Miracle-dz/UniFAR-FTUs huggingface dataset:
German version of the Chelsea Critical Care Physical Assessment Tool (CPAx-GE): translation, cross-cultural adaptation, validity, and reliability

Abstract Purpose To translate and cross-culturally adapt the Chelsea Critical Care Physical Assessment tool from English to German (CPAx-GE) and to examine its validity and reliability. Materials and methods Following a forward-backward translation including an expert round table discussion, the measurement properties of the CPAx-GE were explored in critically ill, mechanically ventilated adults. We investigated construct, cross-sectional, and cross-cultural validity of the CPAx-GE with other measurement instruments at pre-specified timepoints, analysed relative reliability with intraclass correlation coefficients (ICCs) and determined absolute agreement with the Bland–Altman plots. Results Consensus for the translated CPAx-GE was reached. Validity was excellent with >80% of the pre-specified hypotheses accepted at baseline, critical care, and hospital discharge. Interrater reliability was high (ICCs > 0.8) across all visits. Limit of agreement ranged from −2 to 2 points. Error of measurement was small, floor, and ceiling effects limited. Conclusions The CPAx-GE demonstrated excellent construct, cross-sectional, and cross-cultural validity as well as high interrater reliability in critically ill adults with prolonged mechanical ventilation at baseline, critical care, and hospital discharge. Consequently, the CPAx-GE can be assumed equal to the original and recommended in the German-speaking area to assess physical function and activity of critically ill adults across the critical care and hospital stay. Trial registration: German Clinical Trials Register (DRKS) identification number: DRKS00012983 (https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00012983), registered on 20 September 2017, first patient enrolled on 21 November 2017. Implications for rehabilitation Early rehabilitation of critically ill patients is recommended to prevent and treat the subsequent functional disability, but a suitable measurement instrument for the German-speaking area is lacking. The translated, cross-culturally adapted German CPAx demonstrated excellent validity and reliability in assessing physical function and activity in critically ill adults. Cross-sectional validity of the CPAx has been newly established and allows the use of this tool at clinically relevant time-points in the course of a critical illness. The CPAx-GE can therefore be used in clinical practice by German-speaking therapists to assess physical function and activity during early rehabilitation in the ICU and hospital.
Clinical Decision Support Systems in Otolaryngology–Head and Neck Surgery: A State of the Art Review

Objective To offer practical, evidence-informed knowledge on clinical decision support systems (CDSSs) and their utility in improving care and reducing costs in otolaryngology–head and neck surgery. This primer on CDSSs introduces clinicians to both the capabilities and the limitations of this technology, reviews the literature on current state, and seeks to spur further progress in this area. Data Sources PubMed/MEDLINE, Embase, and Web of Science. Review Methods Scoping review of CDSS literature applicable to otolaryngology clinical practice. Investigators identified articles that incorporated knowledge-based computerized CDSSs to aid clinicians in decision making and workflow. Data extraction included level of evidence, Osheroff classification of CDSS intervention type, otolaryngology subspecialty or domain, and impact on provider performance or patient outcomes. Conclusions Of 3191 studies retrieved, 11 articles met formal inclusion criteria. CDSS interventions included guideline or protocols support (n = 8), forms and templates (n = 5), data presentation aids (n = 2), and reactive alerts, reference information, or order sets (all n = 1); 4 studies had multiple interventions. CDSS studies demonstrated effectiveness across diverse domains, including antibiotic stewardship, cancer survivorship, guideline adherence, data capture, cost reduction, and workflow. Implementing CDSSs often involved collaboration with health information technologists. Implications for Practice While the published literature on CDSSs in otolaryngology is finite, CDSS interventions are proliferating in clinical practice, with roles in preventing medical errors, streamlining workflows, and improving adherence to best practices for head and neck disorders. Clinicians may collaborate with information technologists and health systems scientists to develop, implement, and investigate the impact of CDSSs in otolaryngology.
Recipient Obesity and Kidney Transplant Outcomes: A Mate-Kidney Analysis.

