Miracle-dz/UniFAR-FTUs huggingface dataset:
Long-term Mortality and Reintervention After Repair of Ruptured Abdominal Aortic Aneurysms Using VQI-matched Medicare Claims

Objective: The objective of this study was to compare endovascular aortic aneurysm repair (EVAR) versus open aortic repair (OAR) on mortality and reintervention after ruptured infrarenal abdominal aortic aneurysm (rAAA) repair in the Vascular Quality Initiative (VQI). Background: The optimal treatment modality for rAAA remains debated, with little data on long-term comparisons. Methods: VQI rAAA repairs (2004–2018) were matched with Medicare claims (VQI-VISION). Primary outcomes were in-hospital and long-term mortality. Secondary outcome was reintervention. Inverse probability weighting was used to adjust for treatment selection, and Cox Proportional Hazards models and negative binomial regressions were used for analysis. Landmark analysis was performed among patients surviving hospital discharge. Results: Among 1885 VQI/Medicare rAAA patients, 790 underwent OAR, and 1095 underwent EVAR. Median age was 76 years; 73% were male. Inverse probability weighting produced comparable groups. In-hospital mortality was lower after EVAR versus OAR (21% vs 37%, odds ratio: 0.52, 95% CI, 0.4–0.7). One-year mortality rates were lower for EVAR versus OAR [hazard ratio (HR) 0.74, 95% CI, 0.6–0.9], but not statistically different after 1 year (HR: 0.95, 95% CI, 0.8–1.2). This implies additional benefits to EVAR in the short term. Reintervention rates were higher after EVAR than OAR at 2 and 5 years (rate ratio: 1.79 95% CI, 1.2–2.7 and rate ratio:2.03 95% CI, 1.4–3.0), but not within the first year. Reintervention was associated with higher mortality risk for both OAR (HR: 1.66 95% CI, 1.1–2.5) and EVAR (HR: 2.14 95% CI, 1.6–2.9). Long-term mortality was similar between repair types (HR: 0.99, 95% CI, 0.8–1.2). Conclusions: Within VQI/Medicare patients undergoing rAAA repair, the perioperative mortality rate favors EVAR but equalizes after 1 year. Reinterventions were more common after EVAR and were associated with higher mortality regardless of treatment.
Alarm Fatigue in Nursing Students Undertaking Clinical Training in Intensive Care Units: A Multicenter Study

Background: The frequency of alarms from monitors and other electro-medical devices is of great utility but can increase the professional’s workload and expose nurses in the intensive care unit to Alarm Fatigue. A recent study suggested that students in training can also experience the problem during their first clinical experiences in intensive care. Unfortunately, no data are available about the Italian panorama. To explore Alarm Fatigue among Bachelor of Science in Nursing students at the end of their internship experience in intensive care settings. Methods: Multicenter cross-sectional design. A convenience sample of nurses from 3 Italian university hospitals was recruited. The students completed the revised version of the “Alarm Fatigue questionnaire-ita” at the end of the clinical internship in intensive care settings. Results: 130 nursing students were enrolled (response rate 59.36%). The overall level of Alarm Fatigue was Me= 24.5 IQR [17.5, 30.5]. In addition, 9.23% of the sample reported errors or near misses related to Alarm Fatigue during the internship experience. The alarm fatigue level was higher in students who committed “errors/almost errors” (p=0.038) and in “student workers” (p=0.005). Discussion: The extent of alarm fatigue experienced by nursing students requires developing a preventive strategy.
Effects of exercise habits in adolescence and older age on sarcopenia risk in older adults: the Bunkyo Health Study

Sarcopenia, defined as an age‐associated loss of skeletal muscle mass and function, is a major risk factor for requiring long‐term care. Because physical activity in adolescence and older age enhances peak muscle function in youth and prevents muscle function decline in older age, older adults with exercise habits during both periods may be at a lower risk for sarcopenia. We investigated the relationship between exercise habits in adolescence and older age and sarcopenia and its components in community‐dwelling older Japanese adults.
Estimated trends in hospitalizations due to occupational injuries in Korea based on the Korean National Hospital Discharge In-depth Injury Survey (2006-2019)

