Miracle-dz/UniFAR-FTUs huggingface dataset:
A Randomized Controlled Trial Examining the Impact of an Anorectal Surgery Multimodal Enhanced Recovery Program on Opioid Use

Supplemental Digital Content is available in the text Background: Anorectal cases may be a common gateway to the opioid epidemic. Opioid reduction is inherent in enhanced recovery after surgery (ERAS) protocols, but little work has evaluated ERAS in these cases. Objective: To determine if ERAS could reduce postoperative opioid utilization in ambulatory anorectal surgery without sacrificing patient pain or satisfaction. Methods: A randomized controlled trial assigned ambulatory anorectal patients to ERAS (experimental) or routine care (surgeon's choice) for pain management (control) over 30-days postoperatively. Primary outcome was overall days of opioid use. Secondary outcomes included pain and satisfaction scores over multiple time points and new persistent opioid use. The Visual Analog Scale, Functional Pain Scale, and EQ-5D-3L measured patient-reported pain and satisfaction. Univariate analysis compared outcomes overall and at individual time points. Two-way mixed ANOVA evaluated pain and satisfaction measures between groups and over time. Results: Thirty-two patients were randomized into each arm (64 total). The control group consumed significantly more opioids after discharge (median 121.3MME vs 23.5MME, P < 0.001). Significantly more control patients requested additional narcotics (P = 0.004), made unplanned calls (P = 0.009), and had unplanned clinic visits (P = 0.003). The control group had significantly more days on opioids (mean 14.4 vs 2.2, P < 0.001). Three control patients (9.4%) versus no experimental patients had new persistent opioid use. The mean global health, EQ5D-3L, Visual Analog Scale, and Functional Pain scores were comparable between groups over time. Conclusions: An ERAS protocol in ambulatory anorectal surgery is feasible, and resulted in reduced opioid use, and healthcare utilization, with no difference in pain or patient satisfaction. This challenges the paradigm that extended opioids are needed for effective postoperative pain management.
Phenotypic mapping of pathological crosstalk between glioblastoma and innate immune cells by synthetic genetic tracing.

Glioblastoma is a lethal brain tumor which exhibits heterogeneity and resistance to therapy. Our understanding of tumor homeostasis is limited by a lack of genetic tools to selectively identify tumor states and fate transitions. Here, we use glioblastoma subtype signatures to construct synthetic genetic tracing cassettes and investigate tumor heterogeneity at cellular and molecular level, in vitro and in vivo. Through synthetic locus control regions, we demonstrated that proneural glioblastoma is a hardwired identity, whereas the mesenchymal glioblastoma is an adaptive and metastable cell state driven by pro-inflammatory and differentiation cues and DNA damage, but not hypoxia. Importantly, we discovered that innate immune cells divert glioblastoma cells to a proneural-to-mesenchymal transition which confers therapeutic resistance. Our synthetic genetic tracing methodology is simple, scalable and widely applicable to study homeostasis in development and diseases. In glioblastoma, the method causally links distinct (micro)environmental, genetic and pharmacological perturbations and mesenchymal commitment.
Structural Brain Network Abnormalities and the Probability of Seizure Recurrence After Epilepsy Surgery

