Miracle-dz/UniFAR-FTUs huggingface dataset:
The Use of Smartphone-Based Triage to Reduce the Rate of Outpatient Error Registration: Cross-Sectional Study

Background In many clinics, patients now have the option to make Web-based appointments but doing so according to their own judgment may lead to wrong registration and delayed medical services. We hypothesized that smartphone-based triage in outpatient services is superior to Web-based self-appointment registration guided by the medical staff. Objective This study aimed to investigate smartphone-based triage in outpatient services compared with Web-based self-appointment registration and to provide a reference for improving outpatient care under appointment registration. Methods The following parameters in Guangzhou Women and Children’s Medical Center were analyzed: wrong registration rate, the degree of patient satisfaction, outpatient visits 6 months before and after smartphone-based triage, queries after smartphone-based triage, number of successful registrations, inquiry content, and top 10 recommended diseases and top 10 recommended departments after queries. Results Smartphone-based triage showed significant effects on average daily queries, which accounted for 16.15% (1956/12,112) to 29.46% (3643/12,366) of daily outpatient visits. The average daily successful registration after queries accounted for 56.14% (1101/1961) to 60.92% (1437/2359) of daily queries and 9.33% (1130/12,112) to 16.83% (2081/12,366) of daily outpatient visits. The wrong registration rate after smartphone-based triage was reduced from 0.68% (12,810/1,895,829) to 0.12% (2379/2,017,921) (P<.001), and the degree of patient satisfaction was improved. Monthly outpatient visits were increased by 0.98% (3192/325,710) to 13.09% (42,939/328,032) compared with the same period the preceding year (P=.02). Conclusions Smartphone-based triage significantly reduces the wrong registration rate caused by patient Web-based appointment registration and improves the degree of patient satisfaction. Thus, it is worth promoting.
Physical activity, sedentary time and cardiometabolic health indicators among Mexican children

We examined the independent associations of moderate to vigorous physical activity (MVPA) and sedentary time (ST) with cardiometabolic indicators in Mexican children (4‐6 years of age). We conducted a cross‐sectional study (n = 400) using the measures of MVPA and ST (7‐day accelerometry) and the following indicators: % body fat, waist circumference, body mass index (BMI) z‐score, glycated haemoglobin, blood glucose, triglycerides, total cholesterol, low‐density lipoprotein (LDL) cholesterol, high‐density lipoprotein (HDL) cholesterol, leptin, adiponectin and resting blood pressure. We examined the independent associations of MVPA and ST with cardiometabolic indicators through confounder‐adjusted and mutually adjusted (including both MVPA and ST) linear regression models. Confounder‐adjusted models showed that MVPA was associated with higher BMI z‐scores and lower adiponectin levels in girls and lower body fat among boys. ST was associated with higher body fat, in the full sample, and lower LDL cholesterol among boys. After mutually adjusting for MVPA and ST, MVPA (10‐minute increase) remained significantly associated with BMI z‐score in girls (β = 0.187, 95% CI: 0.019, 0.356) and ST (60‐minute increase) remained significantly associated with higher body fat (β = 1.11%, 95% CI: 0.019, 2.203) among boys and higher glycated haemoglobin (β = 0.047% points, 95% CI: 0.000, 0.094) in the full sample. In preschool‐aged children, the objective measures of ST and MVPA were associated with small differences in cardiometabolic health indicators. ST was unfavourably associated with some cardiometabolic indicators even after adjusting for MVPA, and thus appeared to have a more significant role than MVPA, especially in boys. Future longitudinal studies should confirm these results.
Microfluidics-Assisted Size Tuning and Biological Evaluation of PLGA Particles

