Miracle-dz/UniFAR-FTUs huggingface dataset:
American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: May 2021 update on the use of intermediate-intensity anticoagulation in critically ill patients

Background: COVID-19 related critical illness is associated with an increased risk of venous thromboembolism (VTE). Objective:These evidence-based guidelinesof the American Society of Hematology (ASH) are intended to support patients, clinicians and other health care professionalsin decisions aboutthe use of anticoagulation for thromboprophylaxis in patients with COVID-19-related critical illness who do not have confirmed or suspected VTE. Methods:ASH formed a multidisciplinary guideline panel, including three patient representatives,and applied strategies to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including performing systematic evidence reviews(up to March 5, 2021). The panel prioritized clinical questionsand outcomes according to their importance for clinicians and patients. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approachto assess evidence and make recommendations, which were subject to public comment. This is an update on guidelines published in February 2021. Results:The panel agreed on one additional recommendation. The panel issued a conditional recommendation in favor of prophylactic-intensity over intermediate-intensity anticoagulation in patients with COVID-19 related-critical illness who do not have confirmed or suspected VTE. Conclusions: This recommendation was based on low certainty in the evidence, underscoring the need for further high-quality, randomized controlled trials comparing different intensities of anticoagulation in critically ill patients. Other key research priorities include better evidence on predictors of thrombosis and bleeding risk in critically ill patients with COVID-19 and the impact of non-anticoagulant therapies (e.g., antiviral agents, corticosteroids) on thrombotic risk.
An Experimental Study of Heat Transfer Deterioration at Supercritical Pressures

Convective heat transfer to CO2 flowing upward in electrically heated vertical tubes at supercritical pressures was studied for wall heat fluxes q within ranges that included values corresponding to the onset of heat transfer deterioration (HTD). The inlet pressure was P = 8.35 MPa, the mass flux was in the range 200 kg/ms ≤ G ≤ 1500 kg/ms, and the inlet temperature was in the range 0 ◦C ≤ Tin ≤ 35 ◦C. Wall temperature measurements were collected in three tubular test sections, having inner diameters of D = 4.6, 8, and 22 mm. The abilities of three different HTD identification methods to separate the entire data set into deteriorated and normal heat transfer modes were tested. Two types of buoyancy parameters were tested as HTD detection methods, and correction factors for changes in mass flux were devised. The minimum heat flux at HTD onset was found to follow a power law of mass flux with the same exponent for all three sections and the same proportionality coefficient for the two smaller sections but a smaller one for the larger test section. For heat flux values that were larger than this minimum, HTD was found to occur only within a limited range of Tin, whose width increased with increasing heat flux. The heat transfer coefficient for normal heat transfer was expressed as an exponential function of the diameter.
Psychological problems and the associated factors related to the COVID-19 pandemic lockdown among college students in Amhara Region, Ethiopia: a cross-sectional study

Objective The central aim of this study was to assess the level of psychological problems among college students during school closure due to the emerging COVID-19 pandemic. Design Institution-based, cross-sectional study. Setting Colleges in the Amhara regional state of Ethiopia. Participants Participants were college students (N=422, >18 years) who were actively enrolled in the selected colleges preceding the survey. Methods Data entry was done using Epi Info V.7. 02 and data analysis was done using SPSS V.24. 0. Variables with a p value less than 0.25 in the bivariate analysis were entered into the multivariable logistic regression model. Model fitness was checked using the Hosmer-Lemeshow model fitness test. Statistically significant level was declared at p<0.05. Outcome Level of psychological problem. Results This study involved 408 students, with a response rate of 96.6%. In this study, 77.2%, 71.8% and 48.5% of students experienced depression, anxiety and stress-related psychological problems during the lockdown, respectively. The multivariable logistic regression model showed that being female (adjusted OR (AOR)=1.68, 95% CI 1.09 to 2.91), inadequate practice of prevention measures (AOR=1.74, 95% CI 1.01 to 3.02) and living in an urban residency (AOR=0.76, 95% CI 0.48 to 0.94) were independent predictors of psychological problems among students. Conclusions The study revealed that the level of anxiety, stress and depression disorders is optimally high among college students. Therefore, local governments should develop effective psychological interventions for students. Moreover, it is important to consider the educational enrolment type and the academic year of students.
Exploring the “Athlete’s Paradox”: Division I Cross-Country Runners Demonstrate Similar Muscle Characteristics to Recreationally Trained Young Adults

