Miracle-dz/UniFAR-FTUs huggingface dataset:
Dual-process model of older adults' sedentary behavior: an ecological momentary assessment study.

Objective: A 10-day ecological momentary assessment (EMA) study was conducted to test a dual-process model of older adults' sedentary behavior. Design: Older adults (n = 104, 60-98 years) answered 6 EMA questionnaires/day to assess conscious processes (i.e. momentary intentions, self-efficacy to limit sedentary behavior over the next two hours) and wore an activPAL accelerometer to measure sedentary behavior. Habit strength for sedentary behavior, a non-conscious process, was self-reported at an introductory session. Main outcome measure: Time spent sitting in the two hours after the EMA prompt. Results: Older adults engaged in less sedentary behavior on occasions when their intentions (b = -1.63, p = 0.02) and self-efficacy (b = -2.01, p = 0.003) to limit sedentary behavior were stronger than one's average level of intentions or self-efficacy, respectively; however, older adults' average level of intentions (b = -5.30, p = 0.05) or self-efficacy (b = 2.77, p = 0.27) to limit sedentary behavior were not associated with sedentary behavior. Older adults with stronger sedentary behavior habits engaged in greater sedentary behavior in the two hours following the EMA prompt (b = 2.04, p = 0.006). Conclusion: Sedentary behavior is regulated by conscious and non-conscious processes. Interventions targeting older adults' sedentary behavior should promote momentary intention formation and self-efficacy beliefs to limit sitting as well as content to disrupt habitual sedentary behavior.
Patient-Ventilator Interaction With Noninvasive Proportional Assist Ventilation in Subjects With COPD

BACKGROUND: To investigate patient-ventilator interaction during different levels of noninvasive proportional assist ventilation (PAV) compared with noninvasive pressure support ventilation (PSV). METHODS: Fifteen subjects with severe COPD and hypercapnia were consecutively recruited. After the baseline assessment of unassisted spontaneous breathing, 3 levels of ventilatory support were applied. The proportional assist (PA) and pressure support (PS) levels were set by subject comfort. PA−, PS− or PA+, PS+ were set at 25% more or less of PA or PS (PA− = 75% PA, PA+ = 125% PA, PS− = 75% PS, PS+ = 125% PS). Each level lasted at least 20 min. To demonstrate the patient-ventilator interaction, the neural respiratory drive, respiratory muscle effort, flow signal, and airway pressure were simultaneously monitored. RESULTS: The expiratory cycle delay (time between the termination of the diaphragm electromyogram [EMGdi] signal and the end of the inspiratory flow) progressively increased with increasing assist level in both modes. However, compared with PSV, the expiratory cycle delay was significantly longer in each assist level during noninvasive PAV. The runaway phenomenon was observed in PA+. The time between the peak EMGdi signal and the maximum value of the flow signal and the time difference between the peak EMGdi signal and the maximum value of inspiratory pressure were significantly increased with the increasing assist level of PAV. CONCLUSIONS: The expiratory cycle delay of noninvasive PAV was significantly longer than that of noninvasive PSV in the subjects with COPD with respiratory failure. During the levels of PAV, the lag time between neural respiratory drive and airway pressurization was significantly increased and the “runaway” phenomenon may be observed. (ClinicalTrials.gov registration NCT01782768.)
Potent reduction of plasma lipoprotein (a) with an antisense oligonucleotide in human subjects does not affect ex vivo fibrinolysis[S]

