Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of conscious sedation and general anesthesia on periprocedural outcomes in Watchman left atrial appendage closure

Background Transcatheter left atrial appendage closure (LAAC) is performed either in conscious sedation (CS) or general anesthesia (GA), and limited data exist regarding clinical outcomes for the two approaches. The aim of the study was to analyze the effect of CS versus GA on acute outcomes in a large patient cohort undergoing LAAC with a Watchman occluder. Methods A cohort of 521 consecutive patients underwent LAAC with Watchman occluders at two centers (REGIOMED hospitals, Germany) between 2012 and 2018. One site performed 303 consecutive LAAC procedures in GA, and the other site performed 218 consecutive procedures in CS. The safety endpoint was a composite of major periprocedural complications and postoperative pneumonia. The efficacy endpoint was defined as device success. Results After a 1:1 propensity score matching, 196 (CS) vs. 115 (GA) patients could be compared. In 5 (2.6%) cases CS was converted to GA. The primary safety endpoint (3.5% [CS] vs. 7.0% [GA], p = 0.18) and its components (major periprocedural complications: 2.5% vs. 3.5%, p = 0.73; postoperative pneumonia: 2.6% vs. 4.3%, p = 0.51) did not differ between the groups. Also, device success was comparable (96.9% vs. 93.9%, p = 0.24). Conclusions In patients undergoing LAAC with the Watchman device, conscious sedation and general anesthesia showed comparable device success rates and safety outcomes. The type of anesthesia for LAAC may therefore be tailored to patient comorbidities, operator experience, and hospital logistics.
Evaluation of adolescent and adult patients treated with the Carriere Motion Class III appliance followed by fixed appliances.

OBJECTIVES To determine dentoalveolar and skeletal effects produced in mature patients by the Carriere Motion Class III (CM3) appliance followed by fixed appliances. MATERIALS AND METHODS This retrospective study evaluated 32 patients at three time points: T1 (initial), T2 (removal of CM3), and T3 (posttreatment). Serial cephalograms were traced and digitized, and best-fit regional superimpositions were constructed. Eleven linear and 7 angular variables were measured. The starting forms of the CM3 patients were compared with a sample of untreated subjects with normal occlusions and well-balanced faces. RESULTS The CM3 phase lasted 6.3 months, followed by a phase of fixed appliances lasting 12.9 months; the total duration of treatment was 19.2 months. Minimal skeletal changes were measured sagittally, with only a slight increase in lower anterior facial height observed during treatment. Most treatment changes were dentoalveolar in nature. Wits appraisal increased 4.0 mm during treatment. The molar relationship improved by 6.0 mm during phase I, a value that rebounded slightly during phase II, resulting in an improvement toward Class I of 4.8 mm. Best-fit regional superimpositions revealed anterior movement of upper molars relative to the maxilla and posterior movement of lower molars relative to the mandible. CONCLUSIONS The Carriere Motion Class III appliance is an effective and efficient method of resolving occlusal problems in minimally growing Class III patients. Primary treatment effects are dentoalveolar in nature with minimal skeletal alterations.
Artificial Caries Lesion Characteristics after Secondary Demineralization with Theobromine-Containing Protocol

Developing artificial caries lesions with varying characteristics is needed to adequately study caries process in vitro. The objective of this study was to investigate artificial caries lesion characteristics after secondary demineralization protocol containing theobromine and fluoride. Sixty bovine enamel slabs (4 × 3 mm) were demineralized using a Carbopol-containing protocol for 6 days. A baseline area (2 × 3 mm) was protected with acid-resistant nail varnish, after which specimens were exposed for 24 h to a secondary demineralization protocol containing acetic acid plus one of four fluoride/theobromine combinations (n = 15): theobromine (50 or 200 ppm) and fluoride (0 or 1 ppm). Specimens were sectioned and analyzed using transverse microradiography for changes in mineral content, lesion depth, and surface layer mineralization. Data was analyzed using paired t-test and analysis of variance followed by Bonferroni test at 0.05 significance level. After secondary demineralization, fluoride-containing groups had significantly deeper lesions (p = 0.002 and 0.014) compared to the group with 0 ppm fluoride and 50 ppm theobromine. Mineral content and lesion depth were significantly different compared to baseline for all groups. Theobromine did not show an added effect on mineral uptake. Theobromine-containing groups exhibited particularly deep lesions with a more uniform mineral profile in the presence of fluoride.
What science tells us about false and repressed memories

