Miracle-dz/UniFAR-FTUs huggingface dataset:
Safety of Tranexamic Acid in Hip and Knee Arthroplasty in High-risk Patients

Background: With increasing use of tranexamic acid in total hip and knee arthroplasties, safety concerns remain. Using national claims data, this study examined tranexamic acid use in patients with preexisting comorbidities. The hypothesis was that tranexamic acid use is not associated with increased complication risk in hip and knee arthroplasty patients with comorbidities. Methods: Among 765,011 total hip/knee arthroplasties (2013 to 2016, Premier Healthcare claims), tranexamic acid use was assessed in three high-risk groups: group I with patients with a history of venous thromboembolism, myocardial infarction, seizures, or ischemic stroke/transient ischemic attack (n = 27,890); group II with renal disease (n = 44,608); and group III with atrial fibrillation (n = 45,952). The coprimary outcomes were blood transfusion and new-onset “composite complications” (venous thromboembolism, myocardial infarction, seizures, and ischemic stroke/transient ischemic attack). Associations between tranexamic acid use and outcomes were measured separately by high-risk group. The odds ratios and Bonferroni-adjusted 99.9% CIs are reported. Results: Overall, 404,974 patients (52.9%) received tranexamic acid, with similar frequencies across high-risk groups I (13,004 of 27,890 [46.6%]), II (22,424 of 44,608 [50.3%]), and III (22,379 of 45,952 [48.7%]). Tranexamic acid use was associated with decreased odds of blood transfusion in high-risk groups I (721 of 13,004 [5.5%] vs. 2,293 of 14,886 [15.4%]; odds ratio, 0.307; 99.9% CI, 0.258 to 0.366), group II (2,045 of 22,424 [9.1%] vs. 5,159 of 22,184 [23.3%]; odds ratio, 0.315; 99.9% CI, 0.263 to 0.378), and group III (1,325 of 22,379 [5.9%] vs. 3,773 of 23,573 [16.0%]; odds ratio, 0.321; 99.9% CI, 0.266 to 0.389); all adjusted comparisons P < 0.001. No increased odds of composite complications were observed in high-risk group I (129 of 13,004 [1.0%] vs. 239 of 14,886 [1.6%]; odds ratio, 0.89, 99.9% CI, 0.49 to 1.59), group II (238 of 22,424 [1.1%] vs. 369 of 22,184 [1.7%]; odds ratio, 0.98; 99.9% CI, 0.58 to 1.67), and group III (187 of 22,379 [0.8%] vs. 290 of 23,573 [1.2%]; odds ratio, 0.93; 99.9% CI, 0.54 to 1.61); all adjusted comparisons P > 0.999. Conclusions: Although effective in reducing blood transfusions, tranexamic acid is not associated with increased complications, irrespective of patient high-risk status at baseline. National administrative data from more than 500 hospitals and 40,000 patients demonstrate that approximately half of high-risk patients receive tranexamic acid, similar to non–high-risk patients. Tranexamic acid use in high-risk patients undergoing lower-extremity arthroplasty is associated with fewer transfusions. Tranexamic acid use is not associated with venous thromboembolism, myocardial infarction, seizures, ischemic strokes, or transient ischemic attacks. Supplemental Digital Content is available in the text.
Scrutinizing the sanitizing process involving aqueous chlorine from field to fresh-cut iceberg lettuce

The most commonly used sanitizers for numerous procedures in the postharvest industry are chlorine based. However, the impact this sanitizer has on the reduction of pathogenic microorganisms differs depending on the microorganism and produce in question, although it is generally limited to a 1-2 log reduction, when using concentrations permitted for produce. An investigation of the impact of aqueous chlorine sanitization on generic E. coli during postharvest and fresh-cut processing of iceberg lettuce was conducted at The University of Arizona, Yuma Agricultural Center, USA. Common commercial practices were simulated using a high bacterial load (10(8) cfu/ml) culture to contaminate a harvesting tool to assess the number of heads affected from one contamination and the effectiveness of approved sanitizers. Results showed that as many as 75 heads of lettuce could be contaminated with the continued use of a contaminated harvest tool quitar used to core the heads. The concentration of bacterial contamination is reduced if the cored region is sprayed with a sanitizer immediately after coring. While using water alone on the cored region produced 10(5) cfu/g, using either chlorine or peroxyacetic acid (PAA) showed only a decrease to 10(4) cfu/g. The use of the sanitizers in different frequency and in combination as an alternative to the common triple treatment with chlorine, showed the latter as the treatment with the most effective reduction on generic E. coli. The level of reduction was still insufficient to ensure the safety of the lettuce if a high microbial contamination were to occur. This work reveals the high risks associated with the lack of a continuous system for decontaminating harvesting tools and equipment, and highlights the need for further research to identify a better multiple-rinse sanitation system, than the predominant chlorine washes and the emerging approved alternatives.
Monoclonal antibodies to B.anthracis protective antigen are capable to neutralize and to enhance the anthrax lethal toxin action in vitro

