Miracle-dz/UniFAR-FTUs huggingface dataset:
The Effects of Adjunctive Pain Medications on Postoperative Inpatient Opioid Use in Abdominally Based Microsurgical Breast Reconstruction

Background The purposes of this study were to quantify the amount of opioid medication used postoperatively in the hospital setting after abdominally based microsurgical breast reconstruction, to determine factors that are associated with increased opioid use, and to identify other adjunctive medications that may contribute to decreased opioid use. Methods An electronic medical record data pull was performed at the University of Pennsylvania from November 2016 to October 2018. Cases were identified using Current Procedural Terminology code 19364. Only traditional recovery after surgery protocol patients were included. Patient comorbidities, surgical details, and pain scores were captured. Postoperative medications including non–patient-controlled analgesia opioid use and adjunctive nonopioid pain medications were recorded. Non–patient-controlled analgesia total opioid use was calculated and converted to oral morphine milligram equivalents (mme). Statistical analysis was performed using t test analyses and linear regression. Results A total of 328 patients satisfied our inclusion criteria. Five hundred forty free flaps were performed (212 bilateral vs 116 unilateral, 239 immediate vs 89 delayed). Bilateral patients used on average 115.2 mme (95% confidence interval [CI], 103.4–127.0 mme) compared with 89.0 mme in unilateral patients (95% CI, 70.0–108.0 mme; P = 0.015). Patients with abdominal mesh placement (n = 249) required 113.0 mme (95% CI, 100.5–125.5 mme) compared with 83.8 mme (95% CI, 68.8–98.7 mme) for patients without mesh (n = 79; P = 0.016). Each additional hour of surgery increased postoperative mme by 9.4 (P < 0.01). Patients with a nonzero preoperative pain score required 100.3 mme (95% CI, 90.2–110.4 mme) compared with 141.1 mme (95% CI, 102.7–179.7 mme) for patients with preoperative pain score greater than 0/10 (P < 0.01). Patients with postoperative index pain score ≤5/10 required 89.2 mme (95% CI, 78.6–99.8 mme) compared with 141.1 mme (95% CI, 119.9–162.2 mme) for patients with postoperative index pain score >5/10 (P < 0.01). After regression analysis, a dose of intravenous acetaminophen 1000 mg was found to decrease postoperative mme by 11.7 (P = 0.024). A dose of oral ibuprofen 600 mg was found to decrease postoperative mme by 8.3 (P < 0.01). Conclusions Bilateral reconstruction and longer surgery resulted in increased postoperative mme. Patients with no preoperative pain required less opioids than did patients with preexisting pain. Patients with good initial postoperative pain control required less opioids than did patients with poor initial postoperative pain control. Intravenous acetaminophen and oral ibuprofen were found to significantly decrease postoperative mme.
Epigenetic driver mutations in ARID1A shape cancer immune phenotype and immunotherapy.

Whether mutations in cancer driver genes directly affect cancer immune phenotype and T cell immunity remains a standing question. ARID1A is a core member of the polymorphic BAF chromatin remodeling complex. ARID1A mutations occur in human cancers and drive cancer development. Here, we studied the molecular, cellular, and clinical impact of ARID1A aberrations on cancer immunity. We demonstrated that ARID1A aberrations resulted in limited chromatin accessibility to interferon (IFN) responsive genes, caused impaired IFN-gene expression, anemic T cell tumor infiltration, poor tumor immunity, and shortened host survival in many human cancer histologies as well as in murine cancer models. Impaired IFN signaling was associated with poor immunotherapy response. Mechanistically, ARID1A interacted with EZH2 via its carboxyl terminal and antagonized EZH2-mediated IFN responsiveness. Thus, the interaction between ARID1A and EZH2 defines cancer IFN-responsiveness and immune evasion. Our work indicates that cancer epigenetic driver mutations can shape cancer immune phenotype and immunotherapy.
Predicting economics student retention in higher education: The effects of students’ economic competencies at the end of upper secondary school on their intention to leave their studies in economics

