Miracle-dz/UniFAR-FTUs huggingface dataset:
The Efficacy of Ketamine Administration in Prehospital Pain Management of Trauma Patients; a Systematic Review and Meta-Analysis

Introduction: Although previous articles and reviews suggest that ketamine might effectively manage pain in trauma patients, these articles have serious limitations. Accordingly, the current meta-analysis aims to investigate the efficacy of ketamine administration in prehospital pain management of trauma patients. Method: In the present meta-analysis, controlled human studies were included. An extensive search was conducted in electronic databases including Medline (via PubMed), Embase, Central, Scopus, Web of Science, and ProQuest, gathering data to the end of 2018. The efficacy and side effects of ketamine administration in pre-hospital pain management were compared with those of opioid analgesics based on standard mean difference (SMD) and odds ratio (OR) calculations with 95% confidence interval (95% CI). Results: Data from seven articles were included in the present meta-analysis. Ketamine administration was not more effective than administrating morphine or fentanyl in prehospital pain management of trauma patients (SMD = -0.56, 95% CI: -1.38 to 0.26, p = 0.117). However, co-administration of ketamine+morphine was considerably more effective than ketamine alone, in alleviating pain in prehospital settings (SMD = -0.62, 95% CI: -1.12 to -0.12, p = 0.010). Finally, it was concluded that ketamine alone had less side effects than morphine alone (OR = 0.25, 95% CI: 0.11 to 0.56, p = 0.001). However, co-administration of ketamine+morphine increases the risk of side effects to 3.68 times compared to when morphine is prescribed solely (OR=3.68, 95% CI: 1.99 to 6.82, p<0.001). Conclusion: For the first time, findings of the current meta-analysis demonstrated that ketamine, being administered alone, is an effective and safe medication in prehospital pain management in trauma patients, and can be considered as an acceptable alternative to opioid analgesics.
The feasibility and value of parent input when evaluating the mental health of young adults with and without cancer

There has been a growing interest in the specific needs of adolescents and young adults (AYAs) due to their transitional status as emerging adults who are still developing. An important effort involves AYAs with cancer whose unique biology, disease outcomes, and health care needs have led to specialized oncology programs that serve this population. AYAs with cancer can experience delayed psychosocial development and autonomy compared with their healthy peers. As a result, AYAs with cancer may be more dependent on their parents, who in turn may have more opportunities to interact and observe their child's emotional state and behavior. Psychosocial distress and rates of mental disorders as high as 46.7% in the past 4 weeks have been reported in AYAs with cancer; hence, accurate and timely identification by patients, family, and care providers of treatable conditions can ameliorate suffering. Collateral history when evaluating mental health can improve the accuracy of the information. It is not known if discordance between parents and AYA could lead to underdetection of mental health conditions if AYA reports are used alone. Our pilot study focuses on the feasibility and value of collateral parent interviews when evaluating the mental health of young adults with and without cancer. We chose our AYA age range of 18 to 25 because parent input is not generally elicited in mental health evaluations above the age of 17, and 25 is generally the upper limit of patients enrolled in clinical studies in the Pediatric Branch of the National Cancer Institute. Structured diagnostic interviews are the gold standard for psychiatric assessments. The Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL) generates reliable and valid diagnoses based on Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV) for children up to 18 years old, and its methodology involves conducting the same interview with both child and parent. It has good inter-rater reliability for depression (kappa 0.9) and anxiety disorders (kappa 0.8), good construct validity, and compares well with other well-studied assessments such as the Child Behavior Checklist (CBCL). Extending the K-SADS-PL to 18 and above could be useful when following youth with cancer longitudinally. This brief report examined whether the K-SADS-PL could be extended to young adults 18 to 25 with and without cancer by assessing the feasibility of obtaining parent interviews, and furthermore, whether parent interviews improved the detection of mental health symptoms compared with young adult interviews alone.
Modeling of cumulative effects of time-varying drug exposures on within-subject changes in a continuous outcome