It is postulated that lipoprotein (a) [Lp(a)] inhibits fibrinolysis, but this hypothesis has not been tested in humans due to the lack of specific Lp(a) lowering agents. Patients with elevated Lp(a) were randomized to antisense oligonucleotide [IONIS-APO(a)Rx] directed to apo(a) (n = 7) or placebo (n = 10). Ex vivo plasma lysis times and antigen concentrations of plasminogen, factor XI, plasminogen activator inhibitor 1, thrombin activatable fibrinolysis inhibitor, and fibrinogen at baseline, day 85/92/99 (peak drug effect), and day 190 (3 months off drug) were measured. The mean ± SD baseline Lp(a) levels were 477.3 ± 55.9 nmol/l in IONIS-APO(a)Rx and 362.1 ± 89.9 nmol/l in placebo. The mean± SD percentage change in Lp(a) for IONIS-APO(a)Rx was −69.3 ± 12.2% versus −5.4 ± 6.9% placebo (P < 0.0010) at day 85/92/99 and −15.6 ± 8.9% versus 3.2 ± 12.2% (P = 0.003) at day 190. Clot lysis times and coagulation/fibrinolysis-related biomarkers showed no significant differences between IONIS-APO(a)Rx and placebo at all time points. Clot lysis times were not affected by exogenously added Lp(a) at concentrations up to 200 nmol/l to plasma with very low (12.5 nmol/l) Lp(a) levels, whereas recombinant apo(a) had a potent antifibrinolytic effect. In conclusion, potent reductions of Lp(a) in patients with highly elevated Lp(a) levels do not affect ex vivo measures of fibrinolysis; the relevance of any putative antifibrinolytic effects of Lp(a) in vivo needs further study.
Nutritional Complications and the Management of Patients with Gastroenteropancreatic Neuroendocrine Tumors

Neuroendocrine tumors (NETs) have increased in incidence and prevalence over the past 2 decades and affect approximately 170,000 people in the United States alone. Gastroenteropancreatic (GEP) NETs (GEP NET) are a heterogeneous group of rare tumors that have distinct effects on the body due to their tumor location and potential to secrete hormones and peptides. Clinical practice guidelines and consensus guidelines for GEP NETs with regard to best practice for diagnosis, treatment, and medical management are available, but the supportive care needs and optimal nutritional management of patients affected by these unique tumors remain under-researched: evidence to guide clinical practice is lacking. The pathophysiology of the disease and its treatment can cause various symptoms that can have significant effects on vitamin synthesis and absorption, dietary habits, weight change, and appetite. Deficiency of fat-soluble vitamins and niacin exists amongst patients with GEP NET, particularly those on treatment with somatostatin analogs and with serotonin-secreting tumors, respectively. Malnutrition and dietary modification amongst patients with GEP NET is more prevalent than initially thought: up to 25% of inpatients with GEP NET are malnourished. Food intolerance is also reported in up to 40–90% of these patients, though its misdiagnosis is common. This review summarizes the evidence regarding the impact of GEP NET and its treatment on nutritional factors in these patients with emphasis on malnutrition, vitamin deficiencies, dietary intake, and quality of life. Recommendations for clinical practice and research approaches to address these nutritional issues are discussed.
All-polyethylene versus metal-backed posterior stabilized total knee arthroplasty: similar 2-year results of a randomized radiostereometric analysis study

Background and purpose — The all-polyethylene tibial (APT) component, introduced in the early 1970s, was surpassed by metal-backed tibial (MBT) trays as the first choice for total knee arthroplasty (TKA). With improved polyethylene, the modern APT components can reduce costs, and have shown equivalent results in survivorship and early migration of the cruciate-retaining and cruciate-stabilizing designs. This study compares the 2-year migration of a similarly designed APT-posterior stabilized (PS) and a MBT-PS TKA, using radiostereometric analysis (RSA). Patients and methods — 60 patients were randomized to receive either an APT Triathlon PS or an MBT Triathlon PS TKA (Stryker, NJ, USA). Migration measured by RSA and clinical scores were evaluated at baseline and at 3, 12, and 24 months postoperatively. Repeated measurements were analyzed with a linear mixed model and generalized estimating equations. Results — The mean maximum total point movement (MTPM) at 3, 12, and 24 months was 0.41 mm (95% CI 0.33–0.50), 0.57 mm (0.44–0.70), and 0.56 mm (0.42–0.69) respectively in the MBT group and 0.46 mm (0.36–0.57), 0.61 mm (0.49–0.73), and 0.64 mm (0.50–0.77) in the APT group. 2 MBT and 1 APT implant were considered unstable at the 2-year follow-up. The KSS Knee score and KSS Function across 3, 12, and 24 months were comparable in both groups. Interpretation — For an APT-PS designed component, MTPM measured with RSA is comparable to the MBT-PS component after 2 years of follow-up. No differences in complications or clinical outcomes were found.
Establishing a Therapeutic Strategy Targeting NF-κB in Asian Patients with Chronic Rhinosinusitis With Nasal Polyps

