Miracle-dz/UniFAR-FTUs huggingface dataset:
Perioperative SBP changes during orthopedic surgery in the elderly: clinical implications.

OBJECTIVES We aimed to determine SBP changes during the perioperative period of a scheduled knee surgery under regional anesthesia and the extent of perioperative (in-hospital) white-coat effect. METHODS All patients (aged ≥60 years) underwent clinic SBP measurements during both cardiological and anesthesiological visits, while home SBP the week before admission was obtained. Clinic SBP was registered just before surgery, during surgery and reanimation. Ambulatory monitoring was also performed (12 h before surgery to 6-8 h after surgery). One month after discharge, clinic SBP was measured at hypertension unit. RESULTS Eligible participants (N = 50, mean age 74 ± 7 years, 34% men, 26% with history of cardiovascular disease) had higher SBP during the anesthesiologic than the cardiological evaluation (157 ± 23 vs. 144 ± 18 mmHg, P < 0.001), and the former levels were almost identical to those clinically measured just before surgery. A significant white-coat effect between ambulatory and clinic measurements just before surgery (16.4 ± 21 mmHg, P < 0.001) and between entire ambulatory recording and clinic BP measurements the day before surgery (12.4 ± 16 and 24.8 ± 21 mmHg for cardiologic and anesthesiologic visit, respectively, P < 0.001 for both) was noticed, whereas intraoperatively the white-coat effect faded away. There was a greater SBP decline during surgery in patients aged more than 75 years compared with younger, whereas selective treatment discontinuation (except beta blockers and calcium channel blockers) did not modulate SBP trajectories. CONCLUSION The significant white-coat effect observed in scheduled noncardiac surgery is clinically important and the home BP measurement performed before surgery or ABPM, highly reflects the hypertensive burden of the patient. Blood pressure decrease during surgery is quite pronounced especially in patients aged more than 75 years. Aggressive BP lowering should be avoided.
“Beyond the Boundaries of Care Dependence”

Background Dependence is a common life experience and innate condition for human beings due to their bodily and relational essence, but in contemporary society, it has become a stressful condition. Care dependence is central to nursing, and patients with advanced cancer are often dependent on care. Understanding nurses’ perceptions of care dependence can contribute to awareness of the impact it has on nurses. Objective The aim of this study was to explore palliative care nurses’ experiences and perceptions regarding patient dependence. Methods Sixteen nurses taking care of dependent patients in a palliative care center in Rome were interviewed. Giorgi’s descriptive phenomenological method was used. Results Nurses caring for dependent patients transcend the boundaries of dependence. Care dependence is an experience of powerlessness and regression. A patient’s life in dependence is precarious, as they have to overcome the daily limits of life. Taking care of dependent patients requires nurses to manage the unmanageable and to know and to embrace change from within in order to build positive relations of personal closeness and reciprocal self-giving. Conclusions Nurses should be aware that self-transcendence and the consequent positive relations could make the difference in the experience of care dependence and promote personal growth for both patient and nurse. Positive and transcending relationships can transform care dependence into the opportunity to find meaning and purpose in life. Implications for Practice The study highlights what nurses feel in caring for dependent patients. Understanding nurses’ perceptions is important to delineate a proper caring for dependent patients.
Assessment of Cas12a‐mediated gene editing efficiency in plants

