Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of Nonadherence to NCCN Adjuvant Radiotherapy Initiation Guidelines in Head and Neck Squamous Cell Carcinoma in an Underserved Urban Population.

BACKGROUND Nonadherence to NCCN Guidelines during time from surgery to postoperative radiotherapy (S-PORT) can alter survival outcomes in head and neck squamous cell carcinomna (HNSCC). There is a need to validate this impact in an underserved urban population and to understand risk factors and reasons for delay. We sought to investigate the impact of delayed PORT with outcomes of overall survival (OS) in HNSCC, to analyze predictive factors of delayed PORT, and to identify reasons for delay. METHODS We conducted a retrospective cohort study in an urban, community-based academic center. A total of 184 patients with primary HNSCC were identified through the Montefiore Medical Center cancer registry who had been treated between March 1, 2005, and March 8, 2017, and met the inclusion and exclusion criteria. The primary exposure was S-PORT. OS, recurrence, and risk factors and reasons for treatment delay were the main outcomes and measures. RESULTS Among 184 patients with HNSCC treated with PORT, the median S-PORT was 48.5 days (interquartile range, 41-67 days). The S-PORT threshold that optimally differentiated worse OS outcomes was >50 days (46.7% of our cohort; n=86). Independent of other relevant factors, patients with HNSCC and S-PORT >50 days had worse OS (hazard ratio, 2.30; 95% CI, 1.34-3.95) and greater recurrence (odds ratio, 3.51; 95% CI, 1.31-9.39). Predictors of delayed S-PORT included being underweight or obese, prolonged postoperative length of stay, and age >70 years. The most frequent reasons for PORT delay were complications related to surgery (22.09%), unrelated medical comorbidities (18.60%), and nonadherence/missed appointments (6.98%). CONCLUSIONS Delayed PORT beyond 50 days after surgery was associated with decreased OS and greater recurrence. Identification of predictive factors and reasons for treatment delay helps to target at-risk patients and facilitates interventions in underserved populations.
Protective Effects of Statin Therapy in Cirrhosis Are Limited by a Common SLCO1B1 Transporter Variant

Complications of cirrhosis and portal hypertension (PH) can be reduced by statin therapy. The common loss‐of‐function variant p.V174A in the solute carrier organic anion transporter gene 1B1 (SLCO1B1) gene encoding the organic anion transporting polypeptide 1B1 results in decreased hepatic uptake of statins. Our specific aim was to assess the impact of this variant in patients with cirrhosis and statin treatment while controlling for the stage of cirrhosis and other potential confounders with propensity score matching (PSM), availing of a large cohort of genotyped study patients. In total, from 1,088 patients with cirrhosis in two German academic medical centers, PSM yielded 154 patients taking statins and 154 matched controls. The effect on PH was assessed by the liver stiffness–spleen size–to–platelet score (LSPS), and complications of cirrhosis were retrospectively recorded applying consensus criteria. As hypothesized, patients on statin treatment presented less frequently with signs of PH: Esophageal varices (41% vs. 62%; P < 0.001) were less common, and LSPS (4.8 ± 11.5 vs. 5.6 ± 6.4; P = 0.01) was reduced. Correspondingly, decompensation events were also reduced in patients on statins (odds ratio [OR] = 0.54, 95% confidence interval [CI] 0.32‐0.90; P = 0.02). When the variant in SLCO1B1 was present in patients on statins, esophageal varices (OR = 2.68, 95% CI 1.24‐5.81; P = 0.01) and bacterial infections (OR = 2.50, 95% CI 1.14‐5.47; P = 0.02) were more common as compared with wild type carriers on statins.
Muscle mitochondrial catalase expression prevents neuromuscular junction disruption, atrophy, and weakness in a mouse model of accelerated sarcopenia