ABSTRACT What does science tell us about memory phenomena such as false and repressed memories? This issue is highly pressing as incorrect knowledge about these memory phenomena might contribute to egregious effects in the courtroom such as false accusations of abuse. In the current article, we provide a succinct review of the scientific nature of false and repressed memories. We demonstrate that research has shown that about 30% of tested subjects formed false memories of autobiographical experiences. Furthermore, this empirical work has also revealed that such false memories can even be implanted for negative events and events that allegedly occurred repeatedly. Concerning the controversial topic of repressed memories, we show that plausible alternative explanations exist for why people claim to have forgotten traumatic experiences; explanations that do not require special memory mechanisms such as the unconscious blockage of traumatic memories. Finally, we demonstrate that people continue to believe that unconscious repression of traumatic incidents can exist. Disseminating scientifically articulated knowledge on the functioning of memory to contexts such as the courtroom is necessary as to prevent the occurrence of false accusations and miscarriages of justice.
Conservation and Loss of a Putative Iron Utilization Gene Cluster among Genotypes of Aspergillus flavus

Iron is an essential component for growth and development. Despite relative abundance in the environment, bioavailability of iron is limited due to oxidation by atmospheric oxygen into insoluble ferric iron. Filamentous fungi have developed diverse pathways to uptake and use iron. In the current study, a putative iron utilization gene cluster (IUC) in Aspergillus flavus was identified and characterized. Gene analyses indicate A. flavus may use reductive as well as siderophore-mediated iron uptake and utilization pathways. The ferroxidation and iron permeation process, in which iron transport depends on the coupling of these two activities, mediates the reductive pathway. The IUC identified in this work includes six genes and is located in a highly polymorphic region of the genome. Diversity among A. flavus genotypes is manifested in the structure of the IUC, which ranged from complete deletion to a region disabled by multiple indels. Molecular profiling of A. flavus populations suggests lineage-specific loss of IUC. The observed variation among A. flavus genotypes in iron utilization and the lineage-specific loss of the iron utilization genes in several A. flavus clonal lineages provide insight on evolution of iron acquisition and utilization within Aspergillus section Flavi. The potential divergence in capacity to acquire iron should be taken into account when selecting A. flavus active ingredients for biocontrol in niches where climate change may alter iron availability.
High-resolution mapping of the neutralizing and binding specificities of polyclonal sera post-HIV Env trimer vaccination

Mapping polyclonal serum responses is critical to rational vaccine design. However, most high-resolution mapping approaches involve isolating and characterizing individual antibodies, which incompletely defines the polyclonal response. Here we use two complementary approaches to directly map the specificities of the neutralizing and binding antibodies of polyclonal anti-HIV-1 sera from rabbits immunized with BG505 Env SOSIP trimers. We used mutational antigenic profiling to determine how all mutations in Env affected viral neutralization and electron microscopy polyclonal epitope mapping (EMPEM) to directly visualize serum Fabs bound to Env trimers. The dominant neutralizing specificities were generally only a subset of the more diverse binding specificities. Additional differences between binding and neutralization reflected antigenicity differences between virus and soluble Env trimer. Furthermore, we refined residue-level epitope specificity directly from sera, revealing subtle differences across sera. Together, mutational antigenic profiling and EMPEM yield a holistic view of the binding and neutralizing specificity of polyclonal sera.
A Tracheal Intubation Checklist: Curb Your Enthusiasm.

