Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Practice Guideline for Postoperative Rehabilitation in Older Patients With Hip Fractures

Objective The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. Conclusion This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.
Air-Water Annular Two-Phase Flow in Horizontal and Near Horizontal Tubes

An experimental investigation was conducted concerning the circumferential variations of the characteristics of a liquid film formed on the inner surface of a round tube. Attention was paid to the characteristics of the disturbance wave which plays important roles in the maintenance a liquid film near the top of the tube and the transportation of liquid. The circumferential variations of film thickness parameters and the effect of pipe inclination on those parameters were examined. The main results are summarized as follows:(1) Wave height of the base film, hB, is approximately equal to the mean base film thickness, tBm, and the effect of pipe inclination and flow rates of both air and water on hB is qualitatively the same as that on tBm, (2) Disturbance wave height is five to twenty times of tBm, and it depends strongly on superficial water velocity, j1, while tBm has a weak dependence on j1. (3) The generation of a disturbance wave is mainly controlled by the flow condition of the base film at the bottom. (4) The flow mechanism of the base film changes at the liquid flow rate of j1=0.04m/s.
Pain Experience in Pancreatitis: Strong Association of Genetic Risk Loci for Anxiety and PTSD in Patients With Severe, Constant, and Constant-Severe Pain

INTRODUCTION: Recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP) are progressive inflammatory syndromes with variable features. Pain is the primary feature that contributes to low physical and mental quality of life with a third of patients reporting severe pain. Pain experience is worsened by depression. Here, we tested the hypothesis that genetic risk of the psychiatric conditions of anxiety and post-traumatic stress disorder (PTSD) is associated with pain in CP and RAP + CP subjects. METHODS: The study cohort included phenotyped and genotyped RAP and CP patients from the North American Pancreatitis Study II of European Ancestry. Candidate genetic association studies were based on the absence of pain vs pain that is constant, constant-severe, or severe. Twenty-eight candidate genetic loci for anxiety and PTSD risk were identified in the literature and were the focus of this study. RESULTS: We identified 24 significant pain-associated single nucleotide polymorphisms within 13 loci across the 3 pain patterns in CP and RAP + CP (P < 0.002). Thirteen anxiety or PTSD genes were within these pain loci indicating nonrandom associations (P < 4.885 × 10−23). CTNND2 was associated with all pain categories and all pancreatitis etiologies. Implicated systems include neuronal signaling (HTR2A, DRD3, NPY, and BDNF), hypothalamic-pituitary-adrenal axis (NR3C1 and FKBP5), and cell-cell interaction (CTNND2 and THBS2). DISCUSSION: A component of constant and severe pain in patients with RAP and CP is associated with genetic predisposition to anxiety and PTSD. Identification of patients at risk eligible for trials of targeted treatment as a component of a multidisciplinary pain management strategy should be formally evaluated.
Microencapsulation of Phyllanthus emblica L. Fruit Juice

Phyllanthus emblica L. fruit juice was microencapsulated by spray drying for retaining its nutrients and extending its scope of application. The microencapsulation conditions were optimized based on the microencapsulation rate and retention rate of VC and powder yield. The optimal microcapsule wall was a mixture of arabic gum with maltodextrin(1:1, m/m) with a core-to-wall material ratio of 1:5(m/m). Using combination of single factor and orthogonal array designs, the optimal spray drying conditions were determined as follows: solid content, 20%; feeding flow rate, 8 m L/min; input temperature, 140 ℃; and air velocity, 0.6 m3/min. Under these conditions, the yield of powder was 64.83%, the retention rate of vitamin C was 67.33%, and light yellow powder was obtained with a moisture content of 5.59%.
The association between lunch composition and obesity in Iranian adults

