors') to the replacement therapy, thus making it ineffective. Therefore, there is interest in directing immunological responses towards tolerance to infused factors.

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[Influence of Pre-existing Cognitive Impairment on Rehabilitation Outcomes in Patients with Cerebral Infarction]. The present study determined the effects of pre-existing cognitive impairment (PreCI) on the rehabilitation outcomes in patients with cerebral infarction.

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Associations between school lunch consumption and urinary phthalate metabolite concentrations in US children and adolescents: Results from NHANES 2003-2014. Diet is a major route of phthalate exposure in humans due to use in food packaging materials. School lunches may be an important contributor to phthalate exposure in children and adolescents in the US because of the large amount of packaging necessary for mass-produced foods. We used 2003-2014 National Health and Nutrition Examination Survey data to study the association between school lunch consumption and urinary phthalate metabolite concentrations in children (ages 6-11 years, N = 2196) and adolescents (ages 12-19 years, N = 2314). After adjustment for other covariates, children who Always consumed school lunch had significantly elevated urinary concentrations of the following phthalate metabolites compared to levels in children who Never ate school lunch: sum of di(2‑ethylhexyl) phthalate metabolites, (28% higher, 95% confidence interval, CI: 10, 49%); mono‑(carboxy‑octyl) phthalate (MCOP; 43% higher, 95% CI: 17, 76%) and mono‑n‑butyl phthalate (18% higher, 95% CI: 3.5, 34%). We did not find statistically significant associations in adolescents, but the trend for MCOP concentrations was similar to that of children. In sensitivity analyses, associations between 24-hour recall of cafeteria food and urinary phthalate metabolites were not statistically significant, which could indicate that associations observed with Always consuming school lunch are due to residual confounding. Our findings show that children who Always eat school lunch had higher levels of exposure to some phthalates, but the source of differences in exposure need to be evaluated in additional studies.

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Transcriptional Pausing as a Mediator of Bacterial Gene Regulation. Cellular life depends on transcription of DNA by RNA polymerase to express genetic information. RNA polymerase has evolved not just to read information from DNA and write it to RNA but also to sense and process information from the cellular and extracellular environments. Much of this information processing occurs during transcript elongation, when transcriptional pausing enables regulatory decisions. Transcriptional pauses halt RNA polymerase in response to DNA and RNA sequences and structures at locations and times that help coordinate interactions with small molecules and transcription factors important for regulation. Four classes of transcriptional pause signals are now evident after decades of study: elemental pauses, backtrack pauses, hairpin-stabilized pauses, and regulator-stabilized pauses. In this review, I describe current understanding of the molecular mechanisms of these four classes of pause signals, remaining questions about how RNA polymerase responds to pause signals, and the many exciting directions now open to understand pausing and the regulation of transcript elongation on a genome-wide scale.

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Pediatric oropharyngeal microbiome: Mapping in chronic tonsillitis and tonsillar hypertrophy. Aim of our study was to map the adenotonsillar lymphoid tissues' microbiome identifying its potential etiopathogenetic role in children affected by chronic tonsillitis or tonsillar hypertrophy with Obstructive Sleep Apnea Syndrome (OSAS).

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Acute embolisms in multiple arterial districts following Ad26.COV2-S vaccine. A case of multiple arterial thrombosis/embolisms in a 74-year-old Caucasian man with no other cardiovascular risk factors who received Ad26.COV2-S vaccine 16 days before is reported. The unusual presentation required a longer diagnostic workup. The clinical manifestations and the therapy-specific response suggest an unusual presentation of Vaccine-induced immune thrombotic thrombocytopenia (VITT).

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Evidence-informed vaccination decision-making in countries: Progress, challenges and opportunities. Countries face an increasingly complex vaccination landscape. As well as ever-changing infectious disease epidemiology, the number and diversity of vaccine-preventable diseases, vaccine products, and vaccine technologies continue to increase. To ensure that vaccination decision-making is transparent, country-owned and informed by sound scientific evidence, many countries have established national immunization technical advisory groups (NITAGs) to provide independent expert advice. The past decade has seen substantial growth in NITAG numbers and functionality, and there is now a need to consolidate this progress, by further capacity building, to ensure that NITAGs are responsive to the changing face of immunization over the next decade.

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MicroRNA-200c suppresses tumor metastasis in oral squamous carcinoma by inhibiting epithelial-mesenchymal transition. To examine the potential mechanisms implicating miR-200c and epithelial-mesenchymal transition (EMT) in oral squamous carcinoma (OSC).

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Ventricular geometry-regularized QRSd predicts cardiac resynchronization therapy response: machine learning from crosstalk between electrocardiography and echocardiography. Up to one-third of patients selected by current guidelines do not respond to cardiac resynchronization therapy (CRT), the aim of this study was to find out novel analytical approaches to improve pre-implantation CRT response prediction. Among 31 pre-implantation features of clinical, laboratory, electrocardiography (ECG), and echocardiography variables in a consecutive cohort of patients receiving a first-time CRT device (CRT-pacemaker or CRT-defibrillator), we developed a machine learning (ML) model with three classification algorithms (support vector machines (SVM), K nearest neighbors, and random subspaces) with the best features combination to predict CRT response. Three categorical variables, left bundle branch block (LBBB), nonischemic cardiomyopathy, and female gender, were independently associated with CRT responses. Among continuous variables, including septal wall thickness, posterior wall thickness, and relative wall thickness (RWT), could regularize ECG QRS duration (QRSd) and significantly enhance the correlation between QRSd and CRT response. The 3 ML algorithms in a total of 38 features combinations constantly recognized that the features combined with QRSd/RWT outperformed the combinations without it. For each of three algorithms, the triplet feature combination of QRSd/RWT, LBBB, and nonischemic cardiomyopathy repeatedly increased the classification rate more than 8%. The best performance for CRT response prediction occurred with SVM model, which proposed actual QRSd/RWT values that favored CRT responses in patients both with and without LBBB. Lower QRSd/RWT values were required for CRT responses in patients with ischemic cardiomyopathy compared to those with non-ischemic cardiomyopathy. ML from ventricular remodeling characteristics-regularized QRSd improves CRT response prediction.

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Mandibular incisor alignment in untreated subjects compared with long-term changes after orthodontic treatment with or without retainers. The aim of this work was to analyze the dental and skeletal changes in patients treated with fixed orthodontic appliances with or without retention appliances, and to compare the changes with untreated subjects. Specifically, mandibular incisor irregularity was analyzed.

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CAR T-cell therapy is effective for CD19-dim B-lymphoblastic leukemia but is impacted by prior blinatumomab therapy. Tisagenlecleucel, a chimeric antigen receptor (CAR) T-cell product targeting CD19 is approved for relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL). However, the impact of pretreatment variables, such as CD19 expression level, on leukemic blasts, the presence of CD19- subpopulations, and especially prior CD19-targeted therapy, on the response to CAR T-cell therapy has not been determined. We analyzed 166 patients treated with CAR T-cell therapy at our institution. Eleven patients did not achieve a minimal residual disease (MRD)- deep remission, whereas 67 patients had a recurrence after achieving a MRD- deep remission: 28 patients with CD19+ leukemia and 39 patients with CD19- leukemia. Return of CD19+ leukemia was associated with loss of CAR T-cell function, whereas CD19- leukemia was associated with continued CAR T-cell function. There were no significant differences in efficacy of CAR T cells in CD19-dim B-ALL, compared with CD19-normal or -bright B-ALL. Consistent with this, CAR T cells recognized and lysed cells with very low levels of CD19 expression in vitro. The presence of dim CD19 or rare CD19- events by flow cytometry did not predict nonresponse or recurrence after CAR T-cell therapy. However, prior therapy with the CD19-directed, bispecific T-cell engager blinatumomab was associated with a significantly higher rate of failure to achieve MRD- remission or subsequent loss of remission with antigen escape. Finally, immunophenotypic heterogeneity and lineage plasticity were independent of underlying clonotype and cytogenetic abnormalities.

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BET bromodomains' functions in bone-related pathologies. Throughout life, bones are subjected to the so-called 'bone-remodeling' process, which is a balanced mechanism between the apposition and the resorption of bone. This remodeling process depends on the activities of bone-specialized cells, namely the osteoblasts and the osteoclasts. Any deregulation in this process results in bone-related pathologies, classified as either metabolic nonmalignant diseases (such as osteoporosis) or malignant primary bone sarcomas. As these pathologies are not characterized by common targetable genetic alterations, epigenetic strategies could be relevant and promising options. Recently, targeting epigenetic regulators such as the bromodomains and extraterminal domains (BET) readers have achieved success in numerous other pathologies, including cancers. In this review, we highlight the current state of the art in terms of the diverse implications of BET bromodomain proteins in the bone's biology and its defects. Consequently, their role in bone-related pathologies will also be developed, especially in the context of the primary bone sarcomas.

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Operational Communications: Adapting a Hospital Daily Check-In (DCI) for Expanded Use During Emergency Events. Low-frequency, high-acuity emergency events can and do occur within health care settings. Having a strong sense of daily situational and operational awareness is the first step in responding to any emergency event. To maintain high reliability, hospital leaders and staff must understand the full impact to the organization as the emergency event evolves. The Medical University of South Carolina health system has implemented the common practice of a daily operations safety briefing, called the Daily Check-In, to communicate any issues that could impact the operational ability of the hospitals within the enterprise, or any other associated resources during a disaster or emergency. Throughout various emergency events, including extreme weather, the Daily Check-In has evolved as a standard process for use during emergencies that is open to all staff and uses highly reliable systems.

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A Polygenic Risk Score of glutamatergic SNPs associated with schizophrenia predicts attentional behavior and related brain activity in healthy humans. Multiple genetic variations impact on risk for schizophrenia. Recent analyses by the Psychiatric Genomics Consortium (PGC2) identified 128 SNPs genome-wide associated with the disorder. Furthermore, attention and working memory deficits are core features of schizophrenia, are heritable and have been associated with variation in glutamatergic neurotransmission. Based on this evidence, in a sample of healthy volunteers, we used SNPs associated with schizophrenia in PGC2 to construct a Polygenic-Risk-Score (PRS) reflecting the cumulative risk for schizophrenia, along with a Polygenic-Risk-Score including only SNPs related to genes implicated in glutamatergic signaling (Glu-PRS). We performed Factor Analysis for dimension reduction of indices of cognitive performance. Furthermore, both PRS and Glu-PRS were used as predictors of cognitive functioning in the domains of Attention, Speed of Processing and Working Memory. The association of the Glu-PRS on brain activity during the Variable Attention Control (VAC) task was also explored. Finally, in a second independent sample of healthy volunteers we sought to confirm the association between the Glu-PRS and both performance in the domain of Attention and brain activity during the VAC.We found that performance in Speed of Processing and Working Memory was not associated with any of the Polygenic-Risk-Scores. The Glu-PRS, but not the PRS was associated with Attention and brain activity during the VAC. The specific effects of Glu-PRS on Attention and brain activity during the VAC were also confirmed in the replication sample.Our results suggest a pathway specificity in the relationship between genetic risk for schizophrenia, the associated cognitive dysfunction and related brain processing.

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Hyperbaric oxygen therapy for the treatment of perianal fistulas in Crohn's disease (HOT-TOPIC): study protocol of a prospective interventional cohort study with one-year follow-up. Perianal fistulizing Crohn's disease (pCD) has a significant impact on patients' health and quality of life. Current treatment options have a relatively low success rate and a high recurrence risk. Positive effects of hyperbaric oxygen (HBO2) therapy have been indicated in animal studies as well as in small case series.

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Increasing adult vaccinations at a regional supermarket chain pharmacy: A multi-site demonstration project. Millions of American adults do not receive the recommended vaccinations each year. Community pharmacies are well positioned to help fill this gap through easy access and innovative patient-centered interventions. The primary goal of this demonstration project was to implement new notification and motivational interviewing processes at a regional supermarket chain pharmacy to increase the number of influenza, pertussis, pneumococcal, and herpes zoster vaccines provided to adults.

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A comparative study of remote sensing classification methods for monitoring and assessing desert vegetation using a UAV-based multispectral sensor. Restoration programs require long-term monitoring and assessment of vegetation growth and productivity. Remote sensing technology is considered to be one of the most powerful technologies for assessing vegetation. However, several limitations have been observed with regard to the use of satellite imagery, especially in drylands, due to the special structure of desert plants. Therefore, this study was conducted in Kuwait's Al Abdali protected area, which is dominated by a Rhanterium epapposum community. This work aimed to determine whether Unmanned Aerial Vehicle (UAV) multispectral imagery could eliminate the challenges associated with satellite imagery by examining the vegetation indices and classification methods for very high multispectral resolution imagery using UAVs. The results showed that the transformed difference vegetation index (TDVI) performed better with arid shrubs and grasses than did the normalized difference vegetation index (NDVI). It was found that the NDVI underestimated the vegetation coverage, especially in locations with high vegetation coverage. It was also found that Support Vector Machine (SVM) and Maximum Likelihood (ML) classifiers demonstrated a higher accuracy, with a significant overall accuracy of 93% and a kappa coefficient of 0.89. Therefore, we concluded that SVM and ML are the best classifiers for assessing desert vegetation and the use of UAVs with multispectral sensors can eliminate some of the major limitations associated with satellite imagery, particularly when dealing with tiny plants such as native desert vegetation. We also believe that these methods are suitable for the purpose of assessing vegetation coverage to support revegetation and restoration programs.

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Significant alteration of liver metabolites by AAV8.Urocortin 2 gene transfer in mice with insulin resistance. Urocortin 2 (Ucn2) is a 38-amino acid peptide of the corticotropin-releasing factor family. Intravenous (IV) delivery of an adeno-associated virus vector serotype 8 encoding Ucn2 (AAV8.Ucn2) increases insulin sensitivity and glucose disposal in mice with insulin resistance.

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Gait-combined transcranial alternating current stimulation modulates cortical control of muscle activities during gait. Non-invasive brain stimulation has been of interest as a therapeutic tool to modulate cortical excitability. However, there is little evidence that oscillatory brain stimulation can modulate the cortical control of muscle activities during gait, which can be assessed using coherence analysis of paired surface electromyographic (EMG) recordings. This study aimed to investigate the effects of gait-combined transcranial alternating current stimulation (tACS) at the gait cycle frequency on the cortical control of muscle activities during gait using EMG-EMG coherence analysis. Fourteen healthy young adults participated in this study. All participants underwent 2 test conditions (real tACS and sham stimulation over the leg area of the primary motor cortex during 10-min treadmill walking). The average peak-to-peak amplitudes of the motor evoked potentials (MEPs) from the tibialis anterior (TA) and lateral gastrocnemius muscles in the sitting position and EMG-EMG coherences in the TA muscle, triceps surae muscles, quadriceps muscles, and hamstring muscles during gait were measured before and after stimulation. Entrainment effect was significantly higher during real tACS than during sham stimulation. After real tACS, the MEP amplitude and beta band (13-33 Hz) coherence area increased in the TA muscle. The change in MEP amplitude from the TA muscle was positively correlated with the change in beta band coherence area in the TA muscle. Gait-combined tACS can modulate the strength of descending neural drive to TA motoneurons during gait. This suggests that oscillatory brain stimulation is a useful therapeutic tool to modulate the cortical control of muscle activities during gait.

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Clinical problem solving and social determinants of health: a descriptive study using unannounced standardized patients to directly observe how resident physicians respond to social determinants of health. Objectives While the need to address patients' social determinants of health (SDoH) is widely recognized, less is known about physicians' actual clinical problem-solving when it comes to SDoH. Do physicians include SDoH in their assessment strategy? Are SDoH incorporated into their diagnostic thinking and if so, do they document as part of their clinical reasoning? And do physicians directly address SDoH in their "solution" (treatment plan)? Methods We used Unannounced Standardized Patients (USPs) to assess internal medicine residents' clinical problem solving in response to a patient with asthma exacerbation and concern that her moldy apartment is contributing to symptoms - a case designed to represent a clear and direct link between a social determinant and patient health. Residents' clinical practices were assessed through a post-visit checklist and systematic chart review. Patterns of clinical problem solving were identified and then explored, in depth, through review of USP comments and history of present illness (HPI) and treatment plan documentation. Results Residents fell into three groups when it came to clinical problem-solving around a housing trigger for asthma: those who failed to ask about housing and therefore did not uncover mold as a potential trigger (neglectors – 21%; 14/68); those who asked about housing in negative ways that prevented disclosure and response (negative elicitors – 23%, 16/68); and those who elicited and explored the mold issue (full elicitors – 56%; 38/68) [corrected]. Of the full elicitors 53% took no further action, 26% only documented the mold; and 21% provided resources/referral. In-depth review of USP comments/explanations and residents' notes (HPI, treatment plan) revealed possible influences on clinical problem solving. Failure to ask about housing was associated with both contextual factors (rushed visit) and interpersonal skills (not fully engaging with patient) and with possible differences in attention ("known" vs. unknown/new triggers, usual symptoms vs. changes, not attending to relocation, etc.,). Use of close-ended questions often made it difficult for the patient to share mold concerns. Negative responses to sharing of housing information led to missing mold entirely or to the patient not realizing that the physician agreed with her concerns about mold. Residents who fully elicited the mold situation but did not take action seemed to either lack knowledge or feel that action on SDoH was outside their realm of responsibility. Those that took direct action to help the patient address mold appeared to be motivated by an enhanced sense of urgency. Conclusions Findings provide unique insight into residents' problem solving processes including external influences (e.g., time, distractions), the role of core communication and interpersonal skills (eliciting information, creating opportunities for patients to voice concerns, sharing clinical thinking with patients), how traditional cognitive biases operate in practice (premature closure, tunneling, and ascertainment bias), and the ways in which beliefs about expectancies and scope of practice may color clinical problem-solving strategies for addressing SDoH.