https://e-aair.org Chronic rhinosinusitis with nasal polyps (CRSwNPs) is a chronic inflammatory disease within the mucosa of the nasal cavity and paranasal sinuses and is a relatively common disease with a prevalence of about 4% of the population.1 Depending on the degree of eosinophilic infiltration into the polyp tissue, CRSwNPs can be further subdivided into an eosinophilic polyp and non-eosinophilic polyp.1 Compared to non-eosinophilic one, the eosinophilic polyp is featured with more severer clinical manifestations, more recurrence after the surgical removal, and more frequently accompanying other allergic diseases such as allergic asthma.2 As patients with CPSwNPs often complain of discomfort from symptoms such as nasal congestion, postnasal drip, olfactory dysfunction, and remarkably impaired quality of life, clinicians should treat these patients appropriately.3
Allowable bias derived from the NOBIDA reference values

Abstract Figures of allowable bias are used to make rational choices of quality control rules, to judge the validity of published reference values, and to determine the stability of sample materials. Usually, allowable bias is parametrically defined as 0.25 times the total biological standard deviation, because that is half the width of the 90% confidence interval of parametrically estimated reference limits from 120 reference values. The published figures are mostly derived from very small populations, less than 120. We estimated allowable bias non-parametrically as the least of 4 percentile differences in distributions of reference values from the large Nordic reference interval project biobank and database (NOBIDA). The percentile differences are equivalent to 0.25 times the total biological standard deviation in Gaussian distributions. We also estimated allowable bias from the distributions of non-parametrically estimated reference limits after resampling 120 reference values from the same datasets. Clearly larger allowable bias was derived from the resampling method than from the percentile difference method, showing that non-parametric estimation of reference limits from 120 reference values implies a larger allowable bias than 0.25 times the normal biological standard deviation. With some exceptions, the figures of allowable bias using the percentile difference method were in the same order of magnitude as parametrically derived figures in other studies, and lend some support to the results from those smaller studies. Whether such bias specifications, if met, guarantee measurements of sufficient clinical quality is unknown.
Lay Health Worker-Led Cancer Symptom Screening Intervention and the Effect on Patient-Reported Satisfaction, Health Status, Health Care Use, and Total Costs: Results From a Tri-Part Collaboration.

PURPOSE Poor patient experiences and increasing costs from undertreated symptoms require approaches that improve patient-reported outcomes and lower expenditures. We developed and evaluated the effect of a lay health worker (LHW)-led symptom screening intervention on satisfaction, self-reported overall and mental health, health care use, total costs, and survival. METHODS From November 1, 2015, to September 30, 2016, we enrolled in this study all newly diagnosed Medicare Advantage enrollees with stage 3 or 4 solid tumors or hematologic malignancies who were receiving care in a community oncology practice. We evaluated symptom changes from baseline to 12 months for the intervention group. We compared with a control group (a historical cohort of Medicare Advantage enrollees diagnosed with cancer from November 1, 2014, to October 31, 2015) changes in satisfaction and overall and mental health with validated assessments at diagnosis and 5 months postdiagnosis, 12-month health care use, total costs, and survival. RESULTS Among 186 patients in the intervention group and 102 in the control group, most were female and non-Hispanic white or Hispanic, and the mean age was 79 years. There were no survival differences between the groups. Relative to the control group, the intervention group experienced improvements in satisfaction with care (difference-in-difference: 1.35; 95% CI, 1.08 to 1.63), overall health (odds ratio, 2.23; 95% CI, 1.49 to 3.32), and mental or emotional health (odds ratio, 2.22; 95% CI, 1.46 to 3.38) over time; fewer hospitalizations (mean ± standard deviation: 0.72 ± 0.96 v 1.02 ± 1.44; P = .03) and emergency department visits per 1,000 members per year (0.61 ± 0.98 v 0.92 ± 1.53; P = .03), and lower median (interquartile range) total health care costs ($21,266 [$8,102-$47,900] v $31,946 [$15,754-$57,369]; P = .02). CONCLUSION An LHW-led symptom screening intervention could be one solution to improve value-based cancer care.
MicroRNAs in acute pancreatitis: From pathogenesis to novel diagnosis and therapy

