Miracle-dz/UniFAR-FTUs huggingface dataset:
CSF‐to‐blood toxins clearance is modulated by breathing through cranio–spinal CSF oscillation

Clearance of brain toxins occurs during sleep, although the mechanism remains unknown. Previous studies implied that the intracranial aqueductal cerebrospinal fluid (CSF) oscillations are involved, but no mechanism was suggested. The rationale for focusing on the aqueductal CSF oscillations is unclear. This study focuses on the cranio–spinal CSF oscillation and the factors that modulate this flow. We propose a mechanism where increased cranio–spinal CSF movements enhance CSF‐to‐blood metabolic waste clearance through the spinal CSF re‐absorption sites. A recent study demonstrating that disturbed sleep impairs CSF‐to‐blood but not brain‐to‐CSF clearance, supports the fundamentals of our proposed mechanism. Eight healthy subjects underwent phase‐contrast magnetic resonance imaging to quantify the effect of respiration on the cranio–spinal CSF oscillations. Maximal CSF volume displaced from the cranium to the spinal canal during each respiration and cardiac cycle were derived as measures of cranio–spinal CSF mixing level. Transition from normal to slow and abdominal breathing resulted in a 56% increase in the maximal displaced CSF volume. Maximal change in the arterial–venous blood volume, which is the driving force of the CSF oscillations, was increased by 41% during slow abdominal breathing. Cranio–spinal CSF oscillations are driven by the momentary difference between arterial inflow and venous outflow. Breathing modulates the CSF oscillation through changes in the venous outflow. The amount of toxins being transferred to the spinal canal during each respiratory cycle is significantly increased during slow and deeper abdominal breathing, which explains enhanced CSF‐to‐blood toxins clearance during slow‐wave sleep and poor clearance during disrupted sleep.
PAST AND RECENT COPPICE FOREST MANAGEMENT IN SOME REGIONS OF SOuTh EASTERN EuROPE

Abstract High diversity of site conditions and vegetation patterns in South Eastern Europe (SEE), accompanied by different socio-cultural background of countries, has produced a wealth of diverse coppice stands and a variety of management practices. The paper provides an overview on past and recent coppice forest management in four selected countries in SEE: Bulgaria, Croatia, Macedonia and Serbia, in which coppice forestry has been of significant importance. The following main coppice forest types have been recognised in respect to their past management and current condition: (i) traditional coppice forests; (ii) ‘high coppice’ forests; (iii) coppice forests for transformation and reconstruction; (iv) coppice forests with standards and ‘middle-aged’ forests; (v) pollarding forests; (vi) selection coppice forests; (vii) shelterbelts (windbreaks, erosion shelterbelts, etc); (viii) oak coppices for shelling; and (ix) coppice forests subjected to no management. The paper emphasizes the contribution of sustainable management of coppice forest resources to ecological stability and economic development of SEE, which could be achieved by both considering the traditional management concepts and introducing new ecologically, economically and socially sound management practices.
Long-Term Health Outcomes of Limb Salvage Compared with Amputation for Combat-Related Trauma

