Miracle-dz/UniFAR-FTUs huggingface dataset:
Project Five Wishes: promoting advance directives in primary care.

BACKGROUND Despite the widely known and well-established benefits of advance care planning, it is estimated that 15-30% of American adults have completed advance directives (ADs). Evidence suggests that the best place for advance care planning (ACP) is in primary care, but many barriers to this practice exist. LOCAL PROBLEM Providers in a Northern Arizona private practice primary care clinic expressed frustration with their current ability and standard of care regarding ADs. Only 0.8% of their established adult patients had ADs. METHODS Project Five Wishes was a 16-week trial designed to increase the number of ADs recorded at a Northern Arizona primary practice. The secondary purpose was to increase primary care provider knowledge, comfort, confidence, perceived importance, and frequency of discussions about ADs with patients. INTERVENTIONS Interventions used in this project aimed to eliminate common barriers to ACP through a 30-minute presentation for providers and by integrating a user-friendly AD form into the office workflow. RESULTS The number of ADs recorded increased by 25.4%. There were no statistically significant changes in the providers' reported knowledge, comfort, confidence, perceived importance, and frequency of discussions regarding ADs. CONCLUSIONS The feasibly reproducible process used in Project Five Wishes was successful at increasing the number of patients with ADs in this 16-week trial and could lead to improvement in this area for other clinics as well.
Effects of OSA Surgery on Leptin and Metabolic Profiles

Objectives This study is designed to investigate the effects of obstructive sleep apnea/hypopnea syndrome (OSA) surgery on serum leptin levels and metabolic disturbances, both of which contribute to the risk of cardiovascular diseases. Study Design Case series with planned data collection. Setting Tertiary referral medical center. Subjects and Methods A retrospective chart review of 101 consecutive patients with OSA who refused or failed conservative therapy and who then underwent upper airway surgery for OSA treatment was conducted. The personal medical history, anthropometric measurements, subjective symptoms, and objective polysomnographic parameters and fasting morning blood samples for leptin and metabolic biomarkers measurements were collected preoperatively and at a minimum of 3 months postoperatively. Results Eighty patients with OSA (69 men and 11 women; mean [SD] age of 42.2 [10.2] years) with complete data were included in the final analysis. At least 3 months after surgery, serum leptin, low-density lipoprotein cholesterol (LDL-C), and triglyceride levels and the mean systolic blood pressure (SBP) (night and morning) significantly decreased. According to the classical definition of surgical success, 40 subjects had successful surgery and were categorized as surgical responders, and the other 40 patients who failed surgery were categorized as surgical nonresponders. Significant reductions in serum leptin, total cholesterol, LDL-C, and triglyceride levels and improvement of mean SBP (morning) occurred in surgical responders but not in nonresponders. Conclusions Effective OSA surgery improves serum leptin, lipid profiles, and SBP. Further studies are needed to investigate the role of serial measurements of these biomarkers in monitoring surgical outcome of OSA treatment.
Capacidades colaborativas e criação de valor: Systematic Literature Network Analysis

Visando a permanência no mercado, empresas têm recorrido ao desenvolvimento de capacidades colaborativas que resultem na criação de valor conjunto através de redes interorganizacionais. A partir da escassez de pesquisas que analisassem a capacidade colaborativa e a criação de valor conjunto sistematicamente, este trabalho tem como principal objetivo aprofundar os conhecimentos sobre o tema a partir de uma Revisão Sistemática de Rede. O portfólio de artigos foi analisado a partir do software VosViewer. Com base na revisão, foi possível obter resultados acerca de 5 esferas: obras, autores, países, palavras-chave e periódicos. Dentre as contribuições desse artigo, pode-se citar o desenvolvimento de um panorama geral sobre os estudos de CC e CV, análise das tendências e as oportunidades de pesquisa identificadas a partir do portfólio. XXXVIII ENCONTRO NACIONAL DE ENGENHARIA DE PRODUCAO “A Engenharia de Produção e suas contribuições para o desenvolvimento do Brasil”
Osteosarcoma without prior retinoblastoma related to RB1 low‐penetrance germline pathogenic variants: A novel type of RB1‐related hereditary predisposition syndrome?