An accurate assessment of the safety or effectiveness of drugs in pharmaco-epidemiological studies requires defining an etiologically correct time-varying exposure model, which specifies how previous drug use affects the outcome of interest. To address this issue, we develop, and validate in simulations, a new approach for flexible modeling of the cumulative effects of time-varying exposures on repeated measures of a continuous response variable, such as a quantitative surrogate outcome, or a biomarker. Specifically, we extend the linear mixed effects modeling to estimate how past and recent drug exposure affects the way individual values of the outcome change throughout the follow-up. To account for the dosage, duration and timing of past exposures, we rely on a flexible weighted cumulative exposure methodology to model the cumulative effects of past drug use, as the weighted sum of past doses. Weights, modeled with unpenalized cubic regression B-splines, reflect the relative importance of doses taken at different times in the past. In simulations, we evaluate the performance of the model under different assumptions concerning (i) the shape of the weight function, (ii) the sample size, (iii) the number of the longitudinal observations and (iv) the intra-individual variance. Results demonstrate the accuracy of our estimates of the weight function and of the between- and within-patients variances, and good correlation between the observed and predicted longitudinal changes in the outcome. We then apply the proposed method to re-assess the association between time-varying glucocorticoid exposure and weight gain in people living with rheumatoid arthritis.
Gestation and breastfeeding in schistosomotic mice differentially alters the expression of histone deacetylases (HDACs) in adult offspring

BACKGROUND Breastfeeding or gestation in schistosomotic mothers can cause long-term alterations in the immune response of offspring. OBJECTIVES Evaluate the expression of histone deacetylases (HDACs) (all classes), the production of cytokines by T and B lymphocytes and macrophages, and the frequency of CD4+CD25+FoxP3+-cells in adult offspring born and/or suckled by schistosomotic mothers. METHODS We harvested splenocytes from offspring born to (BIM), suckled by (SIM), or born to/suckled by (BSIM) schistosomotic mothers and animals from noninfected mothers (Control) at seven-weeks old and cultured them with/without Concanavalin A. HDAC expression was evaluated by real-time quantitative polymerase chain reaction (qPCR), and cytokines and membrane markers were evaluated by fluorescence-activated cell sorting (FACS). FINDINGS Compared to Control, BIM mice showed increased expression of HDAC9 and frequency of CD4+IL-10+-cells. The SIM group had increased expression of HDAC1, HDAC2, HDAC6, HDAC7, HDAC10, Sirt2, Sirt5, Sirt6, and Sirt7. The BSIM group only had increased HDAC10 expression. The SIM and BSIM groups exhibited decreased frequencies of CD4+IL-4+-cells and CD4+CD25+FoxP3+-cells, along with a higher frequency of CD14+IL-10+-cells and an increase in CD45R/B220+IL-10+-cells. The BSIM group also showed a high frequency of CD4+IL10+-cells. MAIN CONCLUSIONS Breastfeeding induced the expression of HDACs from various classes involved in reducing inflammatory responses. However, gestation enhanced the expression of a single HDAC and breastfeeding or gestation appears to favour multiple IL-10-dependent pathways, but not cells with a regulatory phenotype.
On the Self-Structuring Antenna

This paper shows the results of an investigation on the self-structuring antenna. This antenna consists of a combination of planar paths interconnected by controllable switches. A numerical electromagnetics code (NEC) environment and application with implemented genetic algorithms were used in this research. As a result of the investigation, an antenna template was built and measured.
Striving While Black: Race and the Psychophysiology of Goal Pursuit

Population health scientists have largely overlooked anticipatory stressors and how different groups of people experience and cope with anticipatory stress. I address these gaps by examining black-white differences in the associations between an important anticipatory stressor—goal-striving stress (GSS)—and several measures of psychophysiology. Hypotheses focusing on racial differences in GSS and psychophysiology are tested using self-report and biomarker data from the Nashville Stress and Health Study (2011–2014), a cross-sectional probability survey of black and white working-age adults from Davidson County, Tennessee (n = 1,252). Compared to their white peers, blacks with higher GSS report greater self-esteem and fewer symptoms of depression and anxiety. However, increased GSS also predicts elevated levels of high-effort coping (i.e., John Henryism), neuroendocrine stress hormones, and blood pressure for blacks but not whites. I discuss the implications of these findings for scholars interested in the stress process and broader black-white health inequalities in the United States.
Simulative structure and binding sites of lyral with olfactory receptor 10J5 using computational prediction methods

