Miracle-dz/UniFAR-FTUs huggingface dataset:
Transplant outcomes of 100 cases of living-donor ABO-incompatible kidney transplantation

Abstract Background: Although ABO-incompatible (ABOi) kidney transplantation (KT) has been performed successfully, a standard preconditioning regimen has not been established. Based on the initial antidonor ABO antibody titers, an individualized preconditioning regimen is developed, and this study explored the efficacy and safety of the regimen. Methods: From September 1, 2014, to September 1, 2020, we performed 1668 consecutive living-donor KTs, including 100 ABOi and 1568 ABO-compatible (ABOc) KTs. ABOi KT recipients (KTRs) with a lower antibody titer (≤1:8) were administered oral immunosuppressive drugs (OIs) before KT, while patients with a medium titer (1:16) received OIs plus antibody-removal therapy (plasma exchange/double-filtration plasmapheresis), patients with a higher titer (≥1:32) were in addition received rituximab (Rit). Competing risk analyses were conducted to estimate the cumulative incidence of infection, acute rejection (AR), graft loss, and patient death. Results: After propensity score analyses, 100 ABOi KTRs and 200 matched ABOc KTRs were selected. There were no significant differences in graft and patient survival between the ABOi and ABOc groups (P = 0.787, P = 0.386, respectively). After using the individualized preconditioning regimen, ABOi KTRs showed a similar cumulative incidence of AR (10.0% υs. 10.5%, P = 0.346). Among the ABOi KTRs, the Rit-free group had a similar cumulative incidence of AR (P = 0.714) compared to that of the Rit-treated group. Multivariate competing risk analyses revealed that a Rit-free regimen reduced the risk of infection (HR: 0.31; 95% CI: 0.12–0.78, P = 0.013). Notably, antibody titer rebound was more common in ABOi KTRs receiving a Rit-free preconditioning regimen (P = 0.013) than those receiving Rit. ABOi KTRs with antibody titer rebound had a 2.72-fold risk of AR (HR: 2.72, 95% CI: 1.01–7.31, P = 0.048). ABOi KTRs had similar serum creatinine and estimated glomerular filtration rate compared to those of ABOc KTRs after the first year. Conclusions: An individualized preconditioning regimen can achieve comparable graft and patient survival rates in ABOi KT with ABOc KT. Rit-free preconditioning effectively prevented AR without increasing the risk of infectious events in those with lower initial titers; however, antibody titer rebound should be monitored.
Stop and think: Additional time supports monitoring processes in young children

When children evaluate their certainty, monitoring is often inaccurate. Even though young children struggle to estimate their confidence, existing research shows that monitoring skills are developing earlier than expected. Using a paired associates learning task with integrated monitoring, we implemented a time window to—"Stop and Think"—before children generated their answers and evaluated their confidence in the chosen response. Results show that kindergarten and second grade children in the—"Stop and Think"—condition have higher monitoring accuracy than the control group. Implementing a time window thus seems to support children in their evaluation of different certainty levels. Relating individual differences in independently measured inhibitory control skills revealed a correlation between monitoring and inhibition for kindergarteners.
Beyond opioid prescribing: Evaluation of a substance use disorder curriculum for OBGYN residents

