Miracle-dz/UniFAR-FTUs huggingface dataset:
Tibial Plateau Fracture Surgical Care Using Standardized Protocols Over Time: A Single Center's Longitudinal View

Supplemental Digital Content is Available in the Text. Objective: To report on demographics, injury patterns, management strategies, and outcomes of patients who sustained fractures of the tibial plateau seen at a single center over a 16-year period. Design: Prospective collection of data. Patients/Participants: 716 patients with 725 tibial plateau fractures, were treated by one of 5 surgeons. Intervention: Treatment of tibial plateau fractures. Main Outcome Measurements: Outcomes were obtained at standard time-points. Complications were recorded. Patients were stratified into 3 groups: those treated in the first 5 years, those treated in the second 5 years, and those treated in the most recent 6 years. Results: Six hundred eight fractures were followed for a mean 13.4 months (6–120) and 82% had a minimum 1-year follow-up. Patients returned to self-reported baseline function at a consistent proportion during the 3 time periods. The average knee arc was 125 degrees (75–135 degrees) at latest follow-up and did not differ over time. The overall complication rate after surgery was 12% and did not differ between time periods. Radiographs demonstrated excellent rates of healing and low rates of post-traumatic osteoarthritis and improved articular reductions at healing (0.58 mm in Group 3 compared with 0.94 mm in Group 1 and 1.12 mm in Group 2) (P < 0.05). Conclusions: Most patients regained their baseline functional status after surgical intervention and healing. Over time the ability of surgeons to achieve a more anatomic joint reduction was observed; however, this did not correlate with improved functional outcomes. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
The Atlantic Multidecadal Oscillation as a dominant factor of oceanic influence on climate

A multiple linear regression analysis of global annual mean near‐surface air temperature (1900–2012) using the known radiative forcing and the El Niño–Southern Oscillation index as explanatory variables account for 89% of the observed temperature variance. When the Atlantic Multidecadal Oscillation (AMO) index is added to the set of explanatory variables, the fraction of accounted for temperature variance increases to 94%. The anthropogenic effects account for about two thirds of the post‐1975 global warming with one third being due to the positive phase of the AMO. In comparison, the Coupled Models Intercomparison Project Phase 5 (CMIP5) ensemble mean accounts for 87% of the observed global mean temperature variance. Some of the CMIP5 models mimic the AMO‐like oscillation by a strong aerosol effect. These models simulate the twentieth century AMO‐like cycle with correct timing in each individual simulation. An inverse structural analysis suggests that these models generally overestimate the greenhouse gases‐induced warming, which is then compensated by an overestimate of anthropogenic aerosol cooling.
Sleep Variability, Sleep Irregularity, and Nighttime Blood Pressure Dipping

BACKGROUND: Circadian rhythm regulates many important biological functions in humans. The goal of this study is to explore the impact of day-to-day deviations in the sleep-wake cycle on nighttime blood pressure (BP) dipping and further examine whether the ethnic difference in day-to-day deviations in sleep patterns can explain the ethnic difference in nighttime BP dipping. METHODS: Twenty-four-hour ambulatory BP monitoring and 7-day accelerometer data were obtained from 365 adult participants (age range, 18.7–50.1 years; 52.6% Black participants and 47.3% European Americans; 64.1% females). Systolic BP dipping level was used to represent nighttime BP dipping. The SD of sleep duration was calculated as the index of sleep variability, and the SD of sleep midpoint was calculated as the index of sleep irregularity. RESULTS: A 1-hour increase in the SD of sleep midpoint was associated with a 1.16% decrease in nighttime BP dipping (P<0.001). A 1-hour increase in the SD of sleep duration was associated with a 1.39% decrease in nighttime BP dipping (P=0.017). The ethnic difference in the SD of sleep midpoint can explain 29.2% of the ethnicity difference in BP dipping (P=0.008). CONCLUSIONS: Sleep variability and sleep irregularity are associated with blunted BP dipping in the general population. In addition, data from the present investigation also demonstrate that the ethnic difference in sleep irregularity could partly explain the ethnic difference in BP dipping, an important finding that may help reduce the health disparity between Black participants and European Americans.
Dectin‐3‐targeted antifungal liposomes efficiently bind and kill diverse fungal pathogens