ABSTRACT Olfactory receptor (OR) genes are extensively distributed throughout the human organism. Although these receptors are predominantly located in the olfactory epithelium, binding between odorant chemicals and corresponding ORs initiates downstream events in other tissues. In particular, exposure to allergen fragrances results in the induction of contact dermatitis. At present, current methodologies are limited in their ability to predict the consequences of fragrancy chemicals on humans. The aim of this study was designed to simulate the bindingstructure between lyral and OR10J5, a known allergen which produces contact dermatitis, and its corresponding OR OR10J5 in an effort to predict dermal outcomes using computational methods. Results demonstrated that binding between lyral and OR10J5 involved amino acid residues Phe104, Val105, Cyx178, Ile180, and Tyr258, respectively, which were located on binding sites of the receptor transmembrane 3(TM3), TM3, extracellular loop 2(EL2), EL2, TM6. Evidence indicates that computer simulating binding interactions occurred between an odorant chemical and its receptors which initiated downstream alterations accounting possibly for the observed in vivo contact dermatitis.
Identification of a recurrent nonsense mutation in HR gene responsible for atrichia with papular lesions in two Kashmiri families

Congenital atrichia (CA) is a rare form of irreversible alopecia with an autosomal recessive mode of inheritance. This form of hair loss is mainly associated with mutations in the human hairless (HR) gene located at chromosome 8p21.3. An additional unique feature atrichia with papular lesions (APL) comprises keratin‐filled cysts known as papules. The present study aimed to uncover the underlying genetic causes of APL in two consanguineous Kashmiri families.
Embelin impact on paraquat‐induced lung injury through suppressing oxidative stress, inflammatory cascade, and MAPK/NF‐κB signaling pathway

The current examination was intended to observe the defensive impacts of embelin against paraquat‐incited lung damage in relationship with its antioxidant and anti‐inflammatory action. Oxidative stress marker, like malondialdehyde (MDA), antioxidative enzymes, for example, superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH Px), inflammatory cytokines, such as interleukin‐1β (IL‐1β), tumor necrosis factor‐α, and IL‐6, histological examination, and nuclear factor kappa B/mitogen‐activated protein kinase (NF‐κB/MAPK) gene expression were evaluated in lung tissue. Embelin treatment significantly decreased MDA and increased SOD, CAT, and GSH Px. Embelin significantly reduced levels of inflammatory cytokines in paraquat‐administered and paraquat‐intoxicated rats. In addition, embelin suggestively decreased relative protein expression of nuclear NF‐κB p65, p‐NF‐κBp65, p38 MAPK, and p‐p38 MAPKs in paraquat‐intoxicated rats. The outcomes show the impact of embelin inhibitory action on NF‐κB and MAPK and inflammatory cytokines release, and the decrease of lung tissue damage caused by paraquat.
Cooperation between SS18-SSX1 and miR-214 in Synovial Sarcoma Development and Progression

SS18-SSX fusion proteins play a central role in synovial sarcoma development, although, the genetic network and mechanisms of synovial sarcomagenesis remain unknown. We established a new ex vivo synovial sarcoma mouse model through retroviral-mediated gene transfer of SS18-SSX1 into mouse embryonic mesenchymal cells followed by subcutaneous transplantation into nude mice. This approach successfully induced subcutaneous tumors in 100% recipients, showing invasive proliferation of short spindle tumor cells with occasional biphasic appearance. Cytokeratin expression was observed in epithelial components in tumors and expression of TLE1 and BCL2 was also shown. Gene expression profiling indicated SWI/SNF pathway modulation by SS18-SSX1 introduction into mesenchymal cells and Tle1 and Atf2 upregulation in tumors. These findings indicate that the model exhibits phenotypes typical of human synovial sarcoma. Retroviral tagging of the tumor identified 15 common retroviral integration sites within the Dnm3 locus as the most frequent in 30 mouse synovial sarcomas. miR-199a2 and miR-214 upregulation within the Dnm3 locus was observed. SS18-SSX1 and miR-214 cointroduction accelerated sarcoma onset, indicating that miR-214 is a cooperative oncomiR in synovial sarcomagenesis. miR-214 functions in a cell non-autonomous manner, promoting cytokine gene expression (e.g., Cxcl15/IL8). Our results emphasize the role of miR-214 in tumor development and disease progression.
Increased error-correction leads to both higher levels of variability and adaptation