Retinoblastoma (Rb) is a rare intraocular malignant tumor in children with high overall survival. Predisposition to Rb is linked to RB1 germline mutations with high penetrance, but rare RB1 low‐penetrance variants are also known. Rb survivors are at risk of second primary malignancies (SPMs), mostly osteosarcoma and soft‐tissue sarcoma. Nevertheless, the risk of primary osteosarcoma developing without prior Rb has not been reported in RB1 germline mutation carriers.
Tumour-Derived Extracellular Vesicles (EVs): A Dangerous “Message in A Bottle” for Bone

Several studies have shown the importance of Extracellular Vesicles (EVs) in the intercellular communication between tumour and resident cells. Through EVs, tumour cells can trigger cell-signalling molecules and shuttle exogenous information to target cells, thus promoting spread of the disease. In fact, many processes are fuelled by EVs, such as tumour invasion and dormancy, drug-resistance, immune-surveillance escape, extravasation, extracellular matrix remodelling and metastasis. A key element is certainly the molecular profile of the shed cargo. Understanding the biochemical basis of EVs would help to predict the ability and propensity of cancer cells to metastasize a specific tissue, with the aim to target the release of EVs and to manipulate their content as a possible therapeutic approach. Moreover, EV profiling could help monitor the progression of cancer, providing a useful tool for more effective therapy. This review will focus on all the EV-mediated mentioned mechanisms in the context of both primary bone cancers and bone metastases.
Preparation and Characterization of 3D Printed PLA-Based Conductive Composites Using Carbonaceous Fillers by Masterbatch Melting Method

This study was aimed at improving the conductivity of polylactic acid (PLA)-based composites by incorporating carbonaceous fillers. The composites with the addition of graphene nanoplatelets (rGO) or multi-walled carbon nanotubes (MWCNTs) were fabricated by the masterbatch melting method in order to improve the dispersion of the two kinds of nano-fillers. The results showed that, with the addition of 9 wt % rGO, the volume electrical resistivity of the composite reached the minimum electrical resistance of 103 Ω·m, at which point the conductive network in the composites was completely formed. The interfacial compatibility, apparent viscosity, and the thermal stability of the composite were also good. The rGO functionalized by sodium dodecylbenzene sulfonate (SDBS) was an efficient method to further improve the electrical conductivity of the composite, compared with tannic acid and MWCNTs. The resistivity was reduced by an order in magnitude. Patterns printed onto different baseplates by fused deposition modeling illustrated that the functionalized composite had certain flexibility and it is suitable for printing complex shapes.
Roles of Lytic Transglycosylases in Biofilm Formation and β-Lactam Resistance in Methicillin-Resistant Staphylococcus aureus

Staphylococcus aureus is responsible for numerous community outbreaks and is one of the most frequent causes of nosocomial infections with significant morbidity and mortality. While the function of lytic transglycosylases (LTs) in relation to cell division, biofilm formation, and antibiotic resistance has been determined for several bacteria, their role in S. aureus remains largely unknown. The only known LTs in S. aureus are immunodominant staphylococcal antigen A (IsaA) and Staphylococcus epidermidis D protein (SceD). ABSTRACT Staphylococcus aureus is responsible for numerous community outbreaks and is one of the most frequent causes of nosocomial infections with significant morbidity and mortality. While the function of lytic transglycosylases (LTs) in relation to cell division, biofilm formation, and antibiotic resistance has been determined for several bacteria, their role in S. aureus remains largely unknown. The only known LTs in S. aureus are immunodominant staphylococcal antigen A (IsaA) and Staphylococcus epidermidis D protein (SceD). Our study demonstrates that, in strains of methicillin-resistant S. aureus (MRSA), IsaA and SceD contribute differently to biofilm formation and β-lactam resistance. Deletion of isaA, but not sceD, led to decreased biofilm formation. Additionally, in isaA-deleted strains, β-lactam resistance was significantly decreased compared with that of wild-type strains. Plasmid-based expression of mecA, a major determinant of β-lactam resistance in MRSA, in an isaA-deleted strain did not restore β-lactam resistance, demonstrating that the β-lactam susceptibility phenotype is exhibited by the isaA mutant regardless of the production level of PBP2a. Overall, our results suggest that IsaA is a potential therapeutic target for MRSA infections.
MicroRNA‐9 overexpression suppresses vulnerable atherosclerotic plaque and enhances vascular remodeling through negative regulation of the p38MAPK pathway via OLR1 in acute coronary syndrome

