Miracle-dz/UniFAR-FTUs huggingface dataset:
Malnourishment in the overweight and obese elderly.

Introduction Background: the prevalence of obesity in the elderly has increased in recent years. Malnutrition is a syndrome characterized by inadequate intake and absorption of nutrients. Obesity could mask the presence of malnutrition. Objective: this study aimed to determine malnutrition using the Mini Nutritional Assessment (MNA) test in obese and overweight elderly. Methods: one hundred and eighty-seven overweight or obese elderly have been taken under review and nutritional status was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF). Result: there were 101 (54.3%) male and 86 (45.7%) female elderly. Body mass index (BMI) variability of the sample group was between 25.0 and 48.9. Malnourishment percentile is 49.7% for elderly people whose BMI is over 25. Conclusion: elderly individuals, especially those who are overweight or obese, are under more health threats and should be evaluated more carefully.
A Rare Case of Acute Myeloid Leukemia With SET-NUP214 Fusion and Massive Hyperdiploidy

Dear Editor, The SET-NUP214 fusion gene has been observed most commonly in T-cell ALL (T-ALL) patients, with a frequency of about 3.3% to 10.3%, and in acute undifferentiated leukemia (AUL) patients, but is rare in AML patients [1-4]. Most patients diagnosed as having T-ALL have normal karyotypes according to conventional cytogenetic analysis [2]. SET-NUP214 fusion, though reported rarely, has a significant value in acute leukemia because it often predicts poor patient outcomes [1]. We report a rare case of AML with SET-NUP214 fusion and massive hyperdiploidy. To the best of our knowledge, this is the first case of AML with SETNUP214 fusion in Korea. This study was approved by the Institutional Review Board of Dong-A University Hospital, Busan, Korea, and informed consent was obtained from the patient. A 46-year-old Korean male visited the emergency department of Dong-A University Hospital for further evaluation of fever and general weakness. Clinical evaluations were unremarkable, except for mild haziness on a chest X-ray, suggesting pneumonia. Initial laboratory results showed mild leukocytosis (17.1×10/L leukocytes), severe anemia (53 g/L Hb), and thrombocytopenia (120×10/L platelets). Differential count revealed 89% blasts with 1% segmented neutrophils, 7% lymphocytes, and 3% monocytes. A bone marrow aspirate smear showed 88% of pleomorphic blasts characterized by large size, high nucleic/cytoplasmic ratio, irregular nuclear membranes and convolutions, and cytoplasmic projections (Fig. 1A). A bone marrow biopsy revealed portions of marked hypercellular areas and moderate fibrosis. The blasts were negative for periodic acid-Schiff and non-specific esterase stains and mostly positive for Sudan black B and myeloperoxidase (MPO) stains. In flow-cytometric analysis, the blasts were positive for MPO, CD33, CD7, CD34, and CD71 antigens, indicating AML. Multiplex-nested PCR with HemaVision (DNA Diagnostic A/S, Risskov, Denmark) revealed SET-NUP214 fusion transcripts of 393 base pairs. Chromosome analysis revealed 59–90,XXXY,-1, -2,-5,-7,-7,-10,-13,-13,-16,-17,-18,-21[cp23], interpreted as a composite karyotype with massive hyperdiploidy in all of the 23 examined chromosomes, without any apparent structural abnormalities (Fig. 1B). FISH showed tetrasomy signals for the MLL, ERG1, CEP7, TP53, and MECOM genes. Because SET-NUP214 rearrangement can result from either del(9)(q34.11q34.13) or t(9;9)(q34;q34) [5], further studies with additional FISH probes were conducted. Based on the results of FISH analysis with a BCR/ABL1 probe, we suspected that the SET-NUP214 fusion gene in this patient was probably formed by deletion of chromosome 9, because ABL1 (9q34.12) is located between SET (9q34.11) and NUP214 (9q34.13), and the two red signals were missing (Fig. 1C and 1D) [6, 7]. However, Sanger sequencing indicated
Penetration depth of irrigants into root dentine after sonic, ultrasonic and photoacoustic activation.

