Miracle-dz/UniFAR-FTUs huggingface dataset:
Zero Fluoroscopy During Ablation of Right-Sided Supraventricular Tachycardia Substrates in a Pediatric Population - Initial Experience in Taiwan.

Background Zero fluoroscopy during ablation of arrhythmias has been introduced to reduce radiation exposure. However, the safety, feasibility and efficacy of the technique in pediatric populations have yet to be delineated. Objectives To investigate the safety, feasibility and effectiveness of zero fluoroscopic-guided transcatheter ablation of right-sided supraventricular tachycardia substrates in a pediatric population. Methods Patients < 20 years of age who received ablation of right-sided accessory pathway-mediated arrhythmia and atrioventricular nodal reentrant tachycardia at our hospital between January 2014 and July 2018 were enrolled, and their medical records were reviewed. Patients undergoing ablations with conventional fluoroscopic guidance were enrolled as the control group, and those undergoing ablations with zero fluoroscopic guidance were enrolled as the study group. Repaired or complex congenital heart disease patients were excluded. Results One hundred and two patients (55 male; 47 female) received a total of 109 ablation procedures: 68 procedures in the control group and 41 in the study group. The mean procedure duration was 104.7 ± 65.1 minutes in the control group and 98.6 ± 57.6 minutes in the study group (p = 0.62). The mean fluoroscopy time was 30.9 ± 23.9 minutes in the control group, while all procedures in the study group were performed without fluoroscopy (p < 0.001). In subgroup analysis, the results were similar. Acute procedural success rates were high in both groups (98.5% vs. 97.6%, p = 1.0). The recurrence rate was 11.5% (7/61) in the control group and 7.5% (3/40) in the study group (p = 0.78) at mid-term follow-up. Conclusions Using the zero fluoroscopy technique during pediatric ablation procedures for right-sided supraventricular tachycardia substrates is safe and significantly reduces radiation exposure.
Hearing aid or “band aid”? Evaluating large scale hearing aid donation programmes in the Philippines

Abstract Objective: This study aimed to evaluate the effectiveness of two large scale hearing aid donation programmes in the Philippines. Design: Real ear measurements were made on all hearing aids, for comparison to NAL-RP prescription targets. Performance measures and the International Outcomes Inventory for Hearing Aids (IOI-HA) data was collected from a subsample of participants. Study sample: A total of 101 and 153 low socioeconomic status participants were sampled just after, or 6 months after receiving their hearing devices in each of the programmes evaluated, respectively. Results: Of the 189 hearing aids sampled at fitting, and the 195 hearing aids sampled at 6 months post fitting, less than 2% were within ±5dB of prescription target. At 6 months post fitting IOI-HA outcomes were essentially comparable to those described in the literature but were not a good predictor of fit to prescriptive target. Conclusions: Objective measures of hearing aid outcome were poor and showed no relationship to subjective outcome measures. Although able to fit large numbers in short time frames, to avoid a band aid solution, changes to such programmes should be made including: a focus on those with aidable hearing losses, increased opportunity for follow up care, and improved device quality.
Decision Support Strategies for Hip and Knee Osteoarthritis: Less Is More

