Miracle-dz/UniFAR-FTUs huggingface dataset:
Treatment with CoreTherm in 570 patients with prostate volumes of 80-366 ml: an evaluation of short- and long-term retreatment risk

Abstract Introduction CoreTherm (ProstaLund AB, Lund, Sweden) is an outpatient treatment option in men with lower urinary tract symptoms and catheter-dependent men with chronic urinary retention caused by benign prostatic obstruction (BPO). CoreTherm is high-energy transurethral microwave thermotherapy with feedback technique. Modern treatment with CoreTherm includes transurethral intraprostatic injections of mepivacaine and adrenaline via the Schelin Catheter (ProstaLund AB, Lund, Sweden) and is often referred to as the CoreTherm Concept. Objectives The aim of this study was to evaluate the short- and long-term retreatment risk in men with large prostates and BPO or chronic urinary retention, all primarily treated with CoreTherm. Material and Methods All men from the same geographical area with prostate volumes ≥ 80 ml treated 1999–2015 with CoreTherm and having BPO or were catheter-dependent due to chronic urinary retention, were included. End of study period was defined as December 31, 2019. Results We identified and evaluated 570 men treated with CoreTherm, where 12% (71 patients) were surgically retreated during the follow-up. Mean follow-up was 11 years, and maximum follow-up was 20 years. The long-term retreatment rate in our study was 23%. A majority of these could be retreated with CoreTherm or TURP, with only 3% requiring open surgery. Conclusion We conclude that CoreTherm is a suitable outpatient treatment option in patients with profoundly enlarged prostates, regardless of age, prostate size, and reason for treatment.
Diagnostic experiences of Duchenne families and their preferences for newborn screening: A mixed‐methods study

Duchenne muscular dystrophy is the most common form of muscular dystrophy diagnosed in childhood but is not routinely screened for prenatally or at birth in the United States. We sought to characterize the diagnostic experiences of families and describe their preferences for newborn screening (NBS). We conducted a registry‐based survey of families with Duchenne and Becker muscular dystrophy that included open‐ and closed‐ended questions regarding the journey to a diagnosis, preferences for when to learn of a diagnosis, and how knowledge of a diagnosis would impact life decisions. Open‐ended responses were analyzed thematically, and closed‐ended responses were analyzed descriptively. Sixty‐five families completed the survey. The average ages of first concern and diagnosis were 2 and 4 years, respectively. One‐third of families (30%) indicated that they would prefer to receive a diagnosis in the newborn period irrespective of treatment options available, and nearly all of the remaining families (93%) indicated that they would want to learn about a diagnosis if there were treatments that worked well during the newborn period. All families (100%) indicated that a diagnosis in the newborn period would impact life decisions. We identified three overarching themes, which described the stages of the diagnostic journey, including having concerns about the child, seeking answers, and receiving the diagnosis. NBS can facilitate improved health outcomes through early access to care, and inform families on major health and nonhealth decisions. The preferences and experiences of families and other stakeholders should be considered when determining the potential value and benefit of expanding NBS programs.
Avascular Necrosis and Time to Surgery for Unstable Slipped Capital Femoral Epiphysis: A Systematic Review and Meta-analysis