OBJECTIVES In recent years, occupational injuries have sparked a huge social and political debate. Thus, in this study, we focused on the characteristics and trends of occupational injuries requiring hospitalization in Korea. METHODS The Korea National Hospital Discharge In-depth Injury Survey was designed to estimate the annual number and characteristics of all injury-related hospitalizations in Korea. The annual number of hospitalizations due to occupational injuries and the age-standardized rates (ASRs) were estimated from 2006 to 2019. The annual percentage change (APC) and average annual percentage change (AAPC) of ASRs and their 95% confidence intervals (CIs) were calculated using joinpoint regression. All analyses were stratified by gender. RESULTS In men, the APC of the ASRs of all-cause occupational injuries was -3.1% (95% CI, -4.5 to -1.7) in 2006-2015. However, a non-significant upward trend was observed after 2015 (APC, 3.3%; 95% CI, -1.6 to 8.5). In women, the APC of all-cause occupational injuries was -8.6% (95% CI, -12.1 to -5.1) in 2006-2012. However, a non-significant upward trend was observed after 2012 (APC, 2.1%; 95% CI, -0.9 to 5.2). A recent upward trend in stabbing injuries was observed after 2012 (APC, 4.7%; 95% CI, -1.8 to 11.8) in women. A non-significant overall increasing trend was also observed for occupational injuries caused by exposure to extreme temperatures (AAPC, 3.7%; 95% CI, -1.1 to 8.7) in women. CONCLUSIONS A recent upward trend in all-cause injury hospitalizations and hospitalizations caused by stabbing injuries was observed. Therefore, active policy interventions are required to prevent occupational injuries.
Sur la géométrie des structures de contact invariantes

Ces constructions donnent les meilleurs résultats possibles, puisque dans le chapitre III on constate que la fibration nouée détermine la structure de contact à isomorphisme équivariant près, dans les cas étudiés. On peut remarquer le parallèle curieux entre les constructions de ce travail et celle des feuilletages de codimension un sur les sphères : dans les deux cas les fibrations nouées ont un rôle important, quoique dans le premier cas plus naturellement.
The feasibility analysis of integrating community-based health insurance schemes into the national health insurance scheme in Uganda

Background Uganda has a draft National Health Insurance Bill for the establishment of a National Health Insurance Scheme (NHIS). The proposed health insurance scheme is to pool resources, where the rich will subsidize the treatment of the poor, the healthy will subsidize the treatment of the sick, and the young will subsidize the treatment of the elderly. However, there is still a lack of evidence on how the existing community-based health insurance schemes (CBHIS) can fit within the proposed national scheme. Thus, this study aimed at determining the feasibility of integrating the existing community-based health financing schemes into the proposed National Health Insurance Scheme. Methods In this study, we utilized a multiple–case study design involving mixed methods. The cases (i.e., units of analysis) were defined as the operations, functionality, and sustainability of the three typologies of community-based insurance schemes: provider-managed, community-managed, and third party-managed. The study combined various data collection methods, including interviews, survey desk review of documents, observation, and archives. Findings The CBHIS in Uganda are fragmented with limited coverage. Only 28 schemes existed, which covered a total of 155,057 beneficiaries with an average of 5,538 per scheme. The CBHIS existed in 33 out of 146 districts in Uganda. The average contribution per capita was estimated at Uganda Shillings (UGX) 75,215 = equivalent to United States Dollar (USD) 20.3, accounting for 37% of the national total health expenditure per capita UGX 51.00 = at 2016 prices. Membership was open to everyone irrespective of socio-demographic status. The schemes had inadequate capacity for management, strategic planning, and finances and lacked reserves and reinsurance. The CBHIS structures included promoters, the scheme core, and the community grass-root structures. Conclusion The results demonstrate the possibility and provide a pathway to integrating CBHIS into the proposed NHIS. We however recommend implementation in a phased manner including first providing technical assistance to the existing CBHIS at the district level to address the critical capacity gaps. This would be followed by integrating all three elements of CBHIS structures. The last phase would then involve establishing a single fund for both the formal and informal sectors managed at the national level.
Incentive effect of tax preferences towards the technological innovation of enterprises——Based on China’s GEM listed companies

