Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of tooth brush abrasion on the color, gloss and surface roughness of internally and externally stained monolithic ceramic materials.

PURPOSE To measure the durability of the color, change in surface roughness and gloss of stained monolithic ceramic materials subjected to artificial tooth brush abrasion. MATERIALS AND METHODS Standardized specimens were manufactured from pressable lithium-disilicate glass ceramic (PC; IPS e.max Press), machinable lithium-disilicate glass ceramic (MC; IPS e.max CAD), and zirconia (ZR; Zenostar). Ceramic staining was applied before (internal; in) and after crystallization/sintering (external; ex). Of each ceramic material, specimens without staining were prepared (no staining; no). Porcelain-fused-to-metal specimens served as control (PFM). Each group consisted of 15 specimens. Tooth brushing was simulated with tooth brushing strokes of 21.6 k, 43.2 k, and 64.8 k. Color, gloss and roughness were measured at baseline and after cycle intervals. Kruskal-Wallis and paired Post-hoc Conover tests were applied to detect statistical differences between treatment groups. Differences before and after aging were calculated by Wilcoxon signed rank test (α=0.05). RESULTS In all groups, color difference (∆E) was statistically significant after aging: no-PC (P<.001, 95% CI[0.14,0.84]), no-MC (P=.003, 95% CI[0.23,1.12]), no-ZR (P=.003, 95% CI [0.33,0.62]), in-MC (P=.003, 95% CI[0.35,0.73]), in-ZR (P=.003, 95% CI[0.09,0.32]), ex-PC (P=.003, 95% CI[0.54,0.98]), ex-MC (P<.001, 95% CI[0.23,1.26]), ex-ZR (P=.003, 95% CI[0.27,0.55]), and PFM (P=.002, 95% CI[0.22,0.34]). Aging increased surface roughness and decreased the gloss within all subgroups showing statistical significance. CONCLUSIONS Color, gloss and roughness of stained monolithic ceramic materials changed significantly by means of tooth brush abrasion in vitro. Color changes were below the threshold value for the detection by the human eye (∆E 1.8).
Structural basis for sterol sensing by Scap and Insig

The sterol regulatory element-binding protein (SREBP) pathway senses the cellular cholesterol level through sterol regulated association between Scap and Insig. Despite the recent structural determination of the transmembrane domains of human Scap and Insig-2 bound to 25-hydroxycholesterol (25HC), the structure and regulatory mechanism of the luminal domains of Scap by cholesterol remains elusive. Here, combining cryo-EM analysis and artificial intelligence-facilitated structural prediction, we report the structure of the human Scap/Insig-2 complex in the presence of digitonin instead of 25HC. Despite the lack of sequence similarity, the structure of the luminal domain Loop 1 and a co-folded segment in Loop 7 of Scap resembles that of the luminal/extracellular domain in NPC1 and related proteins. Comparison of the sterol-loaded structures of these proteins provides clues of the regulation of Loop 1/7 interaction by cholesterol. We also show that the structure of Scap(D428A), which suppresses SREBP activation under sterol depletion, is identical to WT when complexed with Insig-2, although the gain of function may also involve a later step in protein trafficking.
Intermittent cold exposure improves glucose homeostasis despite exacerbating diet‐induced obesity in mice housed at thermoneutrality

Ambient cold exposure is often regarded as a promising anti‐obesity treatment in mice. However, most preclinical studies aimed at treating obesity via cold‐induced thermogenesis have been confounded by subthermoneutral housing temperatures. Therefore, the ability of ambient cold to combat diet‐induced obesity in mice housed under humanized thermoneutral conditions is currently unknown. Moreover, mammals such as mice are rarely exposed to chronic ambient cold without reprieve, yet mice are often subjected to experimental conditions of chronic rather than intermittent cold exposure (ICE), despite ICE being more physiologically relevant. In the present study, we provide novel evidence that thermoneutral housing uncouples the effects of ICE on glucose and energy homeostasis suggesting that ICE, despite improving glucose tolerance, is not an effective obesity treatment when mice are housed under humanized thermoneutral conditions.
Temporal determinants of tumour response to neoadjuvant rectal radiotherapy