Polymeric particles made up of biodegradable and biocompatible polymers such as poly(lactic-co-glycolic acid) (PLGA) are promising tools for several biomedical applications including drug delivery. Particular emphasis is placed on the size and surface functionality of these systems as they are regarded as the main protagonists in dictating the particle behavior in vitro and in vivo. Current methods of manufacturing polymeric drug carriers offer a wide range of achievable particle sizes, however, they are unlikely to accurately control the size while maintaining the same production method and particle uniformity, as well as final production yield. Microfluidics technology has emerged as an efficient tool to manufacture particles in a highly controllable manner. Here, we report on tuning the size of PLGA particles at diameters ranging from sub-micron to microns using a single microfluidics device, and demonstrate how particle size influences the release characteristics, cellular uptake and in vivo clearance of these particles. Highly controlled production of PLGA particles with ~100 nm, ~200 nm, and >1000 nm diameter is achieved through modification of flow and formulation parameters. Efficiency of particle uptake by dendritic cells and myeloid-derived suppressor cells isolated from mice is strongly correlated with particle size and is most efficient for ~100 nm particles. Particles systemically administered to mice mainly accumulate in liver and ~100 nm particles are cleared slower. Our study shows the direct relation between particle size varied through microfluidics and the pharmacokinetics behavior of particles, which provides a further step towards the establishment of a customizable production process to generate tailor-made nanomedicines.
Safety and efficacy of the Tablo hemodialysis system for in‐center and home hemodialysis

Introduction: Home hemodialysis remains underutilized despite observational data indicating more favorable outcomes with home compared with in‐center hemodialysis. The Tablo Hemodialysis system is designed to be easy to learn and use and to facilitate adoption of home hemodialysis. The objective of the current investigational device exemption (IDE) study was to evaluate the safety and efficacy of Tablo managed in‐center by health care professionals and in‐home by patients and/or caregivers.
Nanocluster aerosol emissions of a 3D printer.

Many studies exist characterizing the aerosol emissions from fuse ﬁlament fabrication three-dimensional (3D) printers. However, nanocluster aerosol (NCA) particles are rarely studied meaning size range under 3 nm. The purpose of this study was to characterize the NCA emissions and the contribution of NCA to the total number emissions from a 3D printer. We used a particle size magniﬁer (PSM) and a scanning mobility particle sizer (SMPS) to measure the time evolution of particle size distribution, which was used to calculate the average NCA emission rates during a printer operation in a chamber. The NCA emission rates ranged from 1.4·106 to 7.3·109 s-1 depending on the applied combination of ﬁlament material and nozzle temperature, showing increasing emission with increasing temperature. The NCA emissions constitute from 9 up to 48 percent of the total emissions, i.e., almost half of the particle emissions may have been previously neglected. Therefore, it is essential to include the low NCA size range in, e.g., future 3D printer testing protocols, emission measurements standards and risk management measures.
Post-stroke dysphagia rehabilitation in the old and oldest old: outcome and relevance for discharge home

We assessed the outcome of dysphagia rehabilitation in all the 139 patients with post-stroke dysphagia admitted to our Neurorehabilitation Unit during 2 years (2017 and 2018), divided into two groups: old (aged 65–84 years) and oldest-old (aged 85 or above). We studied which factors predicted dysphagia improvement in the two groups. The potential association of improvement with type of discharge was also evaluated. On admission, ‘old’ patients had more frequently aphasia (P = 0.02) and less frequently dysarthria (P = 0.03); ‘oldest old’ had more severe pressure ulcers (P = 0.008), higher levels of c reacting protein (P = 0.01) and more heart problems (P = 0.004). None of these factors was associated with the outcome of dysphagia. We found no difference between the two groups in the severity of dysphagia, as measured with Dysphagia Outcome and Severity Scale on admission and discharge, but due to minor differences, the degree of improvement was higher in the ‘old’ group (P = 0.02). The number of patients discharged with improved swallowing was also comparable. Cognitive impairment had a negative predicting role in the ‘old’ group (odds ratio 0.270, 95% confidence interval 0.101–0.725, P = 0.007). Norton Scale score predicted dysphagia improvement in the ‘oldest old’ group (odds ratio 1.611, 95% confidence interval 1.102–2.355, P = 0.007). Dysphagia improvement was associated with discharge home in general (P = 0.011) and in the ‘old’ group (P = 0.04). Our data, though preliminary, could give a contribution to implement patient-specific rehabilitation strategies; these could increase swallowing improvement in post-stroke dysphagia.
Application of the Academic Research Consortium High Bleeding Risk Criteria in an All-Comers Registry of Percutaneous Coronary Intervention.

