Miracle-dz/UniFAR-FTUs huggingface dataset:
Do Socioeconomic Status and Race Impact the Safety and Efficacy of Breast Reconstruction?

Introduction Immediate breast reconstruction after mastectomy has increased in recent years when compared with delayed reconstruction. Despite this encouraging trend, racial and socioeconomic disparities in the receipt of postmastectomy breast reconstruction have been well documented. We sought to assess the effect of race, socioeconomic status, and patient comorbidities on muscle sparing transverse rectus abdominis myocutaneous outcomes at our safety net hospital institution in the southeast. Methods The database of a tertiary referral center was queried for patients who received free transverse rectus abdominis myocutaneous flaps for immediate reconstruction after mastectomy meeting inclusion criteria from 2006 to 2020. Patient demographics and outcomes were compared based on socioeconomic status. The primary outcome (reconstructive success) was defined as breast reconstruction without flap loss. Statistical analysis included analysis of variance and χ2 tests were appropriate using Rstudio. Results Three-hundred fourteen patients were included in the study, with 76% White, 16% Black, and 8% other. Overall complication rate at our institution was 17% and reconstructive success was 94%. Non-White race, older age at time of breast cancer diagnosis, higher body mass index, and presence of comorbid conditions including current smoking and hypertension were all associated with low socioeconomic status. Despite this, surgical complication rates were not predicted by non-White race, older age, or presence of diabetes mellitus. When analyzing major and minor complications based on radiation received or reconstructive success, there was no significant difference regardless of radiation treatment with the group overall achieving a 94% success rate (P = 0.229). Conclusions This study aimed to characterize the impact of socioeconomic status and race/ethnic status of patients on breast reconstruction outcomes at an institution in the South. We found that despite the greater morbidity in low income and ethnic/minority patients that when treated by a comprehensive safety net institution, they had excellent reconstructive outcomes due to low complications and minimal reoperations.
Sensitivity Analysis of a 6 MeV Photon Beam Monte Carlo Model

Background: This study aimed to optimize efficiency in Monte Carlo (MC) simulation using sensitivity analysis of a beam model. Methods: The BEAMnrc-based model of 6 MV beam of a Siemens Primus linac was developed. For sensitivity analysis, the effect of the electron source, treatment head, and virtual phantom specifications on calculated percent depth dose (PDD) and lateral dose profiles was evaluated. Results: The optimum mean energy (E) and the full width at half maximum (FWHM) of the intensity distribution of the electron beam were calculated as 6.7 MeV and 3 mm, respectively. Increasing E from 6.1 to 6.7 MeV, increased the PDD in the fall-off region by 4.70% and decreased the lateral profile by 8.76%. Changing the FWHM had a significant effect on the buildup region of PDD and the horns and out-of-field regions of the lateral profile. Increasing the collimators opening by 0.5 mm, PDD increased by 2.13% and the central and penumbra regions of profiles decreased by 1.98% and 11.40% respectively. Collimator properties such as thickness and density were effective in changing the penumbra (11.32% for 0.25 cm increment) and the out-of-field (22.82% for 3 g/cm3) regions of the lateral profiles. Conclusion: Analysis of a 6 MV model showed that PDD profiles were more sensitive to changes in energy than to FWHM of the electron source. The lateral profiles were sensitive to E, FWHM, and collimator opening. The density of the collimator affected only the out-of-field region of lateral profiles. The findings of this study may be used to make benchmarking of an MC beam model more efficient.
Comparative Analysis of the Learning of Oral Anatomy and Physiology Under Different Teaching Approaches

: The purpose of this study is t o analyze and compare the influence of traditional lecture, MOOC online learning and flipped classroom on the learning of the course Oral Anatomy and Physiology. We compare and analyze the teaching on three cohorts of undergraduate dental students: students from Grade 2012 (n = 38, traditional lecture cohort), students from Grade 2014 (n = 64, MOOC online teaching cohort) and students from Grade 2018 (n = 60, flipped classroom cohort). We study the teaching by analyzing the scores of tooth identification, tooth waxing during the course
Intellectual Capital and Corporate Sustainability Growth in Firms Listed in Nigerian Stock Exchange

