Miracle-dz/UniFAR-FTUs huggingface dataset:
Methods and Implementation of the 2019 EMS Practice Analysis

Abstract Background: The EMS Practice Analysis provides a vision of current prehospital care by defining the work performed by EMS professionals. In this manuscript, we present the National Advanced Life Support (ALS) EMS Practice Analysis for the advanced EMT (AEMT) and paramedic levels of certification. The goal of the 2019 EMS Practice Analysis is to define the work performed by EMS professionals and present a new template for future practice analyses. Methods: The project was executed in three phases. Phase 1 defined the types/frequency of EMS clinical presentations using the 2016 National Emergency Medical Services Information System (NEMSIS) dataset. Phase 2 defined the criticality or potential for harm of these clinical presentations through a survey of a random sample of nationally certified EMS professionals and medical directors. Phase 3 defined the tasks and the associated knowledge, skills, and abilities (KSA) that encompass EMS care through focus groups of subject matter experts. Results: In Phase 1, the most common EMS adult impressions were traumatic injury, abdominal pain/problems, respiratory distress/arrest, behavioral/psychiatric disorder, and syncope/fainting. The most common pediatric impressions were traumatic injury, behavioral/psychiatric disorder, respiratory distress/arrest, seizure, and abdominal pain/problems. Criticality was defined in Phase 2 with the highest risk of harm for adults being airway obstruction, respiratory distress/arrest, cardiac arrest, hypovolemia/shock, allergic reaction, or stroke/CVA. In comparison, pediatric patients presenting with airway obstruction, respiratory distress/arrest, cardiac arrest, hypovolemia/shock, allergic reaction, stroke/CVA, and inhalation injury had the highest potential for harm. Finally, in Phase 3, task statements were generated for both paramedic and AEMT certification levels. A total of 425 tasks and 1,734 KSAs were defined for the paramedic level and 405 tasks and 1,636 KSAs were defined for the AEMT level. Conclusion: The 2019 ALS Practice Analysis describes prehospital practice at the AEMT and paramedic levels. This approach allows for a detailed and robust evaluation of EMS care while focusing on each task conducted at each level of certification in EMS. The data can be leveraged to inform the scope of practice, educational standards, and assist in validating the ALS levels of the certification examination.
Roles of type IIa receptor protein tyrosine phosphatases as synaptic organizers

Neurons establish circuits for brain functions such as cognition, emotion, learning, and memory. Their connections are mediated by synapses, which are specialized cell‐cell adhesions responsible for neuronal signal transmission. During neurodevelopment, synapse formation is triggered by interactions of cell adhesion molecules termed synaptic organizers or synapse organizers. Type IIa receptor protein tyrosine phosphatases (IIa RPTPs; also known as leukocyte common antigen‐related receptor tyrosine phosphatases or LAR‐RPTPs) play important roles in axon guidance and neurite extension, and also serve as presynaptic organizers. IIa RPTPs transsynaptically interact with multiple sets of postsynaptic organizers, mostly in a splicing‐dependent fashion. Here, we review and update research progress on IIa RPTPs, particularly regarding their functional roles in vivo demonstrated using conditional knockout approach and structural insights into their extracellular and intracellular molecular interactions revealed by crystallography and other biophysical techniques. Future directions in the research field of IIa RPTPs are also discussed, including recent findings of the molecular assembly mechanism underlying the formation of synapse‐specific nanostructures essential for synaptic functions.
Dielectric relaxation of hydrogen bonded liquids: Mixtures of monohydric alcohols with n-alkanes

The complex dielectric spectra for mixtures of unbranched monohydric alcohols with n-alkanes have been measured between 1 MHz and 18 GHz at various mole fractions xCnOH of the alcohols (0.2⩽xCnOH⩽1). Within the frequency range of measurements the spectra exhibit two dispersion/loss regions which can be analytically well represented by a Davidson–Cole-type and a Debye-type relaxation term, respectively. The relaxation parameters are discussed in terms of a wait-and-switch model of relaxation, considering also the effect of the nonpolar hydrocarbon groups in the enthalpy of activation of the dielectric relaxation process. This model allows for a consistent description of the dielectric properties of the alcohol/n-alkane mixtures which, depending on the relative length of the hydrocarbon chains, divide into two groups. Structural features of the alcohol/n-alkane mixtures are proposed to account for the characteristic behavior of both groups of liquids as a function of alcohol content.
Can accurate evaluation of the treatment success after radiofrequency ablation of liver tumors be achieved by visual inspection alone? Results of a blinded assessment with 38 interventional oncologists