AIM To compare penetration depths of endodontic irrigants into the dentinal tubules of extracted teeth when using several activation methods. METHODOLOGY The root canals of 90 extracted human teeth were prepared to size 40, . 06 taper. The straight and round-shaped root canals were distributed randomly into six groups, and final irrigation was performed with EDTA and sodium hypochlorite as follows: (I) manual dynamic activation, (II) Ultrasonic, (III) Sonic, (IV) PIPS (photon-induced photoacoustic streaming, (V) SWEEPS (shock-wave enhanced emission photoacoustic streaming) and (0) control without final irrigation or activation. Subsequently, methylene blue was inserted into the canals and activated according to the groups (I-V). Teeth were sectioned horizontally, imaged under a light microscope, and dye penetration depths were measured in six sections per tooth and 24 points on a virtual clock-face per section. Data were analysed statistically by nonparametric tests for whole teeth and separately for coronal, middle and apical thirds. RESULTS Penetration of dye into the dentinal tubules was lowest for the controls. Median penetration depths amounted to 700-900 μm for groups I-V with differences in the apical thirds between group I and the other test groups. Minimum penetration depths were significantly greater for PIPS in the apical thirds (P ≤ 0.046). CONCLUSIONS Greater penetration depths occurred in the apical thirds for ultrasonic, sonic and laser-induced activation compared to manual dynamic activation. PIPS was associated with deeper penetration of irrigants. The novel SWEEPS mode did not increase irrigant penetration.
Evaluation of hemorrhoidal disease and lower extremity venous insufficiency in primary adult varicocele: A prospective controlled study

Background The study investigated the association between varicocele, lower extremity venous insufficiency and hemorrhoidal disease. Methods The study included 62 patients with varicocele and 60 voluntary subjects with no varicocele. Patients who were diagnosed as having varicocele on physical examination and Doppler ultrasonography were included in the study group. Examination of lower extremity venous insufficiency was performed by physical examination and Doppler ultrasonography. Examination of hemorrhoidal disease was performed by a general surgery specialist. Results The patients with varicocele had a statistically significant (p < 0.05) higher rates of venous insufficiency of the lower extremities and had a borderline significant difference of higher hemorrhoidal disease rates (p = 0.05). Therewithal incidences of hemorrhoidal disease and lower extremity venous insufficiency were significantly higher in body mass index > 25 and age > 30 years of varicocele patients. Conclusion There is a statistically significant relation between varicocele, lower extremity venous insufficiency, and hemorrhoidal disease. In particular, varicocele patients who are aged over 30 years and overweight are at higher risk.
CD8+ T cells are involved in early inflammation before macrophages in a rat adipose tissue engineering chamber model

Adipose tissues regenerated using tissue engineering chambers (TECs) show the potential for applications in reconstruction of soft tissue defects. Previous studies have shown that early inflammation plays a key role in angiogenesis and adipogenesis required for adipose tissue generation. However, the sequence of events of the early inflammatory cascade is unclear. In this study, we investigated the role of early inflammatory cells in adipose tissue engineering using a rat TEC model. Rats in the TEC model were divided into five groups: the control group, the zymosan A‐treated group, the 5‐AIQ‐treated group, the imatinib‐treated group, and the CD8+ T cell injection group. Fat pad volume, angiogenesis, adipogenesis, inflammatory factor levels, and inflammatory cell infiltration in chambers after implantation were evaluated at different time points. The volume of fat pads of was higher in the zymosan A‐treated and CD8+ T cell injection groups than other groups, and these two groups also showed higher levels of proinflammatory factors, greater numbers of CD31+ cells and perillipin+/Ki67+ cells, and higher macrophage infiltration. The infiltration of CD8+ T cell peaked at 3 days after implantation, which was earlier than that of macrophages. However, inhibition of CD8+ T cells reduced the recruitment of macrophages and lowered inflammation in the TECs. CD8+ T cells played a key role in promoting inflammation at earlier stages than macrophages in adipose TECs. Increased levels of interleukin‐2 secretion by CD8+ T cells resulted in recruitment of more infiltrating macrophages to enhance inflammation, as required for adipose tissue regeneration.
Senescence controls prostatic neoplasia driven by Pten loss

