Miracle-dz/UniFAR-FTUs huggingface dataset:
Elucidating variations in outcomes among older end-stage renal disease patients on hemodialysis in Fukuoka Prefecture, Japan

Variations in health care outcomes and services potentially indicate resource allocation inefficiency. Therefore, this study was conducted to examine variations in mortality and hospitalization cases among end-stage renal disease (ESRD) patients receiving hemodialysis (HD) care from medical facilities located in 13 secondary medical care areas (SMAs) of Fukuoka prefecture, Japan. The research was designed as a retrospective, cross-sectional study using insurance claims data. The subjects of the study were older patients (over 65 years old) insured by the Fukuoka prefecture’s Latter-Stage Elderly Healthcare Insurance. Using an electronic claims database, we identified patients with chronic kidney disease (CKD) who had received HD care from April 1, 2017 to March 31, 2018. The CKD status was identified using International Classification of Disease, 10th revision code, and HD maintenance status was ascertained using specific insurance procedure codes. A total of 5,243 patients met our inclusion criteria and their records were subsequently reviewed. About 73% (n = 3,809) of patients had admission records during the period studied. Thus, the data regarding hospital length of stay (LOS) and admission costs were analyzed separately. Significant differences in terms of increased risks in hospitalization were evident in a number of SMAs. An increase in mortality risk due to heart failure and malignancy was observed in two separate SMAs. Also, analyzed LOS, total hospitalization cost, and cost per day according to SMAs showed statistically significant variations. The findings highlight the magnitude of the burden of CKD and ESRD in the community. The high prevalence of ESRD, associated mortality, and hospitalized HD patients signal the need for clinicians to assume broader roles in measures against chronic kidney disease through involvement in community awareness programs. To improve patient outcomes, improvement of regional health care provision, the level of medical care, and the development of existing human resources are needed.
Incidence and Standardized Definitions of Mitral Valve Leaflet Adverse Events After Transcatheter Mitral Valve Repair: the EXPAND Study.

BACKGROUND An independent panel of experts reviewed all investigator-reported cases of mitral valve leaflet adverse events (LAE) after MitraClipTM NTR/XTR in the EXPAND Study. AIMS We aimed to report the findings of the expert panel and standardize definitions for LAE. METHODS Standard definitions for different types of LAE were formulated and events adjudicated after detailed review by the expert panel. RESULTS Enrolling centers reported LAE in 35 cases, 11 leaflet injuries (9 tear, 2 perforation) and 24 single leaflet device attachment (SLDA). The panel confirmed LAE in 20 cases (2.0% incidence), 18 patients had SLDA and 4 had leaflet injury (2 cases had both SLDA and injury). Leaflet injury occurred during device implant and resulted in surgical valve replacement or death. SLDA-alone events were identified during implant (n=2), pre-discharge (7) or at 30 days of follow-up (7) and were resolved (£ 2+ residual MR) with additional clips in 75% of cases. CONCLUSIONS Mitral valve repair with MitraClipTM NTR/XTR is safe. The rate of LAE is lower than previously reported using older generation devices. The proposed definitions and findings will help differentiate leaflet injury from inadequate leaflet insertion and SLDA, and provide guidance to consistently diagnose LAE post MitraClipTM.
Coronavirus lockdown: Excessive alcohol consumption and illicit substance use in DUI subjects

Abstract Objective This study investigates the consequences of the SarS-CoV-2 outbreak and of the resulting control measures on alcohol and illicit substance use in a high-risk population for substance-related disorders, utilizing an integrated medico-legal and toxicological approach. Methods The research was structured as a retrospective case-control study of subjects found to be driving under the influence (DUI) of alcohol and/or other psychoactive substances who were examined for driver’s license regranting. Alcohol and/or drug use was assessed by comparing cases examined in the period from May to August 2020 (immediately after the lockdown in Italy) to control subjects examined in the same period in 2019. DUI subjects were examined by an integrated approach, descriptive analyses were conducted, and significance was determined by chi-square and Mann-Whitney tests. Variables linked to the pandemic outbreak and resulting lockdown were investigated as predictive factors in determining unfitness to drive. Results Cases (281) were significantly different from controls (261) concerning the judgment of unfitness to drive (p<.001) and had more subjects with chronic excessive alcohol use and/or illicit substance use. The two groups were rather homogeneous concerning the other variables, except for a difference in blood alcohol concentration (BAC) at the time of DUI (p = .027). No statistical association was found between the investigated variables linked to the lockdown and the judgment of unfitness to drive. Conclusions Chronic excessive alcohol consumption and illicit substance use were more frequently observed in cases, which suggests a possible correlation between the pandemic/lockdown restrictions and an increase in psychoactive substance misuse. While these potentially correlative factors are discussed in this article, they require further study. If confirmed, the results should be considered in forensic and clinical settings.
An Item Response Theory-Based Scoring of the South Oaks Gambling Screen–Revised Adolescents

