Miracle-dz/UniFAR-FTUs huggingface dataset:
Does the Choice of Spinal Interbody Fusion Approach Significantly Affect Adjacent Segment Mobility?

The differences in adjacent segment mobility were investigated among lateral lumbar interbody fusion (LLIF), transforaminal lumbar interbody fusion (TLIF), and posterior lumbar interbody fusion (PLIF) with their associated interbody devices. L2–L5 cadaveric spines (n = 21, seven specimens per group) with L3–L4 pedicle screw-rod (PSR)+LLIF, TLIF, or PLIF were tested using pure moment loads (7.5 Nm). LLIF had the least adjacent segment mobility. Study Design. Biomechanical study of range of motion (ROM) at the vertebral levels adjacent to the construct of posterior pedicle screw-rod fixation with different types of lumbar interbody fusion techniques (LIF). Objective. To investigate the differences in adjacent segment mobility among three types of LIF: lateral lumbar interbody fusion (LLIF), transforaminal lumbar interbody fusion (TLIF), and posterior lumbar interbody fusion (PLIF). Summary of Background Data. Previous studies have concluded that LLIF, TLIF, and PLIF with posterior pedicle screw-rod fixation (PSR) provide equivalent stability in cadaveric specimens and are comparable in fusion rate and functional outcome. However, long-term complications, such as adjacent segment degeneration associated with each type of interbody device, are currently unclear. Little is known about the biomechanical effects of interbody fusion technique on the mobility of adjacent segments. Methods. Normalized ROM data at the levels adjacent to L3–L4 PSR fixation with three different types of lumbar interbody fusion approaches (LLIF, TLIF, and PLIF) were analyzed. Intact (n = 21) and instrumented (n = 7 per group) L2–L5 cadaveric specimens were tested multidirectionally under pure moment loading (7.5 Nm). Analysis of variance of adjacent segment ROM among the groups was performed. Statistical significance was set at P < 0.05. Results. Normalized ROM was significantly greater with PLIF than with LLIF in all directions at both proximal and distal adjacent segments (P ≤ 0.02) except for axial rotation at the distal adjacent segment (P = 0.07). TLIF also had greater normalized ROM than LLIF during lateral bending at the proximal adjacent segment (P = 0.008) and during flexion, extension, and lateral bending at the distal adjacent segment (P ≤ 0.03). Normalized ROM was not significantly different between PLIF and TLIF. Conclusion. The choice of lumbar interbody fusion approach influences adjacent segment motion in a cadaveric model. LLIF had the least adjacent segment motion. Level of Evidence: 3
Cysteine‐Rich Angiogenic Inducer 61 Improves Prognostic Accuracy of GRACE (Global Registry of Acute Coronary Events) 2.0 Risk Score in Patients With Acute Coronary Syndromes

Background It remains unclear whether the novel biomarker cysteine‐rich angiogenic inducer 61 (CCN1) adds incremental prognostic value to the GRACE 2.0 (Global Registry of Acute Coronary Events) risk score and biomarkers high‐sensitivity Troponin T, hsCRP (high‐sensitivity C‐reactive protein), and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) in patients with acute coronary syndromes. Methods and Results Patients referred for coronary angiography with a primary diagnosis of acute coronary syndromes were enrolled in the Special Program University Medicine – Acute Coronary Syndromes and Inflammation cohort. The primary/secondary end points were 30‐day/1‐year all‐cause mortality and the composite of all‐cause mortality or myocardial infarction as used in the GRACE risk score. Associations between biomarkers and outcome were assessed using log‐transformed biomarker values and the GRACE risk score (versions 1.0 and 2.0). The incremental value of CCN1 beyond a reference model was assessed using Harrell’s C‐statistics calculated from a Cox proportional‐hazard model. The P value of the C‐statistics was derived from a likelihood ratio test. Among 2168 patients recruited, 1732 could be analyzed. CCN1 was the strongest single predictor of all‐cause mortality at 30 days (hazard ratio [HR], 1.77 [1.31, 2.40]) and 1 year (HR, 1.81 [1.47, 2.22]). Adding CCN1 alone to the GRACE 2.0 risk score improved C‐statistics for prognostic accuracy of all‐cause mortality at 30 days (0.87–0.88) and 1 year (0.81–0.82) and when combined with high‐sensitivity Troponin T, hsCRP, NT‐proBNP for 30 days (0.87–0.91), and for 1‐year follow‐up (0.81–0.84). CCN1 also increased the prognostic value for the composite of all‐cause mortality or myocardial infarction. Conclusions CCN1 predicts adverse outcomes in patients with acute coronary syndromes adding incremental information to the GRACE risk score, suggesting distinct underlying molecular mechanisms. Registration URL: https://www.clinicaltrials. gov. Unique identifier: NCT01000701.
Fracture, fatigue, and friction of polymers in which entanglements greatly outnumber cross-links