Oxidative stress and damage are associated with a number of ageing phenotypes, including age‐related loss of muscle mass and reduced contractile function (sarcopenia). Our group and others have reported loss of neuromuscular junction (NMJ) integrity and increased denervation as initiating factors in sarcopenia, leading to mitochondrial dysfunction, generation of reactive oxygen species and peroxides, and loss of muscle mass and weakness. Previous studies from our laboratory show that denervation‐induced skeletal muscle mitochondrial peroxide generation is highly correlated to muscle atrophy. Here, we directly test the impact of scavenging muscle mitochondrial hydrogen peroxide on the structure and function of the NMJ and muscle mass and function in a mouse model of denervation‐induced muscle atrophy CuZnSOD (Sod1−/− mice, Sod1KO).
Comparison of Clinical Outcomes and Complications Between Percutaneous Endoscopic and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Degenerative Lumbar Disease: A Systematic Review and Meta-Analysis.

BACKGROUND Percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) has been increasingly used to treat degenerative lumbar disease in recent years. However, there are still controversies about whether PE-TLIF is superior to minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). OBJECTIVES To compare clinical outcomes and complications of PE-TLIF and MIS-TLIF in treating degenerative lumbar disease. STUDY DESIGN A systematic review and meta-analysis. METHODS A comprehensive search of online databases including PubMed, Embase, and the Cochrane Library was performed to identify related studies reporting the outcomes and complications of PE-TLIF and MIS-TLIF for degenerative lumbar disease. The clinical outcomes were assessed by the Visual Analog Scale and Oswestry Disability Index. In addition, the operative time, intraoperative blood loss, time to ambulation, length of hospital stay, fusion rate, and surgery-related complications were summarized. Forest plots were constructed to investigate the results. RESULTS A total of 28 studies involving 1,475 patients were included in this meta-analysis. PE-TLIF significantly reduced operative time, intraoperative blood loss, time to ambulation, and length of hospital stay compared to MIS-TLIF. Moreover, PE-TLIF was superior to MIS-TLIF in the early postoperative relief of back pain. However, there were no significant differences in medium to long-term clinical outcomes, fusion rate, and incidence of complications between PE-TLIF and MIS-TLIF. LIMITATIONS The current evidence is heterogeneous and most studies included in this meta-analysis are nonrandomized controlled trials. CONCLUSIONS The present meta-analysis indicates that medium to long-term clinical outcomes and complication rates of PE-TLIF were similar to MIS-TLIF for the treatment of degenerative lumbar disease. However, PE-TLIF shows advantages in less surgical trauma, faster recovery, and early postoperative relief of back pain.
Deep Reinforcement Learning for Solving the Heterogeneous Capacitated Vehicle Routing Problem

Existing deep reinforcement learning (DRL)-based methods for solving the capacitated vehicle routing problem (CVRP) intrinsically cope with a homogeneous vehicle fleet, in which the fleet is assumed as repetitions of a single vehicle. Hence, their key to construct a solution solely lies in the selection of the next node (customer) to visit excluding the selection of vehicle. However, vehicles in real-world scenarios are likely to be heterogeneous with different characteristics that affect their capacity (or travel speed), rendering existing DRL methods less effective. In this article, we tackle heterogeneous CVRP (HCVRP), where vehicles are mainly characterized by different capacities. We consider both min–max and min–sum objectives for HCVRP, which aim to minimize the longest or total travel time of the vehicle(s) in the fleet. To solve those problems, we propose a DRL method based on the attention mechanism with a vehicle selection decoder accounting for the heterogeneous fleet constraint and a node selection decoder accounting for the route construction, which learns to construct a solution by automatically selecting both a vehicle and a node for this vehicle at each step. Experimental results based on randomly generated instances show that, with desirable generalization to various problem sizes, our method outperforms the state-of-the-art DRL method and most of the conventional heuristics, and also delivers competitive performance against the state-of-the-art heuristic method, that is, slack induction by string removal. In addition, the results of extended experiments demonstrate that our method is also able to solve CVRPLib instances with satisfactory performance.
Morphometric analysis - effect of the radiofrequency interface of electromagnetic field on the size of hatched Dermacentor reticulatus larvae.