Background: There are little long-term health data, particularly in terms of body composition and development of metabolic syndromes, to help surgeons to guide the decision between limb salvage and amputation in patients with limb-threatening trauma. The purpose of this study was to compare long-term health outcomes after high-energy lower-extremity trauma between patients who underwent attempted flap-based limb salvage or amputation. Methods: We performed a retrospective review of servicemembers with a minimum 10-year follow-up who underwent flap-based limb salvage followed by unilateral amputation or continued limb salvage after combat-related, lower-extremity trauma between 2005 and 2011. Patient demographic characteristics, injury characteristics, and health outcomes including body mass index (BMI) and development of metabolic disease (e.g., hyperlipidemia, hypertension, heart disease, and diabetes) were compared between treatment cohorts. Adjusted BMIs were calculated for the amputation cohort to account for lost surface area. We performed multivariable and propensity score analysis to determine the likelihood of developing obesity or metabolic disease. Results: In this study, 110 patients had available long-term follow-up (mean, 12.2 years) from the time of the injury. Fifty-six patients underwent limb salvage and 54 patients underwent unilateral amputation. There was no difference in preinjury BMI (p = 0.30). After adjusting for limb loss, the amputation cohort had a trend toward higher BMIs at ≥1 years after the injury, a higher rate of obesity, and a greater increase in BMI from baseline after the injury. The development of metabolic comorbidities was common after both amputation (23 [43%] of 54) and limb salvage (27 [48%] of 56). With the numbers available, we were unable to demonstrate a difference in risk for the development of hypertension, hyperlipidemia, diabetes, heart disease, or any comorbidity other than obesity (p > 0.05). Conclusions: Amputations may be medically necessary and may decrease pain, improve mobility, and/or expedite return to activity compared with limb salvage after similar injuries. However, limb loss may negatively impact metabolic regulation and may contribute to a higher risk of obesity despite beneficial effects on mobility. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Modeling Idiographic Longitudinal Relationships between Affect and Cigarette Use: An Ecological Momentary Assessment Study

Abstract Background: Despite public knowledge of the adverse health effects of tobacco use, cigarettes remain widely used due to the addictive nature of nicotine. Physiologic adaptation to the presence of nicotine over time leads to unpleasant effects during withdrawal periods. Alongside these physiological effects, tobacco users often report changes in their consumption of tobacco in response to their emotional state. Objectives: We hypothesized that idiographic, or person-specific level, increases in participants’ negative affect (NA) and positive affect (PA) ratings at a given time point would be associated with higher and lower craving and smoking over the following several hours, respectively. Fifty-two participants completed block randomized ecological momentary assessment surveys on their smartphones 4 times per day for 30 days, reporting from 0-100 their level of seven discrete emotions, stress, current craving, and smoking behavior. We analyzed the relationships between affect and smoking and craving using idiographic generalized linear models. Results: While some participants exhibited the hypothesized relationships, each participant varied in the strength and direction of the relationships between affect and craving/smoking. These outcomes were partially moderated at the group level by anxiety/depression at baseline, but not by level of nicotine dependence or sex. Conclusions: This suggests that the factors driving cigarette use vary significantly between individuals.
Temperature‐mediated diffusion of nanoparticles in semidilute polymer solutions

The temperature is often a critical factor affecting the diffusion of nanoparticles in complex physiological media, but its specific effects are still to be fully understood. Here, we constructed a temperature‐regulated model of semidilute polymer solution and experimentally investigated the temperature‐mediated diffusion of nanoparticles using the particle tracking method. By examining the ensemble‐averaged mean square displacements (MSDs), we found that the MSD grows gradually as the temperature increases while the transition time from sublinear to linear stage in MSD decreases. Meanwhile, the temperature‐dependent measured diffusivity of the nanoparticles shows an exponential growth. We revealed that these temperature‐mediated changes are determined by the composite effect of the macroscale property of polymer solution and the microscale dynamics of polymer chain as well as nanoparticles. Furthermore, the measured non‐Gaussian displacement probability distributions were found to exhibit non‐Gaussian fat tails, and the tailed distribution is enhanced as the temperature increases. The non‐Gaussianity was calculated and found to vary in the same trend with the tailed distribution, suggesting the occurrence of hopping events. This temperature‐mediated non‐Gaussian feature validates the recent theory of thermally induced activated hopping. Our results highlight the temperature‐mediated changes in diffusive transport of nanoparticles in polymer solutions and may provide the possible strategy to improve drug delivery in physiological media.
Determination of Hydraulic Conductivity Using the Direct-Push Injection Logger

p [bar] (45 m) Q [l/h] (45 m) p/Q R [bar×(h/l)]0.05 25 2.00E-03 9.28E-040.10 50 2.00E-03 1.24E-030.21 90 2.33E-03 1.74E-030.28 145 1.93E-03 2.43E-030.62 205 3.02E-03 3.19E-031.00 260 3.85E-03 3.88E-031.25 300 4.17E-03 4.38E-031.80 350 5.14E-03 5.01E-032.30 400 5.75E-03 5.63E-032.85 450 6.33E-03 6.26E-03
Site‐specific trends in gastroenteropancreatic neuroendocrine neoplasms in Bavaria, Germany