Background: Avascular necrosis (AVN) is a well-known complication of unstable slipped capital femoral epiphysis (SCFE) and its cause is multifactorial. Higher AVN rates have been reported with surgery undertaken between 24 hours to 7 days from the onset of symptoms. The current evidence regarding time to surgery and AVN rate remains unclear. The aim of our study was to investigate the rate of AVN and time to surgery in unstable SCFE. Methods: A literature search of several databases was conducted. Eligibility criteria included all studies that reported AVN rates and time to surgery in unstable SCFE patients. We performed a meta-analysis using a random-effects model to pool the rate of AVN in unstable SCFE using different time to surgery subgroups (≤24 h, 24 h - 7 d and >7 d). Descriptive, quantitative and qualitative data were extracted. Results: Twelve studies matched our eligibility criteria. In total, there were 434 unstable SCFE of which 244 underwent closed reduction (CR). The pooled AVN rates were 24% [95% CI: 16%-35%] and 29% [95% CI: 16%-45%] for the total and CR groups, respectively. The highest AVN rates were with surgery between 24 hours to 7 days, 42% and 54% for the total and CR groups, respectively. The lowest rates of AVN were with time to surgery ≤24 hours (22% and 21% respectively) and >7 days (18% and 29% respectively). These differences were not statistically significant. There was significant subgroup heterogeneity which was highest in the 24 hours - 7 days subgroup and lowest in the >7 days subgroup. Conclusions: The cumulative evidence was not conclusive for an association between AVN rate and time to surgery. The overall AVN rates were lower in unstable SCFE patients who had surgery ≤24 hours and >7 days. However, treatment techniques were very variable and there was significant heterogeneity in the included studies. Multi-centre prospective studies are required with well-defined time to surgery outcomes. Level of Evidence: Level III/IV.
Stereotypic beliefs contribute to gender disparities in the field of economics

ABSTRACT Why are women under-represented in the field of economics relative to men? We propose that stereotypes associated with economists contribute to women’s interest in the field. We test the predictions that economists are stereotypically associated with low levels of communion and high levels of agency and that this type of stereotype content is associated with women’s lower interest in the field. In Study 1 (N = 883), stereotypes associated with people in the field of economics were masculine, characterized with low levels of communion and high levels of agency. In Study 2 (N = 182), undergraduate women were less interested than men in majoring in fields that share the same pattern of stereotyping found for economists in Study 1. The results from this study have important implications for increasing young women’s interest and representation in the field of economics.
Cryptococcus neoformans can utilize ferritin as an iron source.

Ferritin, a major iron storage protein in vertebrates, supplies iron upon iron deficiency. Ferritin is also found extracellularly, and acts as an iron carrier and a contributor to the immune response to invading microbes. Some microbial pathogens take advantage of ferritin as an iron source upon infection. However, no information is currently available on whether the human fungal pathogen Cryptococcus neoformans can acquire iron from ferritin. Here, we found that C. neoformans grew well in the presence of ferritin as a sole iron source. We showed that the binding of ferritin to the surface of C. neoformans is necessary and that acidification may contribute to ferritin-iron utilization by the fungus. Our data also revealed that the high-affinity reductive iron uptake system in C. neoformans is required for ferritin-iron acquisition. Furthermore, phagocytosis of C. neoformans by macrophages led to increased intracellular ferritin levels, suggesting that iron is sequestered by ferritin in infected macrophages. The increase in intracellular ferritin levels was reversed upon infection with a C. neoformans mutant deficient in the high-affinity reductive iron uptake system, indicating that this system plays a major role in iron acquisition in the phagocytosed C. neoformans in macrophages.
Engineered IL13 variants direct specificity of IL13Rα2-targeted CAR T cell therapy

Significance Chimeric antigen receptor (CAR) T cell therapy has demonstrated impressive clinical impact. Imperative to CAR design is the optimization of the antigen binding domain, which imparts CAR specificity, and use of natural ligands circumvents the need for engineering new binding proteins. However, natural molecules may have multiple binding partners, some of which are not therapeutic targets. Here, we study CAR specificity using engineered variants of interleukin 13 (IL13) with different levels of selectivity toward the therapeutic target IL13Rα2 relative to the ubiquitously expressed IL13Rα1. Using stringent models, we demonstrate that antigen selectivity strongly influences both cytotoxicity and CAR T cell trafficking in vivo. These studies highlight structure-guided engineering of binding domains and present therapeutic candidates for IL13Rα2-overexpressing malignancies.
Early cytopenias and infections after standard of care idecabtagene vicleucel in relapsed or refractory multiple myeloma

Key Points • Grade ≥ 3 cytopenias were at their worst at day 7 after ide-cel (94% of patients) but persisted in 40% at day 90, particularly thrombocytopenia. • Infections within 30 days of ide-cel were typically bacterial (68%) and severe (50%); moderate viral infections were more prevalent later.
Study of the Association of Single Nucleotide Polymorphisms in Candidate Genes With Sevoflurane

