Miracle-dz/UniFAR-FTUs huggingface dataset:
Relationship Between Community-Level Distress and Cardiac Rehabilitation Participation, Facility Access, and Clinical Outcomes After Inpatient Coronary Revascularization

BACKGROUND: Although disparities in cardiac rehabilitation (CR) participation are well documented, the role of community-level distress is poorly understood. This study evaluated the relationship between community-level distress and CR participation, access to CR facilities, and clinical outcomes. METHODS: A retrospective cohort study was conducted on a 100% sample of Medicare beneficiaries undergoing inpatient coronary revascularization between July 2016 and December 2018. Community-level distress was defined using the Distressed Community Index quintile at the beneficiary zip code level, with the first and fifth quintiles representing prosperous and distressed communities, respectively. Outpatient claims were used to identify any CR use within 1 year of discharge. Beneficiary and CR facility zip codes were used to describe access to CR facilities. Adjusted logistic regression models evaluated the association between Distressed Community Index quintiles, CR use, and clinical outcomes, including one-year mortality, all-cause hospitalization, and acute myocardial infarction hospitalization. RESULTS: A total of 414 730 beneficiaries were identified, with 96 929 (23.4%) located in the first and 67 900 (16.4%) in the fifth quintiles, respectively. Any CR use was lower for beneficiaries in distressed compared with prosperous communities (26.0% versus 46.1%, P<0.001), which was significant after multivariable adjustment (odds ratio, 0.41 [95% CI, 0.40–0.42]). A total of 98 458 (23.7%) beneficiaries had a CR facility within their zip code, which increased from 16.3% in prosperous communities to 26.6% in distressed communities. Any CR use was associated with absolute reductions in mortality (−6.8% [95% CI, −7.0% to −6.7%]), all-cause hospitalization (−5.9% [95% CI, −6.3% to −5.6%]), and acute myocardial infarction hospitalization (−1.3% [95% CI, −1.5% to −1.1%]), which were similar across each Distressed Community Index quintiles. CONCLUSIONS: Although community-level distress was associated with lower CR participation, the clinical benefits were universally received. Addressing barriers to CR in distressed communities should be considered a significant priority to improve survival after coronary revascularization and reduce disparities.
Does Social Support Moderate the Association between Adverse Childhood Experiences and Substance-Related Problems?

ABSTRACT Background: More than half of individuals in the United States have had adverse childhood experiences (ACEs), which can result in physical and mental distress. ACEs has been linked with greater likelihood of harmful alcohol and drug use. Research has found that protective factors, such as social support, may potentially buffer against harmful substance use engagement among those who have experienced ACEs. The purpose of this study was to examine associations between perceived social support, ACEs, and alcohol and cannabis-related problems. Moreover, this study aimed to examine if specific domains of perceived social support (family, friends, and significant other) moderated the relationship between ACEs and alcohol and cannabis-related problems. Method: Validated measures of ACEs, perceived social support, and alcohol and cannabis problems were collected in a sample of 401 emerging adults via Prolific Academic (an online data collection platform). Results: Overall perceived social support and domains such as perceived family and friend social support moderated the relationship between ACEs and alcohol-related problems but not ACEs and cannabis-related problems. The association between ACEs and alcohol-related problems was strongest at low levels of perceived family and friend social support. Perceived social support was not associated with cannabis-related problems. Conclusions: Lack of social support is a potential risk factor for alcohol-related problems among emerging adults. Bolstering perceived social support from family and friends among those who have experienced ACEs may be beneficial in intervention and treatment efforts aiming to reduce harmful substance use in this population.
Prognostic Significance of Different Ventricular Ectopic Burdens During Submaximal Exercise in Asymptomatic UK Biobank Subjects

