Miracle-dz/UniFAR-FTUs huggingface dataset:
Safety and Efficacy of Triple Antithrombotic Therapy with Dabigatran versus Vitamin K Antagonist in Atrial Fibrillation Patients: A Pilot Study

Background Combination of dual antiplatelet (DAPT) and oral anticoagulation therapy is required to decrease cardioembolic stroke and stent thrombosis risk in patients with atrial fibrillation (AF) and acute coronary syndrome (ACS). We compared the safety and efficacy of dabigatran etexilate with vitamin K antagonist (VKA), in combination with DAPT (aspirin plus clopidogrel) treatment in AF patients who underwent percutaneous coronary intervention (PCI) with stenting for ACS. Methods Consecutive nonvalvular AF patients who received twice-daily dabigatran 110 mg (n = 389) or VKA (n = 510) and DAPT were included. Primary endpoints were major bleeding (safety) and the composite of ischemic stroke, systemic embolism, and myocardial infarction (efficacy). The secondary efficacy endpoint was hospitalization for cardiovascular disease. Results After propensity score matching, comparative treatment groups comprised 175 dabigatran recipients and 175 VKA recipients. The cumulative incidence of major bleeding was lower in the dabigatran group (2.3%) compared with the VKA group (10.3%) with a hazard ratio (HR) of 4.81 [95% confidence interval (CI) 1.6–14.2, p < 0.005]. The cumulative incidence of thromboembolic events with dabigatran was slightly higher (8.0%) than with VKA (6.85%), but not statistically significantly so (0.8, 0.39–1.8; p = 0.6). Cumulative incidence of hospitalization for cardiovascular disease was lower with dabigatran (10.3%) compared with VKA (20.6%) treatment (2.2, 1.25–3.8; p < 0.006). Conclusion Dabigatran at the dose used for stroke prevention appears safer than VKA and maintains a similar efficacy profile, when used with DAPT, in AF patients who have undergone PCI with stenting for ACS.
Cross-situational learning in a Zipfian environment

Both adults and children have shown impressive cross-situational word learning in which they leverage the statistics of word usage across many different scenes in order to isolate specific word meanings (e.g., Yu & Smith, 2007). However, relatively little is known about how this learning scales to real language. Some theoretical analyses suggest that when words follow a Zipfian distribution, as they do in natural language, it should be more difficult to learn a lexicon because of the many low-frequency words that are only observed a few times (Blythe, Smith, & Smith, 2010; Vogt, 2012). Although this effect can be mitigated somewhat by assuming mutual exclusivity (Reisenauer, Smith, & Blythe, 2013), no mathematical analyses suggest that learning in a Zipfian environment should be easier. In this work, we show the opposite of the predicted effect using cross-situational learning experiments with adults: when the distribution of words and meanings is Zipfian, learning is not impaired and is usually improved. Over a series of experiments, we provide evidence that this is because Zipfian distributions help people to disambiguate the meanings of the other words in the situation.
Chronic gestational hypoxia accelerates ovarian aging and lowers ovarian reserve in next-generation adult rats

Chronic fetal hypoxia is a common complication observed in human pregnancy, impacting pregnancies across global contexts. Exposure to chronic intrauterine hypoxia has major short‐ and long‐term consequences for offspring health. However, the impact of chronic gestational hypoxia on female reproductive system development is unknown. We aimed to understand the impact of exposure to chronic fetal hypoxia on the developing female reproductive system. Wistar rat dams underwent normoxia (21%) or hypoxia (13%) during pregnancy. Postnatally, all female offspring were maintained in normoxic conditions into early adulthood. Female rats exposed to chronic gestational hypoxia (13%) during their intrauterine development had decreased ovarian primordial follicular reserve compared to controls (P < 0.05). Adult females who had been exposed to chronic fetal hypoxia had significantly reduced somatic ovarian telomere length (P < 0.05) and reduced ovarian protein expression of KU70, a critical component of the DNA‐activated protein kinase repair complex (P < 0.01). Gene expression of NADPH oxidase 2‐mediated oxidative stress markers was increased (P < 0.05). Exposure to chronic hypoxia during fetal development leads to accelerated aging of the somatic ovary and decreased ovarian reserve in adulthood. Ovarian aging is highly sensitive to gestational hypoxia, with implications for future fertility in next‐generation offspring of high‐risk pregnancies. —Aiken, C. E. , Tarry‐Adkins, J. L. , Spiroski, A. ‐M. , Nuzzo, A. M. , Ashmore, T. J., Rolfo, A. , Sutherland, M. J., Camm, E. J., Giussani, D. A. , Ozanne, S. E. Chronic gestational hypoxia accelerates ovarian aging and lowers ovarian reserve in next‐generation adult rats. FASEB J. 33, 7758–7766 (2019). www.fasebj. org
Center Effects in Hospital Mortality of Critically Ill Patients With Hematologic Malignancies*

