Miracle-dz/UniFAR-FTUs huggingface dataset:
Free carnitine concentrations and biochemical parameters in medium‐chain acyl‐CoA dehydrogenase deficiency: Genotype–phenotype correlation

Biallelic variants in the ACADM gene cause medium‐chain acyl‐CoA dehydrogenase deficiency (MCADD). This study reports on differences in the occurrence of secondary free carnitine (C0) deficiency and different biochemical phenotypes related to genotype and age in 109 MCADD patients followed‐up at a single tertiary care center during 22 years. C0 deficiency occurred earlier and more frequently in c.985A>G homozygotes (genotype A) compared to c.985A>G compound heterozygotes (genotype B) and individuals carrying variants other than c.985A>G and c.199C>T (genotype D) (median age 4.2 vs. 6.6 years; p < 0.001). No patient carrying c.199C>T (genotype C) developed C0 deficiency. A daily dosage of 20–40 mg/kg carnitine was sufficient to maintain normal C0 concentrations. Compared to genotype A as reference group, octanoylcarnitine (C8) was significantly lower in genotypes B and C, whereas C0 was significantly higher by 8.28 μmol/L in genotype C (p < 0.05). In conclusion, C0 deficiency is mainly found in patients with pathogenic genotypes associated with high concentrations of presumably toxic acylcarnitines, while individuals carrying the variant c.199C>T are spared and show consistently mild biochemical phenotypes into adulthood. Low‐dose carnitine supplementation maintains normal C0 concentrations. However, future studies need to evaluate clinical benefits on acute and chronic manifestations of MCADD.
Flow past bluff bodies: effect of blockage

The effect of blockage on the flow past a bluff body is investigated. Two flow problems are considered. The first is the onset of wake instability in the flow past a stationary cylinder. We attempt to estimate the value of critical Reynolds number (Rec), via a linear stability analysis (LSA) of the governing equations for incompressible flows. A stabilized finite element formulation is utilized. While the vortex shedding frequency is found to be quite sensitive to blockage, a non-monotonic variation of Rec with blockage is observed. These results are used to suggest a possible explanation of the scatter in the data from various researchers in the past. The next flow problem is the vortex induced vibrations of a circular cylinder at low Re. It is found that for high blockage (5%) a hysteretic behavior close to the lower limit of synchronization/lock-in can occur depending on whether one is on the “increasing Re” branch or the “decreasing Re” branch. The amplitude of cylinder oscillations is higher for the decreasing Re case. The two solutions are associated with different arrangement of vortices in the wake. With the low blockage computation (1%), the hysteretic behavior is completely eliminated. The solutions for the decreasing as well as increasing Re branch appear very similar and are associated with intermittent switching between vortex shedding at structural frequency and shedding frequency for stationary cylinder.
Are we ready for the cold snare revolution?

foration and cannot lead to the post-polypectomy syndrome that is associated with traditional, or hot snare, polypectomy (HSP) involving electrocautery. Extensive research has documented that the risk of bleeding after CSP for subcentimeter polyps is similar or smaller than that after HSP [1]. Meta-analyses have shown that the incomplete resection rate (IRR) is comparable between the two methods, but varies markedly between the studies (0–25%), with significant heterogeneity [1, 2]. The quality of evidence has been rated as very low. Some of the variation is probably caused by differences in study settings, with the lowest IRRs coming from academic expert centers. Complete resection of colorectal polyps is of obvious importance. It has been estimated that 20% of post-colonoscopy cancers may be caused by incompletely removed polyps [3]. In this issue of Endoscopy, von Renteln et al. offer another piece of the puzzle regarding the usefulness of the CSP technique [4]. In their single-center prospective cross-sectional study, the authors investigated the IRR of 128 colorectal polyps sized 4–20mm. The nine endoscopists who participated in the study were all board-certified and had extensive colonoscopy experience. After the removal of all visible polyp tissue, completeness of removal was assessed by biopsies obtained from the resection margins. The IRR was disappointingly high: 18% of polyps of 4–9mm and 21% of polyps of 10–20mm were not completely removed.
Effectiveness of a smartphone application on dental anxiety in adolescents: a randomized controlled trial.