BACKGROUND: The consequences of exercise-induced premature ventricular contractions (PVCs) in asymptomatic individuals remain unclear. This study aimed to assess the association between PVC burdens during submaximal exercise and major adverse cardiovascular events (MI/HF/LTVA: myocardial infarction [MI], heart failure [HF], and life-threatening ventricular arrhythmia [LTVA]), and all-cause mortality. Additional end points were MI, LTVA, HF, and cardiovascular mortality. METHODS: A neural network was developed to count PVCs from ECGs recorded during exercise (6 minutes) and recovery (1 minute) in 48 315 asymptomatic participants from UK Biobank. Associations were estimated using multivariable Cox proportional hazard models. Explorative studies were conducted in subgroups with cardiovascular magnetic resonance imaging data (n=6290) and NT-proBNP (N-terminal Pro-B-type natriuretic peptide) levels (n=4607) to examine whether PVC burden was associated with subclinical cardiomyopathy. RESULTS: Mean age was 56.8±8.2 years; 51.1% of the participants were female; and median follow-up was 12.6 years. Low PVC counts during exercise and recovery were both associated with MI/HF/LTVA risk, independently of clinical factors: adjusted hazard ratio (HR), 1.2 (1–5 exercise PVCs, P<0.001) and HR, 1.3 (1–5 recovery PVCs, P<0.001). Risks were higher with increasing PVC count: HR, 1.8 (>20 exercise PVCs, P<0.001) and HR, 1.6 (>5 recovery PVCs, P<0.001). A similar trend was observed for all-cause mortality, although associations were only significant for high PVC burdens: HRs, 1.6 (>20 exercise PVCs, P<0.001) and 1.5 (>5 recovery PVCs, P<0.001). Complex PVC rhythms were associated with higher risk compared with PVC count alone. PVCs were also associated with incident HF, LTVA, and cardiovascular mortality, but not MI. In the explorative studies, high PVC burden was associated with larger left ventricular volumes, lower ejection fraction, and higher levels of NT-proBNP compared with participants without PVCs. CONCLUSIONS: In this cohort of middle-aged and older adults, PVC count during submaximal exercise and recovery were both associated with MI/HF/LTVA, all-cause mortality, HF, LTVAs, and cardiovascular mortality, independent of clinical and exercise test factors, indicating an incremental increase in risk as PVC count rises. Complex PVC rhythms were associated with higher risk compared with PVC count alone. Underlying mechanisms may include the presence of subclinical cardiomyopathy.
Synthesis and applications of helical polymers with dynamic and static memories of helicity

This review mainly highlights our studies on the synthesis of one-handed helical polymers with a static memory of helicity based on the noncovalent helicity induction with a helical-sense bias and subsequent memory of the helicity approach that we developed during the past decade. Apart from the previous approaches, an excess one-handed helical conformation, once induced by nonracemic molecules, is immediately retained (“memorized”) after the complete removal of the nonracemic molecules, accompanied by a significant amplification of the asymmetry, providing novel switchable chiral materials for chromatographic enantioseparation and asymmetric catalysis as well as a highly sensitive colorimetric and fluorescence chiral sensor. A conceptually new one-handed helix formation in a racemic helical polymer composed of racemic repeating units through the deracemization of the pendants is described.
SYSTEM COMPLIANCE CORRECTION FROM PORE PRESSURE RESPONSE IN UNDRAINED CYCLIC TRIAXIAL TESTS

ABSTRACT The effects of system compliance on pore pressure response during undrained cyclic triaxial tests are examined based on a review of previous studies. The presence of system compliance decreases the amplitude of pore pressure fluctuation caused by cyclic changes in the axial load, making the stress path slanted. On the basis of theoretical studies, equations are presented for determining the system compliance ratio of a specimen using its pore pressure coefficients A and B. A-value can readily be determined from pore pressure fluctuation during an undrained cyclic triaxial test. The system compliance ratios given by the proposed equations are in good agreement with those measured by a special test. A simplified procedure is then presented for correcting for the system compliance effects on triaxial liquefaction test results. The proposed method requires neither special test conditions nor additional tests, and can therefore conveniently be used in many cases.
Inhibitory effect of theaflavin-3,3′-digallate can involve its binding to the “stem” domain of α-hemolysin of Staphylococcus aureus