In order to intercept moving objects, we need to predict the spatiotemporal features of the motion of both the object and our hand. Our errors can result in updates of these predictions to benefit interceptions in the future (adaptation). Recent studies claim that task-relevant variability in baseline performance can help adapt to perturbations, because initial variability helps explore the spatial demands of the task. In this study, we examined whether this relationship is also found in interception (temporal domain) by looking at the link between the variability of hand-movement speed during baseline trials, and the adaptation to a temporal perturbation. 17 subjects performed an interception task on a graphic tablet with a stylus. A target moved from left to right or vice versa, with varying speed across trials. Participants were instructed to intercept this target with a straight forward movement of their hand. Their movements were represented by a cursor that was displayed on a screen above the tablet. To prevent online corrections we blocked the hand from view, and a part of the cursor’s trajectory was occluded. After a baseline phase of 80 trials, a temporal delay of 100 ms was introduced to the cursor representing the hand (adaptation phase: 80 trials). This delay initially caused participants to miss the target, but they quickly accounted for these errors by adapting to most of the delay of the cursor. We found that variability in baseline movement velocity is a good predictor of temporal adaptation (defined as a combination of the rate of change and the asymptotic level of change after a perturbation), with higher variability during baseline being associated with better adaptation. However, cross-correlation results suggest that the increased variability is the result of increased error correction, rather than exploration.
Assessment of a Real-Time Locator System to Identify Physician and Nurse Work Locations.

Understanding how physicians and nurses spend their workdays is important for improving patient care and clinician training and satisfaction. Time-in-motion studies1,2 performed by human observers have demonstrated that little time is spent engaging in direct patient care vs interacting with computers in workrooms. However, studies relying on human observation are resource intensive, introduce bias, and are costly to scale. Radiofrequency identification has been increasingly used to enable real-time location systems (RTLSs) to unobtrusively map the time and locations of health care workers.3 This cross-sectional study reports the results of an RTLS-enabled study of staff time allocation on an inpatient medicine ward.
Risk of Opioid Overdose Associated With Concomitant Use of Opioids and Skeletal Muscle Relaxants: A Population‐Based Cohort Study

The recent opioid prescribing guideline cautions about the concomitant prescribing of opioids and skeletal muscle relaxants (SMRs) given the additive central nervous system depressant effect. However, the clinical relevance remains unclear. In this retrospective cohort study, we compared the risk of opioid overdose associated with concomitant use of opioids and SMRs vs. opioid use alone. Adjusted hazard ratios were 1.09 (95% confidence interval (CI), 0.74–1.62) and 1.26 (95% CI, 1.00–1.58) in the incident and prevalent opioid user cohorts, respectively, generating a combined estimate of 1.21 (95% CI, 1.00–1.48). This risk seemed to increase with treatment duration (≤ 14 days: 0.91 and 95% CI, 0.67–1.22; 15–60 days: 1.37 and 95% CI, 0.81–2.37; >60 days: 1.80 and 95% CI, 1.30–2.48) and for baclofen (1.83 and 95% CI, 1.11–3.04) and carisoprodol (1.84 and 95% CI, 1.34–2.54). Concomitant users with daily opioid dose ≥50 mg (1.50 and 95% CI, 1.18–1.92) and benzodiazepine use (1.39 and 95% CI, 1.08–1.79) also had elevated risk. Clinicians should be cautious about these potentially unsafe practices to optimize pain care and improve patient safety.
From Clinical Practice to Academic Student Instruction: Understanding the Clinical Instructor’s Perspective Using a Mixed-Methods Approach