Abstract Objectives To assess the difficulties in the immediate judgment of treatment success after radiofrequency ablation (RFA) of liver tumors by visual inspection alone and to evaluate whether radiologist’s expertise affects the resultant judgment. Methods Peri-interventional CT-scans of nine patients with nine hepatocellular carcinomas with known outcomes after RFA were presented to 38 participants from 14 different countries. In a total of 342 reads, all interventional oncologists assessed the pre- and immediate post-interventional CT-scans through conventional side-by-side juxtapositioning of images and judged whether complete ablation (i.e., technical success and technique efficacy) was achieved. Results were compared regarding expertise in percutaneous tumor ablation (>50 interventions performed). An ‘overcall’ was defined as insufficient ablation that was misjudged as sufficient, and an ‘undercall’ as an erroneous assessment of complete ablation. Results Overall 3.97 ± 1.27 out of 9 (44.1%) cases per radiologist were misjudged. The mean number of overcalls and undercalls per radiologist were 0.74 ± 0.50 out of 2 (37.0%), and 3.24 ± 1.28 out of 7 (46.3%), respectively. 18/38 (47.4%) participants had considerable experience in percutaneous tumor ablation, with such expertise having no significant influence on the results (overall: p = 0.70; overcalls: p = 0.87; undercalls: p = 0.75). Conclusions Conventional side-by-side evaluation of treatment success after RFA of liver tumors by the juxtaposition of pre- and post-interventional CT-scans is very difficult for experienced radiologists. The implementation of advanced processing techniques such as rigid/non-rigid image fusion with the assessment of the periablational margin is thus likely needed in order to decrease errors and objectively evaluate technical success and predict technique efficacy of liver RFA.
COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II

Abstract Background Our aim was to estimate provisional willingness to receive a coronavirus 2019 (COVID-19) vaccine, identify predictive socio-demographic factors, and, principally, determine potential causes in order to guide information provision. Methods A non-probability online survey was conducted (24th September−17th October 2020) with 5,114 UK adults, quota sampled to match the population for age, gender, ethnicity, income, and region. The Oxford COVID-19 vaccine hesitancy scale assessed intent to take an approved vaccine. Structural equation modelling estimated explanatory factor relationships. Results 71.7% (n=3,667) were willing to be vaccinated, 16.6% (n=849) were very unsure, and 11.7% (n=598) were strongly hesitant. An excellent model fit (RMSEA=0.05/CFI=0.97/TLI=0.97), explaining 86% of variance in hesitancy, was provided by beliefs about the collective importance, efficacy, side-effects, and speed of development of a COVID-19 vaccine. A second model, with reasonable fit (RMSEA=0.03/CFI=0.93/TLI=0.92), explaining 32% of variance, highlighted two higher-order explanatory factors: ‘excessive mistrust’ (r=0.51), including conspiracy beliefs, negative views of doctors, and need for chaos, and ‘positive healthcare experiences’ (r=−0.48), including supportive doctor interactions and good NHS care. Hesitancy was associated with younger age, female gender, lower income, and ethnicity, but socio-demographic information explained little variance (9.8%). Hesitancy was associated with lower adherence to social distancing guidelines. Conclusions COVID-19 vaccine hesitancy is relatively evenly spread across the population. Willingness to take a vaccine is closely bound to recognition of the collective importance. Vaccine public information that highlights prosocial benefits may be especially effective. Factors such as conspiracy beliefs that foster mistrust and erode social cohesion will lower vaccine up-take.
Resilience of nurses in isolation wards during the COVID⁃19 pandemic: a cross-sectional study

