Miracle-dz/UniFAR-FTUs huggingface dataset:
Increased rate of pseudarthrosis in the anterior intersegmental gap after mandibular reconstruction with fibula free flaps: a volumetric analysis

Objectives: Pseudarthrosis after mandibular reconstruction leads to chronic overload of the osteosynthesis and impedes dental rehabilitation. This study evaluates the impact of gap site on osseous union in mandible reconstruction using a new volumetric analysis method with repeated cone-beam computed tomography (CBCT). Methods: The degree of bone regeneration was evaluated in 16 patients after mandible reconstruction with a fibula free flap and patient-specific reconstruction plates. Percentual bone volume and width changes in intersegmental gaps were retrospectively analyzed using a baseline CBCT in comparison to a follow-up CBCT. Patients’ characteristics, plate-related complications, and gap sites (anterior/posterior) were analyzed. Detailed assessments of both gap sites (buccal/lingual/superior/inferior) were additionally performed. Results: Intersegmental gap width (p = 0.002) and site (p < 0.001) significantly influence bone volume change over two consecutive CBCTs. An initial larger gap width resulted in a lower bone volume change. In addition, anterior gaps showed significantly less bone volume changes. Initial gap width was larger at posterior segmental gaps (2.97 vs 1.65 mm, p = 0.017). Conclusions: A methodology framework has been developed that allows to quantify pseuarthrosis in reconstructed mandibles using CBCT imaging. The study identifies the anterior segmental gap as a further risk factor for pseudarthrosis in reconstructions with CAD/CAM reconstruction plates. Future research should evaluate whether this outcome is related to the biomechanics induced at this site.
Tools for Contralateral Prophylactic Mastectomy Decision Making

PURPOSE Women with unilateral breast cancer are increasingly opting for the removal of not only the involved breast, but also for the removal of the opposite uninvolved breast (contralateral prophylactic mastectomy [CPM]), although the risk of contralateral breast cancer (CBC) has decreased in recent years. Models to predict the absolute risk of CBC can help a woman decide whether to undergo CPM. Our objective is to illustrate that a better decision can be made if the patient and doctor also have estimates of the absolute risks of regional and distant recurrences and mortality from non–breast cancer causes. MATERIALS AND METHODS We based our analyses on two published models for CBC and published information on the hazards of regional and distant recurrences and non–breast cancer mortality. Assuming that CPM eliminates CBC but has no effect on other events, we calculated how much CPM reduces a woman's CBC risk and total risk from all these events for 10 hypothetical women with various subtypes of breast cancer and risk factors. RESULTS The risk of CBC and total risk vary greatly, depending on the breast cancer subtype. In some cases, a decision for or against CPM can be based on CBC risk alone, but in others, additional consideration of total risk may cause a woman to decline CPM. CONCLUSION There is a potential to develop more informative tools for deciding on CPM. Realizing this potential will require more and better data to validate existing models of absolute CBC risk and to characterize the hazards of regional and distant recurrences and deaths from non–breast cancer causes for women with various subtypes of breast cancers and risk factors.
Reduced switch‐count structure for symmetric multilevel inverters with a novel switched‐DC‐source submodule

The aim of this study is to present a new cost effective topology for Symmetric multilevel inverters (SMLIs) configurations, which can generate a great number of output voltage levels with a least of switching devices. The proposed structure contains a novel switched-dc-source (SDCS) sub-module that can produce three positive output voltage levels with a contribution of four equal dc voltage sources, two unidirectional, and one bi-directional power switches. Accordingly, to create a uniform staircase output voltage with multiple levels, the proposed SDCS sub-module is integrated into a new design. Therefore, a new family of reduced switch-count (RSC)-SMLIs is derived, which is capable of generating at least 13- and 15-level output voltages using only ten power switches and nine gate drivers. Furthermore, when employing several of the proposed SDCS sub-modules in series, a new generalised RSC-SMLI topology is obtained. Comparisons with prior-art SMLIs structures are done, which also highlights the beneficial potential of the proposed topology. To demonstrate the superior performance of the proposed topology, several simulation and experimental results have been provided.
Herz Prognostic Factors in Chronic Heart Failure A Review of Serum Biomarkers , Metabolic Changes , Symptoms , and Scoring Systems

