Miracle-dz/UniFAR-FTUs huggingface dataset:
Catching Fire: Are Operating Room Fires a Concern in Orthopedics?

Objective Operating room (OR) fires are considered “never events,” but approximately 650 events occur annually in the United States. Our aim was to detail fires occurring during orthopedic procedures via a questionnaire because of the limited information present on this topic. Methods A 25-question survey on witnessing surgical fires, hospital policies on surgical fires, and surgeons’ perspective on OR fires was sent to 617 orthopedic surgeons in 18 institutions whose residency program is a member of the Collaborative Orthopaedic Educational Research Group. The response rate was 28%, with 172 surgeons having completed the survey. Results Twelve of the 172 orthopedic surgeons surveyed reported witnessing at least 1 surgical fire in an OR setting. Electrocautery was the leading ignition source, causing fires in 7 events. A saw, laser, and light source were reported to have caused 1 fire each. Regarding fuel source for the fires, bone cement was a common culprit (n = 4), followed by gauze (n = 3). Oxygen delivery to patients was via a closed system in most cases (n = 9). No patient harm was reported in any of these cases. Just under half of the respondents (47.7%) reported not receiving any formal OR fire prevention or response training. The most common answer for frequency of concern about a surgical fire was “never” (42.4%). Conclusions Fires pose a risk in surgery, even in an orthopedics setting. Room oxygen can supply enough oxidizing power for a fire to occur, especially with the ubiquitous nature of ignition sources and fuels in the OR. Prevention is key with these events. Operating room personnel education must be sought, and surgeons should be mindful of the fire components in the OR.
Abnormal Intracortical Functions in Parkinson’s Disease with Rapid Eye Movement Sleep Behaviour Disorder

ABSTRACT: Background: Rapid eye movement sleep behaviour disorder (RBD) is considered to be one of the most frequent and important prodromal symptoms of Parkinson’s disease (PD). We aimed to study the neurophysiological abnormalities in patients of PD-RBD and PD without RBD (PD-nRBD) using transcranial magnetic stimulation (TMS). Methods: Twenty patients each of PD-RBD and PD-nRBD were included in the study in addition to 20 age and gender-matched healthy controls. RBD was identified using the RBD screening questionnaire (RBDSQ). All the subjects were evaluated with single and paired-pulse TMS and parameters such as resting motor threshold (RMT), central motor conduction time (CMCT), silent period (SP), short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) were recorded. Results: The mean age of the controls and PD patients with and without RBD was comparable. There were no significant differences in RMT, CMCT and silent period between the two patient groups. SICI was present in all the three groups with significant inhibition noted in PD-RBD group (p < 0.001). ICF was absent in patients of PD-RBD (0.19 ± 0.11) and PD-nRBD (0.7 ± 0.5) when compared to controls (1.88 ± 1.02) with profound impairment in patients with PD-RBD (p < 0.001). The mean MoCA score was found to be significantly different in all the three groups with a worse score in patients with RBD (23.10 ± 2.55; p < 0.001). Conclusions: PD-RBD patients have significantly greater inhibition and reduced intracortical facilitation suggesting enhanced GABAergic and reduced glutaminergic transmission. These abnormalities may underlie the different pathophysiological process observed in these patients.
The enigmatic Placozoa part 1: Exploring evolutionary controversies and poor ecological knowledge

The placozoan Trichoplax adhaerens is a tiny hairy plate and more simply organized than any other living metazoan. After its original description by F.E. Schulze in 1883, it attracted attention as a potential model for the ancestral state of metazoan organization, the “Urmetazoon”. Trichoplax lacks any kind of symmetry, organs, nerve cells, muscle cells, basal lamina, and extracellular matrix. Furthermore, the placozoan genome is the smallest (not secondarily reduced) genome of all metazoan genomes. It harbors a remarkably rich diversity of genes and has been considered the best living surrogate for a metazoan ancestor genome. The phylum Placozoa presently harbors three formally described species, while several dozen “cryptic” species are yet awaiting their description. The phylogenetic position of placozoans has recently become a contested arena for modern phylogenetic analyses and view‐driven claims. Trichoplax offers unique prospects for understanding the minimal requirements of metazoan animal organization and their corresponding malfunctions.
CHICKEN-AND-EGG DILEMMA BETWEEN INCOME AND ALMS: REVIEW OF ISLAMIC PERSPECTIVES