Background: As guidelines and payers increasingly recommend use of patient decision aids (DAs), evidence about the comparative effectiveness of available DAs is critical for organizations interested in implementing them. The primary purpose of this study was to compare 2 DAs with regard to their ability to help patients become informed and receive their preferred treatment (that is, make an informed patient-centered decision), shared decision-making, surgical rates, and surgeon satisfaction. Methods: We performed a multisite factorial randomized trial enrolling patients with hip or knee osteoarthritis. Patients were randomly assigned to use a long, detailed DA (long DA) or short, interactive DA (short DA). Eight surgeons were randomly assigned to receive a patient preference report detailing the patient’s goals and treatment preferences or to administer usual care. Results: We distributed 1,636 pre-visit surveys, 1,220 of which were returned (75% response rate), and 1,124 post-visit surveys, 967 of which were returned (86% response rate). The patients in the sample had a mean age (and standard deviation) of 65 ± 10 years, 57% were female, 89% were white non-Hispanic, and 67% had knee osteoarthritis. The majority (67.2%) made informed patient-centered decisions, and the rate did not vary significantly between the DA groups (p = 0.97) or between the surgeon groups (p = 0.23). Knowledge scores were higher for the short-DA group (mean difference = 9%; p < 0.001). More than half of the sample (60.5%) had surgery within 6 months after the visit, and rates did not differ significantly by DA or surgeon group. Overall, the surgeons were highly satisfied and reported that the majority (88.7%) of the visits were of normal duration or shorter. Conclusions: The DECIDE-OA study is, to our knowledge, the first randomized comparative effectiveness study of 2 orthopaedic DAs. The short DA outperformed the long DA with regard to knowledge scores and was comparable with respect to other outcomes. The surgeons reported high satisfaction and normal visit duration with both DAs. Clinical Relevance: Surgeons need to ensure that patients with osteoarthritis are well-informed and have a clear preference regarding whether to undergo hip or knee replacement surgery. The DAs used in this study may help surgeons involve patients in elective surgery decisions and meet the requirements of informed consent.
Infant growth, neurodevelopment and gut microbiota during infancy: which nutrients are crucial?

PURPOSE OF REVIEW To update the role of specific nutrients during infant development. RECENT FINDINGS Several bioactive nutrients such as long-chain polyunsaturated fatty acids (LC-PUFAs), iron, vitamins, proteins, or carbohydrates have been identified to exert an important role during the first 1000 days of life on infant growth, neurodevelopment, and gut microbiota establishment and maturation. LC-PUFAs are structural constituents of the central nervous system (CNS), being essential in retinal development or hippocampal plasticity. Recently, components of the milk fat globule membrane (MFG) are being added to infant formulas because of their key role in infant's development. A high intake of proteins induces a faster weight gain during infancy which correlates with later obesity. Digestible carbohydrates provide glucose, crucial for an adequate functioning of CNS; nondigestible carbohydrates [e.g. human milk oligosaccharides (HMOs)] are the main carbon source for gut bacteria. Iron-deficiency anemia during infancy has been associated with alterations of mental and psychomotor development. Folate metabolism, closely related to vitamins B6 and B12, controls epigenetic changes, whereas inadequate status of vitamin D affects bone development, but may also increase intestinal permeability and alter gut microbiota composition. SUMMARY LC-PUFAs, proteins, carbohydrates, iron, and vitamins during early life are critical for infant's growth, neurodevelopment, and the establishment and functioning of gut microbiota.
Hepatorenal dysfunction identifies high‐risk patients with acute heart failure: insights from the RELAX‐AHF trial

Episodes of acute heart failure (AHF) may lead to end‐organ dysfunction. In this post hoc analysis of the Relaxin in Acute Heart Failure trial, we used the MELD‐XI (Model of End‐Stage Liver Dysfunction) score to examine hepatorenal dysfunction in patients with AHF.
Joint Estimation of Gross Recharge, Groundwater Usage, and Hydraulic Properties within HydroSight

Groundwater management decisions are often founded upon estimates of aquifer hydraulic properties, recharge and the rate of groundwater usage. Too often hydraulic properties are unavailable, recharge estimates are very uncertain, and usage is unmetered or infrequently metered over only recent years or estimated using numerical groundwater models decoupled from the drivers of drawdown. This paper extends the HydroSight groundwater time‐series package ( http://peterson‐tim‐j.github.io/HydroSight/) to allow the joint estimation of gross recharge, transmissivity, storativity, and daily usage at multiple production bores. A genetic evolutionary scheme was extended from estimating time‐series model parameters to also estimating time series of usage that honor metered volumes at each production bore and produces (1) the best fit with the observed hydrograph and (2) plausible estimates of actual evapotranspiration and hence recharge. The reliability of the approach was rigorously tested. Repeated calibration of models for four bores produced estimates of transmissivity, storativity, and mean recharge that varied by a factor of 0.22‐0.32, 0.13‐0.2, and 0.03‐0.48, respectively, when recharge boundary effects were low and the error in monthly, quarterly, and biannual metered usage was generally <10%. Application to the 30 observation bores within the Warrion groundwater management area (Australia), produced a coefficient of efficiency of ≥0.80 at 22 bores and ≥0.90 at 12 bores. The aquifer transmissivity and storativity were reasonably estimated, and were consistent with independent estimates, while mean gross recharge may be slightly overestimated. Overall, the approach allows greater insights from the available data and provides opportunity for the exploration of usage and climatic scenarios.
Interaction between VPS35 and RABG3f is necessary as a checkpoint to control fusion of late compartments with the vacuole

