Miracle-dz/UniFAR-FTUs huggingface dataset:
TFF3 mediates the NF‐κB/COX2 pathway to regulate PMN‐MDSCs activation and protect against necrotizing enterocolitis

Intestinal trefoil factor 3 (TFF3) plays an important role in repairing the intestinal mucosa. However, the detailed mechanism regarding immune regulation by TFF3 is not well defined. Here, we reported that treatment of mouse BM cells and human peripheral blood mononuclear cells from healthy volunteers with TFF3 activated polymorphnuclear myeloid‐derived suppressor cells (PMN‐MDSCs) in vitro. We also found that prostaglandin E2 is a major TFF3‐mediated MDSC target, and that NF‐κB/COX2 signaling was involved in this process. Moreover, TFF3 treatment or transfer of TFF3‐derived PMN‐MDSCs (TFF3‐MDSCs) to experimental necrotizing enterocolitis (NEC) mice caused PMN‐MDSC accumulation in the lamina propria (LP), which was associated with decreased intestinal inflammation, permeability, bacterial loading, and prolonged survival. Interestingly, no NEC severity remission was observed in Rag1 KO mice that were given TFF3‐MDSCs, but coinjection with CD4+ T cells significantly relieved NEC inflammation. Overall, TFF3 mediates the NF‐κB/COX2 pathway to regulate PMN‐MDSC activation and attenuates NEC in a T‐cell‐dependent manner, which suggests a novel mechanism in preventing NEC occurrence.
The battle between harvest and natural selection creates small and shy fish

Significance Fish are harvested nonrandomly, potentially inducing selection pressures and adaptations of phenotypes that could impede sustainable natural resource management. To assess the potential for fishing-induced selection, natural selection must also be considered, which represents a challenge in broadcast spawning fish in the wild. We compared harvest and natural selection on size and behavioral traits in a wild northern pike (Esox lucius) population. Harvest and natural selection on body size operated in opposition. Harvest but not natural selection acted directly on behavior, favoring timid fish. Simulations revealed fisheries selection on body size is likely not easily addressable using traditional length-based regulations and may thus be inevitable. Intensive recreational angling can therefore promote the development of small, inactive, shy, and difficult-to-capture fish. Harvest of fish and wildlife, both commercial and recreational, is a selective force that can induce evolutionary changes to life history and behavior. Naturally selective forces may create countering selection pressures. Assessing natural fitness represents a considerable challenge in broadcast spawners. Thus, our understanding about the relative strength of natural and fisheries selection is slim. In the field, we compared the strength and shape of harvest selection to natural selection on body size over four years and behavior over one year in a natural population of a freshwater top predator, the northern pike (Esox lucius). Natural selection was approximated by relative reproductive success via parent–offspring genetic assignments over four years. Harvest selection was measured by comparing individuals susceptible to recreational angling with individuals never captured by this gear type. Individual behavior was measured by high-resolution acoustic telemetry. Harvest and natural size selection operated with equal strength but opposing directions, and harvest size selection was consistently negative in all study years. Harvest selection also had a substantial behavioral component independent of body length, while natural behavioral selection was not documented, suggesting the potential for directional harvest selection favoring inactive, timid fish. Simulations of the outcomes of different fishing regulations showed that traditional minimum size-based harvest limits are unlikely to counteract harvest selection without being completely restrictive. Our study suggests harvest selection may be inevitable and recreational fisheries may thus favor small, inactive, shy, and difficult-to-capture fish. Increasing fractions of shy fish in angling-exploited stocks would have consequences for stock assessment and all fisheries operating with hook and line.
New developments in anti-biofilm intervention towards effective management of orthopedic device related infections (ODRI’s)