Neuroendocrine neoplasms (NEN) are rare and heterogeneous epithelial tumors, occurring throughout the body. For gastroenteropancreatic (GEP)‐NEN, rising incidence rates were reported for the last decades, with underlying causes remaining largely unexplained. We evaluated NEN trends stratifying by their histologic subtypes.
Examining Changes in Quality of Life as an Outcome Measure in Three Randomized Controlled Trials of Online Interventions That Included an Intervention for Hazardous Alcohol Use

Abstract Background Quality of life (QOL) summarizes an individual’s perceived satisfaction across multiple life domains. Many factors can impact this measure, but research has demonstrated that individuals with addictions, physical, and mental health concerns tend to score lower than general population samples. While QOL is often important to individuals, it is rarely used by researchers as an outcome measure when evaluating treatment efficacy. Methods This secondary analysis used data collected during three separate randomized controlled trials testing the efficacy of different online interventions to explore change in QOL over time between treatment conditions. The first project was concerned with only alcohol interventions. The other two combined either a gambling or mental health intervention with a brief alcohol intervention. Males and females were analyzed separately. Results This analysis found treatment effects among female participants in two projects. In the project only concerning alcohol, female quality of life improved more among those who received an extensive intervention for hazardous alcohol use compared to a brief intervention (p = .029). QOL among females who received only the mental health intervention improved more than those who also received a brief alcohol intervention (p = .049). Conclusion Poor QOL is often cited as a reason individuals decide to make behavior changes, yet treatment evaluations do not typically consider this patient-important outcome. This analysis found some support for different treatment effects on QOL scores in studies involving at least one intervention for hazardous alcohol use.
Land and Power in Ptolemaic Egypt: ISSUES AND HISTORICAL BACKGROUND

You must regard it as one of your most indispensable duties to see that the nome be sown with the kind of crops prescribed by the sowing schedule. Instructions of the Dioiketes to an Oikonomos , preserved in P. Tebt 703, 57–60. Trans. Bagnall and Derow 1981: 135 We offer (the properties) for sale on the following terms. The successful bidders shall pay annually to the Crown in the case of the vineyards the proper money taxes and the apomoira …. and for arable land the rents in kind which have been imposed upon it…. P. Eleph. 14 (Edfu, ca . 223 bce ) Trans. Select Papyri , vol. II, text 233. In this Chapter I will be concerned with the “reach of the state,” and its ability to control land tenure and the surplus agricultural production. The traditional power of the ruler in Egypt with respect to these issues was asserted in assigning rights to land and in taxing production (and on some land collecting rent). The Ptolemies retained these traditional powers over the land. I begin with a discussion of the structure of the state itself, and the organization of social power within the state. From there, I move on to discuss more specifically one aspect of social power, economic power, and the relationship between state economic power and land tenure.
Initial productive and latent HIV infections originate in vivo by infection of resting T cells

Productively infected cells are generally thought to arise from HIV infection of activated CD4+ T cells, and these infected activated cells are thought to be a recurring source of latently infected cells when a portion of the population transitions to a resting state. We discovered and report here that productively and latently infected cells can instead originate from direct infection of resting CD4+ T cell populations in lymphoid tissues in Fiebig I, the earliest stage of detectable HIV infection. We found that direct infection of resting CD4+ T cells was correlated with the availability of susceptible target cells in lymphoid tissues largely restricted to resting CD4+ T cells in which expression of pTEFb enabled productive infection, and we documented persistence of HIV-producing resting T cells during antiretroviral therapy (ART). Thus, we provide evidence of a mechanism by which direct infection of resting T cells in lymphoid tissues to generate productively and latently infected cells creates a mechanism by which the productively infected cells can replenish both populations and maintain two sources of virus from which HIV infection can rebound, even if ART is instituted at the earliest stage of detectable infection.
Risk factors prediction of 6-month mortality after noncardiac surgery of older patients in China: a multicentre retrospective cohort study