Despite the importance of acquiring economic competencies at the secondary level and the worldwide popularity of economics in higher education, there is almost no research on the effects of economic competencies on economics student retention. Based on a longitudinal sample of 538 high school students in Switzerland, this study provides the first results on this topic. The longitudinal study took place from 2011 to 2016 and comprised two points of measurement. Economic competencies were measured multidimensionally and comprised knowledge and skills, as well as attitude, value-oriented dispositions, interest and motivation. Different student retention models were adapted and combined to explain student retention in the field of economics. According to these models, students’ academic and social integration are key mediators to predict their retention. Based on these theoretical explanations, structural equation modelling was then used to test the long-term effects of high school students’ economic competencies at the end of upper-secondary school on their retention in studying in the field of economics. The results show that economic competencies predict economics students’ academic integration (as measured by grade point average) but not their social integration. Additionally, the data confirm that academic and social integration are strong mediators for their retention. In addition to economic competencies, students’ cognitive abilities, prior schooling (school grades, school profile, and school type) and perceived family support predict student retention in economics. Overall, economic competencies account for a substantial proportion of the variance in student retention. Against this background, the results indicate that fostering high school students’ economic competencies plays a crucial role in their study success in the field of economics.
The reciprocal impacts of adversity and personality traits: A prospective longitudinal study of growth, change, and the power of personality.

OBJECTIVE We integrate the study of post-traumatic growth with personality science by examining reciprocal effects of adversity and core personality traits. We implemented conceptual (i.e., incorporating personality traits into the study of adversity-related growth, examining trait-specific and configural personality change, and adopting a cumulative approach to adversity) and methodological (i.e., three-wave prospective design, assessing many life events, sampling from populations likely to experience adversity) innovations to advance the study of personality development and of the generality of adversity-related growth. METHOD A diverse sample (41% non-white, 48% low-income, 68% female, Mage = 44, 30% diagnosed with Borderline Personality Disorder) participated in a three-wave prospective longitudinal study (N = 258-128 across waves). Participants completed a personality inventory and a battery of life-event surveys (including 105 events) at each wave. RESULTS Personality was generally stable from trait-specific and configural perspectives, and all traits were correlated with adversity. All traits, particularly extraversion and conscientiousness, predicted adversity. Adversity predicted increases in emotionality and decreases in agreeableness. CONCLUSIONS Although personality growth is not the typical response to adversity within a 3-year period, findings underscore the real-world impact of personality, and they provide some support for developmental theories emphasizing the effects of life events.
Community Program Activities Predict Local Tobacco Policy Adoption in Florida Counties

The Bureau of Tobacco Free Florida’s community program funds county-level grantees who promote local policy change through activities that educate the public, policy-makers, and decision-makers. There is robust literature linking tobacco control policies such as smoke-free air laws and tax increases to reductions in tobacco use. There is less evidence documenting the local activities programs conduct to achieve local policy change. In the current study, we used a quantitative model to assess the relationship between community tobacco control activities and local tobacco policy adoption. Grantee activities and policy adoption for each county are recorded in a database. To evaluate the community program, we compiled inputs and used a fixed-effects negative binomial regression to examine the relationship between grantee activities and policy adoption across all 67 community-based programs in Florida from 2010 to 2017 and analyzed the data in 2018. Measures included categories of policies (organization policies and jurisdiction policies) and community-based activities associated with tobacco control programs. Organization policy (school and business policy) and jurisdiction policy (county or city ordinances, proclamations, and resolutions) were dependent on partner meetings (incident rate ratio [IRR] = 1.03, confidence interval [CI] = 1.00-1.07 and IRR = 1.04, CI = 1.01-1.07, respectively) and local decision-maker communication (IRR = 1.01, CI = 1.00-1.03 and IRR = 1.05, CI = 1.03-1.07, respectively). Jurisdiction policy was also dependent on media advocacy (IRR = 1.07, CI = 1.02-1.12) and state policy-maker education (IRR = 1.16, CI = 1.06-1.26. Community outreach was negatively associated with jurisdiction policy (IRR = 0.97, CI = 0.94-0.99), and data collection was negatively associated with organization and jurisdiction policy (IRR = 0.97, CI = 0.95-1.00 and IRR = 0.97, CI = 0.95-1.00, respectively). Results from the study demonstrate that the type and timing of community grantee activities may influence local tobacco control policy adoption.
Clusters of cooperative ion channels enable a membrane-potential-based mechanism for short-term memory