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Detection and segmentation of morphologically complex eukaryotic cells in fluorescence microscopy images via feature pyramid fusion. Detection and segmentation of macrophage cells in fluorescence microscopy images is a challenging problem, mainly due to crowded cells, variation in shapes, and morphological complexity. We present a new deep learning approach for cell detection and segmentation that incorporates previously learned nucleus features. A novel fusion of feature pyramids for nucleus detection and segmentation with feature pyramids for cell detection and segmentation is used to improve performance on a microscopic image dataset created by us and provided for public use, containing both nucleus and cell signals. Our experimental results indicate that cell detection and segmentation performance significantly benefit from the fusion of previously learned nucleus features. The proposed feature pyramid fusion architecture clearly outperforms a state-of-the-art Mask R-CNN approach for cell detection and segmentation with relative mean average precision improvements of up to 23.88% and 23.17%, respectively.

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Synergistic effects of combined therapy with transcranial photobiomodulation and enriched environment on depressive- and anxiety-like behaviors in a mice model of noise stress. The development of anxiety and depression due to chronic exposure to noise stress has remained as an unsolved health problem so far. Despite the studies suggesting the neuroenhancement effects of transcranial photobiomodulation (tPBM) and housing in an enriched environment (EE), the combined effects of these treatments have not been elucidated yet. Also, there is no available data on the relationship between the application of tPBM and hippocampal brain-derived neurotrophic factor (BDNF) expression in animal models of stress. The present study aims to investigate the application of the tPBM and EE (alone or in combination) on depressive- and anxiety-like behaviors in a mice model of noise stress. Mice were divided into five groups: control, noise, noise + EE, noise + tPBM, and noise + EE + tPBM. Except for the control group, other groups were subjected to 110 dB SPL white noise for 4 h/day for 14 consecutive days and received their respective treatments. Forced Swimming Test (FST) was used to evaluate depressive-like behaviors. Elevated Plus Maze (EPM) and Open Field Test (OFT) were used to evaluate anxiety-like behaviors. BDNF, tyrosine receptor kinase B (TrkB), and cAMP response element-binding (CREB) protein levels in the hippocampus were determined by the Western blot method, and also serum corticosterone levels were assessed using an ELISA kit. Exposure to noise stress significantly elevated serum corticosterone level; downregulated hippocampal BDNF, TrkB, and CREB protein expressions; and resulted in depressive- and anxiety-like behaviors. While, the application of tPBM (810 nm wavelength, 8 J/cm 2 fluence, 10 Hz pulsed wave mode), housing in EE, and their combination lowered corticosterone levels, upregulated the BDNF/TrkB/CREB signaling pathway in the hippocampus, and improved behavioral outcomes in noise stress subjected mice. Our finding revealed the improving effects of tPBM and EE on depressive and anxiety-like behaviors induced by noise stress, possibly by augmenting the BDNF/TrkB/CREB signaling pathway.

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piR-001773 and piR-017184 promote prostate cancer progression by interacting with PCDH9. Prostate cancer is one of the most common malignancies and the major cause of cancer-related death in men. Increasing evidence has revealed that P-element-induced wimpy (piwi)-interacting RNAs (piRNAs) play an important role in tumor progression. Few studies have been explored the functional mechanism of piRNAs in prostate cancer progression. In the present study, we demonstrated that piR-001773 and piR-017184 were increased in prostate cancer tissues. Protocadherin 9 (PCDH9) was downregulated and acted as a tumor suppressor in prostate cancer cells. PCDH9 could bind to p85α, the regulatory subunit of PI3K. The downregulation of PCDH9 in PCa cells resulted in an increase in AKT phosphorylation and activity. PCDH9 was posttranscriptionally regulated by piR-001773 and piR-017184. The upregulation of piR-001773 and piR-017184 promoted tumor growth both in vitro and in vivo. In addition, the downregulation of piR-001773 and piR-017184 markedly inhibited tumor growth. In conclusion, these results indicated that piR-001773 and piR-017184 are oncogenic RNAs and thus might be therapeutic targets in prostate cancer.

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[Significance of the expression of proliferating cell nuclear antigen and P53 in the regeneration process of an atrophic parotid gland]. This research aims to further explore the expression and significance of proliferating cell nuclear antigen (PCNA) and P53 in regenerating rat atrophy parotid gland from the gene and protein levels.

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Sex Differences in Rupture Risk and Mortality in Untreated Patients With Intact Abdominal Aortic Aneurysms. Background Studies on intact abdominal aortic aneurysms mainly focus on treated patients, and data on untreated patients are sparse. The objective was to investigate sex differences among untreated patients regarding rupture and mortality rates and to determine predictors for these events. Sex-specific causes of death were evaluated. Methods and Results All patients ≥40 years diagnosed from 2001 to 2015 (n=32 393) with intact abdominal aortic aneurysms were identified in national registries; 60% (n=19 569) were untreated. Comorbid loads, crude rupture, and mortality rates were assessed. Predictors of 5-year rupture and mortality were analyzed in Cox models (sex, age, comorbidities, income, and marital status). The proportion of men and women with multiple comorbidities was similar. Within 5 years, 798 ruptures occurred (9.7% women versus 6.9% men, P <0.001). Ruptures were independently predicted by female sex (hazard ratio [HR], 1.23; 95% CI, 1.07-1.42; P =0.004), chronic obstructive pulmonary disease (HR, 1.36; 95% CI, 1.15-1.62; P <0.001), age (HR, 11.49; 95% CI, 5.68-23.25 for ≥80 years; P <0.001), and income (HR, 0.63; 95% CI, 0.53-0.75 for highest tertile; P <0.001). After 5 years, 56.5% women and 50.4% men were deceased. Mortality was not independently predicted by female sex. Rupture was the third most common cause of death (11.9% women versus 8.7% men; P <0.001). The median time-to-events was 2.8 years. Conclusions A considerable proportion of patients with intact abdominal aortic aneurysms in surveillance remain untreated. Despite surveillance algorithms, the healthcare system fails to prevent a high number of ruptures, especially among women. The time-to-event data highlight the urgency to develop more individualized surveillance.

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Shared decision making for elective abdominal aortic aneurysm surgery. Decisions on how and when to treat an abdominal aortic aneurysm involve a number of clinicians; interventional radiologists and vascular surgeons assess the technical ability to repair the aneurysm. Patients' fitness and past medical history is assessed to estimate their short- and long-term survival with or without surgery. Most importantly the patients' personal preference for treatment must be identified. Getting a patient to share what matters most to them requires shared decision making.

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Preparation and properties of hydrophobic films based on acetylated broken-rice starch nanocrystals for slow protein delivery. Native and acetylated broken-rice starches (nanocrystals) with different degrees of substitution (DS) and their corresponding films were individually prepared, and the drug release profiles, weight loss, solubility and dispersion and surface morphology were comparatively studied. Bovine serum albumin (BSA) was used as a model drug. Acetylated native starch (ANS) DS 2.58, acetylated starch nanocrystals (ASN) DS 0.98, ASN DS 1.86, and ASN DS 2.72 were observed to be very soluble in chloroform. BSA was released rapidly from the native rice starch (NS) and ANS DS 2.58 films. ASN with high DS significantly slowed down the release of BSA from films, the percentages of BSA released from film ASN DS 2.72 only reached to 13% after 3.5 weeks release, and the release data followed Korsmeyer-Peppas equation. Further studies reveal that the particle size of ASN DS 2.72 was smallest, and the weight loss of ASN DS 2.72 film was lowest. The results demonstrate that acetylation and nanometer particle form of rice starch film can effectively retard protein drug release, and the prepared films based on ASN with high DS from broken rice may be suitable for the controlled protein delivery.

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Missed Opportunity Encounters for Early Diagnosis of HIV Infection in Adolescents. Early diagnosis of HIV infection improves patient outcomes and reduces transmission. Adolescents make up one-fifth of new HIV diagnoses in the United States. We sought to quantify the number of missed opportunity encounters (MOEs) before HIV diagnosis for adolescents at a pediatric hospital (PediHosp) and a proximate adult hospital which employs universal HIV screening in its emergency department (ED) (CountyHosp).

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Matching Magnetic Heating and Thermal Actuation for Sequential Coupling in Hybrid Composites by Design. Sequentially coupling two material functions requires matching the output from the first with the input of the second function. Here, magnetic heating controls thermal actuation of a hybrid composite in a challenging system environment causing an elevated level of heat loss. The concept is a hierarchical design consisting of an inner actuator of nanocomposite material, which can be remotely heated by exposure to an alternating magnetic field (AMF) and outer layers of a porous composite system with a closed pore morphology. These porous layers act as heat insulators and as barriers to the surrounding water. By exposure to the AMF, a local bulk temperature of 71 °C enables the magnetic actuation of the device, while the temperature of the surrounding water is kept below 50 °C. Interestingly, the heat loss during magnetic heating leads to an increase of the water phase (small volume) temperature. The temperature increase is able to sequentially trigger an adjacent thermal actuator attached to the actuator composite. In this way it could be demonstrated how the AMF is able to initiate two kinds of independent actuations, which might be interesting for robotics operating in aqueous environments.

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Functional properties of Rhizopus oryzae strains isolated from agricultural soils as a potential probiotic for broiler feed fermentation. The most crucial and expensive fragment in the broiler chicken production industry is the feed. Because of the rising demand, finding a cheap and effective feed is an urgent necessity. Fermentation of broiler feed by probiotic fungal starters can enhance the nutrient's availability and digestibility while preventing pathogenic growth. In this study different Rhizopus spp. have been isolated from agricultural soils around Izmir, Turkey, and tested for their probiotic potential and fermentative capacity. The isolated Rhizopus strains first underwent microscopical fluorescent investigation to exclude endofungal bacterial presence, then, those without endofungal bacteria (totally 82) were tested for antimicrobial activity counter bacterial and fungal pathogens. The ones with wide-spectrum antimicrobial activity (totally 10) were tested for gastrointestinal tolerance and antioxidant ability. Upon phenotypic and genotypic identification, the 10 isolates were found to belong to Rhizopus oryzae species. While all 10 strains showed variable gastrointestinal tolerance and antioxidant activities, three of them (92/1, 236/2, and 284) had relatively high antioxidant activity. Upon fermentative capacity assay, compared to unfermented commercial feed, there was a general decrease in crude fiber content by 56% after fermentation by 92/1 isolate for 4 days and 236/2 isolate for 2 days. The highest increase in crude protein content (by 14.5%) occurred after a 4-day fermentation period by 236/2 isolate. The highest increase in metabolizable energy was 8.64%, by the 284 isolate after 2 days of fermentation. In conclusion, the three strains showed good probiotic properties and fermentative capacities hence can be beneficial for the poultry industry.

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Safety and mid-term surgical results of anterior urethroplasty with the tissue-engineered oral mucosa graft MukoCell ® : A single-center experience. To assess the mid-term efficacy and safety of anterior urethroplasty using an autologous tissue-engineered oral mucosa graft (MukoCell ® ).

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Hypoxic exosomes orchestrate tumorigenesis: molecular mechanisms and therapeutic implications. The solid tumor microenvironment possesses a hypoxic condition, which promotes aggressiveness and resistance to therapies. Hypoxic tumor cells undergo broadly metabolic and molecular adaptations and communicate with surrounding cells to provide conditions promising for their homeostasis and metastasis. Extracellular vesicles such as exosomes originating from the endosomal pathway carry different types of biomolecules such as nucleic acids, proteins, and lipids; participate in cell-to-cell communication. The exposure of cancer cells to hypoxic conditions, not only, increases exosomes biogenesis and secretion but also alters exosomes cargo. Under the hypoxic condition, different signaling pathways such as HIFs, Rab-GTPases, NF-κB, and tetraspanin are involved in the exosomes biogenesis. Hypoxic tumor cells release exosomes that induce tumorigenesis through promoting metastasis, angiogenesis, and modulating immune responses. Exosomes from hypoxic tumor cells hold great potential for clinical application and cancer diagnosis. Besides, targeting the biogenesis of these exosomes may be a therapeutic opportunity for reducing tumorigenesis. Exosomes can serve as a drug delivery system transferring therapeutic compounds to cancer cells. Understanding the detailed mechanisms involved in biogenesis and functions of exosomes under hypoxic conditions may help to develop effective therapies against cancer.

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Robot-assisted training after proximal humeral fracture: A randomised controlled multicentre intervention trial. To examine whether robotic-assisted training as a supplement to usual therapy is safe, acceptable and improves function and patient reported outcome after proximal humeral fractures (PHF).

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Distress tolerance in relation to cessation history and smoking characteristics among adult daily smokers. Distress tolerance (DT) is linked to smoking initiation, maintenance, and difficulty quitting. However, there is a lack of consistency in prior findings on DT's relations with conceptually linked smoking variables, and few studies have examined differences across DT domains. We examined interrelations between cessation history, smoking characteristics, and a full battery of multimethod DT measures.

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Epigenetic mechanisms underlying maternal diabetes-associated risk of congenital heart disease. Birth defects are the leading cause of infant mortality, and they are caused by a combination of genetic and environmental factors. Environmental risk factors may contribute to birth defects in genetically susceptible infants by altering critical molecular pathways during embryogenesis, but experimental evidence for gene-environment interactions is limited. Fetal hyperglycemia associated with maternal diabetes results in a 5-fold increased risk of congenital heart disease (CHD), but the molecular basis for this correlation is unknown. Here, we show that the effects of maternal hyperglycemia on cardiac development are sensitized by haploinsufficiency of Notch1, a key transcriptional regulator known to cause CHD. Using ATAC-seq, we found that hyperglycemia decreased chromatin accessibility at the endothelial NO synthase (Nos3) locus, resulting in reduced NO synthesis. Transcription of Jarid2, a regulator of histone methyltransferase complexes, was increased in response to reduced NO, and this upregulation directly resulted in inhibition of Notch1 expression to levels below a threshold necessary for normal heart development. We extended these findings using a Drosophila maternal diabetic model that revealed the evolutionary conservation of this interaction and the Jarid2-mediated mechanism. These findings identify a gene-environment interaction between maternal hyperglycemia and Notch signaling and support a model in which environmental factors cause birth defects in genetically susceptible infants.

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Pulmonary delivery of polyplexes for combined PAI-1 gene silencing and CXCR4 inhibition to treat lung fibrosis. This report describes the development of polyplexes based on CXCR4-inhibiting poly(ethylenimine) derivative (PEI-C) for pulmonary delivery of siRNA to silence plasminogen activator inhibitor-1 (siPAI-1) as a new combination treatment of pulmonary fibrosis (PF). Safety and delivery efficacy of the PEI-C/siPAI-1 polyplexes was investigated in vitro in primary lung fibroblasts isolated from mice with bleomycin-induced PF. Biodistribution analysis following intratracheal administration of fluorescently labeled polyplexes showed prolonged retention in the lungs. Treatment of mice with bleomycin-induced PF using the PEI-C/siPAI-1 polyplexes resulted in a significant down-regulation of the PAI-1 expression and decreased collagen deposition in the lung. The results of this study provide first evidence of the potential benefits of combined inhibition of CXCR4 and PAI-1 in the pulmonary treatment of PF.