Abstract Infections caused by Staphylococcus aureus are currently a worldwide threat affecting millions of individuals. The pathogenicity of S. aureus is associated with numerous virulence factors, including cell surface proteins, polysaccharides, and secreted toxins. The pore-forming α-hemolysin, known as α-toxin, is produced by nearly all virulent strains of S. aureus and is implicated in several diseases including skin and soft tissue infections, atopic dermatitis, and pneumonia. There are currently no vaccines available for the prevention of S. aureus infections and the efficacy of available antibiotics has been fading. In this study we examined the mode of antihemolytic activity of theaflavin-3,3′-digallate against α-hemolysin of methicillin-resistant S. aureus by molecular docking using AutoDock Vina as the molecular docking tool. The theaflavin-3,3′-digallate docked the molecular sequence of the Hla (PDB ID:7ahl). The scores of the top 10 binding modes obtained were between −9.0 and −8.5 kcal mol−1, and the best binding mode was −9.0 kcal mol−1. Direct binding sites of theaflavin-3,3′-digallate to the “stem” domain of Hla were revealed which primarily targeted of the residues Met113, Thr117, Asn139. The disclosure of this potential binding mode warrants further clinical evaluation of theaflavin-3,3′-digallate as an anti-hemolytic compound in order to practically validate our results.
Tracer advances in catchment hydrology

Tracers have become common to hydrological investigations because they specifically offer information about the age, origin and pathways of water and serve as useful tools for evaluating conceptual or numerical models. Tracers, whether artificial (deliberately added to the environment) or environmental (introduced by natural processes), have led to new insights in catchment hydrology such as the role of ‘pre-event’ water in stormflow response, ages of water in catchments or identifying water sources supporting runoff generation or plant–water uptake. We now know that comprehensive understanding of hydrological processes in catchments is not possible based on physical characterization alone. While observations of hydraulic heads, flow rates and physical properties of catchments are useful in establishing internal state properties and boundary conditions, they provide an incomplete picture when it comes to understanding the age, origin and pathways of water in catchments. That is because many of our measurements characterize the celerity of hydraulic potentials rather than the velocity of the water itself, which can be orders of magnitude slower (McDonnell and Beven, 2014). Tracers offer a tool to characterize water velocities and pathways even in complex, heterogeneous subsurface environments. Over the last several years, there has been a flood of review papers and commentaries tackling topics related to tracers in catchment hydrology. Topics have included the use of tracers to assess flow paths, storage and run-off generation (Tetzlaff et al., 2015a), water transit time (McDonnell and Beven, 2014; McDonnell et al., 2010; Rinaldo et al., 2015; Soulsby et al., 2009; Stewart et al., 2012), hydrograph separation (Klaus and McDonnell, 2013) and ecohydrological separation (McDonnell, 2014). The community has moved from the use of tracers in simple models that describe the separation of streamflow into ‘event’ and ‘pre-event’ water components (e.g. Sklash et al., 1976) to more complex models that describe dynamically the age spectrum of streamflow (e.g. Harman, 2015). Separation of water sources has advanced from hydrograph separation to ecohydrological separation where now we are developing a better understanding of the role soils play in partitioning water between vegetation and drainage (i.e. streamflow generation or groundwater recharge)
Investigation of serum isthmin 1 concentration in pregnant women diagnosed with gestational diabetes mellitus; a case-control study

Abstract Objective Isthmin 1 (ISM1) is an adipokine that improves hyperglycemia by increasing glucose uptake in a non-insulin-dependent manner. Studies have shown that ISM is associated with the development of type 2 diabetes mellitus. Based on this, we aimed to investigate serum ISM1 concentrations of pregnant women with gestational diabetes mellitus (GDM). Methods This case-control study was conducted with 80 pregnant women who applied to the Gynecology and Obstetrics Clinic of Umraniye Training and Research Hospital between April 2022 and November 2022. While 40 pregnant women diagnosed with GDM according to 75 g OGTT results formed the GDM group, 40 pregnant women with normal OGTT results formed the control group. The two groups were compared in terms of serum ISM1 concentrations. Results Both groups were similar in terms of demographic characteristics (p > 0.05). Fasting blood glucose levels, 1st-hour and 2nd-hour blood glucose levels in 75 g OGTT, fasting insulin levels, and HOMA-IR were significantly higher in the GDM group (p > 0.05, for each). Both groups were similar in terms of maternal waist circumference, periumbilical, and epigastric subcutaneous adipose tissue thickness (p > 0.05, for each). Both groups were similar in terms of the gestational week at blood sampling for ISM1 (p = 0.253). The median maternal serum ISM1 concentration was found to be 3243.94 pg/ml in the GDM group, while it was determined as 2785.29 pg/ml in the non-GDM group (p = 0.026). ROC analysis was performed to determine the value of maternal serum ISM1 concentration in predicting GDM. AUC analysis of maternal serum ISM1 for estimation of GDM was 0.645 (p = 0.026, 95% CI = 0.523 − 0.766). The optimal threshold value for maternal serum ISM1 concentration was determined as 3124.41 pg/ml with 62.5% sensitivity and 62.5% specificity. Conclusions Serum ISM1 concentrations were found to be higher in pregnant women with GDM than in healthy controls. Whether or how ISM1 participates in the pathophysiology of GDM remains to be investigated.
Delirium During Critical Illness and Subsequent Change of Treatment in Patients With Cancer: A Mediation Analysis*

