Miracle-dz/UniFAR-FTUs huggingface dataset:
Chronic chest pain and paresthesia after video-assisted thoracoscopy for primary pneumothorax

Background This study aims to identify clinical and surgical risk factors for chronic chest pain and paresthesia after video thoracoscopic surgery for primary spontaneous pneumothorax. Methods We retrospectively collected the data of 1,178 consecutive patients <40-years-old undergoing video thoracoscopic surgery for primary spontaneous pneumothorax in 9 Italian centers in 2007–2017. Cases with <2-month follow-up were excluded, leaving 920 patients [80% male; median age: 21 (IQR, 18–27) years] for statistical analysis. The following risk factors for chronic chest pain and chronic paresthesia were assessed by univariable and multivariable Cox regression model: age, gender, cannabis smoking, video thoracoscopy ports number, pleurodesis technique (partial pleurectomy/pleural electrocauterization/pleural abrasion/talc poudrage), chest tube size (24/28 F), postoperative chest tube stay. Results Blebs/bullae resection with pleurodesis was performed in 732 (80%) cases; pleurodesis alone in 188 (20%). During a median follow-up of 68 (IQR: 42–95) months, chronic chest pain developed in 8% of patients, chronic chest paresthesia in 22%; 0.5% of patients regularly assumed painkillers. Chronic chest pain was independently associated with partial pleurectomy/pleura abrasion (P<0.001) and postoperative chest tube stay (P=0.019). Chronic chest paresthesia was independently associated with pleurodesis by partial pleurectomy (P<0.001), chest tube stay (P=0.035) and 28 F chest tube (P<0.001). Conclusions After video thoracoscopic surgery for primary spontaneous pneumothorax, the incidence of chronic chest pain and paresthesia was significantly lower when pleurodesis was performed by pleural electrocauterization or talc poudrage, and chest tube was removed early. A 24 F chest tube was associated with lower risk of chronic chest paresthesia.
Phase relations below 575 degrees C in the system Ag-As-S

Quenching experiments were used to define the thermal stabilities of phase assemblages in the system Ag-As-S. Extensive liquid immiscibility occurs in this system at high temperatures and immiscible liquids are present even below 400 degrees C. Five ternary solid phases were encountered: proustite and xanthoconite (both Ag 3 AsS 3 ), smithite and trechmannite (both AgAsS 2 ), and Ag 7 AsS 6 . The phase relations of proustite were studied in detail. The maximum temperatures at which proustite can coexist with either Ag 7 AsS 6 , Ag 2 S, As, or smithite are, respectively, 480+ or -2 degrees , 469+ or -3 degrees , 452+ or -2 degrees , and 409+ or -4 degrees C. These minimum-melting temperatures define upper-temperature limits (un-corrected for confining pressures) for deposition of corresponding assemblages in ores. The xanthoconite --> proustite transition occurs between 180 degrees and 202 degrees C (confirming previous data) and the assemblage proustite + silver is unstable relative to Ag 2 S + arsenic when heated above about 190 degrees C. Both reactions provide useful indicators for geothermometry. Equilibrium assemblages of smithite + realgar and smithite + orpiment could not be synthesized, although both assemblages occur in nature; phase relations show that the AgAsS 2 modification associated with either realgar or orpiment would be trechmannite if equilibrium were maintained during low-pressure deposition and subsequent cooling.
Is Capability to Manage Finances Stable Over Time?

ABSTRACT:This article reviews the state-employment-system design work resulting in the creation of the High Performing States model of analysis. We apply this analysis to the work needed to improve mental health systems' ability to create structures, funding, and policies to promote employment. We derive recommendations from this analysis on how best to ensure these policies and improve funding mechanisms to obtain better employment outcomes for people experiencing serious mental illnesses. Policy changes cannot stand the test of time without concomitant leadership, training, advocacy, enthusiasm, and high expectations from all parties involved.
Exploring hTERT promoter methylation in cutaneous T‐cell lymphomas