Acute pancreatitis (AP) is an inflammatory disorder initiated by activation of pancreatic zymogens, leading to pancreatic injury and systemic inflammatory response. MicroRNAs (miRNAs) have emerged as important regulators of gene expression and key players in human physiological and pathological processes. Discoveries over the past decade have confirmed that altered expression of miRNAs is implicated in the pathogenesis of AP. Indeed, a number of miRNAs have been found to be dysregulated in various cell types involved in AP such as acinar cells, macrophages, and lymphocytes. These aberrant miRNAs can regulate acinar cell necrosis and apoptosis, local and systemic inflammatory response, thereby contributing to the initiation and progression of AP. Moreover, patients with AP possess unique miRNA signatures when compared with healthy individuals or those with other diseases. In view of their stability and easy detection, therefore, miRNAs have the potential to act as biomarkers for the diagnosis and assessment of patients with AP. In this review, we provide an overview of the novel cellular and molecular mechanisms underlying the roles of miRNAs during the disease processes of AP, as well as the potential diagnosis and therapeutic biomarkers of miRNAs in patients with AP.
Industrializing a bacterial strain for L-serine production through translation initiation optimization.

Turning a proof-of-concept synthetic biology design into a robust, high performing cell factory is a major time and money consuming task, which severely limits the growth of the white biotechnology sector. Here, we extend the use of tunable antibiotic resistance markers for synthetic evolution (TARSyn), a workflow for screening translation initiation region (TIR) libraries with antibiotic selection, to generic pathway engineering, and transform a proof-of-concept synbio design into a process that performs at industrially relevant levels. Using a combination of rational design and adaptive evolution, we recently engineered a high-performing bacterial strain for production of the important building block biochemical L-serine, based on two high-copy pET vectors facilitating expression of the serine biosynthetic genes serA, serC and serB from three independent transcriptional units. Here, we prepare the bacterial strain for industrial scale up by transferring and reconfiguring the three genes into an operon encoded on a single low-copy plasmid. Not surprisingly, this initially reduces production titers considerably. We use TARSyn to screen both experimental and computational optimization designs resulting in high-performing synthetic serine operons and reach industrially relevant production levels of 50 g/L in fed-batch fermentations, the highest reported so far for serine production.
Identifying the Key Risk Factors for Adverse Psychological Outcomes Among Police Officers A Systematic Literature Review.

It is well established that police work is highly stressful; however, a paucity of evidence limits our knowledge and understanding of the factors that may lead to, compromise, and/or compound psychological distress for this unique population. To address this lack, the current systematic review was conducted to reveal the individual, organizational, and operational risk factors that have been identified in the research literature to date and their associations with depression, anxiety, posttraumatic stress disorder (PTSD), and burnout. We performed searches on literature published between January 2008 and January 2018 and identified a total of 20 studies that met our inclusion criteria. The results indicated that individual factors, including high levels of neuroticism, low social support, and engaging in passive or avoidant coping strategies, were associated with adverse psychological outcomes. This review identified low social support from colleagues as the most common risk factor linked to adverse psychological outcomes. Other organizational risk factors associated with such outcomes included high work demands, low resources, and low reward. This article demonstrates that individual, organizational, and operational factors all impact the negative psychological outcomes of police officers to some degree. In particular, the current review suggests that certain negative psychological outcomes are likely a result of a combination of risk factors across the three domains of risk, highlighting the necessity to observe psychological risk of police in a more comprehensive way.
Distinct Elements Confer the Blocking and Bypass Functions of the Bithorax Fab-8 Boundary

Boundaries in the Drosophila bithorax complex (BX-C) enable the regulatory domains that drive parasegment-specific expression of the three Hox genes to function autonomously. The four regulatory domains (iab-5, iab-6, iab-7, and iab-8) that control the expression of the Abdominal-B (Abd-B) gene are located downstream of the transcription unit, and are delimited by the Mcp, Fab-6, Fab-7, and Fab-8 boundaries. These boundaries function to block cross talk between neighboring regulatory domains. In addition, three of the boundaries (Fab-6, Fab-7, and Fab-8) must also have bypass activity so that regulatory domains distal to the boundaries can contact the Abd-B promoter. In the studies reported here, we have undertaken a functional dissection of the Fab-8 boundary using a boundary-replacement strategy. Our studies indicate that the Fab-8 boundary has two separable subelements. The distal subelement blocks cross talk, but cannot support bypass. The proximal subelement has only minimal blocking activity but is able to mediate bypass. A large multiprotein complex, the LBC (large boundary complex), binds to sequences in the proximal subelement and contributes to its bypass activity. The same LBC complex has been implicated in the bypass activity of the Fab-7 boundary.
Do professionals ask about children when establishing a collaborative individual plan for clients? A cross-sectional study