The long R&D process, the high risk, and the externalities of technological innovation are challenges that enterprises have to meet when making decisions on R&D investment. Governments share this risk with enterprises through preferential tax policies. We summarized China’s preferential tax policies related to enterprises and R&D innovation, and used panel data of listed enterprises from 2013 to 2018 in the Growth Enterprises Market (GEM) of the Shenzhen Stock Exchange to explore the incentive effects of current tax policies on the R&D innovation of enterprises. Through empirical analysis, we found that tax incentives significantly motivate R&D innovation input and promote output. In addition, we found that the income tax incentives are greater than that of the circulation tax, since the profitability of enterprise has a positive correlation with R&D investment. Meanwhile, the size of the enterprise is negatively correlated with the intensity of R&D investment.
Immune responses to citrullinated and homocitrullinated peptides in healthy donors are not restricted to the HLA SE shared allele and can be selected into the memory pool

Citrullination and homocitrullination are stress induced post‐translational modifications (siPTMs) which can be recognized by T cells. Peripheral blood mononuclear cells isolated from healthy donors and rheumatoid arthritis (RA) patients were stimulated with nine siPTM‐peptides. CD45RA/CD45RO depletion was employed to determine if peptide‐specific responses are naïve or memory. Human leucocyte antigen (HLA)‐DP4 and HLA‐DR4 transgenic mice were immunized with siPTM‐peptides and immune responses were determined with ex vivo ELISpot assays. The majority (24 out of 25) of healthy donors showed CD4 T cell‐specific proliferation to at least 1 siPTM‐peptide, 19 to 2 siPTM‐peptides, 14 to 3 siPTM‐peptides, 9 to 4 siPTM‐peptides, 6 to 5 siPTM‐peptides and 4 to 6 siPTM‐peptides. More donors responded to Vim28‐49cit (68%) and Bip189‐208cit (75%) compared with Vim415‐433cit (33%). In RA patients, the presentation of citrullinated epitopes is associated with HLA‐SE alleles; however, we witnessed responses in healthy donors who did not express the SE allele. The majority of responding T cells were effector memory cells with a Th1/cytotoxic phenotype. Responses to Vim28‐49cit and Eno241‐260cit originated in the memory pool, while the response to Vim415‐433cit was naïve. In the HLA‐DP4 and HLA‐DR4 transgenic models, Vim28cit generated a memory response. Peptide‐specific T cells were capable of Epstein–Barr virus transformed lymphoblastoid cell line recognition suggesting a link with stress due to infection. These results suggest siPTM‐peptides are presented under conditions of cellular stress and inflammation and drive cytotoxic CD4 T cell responses that aid in the removal of stressed cells. The presentation of such siPTM‐peptides is not restricted to HLA‐SE in both humans and animal models.
Encountering young caregivers: Attitudes and practices of healthcare professionals caring for cancer patients

Cancer and its treatments severely limit patients' daily lives. Relatives of patients may provide caregiving assistance to help patients cope with these limitations. Many children and adolescents—referred to as young caregivers (YCs)—provide support for patients. However, healthcare professionals do not always recognize YCs, and when they do, healthcare professionals are unsure how to support them.
Therapeutic modulation of the liver immune microenvironment

Inflammation is a hallmark of progressive liver diseases such as chronic viral or immune-mediated hepatitis, alcohol-associated liver disease, and NAFLD. Preclinical and clinical studies have provided robust evidence that cytokines and related cellular stress sensors in innate and adaptive immunity orchestrate hepatic disease processes. Unresolved inflammation and liver injury result in hepatic scarring, fibrosis, and cirrhosis, which may culminate in HCC. Liver diseases are accompanied by gut dysbiosis and a bloom of pathobionts, fueling hepatic inflammation. Anti-inflammatory strategies are extensively used to treat human immune-mediated conditions beyond the liver, while evidence for immunomodulatory therapies and cell therapy–based strategies in liver diseases is only emerging. The development and establishment of novel immunomodulatory therapies for chronic liver diseases has been dampened by several clinical challenges, such as invasive monitoring of therapeutic efficacy with liver biopsy in clinical trials and risk of DILI in several studies. Such aspects prevented advancements of novel medical therapies for chronic inflammatory liver diseases. New concepts modulating the liver immune environment are studied and eagerly awaited to improve the management of chronic liver diseases in the future.
Transplacental transfer of Lassa IgG antibodies in pregnant women in Southern Nigeria: A prospective hospital-based cohort study