The South Oaks Gambling Screen–Revised Adolescent (SOGS-RA) is one of the most widely used screening tools for problem gambling among adolescents. In this study, item response theory was used for computing measures of problem gambling severity that took into account how much information the endorsed items provided about the presence of problem gambling. A zero-inflated mixture two-parameter logistic model was estimated on the responses of 4,404 adolescents to the South Oaks Gambling Screen–Revised Adolescent to compute the difficulty and discrimination of each item, and the problem gambling severity level (θ score) of each respondent. Receiver operating characteristic curve analysis was used to identify the cutoff on the θ scores that best distinguished daily and nondaily gamblers. This cutoff outperformed the common cutoff defined on the sum scores in identifying daily gamblers but fell behind it in identifying nondaily gamblers. When screening adolescents to be subjected to further investigations, the cutoff on the θ scores must be preferred to that on the sum scores.
The Effects Of Adult Aging And Culture On Theory Of Mind.

OBJECTIVES Older adults tend to have poorer Theory of Mind (ToM) than their younger counterparts, and this has been shown in both Western and Asian cultures. We examined the role of working memory (WM) in age differences in ToM, and whether this was moderated by education and culture (UK versus Malaysia). METHOD We used two ToM tests with differing demands on updating multiple mental states (false belief) and applying social rules to mental state processing (faux pas). We also looked at the role of education, socioeconomic status (SES), and WM. A total of 298 participants from UK and Malaysia completed faux pas, false belief, and WM tasks. RESULTS Age effects on some aspects of ToM were greater in the Malaysian compared to the UK sample. Malaysian older adults were poorer at faux pas detection, aspects of false belief and WM compared to young adults. In subsequent moderated mediation analyses, we found that, specifically in the Malaysian sample, the mediating effects of WM on the age and ToM relationship occurred at the lowest levels of education. DISCUSSION This pattern of results may reflect changes in the familiarity and cognitive load of explicit mental state attribution, along with cultural differences in the pace and nature of cognitive aging. Cultural differences in education and working memory should be considered when researching age differences in theory of mind.
Single muscle fibre contractile characteristics with lifelong endurance exercise

A hallmark trait of ageing skeletal muscle health is a reduction in size and function, which is most pronounced in the fast muscle fibres. We studied older men (74 ± 4 years) with a history of lifelong (>50 years) endurance exercise to examine potential benefits for slow and fast muscle fibre size and contractile function. Lifelong endurance exercisers had slow muscle fibres that were larger, stronger, faster and more powerful than young exercisers (25 ± 1 years) and age‐matched non‐exercisers (75 ± 2 years). Limited benefits with lifelong endurance exercise were noted in the fast muscle fibres. These findings suggest that additional exercise modalities (e.g. resistance exercise) or other therapeutic interventions are needed to target fast muscle fibres with age.
Impact of Sewage Sludge Compost Utilization on Chemical Properties of Olive Grove Soils