Introduction In locally advanced rectal cancer, longer delay to surgery after neoadjuvant radiotherapy increases the likelihood of histopathological tumour response. Chronomodulated radiotherapy in rectal cancer has recently been reported as a factor increasing tumour response to neoadjuvant treatment in patients having earlier surgery, with patients receiving a larger proportion of afternoon treatments showing improved response. This paper aims to replicate this work by exploring the impact of these two temporal factors, independently and in combination, on histopathological tumour response in rectal cancer patients. Methods A retrospective review of all patients with rectal adenocarcinoma who received long course (≥24 fractions) neoadjuvant radiotherapy with or without chemotherapy at a tertiary referral centre was conducted. Delay to surgery and radiotherapy treatment time were correlated to clinicopathologic characteristics with a particular focus on tumour regression grade. A review of the literature and meta-analysis were also conducted to ascertain the impact of time to surgery from preoperative radiotherapy on tumour regression. Results From a cohort of 367 patients, 197 patients met the inclusion criteria. Complete pathologic response (AJCC regression grade 0) was seen in 46 (23%) patients with a further 44 patients (22%) having at most small groups of residual cells (AJCC regression grade 1). Median time to surgery was 63 days, and no statistically significant difference was seen in tumour regression between patients having early or late surgery. There was a non-significant trend towards a larger proportion of morning treatments in patients with grade 0 or 1 regression (p = 0.077). There was no difference in tumour regression when composite groups of the two temporal variables were analysed. Visualisation of data from 39 reviewed papers (describing 27379 patients) demonstrated a plateau of response to neoadjuvant radiotherapy after approximately 60 days, and a meta-analysis found improved complete pathologic response in patients having later surgery. Conclusions There was no observed benefit of chronomodulated radiotherapy in our cohort of rectal cancer patients. Review of the literature and meta-analysis confirms the benefit of delayed surgery, with a plateau in complete response rates at approximately 60-days between completion of radiotherapy and surgery. In our cohort, time to surgery for the majority of our patients lay along this plateau and this may be a more dominant factor in determining response to neoadjuvant therapy, obscuring any effects of chronomodulation on tumour response. We would recommend surgery be performed between 8 and 11 weeks after completion of neoadjuvant radiotherapy in patients with locally advanced rectal cancer.
Optimal Timing of Tracheostomy in Injured Adolescents*

Supplemental Digital Content is available in the text. OBJECTIVES: To evaluate the optimal timing of tracheostomy for injured adolescents. DESIGN: Retrospective cohort study. SETTING: Trauma facilities in the United States. PATIENTS: Adolescents (age 12–17 yr) in the National Trauma Data Bank (2007–2016) who were ventilated for greater than 24 hours and survived to discharge. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: After stratifying by traumatic brain injury diagnosis, we compared ICU and hospital length of stay, pneumonia, and discharge disposition of patients with tracheostomy prior to three cut points (3, 7, and 14 d after admission) to 1) patients intubated at least as long as each cut point and 2) patients with tracheostomy on or after each cut point. Of 11,045 patients, 1,391 (12.6%) underwent tracheostomy. Median time to tracheostomy was 9 days (interquartile range, 6–13 d) for traumatic brain injury and 7 days (interquartile range, 3–12 d) for nontraumatic brain injury patients. Nontraumatic brain injury patients with tracheostomy prior to 7 days had 5.6 fewer ICU days (–7.8 to –3.5 d) and 5.7 fewer hospital days (–8.8 to –2.7 d) than patients intubated greater than or equal to 7 days and had 14.8 fewer ICU days (–19.6 to –10.0 d) and 15.3 fewer hospital days (–21.7 to –8.9 d) than patients with tracheostomy greater than or equal to 7 days. Similar differences were observed at 14 days but not at 3 days for both traumatic brain injury and nontraumatic brain injury patients. At the 3- and 7-day cut points, both traumatic brain injury and nontraumatic brain injury patients with tracheostomy prior to the cut point had lower risk of pneumonia and risk of discharge to a facility than those with tracheostomy after the cut point. CONCLUSIONS: For injured adolescents, tracheostomy less than 7 days after admission was associated with improved in-hospital outcomes compared with those who remained intubated greater than or equal to 7 days and with those with tracheostomy greater than or equal to 7 days. Tracheostomy between 3 and 7 days may be the optimal time point when prolonged need for mechanical ventilation is anticipated; however, unmeasured consequences of tracheostomy such as long-term complications and care needs must also be considered.
Comparing Results of Five SARS-CoV-2 Antibody Assays Before and After the First Dose of ChAdOx1 nCoV-19 Vaccine among Health Care Workers