Zusammenfassung Therapieentscheidungen bei Patienten mit chronischer Herzinsuffizienz werden zunehmend schwieriger, da es viele neue Behandlungsoptionen gibt. Um neue Behandlungsformen gezielt anwenden zu können, sind Informationen zur Prognoseverbesserung notwendig. Diese prognostischen Marker sollten im Idealfall einfach zu messen und preiswert sein. Prognosemarker können Biomarker (wie natriuretische Peptide, Harnsäure, Serumlipoproteine oder Zytokine), Stoffwechselmarker (wie die Insulinsensitivität oder der Body-Mass-Index), Marker der Symptomatik und der Leistungsfähigkeit oder Prognosescores sein. Es gibt wenig Evidenz, dass die Bestimmung der Prognose herzinsuffizienter Patienten im Rahmen von Therapieentscheidungen die Ergebnisse verbessert. In diesem Forschungsbereich sind noch viele Studien notwendig. Prognostische Faktoren bei chronischer Herzinsuffizienz. Eine Übersicht zu Biomarkern, metabolischen Faktoren, Symptomatik und Score-Systemen Abstract Decision-making in the care for patients with chronic heart failure (CHF) has become increasingly difficult. The many available therapeutic strategies and novel treatment modalities with borderline or modest benefit call for careful risk stratification in patients with CHF. Rather than relying on highly sophisticated and expensive procedures, we may find routinely available parameters of clinical value. This review considers the importance and validity of serum biomarkers (like natriuretic peptides, uric acid, lipoproteins, and cytokines), metabolic changes (like insulin resistance or body mass index), patient measures of symptom status and exercise capacity, as well as prognostic scoring systems. There is limited evidence that the use of prognostic markers to make treatment decisions improves the outcome in CHF. Many studies still need to be done to this end.
Longitudinal impacts of the COVID-19 pandemic on adolescents living with HIV in New York City

ABSTRACT Adolescents living with HIV (ALWH) are particularly susceptible to disruptions in care, which may lead to poor HIV-related health outcomes. Here, we report the results of a longitudinal phone-based study investigating impacts of the COVID-19 pandemic on ALWH in New York City. Participants (N = 10, mean age 21.2 years, 50% female) demonstrated substantial COVID-19 knowledge and identified Instagram as their primary source of COVID-19 information. Nearly all participants reported loss of income, and 50% reported experiencing food insecurity as a result of the pandemic. These findings highlight existing vulnerabilities among ALWH that may threaten the continuum of care.
Regulatory programs of B-cell activation and germinal center reaction allow B-ALL escape from CD19 CAR T-cell therapy.

Chimeric-antigen receptor (CAR) T-cell therapy has led to tremendous successes in the treatment of B-cell malignancies. However, a large fraction of treated patients relapse, often with disease expressing reduced levels of the target antigen. Here, we report that exposing CD19+ B-cell acute lymphoblastic leukemia (B-ALL) cells to CD19 CAR T cells reduced CD19 expression within hours. Initially, CD19 CAR T cells caused clustering of CD19 at the T-cell - leukemia cell interface, followed by CD19 internalization and decreased CD19 surface expression on the B-ALL cells. CD19 expression was then repressed by transcriptional rewiring. Using single-cell RNA-sequencing and single-cell ATAC-sequencing, we demonstrated that a subset of refractory CD19low cells sustained decreased CD19 expression through transcriptional programs of physiological B-cell activation and germinal center reaction. Inhibiting B-cell activation programs with the BTK inhibitor ibrutinib increased the cytotoxicity of CD19 CAR T cells without affecting CAR T-cell viability. These results demonstrate transcriptional plasticity as an underlying mechanism of escape from CAR T cells and highlight the importance of combining CAR T-cell therapy with targeted therapies that aim to overcome this plasticity.
d‐Pinitol promotes tau dephosphorylation through a cyclin‐dependent kinase 5 regulation mechanism: A new potential approach for tauopathies?