Cutaneous T‐cell lymphomas (CTCLs) are telomerase‐positive tumors expressing hTERT, although neither gene rearrangement/amplification nor promoter hotspot mutations could explain the hTERT re‐expression. As the hTERT promoter is rich in CpG, we investigated the contribution of epigenetic mechanisms in its re‐expression. We analyzed hTERT promoter methylation status in CTCL cells compared with healthy cells. Gene‐specific methylation analyses revealed a common methylation pattern exclusively in tumor cells. This methylation pattern encompassed a hypermethylated distal region from −650 to −150 bp and a hypomethylated proximal region from −150 to +150 bp. Interestingly, the hypermethylated region matches with the recently named TERT hypermethylated oncogenic region (THOR). THOR has been associated with telomerase reactivation in many cancers, but it has so far not been reported in cutaneous lymphomas. Additionally, we assessed the effect of THOR on two histone deacetylase inhibitors (HDACi), romidepsin and vorinostat, both approved for CTCL treatment and a DNA methyltransferase inhibitor (DNMTi) 5‐azacytidine, unapproved for CTCL. Contrary to our expectations, the findings reported herein revealed that THOR methylation is relatively stable under these epigenetic drugs' pressure, whereas these drugs reduced the hTERT gene expression.
Team manual handling: a systematic review for identifying research gaps

Objectives. Team manual handling, a process still common in many jobs, can affect the safety and health of employees. A systematic review of the literature was conducted to identify the research gaps in this area for future studies. Methods. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was followed. Related papers were searched on PubMed, Web of Science, ProQuest and Scopus electronic databases until September 2020. Results. A total of 300 papers were identified, of which 28 were selected for final review based on the respective criteria. The findings of these studies were classified and evaluated based on biomechanical, physiological and psychophysical approaches. No study was found for the epidemiological approach. Only three papers mentioned the body physiological responses in team manual handling. The focus of the related studies found in this field was team lifting. No study was found on team pulling and pushing. Most studies were performed in a laboratory setting using young students who had no experience of team manual handling. Conclusion. The results of this study emphasize the need for further research, especially using the epidemiological and physiological approaches in different tasks of team manual handling in real work environments using experienced workers.
Comorbidity Burden Contributing to Racial Disparities in Outpatient Versus Inpatient Total Knee Arthroplasty

Introduction: Outpatient total knee arthroplasty (TKA) is increasingly common in the setting of early-recovery protocols, value-based care, and removal from the inpatient-only list by the Centers for Medicare & Medicaid Services. Given the established racial disparities that exist in different aspects of total joint arthroplasty, we aimed to investigate whether racial and ethnic disparities exist in outpatient compared with inpatient TKA. Methods: This was a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program. We queried TKAs done in 2018. Demographics, inpatient (≥2 midnights) versus outpatient (≤1 midnight) status, comorbidities, and perioperative events/complications were recorded. We analyzed differences between racial/ethnic groups and predictors of inpatient versus outpatient surgery, and outcomes. Results: A total of 54,582 patients were included (83.2% Caucasian, 9.2% African American [AA], 4.5% Hispanic, 2.4% Asian, and 0.6% Native American). AA had the highest mean body mass index, American Society of Anesthesiologists score, and comorbidity burden. AA had the lowest rate of outpatient TKA (18.3%) and Asians the highest rate of outpatient TKA (31.4%, P < 0.0001). AA had the highest postoperative transfusion rate (1.8%, P < 0.0001) and highest rate of discharge to acute rehab (8.4%). Asians had the highest rate of postoperative cardiac arrest and urinary tract infection. AA had the highest rate of acute kidney injury within 30 days. Regression analyses revealed that AAs were more likely to undergo inpatient surgery (odds ratio [OR], 2.58; confidence interval [CI], 1.57-4.23; P = 0.001) and discharge to rehab/skilled nursing facility [SNF] (OR, 2.86; CI, 1.66-4.92; P = 0.001). Asian patients were more likely to undergo outpatient surgery (OR, 2.48, CI, 1.47-4.18, P = 0.001) and discharged to rehab/SNF (OR, 2.41, CI, 1.36-4.25, P = 0.001). Caucasians were more likely to undergo outpatient surgery (OR, 1.62, CI, 1.34-1.97, P = 0.001) and less likely discharged to rehab/SNF (OR, 0.73, CI, 0.60-0.88, P = 0.001). When controlling for comorbidities, race was not an independent risk factor for 30-day complications or inpatient versus outpatient surgery. Discussion: Differences in indications for outpatient TKA between races/ethnicities seem to be highly associated with comorbidity burden and preoperative baseline differences, not race alone. Appropriate patient optimization for either outpatient or inpatient TKA may reduce disparities between groups in either care setting.
Resistance‐associated substitutions after sofosbuvir/velpatasvir/voxilaprevir triple therapy failure

