Miracle-dz/UniFAR-FTUs huggingface dataset:
Distal interphalangeal Joint Arthrodesis using only Kirschner Wires in small distal Phalanges

Abstract Purpose To report the clinical and radiographic results of arthrodesis of relatively small-sized distal interphalangeal joints (DIPJs) using only K-wire fixation. Patients and methods Between January 2000 and December 2018 28 arthrodesis in 21 patients (9 males and 12 females with an average age of 52.1 years) with relatively small-sized DIPJs were performed using only K-wires. Data on patient’s characteristics, such as age, sex, affected finger, and the number and size of the used k-wires were collected from the medical database. The narrowest diameter of the cortex and medulla of the distal phalanx was measured on preoperative plain radiographs. The time to union and the arthrodesis angle was determined using serial X-ray radiography follow-up. Preoperatively and at the latest follow-up examination, pain using the visual analogue scale (VAS) and the quick DASH score was registered. In addition, complications were investigated. Results Average follow-up period was 11.4 months. The small finger was mostly affected (n = 12; 42.9 %). The narrowest diameters of the distal phalanx cortex and the medulla measured on preoperative X-ray images were 2.8 mm (SD 0.5) and 1.2 mm (SD 0.4), respectively. Seven fusions were done with use of 1 K-wire, 20 with 2 (71.4 %), and 1 with 3 K-wires. The most common K-wire sizes were 1.1-inch (24 K-wires = 48 %), and 0.9 inch (21 K-wires = 42 %) The preoperative VAS score and quick DASH score improved from 6.1 (range: 0–9) and 25.8 (range: 2–38) to 0.4 (range: 0–2) and 3.4 (range: 0–10.2), respectively. 25 (89.3 %) out of 28 fingers achieved bony union in an average of 96.1 days (range: 58–114) with three non-union. Conclusion Arthrodesis of small DIPJs with K-wire fixation has a high success rate. Therefore, we suggest K-wire fixation as an acceptable alternative for patients with a small phalanx which may be at risk of mismatch with bigger implants. However, concerns remain in terms of fusion delay with K-wire only fixation.
Christmas holiday triggers of myocardial infarction

Abstract Objectives: Christmas holidays have been associated with the highest incidence of myocardial infarction (MI). We wanted to assess possible triggers of MI during Christmas. Design: A nationwide, retrospective postal survey with case-control design. All individuals suffering an MI during the Christmas holidays 2018 and 2019 in Sweden were identified through the SWEDEHEART registry and a control group matched in age and gender with chronic coronary syndrome who did not seek medical attention during Christmas were asked for participation. Subjects completed a questionnaire asking them to rate 27 potential MI-triggers as having occurred more or less than usual. Results: A total of 189 patients suffering an MI on Christmas Eve, Christmas Day, or Boxing Day, and 157 patients in the control group responded to the questionnaire, representing response rates of 66% and 62%, respectively. Patients with MI on Christmas experienced more stress (37% vs. 21%, p = .002), depression (21% vs. 11%, p = .024), and worry (26% vs. 10%, p < .001) compared to the control group. The food and sweets consumption was increased in both groups, but to a greater extent in the control group (33% vs. 50%, p = .002 and 32% vs. 43%, p = .031). There were no increases in quarrels, anger, economic worries, or reduced compliance with medication. Conclusions: Patients suffering MI on Christmas holiday experienced higher levels of stress and emotional distress compared to patients with chronic coronary syndrome, possibly contributing to the phenomenon of holiday heart attack. Understanding what factors increase the number of MI on Christmas may help reduce the excess number of MIs and cardiovascular burden.
Methotrexate Intolerance

An estimated 11%–33% of persons taking methotrexate for rheumatoid arthritis (RA) are intolerant to this medication. Medications for RA are often discontinued or changed because of patient intolerance. Yet, intolerance is a poorly defined perspective, specifically the patient's perspective. This study used descriptive qualitative methodologies to describe methotrexate intolerance from the perspective of adult patients with RA. Semistructured, audio-recorded individual interviews were conducted with 14 adult English-speaking patients with RA who had been prescribed, were taking, or had ever taken methotrexate. Methotrexate intolerance involves a complex belief system involving 3 themes: beliefs about the risk of methotrexate, beliefs about the benefits of methotrexate, and beliefs about the threat of RA. Participants reported a threshold by which perceived risks and benefits of methotrexate were weighed against perceived risks of RA. The critical underpinnings of the largely undefined and unique patient perspective of methotrexate intolerance are described.
DNA asymmetry promotes SUMO modification of the single‐stranded DNA‐binding protein RPA