Objective Amidst the current opioid crisis, there is a need for better integration of substance use disorder screening and treatment across specialties. However, there is no consensus regarding how to best instruct OBGYN trainees in the clinical skills related to opioid and other substance use disorders (SUD). Study objectives were (1) to assess the effectiveness a SUD curriculum to improve self-reported competence among OBGYN residents and (2) to explore its effectiveness to improve attending evaluations of residents’ clinical skills as well as its feasibility and acceptability from the resident perspective. Methods A pilot 3-session curriculum was developed and adapted to SUD screening and treatment which included readings, didactics, and supervised outpatient clinical experiences for OBGYN post-graduate year 1 (PGY-1) residents rotating through an integrated OBGYN-SUD clinic. Eighteen residents completed pre and post clinical skills self-assessments (SUD screening, counseling, referring, Motivational Interviewing) using an adapted Zwisch Rating Scale (range 1–5). Scores were compared between time points using paired t-tests. Sub-samples also (a) were evaluated by the attending on three relevant Accreditation Council for Graduate Medical Education Milestones (ACGME) milestone sets using the web-based feedback program, myTIPreport (n = 10) and (b) completed a qualitative interview (n = 4). Results All PGY-1s (18/18) across three academic years completed the 3-session SUD curriculum. Clinical skill self-assessments improved significantly in all areas [SUD Screening (2.44 (0.98) vs 3.56 (0.62), p = <0.01); Counseling (1.81 (0.71) vs 3.56 (0.51), p = < . 01; Referring (2.03 (0.74) vs 3.17 (0.71), p = < . 01; Motivational Interviewing (1.94 (1.06) vs 3.33 (0.69), p = < . 01)]. Milestone set levels assigned by attending evaluations (n = 10) also improved. Qualitative data (n = 4) revealed high acceptability; all curriculum components were viewed positively, and feedback was provided (e.g., desire for more patient exposures). Conclusion A pilot SUD curriculum tailored for OBGYN PGY-1 residents that goes beyond opioid prescribing to encompass SUD management is feasible, acceptable and likely effective at improving SUD core clinical skills.
The Accuracy of Computer-Assisted Surgical Planning in Predicting Soft Tissue Responses After Le Fort I Osteotomy: Retrospective Analysis

Purpose: Mismatch between preoperative planning and surgical outcome in maxillofacial surgery relate to on-table replication of presurgical planning and predictive algorithm inaccuracy: software error was hereby decoupled from planning inaccuracy to assess a commercial software. The hypothesis was that soft tissue prediction error would be minimized if the surgical procedure was replicated precisely as planned and is independent of the extent of bone repositioning. Materials and Methods: Cone-beam computed tomography scans of 16 Le Fort I osteotomy patients were collected at Boston Children’s Hospital. Preoperative and postoperative models of bone and soft tissue were constructed and the maxilla repositioning was replicated. Each model was subdivided into 6 regions: mouth, nose, eyes, and cheeks. Soft tissue prediction (performed using Proplan CMF-Materialise) for each patient was compared with the relative postoperative reconstruction and error was determined. P<0.05 was considered significant. Results: Le Fort I segment repositioning was replicated within 0.70±0.18 mm. The highest prediction error was found in the mouth (1.49±0.77 mm) followed by the cheeks (0.98±0.34 mm), nose (0.86±0.23 mm), and eyes (0.76±0.32). Prediction error on cheeks correlated significantly with mouth (r=0.63, P< 0.01) and nose (r=0.67, P< 0.01). Mouth prediction error correlated with total advancement (r=0.52, P=0.04). Conclusions: ProPlan CMF is a useful outcome prediction tool; however, accuracy decreases with the extent of maxillary advancement even when errors in surgical replication are minimized.
Psychological Resilience: An Affect-Regulation Framework.

Exposure to adversity (e.g., poverty, bereavement) is a robust predictor of disruptions in psychological functioning. However, people vary greatly in their responses to adversity; some experience severe long-term disruptions, others experience minimal disruptions or even improvements. We refer to the latter outcomes-faring better than expected given adversity-as psychological resilience. Understanding what processes explain resilience has critical theoretical and practical implications. Yet, psychology's understanding of resilience is incomplete, for two reasons: (a) We lack conceptual clarity, and (b) two major approaches to resilience-the stress and coping approach and the emotion and emotion-regulation approach-have limitations and are relatively isolated from one another. To address these two obstacles, we first discuss conceptual questions about resilience. Next, we offer an integrative affect-regulation framework that capitalizes on complementary strengths of both approaches. This framework advances our understanding of resilience by integrating existing findings, highlighting gaps in knowledge, and guiding future research. Expected final online publication date for the Annual Review of Psychology, Volume 74 is January 2023. Please see http://www.annualreviews. org/page/journal/pubdates for revised estimates.
Global 5′-UTR RNA structure regulates translation of a SERPINA1 mRNA