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Challenges in respiratory management during therapeutic hypothermia for neonatal encephalopathy. Neonatal encephalopathy (NE) is a serious condition with devastating neurological outcomes that can impact oxygenation and ventilation. The currently recommended therapeutic hypothermia (TH) for these infants may also has several respiratory implications. It decreases metabolic rate and oxygen demands; however, it increases oxygen solubility in the blood and impacts its release to peripheral tissue including the brain. Respiratory management of infants treated with TH should aim for minimizing exposure to hypocapnia or hyperoxia. Inspiratory gas should be heated to 37 °C and humidified to prevent airway and alveolar injury. Blood gas values should be corrected to the core temperature during TH and the use of alkaline buffers is discouraged. While mild sedation/analgesia may ameliorate the discomfort related to cooling, paralytic agents/heavy sedation should be used with caution considering their side effects. Finally, the use of caffeine still needs careful investigation in this population.

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Chromium and cerium co-doped magnetite/reduced graphene oxide nanocomposite as a potent antibacterial agent against S. aureus. The development of innovative antibacterial samples with high efficacy has received a great deal of interest. Herein, we synthesized magnetite modified by Cr and co-modified by Cr and Ce, along with their reduced graphene oxide (rGO)-based nanocomposites via facile hydrothermal and co-precipitation methods. The rGO-based samples showed proper magnetic behavior, high porosity, and vast specific surface area. The high specific surface area provided more adsorptive active sites with higher potentials for the decomposition of Staphylococcus aureus (S. aureus) cells. The antibacterial performance of the samples against S. aureus was evaluated at 50 and 100 μg mL -1 through the colony-forming unit (CFU) method and the minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC) values were subsequently determined. As per results, not only chromium cations could effectively damage the DNA of bacteria, but also the antibacterial efficacy was further enhanced by co-doping of cerium and the integration with rGO nanosheets. The antibacterial results were confirmed through the changes observed in the morphology and topology of the bacteria before and after the treatment using SEM and AFM analyses. Ultimately, the plausible S. aureus inactivation mechanism of the samples was disclosed.

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Have Dutch Hospitals Saved Lives and Reduced Costs? A longitudinal patient-level analysis over the years 2013-2017. The purpose of this paper is to shed light on the ongoing Dutch health system reforms and identify whether hospital costs and hospital outcomes have changed over time. We present an empirical analysis that is based on granular micro-costing data and focuses on conditions for which mortality is indicative of outcome quality, that is, acute myocardial infarction (AMI), chronic heart failure (CHF), and pneumonia (PNE). We deploy a dataset of more than 80,000 inpatient episodes over 5 years (2013-2017) to estimate regression models that control for variation between patients and hospitals. We have three main findings. First, our results do not indicate significant outcome improvements over the years; that is, there is no time trend for mortality. Second, there is heterogeneity in cost developments: for patients who survive their inpatient stay, our data indicate that costs increase significantly by 0.9% per year for AMI patients, while costs decrease significantly by 1.7% per year for CHF patients and by 1.9% per year for PNE patients. For patients who pass away during their inpatient stay, our data do not indicate significant time trends. Third and finally, our results suggest the existence of substantial cost variation between hospitals.

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COVID-19: advance in laboratory diagnostic strategy and technology. SARS-CoV-2 is one of the beta-coronaviruses with the spike protein. It invades host cells by binding to angiotensin converting enzyme 2 (ACE2). This newly discovered virus can result in excessive inflammation and immune pathological damage, as shown by a decreased number of peripheral lymphocytes, increased levels of cytokines, and damages of lung, heart, liver, kidney, and other organs. Effective therapeutic modalities such as new antiviral drugs and vaccines against this emerging virus need to be thoroughly studied and developed. However, so far the only recognized but mild progress in this area is the screening of old drugs for new uses. Therefore, rapid and accurate laboratory SARS-CoV-2 testing approaches are the important basis of identification and blockage of COVID-19 transmission. For COVID-19 patients with different clinical classifications (mild, common, severe, and critically severe), dynamic monitoring of functional indicators of susceptible and vital organs is an important strategy for evaluating therapeutic efficacy and prognosis. In this review, we summarized SARS-CoV-2 laboratory diagnostic schemes, pathophysiological indices of tissues and organs of COVID-19 patients, and laboratory diagnostic strategies for distinct disease stages. Further, we discussed the importance of hierarchical management and dynamic observation in SARS-CoV-2 laboratory diagnostics. We then summed up the advance in SARS-CoV-2 testing technology and described the prospect of intelligent medicine in the prevention of infectious disease outbreaks.

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Loneliness and Self-Esteem in Children and Adolescents Affected by Parental HIV: A 3-Year Longitudinal Study. Sociometer theory posits that self-esteem is a subjective monitor of the quality of one's interpersonal relationships. When people feel excluded by others, they may have negative relational evaluation about themselves-low self-esteem. In the present study, we hypothesised and tested that feelings of loneliness among children and adolescents affected by parental HIV would decrease their self-esteem over time; moreover, low self-esteem would intensify feelings of loneliness.

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Gene-based interaction analysis shows GABAergic genes interacting with parenting in adolescent depressive symptoms. Most gene-environment interaction studies (G × E) have focused on single candidate genes. This approach is criticized for its expectations of large effect sizes and occurrence of spurious results. We describe an approach that accounts for the polygenic nature of most psychiatric phenotypes and reduces the risk of false-positive findings. We apply this method focusing on the role of perceived parental support, psychological control, and harsh punishment in depressive symptoms in adolescence.

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CT evaluation of normal bone thickness overlying the superior semicircular canal. Superior semicircular canal dehiscence (SSCD) is a rare inner ear disorder with variable amounts of auditory and vestibular dysfunction. In addition to the absence of bone overlying the superior semicircular canal, thinning of bone in this area can also initiate the vestibulocochlear symptoms of SSCD. We evaluated normal bone thickness overlying the course of the semicircular canal using computed tomography (CT) scans and assessed correlations between bone thickness and age, gender, and location of the thinnest bone. A single-institution retrospective chart review was conducted on 133 high-resolution CT scans from 76 healthy, asymptomatic patients between ages 9 and 96 years. These CT scans of the temporal bone were obtained between January 2012 and August 2017. The superior semicircular canal dome thickness at the apex was reported with a mean of 1.25 mm for all 76 patients; the 10th percentile was 0.60 mm, and the 90th percentile was 2.08 mm. The thinnest area of bone at any location yielded a mean of 0.86 mm. The normal bone thickness overlying the superior semicircular canal does not depend on gender or age. The thinnest location was evenly distributed across the superior semicircular canal. A bone thickness of 0.40 mm or greater was present in 90% of normal patients based on CT scan measurements at the thinnest location.

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Efficacy and Safety of Oral P2Y12 Inhibitors in Older Patients with Acute Coronary Syndrome: A Frequentist Network Meta-Analysis. Previous studies and meta-analyses have assessed optimal P2Y12 inhibitors following acute coronary syndrome in overall trial cohorts. However, there are insufficient data for the elderly cohort who are prone to high bleeding and ischemic events. We aimed to assess the optimal P2Y12 inhibitor therapy for older patients.