BACKGROUND Dental anxiety is a common issue among adolescents. Despite the use of smartphones being an important part of their daily lives, only a few digital-based interventions for dental anxiety have been tested in randomized controlled trials (RCT). AIM To evaluate a new smartphone application (App) named FALE, which was designed to demonstrate interest from the dentist to adolescent and to reduce dental anxiety. DESIGN This is a RCT in which 184 adolescents aged 10 to 19 years were randomly allocated into the intervention (IG) or control (CG) groups. The intervention was applied in the waiting room before the consultation at a dental clinic. The IG answered the FALE, which contained 14 questions - of which the first and last questions addressed anxiety, whereas the CG answered the question about anxiety twice with an interval between them. RESULTS There was a significant difference in the distribution of anxiety rating frequencies before and after the intervention period in both groups. For the intervenvtion group, there was a reduction of anxiety after the intervention of 16.29%, and, in the control group, a reduction of 2.2% (P-value<0.001). CONCLUSION The FALE App effectively reduced dental anxiety before the appointment.
Report on fraying resilience among the Ontario Registered Practical Nurse Workforce in long‐term care homes during COVID‐19

Registered Practical Nurses (RPNs) are frontline healthcare providers in Ontario long‐term care (LTC) homes. Throughout COVID‐19, RPNs working in LTC homes experienced prolonged lockdowns, challenging working conditions, and inadequate resource allocation. This study aimed to describe the personal and professional resilience of RPNs working in LTC during the COVID‐19 pandemic.
Vortex-Vortex Interactions for the Maintenance of Blocking. Part I: The Selective Absorption Mechanism and a Case Study

AbstractA new block maintenance mechanism, the selective absorption mechanism (SAM), is proposed. According to this mechanism, which is based on vortex–vortex interactions (i.e., the interactions between a blocking anticyclone and synoptic eddies with the same polarity), a blocking anticyclone actively and selectively absorbs synoptic anticyclones (strictly, air parcels with low potential vorticity). The blocking anticyclone, which is thus supplied with low potential vorticity of the synoptic anticyclones, can subsist for a prolonged period, withstanding dissipation.The SAM was verified in a case study through trajectory analysis. Ten actual cases of blocking were examined. Trajectories were calculated by tracing parcels originating from synoptic anticyclones and cyclones located upstream of the blocking. Parcels starting from anticyclones were attracted to and absorbed by the blocking anticyclone, whereas parcels from cyclones were repelled by the blocking anticyclone and attracted to the blocking cyclon.
Direct numerical simulations of the effects of shear on turbulent Rayleigh-Bénard convection

The interaction between shear and buoyancy effects for Bénard convection in plane Couette flow is studied by performing direct numerical simulations. At moderate Rayleigh number (≈10000−50000), shear tends to organize the flow into quasi-two-dimensional rolls parallel to the mean flow and can enhance heat transfer, while at higher Rayleigh number (>150000), shear tends to disrupt the formation of convective plumes and can reduce heat transfer. A significant temporal oscillation in the local Nusselt number was consistently observed at high Rayleigh numbers, a factor that may contribute to the scatter seen in experimental data. This effect, plus the time-varying reversal of the mean temperature gradient in the middle of the channel, is consistent with a flow model in which the dynamics of large-scale, quasi-two-dimensional, counter-rotating vortical cells are alternately driven by buoyancy and inertial effects. An analysis of the energy balance in the flow shows that the conservative pressure diffusion term, which has been frequently neglected in turbulence models, plays a very important dynamical role in the flow evolution and should be more carefully modelled. Most of the turbulent energy production due to mean shear is generated in the boundary layers, while the buoyant production occurs mainly in the relatively uniform convective core. The simulations and the laboratory experiments of Deardorff & Willis (1967) are in very reasonable qualitative agreement, suggesting that the basic dynamics of the flow are being accurately simulated.
Sensitivity analysis for dynamic mechanical systems with finite rotations