Indonesia is the most generous country in the world. This opinion is evident from the World Giving Index created by the Charities Aid Foundation, which has placed Indonesia in the world's number one position in 2018. There is an increase compared to the previous year, where Indonesia was in second place after Myanmar. The leading indicators are donating money, helping foreigners, and participating in volunteer activities. On the other hand, the World Bank in 2018 placed Indonesia in the sixteenth position based on GDP Current USD and the eighth position based on GDP PPP Current USD. This data proves that income is not the main thing that encourages someone to give alms. However, it is still uncertain whether the income and level of charities correlate with each other. Jones and Posnett (1991) revealed that an increase in giving alms behavior is not in line with an increase in household income. On the other hand, there is a significant positive relationship between income and a person's level of alms (Mohd Arshad, 2016). The two types of research mentioned (Jones and Posnett, 1991; Mohd Arshad, 2016) conducted testing at the micro-level. Therefore, this research will concentrate more on the macro level. Pharoah and Tanner (1997) explain that people who consider religion in their lives tend to give more. This study uses a quantitative approach to test the correlation between the World Giving Index and GDP using the Spearman rank correlation test. The Spearman rank correlation test measures the correlation between two random variables based on ranking order. The author has found that there is no correlation between high income and the desire to give alms. This research can used as a reference for the Indonesian government to reduce inequality and poverty in the country by realizing the potential of alms in Indonesia.
Stress, Stress Reduction and Obesity in Childhood and Adolescence

Background: Obesity in childhood and adolescence remains a great global health challenge. Stress exposure during childhood and adolescence is associated with a higher risk for obesity, yet the linkage between stress and obesity is multidimensional, and its biological and behavioral mechanisms are still not fully understood. Summary: In this literature review, we identified different types of stress exposure in children and adolescents, including first studied effects of the COVID-19 pandemic as a prolonged stress exposure and their association with obesity risk. We investigated studies on the connection of altered stress biology and behavioral pathways as well as intervention programs on stress reduction in children and adolescents with obesity. Key Messages: There is evidence that stress exposure in childhood and adolescence promotes biological and behavioral alterations that contribute to the multifactorial pathogenesis of obesity. COVID-19 related-stress presents the most current example of a negative influence on weight development in children and adolescents. However, longitudinal studies on the linkage between environmental, behavioral, and biological factors across development are few, and results are partly equivocal. Intervention programs to reduce stress in children through mindfulness might be a promising adjunctive tool in the prevention and treatment of childhood and adolescent obesity that could further offer proof of concept of theoretically elaborated cause-and-effect relationships.
Virus-specific T cells for adenovirus infection after stem cell transplantation are highly effective and class II HLA restricted.

Infection with adenoviruses is a common and significant complication in pediatric patients after allogeneic hematopoietic stem cell transplantation. Treatment options with traditional antivirals are limited by poor efficacy and significant toxicities. T-cell reconstitution is critical for the management of adenoviral infections, but it generally takes place months after transplantation. Ex vivo-generated virus-specific T cells (VSTs) are an alternative approach for viral control and can be rapidly generated from either a stem cell donor or a healthy third-party donor. In the context of a single-center phase 1/2 clinical trial, we treated 30 patients with a total of 43 infusions of VSTs for adenoviremia and/or adenoviral disease. Seven patients received donor-derived VSTs, 21 patients received third-party VSTs, and 2 received VSTs from both donor sources. Clinical responses were observed in 81% of patients, with a complete response in 58%. Epitope prediction and potential epitope identification for common HLA molecules helped elucidate HLA restriction in a subset of patients receiving third-party products. Intracellular interferon-γ expression in T cells in response to single peptides and response to cell lines stably transfected with a single HLA molecule demonstrated HLA-restricted CD4+ T-cell response, and these results correlated with clinical outcomes. Taken together, these data suggest that VSTs are a highly safe and effective therapy for the management of adenoviral infection in immunocompromised hosts. The trials were registered at www.clinicaltrials. gov as #NCT02048332 and #NCT02532452.
Post Dural Puncture Headache After Elective Caesarean Section Using 27 G Quincke and Whitacre Spinal Needles: A Comparative Study