The susceptibility of different individuals to anesthetics varies widely, and sevoflurane is no exception. We hypothesized that polymorphisms in genes involved in pharmacokinetics and pharmacodynamics may explain this variation. A total of 151 individuals undergoing otorhinolaryngology surgery were included. The influence of genetic polymorphisms on sevoflurane sensitivity were investigated through SNaPshot technology. Individuals carrying KCNK2 rs6686529 G > C, MTRR rs3733784 TT, rs2307116 GG, or rs1801394 AA polymorphisms had a higher sensitivity to the sedative effect of sevoflurane than those without those polymorphisms. The univariate linear regression analysis indicated that MTRR rs3733784 TT, rs2307116 GG, and rs1801394 AA were potentially significant predictors of higher sensitivity to the sedative effect of sevoflurane. Moreover, CYP2E1 rs3813867 G > C and rs2031920 C > T, GABRG1 rs279858 T > C, KCNK3 rs1275988 CC, GRIN2B rs1806201 GG, MTRR rs2307116 G > A, and rs1801394 A > G were associated with a higher sensitivity to the cardiovascular effect of sevoflurane. Our results suggested that 9 single nucleotide polymorphisms in genes involved in metabolizing enzymes, transport proteins, target proteins of sevoflurane and folate metabolism may help to explain individual differences in the susceptibility to the sedative or cardiovascular effect of sevoflurane.
Taxonomic and functional components of avian metacommunity structure along an urban gradient

Identifying biological processes that structure natural communities has long interested ecologists. Community structure may be determined by various processes, including differential responses of species to environmental characteristics, regional-level spatial influences such as dispersal, or stochasticity generated from ecological drift. Few studies have used the metacommunity paradigm (interacting communities linked by dispersal) to investigate avian community composition along an urban gradient, yet such a theoretical construct may provide insights into species turnover even in unnatural settings such as rural to urban gradients. We measured the influence of spatial and environmental characteristics on two aspects of avian community structure across a gradient of urbanization: 1) taxonomic composition and 2) functional richness based on diet, foraging strategies, nesting locations and morphology. We also measured the relationship between species traits and environmental variables with an RLQ-fourth corner analysis. Together, environmental and spatial processes were significantly related to taxonomic structure and functional richness, but spatial variables accounted for more variation than environmental variables. Fine spatial scales were positively correlated with insectivorous birds and negatively correlated with body and wing size. Urbanization was positively correlated with birds that forage at the canopy level, while emergent wetlands were negatively correlated with birds that nested in cliffs and frugivorous birds. Functional richness and urbanization were significantly related to fine spatial variables. Spatial and environmental factors played an important role in taxonomic and functional structure in avian metacommunity structure. This study highlights the importance of studying multiple aspects of biodiversity, such as taxonomic and functional dimensions, especially when examining effects of complementary spatial and environmental processes.
In vitro killing of multidrug/extensively drug-resistant Pseudomonas aeruginosa by fosfomycin alone or in combination with antipseudomonal antibiotics

Abstract Pseudomonas aeruginosa is a leading cause of nosocomial infections. Given the constant rise in resistance, adequate therapy is increasingly demanding. Fosfomycin recently became an appealing treatment option of bacterial infections due to multidrug-resistant bacteria (MDR). So far, fosfomycin synergy with other antibiotics has been assessed in studies, but only a limited number focused on MDR P. aeruginosa and on the effect of these combinations on the duration of the postantibiotic effect (PAE). We investigated synergy of fosfomycin with an array of antipseudomonal antibiotics using gradient diffusion strip cross method and time-kill method, and their effect on the duration of PAE against 51 variously resistant P. aeruginosa isolates. The highest rate of synergy was observed for combination with ceftazidime (23.4%) and gentamicin (19.1%). The PAE of antibiotic combinations was superior to that of the drugs alone. Our findings indicate that fosfomycin combination therapy may be a valuable treatment alternative.
State variation in antipsychotic and benzodiazepine prescribing among hospice beneficiaries in the United States