Objective We assessed preoperative structural brain networks and clinical characteristics of patients with drug-resistant temporal lobe epilepsy (TLE) to identify correlates of postsurgical seizure recurrences. Methods We examined data from 51 patients with TLE who underwent anterior temporal lobe resection (ATLR) and 29 healthy controls. For each patient, using the preoperative structural, diffusion, and postoperative structural MRI, we generated 2 networks: presurgery network and surgically spared network. Standardizing these networks with respect to controls, we determined the number of abnormal nodes before surgery and expected to be spared by surgery. We incorporated these 2 abnormality measures and 13 commonly acquired clinical data from each patient into a robust machine learning framework to estimate patient-specific chances of seizures persisting after surgery. Results Patients with more abnormal nodes had a lower chance of complete seizure freedom at 1 year and, even if seizure-free at 1 year, were more likely to relapse within 5 years. The number of abnormal nodes was greater and their locations more widespread in the surgically spared networks of patients with poor outcome than in patients with good outcome. We achieved an area under the curve of 0.84 ± 0.06 and specificity of 0.89 ± 0.09 in predicting unsuccessful seizure outcomes (International League Against Epilepsy [ILAE] 3–5) as opposed to complete seizure freedom (ILAE 1) at 1 year. Moreover, the model-predicted likelihood of seizure relapse was significantly correlated with the grade of surgical outcome at year 1 and associated with relapses up to 5 years after surgery. Conclusion Node abnormality offers a personalized, noninvasive marker that can be combined with clinical data to better estimate the chances of seizure freedom at 1 year and subsequent relapse up to 5 years after ATLR. Classification of Evidence This study provides Class II evidence that node abnormality predicts postsurgical seizure recurrence.
The Crystal and Molecular Structure of 4-n-Pentylphenyl-4′-n-Hexyloxythiobenzoate (6OS5)

Abstract The title compound, 4-n-pentylphenyl-4′-n-hexyloxythiobenzoate (6OS5), C24H32O2S, crystallizes in the orthorhombic system, space group Pbca, with cell constants a = 5.668(2), b = 52.400(10), c = 15.587(4) Å, Z = 8. The structure was solved by direct methods and refined to the final R = 0.0941 for 1717 observed reflections. The hexyloxythiobenzoate moiety is nearly planar. In the crystal, molecules form molecular layers parallel to the (001) plane and within the layer, they are linked in molecular chains parallel to [100] direction by C - H…O weak intermolecular hydrogen bond.
Relationship Between Humeral Energy Flow During the Baseball Pitch and Glenohumeral Stability

Abstract Researchers suggest that motion deriving energy from the more proximal segments of the body is important to reduce injury susceptibility. However, limited clinical assessments have been associated with efficient energy flow within a complex movement such as the baseball pitch. This research aimed to determine the relationship between glenohumeral stability as determined by the closed kinetic chain upper extremity stability test and energy transfer into and out of the humerus during the baseball pitching motion. Kinematic and kinetic data were collected at 240 Hz on twenty-four baseball pitchers. Participants performed the closed kinetic chain upper extremity stability test prior to throwing three fastballs at game speed to a catcher with the fastest fastball used for analysis. Spearman’s Rho were used to examine relationships between energy flow in and out of the humerus with glenohumeral stability as determined by the average score and normalized stance width during the closed kinetic chain upper extremity stability test. There was a significant negative correlation between the average score and normalized peak power leaving the humerus (r s[22]=−0.42, p=0.04). This result provides preliminary support for the use of the closed kinetic chain upper extremity stability test as a clinical assessment of a pitcher’s ability to efficiently transfer energy within the upper extremity during the pitch.
Rectal Adenocarcinoma Presenting as Fournier’s Gangrene

Fournier ’ s gangrene represents an aggressive and extensive necrotizing soft tissue infection of the genital and perineal regions. It requires timely and aggressive surgical therapy in conjunction with antibiotics, and even in this setting, the mortality rate remains 20-35%. There have been very few reports of Fournier ’ s gangrene presenting in the setting of an undiagnosed, locally invasive rectal cancer. We report a case of a 55 year-old man who presented with Fournier ’ s gangrene superimposed on a subsequently diagnosed T4 N2 M0 rectal adenocarcinoma. A 55-year-old man presented to the hospital with complaints of chronic wounds on his perineal and sacral regions. The painful and friable wounds have been present for several months. Past medical history included hy-pertension, chronic alcohol use, and reported borderline diabetes. During initial surgical evaluation in the emer-gency department, the patient was hypotensive, tachy-cardic, and febrile. Full physical examination yielded an extensive soft tissue infection involving the perineal and sacral region, described as erythematous, gangrenous, and malodorous lesions with areas of subcutaneous crepitus on palpation. Laboratory values at that time showed hyponatremia 131 mmol/L, hemoglobin 6.3 g/dL, blood glucose level of 87 mg/dL, and a leukocytosis as high as 31.6 ×10 3 / μ L. CTscan demonstrated a very large complex collection within both the left and right buttock, locules
Monadelpha (Euphorbiaceae, Plukenetieae), a new genus of Tragiinae from the Amazon rainforest of Venezuela and Brazil