DectiSomes are anti‐infective drug‐loaded liposomes targeted to pathogenic cells by pathogen receptors including the Dectins. We have previously used C‐type lectin (CTL) pathogen receptors Dectin‐1, Dectin‐2, and DC‐SIGN to target DectiSomes to the extracellular oligoglycans surrounding diverse pathogenic fungi and kill them. Dectin‐3 (also known as MCL, CLEC4D) is a CTL pathogen receptor whose known cognate ligands are partly distinct from other CTLs. We expressed and purified a truncated Dectin‐3 polypeptide (DEC3) comprised of its carbohydrate recognition domain and stalk region. We prepared amphotericin B (AmB)‐loaded pegylated liposomes (AmB‐LLs) and coated them with this isoform of Dectin‐3 (DEC3‐AmB‐LLs), and we prepared control liposomes coated with bovine serum albumin (BSA‐AmB‐LLs). DEC3‐AmB‐LLs bound to the exopolysaccharide matrices of Candida albicans, Rhizopus delemar (formerly known as R. oryzae), and Cryptococcus neoformans from one to several orders of magnitude more strongly than untargeted AmB‐LLs or BSA‐AmB‐LLs. The data from our quantitative fluorescent binding assays were standardized using a CellProfiler program, AreaPipe, that was developed for this purpose. Consistent with enhanced binding, DEC3‐AmB‐LLs inhibited and/or killed C. albicans and R. delemar more efficiently than control liposomes and significantly reduced the effective dose of AmB. In conclusion, Dectin‐3 targeting has the potential to advance our goal of building pan‐antifungal DectiSomes.
Hornblende and magnetite heavies in the Ellensburg of central Washington

ABSTRACT The mineral assemblage in the Ellensburg formation is unusual in many respects. The heavies are restricted exclusively to hornblende and magnetite. The lights are essentially glass and plagioclase. All of the minerals are remarkably euhedral although evidence points to sources up to 50 miles or more from their present position. The uniform mineral content persists over an area of many hundreds, if not thousands, of square miles and may prove to be an aid in working out the stratigraphy of central Washington.
Characterizing the Patterns of Electronic Health Record–Integrated Secure Messaging Use: Cross-Sectional Study

Background Communication among health care professionals is essential for the delivery of safe clinical care. Secure messaging has rapidly emerged as a new mode of asynchronous communication. Despite its popularity, relatively little is known about how secure messaging is used and how such use contributes to communication burden. Objective This study aims to characterize the use of an electronic health record–integrated secure messaging platform across 14 hospitals and 263 outpatient clinics within a large health care system. Methods We collected metadata on the use of the Epic Systems Secure Chat platform for 6 months (July 2022 to January 2023). Information was retrieved on message volume, response times, message characteristics, messages sent and received by users, user roles, and work settings (inpatient vs outpatient). Results A total of 32,881 users sent 9,639,149 messages during the study. Median daily message volume was 53,951 during the first 2 weeks of the study and 69,526 during the last 2 weeks, resulting in an overall increase of 29% (P=.03). Nurses were the most frequent users of secure messaging (3,884,270/9,639,149, 40% messages), followed by physicians (2,387,634/9,639,149, 25% messages), and medical assistants (1,135,577/9,639,149, 12% messages). Daily message frequency varied across users; inpatient advanced practice providers and social workers interacted with the highest number of messages per day (median 19). Conversations were predominantly between 2 users (1,258,036/1,547,879, 81% conversations), with a median of 2 conversational turns and a median response time of 2.4 minutes. The largest proportion of inpatient messages was from nurses to physicians (972,243/4,749,186, 20% messages) and physicians to nurses (606,576/4,749,186, 13% messages), while the largest proportion of outpatient messages was from physicians to nurses (344,048/2,192,488, 16% messages) and medical assistants to other medical assistants (236,694/2,192,488, 11% messages). Conclusions Secure messaging was widely used by a diverse range of health care professionals, with ongoing growth throughout the study and many users interacting with more than 20 messages per day. The short message response times and high messaging volume observed highlight the interruptive nature of secure messaging, raising questions about its potentially harmful effects on clinician workflow, cognition, and errors.
An Ice Accretion Forecasting System (IAFS) for Power Transmission Lines Using Numerical Weather Prediction