ABSTRACT We report that Pten (phosphatase and tensin homologue) ablation in prostatic epithelial cells of adult mice promotes cell proliferation to generate prostatic intraepithelial neoplasia. Moreover, our results demonstrate that proliferating Pten-deficient cells undergo replication stress and exhibit a DNA damage response, leading to cell senescence, as seen in oncogene-induced senescence.
Divorce, living arrangements, and material well-being during the transition to adulthood in rural Malawi

In this paper, we use longitudinal data to investigate how parental death and divorce influence young women’s own experience of divorce in Malawi, a setting where women marry relatively early and unions are fragile. We find that maternal death and parental divorce are positively associated with divorce for young women but, after controlling for socio-demographic and marital characteristics, only the association with maternal death remains statistically significant. Maternal and paternal death are both strongly associated with women’s post-divorce living arrangements, which in turn affects their material well-being. This finding suggests that divorcing at a young age shapes the subsequent life chances of women; although some women return to their parental home and may have the opportunity to reset the transition to adulthood, other women begin their 20s as head of their own household and with considerable material disadvantage.
The Second Pugilist’s Plight: Why People Believe They Are Above Average But Are Not Especially Happy About It

People’s tendency to rate themselves as above average is often taken as evidence of undue self-regard. Yet, everyday experience is occasioned with feelings of inadequacy and insecurity. How can these 2 experiences be reconciled? Across 12 studies (N = 2,474; including 4 preregistered studies) we argue that although people do indeed believe that they are above average they also hold themselves to standards of comparison that are well above average. Across a host of domains, we find that people’s typical standards of comparison are significantly above the level of the “average” person (Studies 1A, 1B, 2A, and 3). We further show that people’s tendency to measure themselves against above-average others is due to the increased mental availability of such high-performing standards of comparison (Studies 4A and 4B). Finally, we present evidence that this is not simply the result of self-enhancement by showing that people measure themselves against above-average others even when they feel subjectively inadequate (Study 5A), receive objective information about their poor performance (Study 5B), or evaluate themselves on domains in which they chronically underperform (Study 5C). Even in domains where being above average is undesirable (e.g., rudeness), people bring to mind and compare themselves with above average targets (Studies 2B and 2C). We discuss the implications for self-enhancement research and the importance of examining who people compare themselves to in addition to how people believe they compare with others.
Does Transfer to Intensive Care Units Reduce Mortality? A Comparison of an Instrumental Variables Design to Risk Adjustment

Supplemental Digital Content is available in the text. Background: Instrumental variable (IV) analysis can estimate treatment effects in the presence of residual or unmeasured confounding. In settings wherein measures of baseline risk severity are unavailable, IV designs are, therefore, particularly appealing, but, where established measures of risk severity are available, it is unclear whether IV methods are preferable. Objective: We compared regression with an IV design to estimate the effect of intensive care unit (ICU) transfer on mortality in a study with well-established measures of risk severity. Research Design: We use ICU bed availability at the time of assessment for ICU transfer as an instrument. Bed availability increases the chance of ICU admission, contains little information about patient characteristics, and it is unlikely that bed availability has any direct effect on in-hospital mortality. Subjects: We used a cohort study of deteriorating ward patients assessed for critical care unit admission, in 49 UK National Health Service hospitals between November 1, 2010, and December 31, 2011. Measures: Detailed demographic, physiological, and comorbidity data were collected for all patients. Results: The risk adjustment methods reported that, after controlling for all measured covariates including measures of risk severity, ICU transfer was associated with higher 28-day mortality, with a risk difference of 7.2% (95% confidence interval=5.3%–9.1%). The IV estimate of ICU transfer was −5.4% (95% confidence interval=−47.1% to 36.3%) and applies to the subsample of patients whose transfer was “encouraged” by bed availability. Conclusions: IV estimates indicate that ICU care is beneficial but are imprecisely estimated. Risk-adjusted estimates are more precise but, even with a rich set of covariates, report that ICU care is harmful.
Resting-State Neural Firing Rate Is Linked to Cardiac-Cycle Duration in the Human Cingulate and Parahippocampal Cortices