Abstract We aimed to assess the dietary composition of lunch meal using a posteriori-derived dietary patterns and to determine the association of lunch composition with obesity in a sample of Iranian adults. This cross-sectional study was conducted on 850 men and women in Tehran (aged 20–59 years). Dietary intakes were assessed using three 24-h dietary recalls, and dietary patterns were identified via principal component factor analysis. For each identified pattern, scores were calculated for each participant and then classified into tertiles. Central obesity was defined WHO criteria. General obesity was defined as a BMI of more than 30 kg/m2. Three major dietary patterns were identified at lunch meal using twelve food groups: ‘Bread, grains and fat’, ‘Western’ and ‘Potato and eggs’. After adjustment for potential confounders, participants at the top tertile of the ‘Bread, grains and fat’ dietary pattern had greater odds for a higher waist-to-hip ratio (WHR), compared with those in the lowest tertile (OR: 1·44, 95 % CI 1·01, 2·07). However, we found no association between ‘Western’ or ‘potato and eggs’ patterns and WHR (OR: 0·89, 95 % CI 0·62, 1·28 and OR: 1·16, 95 % CI 0·69, 1·42, respectively). None of the identified dietary patterns was associated when defining obesity with waist circumference or BMI. In conclusion, participants had a greater chance of central obesity defined based on WHR following a lunchtime pattern with a higher and positive loading factor for ‘Bread, grains and fat’.
An ultrasound protocol for temporomandibular joint in juvenile idiopathic arthritis: a pilot study

Objectives: As it is well known, the diagnosis of temporomandibular joint (TMJ) involvement in patients affected by Juvenile Idiopathic Arthritis (JIA) is important to avoid the impairment of mandibular growth. In this context, Magnetic Resonance Imaging (MRI) is the gold-standard for detection of TMJ involvement, however it is expensive and requires patients’ collaboration. The aim of this study was to evaluate if ultrasound may be used as an alternative tool to investigate the acute signs of TMJ involvement in JIA patients. Methods: Lateral periarticular space (LPAS) and joint effusion were evaluated by ultrasound in a study Group A of 8 JIA children (11.6±3.5 years old) with 14 TMJs involved, as confirmed by MRI, and in a control Group B of 7 healthy children (9.3±1.2 years old) without temporomandibular disorders (TMD). The LPAS width values were compared between the two groups using the Mann–Whitney test. The ultrasound images of the JIA group were then matched with the corresponding MR images; the Spearman Rank Correlation test and the Bland–Altman test were used to evaluate the differences. Results: The LPAS values in Group A were statistically significantly higher than those in Group B (p < 0.001). There was no overlap of the LPAS values confidence intervals (CIs) between the two groups. No signs of joint effusion were identified in groups A and B. The Spearman test applied to the values of LPAS measured in ultrasound and the corresponding MR images showed a proportional positive correlation with a ρ of 0.623 and a p < 0.05. Conclusions: Ultrasound can detect differences in the TMJ features between JIA patients and healthy patients and it might be used as a follow-up tool in the assessment of TMJ involvement in subject affected by JIA.
Identifying Best Practices for Managing Internal Carotid Artery Injury During Endoscopic Endonasal Surgery by Consensus of Expert Opinion

Background Injury to the internal carotid artery (ICA) is a potentially devastating complication of endoscopic endonasal surgery (EES) that as many as 20% of skull base surgeons will experience at least once during their careers. Managing these injuries is difficult given the small operative field and poor visibility created by high-flow hemorrhage, and, at present, there is no consensus regarding best practices. Objective This study seeks to consolidate the practices and opinions of experienced skull base surgeons from high-volume tertiary care centers into a single consensus statement regarding the best practices for managing ICA injuries during EES. Methods A panel of 23 skull base surgeons (15 neurosurgeons and 8 otolaryngologists) completed a 3-round Delphi survey that assessed experiences and opinions regarding various aspects of ICA injury management. Mean (SD) years since fellowship completion was 15.6 (8.1) and all but 3 surgeons had experienced an ICA injury at least once. Results The final consensus statement included 36 guidelines all of which were grouped under 1 of 4 categories: 11 statements concerned preoperative management and equipment for high-risk patients; 14 statements concerned hemorrhage control; 4 statements concerned definitive management; 7 statements concerned pharmacologic treatment, blood pressure, and neurophysiologic monitoring. Conclusions There are numerous decisions that a surgeon must make when facing a carotid artery injury. In our estimation, many questions can be grouped under 1 of the 4 categories outlined in our consensus statement and can be addressed by these findings.
Identification of the Coenzyme A (CoA) Ester Intermediates and Genes Involved in the Cleavage and Degradation of the Steroidal C-Ring by Comamonas testosteroni TA441