Summary The CRISPR/Cas12a editing system opens new possibilities for plant genome engineering. To obtain a comparative assessment of RNA‐guided endonuclease (RGEN) types in plants, we adapted the CRISPR/Cas12a system to the GoldenBraid (GB) modular cloning platform and compared the efficiency of Acidaminococcus (As) and Lachnospiraceae (Lb) Cas12a variants with the previously described GB‐assembled Streptococcus pyogenes Cas9 (SpCas9) constructs in eight Nicotiana benthamiana loci using transient expression. All three nucleases showed drastic target‐dependent differences in efficiency, with LbCas12 producing higher mutagenesis rates in five of the eight loci assayed, as estimated with the T7E1 endonuclease assay. Attempts to engineer crRNA direct repeat (DR) had little effect improving on‐target efficiency for AsCas12a and resulted deleterious in the case of LbCas12a. To complete the assessment of Cas12a activity, we carried out genome editing experiments in three different model plants, namely N. benthamiana, Solanum lycopersicum and Arabidopsis thaliana. For the latter, we also resequenced Cas12a‐free segregating T2 lines to assess possible off‐target effects. Our results showed that the mutagenesis footprint of Cas12a is enriched in deletions of −10 to −2 nucleotides and included in some instances complex rearrangements in the surroundings of the target sites. We found no evidence of off‐target mutations neither in related sequences nor somewhere else in the genome. Collectively, this study shows that LbCas12a is a viable alternative to SpCas9 for plant genome engineering.
The Use of Wearable Activity Trackers Among Older Adults: Focus Group Study of Tracker Perceptions, Motivators, and Barriers in the Maintenance Stage of Behavior Change

Background Wearable activity trackers offer the opportunity to increase physical activity through continuous monitoring. Viewing tracker use as a beneficial health behavior, we explored the factors that facilitate and hinder long-term activity tracker use, applying the transtheoretical model of behavior change with the focus on the maintenance stage and relapse. Objective The aim of this study was to investigate older adults’ perceptions and uses of activity trackers at different points of use: from nonuse and short-term use to long-term use and abandoned use to determine the factors to maintain tracker use and prevent users from discontinuing tracker usage. Methods Data for the research come from 10 focus groups. Of them, 4 focus groups included participants who had never used activity trackers (n=17). These focus groups included an activity tracker trial. The other 6 focus groups (without the activity tracker trial) were conducted with short-term (n=9), long-term (n=11), and former tracker users (n=11; 2 focus groups per user type). Results The results revealed that older adults in different tracker use stages liked and wished for different tracker features, with long-term users (users in the maintenance stage) being the most diverse and sophisticated users of the technology. Long-term users had developed a habit of tracker use whereas other participants made an effort to employ various encouragement strategies to ensure behavior maintenance. Social support through collaboration was the primary motivator for long-term users to maintain activity tracker use. Short-term and former users focused on competition, and nonusers engaged in vicarious tracker use experiences. Former users, or those who relapsed by abandoning their trackers, indicated that activity tracker use was fueled by curiosity in quantifying daily physical activity rather than the desire to increase physical activity. Long-term users saw a greater range of pros in activity tracker use whereas others focused on the cons of this behavior. Conclusions The results suggest that activity trackers may be an effective technology to encourage physical activity among older adults, especially those who have never tried it. However, initial positive response to tracker use does not guarantee tracker use maintenance. Maintenance depends on recognizing the long-term benefits of tracker use, social support, and internal motivation. Nonadoption and relapse may occur because of technology’s limitations and gaining awareness of one’s physical activity without changing the physical activity level itself.
Afferent neuropeptide Y projections to the ventral tegmental area in normal‐weight male Wistar rats

The hypothalamic neuropeptide Y (NPY) circuitry is a key regulator of feeding behavior. NPY also acts in the mesolimbic dopaminergic circuitry, where it can increase motivational aspects of feeding behavior through effects on dopamine output in the nucleus accumbens (NAc) and on neurotransmission in the ventral tegmental area (VTA). Endogenous NPY in the NAc originates from local interneurons and afferent projections from the hypothalamic arcuate nucleus (Arc). However, the origin of endogenous NPY in the VTA is unknown. We determined, in normal‐weight male Wistar rats, if the source of VTA NPY is local, and/or whether it is derived from VTA‐projecting neurons. Immunocytochemistry, in situ hybridization and RT‐qPCR were utilized, when appropriate in combination with colchicine treatment or 24 hr fasting, to assess NPY/Npy expression locally in the VTA. Retrograde tracing using cholera toxin beta (CTB) in the VTA, fluorescent immunocytochemistry and confocal microscopy were used to determine NPY‐immunoreactive afferents to the VTA. NPY in the VTA was observed in fibers, but not following colchicine pretreatment. No NPY‐ or Npy‐expressing cell bodies were observed in the VTA. Fasting for 24 hr, which increased Npy expression in the Arc, failed to induce Npy expression in the VTA. Double‐labeling with CTB and NPY was observed in the Arc and in the ventrolateral medulla. Thus, VTA NPY originates from the hypothalamic Arc and the ventrolateral medulla of the brainstem in normal‐weight male Wistar rats. These afferent connections link hypothalamic and brainstem processing of physiologic state to VTA‐driven motivational behavior.
How Replicable Are Links Between Personality Traits and Consequential Life Outcomes? The Life Outcomes of Personality Replication Project