Objectives: We aimed to investigate center effects on hospital mortality of ICU patients with hematologic malignancies and to explore interactions between center and patients characteristics. Design: Multicenter prospective cohort. Setting: Seventeen ICUs across France and Belgium. Patients: One-thousand eleven patients with hematologic malignancies hospitalized in ICUs. Interventions: Reanalysis of the original data using state-of-the-art statistical methods with permutation procedures for testing multiple random effects. Measurements and Main Results: Average crude mortality was 39% and varied from 11% to 58% across centers. There was a significant center effect on the mean hospital mortality, after adjustment on individual prognostic factors (p < 0.001; median adjusted odds ratio for center effect 1.57 [interquartile range, 1.24–2.18]). There was also a quantitative interaction between center and the effect of the Sequential Organ Failure Assessment score: higher scores were associated with higher mortality (odds ratio for 1 point = 1.24 on average; 95% CI, 1.15–1.33) but with a magnitude that depended on center (p = 0.028). Conclusions: Between-center heterogeneity in hospital mortality was confirmed after adjustment for individual prognostic factors. It was partially explained by center experience in treating oncology patients. Interestingly, center effect was similar in magnitude to that of known mortality risk factors.
Optimization and Technical Validation of the AIDE-MOI Fall Detection Algorithm in a Real-Life Setting with Older Adults

Falls are the primary contributors of accidents in elderly people. An important factor of fall severity is the amount of time that people lie on the ground. To minimize consequences through a short reaction time, the motion sensor “AIDE-MOI” was developed. “AIDE-MOI” senses acceleration data and analyzes if an event is a fall. The threshold-based fall detection algorithm was developed using motion data of young subjects collected in a lab setup. The aim of this study was to improve and validate the existing fall detection algorithm. In the two-phase study, twenty subjects (age 86.25 ± 6.66 years) with a high risk of fall (Morse > 65 points) were recruited to record motion data in real-time using the AIDE-MOI sensor. The data collected in the first phase (59 days) was used to optimize the existing algorithm. The optimized second-generation algorithm was evaluated in a second phase (66 days). The data collected in the two phases, which recorded 31 real falls, was split-up into one-minute chunks for labelling as “fall” or “non-fall”. The sensitivity and specificity of the threshold-based algorithm improved significantly from 27.3% to 80.0% and 99.9957% (0.43) to 99.9978% (0.17 false alarms per week and subject), respectively.
Perioperative management of renal transplant patients undergoing total joint arthroplasty

The success of renal transplantation depends on lifelong immunosuppression. This can lead to a high incidence of avascular necrosis of major joints in the body for which arthroplasty is the treatment of choice. The risk of surgical complications is high in these patients, and there is no current set of cohesive perioperative management guidelines. In this review, we discuss the perioperative management of renal transplant patients undergoing elective total joint arthroplasty.
In Situ Characterization of Hfq Bacterial Amyloid: A Fourier-Transform Infrared Spectroscopy Study

Hfq is a bacterial protein that regulates gene expression at the post-transcriptional level in Gram-negative bacteria. We have previously shown that Escherichia coli Hfq protein, and more precisely its C-terminal region (CTR), self-assembles into an amyloid-like structure in vitro. In the present work, we present evidence that Hfq unambiguously forms amyloid structures also in vivo. Taking into account the role of this protein in bacterial adaptation and virulence, our work opens possibilities to target Hfq amyloid self-assembly and cell location, with important potential to block bacterial adaptation and treat infections.
Smoking and Physical Activity Trajectories from Childhood to Midlife