Bundles and checklists are aimed at promoting best practices and reducing the occurrence of adverse events. They are collections of activities and actions, each with or without objective evidence of effectiveness, that, when used together, are anticipated to improve care. Hopefully, their utilization will make healthcare safer and improve outcomes. They are most applicable to simple or even complicated tasks that can be broken down into segments that can be managed piece by piece (1). Well-known examples include surgical checklists, ventilator bundles, and the sepsis and central line bundles. Effectiveness studies of bundles and checklists are usually conducted in the context of quality improvement (QI) activities. Unfortunately, QI effectiveness studies often do not have the standards for rigorous design and analysis as other medical intervention studies, even though the need for this rigor has been argued and standards for QI and reporting excellence have been advanced (2–5). Criticisms of QI studies, especially notable when multiple studies are used to assess effectiveness, include heterogeneity of subjects, inconsistent definitions of the intervention and outcomes, statistical analysis, and accounting for confounding variables such as cointerventions that may vary in different care environments (2, 3, 5). Tracheal intubation in children outside of the operating room is a potentially hazardous event. To characterize the process and assess the safety of tracheal intubation procedures across a diverse spectrum of PICUs, the Pediatric Acute Lung Injury and Sepsis Investigators network adopted and modified the National Emergency Airway Registry (NEAR) tools creating National Emergency Airway Registry for Children (NEAR4KIDS), a national airway registry for children (6). This organization has been exceptionally productive in collecting, analyzing, and publishing data concerning tracheal intubations. Using their airway registry, tracheal intubation adverse events (TIAEs) are classified as nonsevere (mainstem bronchial intubation, esophageal intubation with immediate recognition, emesis without aspiration, hypertension requiring treatment, epistaxis, dental/lip trauma, medication error, dysrhythmia, and pain/agitation delaying the procedure) and severe (cardiac arrests, esophageal intubation with delayed recognition, emesis with aspiration, hypotension, laryngospasm, and pneumothorax/pneumomediastinum). In addition, they separately track oxygen desaturations and intubations requiring multiple (≥ 3) attempts. In North America, their data estimated that TIAEs occur in 14.4% of intubations, severe TAIEs occur in 5.5% of intubations, oxygen desaturations less than 80% in 17.4%, and multiple attempts in 10.7% (7). Pediatric patients at nonspecialist centers experienced a serious TAIEs more than twice as often as these PICUs (8). Murray M. Pollack, MD, MCCM A Tracheal Intubation Checklist: Curb Your Enthusiasm*
Probing the Binding Requirements of Modified Nucleosides with the DNA Nuclease SNM1A

SNM1A is a nuclease that is implicated in DNA interstrand crosslink repair and, as such, its inhibition is of interest for overcoming resistance to chemotherapeutic crosslinking agents. However, the number and identity of the metal ion(s) in the active site of SNM1A are still unconfirmed, and only a limited number of inhibitors have been reported to date. Herein, we report the synthesis and evaluation of a family of malonate-based modified nucleosides to investigate the optimal positioning of metal-binding groups in nucleoside-derived inhibitors for SNM1A. These compounds include ester, carboxylate and hydroxamic acid malonate derivatives which were installed in the 5′-position or 3′-position of thymidine or as a linkage between two nucleosides. Evaluation as inhibitors of recombinant SNM1A showed that nine of the twelve compounds tested had an inhibitory effect at 1 mM concentration. The most potent compound contains a hydroxamic acid malonate group at the 5′-position. Overall, our studies advance the understanding of requirements for nucleoside-derived inhibitors for SNM1A and indicate that groups containing a negatively charged group in close proximity to a metal chelator, such as hydroxamic acid malonates, are promising structures in the design of inhibitors.
News Attention and Social-Distancing Behavior Amid COVID-19: How Media Trust and Social Norms Moderate a Mediated Relationship