Background: Identifying the risk factors associated with perioperative mortality is crucial, particularly in older patients. Predicting 6-month mortality risk in older patients based on large datasets can assist patients and surgeons in perioperative clinical decision-making. This study aimed to develop a risk prediction model of mortality within 6 months after noncardiac surgery using the clinical data from 11 894 older patients in China. Materials and methods: A multicentre, retrospective cohort study was conducted in 20 tertiary hospitals. The authors retrospectively included 11 894 patients (aged ≥65 years) who underwent noncardiac surgery between April 2020 and April 2022. The least absolute shrinkage and selection operator model based on linear regression was used to analyse and select risk factors, and various machine learning methods were used to build predictive models of 6-month mortality. Results: The authors predicted 12 preoperative risk factors associated with 6-month mortality in older patients after noncardiac surgery. Including laboratory-associated risk factors such as mononuclear cell ratio and total blood cholesterol level, etc. Also including medical history associated risk factors such as stroke, history of chronic diseases, etc. By using a random forest model, the authors constructed a predictive model with a satisfactory accuracy (area under the receiver operating characteristic curve=0.97). Conclusion: The authors identified 12 preoperative risk factors associated with 6-month mortality in noncardiac surgery older patients. These preoperative risk factors may provide evidence for a comprehensive preoperative anaesthesia assessment as well as necessary information for clinical decision-making by anaesthesiologists.
Associations between antiepileptic use and hypogammaglobulinaemia: findings from a population-based case-control study using data linkage

Background Antiepileptic drugs (AEDs) have been previously associated with transient hypogammaglob- ulinaemia in small case series, which may predispose patients to infections. This study aimed to determine if an association exists between AEDs and hypogammaglobulinaemia. Methods A case-control study was conducted using data linkage of biochemistry, prescribing and morbidity data from 2009-2021. Cases were participants with immunoglobulin levels less than the normal range. Logistic regression was used to investigate associations between AED exposure and hypogamma- globulinaemia, adjusting for age and sex. Secondary analyses were conducted, investigating outcomes of low IgA, IgM and IgG separately. Cumulative exposure data were used to determine whether a exposure-response relationship exists. Results 18,666 cases and 127,157 controls were identified. AEDs were associated with increased risk of hypogammaglobulinaemia (adjusted odds ratio (aOR) 1.26 (95% confidence interval 1.21-1.31), p<0.001). Individual AEDs (except topiramate) were also associated with significantly increased hypogammaglob- ulinaemia risk to varying degrees. There was evidence of an exposure-response relationship for those treated with any AED. Conclusion AEDs may increase hypogammaglobulinaemia risk. Specific classes of immunoglobulins are differentially affected, and risk may increase with AED exposure. Clinicians should test immunoglobulin levels if unusual or recurrent infections occur. Further research should assess whether AED-associated hypogammaglobulinaemia increases infection risk.
What is missing from the sturgeon jaw: Developmental morphology of the upper jaw in Acipenser

Sturgeons belong to the family Acipenseridae, the most species‐rich extant family of Acipenseriformes, a basal actinopterygian group of key importance in assessing the early radiations of the actinopterygians. At the same time, acipenseriforms display unique specializations in the morphology of the snout and jaws which make them a valuable model for studying evolutionary novelties. However, despite a long history of research, the homologies of the snout and the mandibular arch of acipenseriforms remain uncertain preventing further studies on the evolutionary origin of their unique snout and jaw structure, and in particular, of the upper jaw symphysis, the key apomorphy of the group and the preoral snout. In the present study, a detailed description of the upper jaw morphology and development in sturgeons is provided in order to address its composition in terms of the common actinopterygian archetype. Based on the obtained results, the upper jaw of acipenseriforms is assumed to have lost the autopalatine portion, which most likely is represented by the separate cartilages supporting the tentacles. Also, the conventional interpretation of the sturgeon's maxilla as dermopalatine is rejected on the grounds of this bone structure and development. Paedomorphosis is proposed to be the most likely mechanism explaining the evolutionary origin of the upper jaw symphysis and supposed modifications of the snout in sturgeons.
Plating Versus Intramedullary Nailing of OTA/AO 43C1 and C2 Intra-articular Distal Tibia Fractures: A Propensity Score and Multivariate Analysis