Introduction: Despite substantial interest in the development of health behaviors, there is limited research that has examined the longitudinal relationship between physical activity (PA) and smoking trajectories from youth to adulthood in a Finnish population. This study aimed to identify trajectories of smoking and PA for males and females, and study the relationship between these trajectories from youth to adulthood. Methods: Latent profile analysis (LPA) was used to identify trajectories of smoking and PA separately for males and females among 3355 Finnish adults (52.1% females). Participants’ smoking and PA were assessed five to eight times over a 31-year period (3–18 years old at the baseline, 34–49 years at last follow-up). Multinomial logistic regression analysis was used to study the relationship between the trajectories of smoking and PA. Results: Five smoking trajectories and four to five PA trajectories were identified for males and females. Of the PA trajectory groups, the persistently active group were least likely to follow the trajectories of regular smoking and the inactive and low active groups were least likely to follow non-smoking trajectory group. Likewise, inactive (women only) and low active groups were less likely to belong to the non-smokers group. Conclusions: The study suggests that those who are persistently active or increasingly active have substantially reduced probabilities of being in the highest-risk smoking categories.
Sub-10-minute High-quality Diagnostic Colonoscopy With Terminal Ileum Intubation in Children Is Feasible and Safe.

OBJECTIVES To critically appraise ileocolonoscopy (IC) practice in a large tertiary center, where IC is exclusively performed by experienced pediatric colonoscopists, particularly focusing on indications for the procedure; bowel preparation efficacy; IC completion rates and timings; diagnostic yield; and complications. PATIENTS AND METHODS We prospectively evaluated all patients referred to our clinic between July 2015 and June 2016. Data on age, height and weight, sex, surgical history, indications for colonoscopy, bowel preparation given, and bowel cleansing efficacy were collected. The following were calculated: percentage of terminal ileal (TI) intubation; time to terminal ileum; total duration of each procedure. In addition, we evaluated the number and the type of complications encountered and the number of patients readmitted within 30 days from the elective procedure. Endoscopic diagnostic yield, stratified for indication, was calculated. RESULTS A total of 1392 patients were referred; 181 required an endoscopic evaluation of the lower gastrointestinal (GI) tract (Outpatient Department conversion rate: 13%). Main indications for IC were: recurrent abdominal pain 38.1%; unexplained chronic diarrhea 16%; suspected inflammatory bowel disease (IBD) 24.9%; isolated rectal bleeding 13.2%; occult GI bleeding 1.6%; unexplained faltering growth 1.6%; IBD restaging 2.6%; and miscellaneous 1.6%. Terminal ileum was reached in all the patients (TI intubation rate = 100%). Median time to TI was 9.8 minutes (1-50 minutes). Time to TI was lower in younger patients compared to older ones (P = 0.005). Bowel cleansing was judged as grade 1 in 49.2%; grade 2 in 33.7%; grade 3 in 13.3%; and grade 4 in 3.9%. A significant statistical correlation was recorded between bowel cleansing and time to TI. The positive diagnostic yield was: 11.6% in patients with abdominal pain; 37.9% in patients with chronic diarrhea; 51.1% in patients with suspected IBD; 29.2% in patients with isolated rectal bleeding; 33.3% in patients with occult GI bleeding; 0% in patients with faltering growth; and 33% in the miscellaneous group. CONCLUSIONS In conclusion, appropriately targeted IC in the management of children with GI symptoms is a safe, fast, and useful investigation. TI intubation rates of 100% are achievable and desirable and can be conducted quickly. Poor bowel preparation impacts negatively on this and IC duration may be faster in younger children. High diagnostic yields have been recorded in patients with a clinical suspicion of IBD. Diagnostic yield in isolated recurrent abdominal pain is low. Training to excellence in pediatric IC should be a persistent goal.
Mexican Microalgae Biodiversity and State-Of-The-Art Extraction Strategies to Meet Sustainable Circular Economy Challenges: High-Value Compounds and Their Applied Perspectives