ABSTRACT Despite the fact that social distancing is an effective mean to slow the spread of COVID-19, individuals often fail to practice this behavior. Major US news media provided information to the public about social distancing after COVID-19 was declared a pandemic, potentially spurring this preventative health practice. Using data from a representative sample of US residents, this study aims to understand the relationship between news media attention and social-distancing behavior via three potential mediators: perceived effectiveness of social distancing, perceived susceptibility to COVID-19 infection, and perceived negative consequences of infection. Media trust and social norms concerning social distancing were included as potential moderators of these relationships, along with political ideology. With multiple regression and mediation analyses, we found that news media attention was positively associated with social-distancing behavior during this period. Perceived effectiveness of social distancing mediated this relationship, while perceived susceptibility and negative consequences of COVID-19 did not. Notably, media trust negatively moderated news attention’s impact on the perceived effectiveness of social distancing, with the relationship being more pronounced among those who have lower trust in media. Political ideology did not moderate the relationship between news attention and perceived effectiveness. Further, social norms negatively moderated the relationship between perceived effectiveness and social-distancing behavior, with this relationship growing stronger among those uncertain about the adoption of social-distancing norms in their circle. Overall, the study found news media to have an important role in promoting social-distancing behavior when they emphasized safety measures across the ideological spectrum.
In Vitro Human Skin Penetration, Antioxidant and Antimicrobial Activity of Ethanol-Water Extract of Fireweed (Epilobium angustifolium L.)

Epilobium angustifolium L. is applied as an antiseptic agent in the treatment of skin diseases. However, there is a lack of information on human skin penetration of active ingredients with antioxidative potential. It seems crucial because bacterial infections of skin and subcutaneous tissue are common and partly depend on oxidative stress. Therefore, we evaluated in vitro human skin penetration of fireweed ethanol-water extracts (FEEs) by determining antioxidant activity of these extracts before and after penetration study using 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and Folin–Ciocalteu methods. Microbiological tests of extracts were done. The qualitative and quantitative evaluation was performed using gas chromatography-mass spectrometry (GC-MS) and high-performance liquid chromatography (HPLC-UV) methods. The in vitro human skin penetration using the Franz diffusion chamber was assessed. The high antioxidant activity of FEEs was found. Gallic acid (GA), chlorogenic acid (ChA), 3,4-dihydroxybenzoic acid (3,4-DHB), 4-hydroxybenzoic acid (4-HB), and caffeic acid (CA) were identified in the extracts. The antibacterial activities were found against Serratia lutea, S. marcescens, Bacillus subtilis, B. pseudomycoides, and B. thuringiensis and next Enterococcus faecalis, E. faecium, Streptococcus pneumoniae, Pseudomonas aeruginosa, and P. fluorescens strains. In vitro penetration studies showed the penetration of some phenolic acids and their accumulation in the skin. Our results confirm the importance of skin penetration studies to guarantee the efficacy of formulations containing E. angustifolium extracts.
Management of Acute Type A Aortic Dissection at a Public Cardiac Center in the Northeast Region of Brazil

Introduction Aortic diseases are among the most serious cardiovascular diseases; the overall mortality rate due to diseases such as aneurysms and aortic dissections has been estimated at 2.78 per 100,000 persons in 2010, with a higher mortality rate in men than women. Our objective was to evaluate the epidemiological profile of patients with acute type A aortic dissection at a cardiology referral center. Methods A retrospective cross-sectional study was performed at a public cardiac center with 24 patients hospitalized from 1/1/2016 to 12/31/2017 with a confirmed diagnosis of acute type A aortic dissection. Results Twenty (83.3%) out of 24 patients underwent surgery and four (16.7%) did not undergo surgery. Among those who underwent surgery, 10 (50%) died and 10 (50%) were discharged, and all non-operated patients died (P=0.114) (Fisher's exact test). The male gender predominated (n=19, 79.2%), 86.7% (n=13) of the patients presented body mass index > 25 kg/m2, chest pain was found in 91.7% (n=22), and renal failure was present in 45.8% (n=11) of the cases. Hypertension predominated in 91.7% (n=22) and the main exam was aortic angiotomography in 79.2% (n=19) of the cases. Conclusion The study presented a small sample size, making it impossible to associate the factors, although the service was considered a high-volume referral center. It is possible that the delay in arriving at the service and the accomplishment of invasive imaging with the use of contrast agents have aggravated the patients’ condition and have been decisive for the increase in lethality, which requires further studies.
Transient Structures of PdO during CO Oxidation over Pd(100)