Across biological systems, cooperativity between proteins enables fast actions, supra-linear responses, and long-lasting molecular switches. In the nervous system, however, the function of cooperative interactions between voltage-dependent ionic channels remains largely unknown. Based on mathematical modeling, we here demonstrate that clusters of strongly cooperative ion channels can plausibly form bistable conductances. Consequently, clusters are permanently switched on by neuronal spiking, switched off by strong hyperpolarization, and remain in their state for seconds after stimulation. The resulting short-term memory of the membrane potential allows to generate persistent firing when clusters of cooperative channels are present together with non-cooperative spike-generating conductances. Dynamic clamp experiments in rodent cortical neurons confirm that channel cooperativity can robustly induce graded persistent activity – a single-cell based, multistable mnemonic firing mode experimentally observed in several brain regions. We therefore propose that ion channel cooperativity constitutes an efficient cell-intrinsic implementation for short-term memories at the voltage level.
Neurocognitive and psychiatric disorders‐related axonal degeneration in Parkinson's disease

Neurocognitive and psychiatric disorders have significant consequences for quality of life in patients with Parkinson's disease (PD). In the current study, we evaluated microstructural white matter (WM) alterations associated with neurocognitive and psychiatric disorders in PD using neurite orientation dispersion and density imaging (NODDI) and linked independent component analysis (LICA). The indices of NODDI were compared between 20 and 19 patients with PD with and without neurocognitive and psychiatric disorders, respectively, and 25 healthy controls using tract‐based spatial statistics and tract‐of‐interest analyses. LICA was applied to model inter‐subject variability across measures. A widespread reduction in axonal density (indexed by intracellular volume fraction [ICVF]) was demonstrated in PD patients with and without neurocognitive and psychiatric disorders, as compared with healthy controls. Compared with patients without neurocognitive and psychiatric disorders, patients with neurocognitive and psychiatric disorders exhibited more extensive (posterior predominant) decreases in axonal density. Using LICA, ICVF demonstrated the highest contribution (59% weight) to the main effects of diagnosis that reflected widespread decreases in axonal density. These findings suggest that axonal loss is a major factor underlying WM pathology related to neurocognitive and psychiatric disorders in PD, whereas patients with neurocognitive and psychiatric disorders had broader axonal pathology, as compared with those without. LICA suggested that the ICVF can be used as a useful biomarker of microstructural changes in the WM related to neurocognitive and psychiatric disorders in PD.
Comparison of MALDI‐TOF mass spectrometry analysis of peripheral blood and bone marrow‐based flow cytometry for tracking measurable residual disease in patients with multiple myeloma

Matrix‐assisted laser desorption ionisation time‐of‐flight mass spectrometry (MALDI‐TOF MS) may soon replace routine electrophoretic methods for monitoring monoclonal proteins in patients with multiple myeloma. To further evaluate the clinical utility of this assay, we compared the performance of MALDI‐TOF‐MS head‐to‐head with an established bone marrow‐based measurable residual disease assay by flow cytometry (Flow‐BM‐MRD), using Memorial Sloan Kettering Cancer Center’s 10‐color, single‐tube method. Our results suggest that MALDI‐TOF‐MS adds value to bone marrow‐based MRD testing and may be most useful for early detection of relapse in peripheral blood compared to current electrophoretic methods.
The Characteristics and Effectiveness of Interventions for Frequent Emergency Department Utilizing Patients With Chronic Noncancer Pain: A Systematic Review

Patients with chronic noncancer pain (CNCP) present unique challenges to emergency department (ED) care providers and administrators. Their conditions lead to frequent ED visits for pain relief and symptom management and are often poorly addressed with costly, low‐yield care. A systematic review has not been performed to inform the management of frequent ED utilizing patients with CNCP. Therefore, we synthesized the available evidence on interventional strategies to improve care‐associated outcomes for this patient group.
Ethanol differentially enhances hippocampal GABAA receptor