BACKGROUND Recently, the Academic Research Consortium for High Bleeding Risk (ARC-HBR) has been proposed to standardize the definition of HBR, which was arbitrarily defined as a Bleeding Academic Research Consortium 3 or 5 bleeding ≥4% at 1-year. However, the prevalence and the expected bleeding event rate of HBR patients defined by ARC-HBR criteria are currently unknown in the real-world percutaneous coronary intervention practice. METHODS We applied the ARC-HBR criteria in the CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) registry cohort-2, a multicenter registry that enrolled 13 058 consecutive patients who underwent their first percutaneous coronary intervention. The primary bleeding end point was defined as the Global Utilization of Streptokinase and Tissue plasminogen activator for Occluded coronary arteries moderate/severe bleeding. There were 5570 patients (43%) in the HBR group and 7488 patients in the no-HBR group. RESULTS Cumulative incidence of the primary bleeding end point was much higher in the HBR group than in the no-HBR group (10.4% versus 3.4% at 1-year, and 18.9% versus 6.6% at 5-year, P<0.0001). Presence of each ARC-HBR major or even minor criterion, in isolation, with the exception of liver cirrhosis and prior ischemic stroke, was also associated with major bleeding risk higher than 4% at 1-year. Cumulative 5-year incidence of the primary bleeding end point got incrementally higher as the number of the ARC-HBR major criteria increased (≥3 majors: 49.9%, 2 majors: 30.6%, 1 major: 18.5%, ≥2 minors: 14.7%, and no-HBR: 6.6%, P<0.0001). CONCLUSIONS ARC-HBR criteria successfully identified those patients with very HBR after percutaneous coronary intervention, who represented 43% of patients in this all-comers registry.
How BamA recruits OMP substrates via poly‐POTRAs domain

Almost all the outer membrane proteins (OMPs) fold into an invariant β‐barrel fold via the polypeptide‐transport‐associated (POTRA) motif and β‐barrel assembly machinery (BAM). However, whether and how poly‐POTRAs interact with OMPs remain largely unknown. Here, we have characterized the structures of Haemophilus influenzae poly‐POTRAs via X‐ray crystallography, small angle X‐ray scattering, and molecular dynamics simulation. Unexpectedly, crystal packing reveals a putative OMP travel pathway spiraled by the conserved α2‐β2 edges in poly‐POTRAs. Supportively, the structure‐based mutations targeting the OMP binding sites significantly disrupt OMP biogenesis, resulting in severe cell growth defects. Another notable feature in H. influenzae POTRA structures is flexibility. As characterized by ELISA assays, poly‐POTRAs could recruit OMP substrates in a step‐wise manner. More importantly, the restriction of POTRA‐POTRA linkage and flexibility significantly impairs the BamA function and causes cell growth defect. Altogether, these results suggest that the β‐strand augmentations and intrinsic flexibility are important factors for BamA‐OMP recruitment. —Ma, X. , Wang, Q. , Li, Y. , Tan, P., Wu, H. , Wang, P., Dong, X. , Hong, L. , Meng, G. How BamA recruits OMP substrates via poly‐POTRAs domain. FASEB J. 33, 14690‐14702 (2019). www.fasebj. org
Investigating the social environment of the A‐not‐B search task