Background Evidence from previous studies suggest that Lassa fever, a viral haemorrhagic fever endemic to West Africa has high case fatalities, particularly in pregnancy. While there have been remarkable innovations in vaccine development, with some Lassa vaccines undergoing early clinical trials. An understanding of Lassa antibody kinetics and immune responses will support vaccine design and development. However, there is currently no evidence on the antibody kinetics of Lassa (LASV) in pregnancy. Our study sought to estimate the efficiency of transplacental transfer of LASV IgG antibodies from the mother to the child. Methodology/Principal findings The study made use of data from a prospective hospital-based cohort of pregnant women enrolled at the antenatal clinic and followed up at delivery between February and December 2019. Blood samples from mother-child pairs were evaluated for antibodies against Lassa virus. The study demonstrates a transplacental transfer of LASV IgG of 75.3% [60.0–94.0%], with a significant positive correlation between maternal and cord concentrations and a good level of agreement. The study also suggests that transfer may be more variable in women with ‘de novo’ antibodies compared to those with pre-existing antibodies. Conclusions/Significance The study shows that maternal antibody levels play an important role in determining transfer efficiency of Lassa antibodies to the new-born; and while the evidence is preliminary, the study also suggests that transfer efficiency may be less stable in acute or recent infection, as such timing of vaccination before pregnancy, that is in women of childbearing age may be more appropriate for protection of both pregnant women and their neonates.
Gait Asymmetry Variation in Kinematics, Kinetics, and Muscle Force along with the Severity Levels of Knee Osteoarthritis

Knee osteoarthritis (OA) patients exhibit greater gait asymmetry than healthy controls. However, gait asymmetry in kinematics, kinetics and muscle forces across patients with different severity levels of knee OA is still unknown. The study aimed to investigate the changes of gait asymmetry in lower limb kinematics, kinetics, and muscle force across patients with different severity levels of knee OA.
ESTIMATING THE BIRTH PERIOD OF PULSARS THROUGH GLAST LAT OBSERVATIONS OF THEIR WIND NEBULAE

We show that the high-energy γ-ray flux in the GeV domain from mature pulsar wind nebulae (PWNe) scales as the change in rotational kinetic energy I(Ω02 − Ω2)/2 since birth, rather than the present-day spin-down power . This finding holds as long as the lifetime of inverse Compton emitting electrons exceeds the age of the system. For a typical γ−2 electron spectrum, the predicted flux depends mostly on the pulsar birth period, conversion efficiency of spin-down power to relativistic electrons, and distance to the PWN, so that first-order analytic estimates of the birth period can be assessed from GLAST LAT observations of PWNe. The associated ("uncooled") photon spectral index in the GeV domain is expected to cluster around ~1.5, which is bounded at low energies by an intrinsic spectral break, and at higher energies by a second spectral break where the photon index steepens to ~2 due to radiation losses. However, if the spectral parameters deviate from the above-mentioned assumptions, we can combine GLAST LAT observations with multiwavelength data from radio to TeV γ-ray observations to improve such birth period estimates. From the ATNF pulsar catalog we expect more than 50 Galactic PWNe to be detectable if the ratio of birth period to current period is <0.5. However, many of them may remain unidentified during evolved stages characterized by low spin-down power and low synchrotron brightness, while only this relic GeV component is visible.
Differences in the Long-term Impact of the COVID-19 Pandemic on Mental Health and Professional Quality of Life of Resident and Specialist Physicians