Acute coronary syndrome (ACS) is characterized by atherosclerotic plaque rupture with a high incidence of recurrent ischemic events. Several microRNAs are found to be aberrantly expressed in atherosclerotic plaques. This study aims to investigate the effects of microRNA‐9 (miR‐9) on vulnerable atherosclerotic plaque and vascular remodeling in ACS and underlying mechanisms. Microarray‐based gene expression profiling was used to identify differentially expressed genes related to ACS and regulatory miRNAs. Oxidized low‐density lipoprotein (lectin‐like) receptor 1 (OLR1) was identified to be aberrantly activated in ACS and regulated by miR‐9. OLR1 was verified as a target gene of miR‐9 by bioinformatics prediction and dual luciferase reporter gene assay. The atherosclerotic models were induced in ApoE−/− mice, in which the agomir or antagomir of miR‐9, or small interfering RNA (siRNA) against OLR1 were separately introduced. Serum lipid levels and expression of vascular remodeling and inflammatory response‐related factors were determined, respectively. On the basis of the obtained results, in the atherosclerosis mice treated with the agomir of miR‐9 and siRNA against OLR1, the p38‐mitogen‐activated protein kinase (p38MAPK) pathway was inhibited; levels of triglyceride, total cholesterol, low‐density lipoprotein cholesterol, tumor necrosis factor‐α, interleukin‐6, and vascular endothelial growth factor were reduced, but the high‐density lipoprotein cholesterol level was increased, along with decreased vulnerable atherosclerotic plaque area and enhanced vascular remodeling. Taken together, these findings suggested an inhibitory role miR‐9 acts in the formation of vulnerable atherosclerotic plaques in ACS mice, along with a promoted vascular remodeling, via a negative feedback regulation of OLR1‐mediated p38MAPK pathway.
Atomistic study of the strengthening mechanisms of graphene coated aluminum

We have investigated the nano-indentation responses of graphene/aluminum systems via computational nano-indentation processes by using molecular dynamics simulations. The effects of system temperature, grain-orientation and bilayer graphene are also investigated. We demonstrate that, the graphene coating enlarges the load-carrying area by about 5.36 times and changes the deformation behaviors of aluminum substrate during nano-indentation processes. The load bearing capacity of graphene/Al system is significantly improved by about 4.7 times compared with that of bare Al system. It is revealed that higher system temperature weakens the ultimate indentation depth and corresponding load. The grain orientation of aluminum substrate hardly affect the indentation mechanical properties of graphene/Al system. The strengthening effect of bilayer graphene is about 1.5 times that of monolayer graphene.
Dietary patterns and metabolic phenotypes in Brazilian adults: a population-based cross-sectional study

Abstract Objective: Dietary patterns have been pointed out as useful diet quality indicators, but evidence about their relationship to metabolic phenotypes is still scarce. Thus, the present study aimed to verify the relationship between dietary patterns and metabolic phenotypes in Brazilian adults. Design: Cross-sectional study. A food consumption frequency questionnaire assessed food consumption profiles. Metabolic phenotypes were defined based on the criteria of the National Health and Nutrition Examination Survey: overweight or normal weight and metabolically healthy (MHOW and MHNW) or unhealthy (MUOW and MUNW). Dietary patterns were established through exploratory factor analysis and principal component analysis. The associations were tested using multinomial logistic regression. Setting: Viçosa, Minas Gerais, Brazil. Participants: Individuals (n 896) aged 20–59 years of both sexes, selected using probabilistic sampling. Results: Three dietary patterns were identified: Unhealthy pattern (alcoholic beverages, oils and fats, condiments, soda and juice, sugars and sweets, snacks, and meat and derivatives), Traditional pattern (culinary preparations, beans, milk and dairy products, and coffee and tea) and Healthy pattern (vegetables and fruits, whole grains, chicken and fish, and skimmed milk). Unhealthy pattern was positively associated with the MHOW and MUOW phenotypes in the fourth quartile (OR = 1·84; 95 % CI 1·06, 3·22) and in the third (OR = 1·94; 95 % CI 1·11, 3·39) and fourth (OR = 2·56; 95 % CI 1·41, 4·64) quartiles of consumption, respectively. Healthy pattern was also associated with these phenotypes. Conclusions: Both the pattern comprising energy-dense foods and the healthier pattern were associated with overweight phenotypes among Brazilian adults.
New Evaluation of Isoflavone Exposure in the French Population