Antipsychotics and benzodiazepines are common components of the hospice toolkit prescribed for both physical and behavioral symptom management. Despite their routine use in hospice, there are currently limited guidelines or consensus on best prescribing practices. Antipsychotics and benzodiazepines are often utilized to treat distressing symptoms at end of life, however, these medication classes are not without risk when prescribed to older adults including side effects such as sedation, falls, and increased mortality. Hospice represents an increasingly heterogenous population, including many with non-cancer diagnoses, some of whom will outlive and be discharged from the hospice benefit. For those patients who are not imminently dying, patients and their care partners may prefer avoiding such medications in order to maintain function and minimize sedation. Given a clear lack of clear evidence to inform antipsychotic and benzodiazepine prescribing best practice for patients enrolled in hospice, there may be variation or inconsistent utilization of these medications. The goal of this study is to describe the variation in the prevalence of antipsychotic and benzodiazepine prescribing among beneficiaries enrolled in hospice across states. Understanding variation in practice patterns may help to inform appropriate prescribing in hospice and to clarify the current standard of care.
Reliability and Comparison of Sonographic Methods for In Vivo Measurement of Human Biceps Femoris Long-Head Architecture

ABSTRACT Introduction Biceps femoris long-head fascicle length (Lf), fascicle angle (FA), and muscle thickness (MT) estimates obtained across 2 d from extended field-of-view (EFOV) sonographic images were compared with those measured from a collage of single ultrasound images (to visualize entire fascicles) as well as a range of geometric equations and extrapolation methods used on single images. Both test validity and intraday reliability were determined. Methods Twenty healthy adults (10 men and 10 women) were tested on two occasions (day 1 and day 2), 7 d apart at the same time of day for test–retest measurements. Ultrasound imaging was performed using EFOV and static image acquisition sequences; in the latter, four single images were acquired in-series along the muscle. From these images, Lf was assessed using seven methods: EFOV, collage, manual linear extrapolation, and four different trigonometric equations (termed equations A, B, C, and D), and FA and MT were measured in EFOV, collage, and single images. Results Lf, FA, and MT measured on days 1 and 2 were not different (P > 0.05) for any method, reliabilities were very high (intraclass correlation coefficient, 0.91–0.98), and correlations were strong (≥0.84). Significant correlations (P < 0.05; r = 0.67–0.98) were found between EFOV and the other measurement techniques for Lf, FA, and MT. The collage method had the highest reliability for Lf, and highest rank order and correlation with EFOV. Conclusions Although the six different techniques used to estimate Lf provided values similar to EFOV, higher between-subject measurement variability was observed with trigonometric equations, and the collage method described herein provided the most accurate and reliable results and is therefore recommended for biceps femoris long-head architectural analysis when EFOV is not available.
Application of Rotational Thromboelastometry in Patients with Acute Promyelocytic Leukemia

Introduction Hemorrhagic early death (HED) remains a major cause of treatment failure among patients with acute promyelocytic leukemia (APL). We aimed to investigate the prognostic potential of rotational thromboelastometry (ROTEM) for bleeding in patients with APL. Materials and Methods 31 newly-diagnosed APL patients (median age of 40 years; 14 female/17 male) that underwent treatment at the Clinic of Hematology UCCS from 2016-2020 with all-trans retinoic acid and anthracyclines were recruited. CBCs (complete blood count), conventional coagulation tests (CCTs), and ROTEM parameters obtained before treatment initiation were evaluated. Results All patients demonstrated at least one ROTEM parameter out of the reference range. ROTEM parameters associated with significant hemorrhage were EXTEM clotting time (CT) (P = 0.041) and INTEM amplitude 10 (A10) (P = 0.039), however, only EXTEM CT (P = 0.036) was associated with HED. Among CBCs and CCTs, only platelets were associated with significant bleeding (P = 0.015), while D-dimer was associated with both bleeding and HED (P = 0.001 and P = 0.002, respectively). Conclusion Our results indicate that ROTEM parameters may reveal hypocoagulability in APL patients and have the potential to improve current hemorrhage prognostic methods. Additionally, these results suggest the combination of ROTEM and CCTs might be useful in identifying patients at risk for HED.
Revisiting ℓ1-wavelet compressed-sensing MRI in the era of deep learning