Field experiments were conducted for four years, between 1998 and 2002, in two olive grove soils of adult olive orchards (Olea europaea L. cv. Cornicabra) in a clay loam soil in Seseña (Toledo, Spain) and in a sandy loam soil in Aranjuez (Madrid, Spain). There were four treatments, sewage sludge compost (SSC), sewage sludge compost plus urea (SSC+U), urea (U) and control (C). Each treatment was replicated four times and two depths were studied (0-15 and 15-30 cm). Once a year, before spreading sewage sludge compost, soil samples were taken at depths of 0 to 15 cm and 15 to 30 cm. Organic matter, total Kjeldhal nitrogen, phosphorus availability, pH, and electric conductivity were measured. No differences were found between treatment on organic matter and electric conductivity after four years of application of sewage sludge compost to two olive grove soils. In relation to nitrogen content, sewage sludge compost, only in Seseña, produced higher nitrogen soil content than the traditional urea treatment. Sewage sludge compost applied on olive grove soils improved the Phosphorus availability for the olive tree. In Aranjuez, the use of sewage sludge compost increased the pH of the soil with respect to Urea and Control plots. In Seseña, the reverse effect was found.
Identifying barriers to early presentation in patients with locally advanced breast cancer (LABC) in Northern Singapore: Qualitative study

Introduction Breast cancer is the leading cause of death in Singaporean women, with advanced stage rendering a poorer prognosis. This study aims to explore the barriers to early presentation, information needs and sources in patients with locally advanced breast cancer (LABC). Materials & methods A convenience sample of patients who presented with locally advanced breast cancer to the Department of General Surgery in a teaching tertiary hospital were recruited for the study. We conducted semi-structured interviews face to face with the recruited patients. We recorded the interviews, transcribed them verbatim and analysed using thematic content analysis. Results Twenty-three participants were recruited of which 12 were Chinese and 11 were Malay women. Mean age was 60 years (± 13 SD). The most common knowledge barrier resulting in delay was the misconception that a breast lump must be painful to be malignant. Other knowledge barriers include the lack of knowledge and misinformation from the internet or other social media platforms. Some perceived barriers include fear of diagnosis, fear of treatment and fear of imposing financial burden on family members. A significant proportion of participants were also not aware of a national breast screening programme. Conclusions Our study has found that barriers to early presentation of women with locally advanced breast cancer remain similar and have persisted over the years despite targeted efforts. There is a need for a rethink of existing strategies and to develop new innovative ways to reach out to this group of patients.
Dephospho‐CoA kinase, a nuclear‐encoded apicoplast protein, remains active and essential after Plasmodium falciparum apicoplast disruption

Malaria parasites contain an essential organelle called the apicoplast that houses metabolic pathways for fatty acid, heme, isoprenoid, and iron–sulfur cluster synthesis. Surprisingly, malaria parasites can survive without the apicoplast as long as the isoprenoid precursor isopentenyl pyrophosphate (IPP) is supplemented in the growth medium, making it appear that isoprenoid synthesis is the only essential function of the organelle in blood‐stage parasites. In the work described here, we localized an enzyme responsible for coenzyme A synthesis, DPCK, to the apicoplast, but we were unable to delete DPCK, even in the presence of IPP. However, once the endogenous DPCK was complemented with the E. coli DPCK (EcDPCK), we were successful in deleting it. We were then able to show that DPCK activity is required for parasite survival through knockdown of the complemented EcDPCK. Additionally, we showed that DPCK enzyme activity remains functional and essential within the vesicles present after apicoplast disruption. These results demonstrate that while the apicoplast of blood‐stage P. falciparum parasites can be disrupted, the resulting vesicles remain biochemically active and are capable of fulfilling essential functions.
Violet light suppresses lens-induced myopia via neuropsin (OPN5) in mice

Significance The increasing prevalence of myopia is a significant public health concern. Unfortunately, the mechanisms driving myopia remain elusive, limiting effective treatment options. This report identifies a refractive development pathway that requires Opn5-expressing retinal ganglion cells (RGCs). Stimulation of Opn5 RGCs with short-wavelength violet light prevented experimental myopia in mice. Furthermore, this effect was dependent on the time of day, with evening exposure being sufficient to protect against experimental myopia. Thus, these studies suggest Opn5 RGCs may contribute to the mechanisms of emmetropization and identify the OPN5 pathway as a potential target for the treatment of myopia. Myopia has become a major public health concern, particularly across much of Asia. It has been shown in multiple studies that outdoor activity has a protective effect on myopia. Recent reports have shown that short-wavelength visible violet light is the component of sunlight that appears to play an important role in preventing myopia progression in mice, chicks, and humans. The mechanism underlying this effect has not been understood. Here, we show that violet light prevents lens defocus–induced myopia in mice. This violet light effect was dependent on both time of day and retinal expression of the violet light sensitive atypical opsin, neuropsin (OPN5). These findings identify Opn5-expressing retinal ganglion cells as crucial for emmetropization in mice and suggest a strategy for myopia prevention in humans.
COVID-19 Outcomes in Underserved Populations: Reaping What One Sows