Stimulation and functional imaging studies have revealed the existence of a large network of cortical regions involved in the regulation of heart rate. However, very little is known about the link between cortical neural firing and cardiac-cycle duration (CCD). Here, we analyze single-unit and multiunit data obtained in humans at rest, and show that firing rate covaries with CCD in 16.7% of the sample (25 of 150). The link between firing rate and CCD was most prevalent in the anterior medial temporal lobe (entorhinal and perirhinal cortices, anterior hippocampus, and amygdala), where 36% (18 of 50) of the units show the effect, and to a lesser extent in the mid-to-anterior cingulate cortex (11.1%, 5 of 45). The variance in firing rate explained by CCD ranged from 0.5 to 11%. Several lines of analysis indicate that neural firing influences CCD, rather than the other way around, and that neural firing affects CCD through vagally mediated mechanisms in most cases. These results show that part of the spontaneous fluctuations in firing rate can be attributed to the cortical control of the cardiac cycle. The fine tuning of the regulation of CCD represents a novel physiological factor accounting for spontaneous variance in firing rate. It remains to be determined whether the “noise” introduced in firing rate by the regulation of CCD is detrimental or beneficial to the cognitive information processing carried out in the parahippocampal and cingulate regions. SIGNIFICANCE STATEMENT Fluctuations in heart rate are known to be under the control of cortical structures, but spontaneous fluctuations in cortical firing rate, or “noise,” have seldom been related to heart rate. Here, we analyze unit activity in humans at rest and show that spontaneous fluctuations in neural firing in the medial temporal lobe, as well as in the mid-to-anterior cingulate cortex, influence heart rate. This phenomenon was particularly pronounced in the entorhinal and perirhinal cortices, where it could be observed in one of three neurons. Our results show that part of spontaneous firing rate variability in regions best known for their cognitive role in spatial navigation and memory corresponds to precise physiological regulations.
Use of Mechanical Circulatory Support in Patients Undergoing Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry

Background— Little is known about the contemporary use of intra-aortic balloon pump (IABP) and other mechanical circulatory support (O-MCS) devices in patients undergoing percutaneous coronary intervention (PCI) in the setting of cardiogenic shock. Methods and Results— We identified 76 474 patients who underwent PCI in the setting of cardiogenic shock at one of 1429 National Cardiovascular Data Registry CathPCI participating hospitals from 2009 to 2013. Temporal trends and hospital-level variation in the use of IABP and O-MCS were evaluated. No mechanical circulatory support was used in 41 286 (54%) patients, 29 730 (39%) received IABP only, 2711 (3.5%) received O-MCS only, and 2747 (3.6%) received both IABP and O-MCS. At the start of the study period, 45% of patients undergoing PCI in the setting of cardiogenic shock received an IABP and 6.7% received O-MCS. The proportion of patients receiving IABP declined at an average rate of 0.3% per quarter, whereas the rate of O-MCS use was unchanged over the study period. The predicted probability of IABP use varied significantly by site (hospital median 42%, interquartile range 33% to 51%, range 8% to 85%). The probability of O-MCS use was <5% for half of hospitals and >20% in less than one-tenth of hospitals. Conclusions— In this large national registry, the use of IABP in the setting of PCI for cardiogenic shock decreased over time without a concurrent increase in O-MCS use. The probability of IABP and O-MCS use varied across hospitals, and the use of O-MCS was clustered at a small number of hospitals.
Analysis of exotic squirrel trade and detection of human infections with variegated squirrel bornavirus 1, Germany, 2005 to 2018