Post-dural puncture headache (PDPH), a serious complication of spinal anesthesia (SA) may persevere for long time and can be unbearable to the patients. The incidence of PDPH unswervingly relies on the size of the spinal needles used and this gradually decreases with the use of thinner spinal needles. This study was designed to study the more reliable 27-G (0.41 mm) Whitacre and Quincke spinal needles, equating the frequency of PDPH in combination with spinal anesthesia after elective cesarean section.
THE RELATIONSHIP BETWEEN FAMILY FUNCTIONS AND RISKY SEXUAL BEHAVIOR IN INDONESIA IN 2018: A PMA DATA ANALYSIS

This analysis aimed to examine the relationship between family development and risky adolescent sexual behavior in Indonesia. The data were taken from the 2018 Performance and Accountability Survey with a family and adolescent questionnaire; thus, the relationship between parents and adolescents could be identified. The statistical analysis methods used were descriptive and inferential analyses, with the unit of analysis being 15,556 teenagers who dated. The results of the logistic regression analysis (Model 1) by using all the independent variables simultaneously found that sexual risk behavior was mostly found in in boys, age categories 20-24 years, and participants who never had access to PIK-R. Risky sexual behavior was also dependent on whether participants agreed to have relations sexual before marriage, and also the level of education of their parents. The logistic regression analysis (Model 2) found residence, gender, level of adolescent education, age categories, agreement to have sexual relations before marriage, age groups of head of family, gender of head of family, education level of head of family, work status of head of family, economic status, and the activeness of the BKR activities contributed to adolescents committing risky sexual behaviors.
Real-world evaluation of costs of illness for pneumonia in adult patients in Dubai—A claims database study

Background Pneumonia is a significant cause of morbidity and mortality among adults globally. This retrospective cohort analysis assessed the pneumonia burden and related healthcare resource utilization and costs in the at-risk (low, medium, and high-risk) adult patients in Dubai, United Arab Emirates (UAE). Methods The claims data from January 1, 2014 to June 30, 2019 were extracted from the Dubai Real-World Claims Database for patients, aged ≥18 year, having at least 1 pneumonia claim. Data for the inpatient, outpatient and emergency visits were assessed for 12-months, before (pre-index) and after (follow-up) a pneumonia episode. Healthcare costs were calculated based on dollar value of 2020. Results Total 48,562 records of eligible patients were analyzed (mean age = 39.9 years; low [62.1%], medium [36.2%] and high [1.7%] risk cohorts). Mean all-cause healthcare costs were approximately >45% higher in the follow-up period (1,947 USD/patient) versus pre-index period (1,327 USD/patient). During follow-up period, the mean annual pneumonia incidence rate was 1.3 episodes, with a similar pattern across all cohorts. Overall, mean claims and costs (USD) per patient (all-cause) were highest in the high-risk cohort in the follow-up period (claims: overall, 11.6; high-risk, 22.0; medium-risk, 13.9; low-risk, 9.9; costs: high-risk, 14,184; medium-risk, 2,240; low-risk, 1,388). Similarly, the mean pneumonia-related costs (USD) per patient were highest for the high-risk cohort (overall: 1,305; high-risk, 10,207; medium-risk, 1,283; low-risk, 882), however, the claims were similar across cohorts (claims/patient: overall: 2.0; high-risk, 1.9; medium-risk, 2.2; low-risk, 1.9). Most all-cause and pneumonia-related costs were due to inpatient visits (4,901 and 4,818 USD respectively), while outpatient (1,232 and 166 USD respectively) and emergency visits (347 and 206 USD respectively) contributed significantly lesser. Conclusions Pneumonia imposes a significant healthcare burden in the UAE, especially in the high-risk patients with severe comorbidities. These findings would guide clinicians and policy makers to make informed decisions.
Intracellular activation of 4-hydroxycyclophosphamide into a DNA-alkylating agent in human leucocytes