INTRODUCTION AND OBJECTIVE Electromagnetic radiation interactions with living systems have been one of determining factors in biological evolution. This study investigates the effect of 900 MHz radiofrequency (RF) electromagnetics field (EMF) exposure of eggs on the development of Dermacentor reticulatus larvae. The basic objective was to determine whether the 900 MHz RF-EMF has the potential to influence the size of the body of the hatched larvae of D. reticulatus ticks. MATERIAL AND METHODS To this aim, eggs from 3 fully engorged females of D. reticulatus were included in the test procedure. Altogether four groups of eggs were designated which included eggs from each female. We used RF-EMF frequency of 900 MHz. Eggs were exposed to EMF for different time periods (30, 60 and 90 minutes) in dark, electromagnetically shielded anechoic chamber. After the irradiation eggs were allowed to hatch in climatic chamber. Randomly selected 200 larval individuals were measured to get basic morphological records. Four body traits including the total body length (TBL), length of gnathosoma with scutum (GSL), the total body width (TBW), and the width of basis capituli (BCW) were measured. RESULTS The D. reticulatus larvae hatched from eggs exposed for 60 minutes, had demonstrably larger dimensions of all measured body traits not only as a control unexposed group but also as other experimental groups. CONCLUSIONS The study shows, particularly, that artificial EMF that is used in smartphone technology impacts seriously D. reticulatus larvae development.
Perceptions and experiences of risk management by managers of residential aged care facilities: a qualitative study from Hunan Province, China

ABSTRACT Background With adverse events and injuries recurring in residential aged care facilities (RACFs), older adults’ safety in residential age care settings has attracted extensive attention from governments, researchers, and healthcare providers. Risk management is of utmost importance in reducing risks and improving the quality of care for older adults in long-term care. Although previous studies have made great efforts to explore risk management methods and technologies in RACFs, little is known about how managers identify and respond to risks in practice. Purpose This qualitative study aimed to elucidate the perceptions and experiences of managers involved in risk management in RACFs in China. Participants and methods This study used a phenomenological research design. We conducted semi-structured interviews with 13 managers across 11 RACFs in Changsha City, Hunan Province, China. Data were analysed using Colaizzi’s seven steps and NVivo 12 plus software. Results “Facilitation of an error-free culture” emerged as a central theme of managers’ perceptions of risk management. Four sub-themes were revealed, namely “creating an age-friendly physical environment,” “paying close attention to frail older adults,” “improving the competence of nursing staff,” and “building effective management programs. ” Conclusion Facilitation of an error-free culture was of prime importance in risk management. Managers’ experiences can help RACFs to better manage risks, as well as provide new perspectives and approaches for RACFs to improve the quality and outcomes of care. This study developed initiatives for improving resident safety in RACFs and may foster interest in the developing these initiatives.
The golden jackal (Canis aureus) and the African swine fever pandemic: Its role is controversial but not negligible (a diet analysis study)

Abstract Background In Europe, the African swine fever (ASF) pandemic mostly affects the environmental domain of health, which is a strongly human‐impacted ecosystem. However, the current control strategies focus solely on the wild boar and tend to disregard other epidemiologically relevant elements of the ecosystem. Objectives This study investigated the potential impact of the golden jackal on the surveillance effort and disease transmission. Methods For this reason, the authors analysed the content of 277 stomachs of this canid species within its westernmost inhabitant population, in order to determine the amount of suid remains, disposed. Results The findings confirmed that in a densely populated wild boar habitat, the main diet component of jackals was wild boar all the year round. The jackals disposed of 0.3–0.6 kg/km2/day offals that potentially contained suid remains. On the other hand, the scavenging activity removed the most important target objects on which the passive surveillance of ASF should be based. Conclusions This study cannot determine whether canid scavengers positively or negatively influence the control efforts; however, the impact of the jackal should not be disregarded. The results warn the necessity of a multidisciplinary approach to complex epidemiological situations within different ecosystems.
Worrying about the Consequences of COVID-19 for Distant Others Relates to Mitigative Actions