Recent evidence links brain insulin resistance with neurodegenerative diseases, where hyperphosphorylated tau protein contributes to neuronal cell death. In the present study, we aimed to evaluate if d‐pinitol inositol, which acts as an insulin sensitizer, affects the phosphorylation status of tau protein.
Comparative study on the gastrointestinal- and immune- regulation functions of Hedysari Radix Paeparata Cum Melle and Astragali Radix Praeparata cum Melle in rats with spleen-qi deficiency, based on fuzzy matter-element analysis

Abstract Context Hedysari Radix Praeparata Cum Melle (HRPCM) and Astragali Radix Praeparata Cum Melle (ARPCM) are used interchangeably in clinics to treat spleen-qi deficiency (SQD) symptom mainly including gastrointestinal dysfunction and decreased immunity, which has unknown differences in efficacy. Objective To investigate the differences between HRPCM and ARPCM on intervening gastrointestinal- and immune-function with SQD syndrome. Materials and methods After the SQD model was established, the Sprague–Dawley (SD) rats were randomly divided into nine groups (n = 10): normal; model; Bu-Zhong-Yi-Qi Pills; 18.9, 12.6 and 6.3 g/kg dose groups of HRPCM and ARPCM. Gastrointestinal function including d-xylose, gastrin, amylase vasoactive intestinal peptide, motilin, pepsin, H+/K+-ATPase, Na+/K+-ATPase, sodium-glucose cotransporter 1 (SGLT1), glucose transporter 2 (GLUT2) and immune function including spleen and thymus index, blood routine, interleukin (IL)-2, IL-6, interferon-γ (IFN-γ), tumour necrosis factor-α (TNF-α), immunoglobulin (Ig) M, IgA, IgG and delayed-type hypersensitivity (DTH) were detected. Finally, the efficacy differences were analysed comprehensively by the fuzzy matter-element method. Results In regulating immune, the doses differences in efficacy between HRPCM and ARPCM showed in the high-dose (18.9 g/kg), but there were no differences in the middle- and low- dose (12.6 and 6.3 g/kg); the efficacy differences were primarily reflected in levels of IL-6, IFN-γ, TNF-α and IgM in serum, and the mRNA expression of IL-6 and IFN-γ in the spleen. In regulating gastrointestinal, the efficacy differences were primarily reflected in the levels of D-xylose, MTL, and GAS in serum, and the mRNA and protein expression of SGLT1 and GLUT2 in jejunum and ileum. Discussion and conclusions HRPCM is more effective than ARPCM on regulating gastrointestinal function and immune function with SQD syndrome. Therefore, we propose that HRPCM should be mainly used to treat SQD syndrome in the future.
Dispenser printing of piezo-resistive nanocomposite on woven elastic fabric and hysteresis compensation for skin-mountable stretch sensing

Recently, piezo-resistive nanocomposites have emerged as an important smart material for realizing less obtrusive and more comfortable stretch sensing applications. To manufacture cost-effective and skin-mountable stretch sensor, dispenser printing is advantageous method because piezo-resistive nanocomposites can be directly printed on a woven elastic fabric in various patterns. However, both electrical and mechanical properties of the nanocomposites need to be modulated to achieve favorable sensing performance as well as strong adhesion between the nanocomposite and the fabric to sustain large strains. Moreover, inherent hysteretic behavior of the soft nanocomposite should be compensated to obtain consistent stretch sensing. This paper presents silicone rubber mixed with long multi-walled carbon nanotubes (Long-MWCNTs) composites as a piezo-resistive transducing material for dispenser printing. High aspect ratio of the Long-MWCNTs resulted in low viscosity of a liquid state nanocomposite and high electrical conductivity. Due to the low viscosity, the liquid state nanocomposite could permeate into gaps of the woven elastic fabrics and ensured strong bonding force in large strains up to 35%. In addition, a modified Prandtl-Ishilinskii (MPI) model was adopted to compensate for piezo-resistive hysteresis of the nanocomposite. For validation, the skin-mountable sensor was applied to estimate rotation angle of a wrist. The sensor system estimated the rotation angle of the wrist with an estimation error of 1.93 degrees within 65 degrees range (2.9%) for the step increment and decrement test, and 7.15 degrees within 75 degrees range (9.5%) for the arbitrary movement test. Thus, the experimental results show that the dispenser printing method incorporated with hysteresis compensation can provide a guideline to implement skin-mountable smart fabrics for stretch sensing using various nanocomposites
Thermal inactivation of Salmonella on chicken wings cooked in domestic convection and air fryer ovens

