Miracle-dz/UniFAR-FTUs huggingface dataset:
A Toolkit for Community-Based, Medicaid-Funded Case Managers to Introduce Advance Care Planning to Frail, Older Adults: A Pilot Study.

Background: Advance care planning (ACP) among frail, older adults receiving in-home care is low. Leveraging case managers to introduce ACP may increase engagement. Objective: Pilot an ACP-Toolkit for case managers and their clients. Design: Feasibility pilot of an ACP-Toolkit for case managers to introduce ACP and the PREPAREforYourCare.org website and advance directives. Setting/Subjects: Case managers from four local aging service organizations who referred English-speaking clients ≥55 years old. Measurements: Using validated surveys (five-point Likert scales), we assessed changes in case managers' attitudes, confidence, and readiness to facilitate ACP and clients' readiness to engage in ACP from baseline to follow-up (one-week) using Wilcoxon signed-rank tests. Results: We enrolled 9 case managers and 12 clients (median age 69 [standard deviation 8], 75% minority race/ethnicity). At follow-up, case managers' confidence increased (3.2 [0.7] to 4.2 [0.7]; p = 0.02), and clients' readiness increased (2.8 [1.5] to 3.4 [1.4]; p = 0.06). All case managers agreed the Toolkit was easy to use, helped start ACP conversations, and would recommend it to others. All clients found the Toolkit easy to understand and were comfortable with case managers using it. Nearly all clients (92%) would recommend it to others. Suggestions for improvement included offering the Toolkit in other languages and disseminating it in clinical and community settings. Conclusions: The ACP-Toolkit resulted in higher case manager confidence in facilitating ACP and client readiness to engage in ACP, and usability was high. A brief ACP-Toolkit may be a feasible solution to increase ACP engagement among frail, older adults receiving in-home care.
Associations Between Alzheimer’s Disease and Related Dementias and Depressive Symptoms of Partner Caregivers

Family members—mainly spouses and partners—are the primary caregivers for individuals with Alzheimer’s disease and related dementias (ADRDs), chronic progressive illnesses requiring increasing levels of care. We performed a retrospective observational analysis comparing depressive symptoms of 16,650 older individuals with partners without ADRDs, and those recently (within 2 years) or less recently diagnosed (≥2 years prior), controlling for lagged sociodemographic and health characteristics. The mean number of reported depressive symptoms was 1.2 (SD = 1.8). Compared with respondents with partners with no ADRD, having a partner with any ADRD was associated with a 0.35 increase (95% confidence interval [CI] = [0.30, 0.41]), or 30% increase, in depressive symptoms. A less recent partner diagnosis was associated with a 33% increase, while a recent diagnosis was associated with a 27% increase. Clinically meaningful and longitudinally worsening depressive symptoms amplify the need to prioritize partner health and family-centered care following an ADRD diagnosis.
Increased energy expenditure and activated β3‐AR‐cAMP‐PKA signaling pathway in the interscapular brown adipose tissue of 6‐OHDA‐induced Parkinson's disease model rats

To explore the possible mechanism of weight loss in Parkinson's disease (PD). Bilateral injections of 6‐hydroxydopamine (6‐OHDA) into substantia nigra (SN) were performed to induce the PD model rats. The rotarod test, food intake, body weight, and interscapular brown adipose tissue (IBAT) weight were recorded 6 weeks postoperation. HE staining was performed to observe the morphology of multilocular adipose cells in IBAT. Immunohistochemistry and western blot were used to determine the protein levels of tyrosine hydroxylase (TH) in the SN, and the levels of uncoupling protein 1 (UCP1), peroxisome proliferator‐activated receptor gamma coactivator‐1α (PGC‐1α), phosphorylated‐hormone sensitive lipase (p‐HSL), HSL, TH, β3‐adrenergic receptor (β3‐AR), cyclic adenosine monophosphate (cAMP), and protein kinase A (PKA) in IBAT. After treatment with 6‐OHDA for 6 weeks, 6‐OHDA rats exhibited decreased TH expression in SN accompanied with shortened staying time on the rotating rod. This motor impairment paralleled with no significant alteration in body mass, IBAT weight, and food intake until the end of the experimental protocol. However, the decreasing diameter of the single fat vesicle in IBAT was observed in the 6‐OHDA group. Meanwhile, compared with the control group, the protein expression of UCP1, PGC‐1α, p‐HSL, TH, β3‐AR, cAMP, and PKA in IBAT were increased significantly in the 6‐OHDA group, whereas no obvious change in the expression of HSL. The present study suggested an increased energy expenditure and activation of the β3‐AR‐cAMP‐PKA signaling pathway in the IBAT after the destruction of the dopamine system in the SN of the rat.
Effects of soil depth,cache spacing and cache size of sunflower(Helianthus annuus)seeds on seed discovery by Siberian chipmunk(Tamias sibiricus senescens)