Abstract Cabre, HE, Greenwalt, CE, Gould, LM, Hirsch, KR, Blue, MNM, and Smith-Ryan, AE. Exploring the “Athlete’s Paradox”: Division I cross-country runners demonstrate similar muscle characteristics to recreationally trained young adults. J Strength Cond Res 35(11): 3213–3217, 2021—Endurance training can influence body composition and muscle characteristics. Endurance athletes have demonstrated elevated intramuscular fat (IMF), yet individuals with greater body fat also demonstrate elevated IMF. The purpose of this study was to examine differences in muscle characteristics (echo intensity [EI] and muscle cross-sectional area [mCSA]) and body composition between Division I collegiate athletes and college-age adults matched for percent fat (%fat). Thirty cross-country athletes (XC) and 30 normal-weight (NW) recreationally active college students (male athletes: n = 30; female athletes: n = 30; mean ± SD: age: 19.2 ± 1.1 years; body mass: 61.7 ± 8.7 kg; %fat: 18.0 ± 5.2%) underwent a panoramic ultrasound scan of the vastus lateralis to evaluate EI and mCSA. A full-body dual-energy x-ray absorptiometry scan was used to assess fat mass (FM), lean mass (LM), and %fat. Independent t-tests were used to evaluate mCSA, EI, and body composition. Significance level was set at ≤ 0.05. There were no significant differences between the XC and NW cohorts in mCSA (mean difference [MD; XC − NW], −1.30 ± −0.40 cm3; p = 0.340) or EI (MD: 3.97 ± 2.66 a.u.; p = 0.478). Body composition was not different between the groups: FM (MD: −0.14 ± −0.54 kg; p = 0.848), LM (−3.07 ± 1.25 kg; p = 0.268), or bone mineral content (−0.21 ± 0.03 kg; p = 0.120). There were also no significant differences for any outcome variables when stratified by male athletes (p = 0.097–0.468) or female athletes (p = 0.055–0.700). These results suggest that XC athletes may have similar muscle characteristics to NW individuals when matched for %fat. Understanding and tracking muscle characteristics in XC athletes may be important for performance, injury prevention, and the transition to retirement.
FOXP3 Predicts Response to Treatment in Mycosis Fungoides.

BACKGROUND The role of the T-regulatory cells (Tregs) marker forkhead box Protein 3 (FOXP3) in mycoses fungoides (MF) pathogenesis is unclear and the results of previous studies are inconclusive. OBJECTIVE We aimed at ascertaining the possibility that FOXP3 expression may serve to predict MF stage and response to therapy. PATIENTS AND METHODS Immunohistochemistry staining for FOXP3 was performed on 30 skin biopsies from patients with MF, and FOXP3 expression level was quantitatively graded. Disease stage, progression, and response to treatment were determined based on clinical and imaging evidence, and association with FOXP3 expression was assessed. RESULTS FOXP3 expression in the dermis correlated with poor response to treatment (P=0.047). A negative non-significant relationship between epidermal FOXP3 expression and clinical stage severity was observed (P=0.17). CONCLUSIONS Dermal FOXP3 expression in MF lesions could be used to predict response to treatment in patients with MF.
Efficacy and tolerability of vismodegib treatment in locally advanced and metastatic basal cell carcinoma: Retrospective real‐life data