Description Longer and stronger; stiff but not brittle Hydrogels are highly water-swollen, cross-linked polymers. Although they can be highly deformed, they tend to be weak, and methods to strengthen or toughen them tend to reduce stretchability. Two papers now report strategies to create tough but deformable hydrogels (see the Perspective by Bosnjak and Silberstein). Wang et al. introduced a toughening mechanism by storing releasable extra chain length in the stiff part of a double-network hydrogel. A high applied force triggered the opening of cycling strands that were only activated at high chain extension. Kim et al. synthesized acrylamide gels in which dense entanglements could be achieved by using unusually low amounts of water, cross-linker, and initiator during the synthesis. This approach improves the mechanical strength in solid form while also improving the wear resistance once swollen as a hydrogel. —MSL Gels and elastomers with sparse cross-links and dense entanglements have improved mechanical properties without embrittlement. In gels and elastomers, the role of entanglements on deformation has been studied, but their effects on fracture, fatigue, and friction are less well understood. In this study, we synthesized polymers in which entanglements greatly outnumber cross-links. The dense entanglements enable transmission of tension in a polymer chain along its length and to many other chains. The sparse cross-links prevent the polymer chains from disentangling. These polymers have high toughness, strength, and fatigue resistance. After submersion in water, the polymers swell to equilibrium, and the resulting hydrogels have low hysteresis, low friction, and high wear resistance.
Differentiation of viral and autoimmune central nervous system inflammation by kynurenine pathway

To determine whether the metabolites of Kynurenine pathway (KP) could serve as biomarkers for distinguishing between viral CNS infections and autoimmune neuroinflammatory diseases, especially anti‐N‐methyl‐D‐aspartate receptor encephalitis (NMDARE) and herpes virus encephalitis (HSE).
Articulatory suppression delays processing of abstract words: The role of inner speech

Compared to concrete concepts, like “book,” abstract concepts expressed by words like “justice” are more detached from sensorial experiences, even though they are also grounded in sensorial modalities. Abstract concepts lack a single object as referent and are characterised by higher variability both within and across participants. According to the Word as Social Tool (WAT) proposal, owing to their complexity, abstract concepts need to be processed with the help of inner language. Inner language can namely help participants to re-explain to themselves the meaning of the word, to keep information active in working memory, and to prepare themselves to ask information from more competent people. While previous studies have demonstrated that the mouth is involved during abstract concepts’ processing, both the functional role and the mechanisms underlying this involvement still need to be clarified. We report an experiment in which participants were required to evaluate whether 78 words were abstract or concrete by pressing two different pedals. During the judgement task, they were submitted, in different blocks, to a baseline, an articulatory suppression, and a manipulation condition. In the last two conditions, they had to repeat a syllable continually and to manipulate a softball with their dominant hand. Results showed that articulatory suppression slowed down the processing of abstract more than that of concrete words. Overall results confirm the WAT proposal’s hypothesis that abstract concepts processing involves the mouth motor system and specifically inner speech. We discuss the implications for current theories of conceptual representation.
Identification of miRNAs That Mediate Protective Functions of Anti-Cancer Drugs During White Matter Ischemic Injury