Abstract Orthopedic device related infections (ODRI’s) represent a difficult to treat situation owing to their biofilm based nature. Biofilm infections once established are difficult to eradicate even with an aggressive treatment regimen due to their recalcitrance towards antibiotics and immune attack. The involvement of antibiotic resistant pathogens as the etiological agent further worsens the overall clinical picture, pressing on the need to look into alternative treatment strategies. The present review highlightes the microbiological challenges associated with treatment of ODRI’s due to biofilm formation on the implant surface. Further, it details the newer anti-infective modalities that work either by preventing biofilm formation and/or through effective disruption of the mature biofilms formed on the medical implant. The study, therefore aims to provide a comprehensive insight into the newer anti-biofilm interventions (non-antibiotic approaches) and a better understanding of their mechanism of action essential for improved management of orthopedic implant infections.
Antidepressant use in Sweden: an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA)

Introduction: Antidepressants are among the most commonly prescribed drugs in Sweden. However, we lack detailed knowledge on the socioeconomic and demographic distribution of antidepressant use in the population. To fill this gap, we performed an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy. Methods: Analysing all Swedish residents older than 10 years (n=8,190,990), we measured the absolute risk of antidepressant use across 144 intersectional strata defined by combinations of age, gender, income, country of birth and psychiatric diagnosis. We calculated the strata-specific absolute risk of antidepressant use in a series of multilevel logistic regression models. By means of the variance partitioning coefficient and the area under the receiver operating characteristic curve, we quantified the discriminatory accuracy of the intersectional contexts (i.e. strata) for discerning those who use antidepressants from those who do not. Results: The absolute risk of antidepressant use ranged between 0.93% and 24.78% among those without a psychiatric diagnosis, and between 21.41% and 77.56% among those with a psychiatric diagnosis. Both the variance partitioning coefficient of 41.88% and the area under the receiver operating characteristic curve of 0.81 were considerable. Conclusions: Besides overt psychiatric diagnoses, our study shows that antidepressant use is mainly conditioned by age, which might express the embodiment of socioeconomic conditions across the individual life course. Our analysis provides a detailed and highly discriminatory mapping of the heterogeneous distribution of antidepressant use in the Swedish population, which may be useful in public health management.
Detection of diverse carbapenem and multidrug resistance genes and high-risk strain types among carbapenem non-susceptible clinical isolates of target gram-negative bacteria in Kenya

Carbapenem-resistant gram-negative bacteria are an increasingly significant clinical threat globally. This risk may be underestimated in Kenya as only four carbapenemase genes in three bacterial species have been described. The study aimed to understand the antibiotic resistance profiles, genes, sequence types, and distribution of carbapenem-resistant gram-negative bacteria from patients in six hospitals across five Kenyan counties by bacterial culture, antibiotic susceptibility testing, and whole-genome sequence analysis. Forty-eight, non-duplicate, carbapenem non-susceptible, clinical isolates were identified across the five counties (predominantly in Nairobi and Kisii): twenty-seven Acinetobacter baumannii, fourteen Pseudomonas aeruginosa, three Escherichia coli, two Enterobacter cloacae, and two Klebsiella pneumoniae. All isolates were non-susceptible to β-lactam drugs with variable susceptibility to tigecycline (66%), minocycline (52.9%), tetracycline (29.4%), and levofloxacin (22.9%). Thirteen P. aeruginosa isolates were resistant to all antibiotics tested. Eleven carbapenemase genes were identified: blaNDM-1, blaOXA-23, -58, -66, -69, and -91 in A. baumannii (STs 1, 2, 164 and a novel ST1475), blaNDM-1 in E. cloacae (STs 25,182), blaNDM-1, blaVIM-1and -6, blaOXA-50 in P. aeruginosa (STs 316, 357, 654, and1203), blaOXA-181, blaNDM-1 in K. pneumoniae (STs 147 and 219), and blaNDM-5 in E. coli (ST164). Five A. baumannii isolates had two carbapenemases, blaNDM-1, and either blaOXA-23 (4) or blaOXA-58 (1). AmpC genes were detected in A. baumannii (blaADC-25), E. cloacae (blaDHA-1 and blaACT-6, 16), and K. pneumoniae (blaCMY). Significant multiple-drug resistant genes were the pan-aminoglycoside resistance16srRNA methyltransferase armA, rmtB, rmtC, and rmtF genes. This study is the first to report blaOXA-420, -58, -181, VIM-6, and blaNDM-5 in Kenyan isolates. High-risk STs of A. baumannii (ST1475, ST2), E. cloacae ST182, K. pneumoniae ST147, P. aeruginosa (ST357, 654), and E. coli ST167, ST648 were identified which present considerable therapeutic danger. The study recommends urgent carbapenem use regulation and containment of high-risk carbapenem-resistant bacteria.
Sudden Brief Unilateral Tapering Tinnitus (SBUTT) Is Closely Related to the Lateral Pterygoid Muscle

