Miracle-dz/UniFAR-FTUs huggingface dataset:
Optimal strategy for delirium detection in older patients admitted to intensive care unit after non-cardiac surgery

Background Delirium detection is challenging due to the fluctuating nature and frequent hypoactive presentation. This study aimed to determine an optimal strategy that detects delirium with higher sensitivity but lower effort in older patients admitted to the intensive care unit (ICU) after surgery. Methods This was a secondary analysis of the database from a randomized trial. Seven hundred older patients (aged ≥65 years) who were admitted to the ICU after elective noncardiac surgery were enrolled. Delirium was assessed with the Confusion Assessment Method for the ICU (CAM-ICU) twice daily during the first 7 days postoperatively. The sensitivity of different strategies in detecting delirium were analyzed and compared. Results Of all enrolled patients, 111 (15.9%; 95% CI: 13.3% to 18.8%) developed at least one episode of delirium during the first 7 postoperative days. Among patients who developed delirium, 60.4% (67/111) had their first delirium onset on postoperative day 1, 84.7% (94/111) by the end of day 2, 91.9% (102/111) by the end of day 3, and 99.1% (110/111) by the end of day 4. Compared with delirium assessment twice daily for 7 days, twice-daily measurements for 5 days detected 100% of delirium patients with 71% efforts; twice-daily measurements for 4 days detected 99% (95% CI: 94% to 100%) of delirium patients with 57% efforts; twice-daily assessment for 3 days detected 92% (95% CI: 85% to 96%) of delirium patients with only 43% efforts. Conclusions For older patients admitted to the ICU after elective noncardiac surgery, it is reasonable to detect delirium with the CAM-ICU twice daily for no more than 5 days, and if the personnel and funds are insufficient, 4 days could be sufficient.
Phagocytosis is a primary determinant of pulmonary clearance of clinical Klebsiella pneumoniae isolates

Introduction Klebsiella pneumoniae (Kp) is a common cause of hospital-acquired pneumonia. Although previous studies have suggested that evasion of phagocytic uptake is a virulence determinant of Kp, few studies have examined phagocytosis sensitivity in clinical Kp isolates. Methods We screened 19 clinical respiratory Kp isolates that were previously assessed for mucoviscosity for their sensitivity to macrophage phagocytic uptake, and evaluated phagocytosis as a functional correlate of in vivo Kp pathogenicity. Results The respiratory Kp isolates displayed heterogeneity in the susceptibility to macrophage phagocytic uptake, with 14 out of 19 Kp isolates displaying relative phagocytosis-sensitivity compared to the reference Kp strain ATCC 43816, and 5 out of 19 Kp isolates displaying relative phagocytosis-resistance. Intratracheal infection with the non-mucoviscous phagocytosis-sensitive isolate S17 resulted in a significantly lower bacterial burden compared to infection with the mucoviscous phagocytosis-resistant isolate W42. In addition, infection with S17 was associated with a reduced inflammatory response, including reduced bronchoalveolar lavage fluid (BAL) polymorphonuclear (PMN) cell count, and reduced BAL TNF, IL-1β, and IL-12p40 levels. Importantly, host control of infection with the phagocytosis-sensitive S17 isolate was impaired in alveolar macrophage (AM)-depleted mice, whereas AM-depletion had no significant impact on host defense against infection with the phagocytosis-resistant W42 isolate. Conclusion Altogether, these findings show that phagocytosis is a primary determinant of pulmonary clearance of clinical Kp isolates.
Thermodynamic analysis of a geothermal district heating system

Thermoeconomic analysis is considered a useful tool for investigators in engineering and other disciplines due to its methodology based on the quantities exergy, cost, energy and mass. This study deals with an investigation of capital costs and thermodynamic losses for devices in the Balcova Geothermal District Heating Systems (BGDHS). Thermodynamic loss rate-to-capital cost ratios are used for components and the overall system, and a systematic correlation is found between capital cost and exergy loss (total or internal), but not between capital cost and energy loss or external exergy loss. This correlation may imply that devices in successful district heating system are configured so as to achieve an overall optimal design, by balancing the thermodynamic (exergy-based) and economic characteristics of the overall system and their devices. The results provide insights into the relations between thermodynamics and economics and help demonstrate the merits of exergy analysis.
Obesity prevalence, physical activity, and dietary practices among adults in Saudi Arabia