We have previously shown that two anti-cancer drugs, CX-4945 and MS-275, protect and preserve white matter (WM) architecture and improve functional recovery in a model of WM ischemic injury. While both compounds promote recovery, CX-4945 is a selective Casein kinase 2 (CK2) inhibitor and MS-275 is a selective Class I histone deacetylase (HDAC) inhibitor. Alterations in microRNAs (miRNAs) mediate some of the protective actions of these drugs. In this study, we aimed to (1) identify miRNAs expressed in mouse optic nerves (MONs); (2) determine which miRNAs are regulated by oxygen glucose deprivation (OGD); and (3) determine the effects of CX-4945 and MS-275 treatment on miRNA expression. RNA isolated from MONs from control and OGD-treated animals with and without CX-4945 or MS-275 treatment were quantified using NanoString nCounter® miRNA expression profiling. Comparative analysis of experimental groups revealed that 12 miRNAs were expressed at high levels in MONs. OGD upregulated five miRNAs (miR-1959, miR-501-3p, miR-146b, miR-201, and miR-335-3p) and downregulated two miRNAs (miR-1937a and miR-1937b) compared to controls. OGD with CX-4945 upregulated miR-1937a and miR-1937b, and downregulated miR-501-3p, miR-200a, miR-1959, and miR-654-3p compared to OGD alone. OGD with MS-275 upregulated miR-2134, miR-2141, miR-2133, miR-34b-5p, miR-153, miR-487b, miR-376b, and downregulated miR-717, miR-190, miR-27a, miR-1959, miR-200a, miR-501-3p, and miR-200c compared to OGD alone. Interestingly, miR-501-3p and miR-1959 were the only miRNAs upregulated by OGD, and downregulated by OGD plus CX-4945 and MS-275. Therefore, we suggest that protective functions of CX-4945 or MS-275 against WM injury maybe mediated, in part, through miRNA expression.
Effects of new drug interaction index on drug adherence in older patients with hypertension.

OBJECTIVE Hypertension is a challenging problem in the older population because of poor drug adherence (DA). We aimed to determine the DA and examine the drug interaction index (DII) on DA in older patients with hypertension. METHODS In this cross-sectional, observational study, we enrolled 418 eligible patients aged ≥ 65 years between 1 February 2020 and 30 September 2020 in a tertiary hospital outpatient cardiology clinic. We prepared a questionnaire to record sociodemographic characteristics, morbidities, and drugs used by the population. The Morisky Medication Adherence Scale-8 (MMAS-8) was used for DA assessment. We identified drug interactions using the Lexicomp application. We calculated the DII from a ratio of clinically relevant interaction to total interaction. Descriptive tests and multiple linear regression analyses were performed to find independent factors on DA. RESULTS The mean age (± standard deviation [SD]) was 72.91 (±6.47), and 272/146 were female/male in the study population. The most frequent comorbid disease was diabetes mellitus (23.5%). The percentage of patients having polypharmacy was 39.5, and the mean daily drug (±SD) use was 4.27 (±2.57). The most prescribed antihypertensive drugs were thiazide/derivates (29.8%) and angiotensin receptor blockers (24.8%). The mean MMAS-8 (±SD) was 4.55±0.98, and 321 (76.8%) participants had a poor DA. A total of 33.4% of patients had significant drug interaction. The mean DII (±SD) was 0.345±0.017. The area under the receiver operating characteristic (ROC) curve for DII was 0.616 (95% confidence interval [CI]: 0.547-0.686). CONCLUSION We defined a new index for drug interaction intensity. Furthermore, the DII may be a useful tool to study aspects of DA in older patients with hypertension.
Pre-oviposition Period and Immature Development of Maconellicoccus hirsutus (Hemiptera: Pseudococcidae) on Cucurbita moschata ‘Black Futsu’ Squash

Abstract The developmental time of pink hibiscus mealybug, Maconellicoccus hirsutus (Green), immatures was investigated on the host plant Cucurbita moschata Duchesne ex Poiret variety ‘Black Futsu. ’ Because host plant species influences developmental rates of M. hirsutus, understanding the life history of this specific host plant has implications for the mass rearing protocols of its natural enemy, Anagyrus callidusTriapitsyn, Andreason and Perring, currently being released in California, United States. Fruit from ‘Black Futsu’ squash were infested with first instar pink hibiscus mealybug and kept at 26.6 ± 2°C, 50 ± 10% RH, and 0:24 (L:D) h photoperiod for the duration of the experiment. Every 24 h the life stages of pink hibiscus mealybug individuals on the squash were recorded. After adult eclosion, observations of adult females continued until the first eggs hatched, which revealed an average pre-oviposition period of 7.2 ± 0.1 d and an average length of the egg stage of 7.0 ± 0.0 d. The average developmental times for both sexes were similar from the egg stage through the second instar.Third instar females took nearly twice as long (7.2 d) to develop into adults as did third instar males. However, females have just three immature instars while males have four.The males spent an average of 4.5 ± 0.3 d as third instars and 4.8 ± 0.4 d as fourth instars before developing into winged adults. On average, female immature developmental time was 27.8 ± 0.2 d from egg to adult and male developmental time was 29.4 ± 0.2 d from egg to adult.The implications of these results on rearing A. callidus are discussed.
Riboswitch-mediated inducible expression of an astaxanthin biosynthetic operon in plastids