Objective(s): To determine the cause of sudden brief unilateral tapering tinnitus (SBUTTs). Patients: Five adults evaluated at a tertiary tinnitus referral center. Intervention: Dry needling of lateral pterygoid muscle of one patient; jaw maneuvers in two patients. Main Outcome Measure(s): Halting of SBUTTs. Results: Trauma to the region of the lateral pterygoid muscle is associated with ipsilateral SBUTTs. Dry needling of the lateral pterygoid muscles abolishes SBUTTs. Some SBUTTs can be heard by others. Conclusions: Some, if not all, SBUTTs appear to be closely related to trigger points within the lateral pterygoid muscle. SBUTTs may be generated by a local twitch response from trigger points within the lateral pterygoid muscle.
Differences in Basic Life Support Knowledge Between Junior Medical Students and Lay People: Web-Based Questionnaire Study

Background Early cardiopulmonary resuscitation and prompt defibrillation markedly increase the survival rate in the event of out-of-hospital cardiac arrest (OHCA). As future health care professionals, medical students should be trained to efficiently manage an unexpectedly encountered OHCA. Objective Our aim was to assess basic life support (BLS) knowledge in junior medical students at the University of Geneva Faculty of Medicine (UGFM) and to compare it with that of the general population. Methods Junior UGFM students and lay people who had registered for BLS classes given by a Red Cross–affiliated center were sent invitation links to complete a web-based questionnaire. The primary outcome was the between-group difference in a 10-question score regarding cardiopulmonary resuscitation knowledge. Secondary outcomes were the differences in the rate of correct answers for each individual question, the level of self-assessed confidence in the ability to perform resuscitation, and a 6-question score, “essential BLS knowledge,” which only contains key elements of the chain of survival. Continuous variables were first analyzed using the Student t test, then by multivariable linear regression. Fisher exact test was used for between-groups comparison of binary variables. Results The mean score was higher in medical students than in lay people for both the 10-question score (mean 5.8, SD 1.7 vs mean 4.2, SD 1.7; P<.001) and 6-question score (mean 3.0, SD 1.1 vs mean 2.0, SD 1.0; P<.001). Participants who were younger or already trained scored consistently better. Although the phone number of the emergency medical dispatch center was well known in both groups (medical students, 75/80, 94% vs lay people, 51/62, 82%; P=.06), most participants were unable to identify the criteria used to recognize OHCA, and almost none were able to correctly reorganize the BLS sequence. Medical students felt more confident than lay people in their ability to perform resuscitation (mean 4.7, SD 2.2 vs mean 3.1, SD 2.1; P<.001). Female gender and older age were associated with lower confidence, while participants who had already attended a BLS course prior to taking the questionnaire felt more confident. Conclusions Although junior medical students were more knowledgeable than lay people regarding BLS procedures, the proportion of correct answers was low in both groups, and changes in BLS education policy should be considered.
Cu(II)‐Binding N‐Terminal Sequences of Human Proteins