Power transmission networks are exposed to meteorological conditions that can often cause damage resulting in temporary loss of service. Because their reliability is of crucial importance to society, the ability to predict potential hazards in advance is of great interest. Studies conducted by the power transmission industry indicate that the majority of failures is caused by icing on overhead conductors and other components of power networks. This paper outlines an ice accretion forecasting system (IAFS) that uses a state-of-the-art, mesoscale, numerical weather prediction model, augmented by a precipitation type classifier, and an ice accretion model. The system is calibrated by hindcasting a well-documented freezing rain event in the United States, in December, 2002. Results indicate that IAFS can hindcast overall ice thicknesses as well as icing models can diagnose them using observed surface meteorological conditions.
Temporal action segmentation in rooks (Corvus frugilegus) - a three second window or the fast lane?

A three second window has long been suggested by Poppel (2009) and others, to guide the human perception. More recently,a three second constant has been suggested in overt human behaviour (Schleidt, 1988) as well as in mammalian species in general (Gerstner & Goldberg, 1994). It is however unclear whether this temporal window exists in other vertebrate species. This study examines the existence of a temporal constant for overt behaviours in rooks (Corvus frugilegus), and discuss the methods for studying temporal constraints in overt behaviours. Results point to a shorter temporal window in rooks compared to mammals. However, the mechanisms behind this temporal constraint in behaviour are still unknown and should be considered as an ongoing investigation
Paleomagnetism of Mesozoic rocks from the central Andes of southern Peru: Importance of rotations in the development of the Bolivian orocline

A paleomagnetic study has been undertaken in Jurassic volcanics and Cretaceous intrusions from coastal southern Peru. A secondary magnetization in the Jurassic volcanics was identified at 21 sites from three main localities along the southern coast of Peru (mean virtual geomagnetic pole: 59.5°N, 190.1°E, k=111, α95=3.0). This secondary magnetization was acquired during a tectonomagmatic event that may be related to the emplacement of the Peruvian coastal batholith and/or to the first Andean phase of compressional deformation in Late Cretaceous. If we assume that the remagnetization is of Late Cretaceous age, a regional counterclockwise rotation of about 20° is recorded by the forearc of southern Peru from 16°S to 18°S. Primary remanent magnetizations recorded by the volcanics and the batholith reveal a more complex tectonic history of block rotations. Counterclockwise rotations of 50° to 80° are documented near the localities of Chala (eight sites), Ocona (two sites) and Arequipa (four sites). Preliminary results based on three sites of Late Permian to Early Triassic sediments from northern Bolivia also show a large counterclockwise rotation. The observed differences between the primary and the secondary magnetization indicate that large block rotations occurred prior to the acquisition of the secondary magnetization. Perhaps, this first episode of deformation partially structured the Andean chain in the Central Andes and induced an incipient orocline. During the Cenozoic, a differential shortening along the chain gave the present-day shape of the Bolivian deflection and resulted in a counterclockwise rotation of the forearc system by about 20° as indicated by the remagnetization.
Disrupted Binding of Cystathionine γ-Lyase to p53 Promotes Endothelial Senescence

BACKGROUND: Advanced age is unequivocally linked to the development of cardiovascular disease; however, the mechanisms resulting in reduced endothelial cell regeneration remain poorly understood. Here, we investigated novel mechanisms involved in endothelial cell senescence that impact endothelial cell transcription and vascular repair after injury. METHODS: Native endothelial cells were isolated from young (20±3.4 years) and aged (80±2.3 years) individuals and subjected to molecular analyses to assess global transcriptional and metabolic changes. In vitro studies were conducted using primary human and murine endothelial cells. A murine aortic re-endothelialization model was used to examine endothelial cell regenerative capacity in vivo. RESULTS: RNA sequencing of native endothelial cells revealed that aging resulted in p53-mediated reprogramming to express senescence-associated genes and suppress glycolysis. Reduced glucose uptake and ATP contributed to attenuated assembly of the telomerase complex, which was required for endothelial cell proliferation. Enhanced p53 activity in aging was linked to its acetylation on K120 due to enhanced activity of the acetyltransferase MOZ (monocytic leukemic zinc finger). Mechanistically, p53 acetylation and translocation were, at least partially, attributed to the loss of the vasoprotective enzyme, CSE (cystathionine γ-lyase). CSE physically anchored p53 in the cytosol to prevent its nuclear translocation and CSE absence inhibited AKT (Protein kinase B)-mediated MOZ phosphorylation, which in turn increased MOZ activity and subsequently p53 acetylation. In mice, the endothelial cell–specific deletion of CSE activated p53, induced premature endothelial senescence, and arrested vascular repair after injury. In contrast, the adeno-associated virus 9–mediated re-expression of an active CSE mutant retained p53 in the cytosol, maintained endothelial glucose metabolism and proliferation, and prevented endothelial cell senescence. Adenoviral overexpression of CSE in native endothelial cells from aged individuals maintained low p53 activity and reactivated telomerase to revert endothelial cell senescence. CONCLUSIONS: Aging-associated impairment of vascular repair is partly determined by the vasoprotective enzyme CSE.
Pre-emptive infiltration with betamethasone and ropivacaine for postoperative pain in laminoplasty and laminectomy (PRE-EASE): a prospective randomized controlled trial