We conducted three experiments during May-June,2005,to study the effects of artificial depth of placement,cache spacing,and cache size of sunflower(Helianthus annuus Linn.)seeds on seed discovery by Siberian chipmunks(Tamias sibiricus senescens)in the Dongling Mountains,northwestern Beijing,China.We found that the proportions of seeds discovered were negatively correlated with depth from the soil surface,were extremely low,and but did not differ when seeds were buried at 5-8 cm vs.≥ 10 cm depths.Proportions of seeds discovered were negatiyely correlated with distance between caches,with caches spaced at 1.5 m intervals discovered significantly less often than those spaced more closely together.Proprotions of seeds discovered were positively correlated with cache size,with caches of 1 g found less often than caches of larger size.
In vitro antioxidant and antimicrobial activity of Cannabis sativa L. cv ʻFutura 75ʼ essential oil

Abstract In the present work, Cannabis sativa L. cv Futura 75 inflorescences, cultivated in the Abruzzo territory, were characterized for their volatile fraction through SPME-GC-MS. In addition, the essential oil extracted from these inflorescences was investigated for the antioxidant potentialities and for the terpenic profile. The antibacterial activity of hemp essential oil (HEO) against some pathogenic and spoilage microorganisms isolated from food was also evaluated by determining the minimal inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC). The results showed significant antioxidant capacity (DPPH: 63.38 ± 0.08 mg TE/g HEO; FRAP: 438.52 ± 6.92 mg TE/g HEO) alongside good antibacterial activity against Gram-positive bacteria such as S. aureus and L. monocytogenes (MIC 1.25-5 µL/mL). The results obtained suggest that hemp essential oil can inhibit or reduce bacterial growth, also exerting antioxidant activity, and therefore it can find an advantageous application in the food processing field. Graphical Abstract
Analysis of Myomectomy during Cesarean Section: A Tertiary Center Experience

Abstract Purpose This study analyzed the safety of myomectomy during the cesarean section (CS). Methods Pregnant women who underwent myomectomy during CS in a tertiary center between January 2015 and November 2019 were included in the study in Group A, and pregnant women who did not have myoma and who underwent only CS were included in the study in Group B. The following information was obtained from patient files in hospital archives and was then recorded and compared: age, gravidity, parity, gestational week, characteristics of the myomas (i.e., location, size, number, and type), duration of surgery, perioperative complications, need for blood transfusion, preoperative and postoperative hemoglobin (Hb) values, duration of surgery, and hospital stay duration. Results A total of 83 patients underwent CS plus myomectomy (Group A), and 80 patients (without myoma) underwent only CS (Group B). There were no statistically significant differences between the groups in terms of preoperative and postoperative Hb values or blood transfusion rates (p > 0.05). Hospitalization and surgery duration were significantly higher in the group that underwent CS myomectomy (p = 0.001 and p = 0.001, respectively). The mean myoma size was 8.3 ± 4.1 cm in Group A. There was a statistically significant and inverse correlation between the size of the myoma and the delivery week (p = 0.035). There was a statistically significant and positive correlation between the myoma size and hospital stay (p = 0.01). Conclusion Myomectomy during CS is safe and can be applied regardless of the location, size, type, and number of myomas. However, to make myomectomy routine during CS, multi-center studies that include more cases are needed.
Preoperative Depression Influences Outcomes Following Total Ankle Arthroplasty