The study aims to evaluate the vismodegib treatment in local advanced (laBCC) and metastatic (mBCC) basal cell carcinoma. The data of 29 patients were retrospectively reviewed. The clinical and histopathological features of the patients and adverse events of vismodegib were recorded. Overall survival (OS) and progression‐free survival (PFS) were evaluated with Kaplan–Meier analysis. The median follow‐up period was 17 months (range: 1.6–57.3), and the median age at diagnosis 73 years (range: 39–88). The most common disease location was head and neck (86.2%), and the most common non‐skin sites of disease were lymph nodes (13.8%), bone (13.8%), lung (6.9%), and brain (6.9%). Three (10.3%) patients had Gorlin's syndrome. The number of metastatic patients was 5 (17.2%). With vismodegib treatment, the complete response rate was 27.6%, partial response 55.2%, and stable response 10.3%. Treatment responses were most frequently seen within 2 months from the beginning of vismodegib. The median OS was 43.3 ± 9.0 months (25.6–61.1) for all patients. The median PFS in the laBCC was 15.7 ± 1.8 months (12.2–19.3), and 12.1 ± 4.6 months (2.9–21.2) in the mBCC. In the univariable analysis for the OS, only the treatment after the vismodegib was statistically significant, showing chemotherapy was better comparing to no treatment or surgery. The most common adverse events were fatigue‐58.6%, muscle spasms‐48.3%, alopecia‐13.8%, and weight loss‐13.8%. This real‐life data study shows that vismodegib treatment in locally advanced and metastatic BCC was well tolerated and effective.
Evaluation of analgesic effect, joint function recovery and safety of meloxicam in knee osteoarthritis patients who receive total knee arthroplasty

Abstract Meloxicam is commonly administrated to control postoperative pain in orthopedic surgery, while its efficacy in total knee arthroplasty (TKA) is not clear. Therefore, this study aimed to explore the postoperative analgesic effect and tolerance of meloxicam in knee osteoarthritis (OA) patients undergoing TKA. Totally, 128 knee OA patients scheduled for TKA were enrolled in this randomized, controlled, double-blind study, then randomized into meloxicam group (N = 65) and control group (N = 63) as 1:1 ratio. Patients took meloxicam or placebo from 4 hours (h) to 72 h after TKA. Patients were followed up at 6 h, 12 h, day (D)1, D2, D3, D7, month (M)1, and M3. Pain visual analog scale score at rest was decreased in meloxicam group at 12 h, D1 and D3 compared to control group; pain visual analog scale score at flexion was reduced in meloxicam group at 6 h, 12 h, D1, D2, and D3 compared to control group. Additional and total consumption of patient-controlled analgesia were both attenuated in meloxicam group compared to control group. Furthermore, patient satisfaction score was higher on D1, D2, D3 in meloxicam group compared to control group. However, no difference of hospital for special surgery knee score score at M1 or M3 was found between the 2 groups. Moreover, the occurrence of adverse events was similar between the 2 groups. Meloxicam displays good effect on controlling postoperative pain and improving patient satisfaction, while does not affect long-term knee function recovery or safety profile in knee OA patients undergoing TKA.
Workloads in nursing activities performed in university hospitals.

OBJECTIVE Analyze the exposure of nursing workers to workloads present in university hospitals located in southern Brazil. METHOD Cross-sectional quantitative study performed with 361 nursing workers from two University Hospitals between November 2019 and February 2020. An instrument addressing sociodemographic and occupational variables was used together with the previously validated Workloads in Nursing Activities Scale. The distribution of frequencies, measures of location, and variability were identified, and analysis of variance and the Tukey test were performed. RESULTS The construct that obtained the highest mean was F3 - Biological Loads (3.00), revealing that nursing workers are very intensively exposed to biological loads. Workloads were significantly different between the work units - physiological (p = 0.001), biological (p = 0.007), psychological (p = 0.042), mechanical (p = 0.014), chemical (p = 0.001), and physical (p = 0.001). CONCLUSION The workers identified that exposure to workloads varies in intensity, showing aspects of the work performed in health institutions that either aggravate or mitigate workloads through the activities performed by nursing workers.
Effect of initiating biologics compared to intensifying conventional DMARDs on clinical and MRI outcomes in established rheumatoid arthritis patients in clinical remission: Secondary analyses of the IMAGINE-RA trial