Significance In plants, the retromer complex (VPS35, VPS29, VPS26) has been implicated in retrograde traffic from the endosomes back to the trans-Golgi network. Nevertheless, vps35 mutants exhibit impaired anterograde traffic toward the vacuole (synthetic, endocytic, and autophagic). This paradox remains an open question. We show that the small molecule endosidin17 (ES17) targets VPS35, which disrupts its association with RABG3f. This, in turn, impairs retromer complex membrane anchoring, producing vps35 mutant-like phenotypes. Using ES17, we found that VPS35–RABG3f binding precedes the release of RABG3f–GTP to interact with the vacuolar homotypic fusion and vacuole protein sorting (HOPS) complex, which is required for fusion of late compartments with the tonoplast. Thus, VPS35–RABG3f interaction constitutes a checkpoint before proceeding with membrane fusion. Vacuoles are essential organelles in plants, playing crucial roles, such as cellular material degradation, ion and metabolite storage, and turgor maintenance. Vacuoles receive material via the endocytic, secretory, and autophagic pathways. Membrane fusion is the last step during which prevacuolar compartments (PVCs) and autophagosomes fuse with the vacuole membrane (tonoplast) to deliver cargoes. Protein components of the canonical intracellular fusion machinery that are conserved across organisms, including Arabidopsis thaliana, include complexes, such as soluble N-ethylmaleimide–sensitive factor attachment protein receptors (SNAREs), that catalyze membrane fusion, and homotypic fusion and vacuole protein sorting (HOPS), that serve as adaptors which tether cargo vesicles to target membranes for fusion under the regulation of RAB-GTPases. The mechanisms regulating the recruitment and assembly of tethering complexes are not well-understood, especially the role of RABs in this dynamic regulation. Here, we report the identification of the small synthetic molecule Endosidin17 (ES17), which interferes with synthetic, endocytic, and autophagic traffic by impairing the fusion of late endosome compartments with the tonoplast. Multiple independent target identification techniques revealed that ES17 targets the VPS35 subunit of the retromer tethering complex, preventing its normal interaction with the Arabidopsis RAB7 homolog RABG3f. ES17 interference with VPS35–RABG3f interaction prevents the retromer complex to endosome anchoring, resulting in retention of RABG3f. Using multiple approaches, we show that VPS35–RABG3f–GTP interaction is necessary to trigger downstream events like HOPS complex assembly and fusion of late compartments with the tonoplast. Overall, our results support a role for the interaction of RABG3f–VPS35 as a checkpoint in the control of traffic toward the vacuole.
Benefits of Activity-Based Interventions Among Female Adolescents Who Are Overweight and Obese

The purpose of this study was to compare the effects of two activity-based motor interventions among female adolescents who are overweight and obese. Purpose: The purpose of this study was to compare the effects of 2 activity-based motor interventions among female adolescents who are overweight and obese. Methods: This study was conducted in a low-income community of Cape Town, South Africa. The study involved 52 participants classified as overweight and obese. Participants were randomly assigned to task-oriented functional training or Wii Fit intervention. Both interventions were 45 minutes of active training once a week for 14 weeks. Outcome measures included aerobic fitness, motor coordination, and self-efficacy. Data were collected before and after the interventions. Results: Participants in both groups demonstrated significant improvement in aerobic fitness and motor coordination but not self-efficacy. However, no between-group differences were observed on any of the outcomes. Conclusions: Activity-based interventions may improve aerobic fitness and motor coordination in female adolescents who are overweight and obese and may also help prevent declines in physical fitness and coordination in this population.
Near-infrared/visible-emitting nanosilica modified with silylated Ru(II) and Ln(III) complexes