Introduction Total ankle arthroplasty (TAA) is increasing in incidence. While preoperative depression is known to affect outcomes following other procedures, its effect on outcomes following TAA are unknown. Therefore, the purpose of this study was to investigate this relationship. Methods This is a retrospective cohort study using the Nationwide Readmission Database (NRD). All patients undergoing TAA were included. Two cohorts (those with and without preoperative depression) were created. Logistic regression was then performed to assess the contribution of a preoperative diagnosis of depression on rates of 90-day complications, while controlling for patient demographic and comorbid data. Results Overall, 8047 patients were included, of whom, 11.4% (918) were depressed. Compared to patients without depression, patients with depression had increased odds of the following: nonhome discharge (OR 1.61, 95% CI 1.31-1.98), extended length of stay (>2 days; OR 1.34, 95% CI 1.15-1.57), prosthetic complication (OR 1.39, 95% CI 1.10-1.74), wound complication (OR 1.59, 95% CI 1.11-2.29), prosthetic joint infection (OR 1.82, 95% CI 1.06-3.15), superficial surgical site infection (OR 1.62, 95% CI 1.02-2.58), and medical complication (OR 1.32, 95% CI 1.03-1.68). Discussion Depression in patients undergoing TAA is common and is associated with increased health care utilization and complications following surgery. The modifiability of depression should be investigated with future studies. Levels of Evidence: Prognostic, Level III: Comparative study
Effects of CircRNA-ITCH on proliferation and apoptosis of hepatocellular carcinoma cells through inhibiting Wnt/β-catenin signaling pathway.

PURPOSE To explore the effects of circular ribonucleic acid (circRNA)-E3 ubiquitin protein ligase (ITCH) on the proliferation and apoptosis of hepatocellular carcinoma (HCC) cells and its possible molecular mechanism. METHODS To study the role of circRNA-ITCH in the occurrence and development of HCC. The relative expression level of circRNA-ITCH was detected via quantitative polymerase chain reaction (qPCR) in four kinds of HCC Huh-7, U251, HB611 and SMMC-7721 cell lines, and human normal liver L-02 cell line. Moreover, the effect of overexpression of circRNA-ITCH on the TCF luciferase activity was detected using β-catenin/TCF-responsive luciferase reporter assay. Finally, the influences of overexpression of circRNA-ITCH on the protein levels of β-catenin and Wnt3α and the mRNA levels of c-myc and cyclinD1 were determined using Western blotting and qPCR, respectively. RESULTS Compared with that in human normal liver L-02 cell line, the expression of circRNA-ITCH was significantly down-regulated in HCC Huh-7, U251, HB611 and SMMC-7721 cell lines (p<0.05). According to the results of CCK-8 assay, colony formation assay and flow cytometry, the overexpression of circRNA-ITCH could obviously inhibit cell proliferation, suppress colony formation ability and induce apoptosis (p<0.05). The results of dual-luciferase reporter assay revealed that there was a significant interaction between circRNA-ITCH and miR-7 or miR-214 (p<0.05). CircRNA-ITCH was involved in the regulating of Wnt/β-catenin signal transduction pathway and inhibited the expressions of c-myc and cyclinD1. CONCLUSIONS CircRNA-ITCH affects the proliferation and apoptosis of HCC cells through inhibiting the Wnt/β-catenin signal transduction pathway, thereby exerting a carcinogenic effect in the occurrence and development of HCC. The research results provide a new therapeutic target for HCC.
Appendage regeneration in anamniotes utilizes genes active during larval‐metamorphic stages that have been lost or altered in amniotes: The case for studying lizard tail regeneration

This review elaborates the idea that organ regeneration derives from specific evolutionary histories of vertebrates. Regenerative ability depends on genomic regulation of genes specific to the life‐cycles that have differentially evolved in anamniotes and amniotes. In aquatic environments, where fish and amphibians live, one or multiple metamorphic transitions occur before the adult stage is reached. Each transition involves the destruction and remodeling of larval organs that are replaced with adult organs. After organ injury or loss in adult anamniotes, regeneration uses similar genes and developmental process than those operating during larval growth and metamorphosis. Therefore, the broad presence of regenerative capability across anamniotes is possible because generating new organs is included in their life history at metamorphic stages. Soft hyaluronate‐rich regenerative blastemas grow in submersed or in hydrated environments, that is, essential conditions for regeneration, like during development. In adult anamniotes, the ability to regenerate different organs decreases in comparison to larval stages and becomes limited during aging. Comparisons of genes activated during metamorphosis and regeneration in anamniotes identify key genes unique to these processes, and include thyroid, wnt and non‐coding RNAs developmental pathways. In the terrestrial environment, some genes or developmental pathways for metamorphic transitions were lost during amniote evolution, determining loss of regeneration. Among amniotes, the formation of soft and hydrated blastemas only occurs in lizards, a morphogenetic process that evolved favoring their survival through tail autotomy, leading to a massive although imperfect regeneration of the tail. Deciphering genes activity during lizard tail regeneration would address future attempts to recreate in other amniotes regenerative blastemas that grow into variably completed organs.
Analysis of the clinical characteristics of 202 patients with liver abscess associated with diabetes mellitus and biliary tract disease