ABSTRACT To mitigate the impacts and spread of COVID-19, drastic mitigative actions are demanded from individuals worldwide, including social distancing, health behaviors, and self-quarantining. A key question is what motivates individuals to take and support such actions. Early in the COVID-19 crisis, we hypothesized and found in two studies (in the Netherlands and United States) that stronger worries about potential consequences of COVID-19 for oneself and close others (i.e., family and friends), as well as more “distant” others (e.g., citizens in general, vulnerable populations), are associated with stronger engagement in actions to mitigate COVID-19. In line with reasoning on norm activation, we found that these associations were partly mediated by personal norms, reflecting individuals’ feelings of being morally compelled and personally responsible to take mitigative actions. Importantly, individuals generally reported to worry more about consequences of COVID-19 for distant others than for themselves, and worries about distant others were more strongly related to mitigative actions than worries about oneself and close others. Our outcomes offer key novel insights to the health domain, highlighting the potential relevance of worrying about distant others and personal norms in motivating actions to mitigate global health crises.
Peatland microhabitat heterogeneity drives phototrophic microbes distribution and photosynthetic activity.

Phototrophic microbes are widespread in soils but their contribution to soil carbon (C) uptake remains underexplored in most terrestrial systems, including C-accreting systems such as peatlands. Here, by means of metabarcoding and ecophysiological measurements, we examined how microbial photosynthesis and its biotic (e.g., phototrophic community structure, biomass) and abiotic drivers (e.g., Sphagnum moisture, light intensity) vary across peatland microhabitats. Using a natural gradient of microhabitat conditions from pool to forest, we show that the structure of phototrophic microbial communities shifted from a dominance of eukaryotes in pools to prokaryotes in forests. We identified five groups of co-occurring phototrophic operational taxonomic units (OTUs) with specific environmental preferences across the gradient. Along with such structural changes, we found that microbial C uptake was the highest in the driest and shadiest microhabitats. This study renews and improves current views on phototrophic microbes in peatlands, as the contribution of microbial photosynthesis to peatland C uptake has essentially been studied in wet microhabitats. This article is protected by copyright. All rights reserved.
Dimensions of Perception: 3D Real-Life Objects Are More Readily Detected Than Their 2D Images

Most of our interactions with our environment involve manipulating real 3D objects. Accordingly, 3D objects seem to enjoy preferential processing compared with 2D images, for example, in capturing attention or being better remembered. But are they also more readily perceived? Thus far, the possibility of preferred detection for real 3D objects could not be empirically tested because suppression from awareness has been applied only to on-screen stimuli. Here, using a variant of continuous flash suppression (CFS) with augmented-reality goggles (“real-life” CFS), we managed to suppress both real 3D objects and their 2D representations. In 20 healthy young adults, real objects broke suppression faster than their photographs. Using 3D printing, we also showed in 50 healthy young adults that this finding held only for meaningful objects, whereas no difference was found for meaningless, novel ones (a similar trend was observed in another experiment with 20 subjects, yet it did not reach significance). This suggests that the effect might be mediated by affordances facilitating detection of 3D objects under interocular suppression.
PRO‐C3, a Serological Marker of Fibrosis, During Childhood and Correlations With Fibrosis in Pediatric NAFLD

Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver disease in children and may lead to cirrhosis requiring liver transplant. Thus, prompt diagnosis of advanced fibrosis is essential. Our objectives were to examine PRO‐C3 (a neo‐epitope pro‐peptide of type III collagen formation) levels across childhood/adolescence and associations with advanced fibrosis in pediatric NAFLD. This cross‐sectional study included 88 children and adolescents with biopsy‐proven NAFLD (mean age: 13.9 ± 2.9 years, 71% male) and 65 healthy participants (11.8 ± 4.5 years, 38% male). PRO‐C3, and the bone remodeling biomarkers C‐terminal telopeptide of type I collagen (CTX‐I; bone resorption) and osteocalcin (N‐MID; bone formation), were measured in serum by enzyme‐linked immunosorbent assay. Fibrosis was assessed by liver biopsy in participants with NAFLD, who were categorized as having advanced (Ishak score ≥ 3) or none/mild fibrosis (Ishak score ≤ 2). Overall, PRO‐C3 was similar in participants with NAFLD (median [interquartile range]: 20.6 [15.8, 25.9] ng/mL) versus healthy participants (19.0 [13.8, 26.0] ng/mL), but was significantly lower in older adolescents ≥ 15 years old (16.4 [13.0, 21.2] ng/mL) compared with children ≤ 10 years old (22.9 [18.1, 28.4] ng/mL; P < 0.001) or 11‐14 years old (22.4 [18.3, 31.2] ng/mL; P < 0.001). PRO‐C3 was also directly correlated with levels of CTX‐I and N‐MID (r = 0.64 and r = 0.62, respectively; both P < 0.001). Among participants with NAFLD, PRO‐C3 was higher in those with advanced fibrosis (median [IQR]: 28.5 [21.6, 37.6]) compared with none/mild fibrosis (20.3 [18.2, 22.8]; P = 0.020) in models adjusted for age, sex, and body mass index z‐score. However, associations were attenuated after additionally adjusting for bone‐remodeling CTX‐I (P = 0.09) or N‐MID (P = 0.08). Conclusion: Collectively, these findings show that PRO‐C3 levels are higher in children with advanced fibrosis in NAFLD, but are also influenced by age and pubertal growth spurt, assessed by bone remodeling biomarkers, and therefore may not be a reliable biomarker for liver fibrosis in pediatric NAFLD until late adolescence.
Is Osteoporotic Thoracolumbar Burst Fracture a Contraindication to Percutaneous Kyphoplasty? A Systematic Review.

BACKGROUND The management of pain after osteoporotic thoracolumbar burst fracture has not reached a treatment consensus. Percutaneous kyphoplasty has been shown to be efficient in reducing acute pain after burst fracture, although the topic remains highly controversial in this field. OBJECTIVE This study aimed to conduct a systematic review of the current literature to evaluate the effectiveness and safety of percutaneous kyphoplasty on the treatment of osteoporotic thoracolumbar burst fracture. STUDY DESIGN A systematic review. SETTING University hospital. METHODS A comprehensive literature search was performed through PubMed, EMBASE, Web of Science, and Cochrane library without time restriction. Among the studies meeting the eligible criteria, any study in which percutaneous kyphoplasty was utilized alone in the treatment of osteoporotic thoracolumbar burst fracture was included in the current review. For radiographic outcome evaluation, vertebral height and kyphotic angle were analyzed. VAS (Visual Analog Scale) and ODI (Oswestry Disability Index) were utilized for clinical outcome evaluation. Complications such as cement leakage and adjacent vertebral fracture or relapse were also analyzed. RESULTS In total, 289 patients (338 vertebral bodies) were included in the 8 studies. Clinical outcomes indicated that patients achieved pain relief (VAS) from 6.8 preoperatively to 1.1 postoperatively, and improvement of quality of life (ODI) ranged from 87.0 ± 6.0% to 23.9 ± 4.4%. The radiological outcome indicated that anterior vertebral height restoration ranged from 20.1 ± 2.3 to 85.3 ± 10.6, and posterior vertebral height restoration ranged from 27.3 ± 1.7 to 83.3 ± 7.4. Kyphotic angle achieved correction ranged from 21.7 ± 7.8° preoperatively to 3.17° postoperatively. The main complications after PKP were cement leakage and adjacent vertebral fracture or relapse, which had an incidence of 7.7% -45.4% and 4.3% -74.1%, respectively. LIMITATIONS Due to the good quality of the English publications, only English-language research searches were conducted, but they do not unduly affect our aggregate results impact. More prospective randomized controlled trials are needed to provide higher evidence for clinical practice. CONCLUSIONS To osteoporotic thoracolumbar burst fracture is absolutely not a contraindication to percutaneous kyphoplasty. Percutaneous kyphoplasty can obtain satisfactory effectiveness for the treatment of osteoporotic thoracolumbar burst fractures. Complications can be effectively decreased by meticulous evaluation, careful manipulation, and appropriate precautionary measures.