Studies on bacterial steroid degradation were initiated more than 50 years ago primarily to obtain materials for steroid drugs. Steroid-degrading bacteria are globally distributed, and the role of bacterial steroid degradation in the environment, as well as in humans, is attracting attention. ABSTRACT Comamonas testosteroni TA441 degrades steroids aerobically via aromatization of the A-ring accompanied by B-ring cleavage, followed by D- and C-ring cleavage. We previously revealed major enzymes and intermediate compounds in A,B-ring cleavage, the β-oxidation cycle of the cleaved B-ring, and partial C,D-ring cleavage. Here, we elucidate the C-ring cleavage and the β-oxidation cycle that follows. ScdL1L2, a 3-ketoacid coenzyme A (CoA) transferase which belongs to the SugarP_isomerase superfamily, was thought to cleave the C-ring of 9-oxo-1,2,3,4,5,6,10,19-octanor-13,17-secoandrost-8(14)-ene-7,17-dioic acid-CoA ester, the key intermediate compound in the degradation of 9,17-dioxo-1,2,3,4,10,19-hexanorandrostan-5-oic acid (3aα-H-4α [3′-propionic acid]-7aβ-methylhexahydro-1,5-indanedione; HIP)-CoA ester in our previous study; however, the present study suggested that ScdL1L2 is the isomerase of the derivative with a hydroxyl group at C-14 which cleaves the C-ring. The subsequent ring-cleaved product was indicated to be converted to 4-methyl-5-oxo-octane-1,8-dioic acid-CoA ester mainly by ORF33-encoded CoA-transferase (named ScdJ), followed by dehydrogenation by ORF21- and 22-encoded acyl-CoA dehydrogenase (named ScdM1M2). Then, a water molecule is added by ScdN for further degradation by β-oxidation. ScdN is proposed to catalyze the last reaction in C,D-ring degradation by the enzymes encoded in the steroid degradation gene cluster tesB to tesR. IMPORTANCE Studies on bacterial steroid degradation were initiated more than 50 years ago primarily to obtain materials for steroid drugs. Steroid-degrading bacteria are globally distributed, and the role of bacterial steroid degradation in the environment, as well as in humans, is attracting attention. The overall degradation process of the four steroidal rings has been proposed; however, there is still much to be revealed to understand the complete degradation pathway. This study aimed to uncover the whole steroid degradation process in C. testosteroni, which is one of the most studied representative steroid-degrading bacteria and is suitable for exploring the degradation pathway because the involvement of degradation-related genes can be determined by gene disruption.
Real-Time Respiratory Tumor Motion Prediction Based on a Temporal Convolutional Neural Network: Prediction Model Development Study

Background The dynamic tracking of tumors with radiation beams in radiation therapy requires the prediction of real-time target locations prior to beam delivery, as treatment involving radiation beams and gating tracking results in time latency. Objective In this study, a deep learning model that was based on a temporal convolutional neural network was developed to predict internal target locations by using multiple external markers. Methods Respiratory signals from 69 treatment fractions of 21 patients with cancer who were treated with the CyberKnife Synchrony device (Accuray Incorporated) were used to train and test the model. The reported model’s performance was evaluated by comparing the model to a long short-term memory model in terms of the root mean square errors (RMSEs) of real and predicted respiratory signals. The effect of the number of external markers was also investigated. Results The average RMSEs of predicted (ahead time=400 ms) respiratory motion in the superior-inferior, anterior-posterior, and left-right directions and in 3D space were 0.49 mm, 0.28 mm, 0.25 mm, and 0.67 mm, respectively. Conclusions The experiment results demonstrated that the temporal convolutional neural network–based respiratory prediction model could predict respiratory signals with submillimeter accuracy.
Scaffold-based and scaffold-free cardiac constructs for drug testing

