Miracle-dz/UniFAR-FTUs huggingface dataset:
Association between patient-surgeon gender concordance and mortality after surgery in the United States: retrospective observational study

Abstract Objective To determine whether patient-surgeon gender concordance is associated with mortality of patients after surgery in the United States. Design Retrospective observational study. Setting Acute care hospitals in the US. Participants 100% of Medicare fee-for-service beneficiaries aged 65-99 years who had one of 14 major elective or non-elective (emergent or urgent) surgeries in 2016-19. Main outcome measures Mortality after surgery, defined as death within 30 days of the operation. Adjustments were made for patient and surgeon characteristics and hospital fixed effects (effectively comparing patients within the same hospital). Results Among 2 902 756 patients who had surgery, 1 287 845 (44.4%) had operations done by surgeons of the same gender (1 201 712 (41.4%) male patient and male surgeon, 86 133 (3.0%) female patient and female surgeon) and 1 614 911 (55.6%) were by surgeons of different gender (52 944 (1.8%) male patient and female surgeon, 1 561 967 (53.8%) female patient and male surgeon). Adjusted 30 day mortality after surgery was 2.0% for male patient-male surgeon dyads, 1.7% for male patient-female surgeon dyads, 1.5% for female patient-male surgeon dyads, and 1.3% for female patient-female surgeon dyads. Patient-surgeon gender concordance was associated with a slightly lower mortality for female patients (adjusted risk difference −0.2 percentage point (95% confidence interval −0.3 to −0.1); P<0.001), but a higher mortality for male patients (0.3 (0.2 to 0.5); P<0.001) for elective procedures, although the difference was small and not clinically meaningful. No evidence suggests that operative mortality differed by patient-surgeon gender concordance for non-elective procedures. Conclusions Post-operative mortality rates were similar (ie, the difference was small and not clinically meaningful) among the four types of patient-surgeon gender dyads.
What makes a winner? Symbiont and host dynamics determine Caribbean octocoral resilience to bleaching

Unlike reef-building, scleractinian corals, Caribbean soft corals (octocorals) have not suffered marked declines in abundance associated with anthropogenic ocean warming. Both octocorals and reef-building scleractinians depend on a nutritional symbiosis with single-celled algae living within their tissues. In both groups, increased ocean temperatures can induce symbiont loss (bleaching) and coral death. Multiple heat waves from 2014 to 2016 resulted in widespread damage to reef ecosystems and provided an opportunity to examine the bleaching response of three Caribbean octocoral species. Symbiont densities declined during the heat waves but recovered quickly, and colony mortality was low. The dominant symbiont genotypes within a host generally did not change, and all colonies hosted symbiont species in the genus Breviolum. Their association with thermally tolerant symbionts likely contributes to the octocoral holobiont’s resistance to mortality and the resilience of their symbiont populations. The resistance and resilience of Caribbean octocorals offer clues for the future of coral reefs.
Organizational Facilitation of Latino Substance Use Disorder Treatment: Impact of COVID-19

Purpose: Continued high opioid overdose death rates in the United States and increasing New York State (NYS) Latino opioid overdoses make the facilitation of Latino access to NYS substance use disorder (SUD) treatment essential. SUD treatment facilities in NYS sustained an estimated 37% decrease in Latino enrollment during phase one of the pandemic. This study invited NYS SUD service providers to describe ways in which SUD organizations facilitated Latino SUD treatment prior to and during phase one of the pandemic. Methods: Using an individual and community interaction framework of vulnerability and a description of organizational enabling resources in four domains, this study used a cross-sectional descriptive design to investigate the levels of organizational facilitators for Latino SUD treatment access and the impact of the pandemic on these organizational facilitators. A convenience sample of 470 NYS SUD clinicians participated in the study. Results: The outcomes suggest an overall erosion of organizational enabling resources during the pandemic. Erosion was greatest in areas with a higher Latino population density in the domains of insured/immigration/legal information and culture. A pattern of strengthening resources in areas with lower Latino population density in the domains of language and telehealth access has defied the overall pattern of deterioration. The increase in telehealth did not cross the digital divide to stop the decrease in Latino enrollment and did not compensate for the overall erosion of access facilitators. Conclusions: The overall outcomes suggest opportunities to explore local variations in resource health. Recommendations to improve health equity include the use of participatory research to assess community needs and the implementation of community partnerships to address systemic barriers and rebuild equitable addiction services.
Similar but different: Characterization of dddD gene–mediated DMSP metabolism among coral-associated Endozoicomonas