Abstract SERPINA1 mRNAs encode the protease inhibitor α-1-antitrypsin and are regulated through post-transcriptional mechanisms. α-1-antitrypsin deficiency leads to chronic obstructive pulmonary disease (COPD) and liver cirrhosis, and specific variants in the 5′-untranslated region (5′-UTR) are associated with COPD. The NM_000295. 4 transcript is well expressed and translated in lung and blood and features an extended 5′-UTR that does not contain a competing upstream open reading frame (uORF). We show that the 5′-UTR of NM_000295. 4 folds into a well-defined multi-helix structural domain. We systematically destabilized mRNA structure across the NM_000295. 4 5′-UTR, and measured changes in (SHAPE quantified) RNA structure and cap-dependent translation relative to a native-sequence reporter. Surprisingly, despite destabilizing local RNA structure, most mutations either had no effect on or decreased translation. Most structure-destabilizing mutations retained native, global 5′-UTR structure. However, those mutations that disrupted the helix that anchors the 5′-UTR domain yielded three groups of non-native structures. Two of these non-native structure groups refolded to create a stable helix near the translation initiation site that decreases translation. Thus, in contrast to the conventional model that RNA structure in 5′-UTRs primarily inhibits translation, complex folding of the NM_000295. 4 5′-UTR creates a translation-optimized message by promoting accessibility at the translation initiation site.
Pathogens Identified by Minimally Invasive Tissue Sampling in India and Pakistan From Preterm Neonatal Deaths: The PURPOSE Study

Abstract Background We identified pathogens found in internal organs and placentas of deceased preterm infants cared for in hospitals in India and Pakistan. Methods Prospective, observational study conducted in delivery units and neonatal intensive care units. Tissue samples from deceased neonates obtained by minimally invasive tissue sampling and placentas were examined for 73 different pathogens using multiplex polymerase chain reaction (PCR). Results Tissue for pathogen PCR was obtained from liver, lung, brain, blood, cerebrospinal fluid, and placentas from 377 deceased preterm infants. Between 17.6% and 34.1% of each type of tissue had at least 1 organism identified. Organism detection was highest in blood (34.1%), followed by lung (31.1%), liver (23.3%), cerebrospinal fluid (22.3%), and brain (17.6%). A total of 49.7% of the deceased infants had at least 1 organism. Acinetobacter baumannii was in 28.4% of the neonates compared with 14.6% for Klebsiella pneumoniae, 11.9% for Escherichia coli/Shigella, and 11.1% for Haemophilus influenzae. Group B streptococcus was identified in only 1.3% of the neonatal deaths. A. baumannii was rarely found in the placenta and was found more commonly in the internal organs of neonates who died later in the neonatal period. The most common organism found in placentas was Ureaplasma urealyticum in 34% of the samples, with no other organism found in >4% of samples. Conclusions In organ samples from deceased infants in India and Pakistan, evaluated with multiplex pathogen PCR, A. baumannii was the most commonly identified organism. Group B streptococcus was rarely found. A. baumannii was rarely found in the placentas of these deceased neonates.
Exploring the Change in Metabolic Cost of Walking before and after Familiarization with a Passive Load-Bearing Exoskeleton: A Case Series