Reliable results regarding serologic positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody before and after AstraZeneca (AZ) vaccination are essential for estimating the efficacy of vaccination. We assessed positivity rates and associated factors using five SARS-CoV-2 antibody assays. ABSTRACT Reliable results regarding serologic positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody before and after AstraZeneca (AZ) vaccination are essential for estimating the efficacy of vaccination. We assessed positivity rates and associated factors using five SARS-CoV-2 antibody assays. A total of 228 paired serum samples (456 samples) were obtained from 228 participants. After baseline sampling, the second sampling was conducted between 11 and 28 days after the first dose of the AZ vaccine. Sera were tested using five SARS-CoV-2 antibody assays, including two surrogate virus neutralization tests. A questionnaire on the symptoms, severity, and duration of adverse reactions was completed by all participants. The overall positivity rates for SARS-CoV-2 antibody were 84.6% for the Roche assay, 92.5% for the Abbott assay, 75.4% for the Siemens assay, 90.7% for the SD Biosensor assay, and 66.2% for the GenScript assay after the first dose of the AZ vaccine. The positivity rates and antibody titers of sera obtained between 21 and 28 days were significantly higher than those obtained between 11 and 20 days in all five assays. More-severe adverse reactions and longer durations of adverse reactions were related to higher SARS-CoV-2 antibody levels. The agreements and correlations among the assays applied were substantial (к, 0.73 to 0.95) and strong (ρ, 0.83 to 0.91). A single dose of the AZ vaccine led to high positivity rates based on the five assays. Days after vaccination and adverse reactions could help estimate serologic conversion rates. The results should be interpreted cautiously considering the assays and cutoffs applied. Our findings could inform decisions regarding vaccination and laboratory settings and could thus contribute to the control of the spread of SARS-CoV-2 infection.
Applying the Care and Communication Bundle to Promote Palliative Care in a Neuro-Intensive Care Unit: Why and How.

Background: Delivery of palliative care in neurointensive care units (neuro-ICUs) can be inconsistent, often due to absence of formal care triggers. The Care and Communication Bundle (CCB) of Quality Indicators provides a standardized process to deliver effective palliative care services in ICUs, but application of these indicators in this setting has not yet been systemically assessed. Objectives: To evaluate the fit of a CCB in the neuro-ICU through a novel scoring system and identify barriers to adherence. Design: CCB standards for a neuro-ICU were delineated. Assessment of documented indicators and barriers was conducted through electronic medical record retrospective review. Setting/Subjects: A 30-bed neuro-ICU in a large Academic Medical Center in the Southeastern United States. Chart reviews were conducted for 133 critically ill neurology and neurosurgery patients who expired between November 2018 and January 2020. Results: Results demonstrate moderate adherence to CCB standards, including excellent consistency in establishment of patient-centered communication and referral to supportive services (e.g., social work, spiritual support). Identified areas for improvement include documentation of patient and family involvement in care process (i.e., advance directive completion, interdisciplinary team meetings). Conclusions: Application of the CCB in the neuro-ICU is useful for examining adherence to time-based triggers of palliative care standards. The novel scoring system offers opportunities to motivate improvement and reduce variation in palliative care integration.
Embryonic development in the acoel Hofstenia miamia