The safety and therapeutic efficacy of new drugs are tested in experimental animals. However, besides being a laborious, costly process, differences in drug responses between humans and other animals and potential cardiac adverse effects lead to the discontinued development of new drugs. Thus, alternative approaches to animal tests are needed. Cardiotoxicity and responses of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) to drugs are conventionally evaluated by cell seeding and two-dimensional (2D) culture, which allows measurements of field potential duration and the action potentials of CMs using multielectrode arrays. However, 2D-cultured hiPSC-CMs lack 3D spatial adhesion, and have fewer intercellular and extracellular matrix interactions, as well as different contractile behavior from CMs in vivo. This issue has been addressed using tissue engineering to fabricate three-dimensional (3D) cardiac constructs from hiPSC-CMs cultured in vitro. Tissue engineering can be categorized as scaffold-based and scaffold-free. In scaffold-based tissue engineering, collagen and fibrin gel scaffolds comprise a 3D culture environment in which seeded cells exhibit cardiac-specific functions and drug responses, whereas 3D cardiac constructs fabricated by tissue engineering without a scaffold have high cell density and form intercellular interactions. This review summarizes the characteristics of scaffold-based and scaffold-free cardiac tissue engineering and discusses the applications of fabricated cardiac constructs to drug screening.
Toxoplasma gondii in domiciled dogs and cats in urban areas of Brazil: risk factors and spatial distribution

Toxoplasma gondii is a highly prevalent zoonotic parasite in Brazil capable of infecting mammals and birds. The increase in the urban populations of pets and the narrowing of the human–animal relationship can facilitate the transmission of important public health zoonoses, such as toxoplasmosis. This study aimed to evaluate the frequency and spatial distribution of T. gondii infection and its risk factors in domiciled dogs and cats attended at the Jorge Vaitsman Institute, Rio de Janeiro. Serum samples from 400 dogs and 272 cats were evaluated by an indirect fluorescent antibody test (IFAT) for IgG anti-T. gondii antibodies. Epidemiological questionnaires were used to interview the animals’ owners to identify risk factors for infection. Of the total, 34% (136/400) of dogs and 8.1% (22/272) of cats had anti-T. gondii antibodies. Breed (OR: 2.10–95%, CI 1.27–3.46) was a risk factor for dogs, while sex (OR: 3.40–95%, CI 1.10–10.52) and homemade food consumption (OR: 8.49–95%, CI 2.48–29.05) were risk factors for cats. Offal consumption was considered a risk factor for both species evaluated (OR: 2.74–95%, CI 1.38–5.43 for dogs; OR: 7.66–95%, CI 1.24–47.29 for cats). The spatial analysis showed that T. gondii seropositive animals were widely distributed in the metropolitan region of Rio de Janeiro state, with a concentration observed mainly in the west and north zones of Rio de Janeiro city. The results emphasize the importance of adopting prophylactic measures to control T. gondii transmission in domiciled dogs and cats in Rio de Janeiro, contributing positively to public health.
The cecal appendix is correlated with greater maximal longevity in mammals