RATIONALE & OBJECTIVE The impact of extreme recipient obesity on long-term kidney transplant outcomes has been controversial. This study sought to evaluate the association of various levels of recipient obesity on kidney transplantation outcomes by comparing mate-kidney recipient pairs to address possible confounding effects of donor characteristics on post-transplant outcomes. DESIGN Nationwide observational cohort study, using mate-kidney models. SETTING & PARTICIPANTS Analysis based on the Organ Procurement and Transplant Network/United Network of Organ Sharing database. 44,560 adult recipients of first-time deceased donor kidney transplants from 2001-2016, paired by donor. PREDICTORS Recipient body mass index (BMI) was categorized: 18-25 (n=12,446), >25-30 (n=15,477), >30-35 (n=11,144) (obese) and >35 kg/m2 (n=5,493) (extreme obesity). MEASURE ments: Outcomes included patient survival, graft survival, death-censored graft survival, delayed graft function and length of stay. ANALYTICAL APPROACH Conditional logistic regression and stratified proportional hazards models were used to compare outcomes as odds ratios (OR) and hazard ratios (HR), adjusted for recipient and transplant factors, using recipients with BMI>35 as a reference. RESULTS At a median follow-up of 3.9 years, adjusted OR for delayed graft function were 0.42 [95% CI 0.36-0.48], 0.55 [95% CI 0.48-0.62], 0.73 [95% CI 0.64-0.83] for BMI 18-25, >25-30, and >30-35 respectively, P<0.001 for all. Death-censored graft failure was lower for BMI ≤25 (HR 0.66, [95% CI 0.59 -0.74] and BMI >25-30 (HR 0.79, [95% CI 0.70-0.88], P<0.001 for both, but not BMI >30-35 [HR 0.91, 95% CI 0.861-1.02, P=0.09]. Length of stay and patient survival did not differ by recipient BMI. LIMITATIONS Observational study with limited detail regarding potential confounders. CONCLUSIONS Despite an increased risk of delayed graft function likely unrelated to donor organ quality, long-term transplant outcomes among recipients with BMI>35 are similar to those among recipients with BMI >30-35, supporting a flexible approach to kidney transplantation candidacy in candidates with extreme obesity.
3D magnetic nanocomposite scaffolds enhanced the osteogenic capacities of rat bone mesenchymal stem cells in vitro and in a rat calvarial bone defect model by promoting cell adhesion.

Magnetic scaffolds incorporated with iron oxide nanoparticles (IONPs) are biocompatible and present excellent osteogenic properties. However, the underlying mechanism is unclear. In this study, 3D-printed poly(lactic-co-glycolic acid) scaffolds were coated with IONPs using layer-by-layer assembly (Fe-scaffold) to prepare magnetic scaffolds. The effects of this modification on osteogenesis were investigated by comparison with untreated scaffolds (Uncoated-scaffold). The results showed that the proliferation of rat bone mesenchymal stem cells (rBMSCs) on the Fe-scaffold was enhanced compared with those on the Uncoated-scaffold (p < 0.05). The alkaline phosphatase activity and expression levels of osteogenic-related genes of cells on the Fe-scaffold were higher than those on the Uncoated-scaffold (p < 0.05). Fe-scaffold was found to promote the cell adhesion compared with Uncoated-scaffold, including increasing the adhered cell number, promoting cell spreading and upregulating the expression levels of adhesion-related genes integrin α1 and β1 and their downstream signaling molecules FAK and ERK1/2 (p < 0.05). Moreover, the amount of new bone formed in rat calvarial defects at 8 weeks decreased in the order: Fe-scaffold > Uncoated-scaffold > Blank-control (samples whose defects were left empty) (p < 0.05). Therefore, 3D magnetic nanocomposite scaffolds enhanced the osteogenic capacities of rBMSCs in vitro and in a rat calvarial bone defect model by promoting cell adhesion. The mechanisms were attributed to the alteration in its hydrophilicity, surface roughness, and chemical composition.
Substance use, current criminal justice involvement, and lifetime suicidal thoughts and behaviors history: The moderating role of thwarted belonging.