Acoels are marine worms that belong to the phylum Xenacoelomorpha. The phylogenetic placement of this group as a deep-diverging lineage makes acoel embryos an attractive system to study the evolution of major bilaterian traits. Thus far, acoel development has not been described in detail at the morphological and transcriptomic levels in a species where functional genetic studies are possible. Here, we present a set of developmental landmarks for embryogenesis in the highly regenerative acoel Hofstenia miamia. We generated a developmental staging atlas from zygote to hatched worm based on gross morphology, with accompanying bulk transcriptome data for each of the stages. Hofstenia embryos undergo a stereotyped cleavage program known as duet cleavage, which results in two large ‘macromeres’ at the vegetal pole and numerous small ‘micromeres’ at the animal pole. The macromeres become internalized as micromere progeny proliferate and move vegetally, enveloping the larger blastomeres. We also noted a second, previously undescribed cell internalization event at the animal pole, following which we detected tissues corresponding to all three germ layers. Our work on Hofstenia embryos provides a resource for future investigations of acoel development, which will yield insights into the evolution of development and regeneration. Summary Statement Comprehensive characterization of embryonic development in the acoel worm Hofstenia miamia with accompanying transcriptome data.
The association between surgical fixation of hip fractures within 24 hours and mortality : a systematic review and meta-analysis.

AIMS The aim of this study was to assess the effect of time to surgical intervention from admission on mortality and morbidity for patients with hip fractures. METHODS MEDLINE and Embase were searched from inception to June 2020. Reference lists were manually assessed to identify additional papers. Primary comparative research studies that recruited patients aged over 60 years, with non-pathological primary proximal femoral fractures that were treated surgically, were included. Studies that did not include a group operated on within 24 hours or which reported time to surgery in calendar days were excluded. Two investigators extracted data on study characteristics, methods, and outcomes. The pre-defined primary outcome was 30-day mortality. Secondary outcomes were complications and mortality at other time points. Relative risks (RRs) with 95% confidence intervals (CIs) were aggregated and were grouped by study-level characteristics. RESULTS This review included 46 studies (January 1991 to June 2020), comprising 521,857 hip fractures with 64,047 postoperative deaths. No randomized controlled trials were eligible for inclusion. In a pooled analysis of 15 studies, RR of mortality at 30 days comparing time to surgery < 24 hours with > 24 hours was 0.86 (95% CI 0.82 to 0.91; I 2 = 69%; 95% CI 50% to 81%; p-value for heterogeneity < 0.001). The association was stronger in observational studies that did not adjust for confounders than in those that adjusted for multiple covariates. In a pooled analysis of six studies, the RR of mortality at 30 days comparing time to surgery < 24 hours with 24 to 36 hours was 0.87 (95% CI 0.81 to 0.93; I 2 = 65%; 95% CI 16% to 85%; p-value for heterogeneity = 0.014). CONCLUSION This meta-analysis indicates reduced mortality for patients operated within 24 hours compared with those operated on beyond 24 hours or within 24 to 36 hours. Where resources allow and there is no specific reversible contraindication to early surgery, we recommend that hip fractures should be surgically treated within 24 hours. Cite this article: Bone Joint J 2021;103-B(7):1176-1186.
Assessment of serum vitamin D level and seminal vitamin D receptor gene methylation in a sample of Egyptian men with idiopathic infertility

Vitamin D deficiency has been linked with different health problems including male infertility. Its function is mediated by the vitamin D receptor, which acts as a transcription factor. Epigenetic mechanisms such as DNA methylation may affect the vitamin D receptor gene and result in gene silencing. The present study aimed to assess serum vitamin D level and seminal methylation of vitamin D receptor gene in idiopathic male infertility. Blood and semen samples were collected from 60 men with idiopathic infertility and 40 healthy fertile men. Vitamin D levels were detected using enzyme‐linked fluorescent assay technique and methylation status was assessed by methylation‐specific PCR. Results revealed that serum levels of 25OHD were significantly lower in patients compared to controls. Positive correlation was found between serum level of 25OHD and sperm concentration in patients group and progressive motility in total studied group. Methylation of vitamin D receptor gene was significantly higher in patients compared to control group. Negative correlation was found between methylation of vitamin D receptor gene and both sperm concentration and progressive motility in total studied group. Results of the present study suggest that vitamin D deficiency and vitamin D receptor gene methylation may be involved in aetiopathogenesis of idiopathic male infertility.
Unusual high prevalence of antibodies to hepatitis E virus in South Brazil.