ABSTRACT Impact of supportive interventions on resilience and self-assessed psychopathology symptoms of 92 nurses in isolation ward during the COVID-19 pandemic was evaluated. Resilience and psychopathological symptoms of nurses in the isolation ward was assessed by Connor-Davidson Resilience Scale (CD-RISC) and the Symptom Checklist 90 (SCL-90). A total resilience score was 87.04 ± 22.78. The SCL-90 score was 160- to 281 (202.5 ± 40.79). Only 8.70% of the nurses (n = 8) had a total SCL-90 score >160, suggesting positive symptoms. The majority of nurses had 0 to 90 positive self-assessment items (median 14); 19.57% (n = 18) had > 43 positive items. Interpersonal sensitivity, depression, hostility, and paranoid ideation scores were below national averages (p=0.000, 0.040, 0.002, 0.004, respectively). SCL-90 items reflecting diet and sleep conditions were higher(P = 0.009), and somatization, obsessive-compulsive, anxiety, phobic anxiety, and psychoticism domains and scores were similar to national averages (P>0.3). With exception of somatization and other domains, the mean resilience score was negatively associated with the scores of other SCL-90 domains. High resilience promotes physical and mental health, and may be improved by training, psychological interventions and full use of hospital resources
Typologies of Loneliness, Isolation and Living Alone Are Associated with Psychological Well-Being among Older Adults in Taipei: A Cross-Sectional Study

Background: Loneliness, isolation, and living alone are emerging as critical issues in older people’s health and well-being, but the effects are not consistent. The purpose of this study was to examine the clustering of loneliness, isolation, and living alone, the risk factors and the associations with psychological well-being. Methods: The data were collected from the 2019 Taipei City Senior Citizen Condition Survey by face-to-face interviews and included a community-based sample (n = 3553). Loneliness, isolation, and living arrangement were analyzed by cluster analysis to define Loneliness-Isolation-Living-Alone clusters. Multinomial logistic regression was used to examine the factors related to Loneliness-Isolation-Living-Alone clusters, and linear regression was used to examine association of clusters with psychological well-being. Results: Five clusters of older adults were identified and named as follows: Not Lonely-Connected-Others (53.4%), Not Lonely-Isolated-Others (26.6%), Not Lonely-Alone (5.0%), Lonely-Connected (8.1%), and Lonely-Isolated-Others (6.9%). Demographics, financial satisfaction, physical function, family relationship, and social participation were related to the Loneliness-Isolation-Living-Alone clusters. Compared with the Not Lonely-Connected-Others cluster, the Lonely-Connected cluster and Lonely-Isolated-Others cluster had higher depressive symptoms and lower life satisfaction, and the Not Lonely-Isolated-Others cluster reported lower life satisfaction; the Not Lonely-Alone cluster was not different. Discussion: Loneliness and isolation are negatively associated with psychological well-being, and living arrangement is not the determinant to loneliness or isolation. Older adults are suggested to strengthen their informal social support, and the government may encourage social care and create an age friendly environment to reduce loneliness and isolation.
Thermal inactivation of COVID‐19 specimens improves RNA quality and quantity

The rapid spread of coronavirus disease 2019 (COVID‐19), a disease caused by severe acute respiratory syndrome coronavirus 2, poses a huge demand for immediate diagnosis. Real‐time reverse transcriptase‐polymerase chain reaction (rRT‐PCR) of nasopharyngeal (NP) and oropharyngeal (OP) swabs have been used to confirm the clinical diagnosis. To avoid the risk of viral‐exposure of laboratory workers, thermal inactivation is currently recommended but has unknown effects on the accuracy of the rRT‐PCR results. Thirty‐six NP/OP specimens were collected from COVID‐19 patients and subjected to thermal inactivation (60°C for 30 min) or the RNA extraction processes to activate the form. Here, our data showed that the concentration of extracted‐RNA increases upon thermal inactivation compared to the active form (p = .028). Significantly higher levels of RNA copy number were obtained in inactivated compared to the active samples for both N and ORF1ab genes (p = .009, p = .032, respectively). Thermal inactivation elevated concentration and copy number of extracted‐RNA, possibly through viral‐capsid degradation and/or nucleoprotein denaturation.
mTOR inhibition acts as an unexpected checkpoint in p53-mediated tumor suppression

Here, Kon et al. investigated the role of mTOR inhibition in p53-mediated tumor suppression. They show that the early-onset tumor formation observed in p535KR/5KR and p53-null mice was significantly delayed upon the treatment of rapamycin, an mTOR inhibitor, and their results indicate that mTOR inhibition plays a critical role in suppressing the early-onset tumor development.
Development and Initial Validation of Differential Diagnostic Indices for the MMPI-2-RF