Abstract Chicken wings are among the most popular poultry products for home and foodservice consumption. Poultry products must be handled and cooked safely to decrease the risk of foodborne salmonellosis for consumers. This study aims to validate the use of domestic appliances (convection and air fryer ovens) for the thermal inactivation of Salmonella on chicken wings. Wings (n = 3, 46.5 ± 4.3 g) were inoculated with a five‐strain cocktail of Salmonella (ca. 8 log10 CFU/wing) and cooked in a convection oven (179.4°C) or an air fryer (176, 190, or 204°C) for 2, 5, 10, 15, 20, 22, or 25 min. Thermocouples recorded temperature profiles of wings and appliances. Salmonella counts were determined on XLD agar for rinsates (100 ml/sample), and rinsates were enriched to recover bacteria below the limit of quantification. The recommended internal cooking temperature (73.8°C) was achieved after a range of 7.5 to 8.5 min in both appliances. Salmonella counts were reduced by 6.5 log10 CFU/wing when this temperature was achieved. Cumulative lethality (F‐value) calculations predicted a 9‐log reduction after 7.0 to 8.1 min of cooking. However, sample enrichments tested positive for Salmonella for all cooking times below 22 min. Ultimately, cooking at the temperature–time combinations recommended by manufacturers and online recipes helped achieve complete microbial elimination in both appliances. This study contributes to the validation of home cooking methods to ensure consumer safety.
Dynamic Analysis and Reduction of a Cyclic Symmetric System Subjected to Geometric Nonlinearities

The search for ever lighter weight has become a major goal in the aeronautical industry as it has a direct impact on fuel consumption. It also implies the design of increasingly thin structures made of sophisticated and flexible materials. This may result in nonlinear behaviors due to large structural displacements. Stator vanes can be affected by such phenomena, and as they are a critical part of turbojets, it is crucial to predict these behaviors during the design process in order to eliminate them. This paper presents a reduced order modeling process suited for the study of geometric nonlinearities. The method is derived from a classical component mode synthesis (CMS) with fixed interfaces, in which the reduced nonlinear terms are obtained through a stiffness evaluation procedure (STEP) procedure using an adapted basis composed of linear modes completed by modal derivatives (MD). The whole system is solved using a harmonic balance procedure and a classic iterative nonlinear solver. The application is implemented on a schematic stator vane model composed of nonlinear Euler–Bernoulli beams under von Kàrmàn assumptions.
Imaging Scheme for 3-D High-Frame-Rate Intracardiac Echography: A Simulation Study

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is normally treated by RF ablation. Intracardiac echography (ICE) is widely employed during RF ablation procedures to guide the electrophysiologist in navigating the ablation catheter, although only 2-D probes are currently clinically used. A 3-D ICE catheter would not only improve visualization of the atrium and ablation catheter, but it might also provide the 3-D mapping of the electromechanical wave (EW) propagation pattern, which represents the mechanical response of cardiac tissue to electrical activity. The detection of this EW needs 3-D high-frame-rate imaging, which is generally only realizable in tradeoff with channel count and image quality. In this simulation-based study, we propose a high volume rate imaging scheme for a 3-D ICE probe design that employs 1-D micro-beamforming in the elevation direction. Such a probe can achieve a high frame rate while reducing the channel count sufficiently for realization in a 10-Fr catheter. To suppress the grating-lobe (GL) artifacts associated with micro-beamforming in the elevation direction, a limited number of fan-shaped beams with a wide azimuthal and narrow elevational opening angle are sequentially steered to insonify slices of the region of interest. An angular weighted averaging of reconstructed subvolumes further reduces the GL artifacts. We optimize the transmit beam divergence and central frequency based on the required image quality for EW imaging (EWI). Numerical simulation results show that a set of seven fan-shaped transmission beams can provide a frame rate of 1000 Hz and a sufficient spatial resolution to visualize the EW propagation on a large 3-D surface.
How real can we get in generating real world evidence? Exploring the opportunities of routinely collected administrative data for evaluation of medical devices