Introduction The current study evaluated obesity prevalence, physical activity, and dietary practices among Saudi adults in the Makkah region of the Kingdom of Saudi Arabia (KSA). The current survey was accomplished between November 2021 and March 2022. Method A validated questionnaire, Arab Teens Lifestyle Study (ATLS), was used to evaluate all participants' physical activities, sedentary behaviors, and nutritional habits in addition to demographic data. Result A total of 2,115 people [1,238 (58.5%) women and 877 (41.5%) men] participated in this survey. Being overweight was prevalent in 32.8% of the population (41% of men and 28.9% of women), obesity was prevalent in 23% of the population (males 23.1% and females 24.2%). Obese people consumed more soft drinks, and overweight people did not consume enough vegetables (fresh/cooked). Obese people consumed fast food (e.g., burgers, sausage, pizza, or Arabic shawarma) over three times each week. The mean (SD) number of days of practice walking was 2.51 (2.05) vs. 1.3 (1.87) (p < 0.001) for lean and obese individuals, respectively. In addition, individuals with normal BMI had more days of jogging, moderate and high-intensity exercise, dancing, and strength training than those with obesity. The odds of being obese increased with age (OR: 1.07; p < 0.001), in males (OR: 2.16; p < 0.001), in participants earning <5,000 SR/month (1.3 thousand $) and 10–15 thousand SR/month (1.34–2.66 thousand $) (OR: 2.36; P = 0.01). Obesity was inversely associated with moderate-intensity exercise (OR: 0.802; p = 0.009), and regular walking (OR: 0.685; CI: 0.624–0.752; p < 0.001). Discussion Overweight and obesity were prevalent in 32.8% and 23% of the population, respectively. Sociodemographic factors associated with obesity. Focused intervention strategies are needed to overcome the obesity issue.
Comprehensive analysis of microRNA and metabolic profiles in bovine seminal plasma of different semen quality

Background Seminal plasma plays a pivotal role in modulating sperm viability and function. However, the underlying mechanisms have not been fully elucidated. Method In this study, the bull semen production records of core breeding farms and bull stations in the past 10 years were analyzed. Results We found that the semen of 5-year-old bulls collected for the first time is of the best quality (p < 0.05). Despite the bull semen collected under the above conditions, low-quality sperm is still obtained from part of bulls due to individual differences. Interestingly, seminal plasma from normal semen is capable of improving low-quality semen motility. To identify the potential key factors in seminal plasma, the differences in miRNA and metabolite profiles between normal and low-quality seminal plasma were analyzed. We found that 59 miRNAs were differently expressed, including 38 up-regulated and 21 down-regulated miRNAs. Three hundred and ninety-one and 327 significantly different metabolites were identified from the positive and negative ion models, respectively. These multiple miRNAs and metabolites collectively contribute to the motility of sperm, subsequently, affect semen quality. Discussion Together, these results not only revealed the critical factors of seminal plasma improving sperm quality but also provided potential miRNA- or metabolite-based biomarkers to identify the high semen quality.
Anti-rituximab antibodies in patients with refractory autoimmune nodopathy with anti-neurofascin-155 antibody

Background Recent studies have reported that similar to other IgG4 autoimmune diseases, such as muscle-specific kinase antibody-associated myasthenia gravis, most anti-neurofascin-155 (anti-NF155) nodopathies respond well to rituximab treatment, regardless of the dosage. However, there are still a few patients for which rituximab is ineffective for unknown reasons. Currently, there are no studies on the mechanism of ineffective treatment with rituximab. Methods A 33-year-old Chinese man presenting with numbness, tremor, and muscle weakness for 4 years was recruited for this study. Anti-NF155 antibodies were identified by cell-based assay and confirmed by immunofluorescence assay on teased fibers. The anti-NF155 immunoglobulin (IgG) subclasses were also detected by immunofluorescence assay. Anti-rituximab antibodies (ARAs) were quantitatively analyzed using enzyme-linked immunosorbent assay (ELISA), and peripheral B cell counts were determined by flow cytometry. Results The patient exhibited anti-NF155 IgG4-antibody positivity. After the first round of rituximab infusion, the patient showed stratified outcomes with improvements in numbness, muscle weakness and ambulation. However, after three rounds of rituximab infusion, the patient’s symptoms deteriorated, and the numbness, tremor and muscle weakness returned. No obvious improvement was found after plasma exchange and another round of rituximab treatment. 14 days after the last treatment with rituximab, ARAs were detected. And the titers gradually decreased on day 28 and 60 but remained higher than normal. Peripheral CD19+ B cell counts were less than 1% within the 2-month period following the final rituximab administration. Conclusions In this study, ARAs presented in a patient with anti-NF155 nodopathy undergoing rituximab treatment and showed an unfavorable impact on rituximab efficacy. This is the first case to report the occurrence of ARAs in patients with anti-NF155 antibodies. We suggest that ARAs should be tested early during the initial intervention, especially in patients who respond poorly to rituximab treatment. In addition, we believe it is necessary to investigate the association between ARAs and B cell counts, their effect on clinical efficacy, and their potential adverse reactions in a larger cohort of patients with anti-NF155 nodopathy.
Genome-wide analysis of oxylipins and oxylipin profiles in a pediatric population