In this article, I discuss construction of a set of weighted indices for the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) designed to provide direct guidance in three specific differential diagnostic problems. I created a calibration data set using a combined sample of mental health patients (n = 2,043). Using the MMPI-2-RF’s Substantive Scales as a pool of potential predictors, I applied the lasso, a penalized regression technique, to derive three logistic regression equations differentiating three major diagnostic groups (schizophrenia, bipolar disorder, and major depressive disorder) from one another. Then, I extracted empirically derived beta weights from these equations and used them to create composite differential diagnostic indices, which I scored in a separate holdout validation data set (n = 873). The differential diagnostic indices performed well in the validation data set (schizophrenia vs. bipolar area under the curve [AUC] = .76; schizophrenia vs. major depression AUC = .90; bipolar vs. major depression AUC = .75). Moreover, they substantially outperformed any single existing MMPI-2-RF scale in the same differential diagnostic tasks. In addition to discussing the development and initial validation of these indices, I present methods for deriving clinically referenced standard scores and diagnostic classification probabilities for obtained raw index scores.
Anti-Proliferative and Pro-Apoptotic Effects of Calligonum comosum (L’Her.) Methanolic Extract in Human Triple-Negative MDA-MB-231 Breast Cancer Cells

Triple-negative breast cancer (TNBC), the most aggressive subtype, does not respond to targeted therapy due to the lack of hormone receptors. There is an urgent need for alternative therapies, including natural product-based anti-cancer drugs, at lower cost. We investigated the impact of a Calligonum comosum L’Hér. methanolic extract (CcME) on the TNBC MDA-MB-231 cell line proliferation and related cell death mechanisms performing cell viability and cytotoxicity assays, flow cytometry to detect apoptosis and cell cycle analysis. The apoptosis-related protein array and cellular reactive oxygen species (ROS) assay were also carried out. We showed that the CcME inhibited the TNBC cell viability, in a dose-dependent manner, with low cytotoxic effects. The CcME-treated TNBC cells underwent apoptosis, associated with a concomitant increase of apoptosis-related protein expression, including cytochrome c, cleaved caspase-3, cyclin-dependent kinase inhibitor p21, and the anti-oxidant enzyme catalase, compared with the untreated cells. The CcME also enhanced the mitochondrial transition pore opening activity and induced G0/G1 cell growth arrest, which confirmed the cytochrome c release and the increase of the p21 expression detected in the CcME-treated TNBC cells. The CcME-treated TNBC cells resulted in intracellular ROS production, which, when blocked with a ROS scavenger, did not reduce the CcME-induced apoptosis. In conclusion, CcME exerts anti-proliferative effects against TNBC cells through the induction of apoptosis and cell growth arrest. In vivo studies are justified to verify the CcME anti-proliferative activities and to investigate any potential anti-metastatic activities of CcME against TNBC development and progression.
Neutrophil-to-hepatocyte communication via LDLR-dependent miR-223-enriched extracellular vesicle transfer ameliorates nonalcoholic steatohepatitis.

Neutrophil infiltration around lipotoxic hepatocytes is a hallmark of nonalcoholic steatohepatitis (NASH); however, how these two types of cells communicate remain obscure. We have previously demonstrated that neutrophil-specific microRNA-223 (miR-223) is elevated in hepatocytes to limit NASH progression in obese mice. Here we demonstrated that this elevation of miR-223 in hepatocytes was due to preferential uptake of miR-223-enriched extracellular vesicles (EVs) derived from neutrophils as well other types of cells albeit to a lesser extent. This selective uptake was dependent on the expression of low-density lipoprotein receptor (LDLR) on hepatocytes and apolipoprotein E (APOE) on neutrophil-derived EVs, which was enhanced by free fatty acids. Once internalized by hepatocytes, the EV-derived miR-223 acted to inhibit hepatic inflammatory and fibrogenic gene expression. In the absence of this LDLR-APOE dependent uptake of miR-223-enriched EVs, the progression of steatosis to NASH was accelerated. In contrast, augmentation of this transfer by treatment with an inhibitor of proprotein convertase subtilisin/kexin type 9, a drug used to lower blood cholesterol by upregulating LDLR, ameliorated NASH in mice. This specific role of LDLR and APOE in the selective control of miR-223-enriched EV transfer from neutrophils to hepatocytes may serve as a potential therapeutic target for NASH.
Review on Adhesives and Surface Treatments for Structural Applications: Recent Developments on Sustainability and Implementation for Metal and Composite Substrates