OBJECTIVE Criminal justice involvement, substance use, and suicide pose significant public health concerns; however, the unique and synergistic effects of these experiences among high-risk individuals remain understudied. We hypothesized positive main effects for alcohol-related severity, drug-related severity, current criminal justice involvement, and thwarted belonging (TB) on suicide ideation history (SIH) and suicide attempt history (SAH) and that TB would moderate these associations. METHOD We report on cross-sectional analyses of self-report assessments completed by 824 adult residential substance use patients. RESULTS Multinomial logistic regression analyses indicated that as alcohol- and drug-related severity increases, the probability of SIH and SAH increases; however, TB was only associated with a higher SIH probability. Significant two-way interactions (current criminal justice involvement*TB; alcohol-related severity*TB) indicated that (1) those high in TB with current criminal justice involvement were more likely to report a SIH than those without current criminal justice involvement; and (2) those low in TB and alcohol-related severity had the lowest SAH probability, whereas those low in TB and high in alcohol-related severity had the highest SAH probability. CONCLUSION The unique and combined effects of interpersonal and contextual risk factors may improve suicide risk conceptualization and assessment, and allow for tailored treatments for this high-risk population.
Quantitative proteome comparison of human hearts with those of model organisms

Delineating human cardiac pathologies and their basic molecular mechanisms relies on research conducted in model organisms. Yet translating findings from preclinical models to humans present a significant challenge, in part due to differences in cardiac protein expression between humans and model organisms. Proteins immediately determine cellular function, yet their large-scale investigation in hearts has lagged behind those of genes and transcripts. Here, we set out to bridge this knowledge gap: By analyzing protein profiles in humans and commonly used model organisms across cardiac chambers, we determine their commonalities and regional differences. We analyzed cardiac tissue from each chamber of human, pig, horse, rat, mouse, and zebrafish in biological replicates. Using mass spectrometry–based proteomics workflows, we measured and evaluated the abundance of approximately 7,000 proteins in each species. The resulting knowledgebase of cardiac protein signatures is accessible through an online database: atlas.cardiacproteomics. com. Our combined analysis allows for quantitative evaluation of protein abundances across cardiac chambers, as well as comparisons of cardiac protein profiles across model organisms. Up to a quarter of proteins with differential abundances between atria and ventricles showed opposite chamber-specific enrichment between species; these included numerous proteins implicated in cardiac disease. The generated proteomics resource facilitates translational prospects of cardiac studies from model organisms to humans by comparisons of disease-linked protein networks across species.
The online coupling of high performance liquid chromatography with atomic fluorescence spectrometry based on dielectric barrier discharge induced chemical vapor generation for the speciation of mercury

Based on a novel green dielectric barrier discharge plasma induced chemical vapor generation (DBD plasma-CVG), an on-line hyphenation of high performance liquid chromatography (HPLC) with atomic fluorescence spectrometry (AFS) was developed for the speciation of inorganic mercury (Hg2+), methylmercury (MeHg) and ethylmercury (EtHg). Without the use of other chemical reagents, the decomposition of organic mercury species and the reduction of Hg2+ could be completed in one step with the DBD plasma-CVG system. The operating parameters of DBD plasma-CVG and HPLC were optimized. Separation of mercury species was accomplished in less than 14 min on a ZORBAX SB-C18 separation column with a mobile phase containing 0.01% (v/v) 2-mercaptoethanol, 10% (v/v) methanol and 0.06 mol L−1 NH4Ac at pH 6.8. The limits of detection of the method were found to be 1.6, 0.42 and 0.75 μg L−1 for Hg2+, MeHg and EtHg, respectively. The developed method was validated by determination of the main analytical figures of merit and applied to the analysis of the certified reference material GBW10029 (tuna fish). The on-line interfacing of HPLC with DBD plasma-CVG-AFS for the speciation of mercury is simple, environmentally friendly, and represents an attractive alternative to the conventional tetrahydroborate interface system.
KINETICS OF ULTRASOUND ASSISTED EXTRACTION OF WEDELOLACTONE FROM Eclipta alba