Abstract Real‐world data are considered a potentially valuable source of evidence for assessing medical technologies in clinical practice, but their widespread use is hampered by numerous challenges. Using the case of coronary stents in Italy, we investigate the potential of administrative databases for estimating costs and health outcomes associated with the use of medical devices in real world conditions. An administrative dataset was created ad hoc by merging hospital records from patients admitted between 2013 and 2019 for stent implantations with ambulatory records, pharmaceutical use data and vital statistics. Health outcomes were multifold: all‐cause and cardiac mortality and myocardial infarction, within 30 days, 1, 2, 5 years. Costs were estimated from the National Health System perspective. We used multivariable Cox models and propensity score (PS) methods (PS matching; stratification on PS; inverse probability of treatment weighting using PS; PS adjustment). 257,907 coronary stents were implanted in 113,912 patients. For all health outcomes and follow‐up times, and across all methods, patients receiving drug‐eluting stents (DES) presented lower risk. For all‐cause mortality, the DES patient advantage over bare‐metal stent (BMS) patients declined over time but remained significant even at 5 years. For myocardial infarction, results remained quite stable. The DES group presented lower cumulative total costs (ranging from 3264 to 2363 Euros less depending on methods). Our results confirm the consolidated evidence of the benefits of DES compared to BMS. The consistency of results across methods suggests internal validity of the study, while highlighting strengths and limitations of each depending on research context. Administrative data yield great potential to perform comparative effectiveness and cost‐effectiveness analysis of medical devices provided certain conditions are met.
General independent censoring in event‐driven trials with staggered entry

Randomized clinical trials with time‐to‐event endpoints are frequently stopped after a prespecified number of events has been observed. This practice leads to dependent data and nonrandom censoring, which can in general not be solved by conditioning on the underlying baseline information. In case of staggered study entry, matters are complicated substantially. The present paper demonstrates that the study design at hand entails general independent censoring in the counting process sense, provided that the analysis is based on study time information only. To illustrate that the filtrations must not use abundant information, we simulated data of event‐driven trials and evaluated them by means of Cox regression models with covariates for the calendar times. The Breslow curves of the cumulative baseline hazard showed considerable deviations, which implies that the analysis is disturbed by conditioning on the calendar time variables. A second simulation study further revealed that Efron's classical bootstrap, unlike the (martingale‐based) wild bootstrap, may lead to biased results in the given setting, as the assumption of random censoring is violated. This is exemplified by an analysis of data on immunotherapy in patients with advanced, previously treated nonsmall cell lung cancer.
Big-Five Personality of Tertiary Students and Entrepreneurial Intention

This study aims to measure the impact of big-five personality on the entrepreneurial intention of tertiary students. Big-five personality consists of neuroticism, conscientiousness, agreeableness, openness, and extraversion. Data was collected conveniently using an online instrument and it attracted and 647 students from various universities in Jakarta. Data were analyzed using exploratory factor analysis and structural equation model. As a result, only neuroticism dimension had a signlficant impact on entrepreneurial intention. Recommendations for future study are discussed.
Scutellarin‐mediated autophagy activates exosome release of rat nucleus pulposus cells by positively regulating Rab8a via the PI3K/PTEN/Akt pathway

To provide a basis for promising exosome‐based therapies against intervertebral disc degeneration (IDD), our present research aimed to identify a mechanism underlying the vesicle release from nucleus pulposus cells (NPCs). Scutellarin (SC) is a natural chemotherapeutic agent isolated from Erigeron breviscapus with a variety of biological activities. Here, we observed the significantly elevated autophagy levels in rat NPCs under the stimulation of SC, leading to a concomitant enhancement of intracellular vesicle release, which could be attributed to the inactivation of the phosphoinositide 3‐kinase (PI3K)/phosphatase and tensin homolog (PTEN)/protein kinase B (Akt) pathway. To ensure that exosome release was driven by SC via the autophagic pathway, we implemented gain‐of‐function and loss‐of‐function studies by additionally using insulin‐like growth factor‐1 (IGF‐1) and small‐interfering RNA of autophagy‐related gene 5 (ATG5), and the exosome secretion decreased in the case of attenuated autophagy. Evidently, the treatment with SC exerted the remarkable upregulation of Rab8a through the overexpression of ATG5. After the respective knockdown of ATG5 and Rab8a, the increased release of exosomes induced by SC was reversed, whereas the number of intracellular vesicles was restored. Overall, it can be concluded that SC contributes to the autophagy activation in NPCs by acting on the PI3K/PTEN/Akt pathway, which upregulates the expression of Rab8a and promotes the release of exosomes, inspiring novel therapeutic strategies in preventing IDD that might be fruitfully investigated.