In recent years, the demand for naturally derived products has hiked with enormous pressure to propose or develop state-of-the-art strategies to meet sustainable circular economy challenges. Microalgae possess the flexibility to produce a variety of high-value products of industrial interests. From pigments such as phycobilins or lutein to phycotoxins and several polyunsaturated fatty acids (PUFAs), microalgae have the potential to become the primary producers for the pharmaceutical, food, and agronomical industries. Also, microalgae require minimal resources to grow due to their autotrophic nature or by consuming waste matter, while allowing for the extraction of several valuable side products such as hydrogen gas and biodiesel in a single process, following a biorefinery agenda. From a Mexican microalgae biodiversity perspective, more than 70 different local species have been characterized and isolated, whereas, only a minimal amount has been explored to produce commercially valuable products, thus ignoring their potential as a locally available resource. In this paper, we discuss the microalgae diversity present in Mexico with their current applications and potential, while expanding on their future applications in bioengineering along with other industrial sectors. In conclusion, the use of available microalgae to produce biochemically revenuable products currently represents an untapped potential that could lead to the solution of several problems through green technologies. As such, if the social, industrial and research communities collaborate to strive towards a greener economy by preserving the existing biodiversity and optimizing the use of the currently available resources, the enrichment of our society and the solution to several environmental problems could be attained.
Smart Sensing and Adaptive Reasoning for Enabling Industrial Robots with Interactive Human-Robot Capabilities in Dynamic Environments—A Case Study

Traditional industry is seeing an increasing demand for more autonomous and flexible manufacturing in unstructured settings, a shift away from the fixed, isolated workspaces where robots perform predefined actions repetitively. This work presents a case study in which a robotic manipulator, namely a KUKA KR90 R3100, is provided with smart sensing capabilities such as vision and adaptive reasoning for real-time collision avoidance and online path planning in dynamically-changing environments. A machine vision module based on low-cost cameras and color detection in the hue, saturation, value (HSV) space is developed to make the robot aware of its changing environment. Therefore, this vision allows the detection and localization of a randomly moving obstacle. Path correction to avoid collision avoidance for such obstacles with robotic manipulator is achieved by exploiting an adaptive path planning module along with a dedicated robot control module, where the three modules run simultaneously. These sensing/smart capabilities allow the smooth interactions between the robot and its dynamic environment, where the robot needs to react to dynamic changes through autonomous thinking and reasoning with the reaction times below the average human reaction time. The experimental results demonstrate that effective human-robot and robot-robot interactions can be realized through the innovative integration of emerging sensing techniques, efficient planning algorithms and systematic designs.
Exceptional Longevity and Polygenic Risk for Cardiovascular Health

Studies investigating exceptionally long-lived (ELL) individuals, including genetic studies, have linked cardiovascular-related pathways, particularly lipid and cholesterol homeostasis, with longevity. This study explored the genetic profiles of ELL individuals (cases: n = 294, 95–106 years; controls: n = 1105, 55–65 years) by assessing their polygenic risk scores (PRS) based on a genome wide association study (GWAS) threshold of p < 5 × 10−5. PRS were constructed using GWAS summary data from two exceptional longevity (EL) analyses and eight cardiovascular-related risk factors (lipids) and disease (myocardial infarction, coronary artery disease, stroke) analyses. A higher genetic risk for exceptional longevity (EL) was significantly associated with longevity in our sample (odds ratio (OR) = 1.19–1.20, p = 0.00804 and 0.00758, respectively). Two cardiovascular health PRS were nominally significant with longevity (HDL cholesterol, triglycerides), with higher PRS associated with EL, but these relationships did not survive correction for multiple testing. In conclusion, ELL individuals did not have significantly lower polygenic risk for the majority of the investigated cardiovascular health traits. Future work in larger cohorts is required to further explore the role of cardiovascular-related genetic variants in EL.
Development of high-performance two-dimensional gel electrophoresis for human hair shaft proteome