Following their success in numerous imaging and computer vision applications, deep-learning (DL) techniques have emerged as one of the most prominent strategies for accelerated MRI reconstruction. These methods have been shown to outperform conventional regularized methods based on compressed sensing (CS). However, in most comparisons, CS is implemented with two or three hand-tuned parameters, while DL methods enjoy a plethora of advanced data science tools. In this work, we revisit ℓ1-wavelet CS reconstruction using these modern tools. Using ideas such as algorithm unrolling and advanced optimization methods over large databases that DL algorithms utilize, along with conventional insights from wavelet representations and CS theory, we show that ℓ1-wavelet CS can be fine-tuned to a level close to DL reconstruction for accelerated MRI. The optimized ℓ1-wavelet CS method uses only 128 parameters compared to >500,000 for DL, employs a convex reconstruction at inference time, and performs within <1% of a DL approach that has been used in multiple studies in terms of quantitative quality metrics.
Management of acute diarrhea in the emergency department of a tertiary care university medical center

Objectives To examine the management of acute diarrhea in the emergency department (ED) of a large university medical center. Methods Retrospective cross-sectional study over a 10-month period of adult patients (age ≥18 years) presenting to the ED with acute diarrhea. Results Data for 780 patients were reviewed; 101 met the exclusion criteria. Of the 679 patients with acute community-acquired diarrhea, 582 (85.7%) were discharged home and constituted the study cohort of mostly healthy adults (mean age: 32.5 ± 14.5 years). The rate of antibiotic prescription at discharge was 26%. Inappropriate use of antibiotics occurred in 28% of the patients. The presence of fever (odds ratio (OR) = 3.52), leukocytosis (OR = 1.72), and older age (OR = 1.16) were predictors of antibiotic prescription. Patients with dehydration, comorbidities, or bloody diarrhea were more likely to receive antibiotics. Microbiological studies and cross-sectional imaging were ordered in 12.4% and 11.7% of the patients, respectively, but provided very low yield (<10% for both) resulting in significantly higher visit charges. Inappropriately prescribed antibiotics at discharge resulted in higher charges in the ED compared with no antibiotic prescription. Conclusion Acute diarrhea management in our ED is suboptimal and does not adhere to practice guidelines, resulting in unnecessary antibiotic prescriptions, investigations, and cost.
High Temperature and Its Association With Work-Related Injuries by Employment Status in South Korea, 2017–2018

We found that in South Korea, nonpermanent workers were at a significantly higher risk of work-related injury than permanent workers during heatwave. This association was clearer among construction workers. These findings provide evidence for social policies that reduce potential work-related injuries during heatwaves. Objective This study aimed to determine the association between maximum daily temperature and work-related injuries according to employment status in South Korea. Methods Data on workers’ compensation claims and daily maximum temperature between May 20 and September 10, 2017–2018, were collected and analyzed. The absolute temperature risk effect (ATR) was evaluated by comparing the risk effect at 2 temperatures (30°C vs 33°C) across all communities using 2-stage time-series analysis. Results The association between high temperatures and work-related injuries was statistically significant in the construction sector (ATR, 1.129; 95% confidence interval [CI], 1.010–1.261). In addition, the findings of this study also demonstrated a higher risk effect among nonpermanent workers (ATR, 1.109; 95% CI, 1.013–1.214) at 33°C versus 30°C when compared with permanent workers (ATR, 0.963; 95% CI, 0.891–1.041). Conclusions This study found a significant association between high temperatures and work-related injuries among nonpermanent workers in South Korea.