Direct‐acting antivirals (DAAs) resolve chronic HCV infection in >95% of patients, but a small percentage do not respond to DAA‐based therapy. These may be difficult to treat because of resistance‐associated substitutions (RAS) emerging after treatment failure. Triple therapy with sofosbuvir (SOF)/velpatasvir (VEL)/voxilaprevir (VOX) is the recommended retreatment after DAA‐based failure. However, in rare cases, failure to triple therapy occurs, and there is little information characterizing the viruses that relapse. To determine the RAS profile after failing SOF/VEL/VOX, and seek suitable alternatives for retreatment, samples from 5 patients were analysed using MiSeq Illumina deep sequencing before and after triple therapy. All patients were men, aged 59–78 years, 2 HCV genotype (G) 1b and 3 G3a. The most prevalent NS3 substitutions after SOF/VEL/VOX failure were Y56F and A166T. Four patients had the NS5A RAS, Y93H, after triple failure, and Y93H was observed in both G1b patients before retreatment and after SOF/ledipasvir failure. In 2 G3a patients, Y93H appeared at triple failure, and on the other G3a, A30K persisted in 100% of viral genomes. Finally, G1b patients showed C316N in NS5B, associated with SOF failure, but G3a patients had no known NS5B substitutions. HCV RAS analysis identified the following substitutions present at higher rates after triple failure: Y56F in NS3 (G1b), A166T in NS3 (G3a), A30K or Y93H in NS5A, and C316N in NS5B (G1b). A RAS‐based salvage treatment (SOF + glecaprevir/pibrentasvir + RBV) was successfully used in one G3a patient.
CYTOLOGY OF SPERMATOGENESIS IN THE HONEY‐BEE, APIS INDICA (F.)

SYNOPSIS The spermatogenesis of the honey-bee, Apia indica (F.), has been worked out with special reference to the abortive meiosis and the role of cytoplasmic organelles. The haploid number of sixteen chromosomes in the parthenogenetic males remains constant through-out spermatogenesis. Meiosis I is abortive, resulting in the formation of a definite non-nucleated cytoplasmic bud containing some extra-nuclear spindle fibres and the cytoplasmic body. The significance of an extra-and an intra-nuclear spindle in relation to the abortive meiosis is discussed. Meiosis II is normal so far as the nuclear division is concerned. The cytoplasm, however, divides unequally, resulting in the formation of a normal spermatid and a diminutive non-functional spermatid body. The mitochondria are in the form of filaments and granules in the early stages. During meiosis I they assume a characteristic “blebbed” appearance. In the spermatid they fuse to form a typical mitochondrial nebenkern, which ultimately gives rise to the mitochondrial sheath around the axial filament of the sperm. A number of typical duplex spheroids (“Golgi dictyosomes”), each with a lipid sheath enclosing a non-lipid medulla, are present in the spermatocytes. In the spermatid these duplex spheroids fuse to form a typical single acroblast which is sloughed off after depositing a pro-acrosome at the nuclear membrane. The pro-acrosome condenses to form the acrosome of the ripe sperm.
Participation in lung cancer screening

Although there is now strong evidence for the efficacy of low-radiation dose computed tomography in reducing lung cancer mortality, the challenge is to establish screening programmes that have the maximum impact on the disease. In screening programmes, participation rates are a major determinant of the success of the programme. Informed uptake, participation, and adherence (to successive screening rounds) determine the overall impact of the intervention by ensuring the maximum number of people at risk of the disease are screened regularly and therefore have the most chance of benefiting. Existing cancer screening programmes have taught us a great deal about methods that improve participation. Although evidence is emerging for the efficacy of some of those methods in lung cancer screening, there is still much work to do in the specific demographic that is most at risk of lung cancer. This demographic, characterised by higher levels of socioeconomic deprivation, may be less willing to engage with healthcare interventions and present a particular challenge in the process of ensuring informed choice. In this article we review the evidence for improving participation and describe the challenges that need to be addressed to ensure the successful implementation of CT screening programmes.
How the COVID-19 pandemic changed treatment of severe aortic stenosis: a single cardiac center experience