Abstract 1.The conversion of the cyclophosphamide intermediate metabolite 4-hydroxycyclophosphamide (4-OHCP) to the final cytotoxic metabolite phosphoramide mustard (PAM) is classically assumed to occur via chemical hydrolysis of the phospho-ester bond. Whilst it has been suggested previously that this reaction could be enzyme-catalysed, there was only indirect evidence for this (i.e. formation of the by-product acrolein). 2. Using an assay to detect formation of DNA-alkylating adducts which block PCR amplification (QPCR-block assay), we have demonstrated that 4-OHCP can be activated by peripheral blood mononuclear cells (PBMC). The DNA-alkylating potency of 4-OHCP in PBMC increased >18-fold compared to the intrinsic reactivity of 4-OHCP for purified gDNA. 3. We also found that immortalised T-cells (Jurkat) had a similar ability to activate 4-OHCP into a DNA alkylating agent, whereas there was no appreciable activation in epithelial derived (Caco-2) cells. This suggests the possibility of tissue-specific enzyme expression. 4. Of the candidate enzymes tested only recombinant human cAMP-phosphodiesterase-PDE4B and snake-venom phosphodiesterase (PDE-I) could catalyse this activation into a DNA-alkylating agent. 5. This enzymatic catalysis of the phospho-ester bond (P-O-C) is a hitherto unrecognised feature of this important immunomodulatory drug and should be investigated further.
Community Mortality Due to Respiratory Syncytial Virus in Argentina: Population-based Surveillance Study

Background. Many deaths in infants from low-middle income countries (LMICs) occur at home or upon arrival to health facil-ities. Although acute lower respiratory tract illness plays an important role in community mortality, the accuracy of mortality rates due to respiratory syncytial virus (RSV) remains unknown. Methods. An active surveillance study among children aged under 5 years old (U5) was performed in Buenos Aires, Argentina, between January and December 2019, to define the burden and role of RSV in childhood community mortality. Results. A total of 63 families of children U5 participated in the study. Based on a combined approach of tissue sampling, verbal autopsies, and expert’s analysis, RSV infection was found in the causal chain of 11 from 12 cases with positive molecular biology results in respiratory samples. The estimated mortality rate due to RSV among infants was 0.27 deaths/1000 live births. The mean age of RSV-related household deaths was 2.8 months of age (standard deviation [SD] 1.7), and 8/12 were male infants (66.7%). Dying at home from RSV was associated with Streptococcus pneumoniae and/or Moraxella catarrhalis lung coinfection (75%), living in slums and settlement (odds ratio [OR], 17.09; 95% confidence interval [CI], 1.3–219.2), and other underlying comorbidities (OR, 14.87; 95% CI, 1.3–164.6). Conclusions. Infant community mortality rates due to RSV are higher than those reported in industrialized countries and similar to those reported in hospital-based studies in the same catchment population. Bronchiolitis score was: 0 = no remarkable lesions, 1 = minimal de- tectable epithelial degeneration in few bronchioles, 2 = epithelial degeneration in <10% of the airway lumen, 3 = epithelial degeneration in >10–50% of the lumen with cell debris and neutrophils, 4 = circumferential bronchiolitis with dense ad-ventitial lymphocytes in multiple bronchioles [15]. Abbreviation: RSV, respiratory syncytial virus.
Identifying meteorological influences on marine low-cloud mesoscale morphology using satellite classifications

Abstract. Marine low-cloud mesoscale morphology in the southeastern Pacific Ocean is analyzed using a large dataset of classifications spanning 3 years generated by machine learning methods. Meteorological variables and cloud properties are composited by the mesoscale cloud type of the classification, showing distinct meteorological regimes of marine low-cloud organization from the tropics to the midlatitudes. The presentation of mesoscale cellular convection, with respect to geographic distribution, boundary layer structure, and large-scale environmental conditions, agrees with prior knowledge. Two tropical and subtropical cumuliform boundary layer regimes, suppressed cumulus and clustered cumulus, are studied in detail. The patterns in precipitation, circulation, column water vapor, and cloudiness are consistent with the representation of marine shallow mesoscale convective self-aggregation by large eddy simulations of the boundary layer. Although they occur under similar large-scale conditions, the suppressed and clustered low-cloud types are found to be well separated by variables associated with low-level mesoscale circulation, with surface wind divergence being the clearest discriminator between them, regardless of whether reanalysis or satellite observations are used. Clustered regimes are associated with surface convergence, while suppressed regimes are associated with surface divergence.
Relationship between duration of practice and soil chemical characteristics of upland fields under organic farming in Japan