Supplemental Digital Content is Available in the Text. OBJECTIVE: To compare rates of reduction loss, nonunion, and infection in intra-articular distal tibia fractures (IADTF) treated with limited open reduction internal fixation and intramedullary nailing (IMN) as compared to open reduction internal fixation with plate and screws (plate fixation [PF]). METHODS: Design: Retrospective review. Setting: Level-I academic trauma center. Patient Selection Criteria: Patients age ≥ 18 with OTA/AO 43C1 and C2 IADTF treated with IMN or PF between 2013-2021. Outcome Measures and Comparisons: Loss of reduction, surgical site infection (SSI), nonunion, and patient-reported outcomes (PROs) were compared for IMN versus PF treatments. RESULTS: One hundred ten patients met the inclusion criteria (IMN 33 and PF 77). There was no loss of reduction found. Seventeen nonunions (15% overall; IMN 4/33 and PF 13/77) and 13 SSIs (12% overall; IMN 2/33 and PF11/77) were identified. Despite several risk factors being identified for nonunion and SSI in bivariate analysis, only open fracture remained significant as a risk factor for both nonunion (odds ratio 0.09 for closed fracture, 95% confidence interval, 0.02–0.56, P = 0.009) and SSI (odds ratio 0.07 for closed fracture, 95% confidence interval, 0.06–0.26, P = 0.012) in the multivariate model. Propensity scoring based on presurgical variables was significantly different between patients who received IMN versus PF (P = 0.03); however, logistic regression incorporating the propensity score revealed no significant association with nonunion and SSI. Adjusting for the propensity score, there remained no association comparing IMN versus PF with nonunion and SSI (P = 0.54 and P = 0.17, respectively). There was also no difference in PROs between IMN and PF (physical function: P = 0.25 and pain interference: P = 0.21). CONCLUSIONS: Overall nonunion and SSI prevalence was 15% and 12%, respectively, in operatively treated OTA/AO 43C1 and C2 IADTF. An open fracture was a significant risk factor for nonunion and SSI. Metaphyseal fixation through IMN or PF did not affect loss of reduction, nonunion, SSI, or PROs. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Penumbral cooling in ischemic stroke with intraarterial, intravenous or active conductive head cooling: A thermal modeling study

In ischemic stroke, selectively cooling the ischemic penumbra might lead to neuroprotection while avoiding systemic complications. Because penumbral tissue has reduced cerebral blood flow and in vivo brain temperature measurement remains challenging, the effect of different methods of therapeutic hypothermia on penumbral temperature are unknown. We used the COMSOL Multiphysics® software to model a range of cases of therapeutic hypothermia in ischemic stroke. Four ischemic stroke models were developed with ischemic core and/or penumbra volumes between 33–300 mL. Four experiments were performed on each model, including no cooling, and intraarterial, intravenous, and active conductive head cooling. The steady-state temperature of the non-ischemic brain, ischemic penumbra, and ischemic core without cooling was 37.3 °C, 37.5–37.8 °C, and 38.9–39.4 °C respectively. Intraarterial, intravenous and active conductive head cooling reduced non-ischemic brain temperature by 4.3 °C, 2.1 °C, and 0.7–0.8 °C respectively. Intraarterial, intravenous and head cooling reduced the temperature of the ischemic penumbra by 3.9–4.3 °C, 1.9–2.1 °C, and 1.2–3.4 °C respectively. Active conductive head cooling was the only method to selectively reduce penumbral temperature. Clinical studies that measure brain temperature in ischemic stroke patients undergoing therapeutic hypothermia are required to validate these hypothesis-generating findings.