Endozoicomonas are often predominant bacteria and prominently important in coral health. Their role in dimethylsulfoniopropionate (DMSP) degradation has been a subject of discussion for over a decade. A previous study found that Endozoicomonas degraded DMSP through the dddD pathway. This process releases dimethyl sulfide, which is vital for corals coping with thermal stress. However, little is known about the related gene regulation and metabolic abilities of DMSP metabolism in Endozoicomonadaceae. In this study, we isolated a novel Endozoicomonas DMSP degrader and observed a distinct DMSP metabolic trend in two phylogenetically close dddD-harboring Endozoicomonas species, confirmed genetically by comparative transcriptomic profiling and visualization of the change of DMSP stable isotopes in bacterial cells using nanoscale secondary ion spectrometry. Furthermore, we found that DMSP cleavage enzymes are ubiquitous in coral Endozoicomonas with a preference for having DddD lyase. We speculate that harboring DMSP degrading genes enables Endozoicomonas to successfully colonize various coral species across the globe.
ASAS-NANP symposium: mathematical modeling in animal nutrition: agent-based modeling for livestock systems: the mechanics of development and application

Abstract Over the last three decades, agent-based modeling/model (ABM) has been one of the most powerful and valuable simulation-based decision modeling techniques used to study the complex dynamic interactions between animals and their environment. ABM is a relatively new modeling technique in the animal research arena, with immense potential for routine decision-making in livestock systems. We describe ABM’s fundamental characteristics for developing intelligent modeling systems, exemplify its use for livestock production, and describe commonly used software for designing and developing ABM. After that, we discuss several aspects of the developmental mechanics of an ABM, including (1) how livestock researchers can conceptualize and design a model, (2) the main components of an ABM, (3) different statistical methods of analyzing the outputs, and (4) verification, validation, and replication of an ABM. Then, we perform an overall analysis of the utilities of ABM in different subsystems of the livestock systems ranging from epidemiological prediction to nutritional management to livestock market dynamics. Finally, we discuss the concept of hybrid intelligent models (i.e., merging real-time data streams with intelligent ABM), which have applications in artificial intelligence-based decision-making for precision livestock farming. ABM captures individual agents’ characteristics, interactions, and the emergent properties that arise from these interactions; thus, animal scientists can benefit from ABM in multiple ways, including understanding system-level outcomes, analyzing agent behaviors, exploring different scenarios, and evaluating policy interventions. Several platforms for building ABM exist (e.g., NetLogo, Repast J, and AnyLogic), but they have unique features making one more suitable for solving specific problems. The strengths of ABM can be combined with other modeling approaches, including artificial intelligence, allowing researchers to advance our understanding further and contribute to sustainable livestock management practices. There are many ways to develop and apply mathematical models in livestock production that might assist with sustainable development. However, users must be experienced when choosing the appropriate modeling technique and computer platform (i.e., modeling development tool) that will facilitate the adoption of mathematical models by certifying that the model is field-ready and versatile enough for untrained users.
Association between hypoglycemic agent use and the risk of occurrence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus

Nonalcoholic fatty liver disease (NAFLD) is a growing health concern with increasing prevalence and associated health impacts. Although no approved drugs are available for the NAFLD treatment, several hypoglycemic agents have been investigated as promising therapeutic agents. We aimed to compare the risk of occurrence of NAFLD with respect to the use of different hypoglycemic agents in patients with type 2 diabetes. This retrospective cohort study used data from the National Health Insurance Service–National Sample Cohort of South Korea. Participants newly diagnosed with type 2 diabetes (2003–2019) were included in this study. Two new user-active comparator cohorts were assembled: Cohort 1, new users of thiazolidinediones (TZD) and dipeptidyl peptidase-4 inhibitors (DPP-4i), and Cohort 2, new users of sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and DPP-4i. The occurrence of NAFLD was defined based claims that include diagnostic codes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models in 1:3 propensity score (PS)-matched cohorts. For 65,224 patients newly diagnosed with type 2 diabetes, the overall prevalence of NAFLD was 42.6%. The PS-matched Cohort 1 included 6,351 and 2,117 new users of DPP-4i and TZD, respectively. Compared to DPP-4i, TZD use was associated with the decreased risk of NAFLD (HR, 0.66; 95% CI: 0.55–0.78). Cohort 2 consisted of 6,783 and 2,261 new users of DPP-4i and SGLT-2i, respectively; SGLT-2i use was associated with a decreased risk of NAFLD (HR, 0.93; 95% CI: 0.80–1.08). This population-based cohort study supports the clinical implications of prioritizing TZD and SGLT-2i over DPP-4i in reducing the risk of occurrence of NAFLD in patients with type 2 diabetes. However, the findings lacked statistical significance, highlighting the need for further verification studies.
NON-REACTIVE GAS DYNAMICS IN THE PISCATAQUA ESTUARY INLET

For 135 days, from late autumn 2005 to the mid---spring 2006, continuous measurements of dissolved nitrogen, oxygen, and carbon dioxide in near surface seawater were recorded at the interface between the Great Bay-Piscataqua Estuary and the western Gulf of Maine. These surface measurements were made to investigate air-sea gas fluxes and identify the primary controls over gas dynamics in a macrotidal estuary entryway, the estuary inlet. Wind-parameterized air-sea flux estimations were calculated using published flux models and were evaluated to determine their appropriateness in the estuary inlet. Also, using supporting seastate measurements from buoys (wind speed and wave height), the effects of severe weather on dissolved gas concentrations were explored, and a determination was made as to the conditions required for air-injected dissolved gas increases. Measuring two non-reactive gases (nitrogen and oxygen) with different solubilities allowed for differentiation of two bubble-mediated processes. It was determined that the dominant bubblemediated gas transfer in the near shore is bubble exchange and not bubble injection. Finally, we were able to record the effects of the spring bloom on oxygen levels, and compare those levels with oxygen measurements taken in the Gulf.
The Symptom Experience of Older Adults with Mobility Difficulties: Qualitative Interviews

Eighteen million older adults have mobility limitations, defined as difficulty walking a quarter of a mile or climbing stairs unassisted. Little is known about how symptom burden impacts mobility difficulty in older adults. Understanding the burden of symptoms responsible for mobility difficulties may be an area for intervention to improve mobility and to prevent adverse outcomes. We conducted 31 semi-structured qualitative interviews (one interview per participant) regarding the symptom burden experience associated with a current mobility difficulty. Thematic analysis revealed symptoms were limiting, were barriers to participation in daily activities, and produced a psychological and emotional burden that negatively impacted quality of life. Older adults employed various strategies to overcome the symptom burden. Participants also believed symptoms were a non-modifiable part of the aging process and at times felt disregarded by healthcare professionals. Future interventions should focus on reducing the symptom burden experience for older adults to improve mobility and prevent adverse outcomes.
Multi-omics data reveals aberrant gut microbiota-host glycerophospholipid metabolism in association with neuroinflammation in APP/PS1 mice