: The objective of this research was to examine the influence of intellectual capital IC) and its components on corporate sustainability growth in firms listed in Nigerian stock Exchange. Furthermore, this paper aimed at determining the constituent of the intellectual capital that has more predictive ability on business sustainable growth in Nigeria. A sample size of 10 listed consumer goods firms over a period of ten years (2011-2020) was used as sample size for this study. Regression analysis techniques was used to investigate the effect of Intellectula Capital and its components on business sustainability growth. Results from the analyses revealed that intellectual capital (IC) as proxied by the M-VAIC model establishes a significant influence on corporate sustainable growth, (AdjR 2 =0.128, F-Stat =1.6308; p-value = 0.038). Notably, the findings also showed that almost all the independent variables namely, Physical Capital, Human Capital, Structural Capital and Relational Capital exert significant effect in predicting corporate sustainable growth. Furthermore, the results revealed that physical and human capital are the major components of IC that exert powerful influence on corporate sustainable growth. The study concludes that the overall intellectual capital components play an essential role in driving the listed consumer goods in Nigeria in the wheel of sustainable growth.
AN EXPLORATORY STUDY OF ORCHIDACEAE SPECIES FRUITS IN THE CENTRAL ZONE OF VERACRUZ STATE, MEXICO

The knowledge on Orchidaceae family fruits becomes useful in new studies, by helping to identify species that are not in flowering period and providing material for in vitro germination of orchid seeds. The hypothesis was that the number of orchid specimens with naturally pollinated fruits, from the central zone of the state of Veracruz, Mexico, would be more than the number of specimens that do not developed fruit naturally. The objectives of this work were: to record the flowering and fruiting periods, to characterize the orchid fruits pollinated naturally or manually. The fruit collection sites were located within the municipalities of Amatlán de los Reyes, Fortín and Tlaltetela. The work was performed between January 2019 and April 2022 (39 months). Ripe orchid fruits were collected. Morphometry was measured by recording weight (g), length (cm) and diameter of the central region (cm), complemented with a photographic record. The greatest fruit diversity of these orchids was observed and collected during the month of March. Forty-two species and their fruits were recorded, which were grouped into 8 subtribes and 32 genera. The genera with the highest number of species were: Epidendrum, Prosthechea and Oncidium, each with three species. Three species bloomed for 11 months: Platystele stenostachya, Specklinia digitale and S. tribuloides. The minor and major fruiting periods correspond to Specklinia digitale and Trichocentrum stramineum, respectively. Given the fact that in all three sites studied the greatest number of species and fruits is associated with natural pollination (27 species, 113 fruits), which exceeds the number of manually pollinated species (15 species, 51 fruits), it is possible to suggest that the largest contingent inhabits environments still compatible with the natural process of their reproduction in these sites.
Electoral Crisis Communications: Combatting Disinformation & the Contest for Electoral Legitimacy

In the age of weaponized disinformation, the question for democracies is not merely who will win an election, but whether the outcome will be accepted as legitimate. To assess the challenge faced by U.S. electoral officials in convincing the public of the security of election procedure we conducted a survey experiment on a national sample of 4987 U.S. adults in the lead-up to the 2020 election. Subjects were exposed to claims about voter fraud as well as crisis communication counter-messaging attributed to election officials. We find that regardless of the messaging strategy, subjects were unmoved by the counter-messaging with partisanship being a clear predictor of increased skepticism towards election security. Our findings illustrate the difficulties election officials face in convincing the publics about election legitimacy and highlight the systemic dangers posed by electoral disinformation.
Progress of Tumor-Derived Exosomes in Head and Neck Squamous Cell Carcinoma

: Exosomes are extracellular vesicles 40 to 160 nm in diameter that mainly mediate information transmission and substance exchange between cells, and increasing evidence suggests that exosomes are involved in the development of tumors and have great potential in cancer diagnosis and treatment. Squamous cell carcinoma of head and neck is one of the common malignant tumors in the whole body. Although various treatments continue to develop, the 5-year survival rate remains only 50%, which may be related to its characteristics such as easy lymphatic metastasis, chemotherapy resistance and poor radiotherapy sensitivity. Researchers are paying more and more attention to TDE
Building Support Through the Personalization of Twitter Messages in a Permanent Campaign