Objectives To compare the effect of treat-to-target-based escalations in conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and biologics on clinical disease activity and magnetic resonance imaging (MRI) inflammation in a rheumatoid arthritis (RA) cohort in clinical remission. Method One-hundred patients with established RA, Disease Activity Score based on 28-joint count–C-reactive protein (DAS28-CRP) < 3.2, and no swollen joints (hereafter referred to as ‘in clinical remission’) who received csDMARDs underwent clinical evaluation and MRI of the wrist and second to fifth metacarpophalangeal joints every 4 months. They followed a 2 year MRI treatment strategy targeting DAS28-CRP ≤ 3.2, no swollen joints, and absence of MRI osteitis, with predefined algorithmic treatment escalation: first: increase in csDMARDs; second: adding a biologic; third: switch biologic. MRI osteitis and Health Assessment Questionnaire (HAQ) (co-primary outcomes) and MRI combined inflammation and Simplified Disease Activity Index (SDAI) (key secondary outcomes) were assessed 4 months after treatment change and expressed as estimates of group differences. Statistical analyses were based on the intention-to-treat population analysed using repeated-measures mixed models. Results Escalation to first biologic compared to csDMARD escalation more effectively reduced MRI osteitis (difference between least squares means 1.8, 95% confidence interval 1.0–2.6), HAQ score (0.08, 0.03–0.1), MRI combined inflammation (2.5, 0.9–4.1), and SDAI scores (2.7, 1.9–3.5). Conclusions Treat-to-target-based treatment escalations to biologics compared to escalation in csDMARDs more effectively improved MRI inflammation, physical function, and clinical disease activity in patients with established RA in clinical remission. Treatment escalation in RA patients in clinical remission reduces clinical and MRI-assessed disease activity. Trial registration Clinicaltrials.gov identifier: NCT01656278
Galacto-oligosaccharides as infant prebiotics: production, application, bioactive activities and future perspectives

Abstract Galacto-oligosaccharides (GOS) are non-digestible oligosaccharides characterized by a mix of structures that vary in their degree of polymerization (DP) and glycosidic linkage between the galactose moieties or between galactose and glucose. They have enjoyed extensive scientific scrutiny, and their health-promoting effects are supported by a large number of scientific and clinical studies. A variety of GOS-associated health-promoting effects have been reported, such as growth promotion of beneficial bacteria, in particular bifidobacteria and lactobacilli, inhibition of pathogen adhesion and improvement of gut barrier function. GOS have attracted significant interest from food industries for their versatility as a bioactive ingredient and in particular as a functional component of infant formulations. These oligosaccharides are produced in a kinetically-controlled reaction involving lactose transgalactosylation, being catalyzed by particular β-galactosidases of bacterial or fungal origin. Despite the well-established technology applied for GOS production, this process may still meet with technological challenges when employed at an industrial scale. The current review will cover relevant scientific literature on the beneficial physiological properties of GOS as a prebiotic for the infant gut microbiota, details of GOS structures, the associated reaction mechanism of β-galactosidase, and its (large-scale) production.
Effect of Systemic Hypertension on Peripapillary RNFL Thickness in Patients With Diabetes Without Diabetic Retinopathy

Type 2 diabetes mellitus (T2DM) and hypertension (HTN) are both relatively common systemic diseases and cause damage to the retina, such as inner retina reduction and microvascular impairment. The purpose of this study was to identify peripapillary retinal nerve fiber layer (pRNFL) damage by diabetic neurodegeneration and the effects of HTN on the pRNFL thickness in patients with T2DM without clinical diabetic retinopathy. Subjects were divided into three groups: healthy control subjects (group 1), patients with T2DM (group 2), and patients with both diabetes and HTN (group 3). The pRNFL thickness was measured using optical coherence tomography and compared among each group. Linear regression analyses were performed to identify factors associated with pRNFL thickness. A total of 325 eyes were included: 143 eyes in the group 1, 126 eyes in group 2, and 56 eyes in group 3. The mean pRNFL thicknesses of each group were 96.1 ± 7.7, 94.4 ± 8.6, and 91.6 ± 9.6 μm, respectively (P = 0.003). In multivariate linear analyses, diabetes duration (β = −0.236; P = 0.018) and HTN (β = −3.766; P = 0.008) were significant factors affecting the pRNFL thickness in groups 2 and 3. Additionally, the HTN duration was significantly correlated with pRNFL thickness in group 3 (R2 = 0.121; P = 0.008). In conclusion, patients with T2DM with HTN showed thinner pRNFL thickness than those with T2DM only. Additionally, the duration of HTN was significantly correlated with pRNFL thickness in patients with both diabetes and HTN.
Oxidative metabolism of razuprotafib (AKB-9778), a sulfamic acid phosphatase inhibitor, in human microsomes and recombinant human CYP2C8 enzyme