Background Clinical instructors (CIs) are important to the provision of real-world experiential learning because they teach, mentor, and support students in clinical practice settings in higher education programs. CIs experience tensions that influence their retention and impact the sustainability of consistent, quality education for students. Purpose The aim of this study was to examine the experiences of being a CI and how to better support them. Methods CIs in a nursing faculty at a Western Canadian university were approached to participate. Data collection included a survey (n = 17) with questions asking about the importance of and their ability to prepare, teach, and mentor nursing students in practice. Individual interviews (n = 6) and a focus group (n = 3) were conducted that asked CIs about their experiences and challenges. Analysis included descriptive statistics and thematic analysis. Results Participants indicated feeling unprepared entering the instructor role. Key findings were the need to improve CI orientation so that it is more practical and meaningful, to increase peer support from other instructors, and to assist CIs’ transition into becoming educators. Conclusions Understanding CIs’ assessment of their needs can help institutions better support and retain them, promoting consistency and quality in practicum instruction.
Jmjd1c is dispensable for healthy adult hematopoiesis and Jak2V617F-driven myeloproliferative disease initiation in mice

The histone demethylase JMJD1C is overexpressed in patients with myeloproliferative neoplasms (MPNs) and has been implicated in leukemic stem cell function of MLL-AF9 and HOXA9-driven leukemia. In the emerging field of histone demethylase inhibitors, JMJD1C therefore became a potential target. Depletion of Jmjd1c expression significantly reduced cytokine-independent growth in an MPN cell line, indicating a role for JMJD1C in MPN disease maintenance. Here, we investigated a potential role for the demethylase in MPN disease initiation. We introduced a Cre-inducible JAK2V617F mutation into Jmjd1c knockout mice. We show that Jmjd1c is dispensable, both for healthy hematopoiesis as well as for JAK2V617F-driven MPN disease initiation. Jmjd1c knockout mice did not show any significant changes in peripheral blood composition. Likewise, introduction of JAK2V617F into Jmjd1c-/- mice led to a similar MPN phenotype as JAK2V617F in a Jmjd1c wt background. This indicates that there is a difference between the role of JMJD1C in leukemic stem cells and in MPN. In the latter, JMJC domain-containing family members may serve redundant roles, compensating for the loss of individual proteins.
Antitumor immunity triggered by photothermal therapy and photodynamic therapy of a 2D MoS2 nanosheet-incorporated injectable polypeptide-engineered hydrogel combinated with chemotherapy for 4T1 breast tumor therapy

A multifunctional PC10A/DOX/MoS2 hydrogel was designed and prepared for chemotherapy/photothermal therapy/photodynamic therapy of 4T1 tumor, and the immune responses triggered by photothermal and photodynamic effect of MoS2 nanosheet in the hydrogel were also studied. Positively charged DOX and negatively charged PC10A were loaded on the surface of MoS2 nanosheet through layer-by-layer method to prepare hybrid PC10A/DOX/MoS2 nanoparticles. PC10A/DOX/MoS2 nanoparticles were dispersed in PC10A hydrogel to prepare PC10A/DOX/MoS2 hydrogel. 2D MoS2 nanosheet in the hydrogel was simultaneously utilized as photothermal agent and photodynamic agent for the generation of hyperthermia and reactive oxygen species, respectively. This PC10A/DOX/MoS2 hydrogel was injectable and possessed excellent biocompatibility. The results of in vivo tumor-bearing mice experiments showed that a remarkably enhance tumor inhibition was observed by the combination of chemo-photothermal-photodynamic therapy compared with photothermal therapy, photodynamic therapy, or chemotherapy alone. In addition, the results of in vivo therapy exhibited that the PC10A/DOX/MoS2 hydrogel with laser irradiation could activate antitumor immune effects to suppress the growth of primary 4T1 breast tumors and distal lung metastatic nodules. Therefore, these results demonstrated that the PC10A/DOX/MoS2 hydrogel was promising to be utilized in antitumor immunity therapy triggered by photothermal therapy and photodynamic therapy for malignant tumor.