Following the discovery in 2015 of the variegated squirrel bornavirus 1 (VSBV-1) in fatal encephalitis cases among exotic squirrel breeders and a zoo animal caretaker in Germany, a case definition was developed. It was employed during trace-back animal trade investigations and sero-epidemiological studies among breeders and zoo animal caretakers of holdings with VSBV-1 infected squirrels. During the investigation, two possible human cases who had died of encephalitis were identified retrospectively among the squirrel breeders. Moreover, one probable human case was detected among the breeders who had a positive memory T-cell response to VSBV-1 antigen and antibodies against VSBV-1. The low rate of seropositivity found among living persons in risk groups that handle exotic squirrels privately or at zoos may reflect rareness of exposure to VSBV-1 during animal contact, a high lethality of infection or a combination of these factors. As a precaution against human exposure, testing of exotic squirrels for VSBV-1 infection and/or avoiding direct contact with exotic squirrels in zoos and private holdings is strongly advised.
Informing, Reassuring, or Alarming? Balancing Patient Needs in the Development of a Postsurgical Symptom Reporting System in Cancer

After ambulatory surgeries, patients who recover at home have multiple questions about wound healing, symptoms and medication side effects, and recovery expectations. We conducted user testing and rapid application development of a newly developed symptom reporting system that supports home-based recovery by inviting patients to self-report symptoms in the days after surgery and then receive an immediate feedback report giving context for their reported symptoms. Findings showed that some participants primarily valued reassurance, whereas others prioritized receiving alerts about potential problems. Results also showed that most patients wanted feedback framed as comparing their progress to their expected progress, not to that of other patients. The final feedback report provided patients with actionable recommendations, small graphs showing their progress, and with short "gist" text interpretations. The system has been implemented, and recruitment is ongoing for a large clinical trial of its effectiveness for reducing adverse events and unnecessary emergency or urgent care visits.
Engaging Patient Stakeholders in Planning, Implementing, and Disseminating Occupational Therapy Research

Patients 1 are experts on their own lives and the ways in which an illness, injury, or disability affects their health, activity, and quality of life. With its longstanding foundations in participatory action research, patient engagement has been gaining momentum across health care and related research. This momentum is supported by investments from several key research and federal policy–related organizations, including the Patient-Centered Outcomes Research Institute, National Institutes of Health, and Agency for Healthcare Research and Quality. Occupational therapy practitioners are uniquely positioned to champion patient collaborations. In this article, we discuss ways in which patient perspectives can be embraced in occupational therapy research, and we share insights from a research planning collaborative with adolescents and young adults that was led by occupational therapy researchers.
High-density extracellular probes reveal dendritic backpropagation and facilitate neuron classification

Different neuron types serve distinct roles in neural processing. Extracellular electrical recordings are extensively used to study brain function but are typically blind to cell identity. Morpho-electric properties of neurons measured on spatially dense electrode arrays might be useful for distinguishing neuron types. Here we used Neuropixels probes to record from cortical and subcortical regions of the mouse brain. Extracellular waveforms of each neuron were detected across many channels and showed distinct spatiotemporal profiles among brain regions. Classification of neurons by brain region was improved with multi-channel compared to single-channel waveforms. In visual cortex, waveform clustering identified the canonical regular spiking (RS) and fast spiking (FS) classes, but also uncovered a subclass of RS units with unidirectional backpropagating action potentials (BAPs). Moreover, BAPs were observed in many hippocampal RS cells. Overall, waveform analysis of spikes from high-density probes aids neuron identification and can reveal dendritic backpropagation.