OBJECTIVES: To assess whether delirium during ICU stay is associated with subsequent change in treatment of cancer after discharge. DESIGN: Retrospective cohort study. SETTING: A 50-bed ICU in a dedicated cancer center. PATIENTS: Patients greater than or equal to 18 years old with a previous proposal of cancer treatment (chemotherapy, target therapy, hormone therapy, immunotherapy, radiotherapy, oncologic surgery, and bone marrow transplantation). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We considered delirium present if Confusion Assessment Method for the ICU was positive. We assessed the association between delirium and modification of the treatment after discharge. We also performed a mediation analysis to assess both the direct and indirect (i.e., mediated by the development of functional dependence after discharge) of delirium on modification of cancer treatment and whether the modification of cancer treatment was associated with mortality at 1 year. We included 1,134 patients, of whom, 189 (16.7%) had delirium. Delirium was associated with the change in cancer treatment (adjusted odds ratio [OR], 3.80; 95% CI, 2.72–5.35). The association between delirium in ICU and change of treatment was both direct and mediated by the development of functional dependence after discharge. The proportion of the total effect of delirium on change of treatment mediated by the development of functional dependence after discharge was 33.0% (95% CI, 21.7–46.0%). Change in treatment was associated with increased mortality at 1 year (adjusted OR, 2.68; 95% CI, 2.01–3.60). CONCLUSIONS: Patients who had delirium during ICU stay had a higher rate of modification of cancer treatment after discharge. The effect of delirium on change in cancer treatment was only partially mediated by the development of functional dependence after discharge. Change in cancer treatment was associated with increased 1-year mortality.
Tenapanor Improves Long-Term Control of Hyperphosphatemia in Patients Receiving Maintenance Dialysis: the NORMALIZE Study