Repair of DNA double‐stranded breaks by homologous recombination (HR) is dependent on DNA end resection and on post‐translational modification of repair factors. In budding yeast, single‐stranded DNA is coated by replication protein A (RPA) following DNA end resection, and DNA–RPA complexes are then SUMO‐modified by the E3 ligase Siz2 to promote repair. Here, we show using enzymatic assays that DNA duplexes containing 3' single‐stranded DNA overhangs increase the rate of RPA SUMO modification by Siz2. The SAP domain of Siz2 binds DNA duplexes and makes a key contribution to this process as highlighted by models and a crystal structure of Siz2 and by assays performed using protein mutants. Enzymatic assays performed using DNA that can accommodate multiple RPA proteins suggest a model in which the SUMO‐RPA signal is amplified by successive rounds of Siz2‐dependent SUMO modification of RPA and dissociation of SUMO‐RPA at the junction between single‐ and double‐stranded DNA. Our results provide insights on how DNA architecture scaffolds a substrate and E3 ligase to promote SUMO modification in the context of DNA repair.
Outcomes of clinical decision support for outpatient management of Clostridioides difficile infection

Abstract Objective: To determine the impact of clinical decision support on guideline-concordant Clostridioides difficile infection (CDI) treatment. Design: Quasi-experimental study in >50 ambulatory clinics. Setting: Primary, specialty, and urgent-care clinics. Patients: Adult patients were eligible for inclusion if they were diagnosed with and treated for a first episode of symptomatic CDI at an ambulatory clinic between November 1, 2019, and November 30, 2020. Interventions: An outpatient best practice advisory (BPA) was implemented to notify prescribers that “vancomycin or fidaxomicin are preferred over metronidazole for C.difficile infection” when metronidazole was prescribed to a patient with CDI. Results: In total, 189 patients were included in the study: 92 before the BPA and 97 after the BPA. Their median age was 59 years; 31% were male; 75% were white; 30% had CDI-related comorbidities; 35% had healthcare exposure; 65% had antibiotic exposure; 44% had gastric acid suppression therapy within 90 days of CDI diagnosis. The BPA was accepted 23 of 26 times and was used to optimize the therapy of 16 patients in 6 months. Guideline-concordant therapy increased after implementation of the BPA (72% vs 91%; P = .001). Vancomycin prescribing increased and metronidazole prescribing decreased after the BPA. There was no difference in clinical response or unplanned encounter within 14 days after treatment initiation. Fewer patients after the BPA had CDI recurrence within 14–56 days of the initial episode (27% vs 7%; P < .001). Conclusions: Clinical decision support increased prescribing of guideline-concordant CDI therapy in the outpatient setting. A targeted BPA is an effective stewardship intervention and may be especially useful in settings with limited antimicrobial stewardship resources.
Female and male body image ideals among Arab immigrants and Germans in Germany

ABSTRACT The current study explores cross-cultural differences of male and female body image ideals within a rapidly developing intercultural, immigration context that has garnered a considerable degree of popular and scholarly interest; recent Arab immigration to Germany. One hundred eighty participants (Arab immigrants or ethnic Germans) completed self-report online questionnaires (in either Arabic or German) regarding male and female body image ideals, as well as an assessment of their own body image perception. The data suggest cross-cultural differences in the body image ideals of, and held by, men and women of both groups. Slimmer ideals were held by Germans, especially German women, something that has repercussions for self-perceptions of being over- or under-weight by both Arabs and Germans. Culturally-bound body image ideals are important for the study of demographic changes in such socio-biological patterns as weight, weight-related health issues, and intergroup attraction and reproduction. The current study highlights the importance of psychological research on body image ideals for better understanding trends observed in “objective” measures of physiology (e.g., weight, weight-related health conditions) or relationship patterns (e.g., marriages, reproduction).
The Risk of Nonunion in Smokers Revisited: A Systematic Review and Meta-Analysis