Relationships between the duration (in years) of practice and soil (0–30‐cm layer) chemical properties of 189 upland fields under organic farming in Japan were investigated. Electrical conductivity and available phosphorus (P), nitrate nitrogen (NO3‐N), Cl− and sulphate sulphur (SO4‐S) decreased and became constant with increasing duration of practice. This was probably because of the absence of mineral fertilizers and the reduced use of animal‐based fertilizers as the duration of organic farming increased.
Occlusive Mesenteric Ischemia in Chronic Dialysis Patients.

BACKGROUND Among dialysis patients, occlusive mesenteric vascular disease has rarely been reported. OBJECTIVES To report on the experience of one center with regard to diagnosing and treating this complication. METHODS The retrospective case-series involved six patients (3 females, 3 males; age 52-88 years; 5/6 were smokers) on chronic hemodialysis at a single center. All patients with symptoms suggestive of occlusive mesenteric disease and a subsequent angiographic intervention were included. Demographic, clinical, and laboratory data were collected from patient charts for the period before and after angioplasty and stenting of the mesenteric vessels. A Wilcoxon signed-rank test was used to compare the relevant data before and after the intervention. RESULTS All participants had variable co-morbidities and postprandial abdominal pain, food aversion, and weight loss. CT angiography was limited due to heavy vascular calcifications. All underwent angioplasty with stenting of the superior mesenteric artery (4 patients) or the celiac artery (2 patients). All procedures were successful in resolving abdominal pain, malnutrition, and inflammation. Weight loss before was 15 ± 2 kg and weight gain after was 6 ± 2 kg. C-reactive protein decreased from 13.4 ± 5.2 mg/dl to 2.2 ± 0.4 mg/dl (P < 0.05). Serum albumin increased from 3.0 ± 0.2 g/dl to 3.9 ± 0.1 g/dl (P < 0.05). Two patients underwent a repeat procedure (4 years, 5 months, respectively). Follow-up ranged from 0.5-7 years. CONCLUSIONS Occlusive mesenteric ischemia occurs among dialysis patients. The diagnosis requires a high degree of suspicion, and it is manageable by angiography and stenting of the most involved mesenteric artery.
Infection and distribution of Candidatus Liberibacter asiaticus in citrus plants and psyllid vectors at the cellular level

Huanglongbing (HLB) is currently considered the most destructive disease of citrus worldwide. In the major citrus‐growing areas in Asia and the US, the major causal agent of HLB is the bacterial pathogen Candidatus Liberibacter asiaticus (CLas). CLas is vectored by the Asian citrus psyllid, Diaphorina citri, in a persistent propagative manner. CLas cannot be cultured in vitro because of its unclear growth factors, leading to uncertainty in the infection mechanism of CLas at the cellular level in citrus and in D. citri. To characterize the detailed infection of CLas in the host and vector, the incidence of HLB was first investigated in citrus‐growing fields in Fujian Province, China. It was found that the positive association of the level of CLas infection in the leaves correlated with the symptoms. Then antibodies against peptides of the outer membrane protein (OMP) of CLas were prepared and tested. The antibodies OMP‐225, OMP‐333 and OMP724 showed specificity to citrus plants in western blot analyses, whereas the antibodies OMP‐47 and OMP‐225 displayed specificity to the D. citri vector. The application of OMP‐225 in the immunofluorescence assay indicated that CLas was located in and distributed throughout the phloem sieve cells of the leaf midribs and axile placenta of the fruit. CLas also infected the epithelial cells and visceral muscles of the alimentary canal of D. citri. The application of OMP‐333 in immunoelectron microscopy indicated the round or oval CLas in the sieve cells of leaf midribs and axile placenta of fruit as well as in the epithelial cells and reticular tissue of D. citri alimentary canal. These results provide a reliable means for HLB detection, and enlighten a strategy via neutralizing OMP to control HLB. These findings also provide insight for the further investigation on CLas infection and pathogenesis, as well as CLas–vector interaction.