The Big Five personality traits have been linked to dozens of life outcomes. However, metascientific research has raised questions about the replicability of behavioral science. The Life Outcomes of Personality Replication (LOOPR) Project was therefore conducted to estimate the replicability of the personality-outcome literature. Specifically, I conducted preregistered, high-powered (median N = 1,504) replications of 78 previously published trait–outcome associations. Overall, 87% of the replication attempts were statistically significant in the expected direction. The replication effects were typically 77% as strong as the corresponding original effects, which represents a significant decline in effect size. The replicability of individual effects was predicted by the effect size and design of the original study, as well as the sample size and statistical power of the replication. These results indicate that the personality-outcome literature provides a reasonably accurate map of trait–outcome associations but also that it stands to benefit from efforts to improve replicability.
Domain‐specific distribution of gap junctions defines cellular coupling to establish a vascular relay in the retina

In the retina, diverse functions of neuronal gap junctions (GJs) have been established. However, the distribution and function of vascular GJs are less clear. Here in the mouse retina whole mounts, we combined structural immunohistochemical analysis and a functional assessment of cellular coupling with a GJ‐permeable tracer Neurobiotin to determine distribution patterns of three major vascular connexins. We found that Cx43 was expressed in punctate fashion on astroglia, surrounding all types of blood vessels and in continuous string‐like structures along endothelial cell contacts in specialized regions of the vascular tree. Specifically, these Cx43‐positive strings originated at the finest capillaries and extended toward the feeding artery. As this structural arrangement promoted strong and exclusive coupling of pericytes and endothelial cells along the corresponding branch, we termed this region a “vascular relay. ” Cx40 expression was found predominantly along the endothelial cell contacts of the primary arteries and did not overlap with Cx43‐positive strings. At their occupied territories, Cx43 and Cx40 clustered with tight junctions and, to a lesser extent, with adhesion contacts, both key elements of the blood–retina barrier. Finally, Cx37 puncta were associated with the entire surface of both mural and endothelial cells across all regions of the vascular tree. This combinatorial analysis of vascular connexins and identification of the vascular relay region will serve as a structural foundation for future studies of neurovascular signaling in health and disease.
Cardiovascular Disease Risk Factors and Myocardial Infarction in the Transgender Population