Background: Postoperative pain after laminoplasty and laminectomy occurs partially from local trauma of the paraspinal tissue. Finding a multimodal analgesic cocktail to enhance the duration and effect of local infiltration analgesia is crucial. Because of the rapid onset and long duration of action of betamethasone, the authors hypothesized that, a pre-emptive multimodal infiltration regimen of betamethasone and ropivacaine reduces pain scores and opioid demand, and improves patient satisfaction following laminoplasty and laminectomy. Materials and methods: This prospective, randomized, open-label, blinded endpoint study was conducted between 1 September 2021 and 3 June 2022, and included patients between the ages of 18 and 64 scheduled for elective laminoplasty or laminectomy under general anesthesia, with American Society of Anesthesiologists classification I/II. One hundred sixteen patients were randomly assigned to either the BR (Betamethasone-Ropivacaine) group or the R (Ropivacaine) group in a 1:1 ratio. Each group received pre-emptive infiltration of a total of 10 ml study solution into each level. Every 30 ml of study solution composed of 0.5 ml of betamethasone plus 14.5 ml of saline and 15 ml of 1% ropivacaine for the BR group, and 15 ml of 1% ropivacaine added to 15 ml of saline for the R group. Infiltration of epidural space and intrathecal space were avoided and the spinous process, transverse process, facet joints, and lamina were injected, along with paravertebral muscles and subcutaneous tissue. Cumulative 48 h postoperative butorphanol consumption via PCA (Patient-controlled analgesia) was the primary outcome. Intention-to-treat (ITT) principle was used for primary analysis. Results: Baseline characteristics were identical in both groups (P>0.05). The cumulative 48 h postoperative butorphanol consumption via PCA was 3.0±1.4 mg in the BR group (n=58), and 7.1±1.2 mg in the R group (n=58) (P<0.001). Overall cumulative opioid demand was lower at different time intervals in the BR group (P<0.001), along with the estimated median time of first analgesia demand via PCA (3.3 h in the BR group and 1.6 h in the R group). The visual analog scale (VAS) score at movement and rest were also significantly lower until 3 months and 6 weeks, respectively. No side effects or adverse events associated with the intervention were observed in this study. Conclusions: Pre-emptive analgesia with betamethasone and ropivacaine provides better postoperative pain management following laminoplasty and laminectomy, compared to ropivacaine alone. This is an effective technique worthy of further evaluation.
Deposition of the Woodbine-Eagleford Sandstones, Aggieland Field, Brazos County, Texas