OCCUPATIONAL APPLICATIONS Military personnel are at greater risk of injuries due to frequent load carriage. Novel exoskeleton technology may have benefits for soldiers, such as reduced physical burden through load carriage support that may result in decreased metabolic cost, reduced fatigue, and lower risk of injuries during walking. However, as for most assistive devices, a familiarization period is likely necessary to obtain the full potential of the device. Our results show that the metabolic cost of walking (MWC) was initially increased significantly upon provision of the passive exoskeleton, though it returned to baseline values after a 9-day familiarization period. The exoskeleton remained effective after a three-month pause, with a MCW below baseline. These results suggest that to properly assess the assistance of an exoskeleton, a sufficient familiarization period should be mandatory. TECHNICAL ABSTRACT Background: Military load carriage has been shown to alter gait patterns, resulting in an increased metabolic cost during walking (MCW). Soldiers’ burden could be mitigated by wearing a passive exoskeleton, but the additional payload of the device can alter movement patterns during gait, rendering it detrimental. Integrating principles of motor learning during a familiarization period could allow users to develop adaptive motor strategies, thereby decreasing MCW. Purpose: The aim of this study was to explore the influence of a familiarization period on MCW when soldiers wear a passive, load-bearing, prototype exoskeleton (Exo). Methods: Three male soldiers walked on a treadmill with a 38 kg payload at eight speeds (1.8-6.0 km/h) under five conditions: 1) no exoskeleton (NoExo); 2) exoskeleton pre-familiarization (ExoPre); 3) exoskeleton post-familiarization (ExoPost); 4) no exoskeleton follow-up (NoExoFU); and 5) exoskeleton follow-up (ExoFU). Each experimental trial consisted of 10 minutes of standing followed by 10 minutes of walking at a constant speed. Metabolic data were normalized to walking speed (J/kg·m) to obtain the MCW. The familiarization period consisted of 9 days of activities with the exoskeleton using a standardized protocol. Differences in MCW with and without the Exo were compared at the eight walking speeds using a nonparametric analysis of Longitudinal Data. Results: There was a statistically significant decrease in MCW after familiarization with the Exo, particularly during ExoFU with a relative treatment effect of 0.11 − 0.19. There were also significant reductions in MCW during ExoFU when compared to NoExoFU [participant 01 = 0.37; participant 02 = 0.27; participant 03 = 0.35]. Conclusions: A first exposure to the exoskeleton increased MCW. After familiarization, however, the MCW with the Exo returned to the NoExo level or below with a payload of 38 kg among three soldiers. A familiarization period of 3 hours per day over 2 weeks of familiarization may optimize the use of an exoskeleton.
Accessible and Adaptable Multiplexed Real-Time PCR Approaches to Identify SARS-CoV-2 Variants of Concern

Rapid detection and mutation surveillance of SARS-CoV-2 VOCs is crucial for COVID-19 control, management, and prevention. We developed two rapid molecular assays based on the real-time PCR platform to identify important variants of concern, including the Omicron variant with a large number of mutations. ABSTRACT Rapid identification and continuous surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants are critical for guiding the response to the COVID-19 pandemic. Whole-genome sequencing (WGS) is a preferred tool for this aim, but many laboratories suffer from a lack of resources to support population-level sequencing. Here, we describe two PCR strategies targeting spike protein mutations to identify the Alpha, Delta, and Omicron variants. Signature mutations were selected using a dedicated bioinformatic program. The selected mutations in Alpha and Delta variants were detected using multicolor melting curve analysis (MMCA). Thirty-two mutations of the Omicron variant were targeted using the MeltArray approach in one reaction, which was able to detect the Omicron subvariants BA.1, BA.2, BA.3, and BA.4/5. The limits of detection varied from five to 50 copies of RNA templates/reactions. No cross-reactivity was observed with nine other respiratory viruses, including other coronaviruses. We validated the MMCA and MeltArray assays using 309 SARS-CoV-2 positive samples collected at different time points. These assays exhibited 98.3% to 100% sensitivity and 100% specificity compared with WGS. Multiplexed real-time PCR strategies represent an alternative tool capable of identifying current SARS-CoV-2 VOCs, adaptable for emerging variants and accessible for laboratories using existing equipment and personnel. IMPORTANCE Rapid detection and mutation surveillance of SARS-CoV-2 VOCs is crucial for COVID-19 control, management, and prevention. We developed two rapid molecular assays based on the real-time PCR platform to identify important variants of concern, including the Omicron variant with a large number of mutations. Signature mutations were selected by an R program. Then, MMCA assays were established for Alpha and Delta variants, and a MeltArray assay targeting 32 mutations was developed for Omicron variant. These multiplexed PCR assays could be performed in a 96-well real-time PCR instrument within 2.5 h, offering a high-throughput choice for dynamic monitoring of SARS-CoV-2 VOCs in a standard microbiology laboratory.
Glucose Mediates Niche-Specific Repression of Staphylococcus aureus Toxic Shock Syndrome Toxin-1 through the Activity of CcpA in the Vaginal Environment