Ultrasound assisted extraction of wedelolactone, a major coumestan present in Eclipta alba, is investigated in the present work.Various process parameters such as type of solvent, power, solvent to solid ratio and extraction temperature, which affect the extraction yield, are optimized. In the ultrasound-assisted extraction with final optimized conditions, i.e., methanol as solvent, 170 W power, 60:1 solvent to solid ratio, 50 °C temperature and 60% duty cycle, amaximum extraction yieldof 0.62 mg/g is obtained in 45 minutes. The kinetic model (Peleg's model) has been used for the prediction of the yield of wedelolactone in the extract at a given time for all experimental conditions. The values of predicted yields show good agreement with the experimental data for all parameters, i.e., power, solvent to solid ratio and temperature. The extraction of wedelolactone from Eclipta alba is also carried out by conventional extraction methods, i.e., Soxhlet and batch extraction. Ultrasound-assisted extraction gives higher extraction yield in less time as compared to batch extraction (0.41 mg/g in 90 min) and Soxhlet extraction(0.7 mg/g in 360 min). The ultrasound-assisted extraction of wedelolactone from Eclipta alba is an effective way of extraction with the advantages of lower time and higher extraction.
Twisted Molecular Nanoribbons with up to 53 Linearly-Fused Rings.

The synthesis of three molecular nanoribbons with a twisted aromatic framework is described. The largest one shows a 53 linearly fused rings backbone (12.9 nm) and 322 conjugated atoms in its aromatic core (C296N24S2). This new family of nanoribbons shows extremely high molar absorptivities, reaching 986 100 M-1 cm-1, and red-emitting properties.
Highly variable trends in rates of newly diagnosed HIV cases in U.S. hotspots, 2008-2017

The U.S. Ending the HIV Epidemic (EHE) initiative was announced in early 2019 and rapidly became a focal point for domestic HIV prevention and treatment programs. Using publicly available data from CDC, we examined historical trends in the average annual percent change (AAPC) in HIV diagnosis rates for the 57 EHE high incidence “hotspots” using Joinpoint analysis. We then assessed the ecologic association of various hotspot characteristics with changes in these rates over time using a multivariable regression model. From 2008–2017, the overall rate of newly diagnosed HIV cases in the U.S. declined from 19 to 14 per 100,000 persons, with the AAPC declining significantly in the U.S. overall (-3.1%; 95% CI: -3.7, -2.4) and in the 57 hotspots (-3.3%; 95% CI: -4.6, -2.8). There were large (AAPC <-5.0), moderate (-5.0 to -2.5) and small (-2.5 to 0.0) rates of decline in 14, 19 and 17 hotspots respectively, with increasing trends (AAPC >0.0) noted in seven hotspots. In the multivariable regression analysis, higher initial HIV diagnosis rate and location in the Northeast region were significantly associated with declining AAPC rates whereas no significant differences were found by hotspot gender, age, or race/ethnicity distribution. This analysis demonstrates that the rate of decline in HIV diagnosis rates in hotspots across the U.S. has been highly variable. Further exploration is warranted to assess the correlation between programmatic factors such as HIV testing and antiretroviral therapy and pre-exposure prophylaxis coverage with HIV trends across the hotspots.
Ethical Perspectives of Chinese and United States Physicians at Initiation of a Research Collaborative

ABSTRACT Variances in perceived standards regarding research integrity appear to exist between China and the U.S. An established joint institute for translational and clinical research between one Chinese and one U.S. health system provides a valuable venue in which to evaluate these perceptions better. We therefore undertook a survey of 209 physicians at the two institutions in 2013–14. The vast majority of physicians from both institutions understood the necessity of obtaining informed consent from research participants, the need to provide a description of the risks of participation, and the voluntary nature of research participation. However, there were differences in responses between the two sites in willingness to report plagiarism (U.S. 95.65% vs. Chinese 40.21%; p < .0001) and data falsification (U.S. 100% vs. Chinese 81.25%; p < .0001) and in willingness to attend biomedical industry-funded promotional events (U.S. 11.0% vs. Chinese 74.0%; p < .0001). When planning to conduct collaborative clinical research across cultures, particularly when uncertainty regarding the similarity of research cultures exists, exploration of cultural and ethical norms in research may be informative regarding educational needs and the risks of research and academic misconduct.
Impact of Amino Acid Substitutions in Region II and Helix K of Herpes Simplex Virus 1 and Human Cytomegalovirus DNA Polymerases on Resistance to Foscarnet