Background Oxylipins are inflammatory biomarkers derived from omega-3 and-6 fatty acids implicated in inflammatory diseases but have not been studied in a genome-wide association study (GWAS). The aim of this study was to identify genetic loci associated with oxylipins and oxylipin profiles to identify biologic pathways and therapeutic targets for oxylipins. Methods We conducted a GWAS of plasma oxylipins in 316 participants in the Diabetes Autoimmunity Study in the Young (DAISY). DNA samples were genotyped using the TEDDY-T1D Exome array, and additional variants were imputed using the Trans-Omics for Precision Medicine (TOPMed) multi-ancestry reference panel. Principal components analysis of 36 plasma oxylipins was used to capture oxylipin profiles. PC1 represented linoleic acid (LA)- and alpha-linolenic acid (ALA)-related oxylipins, and PC2 represented arachidonic acid (ARA)-related oxylipins. Oxylipin PC1, PC2, and the top five loading oxylipins from each PC were used as outcomes in the GWAS (genome-wide significance: p < 5×10−8). Results The SNP rs143070873 was associated with (p < 5×10−8) the LA-related oxylipin 9-HODE, and rs6444933 (downstream of CLDN11) was associated with the LA-related oxylipin 13 S-HODE. A locus between MIR1302-7 and LOC100131146, rs10118380 and an intronic variant in TRPM3 were associated with the ARA-related oxylipin 11-HETE. These loci are involved in inflammatory signaling cascades and interact with PLA2, an initial step to oxylipin biosynthesis. Conclusion Genetic loci involved in inflammation and oxylipin metabolism are associated with oxylipin levels.
Supplementation of feed and water after long-duration road transportation: The effects on welfare and rumen fermentation in goats

Water and feed are needed for livestock during their long-duration road transportation. However, limited information is available on the need to supply water and feed to livestock at temporary holding stations after road transportation. This study aimed to evaluate the effect of providing water and feed at holding stations on the welfare of goats in mimic surroundings. A total of 24 Guizhou black goats were randomly divided into three groups of eight goats each as follows: deprived of water and feed (TRT0), supplemented with water ad libitum (TRT1), and supplemented with water and feed ad libitum (TRT2). Blood and rumen fluid samples were collected before loading (denoted as “PRE” in this article) and after transport (denoted as “POST” in this article). Statistical analysis was performed via the SAS procedure PROC MIXED. The 10-h road transportation period reduced body weight in TRT0 goats (p < 0.05) but not in TRT1 and TRT2 (p > 0.05). TRT0 and TRT1 goats had POST plasma glucose concentrations above their PRE values (p < 0.05). The PRE-plasma urea nitrogen (PUN) levels were higher in TRT2 compared to TRT0 (p < 0.05) goats, while the POST–PUN levels increased in TRT1 compared to TRT0 goats. The POST non-esterified fatty acid (NEFA) concentration was higher for TRT0 compared to that in TRT1 and TRT2 (p < 0.05) goats. No difference was observed for plasma profiles of malondialdehyde (MDA) and superoxide dismutase (SOD) (p > 0.05). TRT2 goats had higher POST glutathione peroxidase (GSH-Px) activity than TRT0 and TRT1 (p < 0.05) goats. TRT0 goats had higher POST plasma glucagon (GC) compared to TRT2 (p < 0.05) and had increased values compared to their own PRE level as a result of road transportation (p < 0.05). TRT2 goats resulted in a lower POST plasma heat-stressed protein-70 (HSP-70) level than TRT0. There was no difference in ruminal pH (p > 0.05). Ruminal total VFA (acetate, propionate, butyrate), and the NH3-ammonia profiles showed a decrease (p < 0.05) after transportation in all groups. Ruminal microcrystalline cellulose, xylanase, cellobiase, and carboxymethyl cellulose activities were unaffected (p > 0.05). These combined results imply that water and feed supplementation to livestock can effectively alleviate stress responses in goats subjected to road transportation and emphasize the necessity to establish water and feed supplies even at a temporary holding pen.
Health-related quality of life-based definition of remission from depression among primary care patients