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An approach to quantify the dependence of economy on resource efficiency: A case study in Beijing-Tianjin-Hebei region of north China. The improvements of resource efficiency are crucial for economic development of a city. Currently, the variations of utilization efficiency of ecological resources have been studied much, but whether the efficiency has been good enough for driving the economy, is still unknown. Here, we introduced an efficiency dependence index (EDI) to assess the effects of utilization efficiency of land, energy and water resources on economy and evaluated the promotion potentials of resource efficiency. The Beijing-Tianjin-Hebei (BTH) region of north China was selected to validate the method. First, a non-collinear index system was built. After that, the EDI and the score of resource efficiency (SRE) index were constructed based on the generalized linear regression method. The main results were: (1) The efficiency contributions to economy in primary industry (4 of 13 cities) were far weaker than those in secondary industry (10 of 13 cities). (2) Water efficiency of primary industry in developed cities need further promotions. Energy efficiency needs more improvements especially in medium and small cities in both primary and secondary industries. (3) The efficiency utilization patterns of effective efficiency (EE), potential efficiency (PE) and no efficiency (NE) were categorized, and there were 26 of 65 (40%) counts of indicators performed EE, 31% counts of indicators presented PE and 29% counts of indicators showed NE. The improvement of water efficiency was the key driver to promote the resource efficiency. (4) By comparing current and ideal resource efficiency levels (via SRE), it showed that only 1 city reached to 80% of the ideal efficiency, 3 cities showed 70%, 4 cities showed 60% and 5 cities reached to less than 50% of the ideal resource efficiency. Policy suggestions of optimizing energy structure and pay attention to the comprehensiveness of resource efficiency were provided. This paper could serve as a reference for resource management.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Experiences of care coordination among older adults in the United States: Evidence from the Health and Retirement Study. The goal of this study was to examine variation in patient experiences and perceptions of care coordination across sociodemographic and health factors.	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Natural Products for the Treatment of Neurodegenerative Diseases. Neurodegenerative diseases are a heterogeneous group of disorders characterized by the progressive degeneration of the structure and function of the central nervous system or peripheral nervous system. Alzheimer's Disease (AD), Parkinson's Disease (PD) and Spinal Cord Injury (SCI) are the common neurodegenerative diseases, which typically occur in people over the age of 60. With the rapid development of an aged society, over 60 million people worldwide are suffering from these uncurable diseases. Therefore, the search for new drugs and therapeutic methods has become an increasingly important research topic. Natural products especially those from the Traditional Chinese Medicines (TCMs), are the most important sources of drugs, and have received extensive interest among pharmacist. In this review, in order to facilitate further chemical modification of those useful natural products by pharmacists, we will bring together recent studies in single natural compound from TCMs with neuroprotective effect.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Mechanical dyssynchrony and diastolic dysfunction are common in LVH: a pilot correlation study using Doppler echocardiography and CZT gated-SPECT MPI. Hypertrophic cardiomyopathy (HCM) is an often under-diagnosed cause of left ventricular hypertrophy (LVH). It affects 1/500 of the population, is the most commonly inherited cardiovascular disorder, and can present in apical, concentric, or septal forms. Although most patients are asymptomatic, sudden cardiac death can be the initial presentation of HCM. By retrospectively enrolling patients suspected of having three different types of HCM in the absence of epicardial coronary stenosis, we aimed to examine systolic and diastolic dysfunction and perfusion abnormalities using both Doppler echocardiography and state-of-the-art gated single-photon emission computerized tomography (SPECT) myocardial perfusion imaging (MPI) with a cadmium-zinc-telluride camera and thallium-201. Both regional perfusion and gated SPECT parameters were collected in addition to diastolic parameters from Doppler echocardiography. The results showed that mild ischemia was common in patients suspected of having HCM, with a mean summed stress score of 4.7 ± 4.9 (score 0-4 in 17-segment model). The patients with HCM were associated with discernible left ventricular mechanical dyssynchrony, especially those with the apical form. In addition, diastolic dysfunction was prevalent and early to late ventricular filling velocity ratios were significantly different between groups. By combining gated-MPI and Doppler data, the trivial functional changes in HCM may be identified.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Removal of methylene blue via bioinspired catecholamine/starch superadsorbent and the efficiency prediction by response surface methodology and artificial neural network-particle swarm optimization. This paper demonstrates coupling of the artificial neural network (ANN) technique with the particle swarm optimization (PSO) method and compares the performance of ANN-PSO with response surface methodology (RSM) in prediction of the adsorption of methylene blue (MB) by a novel bio-superadsorbent. To this, a starch-based superadsorbent was synthesized using acrylic acid and acryl amid polymers and then catecholamine functional groups were combined onto the surface with oxidative polymerization of dopamine. The adsorption of MB was considered as a function of pH, dye concentration, and contact time. The best topology of the ANN was found to be 3-7-1, and prediction model of the adsorption capacity was demonstrated as a matrix of explicit equations. ANN-PSO is more accurate than RSM. The results revealed that the root-mean-square error, correlation coefficient, and normalized standard deviation for the ANN-PSO are 22.46, 0.99, and 16.83, respectively, while for RSM are 82.89, 0.98, and 65.41, respectively.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	1	1	0	1	0	0	1	0	0	0	0	0	0	0	0
Engaging Patients in Decision-Making and Behavior Change to Promote Prevention. Effectively engaging patients in their care is essential to improve health outcomes, improve satisfaction with the care experience, reduce costs, and even benefit the clinician experience. This chapter will address the topic of patient engagement directly and review the relationships between health literacy and patient engagement. While there are many ways to define patient and family engagement, this chapter will consider engagement as "patients, families, their representatives, and health professionals working in active partnership at various levels across the health care system - direct care, organizational design and governance, and policy making - to improve health and health care [1]." We will specifically focus on the patient engagement and health literacy needs for three scenarios (1) decision-making, (2) health behavior change, and (3) chronic disease management; we will include the theoretical underpinnings of engagement, the systems required to better support patient engagement, how social determinants of health influence patient engagement, and practical examples to demonstrate approaches to better engage patients in their health and wellbeing. We will close by describing the future of patient engagement, which extends beyond the traditional domains of decision-making and self-care to describe how patient engagement can influence the design of the healthcare delivery system; local, state, and national health policies; and future research relevant to the needs and experiences of patients.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
New data about the 21st Century Identified Skeletal Collection (University of Coimbra, Portugal). After the publication of the first article in 2014, 21st Century Identified Skeletal Collection, housed in the Laboratory of Forensic Anthropology, Department of Life Sciences at the University of Coimbra, Portugal, has been growing. Currently, the collection is composed of 302 complete adult skeletons of both sexes, which means that in 5 years it has doubled. The collection consists mostly of elderly individuals, with only 12.25% of the individuals aged less than 61 years old. All individuals are Portuguese nationals who died between 1982 and 2012. Ninety individuals exhibit prostheses, other medical devices and signs of surgical procedures. Moreover, a sub-collection of experimentally burned skeletons is under development, and currently includes 56 individuals (18.54% of the collection). The 21st Century Identified Skeletal Collection constitutes a fundamental tool for forensic anthropology research, including the development and validation studies of methods that focus on elderly individuals, as can be ascertained by the numerous scientific publications and academic scholarship that have been produced in previous years.	0	0	0	0	0	0	1	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0
Considerable variability in antibiotic use among US children's hospitals in 2017-2018. To characterize the prevalence of and seasonal and regional variation in inpatient antibiotic use among hospitalized US children in 2017-2018.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
[Effects of microbial fertilizer on soil improvement and fruit quality of kiwifruit in old orchard.]. The continuous cropping obstacles caused by the increase of kiwifruit planting period resulted in imbalance of soil microbial community structure, and decrease of soil enzyme activity and physicochemical indicators, which substantially reduced both the quality and yield of kiwifruit. Under the field conditions, the traditional fertilization of fruit farmers was used as a control (CK) to study the effects of two different microbial fertilizers, JF and KF, which had been verified the growth promotion of kiwifruit aseptic seedlings test, on soil microbial community structure, soil enzyme activities, soil physicochemical characters during different growth periods of kiwifruit (germination period, florescence period, fruit enlargement period, fruit ripening period and next year germination period), as well as fruit quality. The results showed that both fertilizers significantly increased the ratio of bacteria with fungi and the ratio of actinomycetes with fungi in the kiwifruit orchard soil, indicating that they could improve and balance the soil microbial community structure. The enzymes activity in kiwifruit orchard soil with the addition of both fertilizers were significantly higher than that in CK, and among which sucrose, urease, phosphatase and polyphenol oxidase were increased by 17.9%-83.5%, 7.9%-83.0%, 7.3%-45.4% and 8.1%-140.3%, respectively. JF and KF increased soil fertility (the concentrations of available nitrogen, phosphorus, potassium, total nitrogen, total phosphorus, total potassium, and organic matter content significantly increased) and decreased soil pH (a decrease of 0.29 to 0.34). After application of microbial ferti-lizer, the content of vitamin C, soluble sugar, soluble protein and other contents of kiwifruit increased, and the titratable acid content decreased. Therefore, the application of both fertilizers could balance soil microbial community structure, enhance soil fertility, and improve the fruit quality of kiwifruit. Our results provide robust theoretical basis for the application of microbial fertilizers in the old-aged kiwifruit orchards.	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	1	0	0	0	0	0	0	0	0
Differential effects of working memory load on priming and recognition of real images. Several studies have explored the effects of divided attention on priming, but little is known about the impact of working memory load on implicit visual memory. The aim of this study was to determine whether there are differential effects of working memory load on a visual priming task compared to a recognition task. In the encoding phase, participants were presented with real-object pictures and asked to classify them semantically. At retrieval, 40 studied and 40 new images were presented (partially masked) for 100 ms, and participants had to identify the object. Each trial was immediately followed by a recognition test, in which the unmasked image was shown again, and participants had to indicate whether it had been presented at encoding or not. Regarding working memory load, participants performed a task in which a load was imposed in half of the trials. Twenty-four participants concurrently performed an articulatory suppression task, another group of 24 subjects performed an executive demanding task, and a third group of 24 participants performed a spatial tapping task. Working memory load failed to diminish performance on both priming and recognition tests in the articulatory suppression condition. However, the backward counting and the tapping tasks influenced recognition, rather than priming. The relative pattern of backward counting effects on recognition and priming were then broadly replicated in a follow-up experiment using an adapted priming task (N = 24). Results suggest that a concurrent load has a more robust effect on recognition than on priming, especially when the working memory task is executively demanding.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
What strategies do desk-based workers choose to reduce sitting time and how well do they work? Findings from a cluster randomised controlled trial. Large amounts of sitting at work have been identified as an emerging occupational health risk, and findings from intervention trials have been reported. However, few such reports have examined participant-selected strategies and their relationships with behaviour change.	0	0	0	0	0	0	0	0	0	0	0	0	1	0	1	0	0	0	0	0	0	0	0	0	0	0	0	1	1	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	1	0	0	1	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0
Household Food Insecurity in Early Adolescence and Risk of Subsequent Behavior Problems: Does a Connection Persist Over Time? Household food insecurity is common among U.S. families, and adolescents are almost twice as likely as school-aged children to be food insecure. However, little is known about how household food insecurity relates to adolescent behavioral outcomes over time. The purpose of this study was to examine whether food security status in early adolescence is associated with behavioral problems over a 6-year period in an ethnically diverse sample of teenagers from low-income households.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Influence of Divalent Counterions on the Dynamics in DNA as Probed by Using a Minor-Groove Binder. DNA dynamics, to which water, counterions, and DNA motions contribute, is a topic of considerable interest because it is closely related to the efficiency of biological functions performed by it. Simulation studies and experiments suggest that the counterion dynamics in DNA probed by a minor-groove binder are similar for various monovalent counterions. To date, the influence on DNA dynamics of higher-valence counterions, which are also present around DNA and are known to bind more strongly to it than monovalent ions, has not been studied. Herein we investigated DNA dynamics in the presence of Mg 2+ and Ca 2+ , chosen for their relative abundance in cells, by using minor-groove binder 4',6-diamidino-2-phenylindole (DAPI) as a fluorescence probe. The dynamics, as measured from the time-resolved fluorescence Stokes shifts of DAPI bound to calf thymus DNA on a subpicosecond-to-nanosecond timescale, were found to be very similar in the presence of both the divalent ions and Na + ions. The observation is explained by considering the screening of the electric field of the divalent ion by its hydration shell, preferential binding of the ions to the phosphate groups, and displacement of ions from the minor groove by DAPI due to the stronger binding interaction of the latter. Furthermore, the similarity of our results in the presence of Na + to those reported for smaller oligonucleotides suggests that the chain length of DNA does not influence the DNA dynamics.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
The case of encephalitis in a COVID-19 pediatric patient. The COVID-19 pandemic, induced by the worldwide spreading of the SARS-CoV-2, is well known for its clinical picture consistent with respiratory symptoms. If pulmonary complications are the most common manifestation of the disease, neurological problems are also significantly present, with complications including acute cerebrovascular events, encephalitis, Guillain-Barré and Miller Fisher syndromes, acute necrotizing hemorrhagic encephalopathy and hemophagocytic lymphohistiocytosis. These medical signs can be considered direct effects of the virus on the nervous system, para-infectious or post-infectious immune-mediated diseases, and neurological complications of the systemic effects of the SARS-CoV-2.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Effects of selected rehabilitative exercises on external rotator muscles and trapezius muscles of masonry workers. Masonry workers engaged in occupational work-activities have high risk of shoulder injury that often develops to functional loss and disability. Rehabilitative exercises (REs) have potential for slowing this development.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Skin concerns in patients with trisomy 21 (Down syndrome): A Mayo Clinic 22-year retrospective review. Trisomy 21 has known associated clinical phenotypes, including skin and soft tissue concerns. However, the overall prevalence and types of findings are largely unclear.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Arthroscopic and Endoscopic Treatment of Proximal Rectus Femoris Avulsion. Proximal rectus femoris avulsion (PRFA) is an uncommon injury that is poorly reported in the literature. Historically, these injuries have been treated nonoperatively or with open techniques. This is the first study showing endoscopic treatment of this injury. We present a systematic review of PRFA treatment and a case report of a patient whose injury was treated endoscopically. Sixty-four injuries were reported across several sports. Patients underwent nonoperative management, suture repair, suture anchor repair, or excision of the tendon stump. Surgical complications included lateral femoral cutaneous nerve injury and wound complications. The patient who underwent arthroscopic treatment had a good outcome. [ Orthopedics . 2022;45(1):e1-e6.].	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Is feyerabendian philosophy relevant for scientific knowledge development in nursing? To revitalize nursing science, there is a need for a new approach to guide nurse scientists in addressing complex problems in health care. By applying theoretical concepts from a revolutionary philosopher of science, Paul K. Feyerabend, new nursing knowledge can be produced using creativity and pluralistic approaches. Feyerabend proposed that methods within and outside of science can produce knowledge. Despite the recognition of Feyerabendian philosophy within science, there is currently a lack of literature regarding the relevance of Feyerabendian philosophy for nursing science. We aim to (a) describe and critique Feyerabendian concepts, (b) discuss the potential application of Feyerabendian philosophy for knowledge production within gerontological nursing and (c) describe theoretical possibilities for nurse scientists in using Feyerabendian philosophy to guide nursing knowledge development. We begin by introducing Feyerabend's life and his inspirations for his theoretical concepts, epistemological anarchism, theoretical pluralism and humanitarianism, and conclude by offering suggestions of how to apply Feyerabendian philosophy in nursing research.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Recognition method of construction conflict based on driver's eye movement. Drivers eye movement data in simulated construction conflicts at different speeds were collected and analyzed to find the relationship between the drivers' eye movement and the construction conflict. On the basis of the relationship between the drivers' eye movement and the construction conflict, the peak point of wavelet processed pupil diameter, the first point on the left side of the peak point and the first blink point after the peak point are selected as key points for locating construction conflict periods. On the basis of the key points and the GSA, a construction conflict recognition method so called the CCFRM is proposed. And the construction conflict recognition speed and location accuracy of the CCFRM are verified. The good performance of the CCFRM verified the feasibility of proposed key points in construction conflict recognition.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Pterins as diagnostic markers of exercise-induced stress: a systematic review. To evaluate pterins as diagnostic biomarkers of exercise-induced stress.	0	0	0	0	0	0	0	0	0	0	0	1	0	0	1	1	0	0	0	0	0	1	0	0	0	0	0	0	1	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Changes in socio-economic level and their impact on nutritional status: a follow-up study among young Chilean adults. To verify the association between changes in socio-economic level (SEL) and nutritional status of Chilean adults over a 10-year period.	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	1	1	0	0	0	0	0	0	0	0	0	1	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
A comprehensive review on freshness of fish and assessment: Analytical methods and recent innovations. Fish, a highly nutritious, containing a good amount of protein and fatty acids, has TMA and TVB-N present as major factors responsible for quality deterioration during storage and maintaining of fish freshness. Freshness is one of the most important parameters in the fish market. There are many methods of estimating fish freshness, out of which some are very costly while others are not user-friendly. However, with more technological innovations, there have been efforts to make a more reliable method of calculating and analyzing freshness. Parameters chosen for assessing the freshness are sensory, physical, chemical and microbiological including the recent trends such as SDS-PAGE, fast protein liquid chromatography, hyper Spectral Imaging Technique, etc. focused on reducing time, destruction and labor. Traditional and recent methods of evaluation of freshness along with their comparison based on several parameters are needed to link them and making it convenient for upcoming researchers to have a detailed study for having a universal indicator for assessing the freshness of fish. Information in the present article has all the methods of assessing the fish freshness been discussed in detail. There has also been focus on bringing the readers knowledge about the comprehensive information related to recent developments. The recommended limit for different indicators signifies the time period for which the particular fish can be stored and it depends upon several factors like species, surrounding environment and enzymatic and non-enzymatic actions. Based on these demands, this paper is uniquely worked upon to review the different literature which brought all the discussions from the past including the recent innovations in assessing the freshness of different fishes with the help of various indicators as well as a complete study of spoilage and toxicity mechanism leading to deterioration in quality, making it easy for the reader and researchers to have quick glance over the trends and innovations.	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