Not all aspects of a campaign are issue-oriented, nor are many voters. A candidate builds mass support largely by appearing warm, friendly, and likable, not only by propagating their viewpoints on controversial issues. Based on a prominent candidate’s Twitter accounts and the associated analytics, our research analyzes the online content and reaction to every post across a four-year period, both before and after a major general election. Twitter’s analytic measures demonstrate how a campaign uses social media to accomplish very different outreach goals. Warm and non-politically oriented messages attract broad support in the form of audience likes but are not retweeted with as much frequency as messages that are less liked but more politically pointed. The undeniable popularity of personal, earnest messages underscores the power of the social media platform to present candidates in an approachable and convivial way, despite the necessity of taking positions on difficult issues.
Association Between Sunlight Exposure and Mental Health: Evidence from a Special Population Without Sunlight in Work

Purpose In recent years, mental health problems have become the most serious social problems worldwide. Past studies have proposed that some links exist between sunlight and mental health; however, relevant studies examining low-dose sunlight exposure populations are lacking. We conducted a study among a group of operating room nurses (ORNs) who work long hours in operating rooms and have limited sunlight exposure. We aim to add to and refine previous researches on the association between mental health and sunlight exposure in community population. Patients and Methods A total of 787 ORNs were interviewed and analyzed. Mental health, sunlight exposure duration, sociodemographic and work-related variables, and chronic diseases were evaluated. The Kessler 10 scale (K10) was used to assess participants’ mental health status, and their sunlight exposure duration was assessed using their self-reports. Multiple linear regression analysis was adopted to examine the association between sunlight exposure and mental health. Results The average K10 score of ORNs was 25.41. ORNs exhibit poorer mental health than other populations. Poor mental health was negatively associated with greater sunlight exposure hours per day (β=−0.378) and sleep regularity (β=−3.341). Poor mental health was positively associated with chronic disease (β=3.514). Conclusion This study indicated that the positive association between sunlight exposure and mental health existed. Appropriate enhancement of sunlight exposure will be beneficial to mental health. Hospitals, related organizations and individuals should pay greater attention to ORNs’ mental health and sunlight exposure conditions. More policy recommendations as well as building structure recommendations should be proposed.
Clinical Characteristics of Necrotizing Pneumonia Caused by Different Pathogens

Objective To explore the clinical characteristics of necrotizing pneumonia (NP) caused by different pathogens. Methods A total of 282 children with NP admitted to Kunming Children’s Hospital from January 2014 to November 2022 were enrolled. The clinical data of all children was collected. According to the different pathogens causing NP, the children were divided into three groups: the Mycoplasma pneumoniae necrotizing pneumonia (MPNP) group, the bacterial necrotizing pneumonia (BNP) group, and necrotizing pneumonia with no pathogen detected (NNP) group. The basic information, symptoms, signs, laboratory tests, radiological features, treatment, and prognosis of the three groups were compared. Results Among the 282 cases of NP, there were 62 (22.0%) cases of MPNP, 98 (34.75%) cases of BNP, and 142 (50.35%) cases of NNP. The most common bacteria causing NP were Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Acinetobacter baumannii, respectively. Most clinical features of the three groups were statistically significant. The area under the concentration curve of white blood cell, C-reactive protein, albumin, neutrophil percentage, and fibrinogen in differentiating MPNP from BNP were 0.743 (0.638–0.849), 0.797 (0.711–0.883), 0.766 (0.671–0.861), 0.616 (0.509–0.724), and 0.634 (0.523–0.744), respectively. The decision curve showed that white blood cells, albumin, and C-reactive protein had good clinical application in differentiating MPNP from BNP. All patients were improved and discharged without death. Conclusion Bacteria are the most common cause of NP, and the most common bacteria are Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae. NP with no pathogen detected accounted for a large proportion. white blood, C-reactive protein, and albumin can identify the pathogens of NP. Patients with BNP were more severe, had a longer hospital stay, and were more likely to undergo closed drainage and surgery.
Biogenesis, Composition and Potential Therapeutic Applications of Mesenchymal Stem Cells Derived Exosomes in Various Diseases