Background Currently, two effective therapeutic options for severe aortic stenosis (AS) are available, one catheter-based [transcatheter aortic valve implantation (TAVI)], the other open surgical approach [surgical aortic valve replacement (SAVR)]. The COVID-19 pandemic has limited the availability of medical procedures. The purpose of this cross-sectional study was to assess if this pandemic had any impact on the treatment strategy of severe AS in a single cardiac center. Methods This study involved AS patients treated in 3-month periods (February through April) over 3 consecutive years 2018, 2019 [defined as COV(–) group] and 2020 [COV(+)]. We assessed if there were any differences regarding patients’ clinical profile, applied therapeutic method, procedure complexity and early clinical outcomes. Results In the years 2018 through 2019, approximately 50% of AS patients were treated classically (SAVR) while in 2020 this rate dropped to 34%. The preoperative clinical characteristic of TAVI subjects was comparable irrespective of the year. Regarding SAVR, more patients in COV(+) underwent urgent and more complex procedures. More of them were found in NYHA class III or IV, and had lower left ventricular ejection fraction (LVEF) (51.9%±14.4% vs. 58.3%±8.1%; P=0.021) than in COV(–) individuals. During the pandemic, a change in applied therapeutic methods and differences in patients’ clinical profile did not have an unfavorable impact on in-hospital mortality (2.0% before vs. 3.6% during pandemic) and morbidity. Of note, intubation time and in-hospital stay were significantly shorter (P<0.05) in 2020 (4.2 hours and 7.5 days) than in the previous years (7.5 hours and 9.0 days, respectively). Conclusions The coronavirus pandemic has changed substantially the management of severe AS. The shift into less invasive treatment method of AS patients resulted in shortening of in-hospital stay without compromise of short-term outcomes.
The Role of Intolerance of Uncertainty and Working Alliance in the Outcome of Cognitive Behavioral Therapy for Generalized Anxiety Disorder Delivered by Videoconference: Mediation Analysis

Background Previous meta-analyses have shown a significant relationship between working alliance and treatment outcome in general. Some studies have examined the relationship between working alliance and treatment outcome during telepsychotherapy, but to the best of our knowledge, no study has examined the mediating role of individual components of the working alliance. Objective As part of a clinical trial of cognitive behavioral therapy (CBT) for generalized anxiety disorder (GAD) delivered by videoconference (VC), the aim of this study is to examine the mediating role of intolerance of uncertainty on the relationship between the components of the working alliance and treatment outcome. Methods A sample of 46 adults with primary GAD received 15 sessions of CBT for GAD delivered over VC. Participants completed the measure of working alliance immediately after the fifth therapy session. The degree of change in intolerance of uncertainty (a key psychological process) was assessed from pre- to posttreatment. Treatment outcome was assessed via changes in GAD symptoms from pretreatment to the 6-month follow-up. Results The results revealed that the therapeutic bond did not predict treatment outcome (r=−0.23; P=.12). However, agreement on therapeutic goals and tasks did predict treatment outcome (r=−0.42; P=.004 and r=−0.37; P=.01, respectively). In addition, the relationship between consensus on therapeutic tasks and treatment outcome was completely mediated by changes in intolerance of uncertainty (unstandardized β=−0.03; r2=0.12), whereas consensus relative to treatment goals had a direct impact on treatment outcome. Conclusions These results provide a better understanding of the differential role of the components of the working alliance in telepsychotherapy as a facilitative factor for changes in key cognitive processes, leading to therapeutic change. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 12662027; http://www.isrctn. com/ISRCTN12662027.
Effect of myeloid ecotropic viral integration site (MEIS) family genes on tumor microenvironment remodeling and its potential therapeutic effect