Amino acid substitutions conferring resistance to foscarnet (PFA) to herpes simplex virus 1 (HSV-1) and human cytomegalovirus (HCMV) are located in the genes UL30 and UL54, respectively, encoding the DNA polymerase (pol). In this study, we analyzed the impact of substitutions located in helix K and region II that are involved in the conformational changes of the DNA pol. ABSTRACT Amino acid substitutions conferring resistance of herpes simplex virus 1 (HSV-1) and human cytomegalovirus (HCMV) to foscarnet (PFA) are located in the genes UL30 and UL54, respectively, encoding the DNA polymerase (pol). In this study, we analyzed the impact of substitutions located in helix K and region II that are involved in the conformational changes of the DNA pol. Theoretical substitutions were identified by sequences alignment of the helix K and region II of human herpesviruses (susceptible to PFA) and bacteriophages (resistant to PFA) and introduced in viral genomes by recombinant phenotyping. We characterized the susceptibility of HSV-1 and HCMV mutants to PFA. In UL30, the substitutions I619K (helix K), V715S, and A719T (both in region II) increased mean PFA 50% effective concentrations (EC50s) by 2.5-, 5.6-, and 2.0-fold, respectively, compared to the wild type (WT). In UL54, the substitution Q579I (helix K) conferred hypersusceptibility to PFA (0.17-fold change), whereas the substitutions Q697P, V715S, and A719T (all in region II) increased mean PFA EC50s by 3.8-, 2.8- and 2.5-fold, respectively, compared to the WT. These results were confirmed by enzymatic assays using recombinant DNA pol harboring these substitutions. Three-dimensional modeling suggests that substitutions conferring resistance/hypersusceptibility to PFA located in helix K and region II of UL30 and UL54 DNA pol favor an open/closed conformation of these enzymes, resulting in a lower/higher drug affinity for the proteins. Thus, this study shows that both regions of UL30 and UL54 DNA pol are involved in the conformational changes of these proteins and can influence the susceptibility of both viruses to PFA.
Words with Consistent Diachronic Usage Patterns are Learned Earlier: A Computational Analysis Using Temporally Aligned Word Embeddings

Abstract In this study, we use temporally aligned word embeddings and a large diachronic corpus of English to quantify language change in a data‐driven, scalable way, which is grounded in language use. We show a unique and reliable relation between measures of language change and age of acquisition (AoA) while controlling for frequency, contextual diversity, concreteness, length, dominant part of speech, orthographic neighborhood density, and diachronic frequency variation. We analyze measures of language change tackling both the change in lexical representations and the change in the relation between lexical representations and the words with the most similar usage patterns, showing that they capture different aspects of language change. Our results show a unique relation between language change and AoA, which is stronger when considering neighborhood‐level measures of language change: Words with more coherent diachronic usage patterns tend to be acquired earlier. The results support theories positing a link between ontogenetic and ethnogenetic processes in language.
Fabrication of a dual-layer cell-laden tubular scaffold for nerve regeneration and bile duct reconstruction

Tubular scaffolds serve as a controllable extracellular environment to guide the repair and regeneration of tissues. But it is still a challenge to achieve both excellent mechanical properties and cell compatibility of artificial scaffolds for long-term structural and biological stability. In this study, a four-step solution casting method was developed to fabricate dual-layer cell-laden tubular scaffolds for nerve and bile duct regeneration. The dual-layer tubular scaffold consisted of a bone marrow mesenchymal stem cells (BMSCs)-laden hydrogel inner layer and an outer layer of gelatin methacrylate (GelMA)/polyethylene glycol diacrylate. While the inner layer had a good biocompatibility, the outer layer had desired mechanical properties. The interfacial toughness, Young’s modulus, maximum tensile strain, and compressive modulus of dual-layer tubular scaffolds were 65 J m−2, 122.37 ± 23.21 kPa, 100.87 ± 40.10%, and 39.14 ± 18.56 N m−1, respectively. More importantly, the fabrication procedure was very cell-friendly, since the BMSC viability encapsulated in the inner layer of 10% (w/v) GelMA reached 94.68 ± 0.43% after 5 d of culture. Then, a preliminary evaluation of the potential application of dual-layer tubular scaffolds as nerve conduits and biliary scaffolds was performed, and demonstrated that the cell-laden dual-layer tubular scaffolds proposed in this work are expected to extend the application of tubular scaffolds in tissue engineering.