Study Design Systemic review and meta-analysis. Objective To review and establish the effect of tobacco smoking on risk of nonunion following spinal fusion. Methods A systematic search of Medline, Embase, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews from inception to December 31, 2020, was conducted. Cohort studies directly comparing smokers with nonsmokers that provided the number of nonunions and fused segments were included. Following data extraction, the risk of bias was assessed using the Quality in Prognosis Studies Tool, and the strength of evidence for nonunion was evaluated using the GRADE working group criteria. All data analysis was performed in Review Manager 5, and a random effects model was used. Results Twenty studies assessing 3009 participants, which included 1117 (37%) smokers, met inclusion criteria. Pooled analysis found that smoking was associated with increased risk of nonunion compared to not smoking ≥1 year following spine surgery (RR 1.91, 95% CI 1.56 to 2.35). Smoking was significantly associated with increased nonunion in those receiving either allograft (RR 1.39, 95% CI 1.12 to 1.73) or autograft (RR 2.04, 95% CI 1.54 to 2.72). Both multilevel and single level fusions carried increased risk of nonunion in smokers (RR 2.30, 95% CI 1.64 to 3.23; RR 1.79, 95% CI 1.12 to 2.86, respectively). Conclusion Smoking status carried a global risk of nonunion for spinal fusion procedures regardless of follow-up time, location, number of segments fused, or grafting material. Further comparative studies with robust methodology are necessary to establish treatment guidelines tailored to smokers.
FAD-dependent C-glycoside–metabolizing enzymes in microorganisms: Screening, characterization, and crystal structure analysis

Significance Microbial degradation of C-glycosides is only reported from human intestinal bacteria. This study isolated a C-glycoside–catabolizing bacteria, Microbacterium sp. 5-2b, from soil and identified a C-glycoside–metabolizing enzyme. Surprisingly, while the metabolic pathway of C-glycoside in the strain was similar to that of an intestinal one, the enzyme named CarA catalyzing the initial step of metabolism was completely different from an enzyme identified from the intestinal microorganism; CarA identified as C-glycoside 3-oxidase for C-glycoside metabolism exhibited amino acid sequence similarity to pyranose oxidase family proteins. This study clarified the structure, function, and distribution of the enzyme involved in C-glycoside catabolism and provides insight into the biogeochemical circulation of C-glycosides in nature. C-glycosides have a unique structure, in which an anomeric carbon of a sugar is directly bonded to the carbon of an aglycone skeleton. One of the natural C-glycosides, carminic acid, is utilized by the food, cosmetic, and pharmaceutical industries, for a total of more than 200 tons/y worldwide. However, a metabolic pathway of carminic acid has never been identified. In this study, we isolated the previously unknown carminic acid-catabolizing microorganism and discovered a flavoenzyme “C-glycoside 3-oxidase” named CarA that catalyzes oxidation of the sugar moiety of carminic acid. A Basic Local Alignment Search Tool (BLAST) search demonstrated that CarA homologs were distributed in soil microorganisms but not intestinal ones. In addition to CarA, two CarA homologs were cloned and heterologously expressed, and their biochemical properties were determined. Furthermore, a crystal structure of one homolog was determined. Together with the biochemical analysis, the crystal structure and a mutagenesis analysis of CarA revealed the mechanisms underlying their substrate specificity and catalytic reaction. Our study suggests that CarA and its homologs play a crucial role in the metabolism of C-glycosides in nature.
Cancelable HD-SEMG Biometric Identification via Deep Feature Learning

Conventional biometric modalities, such as the face, fingerprint, and iris, are vulnerable against imitation and circumvention. Accordingly, secure biometric modalities with cancelable properties are needed for personal identification, especially in smart healthcare applications. Here we developed a person identification model using high-density surface electromyography (HD-sEMG) as biometric traits. In this model, the HD-sEMG biometric templates are cancelable and could be customized by the users through finger isometric contractions. A deep feature learning approach, implemented by convolutional neural networks (CNNs) is used to capture user-specific patterns from HD-sEMG signals and make identification decisions. This model has been validated on twenty-two subjects, with training and testing data acquired from two different days. The rank-1 identification accuracy and equal error rate for 44 identities (22 subjects × 2 accounts) can reach 87.23% and 4.66%, respectively. The cross-day identification accuracy of the proposed model is higher than the results of previous methods reported in the literature. The usability and efficiency of the proposed model are also investigated, indicating its potentials for practical applications.
A nomogram for preoperative prediction of prolonged air leak after pulmonary malignancy resection