Background The myeloid ecotropic viral integration site (MEIS) family of genes is related to the occurrence, development, and outcome of many cancers. However, its role in the immune and tumor microenvironment (TME) is unclear. This study explored the relationship between the expression of MEIS genes and patient survival, immune subtypes, TME, tumor stem cell correlation, and drug sensitivity in cancer. Methods We used The Cancer Genome Atlas pan-cancer data to analyze the expression of the MEIS family genes. Kaplan-Meier analysis and univariate Cox proportional hazard regression model were used to detect the relationship between gene expression and overall survival. Analysis of variance was used to explore the relationship between the MEIS family and the immune components in the tumor, and the ESTIMATE algorithm was used to calculate the proportion and level of tumor-infiltrating immune cells. Spearman and Pearson’s correlation tests were carried out to detect the relationship between MEIS and the characteristics of tumor stem cells and drug sensitivity. Results The MEIS family of genes shows different expression profiles in different cancers, with substantial inter- and intra-cancer heterogeneity. Among them, MEIS3 was upregulated in most cancers, whereas MEIS2 was downregulated. The change in MEIS gene expression was usually related to overall survival, but whether a member of the MEIS family was a risk factor or a protective factor was cancer-dependent. Immune component analysis suggested that the role of MEIS genes in promoting or inhibiting cancer may be related to different degrees of immune silencing. Further, there were varying degrees of correlation between MEIS gene expression and cancer cell stemness characteristics. It was also found that MEIS genes, especially MEIS1 and MEIS2, may be related to chemotherapy resistance. Conclusions We explored the expression, prognostic relationship, molecular characteristics, and effects on immunity and TME of the MEIS gene family in cancer. Our results suggest that MEIS members should be studied as independent entities in different types of cancer. The MEIS gene family may be a potential target for cancer therapy, but further experiments are needed to confirm this.
Hand fine motor control in classic galactosemia

Classic galactosemia (CG) is a rare inborn error of metabolism that results from profound deficiency of galactose‐1‐P uridylyltransferase (GALT). Despite early detection and rapid and lifelong dietary restriction of galactose, which is the current standard of care, most patients grow to experience a broad range of complications that can include motor difficulties. The goal of this study was to characterize hand fine motor control deficit among children and adults with classic galactosemia (CG). Specifically, we used Neuroglyphics software to collect digital Archimedes spiral drawings on a touch screen from 57 volunteers with CG (cases) and 80 controls. Hand fine motor control was scored as root mean square (RMS) of spirals drawn relative to an idealized template. Presence of tremor was defined as a peak in periodicity of changes in drawing speed or direction in the 4‐8 Hz range. We observed a highly significant difference (P < .001) in RMS scores between cases and controls, with almost 51% of cases showing at least 1 of 4 spirals scoring outside the 95th percentile for controls. The corresponding prevalence for controls was 10%. Similarly, more than 35% of cases, and almost 14% of controls, showed at least 1 of 4 spirals with a tremor amplitude above the 95th % cutoff for controls. Our results both confirm and extend what is known about hand fine motor control deficit among children and adults with CG and establish digital assessment as a useful approach to quantify this outcome.
A space-charge life model for ac electrical aging of polymers

The dc space-charge model, previously developed by the authors, here is modified to account for the contribution to electrical degradation provided by ac fields. First, the dc model is applied to both dc and ac multistress life test results relevant to a given material. The variations of model parameters from dc to ac data fitting provide indications about the modifications in the degradation mechanisms when passing from a dc to ac regime. Then, a description of aging under ac is achieved through proper assumptions about the space-charge buildup, injection mechanism, and dynamic condition of the polymer lattice. This approach enables the effect of frequency to be accounted for, in a framework where ac aging presents significant analogies with mechanical fatigue. The validity of the ac space-charge model is checked by applying it to the results of accelerated life tests performed on various insulating materials, at different values of voltage, temperature and frequency, on the whole finding very good agreement with experimental data.
Criteria for placenta accreta spectrum in the International Federation of Gynaecology and Obstetrics classification, and topographic invasion area are associated with massive hemorrhage in patients with placenta previa

Placenta previa with placenta accreta spectrum (PAS) is a life‐threatening disease that results in massive hemorrhage. The clinical and histologic criteria of PAS were adopted according to the International Federation of Gynaecology and Obstetrics (FIGO) classification. We aimed to investigate whether FIGO criteria and topography were associated with maternal complications in patients with placenta previa.