The cecal appendix had been considered as a useless vestige since Darwin's work, but recent research questioned this idea demonstrating that the cecal appendix appeared among the mammals at least 80 million years ago and has made multiple and independent appearances without any obvious correlation with diet, social life, ecology, or size of the cecum. However, functions and probable selective advantage conferred by this anatomical structure still remain enigmatic. We found, through analyses of data on 258 mammalian species, that cecal appendix presence is correlated with increased maximal observed longevity. This is the first demonstration of a correlation between cecal appendix presence and life history. Interestingly, the classical evolutionary theory of aging that predicts an increased longevity when the extrinsic mortality is reduced has been questioned several times, but recent comparative studies asserted its validity in the taxa, which experience age‐dependent and density‐dependent mortality, as in mammals. Thus, the cecal appendix may contribute to the increase in longevity through a reduction of extrinsic mortality. A lower risk of fatal infectious diarrhea is one of the most plausible hypotheses that could explain it. However, several hypotheses coexist about the possible functions of the cecal appendix, and our results provide new insights about this much‐disputed question. In addition, we show that the cecal appendix arose at least 16 times and was lost only once during the evolutionary history of the considered mammals, an asymmetry that supports the existence of a positive selective of this structure.
The effectiveness of telehealth for a caregiver wellness program

Introduction This study compared outcomes of a telehealth and in-person delivered caregiver wellness program called Powerful Tools for Caregivers (PTC). Methods A total of 11 pairs of PTC class leaders delivered in-person and telehealth PTC classes. Caregiver participants completed a health-related questionnaire one week before, one week after, and six months after completing the program. A split-plot, mixed-design analysis of variance (ANOVA) and t tests were used to examine attendance and health-related outcome measures: depression as measured by the Center for Epidemiological Studies Depression Scale-Revised (CESD-R), caregiver experience as measured by the Bakas Caregiving Outcomes scale (BCOS), caregiver self-efficacy, and number of negative self-care behaviors. Results A total of 72 caregivers attended PTC in-person and 42 attended via telehealth. Mean attendance was 4.97 ± 1.21 for the in-person group and 5.21 ± 0.071 for the telehealth group, with no significant difference between delivery formats t(112) = 1.074, p = 0.285; 23 caregivers completed all three assessment periods for ANOVA. Interaction of group and time was non-significant for all outcome measures and the main effect of group was only significant for CESD-R scores at pre-PTC assessment, indicating that there were no differences between the two delivery formats for outcomes at post test or six months. The effect of time was significant for all outcome measures, indicating both in-person and telehealth participants improved on health-related outcomes over time. Discussion Telehealth is an effective delivery format for PTC – a traditionally in-person caregiver wellness program. This trial was registered [ClinicalTrials.gov identifier: NCT03800238].
Association of Plasma Uremic Solute Levels with Residual Kidney Function in Children on Peritoneal Dialysis

Visual Abstract Background and objectives Residual native kidney function confers health benefits in patients on dialysis. It can facilitate control of extracellular volume and inorganic ion concentrations. Residual kidney function can also limit the accumulation of uremic solutes. This study assessed whether lower plasma concentrations of uremic solutes were associated with residual kidney function in pediatric patients on peritoneal dialysis. Design, setting, participants, & measurements Samples were analyzed from 29 pediatric patients on peritoneal dialysis, including 13 without residual kidney function and ten with residual kidney function. Metabolomic analysis by untargeted mass spectrometry compared plasma solute levels in patients with and without residual kidney function. Dialytic and residual clearances of selected solutes were also measured by assays using chemical standards. Results Metabolomic analysis showed that plasma levels of 256 uremic solutes in patients with residual kidney function averaged 64% (interquartile range, 51%–81%) of the values in patients without residual kidney function who had similar total Kt/Vurea. The plasma levels were significantly lower for 59 of the 256 solutes in the patients with residual kidney function and significantly higher for none. Assays using chemical standards showed that residual kidney function provides a higher portion of the total clearance for nonurea solutes than it does for urea. Conclusions Concentrations of many uremic solutes are lower in patients on peritoneal dialysis with residual kidney function than in those without residual kidney function receiving similar treatment as assessed by Kt/Vurea.