In this issue of RESPIRATORY CARE, Chaudhary and colleagues report their single-center experience caring for a group of critically ill patients with severe COVID-19 pneumonia. This cohort of 128 subjects consisted of 64% Black, 13% Hispanic, 5% white, and 19% other races and came from a community where almost half of the population live below the poverty line. Nearly 90% of the subjects had cardiovascular comorbidity, and 78% had $ 2 comorbidities. These subjects were stricken with severe respiratory failure with an average PaO2=FIO2 of 109 mm Hg, Murray score indicative of severe lung injury, elevated inflammatory markers, and evidence for acute kidney injury. In this group, 97% required intubation and subsequently were found to have very stiff lungs. Multivariable regression analysis revealed that, among Black subjects, increased age, positive fluid balance, and tocilizumab treatment were associated with mortality, whereas higher platelets and intermediate-dose anticoagulation were protective. Among other groups, higher total bilirubin and higher lactate were associated with a higher mortality rate, whereas tocilizumab treatment was protective. The authors noted that race and ethnicity did not seem to be markers for poor outcomes. Their study provides a full data set and indicates access to all vital equipment for care of the critically ill, application of contemporary treatments, and management paradigms that would be expected from an academic institution. Notwithstanding, in-hospital mortality was a sobering 63%. Corticosteroids remain the only therapeutic intervention associated with mortality benefit in the treatment of severe COVID-19 pneumonia. In the RECOVERY trial, use of dexamethasone resulted in an absolute mortality benefit of 2.8% compared with usual care in the treatment of subjects hospitalized with COVID-19 infection. The magnitude of the mortality benefit rose to 12.1% among subjects who received invasive mechanical ventilation. Tocilizumab, a monoclonal antibody that blocks the interleukin-6 receptor, is used for the treatment of cytokine release syndrome associated with CAR-T cell therapy in the ICU. In the largest
Hexose-6-phosphate dehydrogenase blockade reverses prostate cancer drug resistance in xenograft models by glucocorticoid inactivation

Inhibiting H6PD restores prostate cancer response to AR antagonists by normalizing glucocorticoid metabolism in mouse xenograft models. Restoring tumor metabolism Androgen receptor antagonists have been shown to be effective in the treatment of prostate cancer. However, patients develop mechanisms of resistance associated with loss of the enzyme that inactivates glucocorticoids. Now, Li et al. investigated the mechanisms mediating the resistance to the androgen receptor antagonist enzalutamide (enz) in cancer tissue from patients and mouse xenograft models. The authors reported that treatment with enz induced an up-regulation of hexose-6-phosphate dehydrogenase (H6PD) in human tumor tissue and cell lines. Genetic or pharmacological blockade of H6PD restored glucocorticoid metabolism and sensitivity to enz in vitro and in vivo, suggesting that H6PD could be targeted to overcome pharmacoresistance in prostate cancer. Prostate cancer resistance to next-generation hormonal treatment with enzalutamide is a major problem and eventuates into disease lethality. Biologically active glucocorticoids that stimulate glucocorticoid receptor (GR) have an 11β-OH moiety, and resistant tumors exhibit loss of 11β-HSD2, the oxidative (11β-OH → 11-keto) enzyme that normally inactivates glucocorticoids, allowing elevated tumor glucocorticoids to drive resistance by stimulating GR. Here, we show that up-regulation of hexose-6-phosphate dehydrogenase (H6PD) protein occurs in prostate cancer tissues of men treated with enzalutamide, human-derived cell lines, and patient-derived prostate tissues treated ex vivo with enzalutamide. Genetically silencing H6PD blocks NADPH generation, which inhibits the usual reductive directionality of 11β-HSD1, to effectively replace 11β-HSD2 function in human-derived cell line models, suppress the concentration of biologically active glucocorticoids in prostate cancer, and reverse enzalutamide resistance in mouse xenograft models. Similarly, pharmacologic blockade of H6PD with rucaparib normalizes tumor glucocorticoid metabolism in human cell lines and reinstates responsiveness to enzalutamide in mouse xenograft models. Our data show that blockade of H6PD, which is essential for glucocorticoid synthesis in humans, normalizes glucocorticoid metabolism and reverses enzalutamide resistance in mouse xenograft models. We credential H6PD as a pharmacologic vulnerability for treatment of next-generation androgen receptor antagonist–resistant prostate cancer by depleting tumor glucocorticoids.
Toward next-generation learned robot manipulation