In situ high-energy surface X-ray diffraction was employed to determine the surface structure dynamics of a Pd(100) single crystal surface acting as a model catalyst to promote CO oxidation. The measurements were performed under semirealistic conditions, i.e., 100 mbar total gas pressure and 600 K sample temperature. The surface structure was studied in detail both in a steady gas flow and in a gradually changing gas composition with a time resolution of 0.5 s. The experimental technique allows for rapid reciprocal space mapping providing the complete information on structural changes of a surface with unprecedented time resolution in harsh conditions. Our results show that the (√5 × √5)R27°-PdO(101) surface oxide forms in a close to stoichiometric O2 and CO gas mixture as the mass spectrometry indicates a transition to a highly active state with the reaction rate limited by the CO mass transfer to the Pd(100) surface. Using a low excess of O2 in the gas stoichiometry, islands of bulk oxide grow epitaxial.
A comprehensive epigenome atlas reveals DNA methylation regulating skeletal muscle development

Abstract DNA methylation is important for the epigenetic regulation of gene expression and plays a critical role in mammalian development. However, the dynamic regulation of genome-wide DNA methylation in skeletal muscle development remains largely unknown. Here, we generated the first single-base resolution DNA methylome and transcriptome maps of porcine skeletal muscle across 27 developmental stages. The overall methylation level decreased from the embryo to the adult, which was highly correlated with the downregulated expression of DNMT1 and an increase in partially methylated domains. Notably, we identified over 40 000 developmentally differentially methylated CpGs (dDMCs) that reconstitute the developmental trajectory of skeletal muscle and associate with muscle developmental genes and transcription factors (TFs). The dDMCs were significantly under-represented in promoter regulatory regions but strongly enriched as enhancer histone markers and in chromatin-accessible regions. Integrative analysis revealed the negative regulation of both promoter and gene body methylation in genes associated with muscle contraction and insulin signaling during skeletal muscle development. Mechanistically, DNA methylation affected the expression of muscle-related genes by modulating the accessibly of upstream myogenesis TF binding, indicating the involvement of the DNA methylation/SP1/IGF2BP3 axis in skeletal myogenesis. Our results highlight the function and regulation of dynamic DNA methylation in skeletal muscle development.
Needs Assessment for Eosinophilic Esophagitis Education in School Nurses

Over the past 2 decades, eosinophilic esophagitis (EoE) has become increasingly recognized as a common cause of gastrointestinal morbidity in children. A mainstay of treatment is food avoidance, which must be implemented in both the home and school settings for school-aged children. The aim of this study is to assess school nurses’ familiarity with EoE with regard to food avoidance and treatment in the school setting. We conducted a 19-question online survey of 60 school nurses (elementary through high school) recruited from Dauphin, Lebanon, and Lancaster Counties in Pennsylvania. Results indicated that 62% of respondents were familiar with EoE. However, only 22% felt comfortable distinguishing between symptoms of EoE and food-dependent anaphylaxis. Almost all respondents (97%) were interested in learning more about EoE. We report significantly increased familiarity with food-dependent anaphylaxis in comparison with EoE among school nurses. There is an interest and need for increasing education on EoE.
Immunoaffinity column/hplc determination of aflatoxin m1 in milk

Aflatoxin M1 was selectively bound to a monoclonal antibody immobilized to an affinity column. After washing the column free of the milk matrix with 2 volumes of 10% MeOH in H2O, the aflatoxin was eluted with 1 ml of MeOH. The eluate was subjected to high‐pressure liquid chromatography (HPLC) using a reverse‐phase column and fluorimetric detection. The detection limit was 50–100 ng l‐1 of M1 in milk. The method was tested with two different batches of affinity columns at a spiking level of 300 ng l‐1 in milk, and showed recoveries of 98.7 and 79.3% and repeatabilities of 8.8 and 5.8% respectively. However, the method was found to be more reproducible when columns from the same batch were used (spiking levels 50 and 100 ng l‐1). The detection limit could be further lowered to 10 ng l‐1 by concentrating the eluate from the column. The results at low spiking levels ( ≤ 700 ng l‐1) showed that although the recoveries were low, the repeatability was satisfactory enough to allow the implementation of the method.