The study relates the present evaluation of exposure to estrogenic isoflavones of French consumers through two approaches: (1) identification of the isoflavone sources in the French food offering, (2) a consumption-survey on premenopausal women. For the foodstuff approach 150 food-items were analysed for genistein and daidzein. Additionally, 12,707 labels of processed-foods from French supermarket websites and a restaurant-supplier website were screened, and 1616 foodstuffs of interest were retained. The sources of phytoestrogens considered were soy, pea, broad bean and lupine. A price analysis was performed. A total of 270 premenopausal women from the French metropolitan territory were interviewed for their global diet habits and soy consumption and perception. In supermarkets, there were significantly less selected foodstuffs containing soy than in restaurant (11.76% vs. 25.71%, p < 0.01). There was significantly more soy in low price-foodstuff in supermarket (p < 0.01). Isoflavone levels ranged from 81 to 123,871 µg per portion of the analyzed soy containing foodstuff. Among the women inquired 46.3% claimed to have soy regularly. Isoflavone intake >45 mg/day is associated to vegan-diet (p < 0.01). In total, 11.9% of soy-consumers had a calculated isoflavone intake >50 mg/day. This dose can lengthen the menstrual cycles. The actual exposure to phytoestrogen is likely to have an effect in a part of the French population.
Diagnostic Variation in p53 Usage for Endometrial Carcinoma Diagnosis: Implications for Molecular Subtyping

Immunostaining for p53 is widely but variably used when diagnosing endometrial carcinoma (EC). Mutant-pattern p53 staining can support a diagnosis of serous carcinoma, and also serve as a surrogate test for identifying the “serous-like” subset of aggressive EC identified by The Cancer Genome Atlas characterized by high numbers of somatic copy number abnormalities. We, retrospectively, assessed WHO histotype, usage of p53 immunostaining, and p53 status in a consecutive series of biopsies showing EC from a single hospital. Of 79 ECs, 59 (75%) were low-grade EC (LGEC), 13 (16%) high-grade EC (HGEC), and 7 (9%) were serous. p53 immunostaining was performed at the time of diagnosis in 27/79 (34%) biopsies; 6/7 of serous histotype, 11/13 HGEC, and 10/59 LGEC. Mutant-pattern p53 staining was present in 6/6 serous, 2/11 HGEC, and 2/10 LGEC. The remaining 53 tumors subsequently had p53 immunostaining done; all 49 LGEC showed wild-type staining and the serous carcinoma and 1/2 HGEC showed mutant pattern staining. While there are no guidelines on using p53 in endometrial biopsies, this study shows consistent usage in high-grade histotypes and variable usage in LGEC. As 100% (7/7) of serous EC and 3% (2/59) of the LGECs showed mutant-pattern p53 staining, histotype may serve as a surrogate for p53 assessment, such that only HGEC or ambiguous carcinomas should be routinely subjected to p53 immunostaining.
Cardiovascular Outcomes in Advanced Maternal Age Delivering Women. Clinical Review and Medico-Legal Issues

Background and objecives: Adverse cardiovascular outcomes during pregnancy have increased over the past few decades, with increased numbers of women delivering later in their reproductive life. Other factors include higher rates of female obesity, diabetes, hypertension, cardiovascular diseases and assisted reproductive technology, which has extended fertility. Those at risk require extensive prenatal maternal screening, constant pregnancy supervising, monitoring during labor, delivery and puerperium and careful anesthetic evaluation during delivery. Materials and Methods: The present review reports the relevant information available on cardiovascular outcomes in advanced maternal age delivering women and related medico-legal issues. The search was performed on Pubmed, Cochrane, Semantic Scholar, Medline and Embase databases, accessed by Ovid, including among others the terms “cardiomyopathy”, “ischaemic heart disease”, “arrhythmias”, “hypertension”, “peripartum period”, “diabetes”, “advanced maternal age” “anesthesia”, “maternal morbidity and mortality” and “litigation”. Results: To the extent that underestimating risk factors for peripartum cardiomyopathy (PPCM) can adversely impact maternal and fetal outcomes, the legal implications of misdiagnosis or mismanagement can result in high compensatory damages. Substantial indemnity payments drive up costs of insurance coverage. Conclusions: Multidisciplinary approaches are necessary from obstetricians, cardiologists, anesthesiologists and perinatologists for pregnancy monitoring and delivery outcomes.
Long Term Retention of Gingival Sealing around Titanium Implants with CaCl2 Hydrothermal Treatment: A Rodent Study