ABSTRACT Sandstones of the Upper Cretaceous Woodbine-Eagleford interval produce oil and gas from a stratigraphic trap at Aggieland field. The reservoir has an overall north-south trending, ovate morphology and is composed of two elongate bodies that are 3 mi (4.8 km) long by 1.5 mi (2.7 km) wide. The sandstones are thin and have an average net thickness of 16 ft (4.9 m). Grain size ranges from 0.15 mm (fine grained) to 0.30 mm (medium grained). The sandstones are classified as lithic graywackes, with a composition of 48 percent quartz, 42 percent matrix and 10 percent rock fragments. Due to the high percentage of matrix and pore filling shale clasts, permeability values are low averaging 0.10 md. Porosity ranges from 2.5 to 22 percent. Based on sedimentary structures, texture and composition, two main facies can be defined: (1) a lower massive, clast facies, which contains numerous shale clasts and oolites; (2) a sandstone facies, which exhibits bioturbated, rippled and crossbedded intervals and contains mainly monocrystalline quartz and a clay matrix. The sandstones are encased within marine shales and were transported to a middle- to outer-shelf location by a combination of tidal and storm driven marine currents. The eastern edge of the reservoir is truncated and unconformably overlain by the Austin Chalk. This truncation resulted from submarine erosion over a deep-seated salt uplift, which also influenced the paleotopography and deposition of the sandstones. The lower massive, clast facies was deposited in topographic lows by debris/gravity flows, followed by the upper sandstone facies, which was deposited by marine currents.
Fibroblast Activation Protein-Targeted Radioligand Therapy with 177Lu-EB-FAPI for Metastatic Radioiodine-Refractory Thyroid Cancer: First-in-Human, Dose-Escalation Study

Abstract Purpose: Fibroblast activation protein (FAP) is a promising target for tumor treatment. In this study, we aimed to investigate the safety and efficacy of the albumin binder-conjugated FAP-targeted radiopharmaceutical, 177Lu-EB-FAPI (177Lu-LNC1004), in patients with metastatic radioiodine-refractory thyroid cancer (mRAIR-TC). Patients and Methods: This open-label, non-randomized, first-in-human, dose-escalation, investigator-initiated trial had a 3+3 design and involved a 6-week 177Lu-LNC1004 treatment cycle in patients with mRAIR-TC at 2.22 GBq initially, with subsequent cohorts receiving an incremental 50% dose increase until dose-limiting toxicity (DLT) was observed. Results: 177Lu-LNC1004 administration was well tolerated, with no life-threatening adverse events observed. No patients experienced DLT in Group A (2.22 GBq/cycle). One patient experienced grade 4 thrombocytopenia in Group B (3.33 GBq/cycle); hence, another three patients were enrolled, none of whom experienced DLT. Two patients experienced grade 3 and 4 hematotoxicity in Group C (4.99 GBq/cycle). The mean whole-body effective dose was 0.17 ± 0.04 mSv/MBq. Intense 177Lu-LNC1004 uptake and prolonged tumor retention resulted in high mean absorbed tumor doses (8.50 ± 12.36 Gy/GBq). The mean effective half-lives for the whole-body and tumor lesions were 90.20 ± 7.68 and 92.46 ± 9.66 hours, respectively. According to RECIST, partial response, stable disease, and progressive disease were observed in 3 (25%), 7 (58%), and 2 (17%) patients, respectively. The objective response and disease control rates were 25% and 83%, respectively. Conclusions: FAP-targeted radioligand therapy with 177Lu-LNC1004 at 3.33 GBq/cycle was well tolerated in patients with advanced mRAIR-TC, with high radiation dose delivery to the tumor lesions, encouraging therapeutic efficacy, and acceptable side effects.
Outcomes and long-term effects of hematopoietic stem cell transplant in sickle cell disease

ABSTRACT Introduction Hematopoietic stem cell transplant (HSCT) is the only readily available curative option for sickle cell disease (SCD). Cure rates following human leukocyte antigen (HLA)-matched related donor HSCT with myeloablative or non-myeloablative conditioning are >90%. Alternative donor sources, including haploidentical donor and autologous with gene therapy, expand donor options but are limited by inferior outcomes, limited data, and/or shorter follow-up and therefore remain experimental. Areas Covered Outcomes are improving with time, with donor type and conditioning regimens having the greatest impact on long-term complications. Patients with stable donor engraftment do not experience SCD-related symptoms and have stabilization or improvement of end-organ pathology; however, the long-term effects of curative strategies remain to be fully established and have significant implications in a patient’s decision to seek therapy. This review covers currently published literature on HSCT outcomes, including organ-specific outcomes implicated in SCD, as well as long-term effects. Expert Opinion HSCT, both allogeneic and autologous gene therapy, in the SCD population reverses the sickle phenotype, prevents further organ damage, can resolve prior organ dysfunction in both pediatric and adult patients. Data support greater success with HSCT at a younger age, thus, curative therapies should be discussed early in the patient’s life.