Objective Clinical characteristics of patients with pyogenic liver abscess (PLA) of varying etiologies may be different. This study aimed to analyze the clinical characteristics, pathogenic bacteria, treatment, and prognosis of patients with PLA associated with diabetes and biliary disease. Methods Clinical, imaging, and laboratory data from 202 inpatients with PLA were retrospectively analyzed. Results Eighty-eight patients (43.6%) had a history of diabetes, 73 (36.1%) had a history of underlying biliary tract disease, and 24 (11.9%) had both the diseases. The level of C-reactive protein (CRP) increased in 99.2% (119/120) patients, and the level of procalcitonin (PCT) increased in 95.5% (148/155) patients. The main pathogen of PLA was Klebsiella pneumoniae. The incidence of bloodstream infection increased by 34.4% (22/64) in patients with PLA that was associated with diabetes mellitus, and that of K. pneumoniae infection was 88.6% (39/44). The readmission rate for patients with PLA with underlying biliary diseases was 10.2 to 12.5%. Conclusion The main pathogen of PLA is K. pneumoniae, which is sensitive to most antibiotics. Patients with PLA associated with diabetes were more likely to have bloodstream infections, and the recurrence rate of PLA with underlying biliary diseases was higher than without biliary duct disease.
The phenotypic plasticity in Chinese populations of Daphnia similoides sinensis: recurvate helmeted forms are associated with the presence of predators

Morphological species delineation within the cladoceran genus Daphnia is often blurred by phenotypic plasticity, frequently associated with predator presence. We focused on phenotypic variation and genetic relatedness of nine Chinese populations of Daphnia (Ctenodaphnia) similoides sinensis. The typical form of this taxon inhabits fishless pools, a habitat characteristic for most Ctenodaphnia species. However, we demonstrate that D. similoides sinensis also occurs in large lakes where it coexists with multiple predators (planktivorous fish, Cyclops and Leptodora). Individuals from such lakes differ substantially phenotypically (to the extent they have been considered a distinct undescribed species), being significantly smaller and exhibiting prominent recurvate helmets. Genetic variation of D. similoides sinensis, based on mitochondrial cytochrome c oxidase subunit 1 sequences, was low;all Chinese populations studied, regardless of phenotype or environment, apparently recently expanded from a single mitochondrial lineage. This is consistent with other Daphnia species in which body and helmet size are phenotypically plastic traits responding to predator presence. The general phenotype of lake populations of D. similoides sinensis is strikingly similar to North American Daphnia retrocurva, an unrelated species of the subgenus Daphnia. We presume that similar predation pressures in lake habitats triggered convergent evolution of body shapes in both species.
Optimized tool for evaluation of platelet function measured by impedance aggregometry

Abstract Platelet aggregation measured by impedance aggregometry is highly dependent on platelet count. We previously developed a tool to interpret impedance aggregometry based on the strong linear correlation between platelet counts and platelet aggregation at reduced platelet counts. The present study aimed to optimize the tool by expanding the model to include normal platelet counts. We combined data from three previous studies on 266 healthy individuals measuring impedance aggregometry with four agonists (collagen, adenosine diphosphate, thrombin receptor activating peptide-6, and ristocetin). Reduced platelet counts were established in vitro. The investigated platelet counts ranged from 26–425x109/L. A positive linear correlation was found between platelet counts and platelet aggregation across normal and reduced platelet counts (all p-values <0.001). We established 95% prediction intervals for healthy platelet aggregation in relation to platelet count. The new expanded model serves as an optimized tool for evaluation of platelet aggregation at normal and reduced platelet counts.
The Supply-Equity Trade-Off: The Effect of Spatial Representation on the Local Housing Supply