Background: As of 2016, ≈1.4 million people in the United States identify as transgender. Despite their growing number and increasing specific medical needs, there has been a lack of research on cardiovascular disease (CVD) and CVD risk factors in this population. Recent studies have reported that the transgender population had a significantly higher rate of CVD risk factors without a significant increase in overall CVD morbidity and mortality. These studies are limited by their small sample sizes and their predominant focus on younger transgender populations. With a larger sample size and inclusion of broader age range, our study aims to provide insight into the association between being transgender and cardiovascular risk factors, as well as myocardial infarction. Methods and Results: The Behavioral Risk Factor Surveillance System data from 2014 to 2017 were used to evaluate the cross-sectional association between being transgender and the reported history of myocardial infarction and CVD risk factors. A logistic regression model was constructed to study the association between being transgender and myocardial infarction after adjusting for CVD risk factors including age, diabetes mellitus, hypertension, hypercholesterolemia, chronic kidney disease, smoking, and exercise. Multivariable analysis revealed that transgender men had a >2-fold and 4-fold increase in the rate of myocardial infarction compared with cisgender men (odds ratio, 2.53; 95% CI, 1.14–5.63; P=0.02) and cisgender women (odds ratio, 4.90; 95% CI, 2.21–10.90; P<0.01), respectively. Conversely, transgender women had >2-fold increase in the rate of myocardial infarction compared with cisgender women (odds ratio, 2.56; 95% CI, 1.78–3.68; P<0.01) but did not have a significant increase in the rate of myocardial infarction compared with cisgender men. Conclusions: The transgender population had a higher reported history of myocardial infarction in comparison to the cisgender population, except for transgender women compared with cisgender men, even after adjusting for cardiovascular risk factors.
Dynamic interpersonal neural synchronization underlying pain‐induced cooperation in females

Individuals in pain are motivated to be cooperative in social interaction. Yet, there has been little research on how pain dynamically affects cooperation at a neural level. The present study investigated the cooperative behavior under acute physical pain by asking dyads to complete three blocks of button‐press cooperative task, while neural activities were recorded simultaneously on each subject by the fNIRS‐based hyperscanning. Results showed that individuals in pain improved their cooperation rate across task blocks. Accordingly, increased interpersonal neural synchronization (INS) was found at the left prefrontal cortex in second block, whereas increased INS was found at the right prefrontal cortex and the right parietal cortex in third block compared to the first block. Moreover, the change of INS in right parietal cortex was positively correlated with subjective pain rating in the pain treatment group. In addition, dynamic interpersonal neural networks were identified in painful condition with increasing frontoparietal networks across time. By uncovering dissociative neural processes involved in how pain affects cooperation in social interaction, the present work provides the first interbrain evidence to highlight the sociality of pain on social interaction in perspective of motivational aspect of pain.
Musculoskeletal disorders and occupational demands in nurses at a tertiary care hospital in Mexico City.

OBJECTIVE Identify the association between working conditions, musculoskeletal symptoms and ergonomic demands on nurses. BACKGROUND The physical demands of nursing often require repetitive and forced movements that increase the likelihood of developing musculoskeletal disorders, which are the main occupational diseases in this working population. METHODOLOGY Cross-sectional study of 329 nurses chosen at random. Initial symptoms of musculoskeletal disorders (MSDs) were evaluated using Kuorinka's Nordic questionnaire; occupational demands and domestic activities were evaluated using the Individual Survey for Workers' Health, PROESSAT. Logistic regression models were fit to identify associations between musculoskeletal symptoms and occupational activities. RESULTS A prevalence of 87% and 83% of musculoskeletal disorders was found in the neck and dorsal/lumbar regions, respectively. Using logistic models, associations were identified between ergonomic requirements, exposure time, domestic work, supervision and discomfort in various regions of the body. CONCLUSIONS Postural demands are closely associated with the development of musculoskeletal disorders. Early identification and timely intervention are fundamental. IMPLICATIONS FOR NURSING MANAGEMENT Musculoskeletal disorders are very common among nurses and are closely associated with occupational tasks.
Association of P wave peak time with left ventricular end‐diastolic pressure in patients with hypertension