Proteins anchor copper(II) ions mainly by imidazole from histidine residues located in different positions in the primary protein structures. However, the motifs with histidine in the first three N‐terminal positions (His1, His2, and His3) show unique Cu(II)‐binding properties, such as availability from the surface of the protein, high flexibility, and high Cu(II) exchangeability with other ligands. It makes such sequences beneficial for the fast exchange of Cu(II) between ligands. Furthermore, sequences with His1 and His2, thus, non‐saturating the Cu(II) coordination sphere, are redox‐active and may play a role in Cu(II) reduction to Cu(I). All human protein sequences deposited in UniProt Knowledgebase were browsed for those containing His1, His2, or His3. Proteolytically modified sequences (with the removal of a propeptide or Met residue) were taken for the analysis. Finally, the sequences were sorted out according to the subcellular localization of the proteins to match the respective sequences with the probability of interaction with divalent copper.
A plug‐and‐play, lightweight, single‐axis gradient insert design for increasing spatiotemporal resolution in echo planar imaging‐based brain imaging

The goal of this study was to introduce and evaluate the performance of a lightweight, high‐performance, single‐axis (z‐axis) gradient insert design primarily intended for high‐resolution functional magnetic resonance imaging, and aimed at providing both ease of use and a boost in spatiotemporal resolution. The optimal winding positions of the coil were obtained using a genetic algorithm with a cost function that balanced gradient performance (minimum 0.30 mT/m/A) and field linearity (≥16 cm linear region). These parameters were verified using field distribution measurements by B0‐mapping. The correction of geometrical distortions was performed using theoretical field distribution of the coil. Simulations and measurements were performed to investigate the echo planar imaging echo‐spacing reduction due to the improved gradient performance. The resulting coil featured a 16‐cm linear region, a weight of 45 kg, an installation time of 15 min, and a maximum gradient strength and slew rate of 200 mT/m and 1300 T/m/s, respectively, when paired with a commercially available gradient amplifier (940 V/630 A). The field distribution measurements matched the theoretically expected field. By utilizing the theoretical field distribution, geometrical distortions were corrected to within 6% of the whole‐body gradient reference image in the target region. Compared with a whole‐body gradient set, a maximum reduction in echo‐spacing of a factor of 2.3 was found, translating to a 344 μs echo‐spacing, for a field of view of 192 mm, a receiver bandwidth of 920 kHz and a gradient amplitude of 112 mT/m. We present a lightweight, single‐axis gradient insert design that can provide high gradient performance and an increase in spatiotemporal resolution with correctable geometrical distortions while also offering a short installation time of less than 15 min and minimal system modifications.
Single vs Serial Measurements of Cardiac Troponin Level in the Evaluation of Patients in the Emergency Department With Suspected Acute Myocardial Infarction

Key Points Question Do patients discharged from the emergency department after a single troponin test with negative results have similar outcomes to patients undergoing multiple troponin tests? Findings This cohort study found no significant difference in 30-day acute myocardial infarction or cardiac mortality between patients receiving a single troponin test with negative results and those who underwent serial troponin tests (single troponin test, 0.4% vs serial troponin tests, 0.4%). Meaning This study suggests that physician discretion to order serial or single troponin tests in managing emergency department patients suspected to have acute coronary syndrome appears safe and is a reasonable strategy to possibly improve efficiency without an adverse association with patient outcomes.
Hospital Nurses' Intention to Report Near Misses, Patient Safety Culture and Professional Seniority.

BACKGROUND Preventable medical errors are the third cause of death after cancer and heart disease. The first step in coping with medical errors in the healthcare system is to develop a culture of patient safety. Reporting medical errors, especially near misses, is one of the chosen methods of dealing with patient safety issues, recommended by the Institute of Medicine. Despite this recommendation, few studies examined the relationship between reporting near misses and improvements in patient safety culture. Intention to report a near miss event is another means to understand the phenomena of reporting, but no studies were found that included this variable and its relationship to safety culture.The aims of this study were to determine the extent nurses reported near miss events; to describe the relationship between patient safety culture, professional seniority and intention to report near misses; and to determine predictors of intention to report near miss events. METHODS This was a descriptive cross-sectional study, based on the Hospital Survey on Patient Safety (HSOPS). The target population was ICU and inpatient ward nurses working in general hospitals. The sampling method was cluster convenience sampling. Statistical analysis included descriptive and predictive analyses. RESULTS The sample included 227 nurses. Most nurses rated the patient safety culture components as moderately positive. Approximately 80% stated their intention to report a near miss, however 52.4% indicated that they did not report a near miss event in the past year. A positive correlation was found between all components of the patient safety culture and the intention to report a near miss event. Professional seniority was not related to any safety culture components or intention to report a near-miss event. Three variables predicted intention to report: team work, feedback and communication about errors, and the amount of near misses reported in the last year. CONCLUSIONS There is a discrepancy between what nurses describe as their intent to report a near miss event and their actual reporting of an event. Components of safety culture, especially communication openness, teamwork and reported near misses in the last year are significant predictors of the intent to report. Therefore, reinforcement of these components should be encouraged at the policy level to enable nurses to report near misses and thus improve patient safety.
Toolkits for implementing and evaluating digital health: A systematic review of rigor and reporting