A High-Fat High-Fructose Diet Dysregulates the Homeostatic Crosstalk Between Gut Microbiome, Metabolome, and Immunity in an Experimental Model of Obesity. Ample evidence supports the prominent role of gut-liver axis in perpetuating pathological networks of high-fat high-fructose (HFF) diet induced metabolic disorders, however, the molecular mechanisms are still not fully understood. Herein, this study aims to present a holistic delineation and scientific explanation for the crosstalk between the gut and liver, including the potential mediators involved in orchestrating the metabolic and immune systems.	1	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Student evaluations of teaching (SET): implications for medical education in psychiatry and an approach to evaluating SET and student performance. We present reflections on student evaluation of teaching (SET) in the context of recent higher educational research that assesses SET, as well as concurrent and/or subsequent student performance.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Probing prodrug metabolism and reciprocal toxicity with an integrated and humanized multi-tissue organ-on-a-chip platform. Current drug development techniques are expensive and inefficient, partially due to the use of preclinical models that do not accurately recapitulate in vivo drug efficacy and cytotoxicity. To address this challenge, we report on an integrated, in vitro multi-organoid system that enables parallel assessment of drug efficiency and toxicity on multiple 3D tissue organoids. Built in a low-cost, adhesive film-based microfluidic device, these miniaturized structures require less than 200 µL fluid volume and are amenable to both matrix-based 3D cell culture and spheroid aggregate integration, each supported with an in situ photocrosslinkable hyaluronic acid hydrogel. Here, we demonstrate this technology first with a three-organoid device consisting of liver, cardiac, and lung constructs. We show that these multiple tissue types can be kept in common circulation with high viability for 21 days and validate the platform by investigating liver metabolism of the prodrug capecitabine into 5-fluorouracil (5-FU) and observing downstream toxicity in lung and cardiac organoids. Then we expand the integrated system to accommodate six humanized constructs, including liver, cardiac, lung, endothelium, brain, and testes organoids. Following a 14-day incubation in common media, we demonstrate multi-tissue interactions by metabolizing the alkylating prodrug ifosfamide in the liver organoid to produce chloroacetaldehyde and induce downstream neurotoxicity. Our results establish an expandable, multi-organoid body-on-a-chip system that can be fabricated easily and used for the accurate characterization of drug interactions in vitro. STATEMENT OF SIGNIFICANCE: The use of 3-dimensional (3D) in vitro models in drug development has advanced over the past decade. However, with several exceptions, the majority of research studies using 3D in vitro models, such as organoids, employ single tissue types, in isolated environments with no "communication" between different tissues. This is a significant limiting factor because in the human body there is significant signaling between different cells, tissues, and organs. Here we employ a low-cost, adhesive film-based microfluidic device approach, paired with a versatile extracellular matrix-derived hyaluronic acid hydrogel to support integrated systems of 3 and 6 3D organoid and cell constructs. Moreover, we demonstrate an integrated response to drugs, in which downstream toxicity is dependent on the presence of liver organoids.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Signaling-to-chromatin pathways in the immune system. Complex organisms are able to respond to diverse environmental cues by rapidly inducing specific transcriptional programs comprising a few dozen genes among thousands. The highly complex environment within the nucleus-a crowded milieu containing large genomes tightly condensed with histone proteins in the form of chromatin-makes inducible transcription a challenge for the cell, akin to the proverbial needle in a haystack. The different signaling pathways and transcription factors involved in the transmission of information from the cell surface to the nucleus have been readily explored, but not so much the specific mechanisms employed by the cell to ultimately instruct the chromatin changes necessary for a fast and robust transcription activation. Signaling pathways rely on cascades of protein kinases that, in addition to activating transcription factors can also activate the chromatin template by phosphorylating histone proteins, what we refer to as "signaling-to-chromatin." These pathways appear to be selectively employed and especially critical for driving inducible transcription in macrophages and likely in diverse other immune cell populations. Here, we discuss signaling-to-chromatin pathways with potential relevance in diverse immune cell populations together with chromatin related mechanisms that help to "solve" the needle in a haystack challenge of robust chromatin activation and inducible transcription.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Improved efficacy and safety of low-dose oxaliplatin/pegylated liposomal doxorubicin/S-1 regimen in advanced gastric cancer: a cohort study. Dose-limiting neurotoxicity is the major side effect caused by oxaliplatin treatment. Optimization of oxaliplatin-containing chemotherapeutic regimens may potentially benefit advanced gastric cancer (AGC) patients. We tried to reduce the dose of oxaliplatin and add a drug to compensate for the efficacy. This cohort study evaluated the efficacy and side effects of low-dose oxaliplatin combined with pegylated liposomal doxorubicin and S-1 (D-SOX) as first-line treatment for AGC.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0
Anatomic study of fibrous structures attached to the volar ulnar corner of the radius: implications in the volar rim fracture. This study aimed to clarify the bone and soft tissue morphological features at the volar ulnar corner of the radius. Micro-computed tomography, macroscopic and histological analyses were conducted using 12 cadaveric wrists, and in vivo MRI studies of the wrist were evaluated in five healthy volunteers. The volar ulnar corner of the distal radius has a protrusion volar to the sigmoid notch. The capsule elements of the radiolunate and radioulnar joints merge and this conjoined capsule attaches to the radius at the ulnar protrusion. Histologically, this capsule attaches to the radius via fibrocartilage, with fibres running in the radioulnar direction. In-vivo MRI studies showed that the capsule attaching to the volar ulnar corner could be traced to the dorsal side of the ulnar styloid. Our findings indicate that, given the direction of the fibres, an avulsion force in the radioulnar direction could be a cause for volar rim fractures.	0	0	0	0	0	0	1	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
The effect of speed limit reductions in urban areas on cyclists' injuries in collisions with cars. Objective: Impact speed is one of the most important factors explaining the severity of injuries to cyclists when they collide with passenger cars. To reduce injury severity (especially for vulnerable road users), since 2008, Swedish municipalities have the authority to lower the speed limit to 30 or 40 km/h in urban areas as appropriate. The aim of this study was to evaluate how this speed limit reduction has influenced the injury severity for cyclists in this type of collision. Method : Data from 1,953 collisions between bicycles and passenger cars were collected using information from third-party-liability insurance claims from 2005 to 2017. The change of speed limit distribution, influenced by the reduction of speed limits in urban areas, where car-to-cyclist collisions occurred was studied. Following that, injury severity for cyclists was evaluated regarding collisions occurring in areas with different speed limits. Results: The results show that, in collisions with cars, cyclists have a significantly lower risk of a moderate-to-fatal (MAIS 2+) injury when the speed limit is 30-40 km/h compared to 50-60 km/h. During the last decade, while the speed-limit has been lowered on many road-sections in urban areas from 50-60 km/h to 30-40 km/h the risk of a cyclist getting a MAIS 2+ injury decreased by 25%. In 2005 to 2011, 16% of the crashes happened on a road with a speed limit of 30-40 km/h; in 2016-2017, this percentage had increased to approximately 50%. Thus, in recent years more crashes occurred on roads with lower speed limits, and in these crashes, there was a lower risk of severe injuries to cyclists. Unfortunately, it was not possible to evaluate the risk of a crash for specific speed limits; since one limitation of this study was the lack of exposure data, nor do we know the impact speed or the actual speed of the vehicles. Conclusions: This study is an important follow-up on the implementation of measures that can influence bicycle safety. The insurance data used, made it possible to quantify a positive effect on injury severity for cyclists in passenger car-to-cyclist collisions when the speed limit was reduced in urban areas. Insurance claims cover collisions of all crash severity, so they include data covering all types of injuries-not just the most severe/fatal ones. This aspect is especially important in the speed intervals evaluated here, since moderate (MAIS 2) injuries are very frequent in lower-speed crashes and even these injuries can result in long-term consequences.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Surgery Versus Endoscopic Mucosal Resection Versus Endoscopic Submucosal Dissection for Large Polyps: Making Sense of When to Use Which Approach. Endoscopic resection for large colorectal lesion is effective and cost-saving than surgery. Piecemeal resections are often effective if applied meticulously but endoscopic submucosal dissection (ESD) allows meritorious removal of large lesions in one piece. For rectal lesions, transanal endoscopic microsurgery or transanal minimally invasive surgery offers more radical transmural resection but ESD is also effective for removal of complex rectal lesions. Surgical resection with lymph node dissection is the gold standard for invasive cancer; however, the management of low-risk early-stage colorectal cancer is worth debating. Treatment selection for large colorectal lesions is discussed based on lesion factor and treatment outcomes.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Correlation between osteoarthritis of the atlantoaxial facet joint and a high-riding vertebral artery. A high-riding vertebral artery (HRVA) is an intraosseous anomaly that narrows the trajectory for C2 pedicle screws. The prevalence of a HRVA is high in patients who need surgery at the craniovertebral junction, but reports about HRVAs in subaxial cervical spine disorders are limited. We sought to determine the prevalence of HRVAs among patients with subaxial cervical spine disorders to elucidate the potential risk for VA injury in subaxial cervical spine surgery.	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Esophageal Button Battery in the Pediatric Population: Experience from a Tertiary Care Center. To highlight different patterns of clinical presentation, share authors' experience in the management of children following button battery ingestion and their outcomes.	0	0	0	0	0	1	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Versatility of buccinator flaps for the treatment of palatal defects: a series of cases. The buccinator flap is currently one of the best techniques for the reconstruction of defects in the oral cavity and other sites. Reconstruction of the palate is a major challenge because of the functional consequences of the excision of lesions in this area. The main goal is to maintain separation between the mouth and the nose. We have done a cross-sectional retrospective descriptive study of a series of cases reconstruction of palatal defects with buccinator flap at the University Hospital Miguel Servet in Zaragoza during a six-year period and compared our results, morbidity, and mortality with those of published series. The main complication was partial loss of the flap. We have analysed the reasons for this and report the steps needed to avoid it.	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Nanoparticle-mediated histotripsy (NMH) using perfluorohexane 'nanocones'. Nanoparticle-mediated histotripsy (NMH) is an ultrasound treatment strategy that combines acoustically sensitive nanoparticles with histotripsy. Previous NMH studies using perfluorocarbon (PFC) nanodroplets (ND's), ~200 nm in diameter, demonstrated that NMH can selectively generate cavitation by reducing the cavitation threshold from ~25-30 MPa to ~10-15 MPa. Recent studies have also shown that cavitation nucleation in NMH is directly caused by the incident negative pressure (p-) exposed to the PFC, as predicted by classical nucleation theory (CNT), suggesting that the NMH cavitation threshold is dependent on the total volume of PFC present in the focal region. In this study, we investigate the use of a newly developed NMH nanoparticle synthesized using an inclusion complex of methylated β-cyclodextrin and perfluorohexane (PFH). These 'nanocones' (NCs) have advantages compared to previously used ND's due to their smaller size (~50 nm), simple synthesis method, higher stability and information of definite PFH amount carried by the NC. To test the hypothesis that NCs can reduce the NMH cavitation threshold similar to ND's, and that the NMH cavitation threshold is dependent upon the total PFH concentration, tissue phantoms containing concentrations of NCs ranging from 10 -5 to 10 -10 (ml PFH/ml water) were exposed to single cycle ultrasound pulses using a 500 kHz focused transducer where high speed imaging captured cavitation data. Results showed that NCs significantly reduced the histotripsy cavitation threshold to 11.0 MPa for a concentration of 10 -5 (ml PFH/ml water), with the threshold increasing at lower concentrations. Finally, the ability of NCs to be used for effective NMH ablation was demonstrated in tissue phantoms containing red blood cells (RBCs). Overall, the results of the study support our hypotheses that NCs can be used for effective NMH therapy and that NC concentration has a predictable threshold-reducing effect.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Properties of natural rubber reinforced with cellulose nanofibers based on fiber diameter distribution as estimated by differential centrifugal sedimentation. Cellulose nanofibers (CNFs) with different degrees of fibrillation are prepared by the mechanical fibrillation of kraft pulp using wet disk milling, and dispersions of the prepared CNFs were subjected to differential centrifugal sedimentation (DCS) in order to estimate the diameter distributions of the CNFs. The low-fibrillated CNFs (fiber diameter (d): >10 μm) had a weak reinforcing effect on natural rubber (NR), while the medium-fibrillated CNFs (d: 0.1-10 μm) dramatically improve the initial modulus and decrease the elongation at break. The high-fibrillated CNFs (d: <0.1 μm) enhanced the tensile strength even further while maintaining the elongation at break. The reinforcing mechanism of the NR composites reinforced by the CNFs (NR-CNFs) was confirmed by field-emission scanning electron microscopy imaging, dynamic mechanical analysis, and toluene uptake measurements. It was concluded that these characteristic mechanical properties of the NR-CNFs were determined by the morphologies of the CNFs. The branching structure of the medium-fibrillated CNFs affected high improvement of the initial modulus, and the network formed by the high-fibrillated CNFs were involved in enhancement of the tensile strength without compromising viscoelastic properties. Understanding the effect of their diameter distribution can potentially reduce the production cost of CNFs and thus expand their applicability.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
[Stress Echocardiography in the Assessment of Long-Term Outcomes After Percutaneous Coronary Intervention in Patients With Stable Coronary Heart Disease]. To study the possibilities of stress echocardiography (EchoCG) in the assessment of clinical state of patients after percutaneous coronary intervention (PCI).	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Characterization of Thrombospondin Type 1 Repeat in Haliotis diversicolor and Its Possible Role in Osteoinduction. Thrombospondin repeats (TSR) are important peptide domains present in the sequences of many extracellular and transmembrane proteins with which a variety of ligands interact. In this study, we characterized HdTSR domains in the ADAMTS3 protein of Thai abalone, Haliotis diversicolor, based on the transcriptomic analysis of its mantle tissues. PCR amplification and localization studies demonstrated the existence of HdTSR transcript and protein in H. diversicolor tissues, particularly in both the inner and outer mantle epithelial folds. We, therefore, generated a short recombinant protein, termed HdTSR1/2, based on the existence of the WxxWxxW or WxxxxW motif (which binds to TGF-β, a known signaling in bone formation/repair) in HdTSR1 and HdTSR2 sequences and used it to test the osteoinduction function in the pre-osteoblastic cell line, MC3T3-E1. This recombinant protein demonstrated the ability to induce the differentiation of MC3T3-E1 cells by the concentration- and time-dependent upregulation of many known osteogenic markers, including RUNX2, COL1A1, OCN, and OPN. We also demonstrated the upregulation of the SMAD2 gene after cell treatment with HdTSR1/2 proteinindicating its possible interaction through TGF-β, which thus activates its downstream signaling cascade and triggers the biomineralization process in the differentiated osteoblastic cells. Together, HdTSR domains existed in an extracellular ADAMTS3 protein in the mantle epithelium of H. diversicolor and played a role in osteoinduction as similar to the other nacreous proteins, opening up its possibility to be developed as an inducing agent of bone repair.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Knockdown of LncRNA MALAT1 contributes to cell apoptosis via regulating NF-κB/CD80 axis in neonatal respiratory distress syndrome. Neonatal respiratory distress syndrome (NRDS) is a leading cause of morbidity in premature newborns and is a common reason for admission to the neonatal intensive care unit (NICU). Recent studies found that the pathogenesis of NRDS is not simply lung immaturity. Apoptosis is an essential process for the development and maturation of the lungs. In this study, we report a critical role of lncRNA MALAT1 in regulating CD80 transcription in the NRDS-associated apoptosis via binding with NF-κB. We first showed MALAT1 and CD80 were highly expressed in the peripheral blood mononuclear cells of NRDS with infection exposure. Then we found MALAT1 expressions were significantly increased by the treatment of LPS. We confirmed knockdown of MALAT1 promoted cell viability by CCK-8 assays, cell apoptosis by flow cytometric assays and cytoskeleton destruction by immunocytochemistry. We confirmed CD80 expression level was associated with cell apoptosis by affecting PARP and caspase-3. Then we demonstrated knockdown of MALAT1 promoted CD80 transcription in A549 cells. Furthermore, we confirmed that MALAT1 downregulated transcriptional expression of CD80 by interfering with NF-κB activation and disrupting its binding efficiency with the CD80 promoter in the cell nucleus. In conclusion, we first identified lncRNA MALAT1 as an important prognosis maker for NRDS patients. Most significantly, this study then demonstrated a novel regulatory function of knocked-down MALAT1 on the transcriptional level of CD80 by enhancing the binding of NF-κB to CD80 promoter. Since the interaction between MALAT1 and CD80 plays an essential role in the cell apoptosis of NRDS, our findings demonstrate the possibility of using MALAT1 as therapeutic target for treatment of NRDS, and extend existing knowledge about the molecular mechanism that underlies NRDS pathogensis.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Biomarkers to Predict Cardiovascular Death. This article reviews biomarkers that have been shown to identify subjects at increased risk for cardiovascular death within the general population, in those with established coronary artery disease, and in those with heart failure. Use of biomarkers for risk stratification for sudden cardiac death continues to evolve. It seems that a multimarker strategy for risk stratification using simple measures of circulating proteins and usual clinical risk factors, particularly in patients with known coronary artery disease, can be used to identify patients at near-term risk of death. Whether similar strategies in the general population will prove to be cost-effective needs to be investigated.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1