The primary components of human hair shaft—keratin and keratin-associated proteins (KAPs), together with their cross-linked networks—are the underlying reason for its rigid structure. It is therefore requisite to overcome the obstacle of hair insolubility and establish a reliable protocol for the proteome analysis of this accessible specimen. The present study employed an alkaline-based method for the efficient isolation of hair proteins and subsequently examined them using gel-based proteomics. The introduction of two proteomic protocols, namely the conventional and modified protocol, have resulted in the detection of more than 400 protein spots on the two-dimensional gel electrophoresis (2DE). When compared, the modified protocol is deemed to improve overall reproducibility, whilst offering a quick overview of the total protein distribution of hair. The development of this high-performance protocol is hoped to provide a new approach for hair analysis, which could possibly lead to the discovery of biomarkers for hair in health and diseases in the future.
Including and Training Family Caregivers of Older Adults in Hospital Care

Supplemental Digital Content is Available in the Text. Background: Despite the role caregivers play in the delivery of care, the interactions and training methods used with caregivers during an inpatient stay are not clear. Purpose: The purpose was to examine interactions and training methods used with caregivers during hospital care. Methods: A mixed-methods case study was conducted. Observations were summarized and interviews were analyzed using thematic analysis. Results: The frequency of caregiver engagement varied at different points in the care process but was highest among observations during the stay care point. Providers were most commonly using written and verbal instructions to train caregivers. Three themes emerged from the interviews and were described to be both facilitators and barriers to caregiver involvement: experience, time, and relationship. Conclusions: High-quality person and family-centered care depends upon coordinated efforts among health care systems, providers, patients, and caregivers. Future caregiver initiatives should aim to decrease disengagement, increase assessment, and broaden the use of training methods.
International Collaborative Assessment of the Validity of the EAONO-JOS Cholesteatoma Staging System.

OBJECTIVE Assessment of validity of the Japanese Otological Society and the European Academy of Otology and Neurotology (EAONO-JOS) cholesteatoma staging system (EJS) through international collaboration to investigate: (a) feasibility of retrospectively staging previously acquired data, (b) strengths and weaknesses of the staging system. METHOD Nine centers with prospective cholesteatoma databases were recruited. Cases were allocated to EJS Stage at each center using details from time of initial surgery. An independent rater also staged the cases and noted any discrepancies. At one center results from database staging were compared with staging based on contemporaneous operative records. Inter and intrarater reliabilities were calculated, and recidivism rates calculated according to Stage. RESULTS Of 1482 cases of cholesteatoma, 320 (22%) were Stage 1, 977 (67%) Stage 2, 153 (11%) Stage 3 and 4 (0.3%) Stage 4. No database contained details of all parameters required for accurate staging. Staging discrepancies occurred in >10% cases but inter and intrarater reliability of staging were high (Kappa 0.8; 95% confidence interval between 0.7-0.9). At 5 years, 11% had residual and 8% had recurrent cholesteatoma: rates increased with Stage but generally not significantly (Kaplan-Meier Log Rank analysis). CONCLUSION The EJS Staging system provides an internationally agreed standard for collecting data to classify cholesteatoma severity. Although data can be applied retrospectively with reasonable reliability, prospective data collection would prevent inaccuracies that arise from missing data fields. To enhance validity of the EJS system, we propose clearer definitions of some categories. Refinements to definitions of stage may improve prognostic utility of the EJS but should be made using evidence powered by large-scale collaboration.
Characterization of the Mechanical Properties of FFF Structures and Materials: A Review on the Experimental, Computational and Theoretical Approaches

The increase in accessibility of fused filament fabrication (FFF) machines has inspired the scientific community to work towards the understanding of the structural performance of components fabricated with this technology. Numerous attempts to characterize and to estimate the mechanical properties of structures fabricated with FFF have been reported in the literature. Experimental characterization of printed components has been reported extensively. However, few attempts have been made to predict properties of printed structures with computational models, and a lot less work with analytical approximations. As a result, a thorough review of reported experimental characterization and predictive models is presented with the aim of summarizing applicability and limitations of those approaches. Finally, recommendations on practices for characterizing printed materials are given and areas that deserve further research are proposed.