Background: The COVID-19 pandemic created a challenging situation for healthcare workers (HCWs) worldwide. We aimed to compare the mental health and professional quality of life of residents and specialist physicians in a cohort of Italian HCWs caring for patients with COVID-19 about two years after the start of the COVID-19 pandemic. Methods: Between November 2021 and November 2022, an online survey investigating the emotional states of depression, anxiety, stress, compassion satisfaction, and compassion fatigue was administered to HCWs (N=78) at the Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome. Results: Our findings suggest that from 5 to 20% of our HCWs still showed the effects of the adverse psychological impact of the pandemic, and more than half experienced medium levels of compassion fatigue and a medium level of compassion satisfaction. Our results also show that those with fewer years of clinical practice might be at greater risk of burnout (p=0.021), anxiety, and stress symptoms (both p=0.027). In addition, they might develop a lower level of compassion satisfaction (p=0.018). Moreover, the factors that potentially contribute to poor mental health, compassion fatigue, and compassion satisfaction differ between residents and specialist physicians. Conclusions: This overview presents one of the first pictures of the long-term effects of the pandemic on the mental health and professional quality of life of an Italian sample of HCWs. Moreover, it also helps identify professionals who most need support and emphasizes the importance of improving these individuals’ psychological and professional well-being, especially during a pandemic-like crisis with long-lasting effects.
Incidence and risk factors of early transient intraocular pressure elevation after canaloplasty for primary open-angle glaucoma

为分析原发性开角型青光眼(primary open-angle glaucoma, POAG)黏小管成形术后早期短暂性高眼压的发生率及危险因素, 本研究纳入了本院顺利完成360°黏小管成形术的POAG患者。 我们收集了以下数据: 术后各随访时间点眼压(intraocular pressure, IOP), 术后早期是否发生短暂性高眼压(定义: 术后1周至3月内IOP>21 mmHg但能回落至≤21 mmHg)及术后一周最低IOP(IOPmin-1w)。 根据是否发生术后早期短暂性高眼压, 将其分为正常眼压组(normal IOP, NIOP)和短暂性高眼压组(high IOP, HIOP)。 此外, 我们也对术后早期短暂性高眼压的相关危险因素进行了分析。 最终来自57位患者的57只眼纳入分析。 他们的平均视野缺损值(mean defect, MD)为(-15.57±10.13) dB, IOP由术前 (29.43±10.27) mmHg显著降低至术后1年的(14.73±3.60) mmHg(P<0.01)。 其中, 20只眼发生HIOP(35.1%)。 HIOP组的IOPmin-1w显著高于NIOP组(P<0.01), 并与较低的1年完全成功率相关。 本研究结果提示POAG中黏小管成形术后HIOP组患者可能IOPmin-1w较高, 1年手术效果较差, 且IOPmin-1w≥12 mmHg可能是HIOP发生的独立危险因素。
Single-nuclei RNA Profiling Reveals Disruption of Adipokine and Inflammatory Signaling in Adipose Tissue of Burn Patients

Objective: We conducted a large-scale investigation of the systemic and adipose tissue-specific alterations in a clinical population of burn patients to identify factors that may influence hypermetabolism. Background: Previous research has identified chronic disturbances in adipose tissue inflammation, lipolysis, and browning, which may drive the perpetuation of hypermetabolism following the severe adrenergic stress of a burn injury. Given that adipose tissue is thought to be a central node in the regulation of systemic metabolism, we believe that systematically delineating the pathologic role of adipose tissue postburn, will lead to the identification of novel interventions to mitigate morbidity and mortality from severe burns. Methods: This was a single-institution cohort study, which obtained plasma and subcutaneous adipose tissue samples from severely burn adult patients over various time points during acute hospitalization. Whole-body clinical, metabolic, and inflammatory mediators were assessed in plasma, while genetic analyses through RT-qPCR and single-nuclei RNA sequencing were conducted in adipose tissue. Results: Systemic inflammation and adrenergic stress increase IL-6 signaling, lipolysis, browning, and adipokine dysfunction in the adipose tissue of adult burn patients, which may further propagate the long-term hypermetabolic response. Moreover, using single-nuclei RNA sequencing, we provide the first comprehensive characterization of alterations in the adipose tissue microenvironment occurring at acute and chronic stages postburn. Conclusion: We provide novel insight toward the effect of burns on adipokine release, inflammatory signaling pathways, and adipose heterogeneity over the trajectory of acute and chronic stages.