Abstract The high-value carotenoid astaxanthin (3,3′-dihydroxy-β,β-carotene-4,4′-dione) is one of the most potent antioxidants in nature. In addition to its large-scale use in fish farming, the pigment has applications as a food supplement and an active ingredient in cosmetics and in pharmaceuticals for the treatment of diseases linked to reactive oxygen species. The biochemical pathway for astaxanthin synthesis has been introduced into seed plants, which do not naturally synthesize this pigment, by nuclear and plastid engineering. The highest accumulation rates have been achieved in transplastomic plants, but massive production of astaxanthin has resulted in severe growth retardation. What limits astaxanthin accumulation levels and what causes the mutant phenotype is unknown. Here, we addressed these questions by making astaxanthin synthesis in tobacco (Nicotiana tabacum) plastids inducible by a synthetic riboswitch. We show that, already in the uninduced state, astaxanthin accumulates to similarly high levels as in transplastomic plants expressing the pathway constitutively. Importantly, the inducible plants displayed wild-type–like growth properties and riboswitch induction resulted in a further increase in astaxanthin accumulation. Our data suggest that the mutant phenotype associated with constitutive astaxanthin synthesis is due to massive metabolite turnover, and indicate that astaxanthin accumulation is limited by the sequestration capacity of the plastid.
Demographic correlates of inflammatory and antiviral gene expression in the study of Midlife in the United States (MIDUS)

ABSTRACT The present study examined the demographic correlates of gene expression in a sample of adults (n = 543) from the Study of Midlife in the United States (MIDUS). Inflammatory and antiviral gene sets were operationalized using a priori composite scores and empirically derived co-regulatory gene sets. For both composite scores and co-regulatory gene sets, White/European Americans showed lower while Black/African Americans showed higher expression of genes involved in interferon responses and antibody synthesis. The effects of chronological age on gene expression varied by sex, such that pro-inflammatory gene expression increased with age more rapidly for females than males. The difference between the average expression of inflammatory and antiviral genes also increased with age for females but not males. Results shed light on differential gene expression as a potential physiological correlate for race/ethnicity, age, and sex-related health disparities in adulthood.
Combined Platelet Rich Plasma and Amniotic membrane in the treatment of Perforated Corneal Ulcers

Purpose To report the outcomes of using synthetic amniotic membrane with platelet rich plasma for the primary management of corneal perforations. Setting Ophthalmology department. Faculty of Medicine, Minia University, Minia, Egypt Methods A case series of 10 patients diagnosed with corneal perforation underwent emergency surgical procedure for repair of the perforation through the implantation of synthetic amniotic membrane with platelet-rich plasma clot under it and the application of platelet-rich plasma eye drops, with a follow up period of up to 4 weeks. Results All cases demonstrated formation of adequate intraocular pressure digitally, within the first 7 days, and all cases showed complete sealing of the corneal perforation within the 4 weeks follow up period, mild symptoms were reported only in the 1st postoperative week like foreign body sensation and lacrimation. 3 of the treated patients underwent penetrating keratoplasty after 6 months with satisfactory visual outcomes. Conclusion The combination of amniotic membrane implant and platelet rich plasma in both the clot and eye drop forms is an effective and easy accessible method for the primary management of corneal perforations
Activity of daily living in mucopolysaccharidosis IVA patients: Evaluation of therapeutic efficacy