OBJECTIVE Toolkits are an important knowledge translation strategy for implementing digital health. We studied how toolkits for the implementation and evaluation of digital health were developed, tested, and reported. MATERIALS AND METHODS We conducted a systematic review of toolkits that had been used, field tested or evaluated in practice, and published in the English language from 2009 to July 2019. We searched several electronic literature sources to identify both peer-reviewed and gray literature, and records were screened as per systematic review conventions. RESULTS Thirteen toolkits were eventually identified, all of which were developed in North America, Europe, or Australia. All reported their intended purpose, as well as their development process. Eight of the 13 toolkits involved a literature review, 3 did not, and 2 were unclear. Twelve reported an underlying conceptual framework, theory, or model: 3 cited the normalization process theory and 3 others cited the World Health Organization and International Telecommunication Union eHealth Strategy. Seven toolkits were reportedly evaluated, but details were unavailable. Forty-three toolkits were excluded for lack of field-testing. DISCUSSION Despite a plethora of published toolkits, few were tested, and even fewer were evaluated. Methodological rigor was of concern, as several did not include an underlying conceptual framework, literature review, or evaluation and refinement in real-world settings. Reporting was often inconsistent and unclear, and toolkits rarely reported being evaluated. CONCLUSION Greater attention needs to be paid to rigor and reporting when developing, evaluating, and reporting toolkits for implementing and evaluating digital health so that they can effectively function as a knowledge translation strategy.
How Does Rescuer Fitness Affect the Quality of Prolonged Cardiopulmonary Resuscitation?

Abstract Objective: High quality cardiopulmonary resuscitation (CPR) is crucial for patients experiencing cardiac arrest. CPR quality declines within the first few minutes of CPR performance. Being more fit is associated with higher CPR quality, yet the fitness parameters needed remain uncertain. It is also unknown how CPR quality is affected during a protocol of realistic CPR when rescuers switch compressors every two minutes, as recommended by the American Heart Association (AHA), and extended duration, as might be encountered with an out-of-hospital cardiac arrest. The purpose of the present study is to determine the extent to which different measures of physical fitness predict high quality CPR performance when rescuers follow current CPR guidelines. Methods: Subjects underwent a fitness assessment evaluating lower back muscular endurance, abdominal muscular endurance, upper body muscular strength, and upper body anaerobic power. At least 48 hours later, subjects returned to the laboratory for CPR testing. CPR quality was determined by compression rate (>100/minute), compression depth (>2 inches, or 50 mm), and adequate (full) chest recoil between compressions, based on American Heart Association guidelines. A CPR Quality Score, designed to represent cardiac output, was calculated as the product of compression rate and depth. Results: Thirty-three of 42 subjects were able to achieve a CPR Quality Score greater than 5000, the minimum needed to meet AHA recommendations. Higher anaerobic power and bench press scores were predictive of both high CPR Quality Scores (R2=0.47) and compression depth (R2=0.47). Sex (female) was predictive of better chest compression recoil percentages (R2=0.15). Conclusion: Most rescuers can maintain high quality CPR if given two minute breaks between cycles. Rescuers with high anaerobic fitness and muscular strength may be able to provide higher quality CPR.