Abstract Monadelpha L.J.Gillespie & Card. -McTeag. , gen. nov., is described as a new member of Euphorbiaceae tribe Plukenetieae subtribe Tragiinae, to accommodate Tragiaguayanensis, a species known from western Amazonas, Venezuela and, newly reported here, from Amazonas, Brazil. The genus is unique in the subtribe for having 5-colpate pollen and staminate flowers with filaments entirely connate into an elongate, cylindrical staminal column terminated by a tight cluster of anthers. Phylogenetic analyses based on nuclear rDNA ITS and sampling 156 accessions across the diversity of Tragiinae (all 12 genera and 77 of ~195 species) also support Monadelpha as a distinct lineage that is separate from Tragia. A revised key to the genera of Tragiinae in South America and Central America is provided.
Mean Platelet Volume and Related Parameters May not Contribute to the Diagnosis in Patients with Ascending Thoracic Aortic Aneurysm

We read with great interest the retrospective study by Tekin and Tekin related to mean platelet volume (MPV), MPV to platelet count ratio and MPV to lymphocyte ratio in patients with ascending thoracic aortic aneurysm[1]. Based on the results of the study, the researchers suggested that these parameters will contribute to the diagnosis of ascending thoracic aortic aneurysm and will guide the evaluating physician in terms of the need for additional imaging studies. We believe that there are other factors that may have negatively affected and changed the results of this research. First of all, the fact that the study was designed retrospectively prevented the elimination of pre-analytical and analytical errors, which may have negatively affected the laboratory tests. In addition, the control group did not consist of healthy volunteers, and it was made up of individuals who applied in the hospital at the same time. The fact that the control group is not composed of healthy volunteers and does not represent the society makes it difficult to interpret the results obtained. As a reason for the research, it has been shown that MPV and its derived parameters were used in diagnosis and prognosis in various diseases. MPV is a complete blood count parameter whose measurement has not been standardized to date and, therefore, it has been reported to have no role in diagnosis and prognosis of acquired diseases[2]. Variables that negatively affect the MPV measurement have been known for a long time, and the main variables are the time from venipuncture to measurement, the anticoagulant used, the method of analysis, the sample storage temperature and the difference in the instruments used in the measurement[3-5]. When ethylenediaminetetraacetic acid (EDTA) is present in the blood tube as an anticoagulant, EDTA contact with platelets rapidly causes an increase in MPV. In various studies, the deviation has been reported at a rate of 2-50% in relation to the change in the MPV measurement time[3]. The measurement of MPV with different devices also leads to differences in MPV of up to 40%[4,5]. A meta-analysis study involving 181 MPV studies indexed in the PubMed database showed that the MPV measurements could deviate by up to 27.7%, depending on the time variability between venipuncture and measurement and the difference in the measurement devices used[5]. In this study, not knowing the method of MPV measurement raises important concerns about the reliability of the data. Moreover, the fact that it is not known which devices are measured makes the cutoff values defined by the researchers unusable. As a result, MPV and related parameters may not contribute to the diagnosis in patients with ascending thoracic aortic aneurysm.
The Adaption of the Work Environment Survey for Public Health Nurses

The study presents the iterative process of the adaption and psychometric properties evaluation of the Work Environment/Support/Encouragement section of the Revised Casey-Fink Nurse Retention Survey© (2009) to measure the work environment of public health nurses (PHNs). This secondary data analysis was based on data collected from a convenience sample of 596 PHNs across North Carolina that were originally used to study PHNs workforce retention. Classical test theory analyses were used to evaluate scale reliability and identify potential problematic items that were further examined from a substantive perspective using content validity survey. Confirmatory factor analysis and exploratory factor analysis were performed to evaluate the construct validity and assist further development of the scale. Analyses suggest a three-factor structure for the retained 19-item scale including managerial support, professional nursing role, and recognition, with reliability ranging from alpha of . 859 to . 959.
Quantifying Mineral Intake and the Role of Minerals on Food Selection in Angola Black and White Colobus Monkeys (Colobus angolensis palliatus)