Abstract Controversy exists concerning the origins of object permanence, with different measures suggesting different conclusions. Looking measures have been interpreted as evidence for early understanding (Baillargeon, 1987, Developmental Psychology, 23:655), while Piaget (The construction of reality in the child, 1954) interpreted perseverative reaching behaviour on his AB search task to be indicative of limited understanding. However, looking measures are often reported to be an unreliable index of infant expectation (Haith, 1998, Infant Behaviour and Development, 21:167) and reaching behaviour has been explained by many alternative processes (e.g. Smith et al., 1999, Psychological Review, 106:235; Topál et al., 2008, Science, 321:1831). We aimed to investigate whether social looking (Dunn & Bremner, 2017, Developmental Science, 20:e12452; Walden et al., 2007, Developmental Science, 10:654) can be used as a valid measure of infant expectation of object location during the Piagetian AB search task. Furthermore, we aimed to test the social accounts of perseverative reaching by investigating how the direction of experimenter gaze would affect infant search and social behaviour. Infant search and social behaviour was compared on B trials across three different conditions, namely experimenter gaze to midline, location A and location B. Search performance significantly improved when the experimenter looked to location B. Infant social looking indicated that infants expect the object to be found in the location in which they search and are actively seeking information about object location from the experimenter. We conclude that social looking is a valid index of infant expectation that has provided support for the importance of the social environment on the AB search task. This casts doubt on the potential for this task to provide information related to the development of object permanence in infancy.
Design and characterization of novel dual Fc antibody with enhanced avidity for Fc receptors

Monoclonal antibodies (mAbs) have become an important class of therapeutics, particularly in the realm of anticancer immunotherapy. While the two antigen‐binding fragments (Fabs) of an mAb allow for high‐avidity binding to molecular targets, the crystallizable fragment (Fc) engages immune effector elements. mAbs of the IgG class are used for the treatment of autoimmune diseases and can elicit antitumor immune functions not only by several mechanisms including direct antigen engagement via their Fab arms but also by Fab binding to tumors combined with Fc engagement of complement component C1q and Fcγ receptors. Additionally, IgG binding to the neonatal Fc receptor (FcRn) allows for endosomal recycling and prolonged serum half‐life. To augment the effector functions or half‐life of an IgG1 mAb, we constructed a novel “2Fc” mAb containing two Fc domains in addition to the normal two Fab domains. Structural and functional characterization of this 2Fc mAb demonstrated that it exists in a tetrahedral‐like geometry and retains binding capacity via the Fab domains. Furthermore, duplication of the Fc region significantly enhanced avidity for Fc receptors FcγRI, FcγRIIIa, and FcRn, which manifested as a decrease in complex dissociation rate that was more pronounced at higher densities of receptor. At intermediate receptor density, the dissociation rate for Fc receptors was decreased 6‐ to 130‐fold, resulting in apparent affinity increases of 7‐ to 42‐fold. Stoichiometric analysis confirmed that each 2Fc mAb may simultaneously bind two molecules of FcγRI or four molecules of FcRn, which is double the stoichiometry of a wild‐type mAb. In summary, duplication of the IgG Fc region allows for increased avidity to Fc receptors that could translate into clinically relevant enhancement of effector functions or pharmacokinetics.
Decreasing Expander Breast Infection: A New Drain Care Protocol

BACKGROUND Risk factors for expander reconstruction infection are well known. However, drain use as a risk factor for the development of infection is unclear. OBJECTIVE To review a simple method for drain use to help reduce rates of infection in expander breast reconstruction. METHODS Two hundred consecutive single-surgeon (JDM) immediate first-stage expander breast reconstructions were retrospectively reviewed. The records were reviewed for history and physical examination, intraoperative technique, perioperative management, adjuvant therapy, and outcome with respect to expander infection necessitating premature explantation within the first eight weeks. Infection was defined on clinical basis, with or without culture positivity. All expanders (Mentor, USA) were the same model (textured, port-integrated and biodimensional). Two consecutive series of reconstructions were then created. The first series included 177 reconstructions while the second series included 23 reconstructions. Unlike the first series, the second series introduced a protocol in which all reconstructions received mupirocin 2% cream to the drain sites and all drains were removed at the end of the first week. Additionally, in the second series, all expanders were secluded from direct in vivo contact with the closed suction drain either by the use of an intervening Alloderm sling (LifeCell Corporation, USA, 15 of 23 breasts) or by subdermally tunnelling the drain superficial to an adequate fatty subcutaneous layer (eight of 23 breasts). RESULTS Patients who developed infection in the first series and all patients in the second series shared statistically the same level of aggregate risk factors (P=0.531). The infection rate (5.65%, 10 infections in 177 breasts) in the first series was statistically greater than in the second series (0%, 0 in 23 breasts, P=0.001). CONCLUSIONS The present study found that percutaneous closed suction drains do serve as an increased risk for expander infection. However, early results indicate that in vivo protection of the expander with Alloderm or subdermal tunnelling, topical antibiotic ointment use and early drain removal may significantly reduce expander infection.
Does self-report of aggression after first arrest predict future offending and do the forms and functions of aggression matter?