Mucopolysaccharidosis IVA (MPS IVA, also called Morquio A syndrome) is caused by a deficiency of N‐acetylglucosamine‐6‐sulfate sulfatase (GALNS) and results in skeletal dysplasia symptoms such as short stature and abnormal gait. Treatments include enzyme replacement therapy (ERT) and hematopoietic stem cell transplantation (HSCT), but the effects are limited depending on the age of initiation and clinical phenotype. Thus, this study aims to assess the effects of treatments on MPS IVA patients compared to untreated MPS IVA patients and an age‐matched control group.
Low awareness of non-alcoholic fatty liver disease in patients with type 2 diabetes in Swedish Primary Health Care

Abstract Objectives Non-alcoholic fatty liver disease (NAFLD) is more common in patients with type 2 diabetes mellitus (T2DM) compared to individuals without. Recent guidelines recommend screening for NAFLD in patients with T2DM. Our aim was to investigate the prevalence of NAFLD in patients with T2DM in a Swedish primary health care setting, how they are cared for and assess the risk of biochemical signs of advanced fibrosis. Material and methods In this cohort study, patients with T2DM from five primary health care centers were included. Medical records were retrospectively reviewed and living habits, medical history, results of diagnostic imaging and anthropometric and biochemical features were noted in a standardized form. The risk of steatosis and advanced fibrosis was assessed using commonly used algorithms (FLI, HSI, NAFLD-LFS, NAFLD ridge score, FIB-4 and NFS). Results In total 350 patients were included. Diagnostic imaging had been performed in 132 patients and of these, 34 (26%) had steatosis, which was not noted in the medical records in 16 (47%) patients. One patient with steatosis had been referred to a hepatologist. Of assessable patients, 71–97% had a high to intermediate risk of steatosis and 29–65% had an intermediate to high risk of advanced fibrosis according to the algorithms used. Conclusion This study indicates a high prevalence of NAFLD among T2DM patients in Swedish primary care. Patients with known NAFLD were followed up to a very low extent. Using fibrosis algorithms in primary health care would result in many patients needing further assessment in secondary care.
Cyclic helix B peptide promotes random‐pattern skin flap survival via TFE3‐mediated enhancement of autophagy and reduction of ROS levels

Necrosis of random‐pattern skin flaps limits their clinical application. Helix B surface peptide (HBSP) protects tissues from ischaemia–reperfusion injury but its short plasma half‐life limits its applications. Here, we have synthesized cyclic helix B peptide (CHBP) and investigated its role in flap survival and the underlying mechanisms.
Implant Microbial Colonization Detected by Sonication as a Cause for Spinal Device Failure

Clinical presentation of implant chronic infection is unspecific. Consequently, implant sonication followed by culture should be performed. The present study identified screw loosening, screw breakage, not receiving prophylactic cefazolin, ICU hospitalization, and L1-L3 instrumentation level being associated with spinal implant infection. Consideration of these factors could help patient's management. Study Design. A prospective single center observational study. Objectives. The aim of this study was to examine the potential role of sonication in the diagnosis of low-grade infections and its association with pedicle screw (PS) loosening, and to describe risk factors and radiological findings associated with spinal implant infection. Summary of Background Data. Although PS loosening has mainly been attributed to mechanical overload, implant colonization and biofilm formation have recently been suggested. Culturing of sonication fluid implants is promising in the field of spine instrumentation infection, but little data are available. Methods. We prospectively included all patients who were subjected to implant removal. PS loosening was assessed with computed tomography (CT) scan. Different clinical and radiological parameters which could serve as indicators of implant infection were studied. Results. Thirty-eight patients were included in the study and 11 of them (29%) had a positive sonication result. Patients with spinal implant infection were associated with screw loosening (P = 0.005). Particularly, those screws with a positive microbiological culture showed signs of screw loosening in the preoperative CT scan (P < 0.001). Our results also showed that radiological screw loosening at L1-L3 level, and loosened larger constructs were associated with screw microbial colonization. The most common isolated microorganisms were coagulase-negative staphylococci and Cutibacterium acnes. An implant-based multivariate analysis indicated that screw loosening, the absence of prophylactic cefazolin, ICU hospitalization, screw breakage, and L1-L3 spine level were independent risk factors for implant-associated infection. Our model exhibited a high predictive power with an area under the curve of 0.937. Conclusion. As clinical presentation of deep implant chronic infection is unspecific, consideration of these factors enables preoperative prediction and risk stratification of implant colonization, thus helping patient's management. Level of Evidence: 3