[DICER1 mutated, solid/trabecular thyroid papillary carcinoma in an 11-year-old child]. We report the case of an 11-year-old patient diagnosed with a solid variant of papillary thyroid carcinoma. Papillary thyroid carcinoma (PTC) is the most common thyroid cancer, representing 80-90% of all newly diagnosed thyroid cancers. Among the many variants described, solid/trabecular variant of papillary thyroid carcinoma is a rare entity and account for 3% of thyroid cancers. It is more common in children and young adults, and it is seen in higher proportion in post radiation papillary thyroid carcinoma cases. Histologically, solid variant papillary carcinoma is characterized by a predominantly solid, trabecular or insular growth pattern, and the presence of cytological features typical of PTC. Its main differential diagnosis is poorly differentiated thyroid carcinoma. It has a less favorable prognosis than the classical papillary type, with a higher risk of distant metastasis, extrathyroidal extension and lympho-vascular invasion. It is associated with a slightly lower long-term survival in adult cases, but not in children. The management of solid variant PTC includes surgery, associated or not with postoperative radioiodine ablation, according to the aggressiveness criteria. Our patient had a DICER1 somatic mutation. Carriers of germline DICER1 mutations are predisposed to a rare cancer syndrome, the DICER1 syndrome, with a higher risk of numerous tumors and infrequently differentiated thyroid carcinomas.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Unusual mechanical processing of sounds at the apex of the Guinea pig cochlea. One of the tenets of mammalian auditory physiology is that the frequency selectivity at the cochlear base decreases as a function of stimulus level. Changes in frequency selectivity have been shown to be accompanied by changes in response phases as a function of stimulus level. The existence of such nonlinear properties has been revealed by the analysis of either direct or indirect recordings of mechanical vibrations of the cochlea. Direct measurements of cochlear mechanical vibrations, however, have been carried out with success primarily in cochlear regions that are tuned to frequencies >7 kHz, but not in regions sensitive to lower frequencies. In this paper we continue to analyze recently published data from measurements of sound-induced vibrations at four locations near the apex of the intact guinea pig cochlea, in a region encompassing approximately 25% of its total length. Analysis of the responses at all locations reveal level-dependent phase properties that are rather different from those usually reported at the base of the cochlea of laboratory animals such as the chinchilla. Cochlear group delays, for example, increase or remain constant with increasing stimulus. Similarly, frequency selectivity at all the regions increases as a function of stimulus level.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Lymphoscintigraphy of Chylous Anomalies: Chylothorax, Chyloperitoneum, Chyluria, and Lymphangiomatosis-15-Year Experience in a Pediatric Setting and Review of the Literature. In the pediatric setting, lymphoscintigraphy is used mostly for the evaluation of lymphedema. Only a few cases of chylous anomalies and lymphatic malformations imaged with lymphoscintigraphy have been reported in the literature. The aim of this study was to review the use of lymphoscintigraphy in those pathologies. Methods: All lymphoscintigraphy studies performed for chylous anomalies between 2001 and 2017 in our hospital were retrospectively reviewed. The results were correlated to clinical and radiologic findings. Lymphoscintigraphy consisted of sequential imaging after injection of 3.7-9.25 MBq (100-250 μCi) of 99m Tc-filtered sulfur colloid at the level of the feet or hands. Results: Twenty-five studies were performed on 21 patients. Fourteen studies were obtained for the evaluation of chylothorax. Eleven were performed for chyloperitoneum, chyluria, chylopericardium, exudative enteropathy, or lymphangiomatosis. Ten studies were positive for lymphatic leakage, and 1 had uncertain results. After correlation with radiologic findings and follow-up, there were 7 true-negative and 5 false-negative results (previous 67 Ga-interfering activity in 1, injection in only the hands in 3, and a low-fat diet in 1). One study became positive after injection in the feet, and another became positive after a switch to a high-fat diet. Conclusion: Lymphoscintigraphy is a useful tool for imaging lymphatic anomalies in children. Suggestions to optimize results include placing the patient on a high-fat diet, withholding octreotide, injecting the 4 extremities, and imaging with SPECT/CT.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Expanding Palliative Medicine across Care Settings: One Health System Experience. The success of our hospital-based Palliative Care program stimulated requests to duplicate the program across the health system continuum of care.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0
Kinesio Taping in Dysphonic Patients. Kinesio taping (KT) is a method of elastic bandaging that produces a biomechanical effect on the organism. This study aims to evaluate its use in dysphonic patients tratment, as integrated part of speech therapy.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	1	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Non-coding cancer driver candidates identified with a sample- and position-specific model of the somatic mutation rate. Non-coding mutations may drive cancer development. Statistical detection of non-coding driver regions is challenged by a varying mutation rate and uncertainty of functional impact. Here, we develop a statistically founded non-coding driver-detection method, ncdDetect, which includes sample-specific mutational signatures, long-range mutation rate variation, and position-specific impact measures. Using ncdDetect, we screened non-coding regulatory regions of protein-coding genes across a pan-cancer set of whole-genomes (n = 505), which top-ranked known drivers and identified new candidates. For individual candidates, presence of non-coding mutations associates with altered expression or decreased patient survival across an independent pan-cancer sample set (n = 5454). This includes an antigen-presenting gene ( CD1A ), where 5'UTR mutations correlate significantly with decreased survival in melanoma. Additionally, mutations in a base-excision-repair gene ( SMUG1 ) correlate with a C-to-T mutational-signature. Overall, we find that a rich model of mutational heterogeneity facilitates non-coding driver identification and integrative analysis points to candidates of potential clinical relevance.	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0
A worldwide epidemiological database for COVID-19 at fine-grained spatial resolution. This database provides the daily time-series of COVID-19 cases, deaths, recovered people, tests, vaccinations, and hospitalizations, for more than 230 countries, 760 regions, and 12,000 lower-level administrative divisions. The geographical entities are associated with identifiers to match with hydrometeorological, geospatial, and mobility data. The database includes policy measures at the national and, when available, sub-national levels. The data acquisition pipeline is open-source and fully automated. As most governments revise the data retrospectively, the database always updates the complete time-series to mirror the original source. Vintage data, immutable snapshots of the data taken each day, are provided to ensure research reproducibility. The latest data are updated on an hourly basis, and the vintage data are available since April 14, 2020. All the data are available in CSV files or SQLite format. By unifying the access to the data, this work makes it possible to study the pandemic on a global scale with high resolution, taking into account within-country variations, nonpharmaceutical interventions, and environmental and exogenous variables.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Value of CT to detect radiographically occult injuries of the proximal femur in elderly patients after low-energy trauma: determination of non-inferiority margins of CT in comparison with MRI. To determine the margins of non-inferiority of the sensitivity of CT and the sample size needed to test the non-inferiority of CT in comparison with MRI.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0
Mapping Risk of Malaria as a Function of Anthropic and Environmental Conditions in Sussundenga Village, Mozambique. Mozambique is a country in Southern Africa with around 30 million inhabitants. Malaria is the leading cause of mortality in the country. According to the WHO, Mozambique has the third highest number of malaria cases in the world, representing approximately 5% of the world total cases. Sussundenga District has the highest incidence in the Manica province and environmental conditions are the major contributor to malaria transmission. There is a lack of malaria risk maps to inform transmission dynamics in Sussundenga village. This study develops a malaria risk map for Sussundenga Village in Mozambique and identifies high risk areas to inform on appropriate malaria control and eradication efforts. One hundred houses were randomly sampled and tested for malaria in Sussundenga Rural Municipality. To construct the map, a spatial conceptual model was used to estimate risk areas using ten environmental and anthropic factors. Data from Worldclim, 30 × 30 Landsat images were used, and layers were produced in a raster data set. Layers between class values were compared by assigning numerical values to the classes within each layer of the map with equal rank. Data set input was classified, using diverse weights depending on their appropriateness. The reclassified data outputs were combined after reclassification. The map indicated a high risk for malaria in the northeast and southeast, that is, the neighborhoods of Nhamazara, Nhamarenza, and Unidade. The central eastern areas, that is, 25 de Junho, 1 and 2, 7 de Abril, and Chicueu presented a moderate risk. In Sussundenga village there was 92% moderate and 8% high risk. High malaria risk areas are most often located in densely populated areas and areas close to water bodies. The relevant findings of this study can inform on effective malaria interventions.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Effects of ethnicity on proximal femoral intramedullary nail protrusion-a 3D computer graphical analysis. Antegrade nailing of proximal femur or femoral shaft fractures is a proven treatment with good to excellent results. Nonetheless, clinical evidence from Asia indicates that proximal femur nails can be too proud at the greater trochanter (GT) causing irritation for some Asian patients. This study aimed to identify any significant differences in proximal nail misfit for a set of Asian and Caucasian femora.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Physician death by suicide in the United States: 2012-2016. Reports of incidence of physician suicide in the United States (US) are outdated. The aims of this research were to assess incidence, methods, and associated risk factors of physicians compared to non-physicians in the general US population. Retrospective suicide data (victim age 25 and over) from the 2012-2016 National Violent Death Reporting System were analyzed to test for differences in rates, methods, and risk factors of male and female physicians to non-physicians. The dataset included 498 physician suicides (403 males and 95 females) and 74,420 non-physicians (57,188 males and 17,232 females). No significant difference was found in suicide incidence between gender and age-adjusted physicians vs. non-physicians, though the female physician rate of suicide appeared higher than female non-physicians. The male to female physician ratio of suicide was about 2:1, whereas the ratio in non-physicians was closer to 4:1. Female physicians used poisoning and hanging most often as a method of suicide, where males used firearms. Depressed mood (as perceived by self or others), mental health problems (defined by a diagnosis of depression, a prescribed antidepressants or toxicology report of antidepressants), poor general medical health, and work-related stressors were more frequently associated with physician than with non-physician suicides. In conclusion, results suggest a possible heightened risk to female physicians, which warrants further investigation. Several physician-specific modifiable suicide risk factors present opportunities for prevention.	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
[Habitat suitability index of larval Japanese Halfbeak (Hyporhamphus sajori) in Bohai Sea based on geographically weighted regression.]. To investigate the early supplementary processes of fishre sources in the Bohai Sea, the geographically weighted regression (GWR) was introduced to the habitat suitability index (HSI) model. The Bohai Sea larval Japanese Halfbeak HSI GWR model was established with four environmental variables, including sea surface temperature (SST), sea surface salinity (SSS), water depth (DEP), and chlorophyll a concentration (Chl a). Results of the simulation showed that the four variables had different performances in August 2015. SST and Chl a were global variables, and had little impacts on HSI, with the regression coefficients of -0.027 and 0.006, respectively. SSS and DEP were local variables, and had larger impacts on HSI, while the average values of absolute values of their regression coefficients were 0.075 and 0.129, respectively. In the central Bohai Sea, SSS showed a negative correlation with HSI, and the most negative correlation coefficient was -0.3. In contrast, SSS was correlated positively but weakly with HSI in the three bays of Bohai Sea, and the largest correlation coefficient was 0.1. In particular, DEP and HSI were negatively correlated in the entire Bohai Sea, while they were more negatively correlated in the three bays of Bohai than in the central Bohai Sea, and the most negative correlation coefficient was -0.16 in the three bays. The Poisson regression coefficient of the HSI GWR model was 0.705, consistent with field measurements. Therefore, it could provide a new method for the research on fish habitats in the future.	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0
The decoy SNARE Tomosyn sets tonic versus phasic release properties and is required for homeostatic synaptic plasticity. Synaptic vesicle (SV) release probability ( P r ) is a key presynaptic determinant of synaptic strength established by cell-intrinsic properties and further refined by plasticity. To characterize mechanisms that generate P r heterogeneity between distinct neuronal populations, we examined glutamatergic tonic (Ib) and phasic (Is) motoneurons in Drosophila with stereotyped differences in P r and synaptic plasticity. We found the decoy soluble N-ethylmaleimide sensitive factor attachment protein receptor (SNARE) Tomosyn is differentially expressed between these motoneuron subclasses and contributes to intrinsic differences in their synaptic output. Tomosyn expression enables tonic release in Ib motoneurons by reducing SNARE complex formation and suppressing P r to generate decreased levels of SV fusion and enhanced resistance to synaptic fatigue. In contrast, phasic release dominates when Tomosyn expression is low, enabling high intrinsic P r at Is terminals at the expense of sustained release and robust presynaptic potentiation. In addition, loss of Tomosyn disrupts the ability of tonic synapses to undergo presynaptic homeostatic potentiation.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Lung Cancer Screening Eligibility and Utilization Among Transgender Patients: An Analysis of the 2017-2018 United States Behavioral Risk Factor Surveillance System Survey. Transgender and gender diverse (TGD) persons disproportionately face many health disparities including a higher risk of lung cancer. Lung cancer screening (LCS) using low-dose chest computed tomography has reduced lung cancer mortality in eligible high-risk smokers across several large trials, yet utilization of LCS remains low. TGD persons may be less likely to receive recommended cancer screening compared with cisgender populations. We sought to compare eligibility for and utilization of LCS between TGD and cisgender persons in the United States. We also examined if the utilization of LCS varied by smoking status within each gender identity group.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Wastewater treatment nexus: Carbon nanomaterials towards potential aquatic ecotoxicity. Carbon nanomaterials (CNMs) provide an effective solution and a novel advancement for wastewater treatment. In this review, a total of 3823 bibliographic records derived from recent 10 years are visualized based on scientometric analysis. The results indicate metal-free CNMs-mediated advanced oxidation processes (AOPs) might be a motive force to develop CNMs application for wastewater treatment; however, corresponding evaluations of aquatic toxicity still lack sufficient attention. Therefore, recent breakthroughs and topical innovations related to prevalent wastewater treatment technologies (i.e., adsorption, catalysis and membrane separation) using three typical dimensional CNMs (nanodiamonds, carbon nanotubes, and graphene-based nanomaterials) are comprehensively summarized in-depth, along with a compendious introduction to some novel techniques (e.g., computational simulation) for identifying reaction mechanisms. Then, current research focusing on CNMs-associated aquatic toxicity is discussed thoroughly, mainly demonstrating: (1) the adverse effects on aquatic organisms should not be overlooked prior to large-scale CNMs application; (2) divergent consequences can be further reduced if the ecological niche of aquatic organisms is emphasized; and (3) further investigations on joint toxicity can provide greater beneficial insight into realistic exposure scenarios. Finally, ongoing challenges and developmental directions of CNMs-based wastewater treatment and evaluation of its aquatic toxicity are pinpointed and shaped in terms of future research.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0
Skill acquisition is enhanced by reducing trial-to-trial repetition. Developing approaches to improve motor skill learning is of considerable interest across multiple disciplines. Previous research has typically shown that repeating the same action on consecutive trials enhances short-term performance but has detrimental effects on longer term skill acquisition. However, most prior research has contrasted the effects of repetition only at the block level; in the current study we examined the effects of repeating individual trials embedded in a larger randomized block, a feature that is often overlooked when random trial orders are generated in learning tasks. With 4 days of practice, a "Minimal Repeats" group, who rarely experienced repeating stimuli on consecutive trials during training, improved to a greater extent than a "Frequent Repeats" group, who were frequently presented with repeating stimuli on consecutive trials during training. Our results extend the previous finding of the beneficial effects of random compared with blocked practice on performance, showing that reduced trial-to-trial repetition during training is favorable with regard to skill learning. This research highlights that limiting the number of repeats on consecutive trials is a simple behavioral manipulation that can enhance the process of skill learning. Data/analysis code and Supplemental Material are available at https://osf.io/p3278/. NEW & NOTEWORTHY Numerous studies have shown that performing different subtasks across consecutive blocks of trials enhances learning. We examined whether the same effect would occur on a trial-to-trial level. Our Minimal Repeats group, who primarily responded to different stimuli on consecutive trials, learned more than our Frequent Repeats group, who frequently responded to the same stimulus on consecutive trials. This shows that minimizing trial-to-trial repetition is a simple and easily applicable manipulation that can enhance learning.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Safety and efficacy of plasma exchange via direct femoral vein puncture in autoimmune blistering diseases. Plasma exchange (PE) is performed for patients with autoimmune blistering diseases by using multiple vascular access routes. We retrospectively examined the safety and the efficacy of PE using direct femoral vein puncture (FVP) technique, by comparing with that using double-lumen catheter (DLC). The troubles related to vascular route, such as catheter occlusion, insufficient blood flow and hematoma, were not different between the FVP group (4.6%) and the DLC group (6.7%), whereas access-related infections occurred more frequently in the DLC group (6.7%) than the FVP group (0.4%). Regarding the efficacy, the removal rate of autoantibodies in PE using the FVP technique was similar or lower, as compared with that using the DLC. These results suggest that PE with the FVP technique is able to be performed safely in patients with autoimmune blistering diseases, although the removal of autoantibodies is not superior to that using the DLC.	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Tolerance induction in hemophilia: innovation and accomplishments. Hemophilia is an X-linked blood coagulation genetic disorder, which can cause significant disability. Replacement therapy for coagulation factor VIII (hemophilia A) or factor IX (hemophilia B) may result in the development of high-affinity alloantibodies ('inhibitors') to the replacement therapy, thus making it ineffective. Therefore, there is interest in directing immunological responses towards tolerance to infused factors.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	1	1	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	1	1	0	0	0	0	0	0	0	0	0	0	0	0	0
[Influence of Pre-existing Cognitive Impairment on Rehabilitation Outcomes in Patients with Cerebral Infarction]. The present study determined the effects of pre-existing cognitive impairment (PreCI) on the rehabilitation outcomes in patients with cerebral infarction.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Associations between school lunch consumption and urinary phthalate metabolite concentrations in US children and adolescents: Results from NHANES 2003-2014. Diet is a major route of phthalate exposure in humans due to use in food packaging materials. School lunches may be an important contributor to phthalate exposure in children and adolescents in the US because of the large amount of packaging necessary for mass-produced foods. We used 2003-2014 National Health and Nutrition Examination Survey data to study the association between school lunch consumption and urinary phthalate metabolite concentrations in children (ages 6-11 years, N = 2196) and adolescents (ages 12-19 years, N = 2314). After adjustment for other covariates, children who Always consumed school lunch had significantly elevated urinary concentrations of the following phthalate metabolites compared to levels in children who Never ate school lunch: sum of di(2‑ethylhexyl) phthalate metabolites, (28% higher, 95% confidence interval, CI: 10, 49%); mono‑(carboxy‑octyl) phthalate (MCOP; 43% higher, 95% CI: 17, 76%) and mono‑n‑butyl phthalate (18% higher, 95% CI: 3.5, 34%). We did not find statistically significant associations in adolescents, but the trend for MCOP concentrations was similar to that of children. In sensitivity analyses, associations between 24-hour recall of cafeteria food and urinary phthalate metabolites were not statistically significant, which could indicate that associations observed with Always consuming school lunch are due to residual confounding. Our findings show that children who Always eat school lunch had higher levels of exposure to some phthalates, but the source of differences in exposure need to be evaluated in additional studies.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	1	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Transcriptional Pausing as a Mediator of Bacterial Gene Regulation. Cellular life depends on transcription of DNA by RNA polymerase to express genetic information. RNA polymerase has evolved not just to read information from DNA and write it to RNA but also to sense and process information from the cellular and extracellular environments. Much of this information processing occurs during transcript elongation, when transcriptional pausing enables regulatory decisions. Transcriptional pauses halt RNA polymerase in response to DNA and RNA sequences and structures at locations and times that help coordinate interactions with small molecules and transcription factors important for regulation. Four classes of transcriptional pause signals are now evident after decades of study: elemental pauses, backtrack pauses, hairpin-stabilized pauses, and regulator-stabilized pauses. In this review, I describe current understanding of the molecular mechanisms of these four classes of pause signals, remaining questions about how RNA polymerase responds to pause signals, and the many exciting directions now open to understand pausing and the regulation of transcript elongation on a genome-wide scale.	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Pediatric oropharyngeal microbiome: Mapping in chronic tonsillitis and tonsillar hypertrophy. Aim of our study was to map the adenotonsillar lymphoid tissues' microbiome identifying its potential etiopathogenetic role in children affected by chronic tonsillitis or tonsillar hypertrophy with Obstructive Sleep Apnea Syndrome (OSAS).	1	0	0	0	0	0	0	0	0	1	0	1	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Acute embolisms in multiple arterial districts following Ad26.COV2-S vaccine. A case of multiple arterial thrombosis/embolisms in a 74-year-old Caucasian man with no other cardiovascular risk factors who received Ad26.COV2-S vaccine 16 days before is reported. The unusual presentation required a longer diagnostic workup. The clinical manifestations and the therapy-specific response suggest an unusual presentation of Vaccine-induced immune thrombotic thrombocytopenia (VITT).	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	1	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	1	0	1	0	0	0	0	0	0	0	0	0	0	0	0