Minerals are vital for many metabolic processes, and mineral deficiencies can adversely impact health and fitness. Mineral concentrations of food items are commonly reported in primate nutritional ecology studies and have been identified as important factors in primate food selection; however, very few studies have quantified daily mineral intake of free-ranging primates. We examined the concentration of 9 minerals (Ca, P, Mg, K, Na, Fe, Zn, Cu, and Mn) in foods consumed by Colobus angolensis palliatus inhabiting the Diani Forest of Kenya, and test whether individuals preferentially selected leaves in accordance with their mineral concentrations. We also examined the effects of sex, group, and season on daily mineral intake, quantifying both percentage-based and mass-based intakes. We then compared daily mineral intake values to published recommendations. Behavioral data and plant samples were collected from July 2014 to December 2015. We found that individuals preferred leaves with greater P content and lower Ca content. Daily mineral intake differed significantly between sexes and among groups and seasons. These results are interpretable via differences in time spent feeding and total energy intake. Intakes fell below percentage-based recommendations for P, Na, Fe, Cu, and Mn but met or exceeded mass-based recommendations for all minerals except Na. This discrepancy is likely explained by the conservative nature of percentage-based mineral recommendations and the difficulty of comparing and scaling mass-based mineral recommendations among primate species. Studies that quantify daily mineral intake are needed to better understand the role of minerals on dietary selection, more accurately identify potential mineral deficiencies, and provide more informed recommendations for captive primates.
Deep learning-augmented radiotherapy visualization with a cylindrical radioluminescence system

This study aims to demonstrate a low-cost camera-based radioluminescence imaging system (CRIS) for high-quality beam visualization that encourages accurate pre-treatment verifications on radiation delivery in external beam radiotherapy. To ameliorate the optical image that suffers from mirror glare and edge blurring caused by photon scattering, a deep learning model is proposed and trained to learn from an on-board electronic portal imaging device (EPID). Beyond the typical purposes of an on-board EPID, the developed system maintains independent measurement with co-planar detection ability by involving a cylindrical receptor. Three task-aware modules are integrated into the network design to enhance its robustness against the artifacts that exist in an EPID running at the cine mode for efficient image acquisition. The training data consists of various designed beam fields that were modulated via the multi-leaf collimator (MLC). Validation experiments are performed for five regular fields ranging from 2 × 2 cm2 to 10 × 10 cm2 and three clinical IMRT cases. The captured CRIS images are compared to the high-quality images collected from an EPID running at the integration-mode, in terms of gamma index and other typical similarity metrics. The mean 2%/2 mm gamma pass rate is 99.14% (range between 98.6% and 100%) and 97.1% (ranging between 96.3% and 97.9%), for the regular fields and IMRT cases, respectively. The CRIS is further applied as a tool for MLC leaf-end position verification. A rectangular field with introduced leaf displacement is designed, and the measurements using CRIS and EPID agree within 0.100 mm ± 0.072 mm with maximum of 0.292 mm. Coupled with its simple system design and low-cost nature, the technique promises to provide viable choice for routine quality assurance in radiation oncology practice.
The effect of adenosine triphosphate on propofol-induced myopathy in rats: a biochemical and histopathological evaluation