ABSTRACT Numerous studies have described the notable impact of gut microbiota on the brain in Alzheimer’s disease (AD) via the gut – brain axis. However, the molecular mechanisms underlying the involvement of gut microbiota in the development of AD are limited. This study aimed to explore the potential mechanisms of gut microbiota in AD by integrating multi-omics data. In this study, APP/PS1 and WT mice at nine months of age were used as study mouse model. Cognitive function was assessed using the Morris water maze test. The levels of Aβ plaque and neuroinflammation in the brain were detected using immunofluorescence and PET/CT. In addition, we not only used 16S rRNA gene sequencing and metabolomics to explore the variation characteristics of gut microbiota and serum metabolism abundance, but also combined spatial metabolomics and transcriptomics to explore the change in the brain and identify their potential correlation. APP/PS1 mice showed significant cognitive impairment and amyloid-β deposits in the brain. The abundance of gut microbiota was significantly changed in APP/PS1 mice, including decreased Desulfoviobrio, Enterococcus, Turicibacter, and Ruminococcus and increased Pseudomonas. The integration of serum untargeted metabolomics and brain spatial metabolomics showed that glycerophospholipid metabolism was a common alteration pathway in APP/PS1 mice. Significant proliferation and activation of astrocyte and microglia were observed in APP/PS1 mice, accompanied by alterations in immune pathways. Integration analysis and fecal microbiota transplantation (FMT) intervention revealed potential association of gut microbiota, host glycerophospholipid metabolism, and neuroinflammation levels in APP/PS1 mice.
A Phase I/II Study of GSK525762 Combined with Fulvestrant in Patients with Hormone Receptor–positive/HER2-negative Advanced or Metastatic Breast Cancer

Abstract Purpose: Endocrine-based therapy is the initial primary treatment option for hormone receptor–positive and human epidermal growth factor receptor 2-negative (HR+/HER2−) metastatic breast cancer (mBC). However, patients eventually experience disease progression due to resistance to endocrine therapy. Molibresib (GSK525762) is a small-molecule inhibitor of bromodomain and extraterminal (BET) family proteins (BRD2, BRD3, BRD4, and BRDT). Preclinical data suggested that the combination of molibresib with endocrine therapy might overcome endocrine resistance. This study aimed to investigate the safety, tolerability, pharmacokinetics, pharmacodynamics, and efficacy [objective response rate (ORR)] of molibresib combined with fulvestrant in women with HR+/HER2− mBC. Patients and Methods: In this phase I/II dose-escalation and dose-expansion study, patients received oral molibresib 60 or 80 mg once daily in combination with intramuscular fulvestrant. Patients enrolled had relapsed/refractory, advanced/metastatic HR+/HER2− breast cancer with disease progression on prior treatment with an aromatase inhibitor, with or without a cyclin-dependent kinase 4/6 inhibitor. Results: The study included 123 patients. The most common treatment-related adverse events (AE) were nausea (52%), dysgeusia (49%), and fatigue (45%). At a 60-mg dosage of molibresib, >90% of patients experienced treatment-related AE. Grade 3 or 4 treatment-related AE were observed in 47% and 48% of patients treated with molibresib 60 mg and molibresib 80 mg, respectively. The ORR was 13% [95% confidence interval (CI), 8–20], not meeting the 25% threshold for proceeding to phase II. Among 82 patients with detected circulating tumor DNA and clinical outcome at study enrollment, a strong association was observed between the detection of copy-number amplification and poor progression-free survival (HR, 2.89; 95% CI, 1.73–4.83; P < 0.0001). Conclusions: Molibresib in combination with fulvestrant did not demonstrate clinically meaningful activity in this study.
The mechanism of Gαq regulation of PLCβ3-catalyzed PIP2 hydrolysis