Evidence-informed vaccination decision-making in countries: Progress, challenges and opportunities. Countries face an increasingly complex vaccination landscape. As well as ever-changing infectious disease epidemiology, the number and diversity of vaccine-preventable diseases, vaccine products, and vaccine technologies continue to increase. To ensure that vaccination decision-making is transparent, country-owned and informed by sound scientific evidence, many countries have established national immunization technical advisory groups (NITAGs) to provide independent expert advice. The past decade has seen substantial growth in NITAG numbers and functionality, and there is now a need to consolidate this progress, by further capacity building, to ensure that NITAGs are responsive to the changing face of immunization over the next decade.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	1	0	1	0	0	0	0	0	0	0	0	0	0	0	0
MicroRNA-200c suppresses tumor metastasis in oral squamous carcinoma by inhibiting epithelial-mesenchymal transition. To examine the potential mechanisms implicating miR-200c and epithelial-mesenchymal transition (EMT) in oral squamous carcinoma (OSC).	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Ventricular geometry-regularized QRSd predicts cardiac resynchronization therapy response: machine learning from crosstalk between electrocardiography and echocardiography. Up to one-third of patients selected by current guidelines do not respond to cardiac resynchronization therapy (CRT), the aim of this study was to find out novel analytical approaches to improve pre-implantation CRT response prediction. Among 31 pre-implantation features of clinical, laboratory, electrocardiography (ECG), and echocardiography variables in a consecutive cohort of patients receiving a first-time CRT device (CRT-pacemaker or CRT-defibrillator), we developed a machine learning (ML) model with three classification algorithms (support vector machines (SVM), K nearest neighbors, and random subspaces) with the best features combination to predict CRT response. Three categorical variables, left bundle branch block (LBBB), nonischemic cardiomyopathy, and female gender, were independently associated with CRT responses. Among continuous variables, including septal wall thickness, posterior wall thickness, and relative wall thickness (RWT), could regularize ECG QRS duration (QRSd) and significantly enhance the correlation between QRSd and CRT response. The 3 ML algorithms in a total of 38 features combinations constantly recognized that the features combined with QRSd/RWT outperformed the combinations without it. For each of three algorithms, the triplet feature combination of QRSd/RWT, LBBB, and nonischemic cardiomyopathy repeatedly increased the classification rate more than 8%. The best performance for CRT response prediction occurred with SVM model, which proposed actual QRSd/RWT values that favored CRT responses in patients both with and without LBBB. Lower QRSd/RWT values were required for CRT responses in patients with ischemic cardiomyopathy compared to those with non-ischemic cardiomyopathy. ML from ventricular remodeling characteristics-regularized QRSd improves CRT response prediction.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	1	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Mandibular incisor alignment in untreated subjects compared with long-term changes after orthodontic treatment with or without retainers. The aim of this work was to analyze the dental and skeletal changes in patients treated with fixed orthodontic appliances with or without retention appliances, and to compare the changes with untreated subjects. Specifically, mandibular incisor irregularity was analyzed.	0	0	0	0	0	0	1	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
CAR T-cell therapy is effective for CD19-dim B-lymphoblastic leukemia but is impacted by prior blinatumomab therapy. Tisagenlecleucel, a chimeric antigen receptor (CAR) T-cell product targeting CD19 is approved for relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL). However, the impact of pretreatment variables, such as CD19 expression level, on leukemic blasts, the presence of CD19- subpopulations, and especially prior CD19-targeted therapy, on the response to CAR T-cell therapy has not been determined. We analyzed 166 patients treated with CAR T-cell therapy at our institution. Eleven patients did not achieve a minimal residual disease (MRD)- deep remission, whereas 67 patients had a recurrence after achieving a MRD- deep remission: 28 patients with CD19+ leukemia and 39 patients with CD19- leukemia. Return of CD19+ leukemia was associated with loss of CAR T-cell function, whereas CD19- leukemia was associated with continued CAR T-cell function. There were no significant differences in efficacy of CAR T cells in CD19-dim B-ALL, compared with CD19-normal or -bright B-ALL. Consistent with this, CAR T cells recognized and lysed cells with very low levels of CD19 expression in vitro. The presence of dim CD19 or rare CD19- events by flow cytometry did not predict nonresponse or recurrence after CAR T-cell therapy. However, prior therapy with the CD19-directed, bispecific T-cell engager blinatumomab was associated with a significantly higher rate of failure to achieve MRD- remission or subsequent loss of remission with antigen escape. Finally, immunophenotypic heterogeneity and lineage plasticity were independent of underlying clonotype and cytogenetic abnormalities.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
BET bromodomains' functions in bone-related pathologies. Throughout life, bones are subjected to the so-called 'bone-remodeling' process, which is a balanced mechanism between the apposition and the resorption of bone. This remodeling process depends on the activities of bone-specialized cells, namely the osteoblasts and the osteoclasts. Any deregulation in this process results in bone-related pathologies, classified as either metabolic nonmalignant diseases (such as osteoporosis) or malignant primary bone sarcomas. As these pathologies are not characterized by common targetable genetic alterations, epigenetic strategies could be relevant and promising options. Recently, targeting epigenetic regulators such as the bromodomains and extraterminal domains (BET) readers have achieved success in numerous other pathologies, including cancers. In this review, we highlight the current state of the art in terms of the diverse implications of BET bromodomain proteins in the bone's biology and its defects. Consequently, their role in bone-related pathologies will also be developed, especially in the context of the primary bone sarcomas.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Operational Communications: Adapting a Hospital Daily Check-In (DCI) for Expanded Use During Emergency Events. Low-frequency, high-acuity emergency events can and do occur within health care settings. Having a strong sense of daily situational and operational awareness is the first step in responding to any emergency event. To maintain high reliability, hospital leaders and staff must understand the full impact to the organization as the emergency event evolves. The Medical University of South Carolina health system has implemented the common practice of a daily operations safety briefing, called the Daily Check-In, to communicate any issues that could impact the operational ability of the hospitals within the enterprise, or any other associated resources during a disaster or emergency. Throughout various emergency events, including extreme weather, the Daily Check-In has evolved as a standard process for use during emergencies that is open to all staff and uses highly reliable systems.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	1	0	0	0	0	0	0	0	0	0	0	1	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
A Polygenic Risk Score of glutamatergic SNPs associated with schizophrenia predicts attentional behavior and related brain activity in healthy humans. Multiple genetic variations impact on risk for schizophrenia. Recent analyses by the Psychiatric Genomics Consortium (PGC2) identified 128 SNPs genome-wide associated with the disorder. Furthermore, attention and working memory deficits are core features of schizophrenia, are heritable and have been associated with variation in glutamatergic neurotransmission. Based on this evidence, in a sample of healthy volunteers, we used SNPs associated with schizophrenia in PGC2 to construct a Polygenic-Risk-Score (PRS) reflecting the cumulative risk for schizophrenia, along with a Polygenic-Risk-Score including only SNPs related to genes implicated in glutamatergic signaling (Glu-PRS). We performed Factor Analysis for dimension reduction of indices of cognitive performance. Furthermore, both PRS and Glu-PRS were used as predictors of cognitive functioning in the domains of Attention, Speed of Processing and Working Memory. The association of the Glu-PRS on brain activity during the Variable Attention Control (VAC) task was also explored. Finally, in a second independent sample of healthy volunteers we sought to confirm the association between the Glu-PRS and both performance in the domain of Attention and brain activity during the VAC.We found that performance in Speed of Processing and Working Memory was not associated with any of the Polygenic-Risk-Scores. The Glu-PRS, but not the PRS was associated with Attention and brain activity during the VAC. The specific effects of Glu-PRS on Attention and brain activity during the VAC were also confirmed in the replication sample.Our results suggest a pathway specificity in the relationship between genetic risk for schizophrenia, the associated cognitive dysfunction and related brain processing.	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Hyperbaric oxygen therapy for the treatment of perianal fistulas in Crohn's disease (HOT-TOPIC): study protocol of a prospective interventional cohort study with one-year follow-up. Perianal fistulizing Crohn's disease (pCD) has a significant impact on patients' health and quality of life. Current treatment options have a relatively low success rate and a high recurrence risk. Positive effects of hyperbaric oxygen (HBO2) therapy have been indicated in animal studies as well as in small case series.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Increasing adult vaccinations at a regional supermarket chain pharmacy: A multi-site demonstration project. Millions of American adults do not receive the recommended vaccinations each year. Community pharmacies are well positioned to help fill this gap through easy access and innovative patient-centered interventions. The primary goal of this demonstration project was to implement new notification and motivational interviewing processes at a regional supermarket chain pharmacy to increase the number of influenza, pertussis, pneumococcal, and herpes zoster vaccines provided to adults.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
A comparative study of remote sensing classification methods for monitoring and assessing desert vegetation using a UAV-based multispectral sensor. Restoration programs require long-term monitoring and assessment of vegetation growth and productivity. Remote sensing technology is considered to be one of the most powerful technologies for assessing vegetation. However, several limitations have been observed with regard to the use of satellite imagery, especially in drylands, due to the special structure of desert plants. Therefore, this study was conducted in Kuwait's Al Abdali protected area, which is dominated by a Rhanterium epapposum community. This work aimed to determine whether Unmanned Aerial Vehicle (UAV) multispectral imagery could eliminate the challenges associated with satellite imagery by examining the vegetation indices and classification methods for very high multispectral resolution imagery using UAVs. The results showed that the transformed difference vegetation index (TDVI) performed better with arid shrubs and grasses than did the normalized difference vegetation index (NDVI). It was found that the NDVI underestimated the vegetation coverage, especially in locations with high vegetation coverage. It was also found that Support Vector Machine (SVM) and Maximum Likelihood (ML) classifiers demonstrated a higher accuracy, with a significant overall accuracy of 93% and a kappa coefficient of 0.89. Therefore, we concluded that SVM and ML are the best classifiers for assessing desert vegetation and the use of UAVs with multispectral sensors can eliminate some of the major limitations associated with satellite imagery, particularly when dealing with tiny plants such as native desert vegetation. We also believe that these methods are suitable for the purpose of assessing vegetation coverage to support revegetation and restoration programs.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Significant alteration of liver metabolites by AAV8.Urocortin 2 gene transfer in mice with insulin resistance. Urocortin 2 (Ucn2) is a 38-amino acid peptide of the corticotropin-releasing factor family. Intravenous (IV) delivery of an adeno-associated virus vector serotype 8 encoding Ucn2 (AAV8.Ucn2) increases insulin sensitivity and glucose disposal in mice with insulin resistance.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Gait-combined transcranial alternating current stimulation modulates cortical control of muscle activities during gait. Non-invasive brain stimulation has been of interest as a therapeutic tool to modulate cortical excitability. However, there is little evidence that oscillatory brain stimulation can modulate the cortical control of muscle activities during gait, which can be assessed using coherence analysis of paired surface electromyographic (EMG) recordings. This study aimed to investigate the effects of gait-combined transcranial alternating current stimulation (tACS) at the gait cycle frequency on the cortical control of muscle activities during gait using EMG-EMG coherence analysis. Fourteen healthy young adults participated in this study. All participants underwent 2 test conditions (real tACS and sham stimulation over the leg area of the primary motor cortex during 10-min treadmill walking). The average peak-to-peak amplitudes of the motor evoked potentials (MEPs) from the tibialis anterior (TA) and lateral gastrocnemius muscles in the sitting position and EMG-EMG coherences in the TA muscle, triceps surae muscles, quadriceps muscles, and hamstring muscles during gait were measured before and after stimulation. Entrainment effect was significantly higher during real tACS than during sham stimulation. After real tACS, the MEP amplitude and beta band (13-33 Hz) coherence area increased in the TA muscle. The change in MEP amplitude from the TA muscle was positively correlated with the change in beta band coherence area in the TA muscle. Gait-combined tACS can modulate the strength of descending neural drive to TA motoneurons during gait. This suggests that oscillatory brain stimulation is a useful therapeutic tool to modulate the cortical control of muscle activities during gait.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Clinical problem solving and social determinants of health: a descriptive study using unannounced standardized patients to directly observe how resident physicians respond to social determinants of health. Objectives While the need to address patients' social determinants of health (SDoH) is widely recognized, less is known about physicians' actual clinical problem-solving when it comes to SDoH. Do physicians include SDoH in their assessment strategy? Are SDoH incorporated into their diagnostic thinking and if so, do they document as part of their clinical reasoning? And do physicians directly address SDoH in their "solution" (treatment plan)? Methods We used Unannounced Standardized Patients (USPs) to assess internal medicine residents' clinical problem solving in response to a patient with asthma exacerbation and concern that her moldy apartment is contributing to symptoms - a case designed to represent a clear and direct link between a social determinant and patient health. Residents' clinical practices were assessed through a post-visit checklist and systematic chart review. Patterns of clinical problem solving were identified and then explored, in depth, through review of USP comments and history of present illness (HPI) and treatment plan documentation. Results Residents fell into three groups when it came to clinical problem-solving around a housing trigger for asthma: those who failed to ask about housing and therefore did not uncover mold as a potential trigger (neglectors – 21%; 14/68); those who asked about housing in negative ways that prevented disclosure and response (negative elicitors – 23%, 16/68); and those who elicited and explored the mold issue (full elicitors – 56%; 38/68) [corrected]. Of the full elicitors 53% took no further action, 26% only documented the mold; and 21% provided resources/referral. In-depth review of USP comments/explanations and residents' notes (HPI, treatment plan) revealed possible influences on clinical problem solving. Failure to ask about housing was associated with both contextual factors (rushed visit) and interpersonal skills (not fully engaging with patient) and with possible differences in attention ("known" vs. unknown/new triggers, usual symptoms vs. changes, not attending to relocation, etc.,). Use of close-ended questions often made it difficult for the patient to share mold concerns. Negative responses to sharing of housing information led to missing mold entirely or to the patient not realizing that the physician agreed with her concerns about mold. Residents who fully elicited the mold situation but did not take action seemed to either lack knowledge or feel that action on SDoH was outside their realm of responsibility. Those that took direct action to help the patient address mold appeared to be motivated by an enhanced sense of urgency. Conclusions Findings provide unique insight into residents' problem solving processes including external influences (e.g., time, distractions), the role of core communication and interpersonal skills (eliciting information, creating opportunities for patients to voice concerns, sharing clinical thinking with patients), how traditional cognitive biases operate in practice (premature closure, tunneling, and ascertainment bias), and the ways in which beliefs about expectancies and scope of practice may color clinical problem-solving strategies for addressing SDoH.	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Detection and segmentation of morphologically complex eukaryotic cells in fluorescence microscopy images via feature pyramid fusion. Detection and segmentation of macrophage cells in fluorescence microscopy images is a challenging problem, mainly due to crowded cells, variation in shapes, and morphological complexity. We present a new deep learning approach for cell detection and segmentation that incorporates previously learned nucleus features. A novel fusion of feature pyramids for nucleus detection and segmentation with feature pyramids for cell detection and segmentation is used to improve performance on a microscopic image dataset created by us and provided for public use, containing both nucleus and cell signals. Our experimental results indicate that cell detection and segmentation performance significantly benefit from the fusion of previously learned nucleus features. The proposed feature pyramid fusion architecture clearly outperforms a state-of-the-art Mask R-CNN approach for cell detection and segmentation with relative mean average precision improvements of up to 23.88% and 23.17%, respectively.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0
Synergistic effects of combined therapy with transcranial photobiomodulation and enriched environment on depressive- and anxiety-like behaviors in a mice model of noise stress. The development of anxiety and depression due to chronic exposure to noise stress has remained as an unsolved health problem so far. Despite the studies suggesting the neuroenhancement effects of transcranial photobiomodulation (tPBM) and housing in an enriched environment (EE), the combined effects of these treatments have not been elucidated yet. Also, there is no available data on the relationship between the application of tPBM and hippocampal brain-derived neurotrophic factor (BDNF) expression in animal models of stress. The present study aims to investigate the application of the tPBM and EE (alone or in combination) on depressive- and anxiety-like behaviors in a mice model of noise stress. Mice were divided into five groups: control, noise, noise + EE, noise + tPBM, and noise + EE + tPBM. Except for the control group, other groups were subjected to 110 dB SPL white noise for 4 h/day for 14 consecutive days and received their respective treatments. Forced Swimming Test (FST) was used to evaluate depressive-like behaviors. Elevated Plus Maze (EPM) and Open Field Test (OFT) were used to evaluate anxiety-like behaviors. BDNF, tyrosine receptor kinase B (TrkB), and cAMP response element-binding (CREB) protein levels in the hippocampus were determined by the Western blot method, and also serum corticosterone levels were assessed using an ELISA kit. Exposure to noise stress significantly elevated serum corticosterone level; downregulated hippocampal BDNF, TrkB, and CREB protein expressions; and resulted in depressive- and anxiety-like behaviors. While, the application of tPBM (810 nm wavelength, 8 J/cm 2 fluence, 10 Hz pulsed wave mode), housing in EE, and their combination lowered corticosterone levels, upregulated the BDNF/TrkB/CREB signaling pathway in the hippocampus, and improved behavioral outcomes in noise stress subjected mice. Our finding revealed the improving effects of tPBM and EE on depressive and anxiety-like behaviors induced by noise stress, possibly by augmenting the BDNF/TrkB/CREB signaling pathway.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	1	0	0	0	0	0	0	0	1	0	0	0	0	0