This Review identifies challenges and research frontiers in learning techniques to advance adaptive robot manipulation skills. The ever-changing nature of human environments presents great challenges to robot manipulation. Objects that robots must manipulate vary in shape, weight, and configuration. Important properties of the robot, such as surface friction and motor torque constants, also vary over time. Before robot manipulators can work gracefully in homes and businesses, they must be adaptive to such variations. This survey summarizes types of variations that robots may encounter in human environments and categorizes, compares, and contrasts the ways in which learning has been applied to manipulation problems through the lens of adaptability. Promising avenues for future research are proposed at the end.
Examining the inertial subrange with nanoscale cross-wire measurements of turbulent pipe flow at high Reynolds number near the centreline

Abstract Highly resolved, two-component velocity measurements were made near the centreline of turbulent pipe flow for Reynolds numbers in the range $102 \le Re_\lambda \leq 411$ ($1800 \le Re_\tau \leq 24\,700$). These unique data were obtained with a nanoscale cross-wire probe and used to examine the inertial subrange scaling of the longitudinal and transverse velocity components. Classical dissipation rate estimates were made using both the integration of one-dimensional dissipation spectra for each velocity component and the third-order moment of the longitudinal structure function. Although the second-order moments and one-dimensional spectra for each component showed behaviour consistent with local isotropy, clear inertial range similarity and behaviour were not exhibited in the third-order structure functions at these Reynolds numbers. When corrected for the effects of radial inhomogeneities at the centreline following the generalized expression of Danaila et al. (J. Fluid Mech., vol. 430, 2001, pp. 87–109), re-derived for the pipe flow domain, the third-order moments of the longitudinal structure function exhibited a clearer plateau per the classical Kolmogorov ‘four-fifths law’. Similar corrections described by Danaila et al. (J. Fluid Mech., vol. 430, 2001, pp. 87–109) applied to the analogous equation for the mixed structure functions (i.e. the ‘four-thirds law’) also yielded improvement over all ranges of scale, improving with increasing Reynolds number. The rate at which the ‘four-fifths’ law and ‘four-thirds’ law were approached by the third-order structure functions was found to be more gradual than decaying isotropic turbulence for the same Reynolds numbers.
Modelling, Analysis, and Optimization of Three-Dimensional Restricted Visual Field Metric-Free Swarms

Models of collective behaviour have been proved helpful in revealing what mechanism may underlie characteristics of a flock of birds, a school of fish, and a swarm of herds. Recently, the metric-free model gradually occupies a dominant position in the research field of collective intelligence. Most of these models endow every single individual with the ability of a global visual field, which can offer each particle sufficient external information. In this paper, we mainly focus on whether the global visual field is necessary to form a consistent and cohesive group or not. Inspired by the biological characteristic of starlings, we develop a three-dimensional restricted visual field metric-free(RVFMF) model based on Pearce and Turner’s previous work. We further investigate several vital factors governing the convergent consistency of the RVFMF model with the assistance of extensive numerical simulations. According to the simulation results, we conclude that the best view angle of each particle in a swarm increases with the expansion of the population size. Besides, the best view angle gradually becomes stable around 155 degrees when the population size is larger than 1000. We also offer quantitative analysis data to prove that a flock of birds could obtain better consistency under optimal restricted visual field than under global visual field.