Three luminescent silica-based nanohybrids were fabricated by grafting of silylated Ru(II) and Nd/Yb(III) complexes onto mesoporous silica nanoparticles obtained by microemulsion method. The prepared nanohybrids were characterized by Fourier transform-Raman spectroscopy, solid state-nuclear magnetic resonance, high resolution-transmission electron microscopy and scanning and transmission electron microscopy techniques. The chemical integrity and the grafting of all complexes inside MSNs nanopores as well as a good distribution of metal complexes onto MSNs surface were achieved for all nanohybrids. Photophysical results revealed that by monitoring the excitation on Ru(II) moieties from SiO2–RuNd and SiO2–RuYb nanohybrids, the sensitization of NIR-emitting Nd/Yb(III) ions were successfully detected via energy transfer processes. Energy transfer rates (kEnT) of 0.20 × 107 and 0.11 × 107 s−1 and efficiencies of energy transfer (ηEnT) of 40% and 27.5% were obtained for SiO2–RuNd and SiO2–RuYb nanohybrids, respectively. These results confirm the preparation of promising dual (near-infrared/visible)-emitting silica-based nanohybrids as new nanotools for applications as nanosensores and nanomarkers.
Edible Gelatin Diagnosis Using Laser-Induced Breakdown Spectroscopy and Partial Least Square Assisted Support Vector Machine

Edible gelatin has been widely used as a food additive in the food industry, and illegal adulteration with industrial gelatin will cause serious harm to human health. The present work used laser-induced breakdown spectroscopy (LIBS) coupled with the partial least square–support vector machine (PLS-SVM) method for the fast and accurate estimation of edible gelatin adulteration. Gelatin samples with 11 different adulteration ratios were prepared by mixing pure edible gelatin with industrial gelatin, and the LIBS spectra were recorded to analyze their elemental composition differences. The PLS, SVM, and PLS-SVM models were separately built for the prediction of gelatin adulteration ratios, and the hybrid PLS-SVM model yielded a better performance than only the PLS and SVM models. Besides, four different variable selection methods, including competitive adaptive reweighted sampling (CARS), Monte Carlo uninformative variable elimination (MC-UVE), random frog (RF), and principal component analysis (PCA), were adopted to combine with the SVM model for comparative study; the results further demonstrated that the PLS-SVM model was superior to the other SVM models. This study reveals that the hybrid PLS-SVM model, with the advantages of low computational time and high prediction accuracy, can be employed as a preferred method for the accurate estimation of edible gelatin adulteration.
Freeze‐dried plasma stability under prehospital field conditions

This study evaluated the effect of routine, uncontrolled, Israeli field storage conditions on the stability and efficacy of Lyo‐Plas N freeze‐dried plasma (FDP). We evaluated clotting factors V, VIII, and XI; proteins S and C; fibrinogen; partial thromboplastin time (PTT); antithrombin III (ATIII); von Willebrand factor (VWF); and international normalized ratio (INR) in FDP stored at 4°C, 25°C, and 40°C for 6 and 12 months, as well as FDP returned from field units after uncontrolled storage for 15 months (manufacturer's shelf life).
The Effects of Force That Pushes Forward Lumbar Region on Sagittal Spinal Alignment When Wearing Backpack