piR-001773 and piR-017184 promote prostate cancer progression by interacting with PCDH9. Prostate cancer is one of the most common malignancies and the major cause of cancer-related death in men. Increasing evidence has revealed that P-element-induced wimpy (piwi)-interacting RNAs (piRNAs) play an important role in tumor progression. Few studies have been explored the functional mechanism of piRNAs in prostate cancer progression. In the present study, we demonstrated that piR-001773 and piR-017184 were increased in prostate cancer tissues. Protocadherin 9 (PCDH9) was downregulated and acted as a tumor suppressor in prostate cancer cells. PCDH9 could bind to p85α, the regulatory subunit of PI3K. The downregulation of PCDH9 in PCa cells resulted in an increase in AKT phosphorylation and activity. PCDH9 was posttranscriptionally regulated by piR-001773 and piR-017184. The upregulation of piR-001773 and piR-017184 promoted tumor growth both in vitro and in vivo. In addition, the downregulation of piR-001773 and piR-017184 markedly inhibited tumor growth. In conclusion, these results indicated that piR-001773 and piR-017184 are oncogenic RNAs and thus might be therapeutic targets in prostate cancer.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0
[Significance of the expression of proliferating cell nuclear antigen and P53 in the regeneration process of an atrophic parotid gland]. This research aims to further explore the expression and significance of proliferating cell nuclear antigen (PCNA) and P53 in regenerating rat atrophy parotid gland from the gene and protein levels.	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0
Sex Differences in Rupture Risk and Mortality in Untreated Patients With Intact Abdominal Aortic Aneurysms. Background Studies on intact abdominal aortic aneurysms mainly focus on treated patients, and data on untreated patients are sparse. The objective was to investigate sex differences among untreated patients regarding rupture and mortality rates and to determine predictors for these events. Sex-specific causes of death were evaluated. Methods and Results All patients ≥40 years diagnosed from 2001 to 2015 (n=32 393) with intact abdominal aortic aneurysms were identified in national registries; 60% (n=19 569) were untreated. Comorbid loads, crude rupture, and mortality rates were assessed. Predictors of 5-year rupture and mortality were analyzed in Cox models (sex, age, comorbidities, income, and marital status). The proportion of men and women with multiple comorbidities was similar. Within 5 years, 798 ruptures occurred (9.7% women versus 6.9% men, P <0.001). Ruptures were independently predicted by female sex (hazard ratio [HR], 1.23; 95% CI, 1.07-1.42; P =0.004), chronic obstructive pulmonary disease (HR, 1.36; 95% CI, 1.15-1.62; P <0.001), age (HR, 11.49; 95% CI, 5.68-23.25 for ≥80 years; P <0.001), and income (HR, 0.63; 95% CI, 0.53-0.75 for highest tertile; P <0.001). After 5 years, 56.5% women and 50.4% men were deceased. Mortality was not independently predicted by female sex. Rupture was the third most common cause of death (11.9% women versus 8.7% men; P <0.001). The median time-to-events was 2.8 years. Conclusions A considerable proportion of patients with intact abdominal aortic aneurysms in surveillance remain untreated. Despite surveillance algorithms, the healthcare system fails to prevent a high number of ruptures, especially among women. The time-to-event data highlight the urgency to develop more individualized surveillance.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0
Shared decision making for elective abdominal aortic aneurysm surgery. Decisions on how and when to treat an abdominal aortic aneurysm involve a number of clinicians; interventional radiologists and vascular surgeons assess the technical ability to repair the aneurysm. Patients' fitness and past medical history is assessed to estimate their short- and long-term survival with or without surgery. Most importantly the patients' personal preference for treatment must be identified. Getting a patient to share what matters most to them requires shared decision making.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	1	0	0	0	0	0	0	0	1	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0
Preparation and properties of hydrophobic films based on acetylated broken-rice starch nanocrystals for slow protein delivery. Native and acetylated broken-rice starches (nanocrystals) with different degrees of substitution (DS) and their corresponding films were individually prepared, and the drug release profiles, weight loss, solubility and dispersion and surface morphology were comparatively studied. Bovine serum albumin (BSA) was used as a model drug. Acetylated native starch (ANS) DS 2.58, acetylated starch nanocrystals (ASN) DS 0.98, ASN DS 1.86, and ASN DS 2.72 were observed to be very soluble in chloroform. BSA was released rapidly from the native rice starch (NS) and ANS DS 2.58 films. ASN with high DS significantly slowed down the release of BSA from films, the percentages of BSA released from film ASN DS 2.72 only reached to 13% after 3.5 weeks release, and the release data followed Korsmeyer-Peppas equation. Further studies reveal that the particle size of ASN DS 2.72 was smallest, and the weight loss of ASN DS 2.72 film was lowest. The results demonstrate that acetylation and nanometer particle form of rice starch film can effectively retard protein drug release, and the prepared films based on ASN with high DS from broken rice may be suitable for the controlled protein delivery.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Missed Opportunity Encounters for Early Diagnosis of HIV Infection in Adolescents. Early diagnosis of HIV infection improves patient outcomes and reduces transmission. Adolescents make up one-fifth of new HIV diagnoses in the United States. We sought to quantify the number of missed opportunity encounters (MOEs) before HIV diagnosis for adolescents at a pediatric hospital (PediHosp) and a proximate adult hospital which employs universal HIV screening in its emergency department (ED) (CountyHosp).	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Matching Magnetic Heating and Thermal Actuation for Sequential Coupling in Hybrid Composites by Design. Sequentially coupling two material functions requires matching the output from the first with the input of the second function. Here, magnetic heating controls thermal actuation of a hybrid composite in a challenging system environment causing an elevated level of heat loss. The concept is a hierarchical design consisting of an inner actuator of nanocomposite material, which can be remotely heated by exposure to an alternating magnetic field (AMF) and outer layers of a porous composite system with a closed pore morphology. These porous layers act as heat insulators and as barriers to the surrounding water. By exposure to the AMF, a local bulk temperature of 71 °C enables the magnetic actuation of the device, while the temperature of the surrounding water is kept below 50 °C. Interestingly, the heat loss during magnetic heating leads to an increase of the water phase (small volume) temperature. The temperature increase is able to sequentially trigger an adjacent thermal actuator attached to the actuator composite. In this way it could be demonstrated how the AMF is able to initiate two kinds of independent actuations, which might be interesting for robotics operating in aqueous environments.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Functional properties of Rhizopus oryzae strains isolated from agricultural soils as a potential probiotic for broiler feed fermentation. The most crucial and expensive fragment in the broiler chicken production industry is the feed. Because of the rising demand, finding a cheap and effective feed is an urgent necessity. Fermentation of broiler feed by probiotic fungal starters can enhance the nutrient's availability and digestibility while preventing pathogenic growth. In this study different Rhizopus spp. have been isolated from agricultural soils around Izmir, Turkey, and tested for their probiotic potential and fermentative capacity. The isolated Rhizopus strains first underwent microscopical fluorescent investigation to exclude endofungal bacterial presence, then, those without endofungal bacteria (totally 82) were tested for antimicrobial activity counter bacterial and fungal pathogens. The ones with wide-spectrum antimicrobial activity (totally 10) were tested for gastrointestinal tolerance and antioxidant ability. Upon phenotypic and genotypic identification, the 10 isolates were found to belong to Rhizopus oryzae species. While all 10 strains showed variable gastrointestinal tolerance and antioxidant activities, three of them (92/1, 236/2, and 284) had relatively high antioxidant activity. Upon fermentative capacity assay, compared to unfermented commercial feed, there was a general decrease in crude fiber content by 56% after fermentation by 92/1 isolate for 4 days and 236/2 isolate for 2 days. The highest increase in crude protein content (by 14.5%) occurred after a 4-day fermentation period by 236/2 isolate. The highest increase in metabolizable energy was 8.64%, by the 284 isolate after 2 days of fermentation. In conclusion, the three strains showed good probiotic properties and fermentative capacities hence can be beneficial for the poultry industry.	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0
Safety and mid-term surgical results of anterior urethroplasty with the tissue-engineered oral mucosa graft MukoCell ® : A single-center experience. To assess the mid-term efficacy and safety of anterior urethroplasty using an autologous tissue-engineered oral mucosa graft (MukoCell ® ).	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0
Hypoxic exosomes orchestrate tumorigenesis: molecular mechanisms and therapeutic implications. The solid tumor microenvironment possesses a hypoxic condition, which promotes aggressiveness and resistance to therapies. Hypoxic tumor cells undergo broadly metabolic and molecular adaptations and communicate with surrounding cells to provide conditions promising for their homeostasis and metastasis. Extracellular vesicles such as exosomes originating from the endosomal pathway carry different types of biomolecules such as nucleic acids, proteins, and lipids; participate in cell-to-cell communication. The exposure of cancer cells to hypoxic conditions, not only, increases exosomes biogenesis and secretion but also alters exosomes cargo. Under the hypoxic condition, different signaling pathways such as HIFs, Rab-GTPases, NF-κB, and tetraspanin are involved in the exosomes biogenesis. Hypoxic tumor cells release exosomes that induce tumorigenesis through promoting metastasis, angiogenesis, and modulating immune responses. Exosomes from hypoxic tumor cells hold great potential for clinical application and cancer diagnosis. Besides, targeting the biogenesis of these exosomes may be a therapeutic opportunity for reducing tumorigenesis. Exosomes can serve as a drug delivery system transferring therapeutic compounds to cancer cells. Understanding the detailed mechanisms involved in biogenesis and functions of exosomes under hypoxic conditions may help to develop effective therapies against cancer.	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0
Robot-assisted training after proximal humeral fracture: A randomised controlled multicentre intervention trial. To examine whether robotic-assisted training as a supplement to usual therapy is safe, acceptable and improves function and patient reported outcome after proximal humeral fractures (PHF).	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Distress tolerance in relation to cessation history and smoking characteristics among adult daily smokers. Distress tolerance (DT) is linked to smoking initiation, maintenance, and difficulty quitting. However, there is a lack of consistency in prior findings on DT's relations with conceptually linked smoking variables, and few studies have examined differences across DT domains. We examined interrelations between cessation history, smoking characteristics, and a full battery of multimethod DT measures.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Epigenetic mechanisms underlying maternal diabetes-associated risk of congenital heart disease. Birth defects are the leading cause of infant mortality, and they are caused by a combination of genetic and environmental factors. Environmental risk factors may contribute to birth defects in genetically susceptible infants by altering critical molecular pathways during embryogenesis, but experimental evidence for gene-environment interactions is limited. Fetal hyperglycemia associated with maternal diabetes results in a 5-fold increased risk of congenital heart disease (CHD), but the molecular basis for this correlation is unknown. Here, we show that the effects of maternal hyperglycemia on cardiac development are sensitized by haploinsufficiency of Notch1, a key transcriptional regulator known to cause CHD. Using ATAC-seq, we found that hyperglycemia decreased chromatin accessibility at the endothelial NO synthase (Nos3) locus, resulting in reduced NO synthesis. Transcription of Jarid2, a regulator of histone methyltransferase complexes, was increased in response to reduced NO, and this upregulation directly resulted in inhibition of Notch1 expression to levels below a threshold necessary for normal heart development. We extended these findings using a Drosophila maternal diabetic model that revealed the evolutionary conservation of this interaction and the Jarid2-mediated mechanism. These findings identify a gene-environment interaction between maternal hyperglycemia and Notch signaling and support a model in which environmental factors cause birth defects in genetically susceptible infants.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Pulmonary delivery of polyplexes for combined PAI-1 gene silencing and CXCR4 inhibition to treat lung fibrosis. This report describes the development of polyplexes based on CXCR4-inhibiting poly(ethylenimine) derivative (PEI-C) for pulmonary delivery of siRNA to silence plasminogen activator inhibitor-1 (siPAI-1) as a new combination treatment of pulmonary fibrosis (PF). Safety and delivery efficacy of the PEI-C/siPAI-1 polyplexes was investigated in vitro in primary lung fibroblasts isolated from mice with bleomycin-induced PF. Biodistribution analysis following intratracheal administration of fluorescently labeled polyplexes showed prolonged retention in the lungs. Treatment of mice with bleomycin-induced PF using the PEI-C/siPAI-1 polyplexes resulted in a significant down-regulation of the PAI-1 expression and decreased collagen deposition in the lung. The results of this study provide first evidence of the potential benefits of combined inhibition of CXCR4 and PAI-1 in the pulmonary treatment of PF.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Challenges in respiratory management during therapeutic hypothermia for neonatal encephalopathy. Neonatal encephalopathy (NE) is a serious condition with devastating neurological outcomes that can impact oxygenation and ventilation. The currently recommended therapeutic hypothermia (TH) for these infants may also has several respiratory implications. It decreases metabolic rate and oxygen demands; however, it increases oxygen solubility in the blood and impacts its release to peripheral tissue including the brain. Respiratory management of infants treated with TH should aim for minimizing exposure to hypocapnia or hyperoxia. Inspiratory gas should be heated to 37 °C and humidified to prevent airway and alveolar injury. Blood gas values should be corrected to the core temperature during TH and the use of alkaline buffers is discouraged. While mild sedation/analgesia may ameliorate the discomfort related to cooling, paralytic agents/heavy sedation should be used with caution considering their side effects. Finally, the use of caffeine still needs careful investigation in this population.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Chromium and cerium co-doped magnetite/reduced graphene oxide nanocomposite as a potent antibacterial agent against S. aureus. The development of innovative antibacterial samples with high efficacy has received a great deal of interest. Herein, we synthesized magnetite modified by Cr and co-modified by Cr and Ce, along with their reduced graphene oxide (rGO)-based nanocomposites via facile hydrothermal and co-precipitation methods. The rGO-based samples showed proper magnetic behavior, high porosity, and vast specific surface area. The high specific surface area provided more adsorptive active sites with higher potentials for the decomposition of Staphylococcus aureus (S. aureus) cells. The antibacterial performance of the samples against S. aureus was evaluated at 50 and 100 μg mL -1 through the colony-forming unit (CFU) method and the minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC) values were subsequently determined. As per results, not only chromium cations could effectively damage the DNA of bacteria, but also the antibacterial efficacy was further enhanced by co-doping of cerium and the integration with rGO nanosheets. The antibacterial results were confirmed through the changes observed in the morphology and topology of the bacteria before and after the treatment using SEM and AFM analyses. Ultimately, the plausible S. aureus inactivation mechanism of the samples was disclosed.	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	1	0	0	0	0	0	0	0	0	0	0	0	0	1	0
Have Dutch Hospitals Saved Lives and Reduced Costs? A longitudinal patient-level analysis over the years 2013-2017. The purpose of this paper is to shed light on the ongoing Dutch health system reforms and identify whether hospital costs and hospital outcomes have changed over time. We present an empirical analysis that is based on granular micro-costing data and focuses on conditions for which mortality is indicative of outcome quality, that is, acute myocardial infarction (AMI), chronic heart failure (CHF), and pneumonia (PNE). We deploy a dataset of more than 80,000 inpatient episodes over 5 years (2013-2017) to estimate regression models that control for variation between patients and hospitals. We have three main findings. First, our results do not indicate significant outcome improvements over the years; that is, there is no time trend for mortality. Second, there is heterogeneity in cost developments: for patients who survive their inpatient stay, our data indicate that costs increase significantly by 0.9% per year for AMI patients, while costs decrease significantly by 1.7% per year for CHF patients and by 1.9% per year for PNE patients. For patients who pass away during their inpatient stay, our data do not indicate significant time trends. Third and finally, our results suggest the existence of substantial cost variation between hospitals.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
COVID-19: advance in laboratory diagnostic strategy and technology. SARS-CoV-2 is one of the beta-coronaviruses with the spike protein. It invades host cells by binding to angiotensin converting enzyme 2 (ACE2). This newly discovered virus can result in excessive inflammation and immune pathological damage, as shown by a decreased number of peripheral lymphocytes, increased levels of cytokines, and damages of lung, heart, liver, kidney, and other organs. Effective therapeutic modalities such as new antiviral drugs and vaccines against this emerging virus need to be thoroughly studied and developed. However, so far the only recognized but mild progress in this area is the screening of old drugs for new uses. Therefore, rapid and accurate laboratory SARS-CoV-2 testing approaches are the important basis of identification and blockage of COVID-19 transmission. For COVID-19 patients with different clinical classifications (mild, common, severe, and critically severe), dynamic monitoring of functional indicators of susceptible and vital organs is an important strategy for evaluating therapeutic efficacy and prognosis. In this review, we summarized SARS-CoV-2 laboratory diagnostic schemes, pathophysiological indices of tissues and organs of COVID-19 patients, and laboratory diagnostic strategies for distinct disease stages. Further, we discussed the importance of hierarchical management and dynamic observation in SARS-CoV-2 laboratory diagnostics. We then summed up the advance in SARS-CoV-2 testing technology and described the prospect of intelligent medicine in the prevention of infectious disease outbreaks.	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Loneliness and Self-Esteem in Children and Adolescents Affected by Parental HIV: A 3-Year Longitudinal Study. Sociometer theory posits that self-esteem is a subjective monitor of the quality of one's interpersonal relationships. When people feel excluded by others, they may have negative relational evaluation about themselves-low self-esteem. In the present study, we hypothesised and tested that feelings of loneliness among children and adolescents affected by parental HIV would decrease their self-esteem over time; moreover, low self-esteem would intensify feelings of loneliness.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Gene-based interaction analysis shows GABAergic genes interacting with parenting in adolescent depressive symptoms. Most gene-environment interaction studies (G × E) have focused on single candidate genes. This approach is criticized for its expectations of large effect sizes and occurrence of spurious results. We describe an approach that accounts for the polygenic nature of most psychiatric phenotypes and reduces the risk of false-positive findings. We apply this method focusing on the role of perceived parental support, psychological control, and harsh punishment in depressive symptoms in adolescence.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0
CT evaluation of normal bone thickness overlying the superior semicircular canal. Superior semicircular canal dehiscence (SSCD) is a rare inner ear disorder with variable amounts of auditory and vestibular dysfunction. In addition to the absence of bone overlying the superior semicircular canal, thinning of bone in this area can also initiate the vestibulocochlear symptoms of SSCD. We evaluated normal bone thickness overlying the course of the semicircular canal using computed tomography (CT) scans and assessed correlations between bone thickness and age, gender, and location of the thinnest bone. A single-institution retrospective chart review was conducted on 133 high-resolution CT scans from 76 healthy, asymptomatic patients between ages 9 and 96 years. These CT scans of the temporal bone were obtained between January 2012 and August 2017. The superior semicircular canal dome thickness at the apex was reported with a mean of 1.25 mm for all 76 patients; the 10th percentile was 0.60 mm, and the 90th percentile was 2.08 mm. The thinnest area of bone at any location yielded a mean of 0.86 mm. The normal bone thickness overlying the superior semicircular canal does not depend on gender or age. The thinnest location was evenly distributed across the superior semicircular canal. A bone thickness of 0.40 mm or greater was present in 90% of normal patients based on CT scan measurements at the thinnest location.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Efficacy and Safety of Oral P2Y12 Inhibitors in Older Patients with Acute Coronary Syndrome: A Frequentist Network Meta-Analysis. Previous studies and meta-analyses have assessed optimal P2Y12 inhibitors following acute coronary syndrome in overall trial cohorts. However, there are insufficient data for the elderly cohort who are prone to high bleeding and ischemic events. We aimed to assess the optimal P2Y12 inhibitor therapy for older patients.	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0