Left ventricular diastolic dysfunction (LVDD) is commonly seen in hypertensive patients, and it is associated with increased morbidity and mortality. Hence, the detection of LVDD with a simple, inexpensive, and easy‐to‐obtain method can contribute to improving patient prognosis. Therefore, we aimed to evaluate whether there was any association between the electrocardiographic P wave peak time (PWPT) and invasively measured left ventricular end‐diastolic pressure (LVEDP) in hypertensive patients who had undergone coronary angiography following preliminary diagnosis of coronary artery disease. A total of 78 patients were included in this cross‐sectional study. The PWPT was defined as the time from the beginning of the P wave to its peak, and it was calculated from the leads DII and VI. In all patients, LVEDP was measured in steady state. The PWPT in lead DII was significantly longer in patients with high LVEDP; however, there was no significant difference between groups in terms of PWPT in the lead VI. In multivariable analysis, PWPT in lead DII was found to be independent predictor of increased LVEDP (OR: 1.257, 95% CI: 1.094‐1.445; P = 0.001). In receiver operating characteristic curve analysis, the optimal cut‐off value of PWPT in the lead DII for prediction of elevated LVEDP was 64.8 ms, with a sensitivity of 68.7% and a specificity of 91.3% (area under curve: 0.882, 95% CI: 0.789‐0.944, P < 0.001). In conclusion, this study result suggested that prolonged PWPT in the lead DII may be an independent predictor of increased LVEDP among hypertensive patients.
Distribution, diversity and functional dissociation of the mac genes in marine biofilms

Abstract Bacteria produce metamorphosis-associated contractile (MAC) structures to induce larval metamorphosis in Hydroides elegans. The distribution and diversity of mac gene homologs in marine environments are largely unexplored. In the present study mac genes were examined in marine environments by analyzing 101 biofilm and 91 seawater metagenomes. There were more mac genes in biofilms than in seawater, and substratum type, location, or sampling time did not affect the mac genes in biofilms. The mac gene clusters were highly diverse and often incomplete while the three MAC components co-occurred with other genes of different functions. Genomic analysis of four Pseudoalteromonas and two Streptomyces strains revealed the mac genes transfers among different microbial taxa. It is proposed that mac genes are more specific to biofilms; gene transfer among different microbial taxa has led to highly diverse mac gene clusters; and in most cases, the three MAC components function individually rather than forming a complex.
Ankle brachial index (ABI) in a cohort of older women in the Philippines: Prevalence of peripheral artery disease and predictors of ABI

Cardiovascular disease (CVD) is rising in low and middle‐income countries, but studies of CVD epidemiology in such settings often focus on risk factors rather than measures of disease progression. Here we use the ankle brachial index (ABI) to assess the prevalence of peripheral artery disease (PAD) among older women living in Metropolitan Cebu, Philippines, and relationships between ABI and CVD risk factors and body composition.
Association of the Usability of Electronic Health Records With Cognitive Workload and Performance Levels Among Physicians

Key Points Question Is enhanced usability of an electronic health record system associated with physician cognitive workload and performance? Findings In this quality improvement study, physicians allocated to perform tasks in an electronic health record system with enhancement demonstrated statistically significantly lower cognitive workload; those who used a system with enhanced longitudinal tracking appropriately managed statistically significantly more abnormal test results compared with physicians allocated to use the baseline electronic health record. Meaning Usability improvements in electronic health records appear to be associated with improved cognitive workload and performance levels among clinicians; this finding suggests that next-generation systems should strip away non–value-added interactions.
Monte Carlo simulation-based probabilistic health risk assessment of metals in groundwater via ingestion pathway in the mining areas of Singhbhum copper belt, India

ABSTRACT Probabilistic health risk assessment was conducted for metal exposure through groundwater in mining areas of Singhbhum Copper Belt, India. The concentrations of metals showed notable spatial variation exceeding drinking water standards at some of the locations. Hazard Quotient revealed that chronic risks to the local population were largely contributed by Mn, Co and As. The 95th percentiles of Hazard Index (HI) calculated using Monte Carlo simulations showed that the HI for male, female and child populations was 2.87, 2.54 and 4.57 for pre-monsoon, 2.16, 1.88 and 3.49 for monsoon and 2.28, 2.02 and 3.75 for post-monsoon seasons, respectively. The Hazard Indices indicated that amongst the populations, risk was greater for child population and considering the seasons the risk was higher during the pre-monsoon season. The sensitivity analysis suggested that concentration of metals in groundwater and exposure duration were 2 most influential input variables that contributed to the total risk.