Abstract Razuprotafib, a sulphamic acid-containing phosphatase inhibitor, is shown in vivo to undergo enzymatic oxidation and methylation to form a major metabolite in monkey and human excreta with an m/z – value of 633. LC-MS/MS analysis of samples derived from incubations of razuprotafib with human liver microsomes and recombinant CYP2C8 enzyme has elucidated the metabolic pathway for formation of the thiol precursor to the S-methyl metabolite MS633 (m/z – 633). Under in vitro conditions, the major pathway of razuprotafib metabolism involves extensive oxidation of the thiophene and phenyl rings. A single oxidation takes place at one of the phenyl groups. Multiple oxidations occur at the thiophene moiety: initial oxidation results in the formation of a thiolactone followed by a second oxidation giving rise to an S-oxide of the thiolactone, which is further metabolised to the ring-opened form and ultimate formation of a thiol (m/z – 619). An additional mono-oxidation pathway involves epoxidation of the thiophene followed by hydrolysis to a diol. The thiol and diol metabolites are trapped by the addition of a nucleophilic trapping agent, 3-methoxyphenacyl bromide (MPB), giving adducts with m/z – 767. The thiol is a likely precursor to the major in vivo razuprotafib metabolite, MS633.
Expansion of Information in the Binary Autoencoder With Random Binary Weights

Abstract This letter studies the expansion and preservation of information in a binary autoencoder where the hidden layer is larger than the input. Such expansion is widespread in biological neural networks, as in the olfactory system of a fruit fly or the projection of thalamic inputs to the neocortex. We analyze the threshold model, the kWTA model, and the binary matching pursuit model to find how the sparsity and the dimension of the encoding influence the input reconstruction, similarity preservation, and mutual information across layers. It is shown that the sparser activation of the hidden layer is preferable for preserving information between the input and the output layers. All three models show optimal similarity preservation at dense, not sparse, hidden layer activation. Furthermore, with a large enough hidden layer, it is possible to get zero reconstruction error for any input just by varying the thresholds of neurons. However, we show that the preference for sparsity is due to the noise in the weight matrix between layers. A fixed number of nonzero connections to every neuron achieves better information preservation and input reconstruction for the dense hidden layer activation. The theoretical results give useful insight into models of neural computation based on sparse binary representation and association memory.
Score, Rank, and Decision-Level Fusion Strategies of Multicode Electromyogram-Based Verification and Identification Biometrics

Recent advances in biometric research have established surface electromyogram (sEMG) as a potential spoof-free solution to address some key limitations in current biometric traits. The nature of sEMG signals provide a unique dual-mode security: sEMGs have individual-specific characteristics (biometrics), and users can customize and change gestures just like passcodes. Such security also facilitates the use of code sequences (multicode) to further enhance the security. In this study, three levels of fusion, score, rank, and decision were investigated for two biometric applications, verification and identification. This study involved 24 subjects performing 16 hand/finger gestures, and code sequences with varying codelengths were generated. The performance of the verification and identification system was analyzed for varying codelength (M: 1–6) and rank (K: 1–4) to determine the best fusion scheme and desirable parameter values for a multicode sEMG biometric system. The results showed that the decision-level fusion scheme using a weighted majority voting resulted in an average equal error rate of 0.6% for the verification system when M = 4. For the identification system, the score-level fusion scheme with score normalization based on fitting a Weibull distribution resulted in a minimum false rejection rate of 0.01% and false acceptance rate of 4.7% using a combination of K = 2 and M = 4. The results also suggested that the parameters M and K could be adjusted based on the number of users in the database to facilitate optimal performance. In summary, a multicode sEMG biometric system was developed to provide improved dual-mode security based on the personalized codes and biometric traits of individuals, with the combination of enhanced security and flexibility.