Key Points Tenapanor is a first-in-class, minimally systemic sodium–hydrogen exchanger 3 inhibitor with a mechanism of action distinct from phosphate binders. Tenapanor alone or with phosphate binders led to 35%–49% of patients achieving serum phosphate ≤4.5 mg/dl over an 18-month period versus 22% at baseline. Tenapanor alone or with phosphate binders may help adults with CKD on maintenance dialysis achieve normal serum phosphate concentrations. Background Most patients with ESKD and hyperphosphatemia have difficulty controlling serum phosphate (sP) concentrations despite maintenance dialysis, dietary restriction, and phosphate binder treatment. NORMALIZE evaluated the efficacy and safety of tenapanor 30 mg twice daily alone or in combination with phosphate binders to achieve sP within the adult population reference range (2.5–4.5 mg/dl). Methods Patients who completed the Phase 3 PHREEDOM study could enroll in NORMALIZE. Patients enrolled in NORMALIZE who had received tenapanor during the PHREEDOM study (n=111) added sevelamer carbonate if sP was >4.5 mg/dl. Patients who had received sevelamer carbonate during the PHREEDOM study (n=61) added tenapanor and decreased sevelamer carbonate if sP was ≤4.5 mg/dl, per protocol titration schedule. Patients were followed in NORMALIZE for up to 18 months. We assessed efficacy in the full analysis set, defined as patients who received ≥1 dose of study drug and had ≥1 post-treatment sP measurement (n=171). We assessed safety in all patients who received ≥1 dose of study drug (n=172). Results At the end point visit, 57 of 171 patients (33%) in the full analysis set achieved sP between 2.5 and 4.5 mg/dl. Eight of 23 patients (35%) who were on tenapanor alone at the end point visit achieved sP between 2.5 and 4.5 mg/dl. The mean reduction from PHREEDOM baseline to end of NORMALIZE in sP was 2.0 mg/dl. Serum intact fibroblast growth factor-23 was significantly reduced; serum intact parathyroid hormone was significantly reduced among patients with intact parathyroid hormone ≥300 pg/ml at PHREEDOM baseline. The most commonly reported treatment-emergent adverse event was diarrhea in 38 of 172 patients (22%), which led to tenapanor discontinuation in four patients (2%). Conclusions Tenapanor alone or in combination with phosphate binders helped adult patients on maintenance dialysis achieve normal sP concentrations. Safety was consistent with previous studies of tenapanor. Clinical trial registry name and registration number A Long-Term Study to Evaluate the Ability of Tenapanor Alone or in Combination With Sevelamer to Treat to Goal Serum Phosphorus in Patients With ESKD on Dialysis (NORMALIZE), NCT03988920.
Thermal and Maturation Modeling of the Urengoy Field, West Siberian Basin: Some Special Considerations in Basin Modeling

Present-day temperature and vitrinite reflectance (Ro) profiles are considered key factors for calibration in numerical basin modeling; therefore, it is important to understand how such profiles are generated. Basin modeling typically considers factors such as rock consolidation, depth-variation of petrophysical characteristics, changes in heat flow, and paleoclimate; however, our basin evaluations have shown that other processes that influence temperature and Ro (vitrinite reflectance) profiles commonly are inadequately studied. Modeling within the Urengoy field of the West Siberian basin has allowed numerical estimates of some of these nonstandard processes. First, a substantial increase in temperature (up to 5-10iC) is expected from changes in heat conductivity due to the formation of significant free gas, gas-condensate, and condensate. Second, climate variations creating numerous periods of formation and degradation of permafrost zones for the last 3.4 m.y. could decrease the modern rock temperatures by 10-17iC in the upper 1.5 km of the sedimentary section and up to 10iC at its base. Due to the short duration of these two processes, their effect on organic matter maturation is minimal; nevertheless, their roles in the formation of present-day temperature profiles necessitate their inclusion in basin modeling. Third, modeling results demonstrated that change in heat conductivity of rocks with dispersed organic matter can increase temperature of sedimentary rocks by 3-5iC and rock maturity by not more than 0.02% (Ro). Finally, the sharp increase in vitrinite reflectance (% Ro) with depth, typical for the deep sedimentary units of the Urengoy field and many other continental rift basins, is possible to explain from hydrothermal activity. The influence of these processes on subsurface temperatures and maturation of organic matter can vary significantly depending on lithology, organic matter content, and the location of the modeled section relative to the ancient rift system. The results of this study can help one estimate the relative influence of these parameters.
Spectroscopically dark phosphate features revealed by chemical exchange saturation transfer

Phosphate is an essential anion in the human body, comprising approximately 1% of the total body weight, and playing a vital role in metabolism, cell membranes, and bone formation. We have recently provided spectroscopic, microscopic, and computational evidence indicating that phosphates can aggregate much more readily in solution than previously thought. This prior work provided indirect evidence through the observation of unusual 31 P NMR relaxation and line‐broadening effects with increasing temperature. Here, we show that, under conditions of slow exchange and selective RF saturation, additional features become visible in chemical exchange saturation transfer (CEST) experiments, which appear to be related to the previously reported phosphate clustering. In particular, CEST shows pronounced dips several ppm upfield of the main phosphate resonance at low temperatures, while direct 31 P spectroscopy does not produce any signals in that range. We study the pH dependence of these new spectroscopic features and present exchange and spectroscopic parameters based on fitting the CEST data. These findings could be of importance in the investigation of phosphate dynamics, especially in the biological milieu.