Propofol infusion syndrome characterized by rhabdomyolysis, metabolic acidosis, kidney, and heart failure has been reported in long-term propofol use for sedation. It has been reported that intracellular adenosine triphosphate (ATP) is reduced in rhabdomyolysis. The study aims to investigate the protective effect of ATP against possible skeletal muscle damage of propofol in albino Wistar male rats biochemically and histopathologically. PA-50 (n = 6) and PA-100 (n = 6) groups of animals was injected intraperitoneally to 4 mg/kg ATP. An equal volume (0.5 ml) of distilled water was administered intraperitoneally to the P-50, P-100, and HG groups. One hour after the administration of ATP and distilled water, 50 mg/kg propofol was injected intraperitoneally to the P-50 and PA-50 groups. This procedure was repeated once a day for 30 days. The dose of 100 mg/kg propofol was injected intraperitoneally to the P-100 and PA-100 groups. This procedure was performed three times with an interval of 1 days. Our experimental results showed that propofol increased serum CK, CK-MB, creatinine, BUN, TP I, ALT, AST levels, and muscle tissue MDA levels at 100 mg/kg compared to 50 mg/kg and decreased tGSH levels. At a dose of 100 mg/kg, propofol caused more severe histopathological damage compared to 50 mg/kg. It was found that ATP prevented propofol-induced muscle damage and organ dysfunction at a dose of 50 mg/kg at a higher level compared to 100 mg/kg. ATP may be useful in the treatment of propofol-induced rhabdomyolysis and multiple organ damage.
Saffron bioactives crocin, crocetin and safranal: effect on oxidative stress and mechanisms of action

Abstract Saffron (Crocus sativus L.) is used as a spice for its organoleptic characteristics related to its coloring and flavoring properties, and it has been also used in traditional medicine to treat various diseases. The main chemical components responsible for these properties are crocin, crocetin and safranal. These compounds have been shown to have a wide spectrum of biological activities, including several properties as antigenotoxic, antioxidant, anticancer, anti-inflammatory, antiatherosclerotic, antidiabetic, hypotensive, hypoglycemic, antihyperlipidemic, antidegenerative and antidepressant, among others. This review article highlights the antioxidant effects of these bioactive compounds to reduce reactive oxygen species (ROS) and the mechanisms of action involved, since there are a multitude of diseases related to oxidative stress and the generation of free radicals (FRs). Recent studies have shown that the effects of crocin, crocetin and safranal against oxidative stress include the reduction in lipid peroxidation (malondialdehyde [MDA] levels) and nitric oxide (NO) levels, and the increase in the levels of glutathione, antioxidant enzymes (superoxide dismutase [SOD], catalase (CAT) and glutathione peroxidase [GPx]) and thiol content. Therefore, due to the great antioxidant effects of these saffron compounds, it makes saffron a potential source of bioactive extracts for the development of bioactive ingredients, which can be used to produce functional foods.
Stability of maxillary anterior teeth after 2 years of retention in adolescents: a randomized controlled trial comparing two bonded and a vacuum-formed retainer.

BACKGROUND Retention of the maxillary anterior teeth is commonly recommended to maintain the teeth in their corrected positions. Both fixed and removable retention methods are used, but the certainty of evidence is low. OBJECTIVE To evaluate post-treatment changes in irregularity of the maxillary six anterior teeth and single tooth contact point discrepancy (CPD) of three different retention methods. TRIAL DESIGN Three-arm parallel group single-centre randomized controlled trial. MATERIALS AND METHODS Ninety patients, 54 girls and 36 boys, were recruited to the study. The inclusion criteria were adolescent patients treated with fixed appliances at least in the maxilla. After gaining informed consent from the patient and their custodians, the patients were randomized to one of three groups: bonded retainer 13-23, bonded retainer 12-22, and removable vacuum-formed retainer (VFR) covering the maxillary teeth including the second molars. The randomization, prepared by an independent person, used blocks of 30. The primary outcomes were changes in single CPD and Little's irregularity index (LII) measured on digitalized three-dimensional study casts before and after 2-year retention. The study casts were anonymized before assessment and the changes were blinded for the assessor. Data were evaluated on an intention-to-treat basis. Thus, all randomized patients were incorporated into the final analysis. RESULTS The LII and CPDs increased slightly in all three groups without any statistically significant differences between the groups. The VFR group showed a small intercanine width increase and some more changes of canine rotations than in the other groups. HARMS No harm was observed in any subjects and none of the patients needed retreatment. LIMITATIONS The trial was a single-centre study and short-term changes were evaluated. CONCLUSIONS All three retention methods showed equally effective retention capacity and all the changes found in the three groups were small and considered clinically insignificant. Thus, the null hypothesis was confirmed. All three methods can be recommended. TRIAL REGISTRATION NCT04616755.