PLCβ enzymes cleave PIP2 producing IP3 and DAG. PIP2 modulates the function of many ion channels, while IP3 and DAG regulate intracellular Ca2+ levels and protein phosphorylation by protein kinase C, respectively. PLCβ enzymes are under the control of GPCR signaling through direct interactions with G proteins Gβγ and Gαq and have been shown to be coincidence detectors for dual stimulation of Gαq and Gαi coupled receptors. PLCβs are aqueous-soluble cytoplasmic enzymes, but partition onto the membrane surface to access their lipid substrate, complicating their functional and structural characterization. Using newly developed methods, we recently showed that Gβγ activates PLCβ3 by recruiting it to the membrane. Using these same methods, here we show that Gαq increases the catalytic rate constant, kcat, of PLCβ3. Since stimulation of PLCβ3 by Gαq depends on an autoinhibitory element (the X-Y linker), we propose that Gαq produces partial relief of the X-Y linker autoinhibition through an allosteric mechanism. We also determined membrane-bound structures of the PLCβ3-Gαq, and PLCβ3-Gβγ(2)-Gαq complexes, which show that these G proteins can bind simultaneously and independently of each other to regulate PLCβ3 activity. The structures rationalize a finding in the enzyme assay, that co-stimulation by both G proteins follows a product rule of each independent stimulus. We conclude that baseline activity of PLCβ3 is strongly suppressed, but the effect of G proteins, especially acting together, provides a robust stimulus upon G protein stimulation. Significance Statement For certain cellular signaling processes, the background activity of signaling enzymes must be minimal and stimulus-dependent activation robust. Nowhere is this truer than in signaling by PLCβ3, whose activity regulates intracellular Ca2+, phosphorylation by Protein Kinase C, and the activity of numerous ion channels and membrane receptors. In this study we show how PLCβ3 enzymes are regulated by two kinds of G proteins, Gβγ and Gαq. Enzyme activity studies and structures on membranes show how these G proteins act by separate, independent mechanisms, leading to a product rule of co-stimulation when they act together. The findings explain how cells achieve robust stimulation of PLCβ3 in the setting of very low background activity, properties essential to cell health and survival.
Clinical validation of the ‘C-arm rotational view (CARV)’: study protocol of a prospective randomised controlled trial

Introduction Rotational malalignment occurs in up to 30% of cases after intramedullary nailing of tibial shaft fractures. The aim of this study is to assess the clinical feasibility of a newly introduced standardised intraoperative fluoroscopy protocol coined ‘C-arm rotational view (CARV)’ in order to reduce the risk of rotational malalignment during intramedullary nailing of tibial shaft fractures. The CARV includes predefined fluoroscopy landmark views of the uninjured side to obtain correct alignment of the injured side with use of the rotation of the C-arm. Methods and analysis This randomised controlled trial will be conducted in a level 1 trauma centre. Adult patients with an open or closed tibial fracture, eligible for intramedullary nailing, will be enrolled in the study. The interventional group will undergo intramedullary nailing guided by the CARV protocol to obtain accurate alignment. The control group is treated according to current clinical practice, in which alignment control of the tibia is based on clinical estimation of the treating surgeon. The primary endpoint is defined as the degree of rotation measured on low-dose postoperative CT scans. Ethics and dissemination The study protocol will be performed in line with local ethical guidelines and the Declaration of Helsinki. The results of this trial will be disseminated in a peer-reviewed manuscript. Future patients are likely to benefit from this trial as it aims to provide a clinically feasible and easy-to-use standardised fluoroscopy protocol to reduce the risk for rotational malalignment during intramedullary nailing of tibial shaft fractures. Trial registration number NCT05459038.
ASSESSMENT FOR DEEP CATASTROPHIC LANDSLIDE SUSCEPTIBILITY IN JAPAN

In steep mountainous regions, deep catastrophic landslides that involve weathered bedrock as well as soils can cause serious damage. However, there is currently no widely used method for estimating spatial patterns of susceptibility to deep catastrophic landslides. First, we examined roles of bedrock geology and rock uplift rate on regional frequency of deep catastrophic landslides. According to these results, we had roughly classified Japan into four categories in terms of past deep catastrophic landslides frequency and published “Deep catastrophic landslide frequency map of Japan” Then, we propose a new method to estimate landslide susceptibilities for many small catchments (~1 km) over relatively large areas (hundreds of square kilometres). Our method identifies catchments prone to deep catastrophic landslides according to three criteria: (1) catchments with ancient deep catastrophic landslide scars, (2) catchments with faults and landforms caused by long-lasting mass movements, and (3) catchments with many steep slopes that have large upslope contributing areas. We started the survey for clarification of potential sources of deep catastrophic landslide in high frequency region using this method.