Institutions that structure representation have systematically disadvantaged racial and ethnic minorities in the United States. We examine an understudied dimension of this problem: how local electoral rules shape the provision of collective goods in relation to racial groups. We leverage the California Voting Rights Act of 2001, which compelled over 100 cities to switch from at-large to district elections for city council, to causally identify how equalizing spatial representation changes the permitting of new housing. District elections decrease the supply of new multifamily housing, particularly in segregated cities with sizable and systematically underrepresented minority groups. But district elections also end the disproportionate channeling of new housing into minority neighborhoods. Together, our findings highlight a fundamental trade-off: at-large representation may facilitate the production of goods with diffuse benefits and concentrated costs, but it does so by forcing less politically powerful constituencies to bear the brunt of those costs.
Temporal Trends in the Incidence and Outcomes of Pacemaker Implantation After Transcatheter Aortic Valve Replacement in the United States (2012–2017)

Background Nationwide studies documenting temporal trends in permanent pacemaker implantation (PPMI) following transcatheter aortic valve replacement (TAVR) are limited. Methods and Results We selected patients who underwent TAVR between 2012 and 2017 in the National Readmission Database. The primary end point was the 6‐year trend in post‐TAVR PPMI at index hospitalization and at 30, 90, and 180 days after discharge. The secondary end point was the association between PPMI and in‐hospital mortality, stroke, cost, length of stay, and disposition. Among the 89 202 patients who underwent TAVR, 77 405 (86.8%) with no prior pacemaker or defibrillator were included. Patients who required PPMI had a higher prevalence of atrial fibrillation (43.6% versus 38.7%, P<0.001) and conduction abnormalities (28.4% versus 15.3%, P<0.001). The incidence of PPMI during index admission increased from 8.7% in 2012 to 13.2% in 2015, and then decreased to 9.6% in 2017. The incidence of inpatient PPMI within 30 days after discharge increased from 0.5% in 2012 to 1.25% in 2017 (P trend<0.001). Inpatient PPMI beyond 30 days remained rare (<0.5%) during the study period. After risk adjustment, PPMI was not associated with in‐hospital mortality or stroke but was associated with increased nonhome discharge, longer hospitalization, and higher cost. The incremental expenditure associated with post‐TAVR PPMI during index admission increased from $9.6 million to $72.2 million between 2012 and 2017. Conclusions After an upward trend, rates of PPMI after TAVR in the United States stabilized at ~10% in 2016 to 2017, but there was a notable increase in PPMI within 30 days after the index admission. PPMI was not associated with increased in‐hospital morbidity or mortality but led to longer hospitalization, higher cost, and more nonhome discharges.
The effect of calcitriol and all‐trans retinoic acid on T‐bet, IFN‐γ, GATA3 and IL‐4 genes expression in experimental autoimmune encephalomyelitis

Multiple sclerosis (MS) is an immune‐mediated inflammatory disease which affects the central nervous system (CNS). In the present study, the in vivo effects of ATRA, calcitriol, and their combinations on the expression of murine CD4+ T cell cytokines and their specific transcription factors in experimental autoimmune encephalomyelitis (EAE)‐induced mice were explored. Thirty‐two EAE induced inbred C57BL/6 female mice with an age ranged from 8 to 10 weeks were divided into four categories in a random manner. The first, second, and third groups received ATRA, calcitriol, ATRA+ calcitriol, respectively, and the fourth group received vehicle. The treatment started on the day prior to immunization and through the IP injections every other days for 21 days. The dosages of administration for calcitriol, ATRA, and calcitriol+ ATRA were 100 ng, 250 μg, and 50ng + 125 μg, respectively per mouse. An equal volume of excipient was administered for the vehicle group. T‐bet, IFN‐γ, GATA‐3, and IL‐4 genes expression were assessed in the splenocytes of EAE ‐induced mice. The expression of T‐bet and IFN‐γ genes in the splenocytes of ATRA, calcitriol and combination‐ treated mice were significantly reduced compared to vehicle group (p < 0.05). A significant decrease in T‐bet expression was observed in the combination‐treated group compared to the ATRA‐treated group (p < 0.05). The expression of GATA3 and IL‐4 genes was significantly increased in the ATRA‐, calcitriol‐, and combination‐treated mice when compared with the control group (p < 0.05). Furthermore, the effect of calcitriol alone and in combination with ATRA was more considerable than that of ATRA alone. The nutraceutical approaches may be promising in the prevention and/or treatment of MS.