Background Prolonged air leak (PAL) is one of the most common postoperative complications after lung surgery. This study aimed to identify risk factors of PAL after lung resection and develop a preoperative predictive model to estimate its risk for individual patients. Methods Patients with pulmonary malignancies or metastasis who underwent pulmonary resection between January 2014 and January 2018 were included. PAL was defined as an air leak more than 5 days after surgery, risk factors were analyzed. Forward stepwise multivariable logistic regression analysis was performed to identify independent risk factors, and a derived nomogram was built. Data from February 2018 to September 2018 were collected for internal validation. Results A total of 1,511 patients who met study criteria were enrolled in this study. The overall incidence of PAL was 9.07% (137/1,511). Age, percent forced expiratory volume in 1 second, surgical type, surgical approach and smoking history were included in the final model. A nomogram was developed according to the multivariable logistic regression results. The C-index of the predictive model was 0.70, and the internal validation value was 0.77. The goodness-of-fit test was non-significant for model development and internal validation. Conclusions The predictive model and derived nomogram achieved satisfied preoperative prediction of PAL. Using this nomogram, the risk for an individual patient can be estimated, and preventive measures can be applied to high-risk patients.
Butrylacetycholinesterase Activity in Liver and Plasma, Liver Glycogen and Plasma Glucose Content, Haematology and Behaviour of Clariid Catfish Clarias Gariepinus to Dichlorvos

Semi-static bioassay experiment was conducted to ascertain Butrylacetycholinesterase enzyme activity in liver and plasma, liver glycogen and plasma glucose content, haematology as well as behaviour of Clarias gariepinus (mean weight 24.52±1.64 g) to varying concentrations (0, 0.4, 0.8, 1.6 mg L -1 ) of Dichlorvos for 96 hours. Butrylacetycholinesterase activity in liver was significantly (P <0.05) inhibited all through the exposure duration to 0.4, 0.8 and 1.6 mg L -1 of DDVP compared with control group of fish. Similarly, plasma BuChE activity was inhibited all through the exposure duration to 1.6 mg L -1 DDVP compared to control. There was a significant (P <0.05) inhibition in HB, RBC and MCV of exposed fish after 24,48, 72 and 96h to 1.6 mg L -1 DDVP compared to the control but PCV and WBC were significantly elevated after 72 and 96h to 1.6 mg L -1 DDVP compared to the control. Plasma cortisol and liver glycogen were significantly inhibited after 72 and 96 h to 0.8 and 1.6 mg L -1 compared to the control but plasma glucose was elevated after 24, 48, 72 and 96 h exposure to 0.4, 0.8 and 1.6 mg L -1 compared to the control group of fish. The 96 h LC 50 of DDVP to the exposed fish was found to be 0.66 mg L − 1 with safety value estimated to be 0.01 mg L -1 while lower and upper confidence limits gave 0.29 and 1.49 mg L − 1 , respectively. The 96 h LT 50 values for 0.8 and 1.6 mg L -1 was shown to be 79.23 and 60.26 hours with safety values of 3.98 and 3.01 hours respectively. WBC value was inversely related to HB (r=-0.997, p <0.05, RBC (r=-0.999, p <0.05) and PCV (r=-0.953, p <0.05). RBC related positively to HB (r=0.998 and PCV (r=0.959), and inversely to MCH (r=-0.996) and MCHC (r=0.995). Plasma BuChE activity related positively to PCV (r=0.979) and inversely to MCHC (r=-0.995 and TBF (r=984). Liver BuChE related positively with plasma BuChE (r=0.978), plasma cortisol (r= 0.970) and liver glycogen (r= 0.975) and inversely to TBF (r=-0.998). Changes in BuChE activity may serve as surrogate information for projecting potential hazards in the health status of C. gariepinus.
SYNTHESIS, CHARACTERIZATION AND BIOLOGICAL EVALUATION OF INDOLE DERIVATIVES BEARING BENZIMIDAZOLE/BENZOTHIAZOLE MOIETY