Using adhesives for connection technology has many benefits. It is cost-efficient, fast, and allows homogeneous stress distribution between the bonded surfaces. This paper gives an overview on the current state of knowledge regarding the technologically important area of adhesive materials, as well as on emergent related technologies. It is expected to fill some of the technological gaps between the existing literature and industrial reality, by focusing at opportunities and challenges in the adhesives sector, on sustainable and eco-friendly chemistries that enable bio-derived adhesives, recycling and debonding, as well as giving a brief overview on the surface treatment approaches involved in the adhesive application process, with major focus on metal and polymer matrix composites. Finally, some thoughts on the connection between research and development (R&D) efforts, industry standards and regulatory aspects are given. It contributes to bridge the gap between industry and research institutes/academy. Examples from the aeronautics industry are often used since many technological advances in this industry are innovation precursors for other industries. This paper is mainly addressed to chemists, materials scientists, materials engineers, and decision-makers.
Optimization of cellulase production by Bacillus subtilis subsp. subtilis JJBS300 and biocatalytic potential in saccharification of alkaline-pretreated rice straw

Abstract Optimization of cellulase production by Bacillus subtilis subsp. subtilis JJBS300 resulted in maximum cellulase (CMCase 9.7 U/g substrate) using wheat bran and rice straw in 1:1 ratio at substrate to moisture ratio of 1:3 at 35 °C and pH 4.0 after 48 h. Partially purified cellulase of B. subtilis subsp. subtilis showed optimal activity at 50 °C and pH 5.0. Among the metal ions, Na+, Ca2+ and Fe2+ stimulated the cellulase activity. Glutaraldehyde and 1-butanol also enhanced the cellulase activity as compared to other solvents. Bacterial cellulase hydrolyzed ammonia-pretreated rice straw more efficiently as compared to sodium-carbonate pretreated and untreated biomass. Optimization of saccharification of untreated and pretreated (sodium carbonate and ammonia) rice straw by bacterial cellulase resulted in high liberation of reducing sugars with enzyme dose of 100 U/g substrate (221 mg/g substrate) at pH 5.0 (103 mg/g substrate) and 50 °C (142 mg/g substrate) after 6 h in ammonia-pretreated rice straw. Furthermore, liberation of reducing sugars increased with incubation time showing maximum reducing sugars (171 mg/g substrate) after 24 h in ammonia-pretreated rice straw. HPLC analysis of enzymatic hydrolysate of ammonia-pretreated rice straw verified the ability of bacterial cellulase in liberation of various monomeric and oligomeric sugars.
Phosphorus mobilization from intact soil monoliths flooded under simulated summer versus spring snowmelt with intermittent freeze-thaw conditions.

Enhanced phosphorus (P) release from flooded, anaerobic soils have been extensively studied under summer temperatures, but not under cold temperatures with intermittent freeze-thaw events. We investigated the temperature and freeze/ thaw effects during flooding on the release of P to floodwater from soil monoliths (15-cm depth) collected from eight agricultural fields in Manitoba. Soil monoliths were flooded with reverse osmosis water and incubated for 56 d under simulated summer flooding (SSF, 22±1 °C), or snowmelt flooding with intermittent freeze thaw (IFT, 4±1 °C with intermittent freezing) in triplicates. Redox potential (Eh), pore water and floodwater dissolved reactive P (DRP) concentrations, pH and concentrations of Ca, Mg, Fe and Mn were determined weekly. In seven soils, Eh decreased rapidly with days after flooding (DAF) under SSF to values < 200 mV, but not under IFT. Both pore water and floodwater DRP concentrations significantly increased with DAF in all soils under SSF, and in seven soils under IFT. While DRP concentrations were consistently greater under SSF than IFT in four soils, other soils had similar concentrations at certain DAFs. Significant relationships between ion concentrations and redox status, that fitted both IFT and SSF data in most soils, suggests that similar redox-driven mechanisms are responsible for the P release; however, less P is released under IFT than SSF, since soils were not severely reduced under IFT. Substantial P release in a few soils under IFT, appeared to be unrelated to redox status, suggesting other P release mechanisms that are not redox driven. This article is protected by copyright. All rights reserved.