This paper presents a sensitivity analysis for dynamic systems with large rotations using a semi‐analytical direct differentiation technique. The choice of a suitable time integration strategy for the rotation group appears to be critical for the development of an efficient sensitivity analysis. Three versions of the generalized‐α time integration scheme are considered: a residual form, a linear form, and a geometric form. Their consistency is discussed, and we show that the residual form, which is the most direct extension of the generalized‐α algorithm defined in structural dynamics, should not be used for problems with large rotations. The sensitivity analysis is performed and close connections are highlighted between the structure of the sensitivity equations and of the linearized dynamic equations. Hence, algorithms developed for the original problem can be directly reused for the sensitivities. Finally, a numerical example is analysed in detail. Copyright © 2007 John Wiley & Sons, Ltd.
Transmission zeros in structural control with collocated multi-input/ multi-output pairs

I N ACTIVE vibration control of flexible structures with a singleinput/single-output (SISO) collocated (dual) actuator/sensor pair, the transmission zeros exhibit the well-known property of interlacing, that is, the poles and zeros alternate along the imaginary axis (strictly if the structure is undamped, slightly in the left-half plane for a lightly damped structure). This property is the origin of the guaranteed stability of the so-called low authority control (LAC) strategies for active damping [1,2]. Besides, the transmission zeros coincide with the poles (natural frequencies) of a modified system which depends on the sensor configuration. For a displacement (velocity) sensor, the modified system is the constrained system where the degree of freedom (DOF) alongwhich the control operates is blocked [3,4]. For a force sensor, the modified system is obtained by removing the contribution of the active member to the global stiffness matrix of the structure [2]. As the gain increases, the closedloop poles start from the open-loop poles and those which remain at finite distance move on loops going asymptotically to the transmission zeros. For displacement sensors, the extension of the SISO result to multi-input/multi-output (MIMO) collocated pairs has already been discussed in the literature [5] and, based on the fact that transmission zeros give identically zero output response, it has been inferred that, for MIMO systems, the transmission zeros are the eigenvalues of an associated constrained modes problem. To the authors’ knowledge, however, no formal proof is available. This Note provides such a proof for an undamped structure; the two cases (force actuator, displacement sensor and displacement actuator, force sensor) are discussed separately. II. Force Actuator, Displacement Sensor
Applying a risk prediction model for bloodstream infection in a febrile, nonseverely neutropenic cohort of pediatric stem cell transplant patients

The optimal management of febrile stem cell transplant (SCT) patients presenting without severe neutropenia (absolute neutrophil count [ANC] ≥ 500/µL) is unclear. The authors have developed iterative risk prediction models (Esbenshade Vanderbilt [EsVan] models) that reliably predict bloodstream infections (BSIs) in the febrile general pediatric oncology population without severe neutropenia, but SCT‐specific data are limited.
What is the Optimal Dipole Moment for Nonpolarizable Models of Liquids?

In classical nonpolarizable models, electrostatic interactions are usually described by assigning fixed partial charges to interaction sites. Despite the multitude of methods and theories proposed over the years for partial charge assignment, a fundamental question remains—what is the correct degree of polarization that a fixed-charge model should possess to provide the best balance of interactions (including induction effects) and yield the best description of the potential energy surface of a liquid phase? We address this question by approaching it from two separate and independent viewpoints: the QUantum mechanical BEspoke (QUBE) approach, which assigns bespoke force field parameters for individual molecules from ab initio calculations with minimal empirical fitting, and the Polarization-Consistent Approach (PolCA) force field, based on empirical fitting of force field parameters with an emphasis on transferability by rigorously accounting for polarization effects in the parameterization process. We show that the two approaches yield consistent answers to the above question, namely, that the dipole moment of the model should be approximately halfway between those of the gas and the liquid phase. Crucially, however, the reference liquid-phase dipole needs to be estimated using methods that explicitly consider both mean-field and local contributions to polarization. In particular, continuum dielectric models are inadequate for this purpose because they cannot account for local effects and therefore significantly underestimate the degree of polarization of the molecule. These observations have profound consequences for the development, validation, and testing of nonpolarizable models.
Endoscopic vacuum therapy for esophageal perforation: a multicenter retrospective cohort study