Objective: The present work deals with the synthesis and characterization of biologically active new indole derivatives viz., 2-((1 H -benzo[d]imidazol-2-yl)thio)- N -(4-(3-(1 H -indol-3-yl)acryloyl)phenyl)acetamide 6a-d, N -(4-(3-(1 H -indol-3-yl)acryloyl)phenyl)-2-((5-methoxy-1 H -benzo[d]imidazol-2-yl)thio)acetamide 7a-d and N -(4-(3-(1 H -indol-3-yl)acryloyl)phenyl)-2-(benzo[d]thiazol-2-ylthio)acetamide 8a-d. Methods: All these newly synthesized compounds were screened for their in vitro antimicrobial activity by an agar plate diffusion method, antioxidant activities: like 1,1-diphenyl-2-picryl hydrazyl (DPPH) radical scavenging activity (RSA), ferric ions (Fe 3+ ) reducing antioxidant power (FRAP), ferrous (Fe 2+ ) metal ion chelating activity. Results: The structures of all the newly synthesized compounds were characterized by their IR, 1 HNMR, mass spectral studies and elemental analysis. Compounds 6b, 7a, 7b, 8a and 8b exhibited good radical scavenging activity (RSA) at a concentration 100 µg/ml, compounds 7b, 7c, 7d and 8b displayed good ferric ions (Fe 3+ ) reducing antioxidant power (FRAP) at a concentration 100 µg/ml, compounds 7b, 7d, 8b and 8d showed good ferrous (Fe 2+ ) ion metal chelating activity. Compounds 7d and 8d exhibited good activity against all the screened bacteria and fungi. Conclusion: The synthesised compounds 7d having methoxy group at 5 positions of benzimidazoles ring, bromo group at 5 positions of indole ring, and 8d having bromo group at position 5 of indole ring, both the compounds have exhibited potent antimicrobial activity. Some compound s have shown very good antioxidant activity.
New-generation endocytoscopy for optical characterization of elevated-type early gastric cancer

Narrow-band imaging withmagnification is a tool often used to predict the histology of early depressed-type gastric cancer on the basis of the observation of the vascular and surface structure [1]. However, it can be relatively difficult to characterize elevated-type lesions because the alert signs, such as microvascular pattern or demarcation line, are sometimes obscure [2]. New-generation endocytoscopy (single lens, continuous zoom) enables in vivo ultrahigh magnification (×520) for direct visualization at the cellular level and allows a precise pathological prediction of gastrointestinal neoplasia [3]. Herein, we report two patients with gastric elevated lesions that were characterized accurately by endocytoscopy (▶Video 1). Patient 1 An 80-year-old man was referred for endoscopic examination because of intermittent epigastralgia. One 2-cm elevated lesion was found on the posterior wall of gastric antrum using conventional white-light endoscopy (▶Fig. 1 a) and narrow-band imaging (▶Fig. 1 b). Prior to endocytoscopic observation, a mixture of 1% methylene blue and 0.05% crystal violet (CM double staining) was sprayed over the lesion to stain the nuclei and cytoplasm. Endocytoscopy showed some enlarged, disarranged, hyperchromatic nuclei (“enlarged nuclear sign”), with complete distortion of the glandular structure, features which are consistent with gastric cancer (▶Fig. 1 c) [4]. Endoscopic submucosal dissection (ESD) was performed, with histopathology revealing a well-differentiated adenocarcinoma with invasion of the muscularis mucosa (▶Fig. 1d). Patient 2 A 52-year-old man underwent endoscopic examination for longstanding acid regurgitation. A 2-cm elevated lesion was found accidentally on the posterior wall of the prepyloric antrumon endoscopy (▶Fig. 2 a, b). Endocytoscopy was performed after CM double staining and showed a regularly arranged glandular structure, with sparse small round nuclei, which was recognized as being a benign lesion (▶Fig. 2 c). ESD was performed, and the histopathology revealed a hyperplastic polyp (▶Fig. 2d). Endocytoscopy is therefore useful for real-time optical biopsy to distinguish early gastric cancer from non-cancerous lesions.