Abstract Aim: To examine the extent to which structured action plans, i.e. collaborative individual plans (CIPs), used by professionals within the psychiatric care, substance use treatment services and social services, evaluate if clients have children, and if professionals take actions if clients do have children. According to Swedish law, a CIP should be established when a client is in need of care from more than one branch of the care network. Professionals who meet adult clients have the opportunity to identify children at risk. Including a question in the CIP on whether a client has a child is a good approach to identify children in need of support. Methods: Cross-sectional data from professionals were collected prior to attending a three-day CIP course. A total of 705 individuals (n = 797 invited) responded to the questionnaire. Results: More than 90% reported that they meet clients for whom a CIP should be established, and 52.6% of these (n = 346) were aware of an existing CIP template within their organization. Approximately 30% (n = 203) reported that this template included an item on whether the client has one or more children. Of these, a majority reported ensuring that the children receive adequate care (83.3%, n = 169), and that they follow up on the receipt of such care (62.6%, n = 125). Conclusions: The care network needs to implement CIPs to a higher degree, and CIP templates need to include items about the clients’ children to ensure that children at risk are identified and thereby can receive adequate support.
Cytoplasmic protein misfolding titrates Hsp70 to activate nuclear Hsf1

Hsf1 is an ancient transcription factor that responds to protein folding stress by inducing the heat-shock response (HSR) that restore perturbed proteostasis. Hsp70 chaperones negatively regulate the activity of Hsf1 via stress-responsive mechanisms that are poorly understood. Here, we have reconstituted budding yeast Hsf1-Hsp70 activation complexes and find that surplus Hsp70 inhibits Hsf1 DNA-binding activity. Hsp70 binds Hsf1 via its canonical substrate binding domain and Hsp70 regulates Hsf1 DNA-binding activity. During heat shock, Hsp70 is out-titrated by misfolded proteins derived from ongoing translation in the cytosol. Pushing the boundaries of the regulatory system unveils a genetic hyperstress program that is triggered by proteostasis collapse and involves an enlarged Hsf1 regulon. The findings demonstrate how an apparently simple chaperone-titration mechanism produces diversified transcriptional output in response to distinct stress loads.
Predictors of malnutrition in Australian haemodialysis patients and comparison of dietary protein intakes to national guidelines

Background: Malnutrition is an important concern for patients undergoing dialysis therapy. We aimed to investigate predictors of nutritional status in a population of in-centre Western Australian haemodialysis (HD) patients and compare dietary protein intakes to national guidelines of 1.2-1.4 g/kg body weight/day. Method: Dietary intakes were assessed by diet history interview for 35 in-centre patients receiving HD (mean age 65.2 +/- 13.1 years; median dialysis vintage 3 [IQR 22] months). Patient Generated Subjective Global Assessment was used to classify patients as well-nourished or malnourished. Patient characteristics, co-morbidities and dialysis vintage were investigated along with biochemical data. Logistic regression was used to determine which factors were independent predictors of malnutrition. Results: Out of the 35 patients, 54% (n=19) were classified as well-nourished with 46% (n=16) malnourished. Increased body mass index, protein intake and albumin were independently associated with lower odds of malnutrition. A mean protein intake of 1.05 +/- 0.33 g/kg/d was observed in the well-nourished group compared with 0.86 +/- 0.28 g/kg/d for the malnourished group. Only one patient in each group (malnourished and well-nourished) was within the recommended protein intake guidelines (1.2-1.4 g/kg/d). Conclusion: Malnutrition remains a problem for HD patients, and dietary protein intake is an important predictor. However, our findings suggest that patients may be well-nourished at protein intakes lower than the current Australian guidelines. Further research investigating the application of the international protein intake guidelines of 1.1-1.2 g/kg/d for maintenance of nutritional status in clinically stable dialysis patients in Australia may be useful.