Background Endoscopic vacuum therapy (EVT) is a novel treatment for esophageal perforations. This study aimed to describe initial experience with EVT of esophageal perforations due to iatrogenic cause, Boerhaave syndrome, or other perforations not related to prior upper gastrointestinal surgery. Methods Data from patients treated with EVT for esophageal perforation at five hospitals in three European countries, between January 2018 and October 2021, were retrospectively collected. The primary end point was successful defect closure by EVT, with or without the use of other endoscopic treatment modalities. Secondary end points included mortality and adverse events. Results 27 patients were included (median age 71 years). The success rate was 89 % (24/27, 95 %CI 77–100). EVT failed in three patients: two deceased during EVT (septic embolic stroke, pulmonary embolism) and one underwent esophagectomy due to a persisting defect. Two adverse events occurred: one iatrogenic defect expansion during sponge exchange and one hemorrhage during sponge removal. Median treatment duration was 12 days (interquartile range [IQR] 6–16) with 1 sponge exchange (IQR 1–3). Conclusion EVT is a promising organ-preserving treatment for esophageal perforations, with a success rate of 89 %. More experience with the technique and indications will likely improve success rates.
Image reconstruction from truncated data in single-photon emission computed tomography with uniform attenuation

We present a mathematical analysis of the problem of image reconstruction from truncated data in two-dimensional (2D) single-photon emission computed tomography (SPECT). Recent results in classical tomography have shown that accurate reconstruction of some parts of the object is possible in the presence of truncation. We have investigated how these results extend to 2D parallel-beam SPECT, assuming that the attenuation map is known and constant in a convex region Ω that includes all activity sources. Our main result is a proof that, just like in classical tomography accurate SPECT reconstruction at a given location , does not require the data on all lines passing through Ω; some amount of truncation can be tolerated. Experimental reconstruction results based on computer-simulated data are given in support of the theory.
Receiving uncertain results from prenatal chromosomal microarray analysis: Women's decisions on continuation or termination of pregnancy

Chromosomal microarray analysis (CMA) may detect variants of uncertain clinical significance (VUS) and susceptibility loci (SL) with incomplete penetrance for neurodevelopmental disorders. This qualitative study provides empirical data on women's experiences with receiving such findings in pregnancy and their decisions regarding continuation or termination of the pregnancy.
Barotropic Regeneration of Upper-Level Synoptic Disturbances in Different Configurations of the Zonal Weather Regime

Abstract Barotropic dynamics of upper-tropospheric midlatitude disturbances evolving in different configurations of the zonal weather regime (i.e., in different zonal-like large-scale flows) were studied using observational analyses and barotropic model experiments. The contraction stage of upper-level disturbances that follows their elongation stage leads to an increase of eddy kinetic energy that is called the barotropic regeneration process in this text. This barotropic mechanism is studied through notions of barotropic critical regions (BtCRs) and effective deformation that have been introduced in a previous paper. The effective deformation field is equal to the difference between the square of the large-scale deformation magnitude and the square of the large-scale vorticity. Regions where the effective deformation is positive correspond to regions where the large-scale flow tends to strongly stretch synoptic disturbances. A BtCR is an area separating two large-scale regions of positive effective defo.
BUCKLING ANALYSIS OF LINE CONTINUUM WITH NEW MATRICES OF STIFFNESS AND GEOMETRY