Abstract Exosomes are nanovesicles with a wide range of chemical compositions used in many different applications. Mesenchymal stem cell-derived exosomes (MSCs-EXOs) are spherical vesicles that have been shown to mediate tissue regeneration in a variety of diseases, including neurological, autoimmune and inflammatory, cancer, ischemic heart disease, lung injury, and liver fibrosis. They can modulate the immune response by interacting with immune effector cells due to the presence of anti-inflammatory compounds and are involved in intercellular communication through various types of cargo. MSCs-EXOs exhibit cytokine storm-mitigating properties in response to COVID-19. This review discussed the potential function of MSCs-EXOs in a variety of diseases including neurological, notably epileptic encephalopathy and Parkinson’s disease, cancer, angiogenesis, autoimmune and inflammatory diseases. We provided an overview of exosome biogenesis and factors that regulate exosome biogenesis. Additionally, we highlight the functions and potential use of MSCs-EXOs in the treatment of the inflammatory disease COVID-19. Finally, we covered a strategies and challenges of MSCs-EXOs. Finally, we discuss conclusion and future perspectives of MSCs-EXOs.
A Systematic Review and Statistical Analysis of Factors Influencing the Cost-Effectiveness of Transcatheter Aortic Valve Implantation for Symptomatic Severe Aortic Stenosis

Objective Transcatheter aortic valve implantation (TAVI) is a disruptive technology recommended for patients with symptomatic severe aortic stenosis (sSAS). Despite being available for over 15 years in Europe, with an extensive volume of clinical and economic evaluations across all surgical risk groups, there is little evidence on the identification of the key drivers of TAVI’s cost-effectiveness. This study sought to identify these factors and quantify their role. Methods A systematic literature review was conducted to identify published economic evaluations of TAVI. This was supplemented by health technology assessment reports. The primary outcome was the likelihood of TAVI being found cost-effective. Secondary outcomes of TAVI being dominant, and the incremental health benefits of TAVI were also explored. Results Forty-two studies, reporting 65 unique analyses, were identified. TAVI was found to be cost-effective and dominant in 74% and 20% of analyses, respectively. The latest generation balloon-expandable TAVI device (SAPIEN 3) was more likely to be found cost-effective, as was TAVI use in low-risk populations and when performed via transfemoral access route. There was heterogeneity in the approach taken to economic modelling, which may also influence estimates of cost-effectiveness. Analyses that found TAVI to be dominant always compared it to surgery and usually considered the latest generation balloon-expandable TAVI device. Largest health benefits were observed for the inoperable risk group. Conclusion For patients with sSAS, TAVI is typically a cost-effective treatment option. There are important differences by device generation, risk group and access route. It is crucial to consider these differences when appraising the health economic evidence-base for TAVI.
Skin Temperature of Acupoints in Health and Primary Dysmenorrhea Patients: A Systematic Review and Meta-Analysis