The purpose of this study is to design a backpack to push the lumbar region forward and confirm the change in the sagittal plane of the spine using radiography when wearing the backpack to present an effective backpack wearing method that can help spinal alignment. Place the question addressed in a broad context and highlight the purpose of the study. A total of 14 adult volunteers participated in the study. The study was carried out on the subjects without carrying a backpack, with a general backpack, and with a backpack designed to push the lumbar region forward. We investigated cervical, thoracic, lumbar, and sacral alignment under these three conditions. Lumbar lordosis showed a significant decrease in the state of wearing a general backpack compared to the case without a backpack, and a significant increase in the state of wearing a backpack designed to push the lumbar region forward rather than a general backpack. In addition, the sacral slope was significantly increased when carrying the backpack designed to push the lumbar region forward, compared to carrying the general backpack. There was a significant correlation between the sacral and lumbar alignment change when wearing the backpack compared to the state without a backpack. The results of this study indicate that wearing a backpack designed to push the lumbar region forward may contribute to the recovery of lumbar lordosis that is reduced when wearing a general backpack. This may be due to an increase in the sacral slope corresponding to the inferior angle of lumbar spine.
Structural basis of light-induced redox regulation in the Calvin–Benson cycle in cyanobacteria

Significance The Calvin–Benson (CB) cycle in plants, algae, and cyanobacteria fixes most of the carbon in most of the biomass on Earth. The CB cycle is regulated by the redox state, which enables it to be turned off in the dark. One part of this regulatory system is the small protein CP12, which binds to 2 essential CB-cycle enzymes in the dark, inactivating them. We have solved the structure of the complex between CP12 and the enzymes, explaining the mechanism of deactivation. Now that this is understood, this structure can be used as the starting point for modulating the redox regulation, which may have applications in improving crop productivity. Plants, algae, and cyanobacteria fix carbon dioxide to organic carbon with the Calvin–Benson (CB) cycle. Phosphoribulokinase (PRK) and glyceraldehyde 3-phosphate dehydrogenase (GAPDH) are essential CB-cycle enzymes that control substrate availability for the carboxylation enzyme Rubisco. PRK consumes ATP to produce the Rubisco substrate ribulose bisphosphate (RuBP). GAPDH catalyzes the reduction step of the CB cycle with NADPH to produce the sugar glyceraldehyde 3-phosphate (GAP), which is used for regeneration of RuBP and is the main exit point of the cycle. GAPDH and PRK are coregulated by the redox state of a conditionally disordered protein CP12, which forms a ternary complex with both enzymes. However, the structural basis of CB-cycle regulation by CP12 is unknown. Here, we show how CP12 modulates the activity of both GAPDH and PRK. Using thermophilic cyanobacterial homologs, we solve crystal structures of GAPDH with different cofactors and CP12 bound, and the ternary GAPDH-CP12-PRK complex by electron cryo-microscopy, we reveal that formation of the N-terminal disulfide preorders CP12 prior to binding the PRK active site, which is resolved in complex with CP12. We find that CP12 binding to GAPDH influences substrate accessibility of all GAPDH active sites in the binary and ternary inhibited complexes. Our structural and biochemical data explain how CP12 integrates responses from both redox state and nicotinamide dinucleotide availability to regulate carbon fixation.
Work strain and burnout risk in postgraduate trainees in general practice: an overview

ABSTRACT Primary care physicians (general practitioners (GPs)) are burdened for various reasons and are particularly affected by stress-related complaints and an increasing prevalence of burnout. Thus, the prevention of physician burnout has become a major interest for health care services. Although many studies have addressed this issue in recent years, little seems to be known about the work strain and burnout rates in GP trainees. Therefore the objective of this article is to review the psychosocial burden and relevant prevention strategies for GPs with a special emphasis on GP trainees. Regardless of the specialty, burnout is more prevalent among medical trainees and so-called ‘early career’ physicians than among the age-matched population. Accordingly, burnout seems to be frequent among GP trainees, although there is some evidence that there are fewer doctors working in general medicine who were already heavily burdened at the time of choosing their career. The sudden assumption of responsibility in patient care as well as the fear of showing imperfection in front of their supervisors, or lack of recognition from senior doctors, the medical team, or patients might be stressors typical to this career stage. GP trainees might also feel burdened by the new level of personal involvement and thus have to develop or increase their individual level of professionality to deal with the patients’ medical and personal problems. In conclusion, interventions to promote physical and mental health of GP trainees are a necessity to ensure passionate GPs in the future and should therefore be integrated into any postgraduate training curriculum in general practice.