This research work present buckling analysis of line continuum with new matrices of elastic stiffness and geometric stiffness. The stiffness matrices were developed using energy variational principle. Two deformable nodes were considered at the centre and at the two ends of the continuum which brings the number of deformable node to six. The six term Taylor McLaurin’s shape function was substituted into strain energy equation and the result functional was minimized, resulting in a 6 x 6 stiffness matrix used herein. The six term shape function is also substituted into the geometric work equation and minimized to obtain 6 x 6 geometric stiffness matrix for buckling analysis. The two matrices were employed, as well as traditional 4 x 4 matrices in classical buckling analysis of four line continua. The results from the new 6 x 6 matrices of stiffness and geometry were very close to exact results, with average percentage difference of 2.33% from exact result. Whereas those from the traditional 4 x 4 matrices and 5 x 5 matrices differed from exact results, with average percentage difference of 23.73% and 2.55% respectively. Thus the newly developed 6 x 6 matrices of stiffness and geometry are suitable for classical buckling analysis of line continuum.
Predicting Outcomes of Language Rehabilitation: Prognostic Factors for Immediate and Long-Term Outcomes After Aphasia Therapy

Background: Aphasia therapy is an effective approach to improve language function in chronic aphasia. However, it remains unclear what prognostic factors facilitate therapy response at the individual level. Here, we utilized data from the POLAR (Predicting Outcomes of Language Rehabilitation in Aphasia) trial to (a) determine therapy-induced change in confrontation naming and long-term maintenance of naming gains and (b) examine the extent to which aphasia severity, age, education, time postonset, and cognitive reserve predict naming gains at 1 week, 1 month, and 6 months posttherapy. Method: A total of 107 participants with chronic (≥ 12 months poststroke) aphasia underwent extensive case history, cognitive–linguistic testing, and a neuroimaging workup prior to receiving 6 weeks of impairment-based language therapy. Therapy-induced change in naming performance (measured as raw change on the 175-item Philadelphia Naming Test [PNT]) was assessed 1 week after therapy and at follow-up time points 1 month and 6 months after therapy completion. Change in naming performance over time was evaluated using paired t tests, and linear mixed-effects models were constructed to examine the association between prognostic factors and therapy outcomes. Results: Naming performance was improved by 5.9 PNT items (Cohen's d = 0.56, p < .001) 1 week after therapy and by 6.4 (d = 0.66, p < .001) and 7.5 (d = 0.65, p < .001) PNT items at 1 month and 6 months after therapy completion, respectively. Aphasia severity emerged as the strongest predictor of naming improvement recovery across time points; mild (ß = 5.85–9.02) and moderate (ß = 9.65–11.54) impairment predicted better recovery than severe (ß = 1.31–3.37) and very severe (ß = 0.20–0.32) aphasia. Age was an emergent prognostic factor for recovery 1 month (ß = −0.14) and 6 months (ß = −0.20) after therapy, and time postonset (ß = −0.05) was associated with retention of naming gains at 6 months posttherapy. Conclusions: These results suggest that therapy-induced naming improvement is predictable based on several easily measurable prognostic factors. Broadly speaking, these results suggest that prognostication procedures in aphasia therapy can be improved and indicate that personalization of therapy is a realistic goal in the near future. Supplemental Material: https://doi.org/10.23641/asha.22141829
The Healthy Work Survey

The Healthy Work Survey is a short, standardized online tool to assess the level of work-related psychosocial risk based on distributions from a U.S. national working population. Occupational medicine professionals can easily access this free tool and report to evaluate individual and workplace psychosocial hazards impacting worker health and safety. Objectives Work-related psychosocial stressors have been recognized as occupational hazards and assessed in workplaces in many countries for decades. Identifying tools to measure work-related psychosocial hazards to increase awareness in the United States about the impact on employees’ health and safety is critical (J Occup Environ Med. 2021;63:e245–e249). Methods We describe the development and psychometric validation of an online tool, the Healthy Work Survey, utilizing items from the National Institute for Occupational Safety and Health Quality of Work Life questionnaire. Results There are 55 items in the final core work section of the HWS. Factor analyses confirmed nine factors, and the subsequent multi-item scales had acceptable internal consistency. A user-friendly, online system and automated report compares individual’s and organization’s scores to distributions from a representative US working population (General Social Survey Quality of Work Life). Discussion The HWS is a reliable, valid tool for organizations and individuals to assess psychosocial work hazards.