Menstrual toxic shock syndrome (mTSS) is caused by strains of Staphylococcus aureus that overproduce a toxin known as toxic shock syndrome toxin-1 (TSST-1). This work studied how glucose levels in a model vaginal environment could influence the amount of TSST-1 that is produced by S. aureus. ABSTRACT Staphylococcus aureus chronically colonizes up to 30% of the human population on the skin or mucous membranes, including the nasal tract or vaginal canal. While colonization is often benign, this bacterium also has the capability to cause serious infections. Menstrual toxic shock syndrome (mTSS) is a serious toxinosis associated with improper use of tampons, which can induce an environment that is favorable to the production of the superantigen known as toxic shock syndrome toxin-1 (TSST-1). To better understand environmental signaling that influences TSST-1 production, we analyzed expression in the prototype mTSS strain S. aureus MN8. Using transcriptional and protein-based analysis in two niche-related media, we observed that TSST-1 expression was significantly higher in synthetic nasal medium (SNM) than in vaginally defined medium (VDM). One major divergence in medium composition was high glucose concentration in VDM. The glucose-dependent virulence regulator gene ccpA was deleted in MN8, and, compared with wild-type MN8, we observed increased TSST-1 expression in the ΔccpA mutant when grown in VDM, suggesting that TSST-1 is repressed by catabolite control protein A (CcpA) in the vaginal environment. We were able to relieve CcpA-mediated repression by modifying the glucose level in vaginal conditions, confirming that changes in nutritional conditions contribute to the overexpression of TSST-1 that can lead to mTSS. We also compared CcpA-mediated repression to other key regulators of tst, finding that CcpA regulation is dominant compared to other characterized regulatory mechanisms. This study underlines the importance of environmental signaling for S. aureus pathogenesis in the context of mTSS. IMPORTANCE Menstrual toxic shock syndrome (mTSS) is caused by strains of Staphylococcus aureus that overproduce a toxin known as toxic shock syndrome toxin-1 (TSST-1). This work studied how glucose levels in a model vaginal environment could influence the amount of TSST-1 that is produced by S. aureus. We found that high levels of glucose repress TSST-1 production, and this is done by a regulatory protein called catabolite control protein A (CcpA). The research also demonstrated that, compared with other regulatory proteins, the CcpA regulator appears to be the most important for maintaining low levels of TSST-1 in the vaginal environment, and this information helps to understand how changes in the vaginal environmental can lead to mTSS.
Characterizing production: the production effect is eliminated for unusual voices unless they are frequent at study

ABSTRACT The production effect refers to the finding that items read aloud are better remembered than items read silently. This is often explained with reference to distinctiveness, arguing that aloud items become associated with distinctive sensorimotor features that facilitate retrieval at test. Based on this framework, more distinctive forms of production should result in larger production effects. The present study tested this theory by having participants study items silently or aloud in either their own voice or as a popular character. Participants were then tested for those items using recognition memory. Relative to silent items, aloud items read in the participants’ own voice demonstrated a typical production effect; however, contrary to any predictions, no production effect was observed for the character voices. We next manipulated how frequently the character voice was used relative to the participants’ own voice. This revealed a production effect for character voices only when those voices were more common than the participant’s own voice. This pattern could not be attributed to cognitive demands or performance anxiety but was predicted by a novel computational account based on the Retrieving Effectively from Memory (REM) model. Our results show that the relation between distinctiveness and memory is not necessarily linear.