Department of Veterans Affairs Medical Center, Research Service, Denver, CO 80220 (W.R.P., T.V.D.), Department of Pharmacology, University of Colorado Health Sciences Center, Denver CO 80262 (W.R.P., W.P., T.V.D.), Institute for Behavioral Genetics and Colorado Alcohol Research Center, University of Colorado, Boulder CO 80309 (B.J.B., J.M.W.), and the Ernest Gallo Clinic and Research Center, Department of Neurology, University of California at San Francisco, Emeryville, CA 94608 (R.O.M.)
Chronic Critical Illness Patients Fail to Respond to Current Evidence-Based Intensive Care Nutrition Secondarily to Persistent Inflammation, Immunosuppression, and Catabolic Syndrome.

BACKGROUND Sepsis-induced multiple-organ failure (MOF) has plagued surgical intensive care units (ICUs) for decades. Early nutrition (principally enteral) improves hospital outcomes of high-risk ICU patients. The purpose of this study is to document how the growing epidemic of chronic critical illness (CCI) patients responds to adequate evidence-based ICU nutrition. METHODS This retrospective post hoc subgroup analysis of an ongoing sepsis database identified 56 CCI patients who received early, adequate nutrition per an established surgical ICU protocol compared with 112 matched rapid-recovery (RAP) patients. RESULTS The matched CCI and RAP groups had similar baseline characteristics. Serial biomarkers showed that CCI patients remained persistently inflamed with ongoing stress metabolism and that despite receiving evidence-based protocol nutrition, they had persistent catabolism and immunosuppression with more secondary infections. More CCI patients were discharged to poor nonhome destinations (ie, skilled nursing facilities, long-term acute care, hospice) (81% vs 29%, P < 0.05). At 12-month follow-up, CCI patients had worse functional status by Zubrod score (3.17 vs 1.62, P < 0.001) and Short Physical Battery Testing (4.78 vs 8.59, P < 0.02), worse health-related quality of life by EQ-5D-3L descriptive measures (9.07 vs 7.45, P < 0.003), and lower survival (67% vs 92%, P < 0.05). CONCLUSIONS Despite early, adequate, evidence-based ICU nutrition, septic surgical ICU patients who develop CCI exhibit persistent inflammation, immunosuppression, and catabolism with unacceptable long-term morbidity and mortality. Although current evidence-based ICU nutrition may improve short-term ICU outcomes, novel adjuncts are needed to improve long-term outcomes for CCI patients.
Pyrocatalysis—The DCF assay as a pH-robust tool to determine the oxidation capability of thermally excited pyroelectric powders

Pyrocatalysis uses thermally excited pyroelectric materials for the generation of reactive oxygen species in water. This unique feature allows it to harvest energy in the form of natural temperature gradients or waste heat from industrial processes in order to degrade organic pollutants at low costs. Its further development into an advanced oxidation process for water remediation is dependent on the availability of pH-robust and nonspecific redox assays for the determination of its oxidation capability. Nevertheless, previous studies neglected the influence of pH changes and they were focused mainly on the degradation of one organic compound or specific chemical dosimetries. In this study, a pH-robust and nonspecific reaction protocol of the dichlorofluorescein assay was established for the investigation of the oxidation capability of the pyrocatalytic process. This reaction protocol was tested on three pyroelectric powders (LiNbO3, LiTaO3, BaTiO3) in different amounts and it overcomes major constraints of a previously used dichlorodihydrofluorescein diacetate-based reaction protocol. Instead of its diacetate, dichlorodihydrofluorescein was used as fluorogenic probe and its concentration was drastically reduced to 1 μM. For the first time, these changes enable the determination and comparison of the oxidation capability independently of pH-rising processes, which are present for all investigated pyroelectric powders up to a pH of 11. Additionally, the precision of the dichlorofluorescein assay was drastically increased and the determination and consideration of autoxidation processes was enabled. Of all three pyroelectric powders, BaTiO3 exhibited the highest oxidation capability with a linear increase with respect to the powder amount.
Integrative Transcriptome and Proteome Analysis of the Tube Foot and Adhesive Secretions of the Sea Urchin Paracentrotus lividus