Background Depression undermines health-related quality of life (HRQoL). Remission is the central aim of all treatments for depression, but the degree of remission necessary for depressive patients’ HRQoL to correspond to the normal range of the general population remains unknown. Methods The Vantaa Primary Care Depression Study prospectively followed-up a screening-based cohort of depressive primary care patients for 5 years. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used to diagnose major depressive disorder. HRQoL was measured by the generic 15D instrument at baseline and at 5 years (N = 106, 77% of baseline patients), and compared with the 15D results of an age-standardized general population sample from the Finnish Health 2011 Survey (N = 4,157). Receiver operating characteristic analyses determined the optimal Hamilton Depression Rating Scale (HAMD), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) cut-offs for remission, using the 15D score as the construct validator. Remission was defined as the score at which HRQoL reached the general population range (minimum mean − 1 SD). As age may influence HRQoL, patients older and younger than the median 52 years were investigated separately. Results For HAMD, the optimal cut-off point score was 8.5, for BDI 10.5, and for BAI 11.5. The differences between the findings of the younger and older patients were small. Limitations Cross-sectional analysis, small number of patients in the cohort. Conclusion Depressive primary care patients’ HRQoL reaches the normal variation range of the general population when their depression and anxiety scores reach the conventional clinical cut-offs for remission.
Gold-iron oxide (Au/Fe3O4) magnetic nanoparticles as the nanoplatform for binding of bioactive molecules through self-assembly

Nanomedicine plays a crucial role in the development of next-generation therapies. The use of nanoparticles as drug delivery platforms has become a major area of research in nanotechnology. To be effective, these nanoparticles must interact with desired drug molecules and release them at targeted sites. The design of these “nanoplatforms” typically includes a functional core, an organic coating with functional groups for drug binding, and the drugs or bioactive molecules themselves. However, by exploiting the coordination chemistry between organic molecules and transition metal centers, the self-assembly of drugs onto the nanoplatform surfaces can bypass the need for an organic coating, simplifying the materials synthesis process. In this perspective, we use gold-iron oxide nanoplatforms as examples and outline the prospects and challenges of using self-assembly to prepare drug-nanoparticle constructs. Through a case study on the binding of insulin on Au-dotted Fe3O4 nanoparticles, we demonstrate how a self-assembly system can be developed. This method can also be adapted to other combinations of transition metals, with the potential for scaling up. Furthermore, the self-assembly method can also be considered as a greener alternative to traditional methods, reducing the use of chemicals and solvents. In light of the current climate of environmental awareness, this shift towards sustainability in the pharmaceutical industry would be welcomed.
Effects of aging and macrophages on mice stem Leydig cell proliferation and differentiation in vitro