The current study tested whether a self-report measure of aggression (i.e., the Peer Conflict Scale; PCS) would predict later delinquency, after controlling for other risk factors, and tested whether the different forms and functions of aggression contributed independently to this prediction. Self-report of aggression was assessed at the time of first arrest, and both self-report of delinquency and official arrests were assessed at 5 different time points over a 30-month follow-up period in a sample of male adolescent offenders (N = 1,216; Mage = 15.12, SD = 1.29 years) arrested in 3 regions (i.e., western, southern, northeast) of the United States. Aggression predicted both later total and later violent self-reported delinquency (odds ratio [OR] = 1.02, 95% confidence interval [CI: 1.01, 1.02]), even after controlling for youths' self-reported lifetime history of delinquent acts and callous-unemotional (CU) traits (i.e., Inventory of Callous-Unemotional Traits) collected at initial arrest. Further, only self-reported aggression (but not lifetime delinquency and CU traits) contributed independently (OR = 1.02, 95% CI [1.00, 1.03]) to the prediction of arrests for violent offenses. Finally, the predictive utility of aggression was largely accounted for by physical and reactive aggression, with limited incremental prediction provided by relational and proactive aggression. These findings support the potential utility of self-reports of aggression, such as the PCS, when assessing risk for future violence. Findings also suggest that the utility of these self-reports of aggression cannot be solely accounted for by other risk factors often included in typical risk assessment tools. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Is the Functional Threshold Power a Valid Metric to Estimate the Maximal Lactate Steady State in Cyclists?

Abstract Lillo-Beviá, JR, Courel-Ibáñez, J, Cerezuela-Espejo, V, Morán-Navarro, R, Martínez-Cava, A, and Pallarés, JG. Is the functional threshold power a valid metric to estimate the maximal lactate steady state in cyclists? J Strength Cond Res 36(1): 167–173, 2022—The aims of this study were to determine (a) the repeatability of a 20-minute time-trial (TT20), (b) the location of the TT20 in relation to the main physiological events of the aerobic-anaerobic transition, and (c) the predictive power of a list of correction factors and linear/multiple regression analysis applied to the TT20 result to estimate the individual maximal lactate steady state (MLSS). Under laboratory conditions, 11 trained male cyclists and triathletes (V̇o2max 59.7 ± 3.0 ml·kg−1·min−1) completed a maximal graded exercise test to record the power output associated with the first and second ventilatory thresholds and V̇o2max measured by indirect calorimetry, several 30 minutes constant tests to determine the MLSS, and 2 TT20 tests with a short warm-up. Very high repeatability of TT20 tests was confirmed (standard error of measurement of ±3 W and smallest detectable change of ±9 W). Validity results revealed that MLSS differed substantially from TT20 (bias = 26 ± 7 W). The maximal lactate steady state was then estimated from the traditional 95% factor (bias = 12 ± 7 W) and a novel individual correction factor (ICF% = MLSS/TT20), resulting in 91% (bias = 1 ± 6 W). Complementary linear (MLSS = 0.7488 × TT20 + 43.24; bias = 0 ± 5 W) and multiple regression analysis (bias = 0 ± 4 W) substantially improved the individual MLSS workload estimation. These findings suggest reconsidering the TT20 procedures and calculations to increase the effectiveness of the MLSS prediction.