Echinoderms, such as the rock-boring sea urchin Paracentrotus lividus, attach temporarily to surfaces during locomotion using their tube feet. They can attach firmly to any substrate and release from it within seconds through the secretion of unknown molecules. The composition of the adhesive, as well as the releasing secretion, remains largely unknown. This study re-analyzed a differential proteome dataset from Lebesgue et al. by mapping mass spectrometry-derived peptides to a P. lividus de novo transcriptome generated in this study. This resulted in a drastic increase in mapped proteins in comparison to the previous publication. The data were subsequently combined with a differential RNAseq approach to identify potential adhesion candidate genes. A gene expression analysis of 59 transcripts using whole mount in situ hybridization led to the identification of 16 transcripts potentially involved in bioadhesion. In the future these data could be useful for the production of synthetic reversible adhesives for industrial and medical purposes.
Prevalence of and factors related with abnormal fundoscopic findings among the elderly population in a rural community in South Korea

ABSTRACT We aimed to report the results of fundus photography ophthalmic examinations among older adults in a rural community in South Korea. We used data from the Korean Social Life, Health, and Aging Project cohort study, which was designed to examine the entire population of individuals aged 60 years or older and their spouses living in a rural Village K of Ganghwa Island, South Korea. At baseline, a total of 860 people was targeted as the study population. From December 2011 to January 2019, five health examinations were conducted, including baseline and follow-up tests. During the fifth wave of the study, we performed fundus photography to assess eye health. Ophthalmic and physical examinations were conducted for 387 people who participated in the fifth wave by trained researchers. Systemic factors were evaluated via blood and diagnostic tests. After excluding eight people who did not undergo follow-up fundoscopy, a total of 379 participants was included for analysis. We classified the participants into two groups with either no (zero) or one or more suspicious ophthalmic diseases. The abnormalities included media opacity, suspected glaucoma, and suspicion of retinal disease as diagnosed by a trained specialist. We further categorized ophthalmic conditions as clinically insignificant, follow-up needed, semi-urgent, and urgent conditions. We included 379 participants, of which 225 (59.4%) were women. The mean age of the participants was 76.4 ± 6.2 years. Among all participants, 81% (n=307) had one or more abnormalities on fundus screening. Older age, living alone, high blood pressure, and high fasting insulin were associated with an increased risk of having ≥ one eye disease. In terms of triage, 3.7% (n= 14) of the observed conditions were urgent, and 25.9% (n= 98) were semi-urgent. Therefore, we documented fundoscopy results among the elderly population in a rural community in South Korea. Elderly people living alone were more likely to have eye disease. Policies to improve eye health are needed to prevent vision loss in this population.
Antidiabetic and hypolipidemic potentials of Solidago virgaurea extract in alloxan-induced diabetes type 1

Abstract Objectives The aim of the current study is to investigate the antidiabetic and hypolipidemic potentials of Solidago virgaurea extract in alloxan-induced diabetic rats. Materials and methods Alloxan-induced diabetic rats were orally administered a dose of Solidago virgaurea extract (250 mg/kg body weight) daily for 15 days. Then blood glucose, insulin, serum lipid profile, amylase, tumour necrosis factor-α (TNF- α), and liver glycogen were determined. Besides, superoxide dismutase (SOD), catalase activities, and malondialdehyde (MDA) levels in pancreatic tissue were assessed. Results Solidago virgaurea extract significantly reduced blood glucose level, serum amylase activity, TNF-α level, and pancreatic MDA level as well as increasing the serum insulin, liver glycogen level, pancreatic SOD, and catalase activities in comparison with their corresponding diabetic rats, p < . 05. Conclusion The findings of this study support the ethnomedicinal use of Solidago virgaurea extract as an antidiabetic and antihyperlipidemic in the management of diabetes mellitus.