Background Testosterone plays a critical role in maintaining reproductive functions and well-beings of the males. Adult testicular Leydig cells (LCs) produce testosterone and are generated from stem Leydig cells (SLCs) during puberty through adulthood. In addition, macrophages are critical in the SLC regulatory niche for normal testicular function. Age-related reduction in serum testosterone contributes to a number of metabolic and quality-of-life changes in males, as well as age-related changes in immunological functions. How aging and testicular macrophages may affect SLC function is still unclear. Methods SLCs and macrophages were purified from adult and aged mice via FACS using CD51 as a marker protein. The sorted cells were first characterized and then co-cultured in vitro to examine how aging and macrophages may affect SLC proliferation and differentiation. To elucidate specific aging effects on both cell types, co-culture of sorted SLCs and macrophages were also carried out across two ages. Results CD51+ (weakly positive) and CD51++ (strongly positive) cells expressed typical SLC and macrophage markers, respectively. However, with aging, both cell types increased expression of multiple cytokine genes, such as IL-1b, IL-6 and IL-8. Moreover, old CD51+ SLCs reduced their proliferation and differentiation, with a more significant reduction in differentiation (2X) than proliferation (30%). Age matched CD51++ macrophages inhibited CD51+ SLC development, with a more significant reduction in old cells (60%) than young (40%). Crossed-age co-culture experiments indicated that the age of CD51+ SLCs plays a more significant role in determining age-related inhibitory effects. In LC lineage formation, CD51+ SLC had both reduced LC lineage markers and increased myoid cell lineage markers, suggesting an age-related lineage shift for SLCs. Conclusion The results suggest that aging affected both SLC function and their regulatory niche cell, macrophages.
SPRAY COOLING OF HIGH TEMPERATURE METALS USING HIGH MASS FLUX INDUSTRIAL NOZZLES

Systematic experiments were conducted for the spray cooling of high-temperature stainless steel using three different types of industrial sprays: full cone and flat hydraulic nozzles and a flat air-mist nozzle. In the present study, a wide range of mass flux (1.5–30 kg/m2sec) is covered, which has never been thoroughly investigated before. Orientations with respect to gravity and spray angle were also explored. The data have been analyzed and correlated. The results of this study will be important to the product quality control in industries by providing a good estimation of heat flux at different mass flux, spray types, and surface temperatures, especially for spray cooling of stainless steel and other metals with similar thermal properties.
Large-eddy simulation of a 15 GW wind farm: Flow effects, energy budgets and comparison with wake models

Planned offshore wind farm clusters have a rated capacity of more than 10 GW. The layout optimization and yield estimation of wind farms is often performed with computationally inexpensive, analytical wake models. As recent research results show, the flow physics in large (multi-gigawatt) offshore wind farms are more complex than in small (sub-gigawatt) wind farms. Since analytical wake models are tuned with data of existing, sub-gigawatt wind farms they might not produce accurate results for large wind farm clusters. In this study the results of a large-eddy simulation of a 15 GW wind farm are compared with two analytical wake models to demonstrate potential discrepancies. The TurbOPark model and the Niayifar and Porté-Agel model are chosen because they use a Gaussian wake profile and a turbulence model. The wind farm has a finite size in the crosswise direction, unlike as in many other large-eddy simulation wind farm studies, in which the wind farm is effectively infinitely wide due to the cyclic boundary conditions. The results show that new effects like crosswise divergence and convergence occur in such a finite-size multi-gigawatt wind farm. The comparison with the wake models shows that there are large discrepancies of up to 40% between the predicted wind farm power output of the wake models and the large-eddy simulation. An energy budget analysis is made to explain the discrepancies. It shows that the wake models neglect relevant kinetic energy sources and sinks like the geostrophic forcing, the energy input by pressure gradients and energy dissipation. Taking some of these sources and sinks into account could improve the accuracy of the wake models.
Heart failure and cognitive impairment: A narrative review of neuroimaging mechanism from the perspective of brain MRI

Both heart failure (HF) and cognitive impairment (CI) have a significant negative impact on the health of the elderly individuals. Magnetic resonance imaging (MRI) can non-invasively detect functional and structural variations in the heart and brain, making it easier to explore the connection between the heart and brain. According to neuroimaging studies, HF patients have a higher chance of developing CI because they have a variety of different types of brain injuries. To examine how HF and CI are influenced by one another, English-language literature was searched in the Web of Science, PubMed EMBASE (OVID), PsycInfo, and Scopus databases. The search terms included “high-frequency,” “brain function,” “brain injury,” “cognition,” “cognitive impairment,” and “magnetic resonance imaging. ” Normal brain function is typically impaired by HF in the form of decreased cerebral perfusion pressure, inflammation, oxidative stress, and damage to the BBB, resulting in CI and subsequent HF. Early pathophysiological alterations in patients’ brains have been widely detected using a range of novel MRI techniques, opening up new avenues for investigating the connection between HF and CI. This review aims to describe the pathogenesis of HF with CI and the early diagnostic role of MRI in the heart-brain domain.