We previously reported that CaCl2 hydrothermal-treated (Ca-HT) titanium (Ti) implants induced a tight sealing at the interface between the implant and peri-implant epithelium (PIE) after implantation. However, it is not clear how long this improved epithelium sealing can be maintained. We subsequently investigated whether the positive effect of Ca-HT to promote sealing between the PIE and implant was sustained longer term. Maxillary molars were extracted from rats and replaced with either Ca-HT implants (Ca-HT group), distilled water-HT implants (DW-HT group) or non-treated implants (control group). After 16 weeks, the majority of implants in the Ca-HT group remained at the maxillary with no apical extension of the PIE. Conversely, half the number of control implants was lost following down-growth of the PIE. The effect of Ca-HT on migration and proliferation of rat oral epithelial cells (OECs) was also investigated. In OECs cultured on Ca-HT Ti plates, protein expression in relation to cell migration decreased, and proliferation was higher than other groups. Surface analysis indicated HT enhanced the formation of surface TiO2 layer without altering surface topography. Consequently, Ca-HT of Ti reduced PIE down-growth via tight epithelial attachment to the surface, which may enhance implant capability for a longer time post-implantation.
Oxygen Limitation Does Not Drive the Decreasing Heat Tolerance of Grasshoppers during Development

Thermal physiology changes as organisms grow and develop, but we do not understand what causes these ontogenetic shifts. According to the theory of oxygen- and capacity-limited thermal tolerance, an organism’s heat tolerance should change throughout ontogeny as its ability to deliver oxygen varies. As insects grow during an instar, their metabolic demand increases without a proportional increase in the size of tracheae that supply oxygen to the tissues. If oxygen delivery limits heat tolerance, the mismatch between supply and demand should make insects more susceptible to heat and hypoxia as they progress through an instar. We tested this hypothesis by measuring the heat tolerance of grasshoppers (Schistocerca americana) on the second and seventh days of the sixth instar, in either a normoxic or a hypoxic atmosphere (21% or 10% O2, respectively). As expected, heat tolerance decreased as grasshoppers grew larger. Yet contrary to expectation, hypoxia had no effect on heat tolerance across all stages and sizes. Although heat tolerance declines as grasshoppers grow, this pattern must stem from a mechanism other than oxygen limitation.
The menopause transition and women's health at midlife: a progress report from the Study of Women's Health Across the Nation (SWAN)

Abstract Objective: Our initial understanding of the menopause transition (MT) has been framed by clinical samples of women seeking treatment rather than by population-based studies. The Study of Women's Health Across the Nation (SWAN) initiated in 1996 with an overall goal to define the MT, to characterize its biological and psychosocial antecedents and sequelae in an ethnically and racially diverse sample of midlife women. Methods: This review summarizes the central findings of SWAN to date that can inform women and their healthcare providers about the impact of the MT and midlife aging on overall health and well-being. Results: SWAN characterized changes in reproductive axis and menstrual cycle patterns that informed the development of the reproductive aging staging system Staging of Reproductive Aging Workshop+10; MT-related symptoms and mental health (vasomotor symptoms, sleep complaints, psychological symptoms, cognitive performance, and urogenital and sexual health); and physiological systems and functions (cardiovascular and cardiometabolic health, bone health, physical function performance) that are influenced by the MT. SWAN demonstrated substantial interrelations among these changes and significant racial/ethnic differences in the rate and magnitude of change in multiple health indictors in midlife women. The findings point to midlife as a critical stage for adopting healthy behavior and preventive strategies. Conclusions: Over the past 23 years, SWAN has advanced our understanding of the impact of the MT and midlife aging on health and well-being in women. SWAN will be instrumental to determine whether MT-related changes during midlife are related to unfavorable health and well-being in early old age.