Objective Dysmenorrhea is a common clinical condition and some studies shown that the skin temperature of some acupoints changes in primary dysmenorrhea (PD) patients. This study aimed to evaluate the changes in skin temperature at specific acupoints in PD patients and healthy subjects. Methods The literature for assessing skin temperature at acupoints in PD patients and healthy subjects was searched in eight databases. The literatures obtained from the search was independently screened by two authors, and the quality of the included articles was evaluated using the consensus checklist of the Thermographic Imaging in Sports and Exercise Medicine (TISEM) and the Newcastle–Ottawa Scale (NOS) scale. The skin temperature of the relevant acupoints or the difference between the left and right acupoints of the same name was used as the outcome during any period of menstruation. Finally, the meta-analysis was performed using RevMan 5.4. 1 software to evaluate the changes in skin temperature in the related acupoints. Results Seven eligible studies were included, which included 328 patients with PD and 279 healthy subjects. The results of the meta-analysis revealed a significant difference in skin temperature around the Sanyinjiao (SP6)(MD: 0.04, 95% CI: 0.00, 0.08), Xuehai (SP 10)(MD: −0.07, 95% CI:-0.11, −0.02) and Taixi (KI 3)(MD: 0.06, 95% CI:0.01, 0.11) acupoints between PD and healthy subjects. PD patients also showed a difference in skin temperature at the Taixi (KI 3)(MD: 0.14, 95% CI:0.04, 0.24), Shuiquan (KI 5)(MD: 0.11, 95% CI: 0.03,0.19), Taichong (LR 3)(MD: −0.10, 95% CI: −0.19,-0.01), Diji (SP 8)(MD: −0.09, 95% CI: −0.16, −0.01), and Xuehai (SP 10)(MD: −0.14, 95% CI: −0.23, −0.06) acupoint areas at different times of menstruation compared to that of healthy subjects, as revealed by the subgroup analysis. Conclusion Primary dysmenorrhea patients showed some differences in the skin temperature of the special acupoints are as Sanyinjiao (SP6), Diji (SP 8), Xuehai (SP 10), Shuiquan (KI 5), Taichong (LR 3), and Taixi (KI 3) compared with healthy subjects. Registration Number CRD42022381387.
Frailty Identification in Prehospital Care: A Scoping Review of the Literature

Abstract The proportion of older adults is increasing worldwide. Frailty assessment in prehospital care was suggested to improve triage decisions and paramedics’ judgment. This study aimed to assess the scope and nature of available evidence around frailty identification in prehospital care. A systematic search of the literature was performed using MEDLINE, SCOPUS, CINHAL, and Web of Science to identify relevant articles published from January 2022 downwards. A list of indexed terms and their associated alternatives were pre-determined. Of the 71 identified and reviewed articles after removing duplicates, six articles were included in the review. Due to the heterogeneity of the included articles, the findings were described narratively. The findings of this review showed that the available evidence is limited and heterogenic. Two themes emerged from the findings of the included articles: 1) Paramedics’ Perceptions about Frailty Assessment in Prehospital Care and 2) Frailty Scores for Application in Prehospital Care. Paramedics recognised frailty assessment in pre-hospital care to be feasible and important. They highlighted the need for a simple and clear frailty score that could be used and mentioned to other healthcare professionals when handing over patients. Six frailty scores were reported to be used in prehospital care. The evidence around each frailty score is very limited. Overall, frailty assessment in prehospital care was shown to be important and feasible. Different frailty scores have been assessed for use in prehospital care. Further research investigating frailty identification in prehospital care is needed.
Clinical Outcomes of Anticoagulant Therapy in COVID-19 Patients with Pre-Existing Cardiovascular Diseases: A Systematic Review

Abstract The COVID-19 infection caused by SARS-CoV-2 is a healthcare crisis that has led to unparalleled disruption and has impacted healthcare services, leading to significant morbidity and mortality in the worldwide population. Insufficient data on the management of COVID-19 complications such as hypercoagulability and the controversy about the benefits of anticoagulant therapy are major challenges encountered by clinicians, especially for patients with pre-existing cardiovascular diseases (CVD), and are still debatable. Therefore, we endeavored to conduct a systematic review to assess the clinical outcomes of prior anticoagulant therapy in patients with COVID-19 having pre-existing CVD. Electronic searches of the PubMed database and EBSCO Information Services were carried out, and all relevant articles were employed. Seven articles with data from 21,989 subjects were included. Despite the promised clinical outcomes of anticoagulant therapy, the results of the current systematic review indicated insignificant improvements in the reduction of mortality rate or ICU admission among patients with COVID-19 having pre-existing CVD. Furthermore, direct oral anticoagulant (DOAC) were favored over vitamin K antagonists (VKAs) due to better action and less side effects. In conclusion, the findings are controversial as we did not statistically analyze the results. The data showed inconsistent information with no clear effect of anticoagulant use before patient hospitalization or decreasing COVID-19 severity, particularly in those with CVD. Further studies including randomized controlled trials are required to describe the best course as well as optimal dose of anticoagulant use in the treatment of patients with COVID-19, particularly those with comorbidities such as CVD.