Hepatitis E virus (HEV) is worldwide distributed and might cause acute or chronic hepatitis mainly in immunocompromised individuals. In previous studies we found a high prevalence of antibodies to HEV within blood donors in south Brazil and also within backyard-raised pigs. Here we aimed to investigate the prevalence of anti-HEV antibody and HEV RNA within the general population from three major municipalities (Caxias do Sul, Passo Fundo and Santa Maria) in south Brazil. A total of 3,000 blood samples were randomly obtained from clinical laboratories at each of the three municipality (n = 1,000 each) to determine the presence of anti-HEV antibodies and HEV RNA. Overall, anti-HEV antibodies were detected in 574/1,000 (57,4%) samples in Caxias do Sul, 655/1,000 (65.5%) samples in Passo Fundo and 554/1,000 (55.4%) samples in Santa Maria. The prevalence of HEV-positive samples increased steadily and significantly (P < 0,001) with age and was unusually higher within individual over 40 years. Despite of this, none of the pooled serum samples had detectable levels of HEV RNA. The high anti-HEV antibody prevalence suggests that the virus might be present on the environment and/or foodstuff and poses a permanent threat to immune-compromised individuals.
Is the Nox-T3 device scoring algorithm accurate enough for the diagnosis of obstructive sleep apnea?

INTRODUCTION Obstructive sleep apnea (OSA) is highly prevalent. Home sleep apnea testing (HSAT) for OSA is rapidly expanding because of its cost effectiveness in the diagnosis of OSA. Type 3 portable monitors are used for this purpose. In most cases, these devices contain an algorithm for automatic scoring of events. We propose to study the accuracy of the automatic scoring algorithm in our population in order to compare it with the manually edited scoring of Nox-T3®. MATERIAL AND METHODS For five months, a prospective study was performed. Patients were randomly distributed to the available HSAT devices. We collected the data of patients who performed HSAT with Nox-T3®. We used normality plots, the Spearman correlation, the Wilcoxon signed-rank test, and Bland-Altman plots. RESULTS The sample consisted of 283 participants. The average manual apnea and hypopnea index (AHI) was 23.7 ± 22.1 events/h. All manual scores (AHI, apnea index, hypopnea index, and oxygen desaturation index) had strong correlations with their respective automated scores. When AHI > 15 and AHI > 30 the difference between the values of this index (automatic and manual) was not statistically significant. Also, for AHI values > 15 the mean difference between the two scoring methods was 0.17 events/h. For AHI values > 30, this difference was - 1.23 events/h. CONCLUSIONS When AHI is < 15, there may be a need for confirmation of automatic scores, especially in symptomatic patients with a high pretest probability of OSA. But, for patients with AHI > 15, automatic scores obtained from this device seem accurate enough to diagnose OSA in the correct clinical setting.
Prevalence and severity of verbal, physical, and sexual inpatient violence against nurses in Swiss psychiatric hospitals and associated nurse‐related characteristics: Cross‐sectional multicentre study

Abstract This analysis (1) describes the prevalence and severity of psychiatric inpatient violence against nurses in Switzerland’s German‐speaking region and (2) investigates the associations between nurse‐related characteristics (socio‐demographics; previous exposure to severe forms of psychiatric inpatient violence; attitude towards psychiatric inpatient violence) and nurses’ exposure to various types of psychiatric inpatient violence. We used cross‐sectional survey data from the MatchRN Psychiatry study sample of 1128 nurses working on 115 units across 13 psychiatric hospitals. In addition to lifetime severe assaults, nurses’ exposure to violence against property, verbal violence, verbal sexual violence, physical violence, and physical sexual violence was assessed for the 30 days prior to the survey. Descriptive statistics (frequency and percentage) were calculated for each class of violence as also for items under study. With generalized linear mixed models, odds ratios and 95% confidence intervals were calculated. Of nurse respondents, 73% reported facing verbal violence, 63% violence against property, 40% verbal sexual violence, 28% physical violence, and 14% physical sexual violence. Almost 30% had been subjected to a serious assault in their professional lifetimes. All nurse characteristics were associated with psychiatric inpatient violence against nurses, especially a history of sexual assault (OR 4.53, 95%‐CI 2.19–9.34; P = 0.00) and ≤3 years’ professional experience (OR 3.70, 95%‐CI 1.95–7.02; P = 0.00). Prevalence data suggest that widely used strategies such as aggression management courses or alarm devices cannot fully reduce patient violence against nurses in psychiatry. This situation demands proactive strategies in safety and violence prevention.