: Anthrax belongs to highly dangerous infections of man and animals. No effective treatment methods for pulmonary types of the disease have been yet developed. The existing anthrax vaccines were designed decades ago and need improvement to fit the large-scale vaccination of population. At the same time, the immunological properties of the anthrax vaccine main component, i.e. of the protective agent, have been poorly studied. We obtained, within the present case study, a panel of mouse monoclonal antibodies to the protective agent and investigated the properties of the highest-affine panel representatives. An unusual phenomenon was detected, which is related with enhancement of the anthrax toxin action on the mouse macrophage-like cell-line in presence of the 1F2 monoclonal antibody. The remaining analyzed antibodies, i.e. 6G8 and 6G7, were found to neutralize effectively the toxin action. The enhancing and neutralizing antibodies were proven to be specific to different domains of the protective antigen and to recognize epitopes in its composition. The antibody-mediated enhancement of the anthrax lethal action is a convincing argument for further development of a new-generation anthrax vaccine. Definition of the linear antigen determinants for neutralizing antibodies in the protective antigens is an important step in the development of the next-generation anthrax vaccine.
Development of a Measure of State-Level Supports for School Nursing Services Delivery

States have key roles and responsibilities in protecting and promoting the health of all of school-age youth. Though assessment and planning instruments exist to support quality school nursing service delivery at individual school building, community, and district levels, no comparable measure was available to assess state-level support for the delivery of quality school nursing. This project, conducted in three phases, resulted in the development of a novel measure to identify state-level infrastructure supports for school nursing services delivery. The State School Health Infrastructure Measure is comprised of seven domains with 24 indicators and demonstrated initial content validity and test–retest reliability. States can use this measure to self-assess, identify, benchmark, prioritize, and address state-level infrastructure strengths and gaps related to supporting the delivery of high-quality, equitable school nursing services.
Consensus on Prostate Cancer Treatment of Localized Disease With Very Low, Low, and Intermediate Risk: A Report From the First Prostate Cancer Consensus Conference for Developing Countries (PCCCDC)

PURPOSE A group of international urology and medical oncology experts developed and completed a survey on prostate cancer (PCa) in developing countries. The results are reviewed and summarized, and recommendations on consensus statements for very low-, low-, and intermediate-risk PCa focused on developing countries were developed. METHODS A panel of experts developed more than 300 survey questions of which 66 questions concern the principal areas of interest of this paper: very low, low, and intermediate risk of PCa in developing countries. A larger panel of 99 international multidisciplinary cancer experts voted on these questions to create the recommendations for treatment and follow-up for very low-, low-, and intermediate-risk PCa in areas of limited resources discussed in this manuscript. RESULTS The panel voted publicly but anonymously on the predefined questions. Each question was deemed consensus if 75% or more of the full panel had selected a particular answer. These answers are based on panelist opinion not a literature review or meta-analysis. For questions that refer to an area of limited resources, the recommendations consider cost-effectiveness and the possible therapies with easier and greater access. Each question had five to seven relevant answers including two nonanswers. The results were tabulated in real time. CONCLUSION The voting results and recommendations presented in this document can be used by physicians to support management for very low, low, and intermediate risk of PCa in areas of limited resources. Individual clinical decision making should be supported by available data; however, as guidelines for treatment for very low, low, and intermediate risk of PCa in developing countries have not been developed, this document will serve as a point of reference when confronted with this disease.
Opioid Tapering/Detoxification Protocols, A Compendium: Narrative Review.

OBJECTIVES The opioid epidemic has put pressure on clinicians to taper their chronic pain patients (CPPs) from opioids. This has resulted in rapid or forced tapers and opioid discontinuation. Partially responsible is lack of information on how to taper (tapering protocols). The objectives of this narrative review were then the following: compile all the published opioid tapering/detoxification protocols from the pain/drug rehabilitation/psychiatric literature whether for inpatient or outpatient use; organize these into general types; compare the types for advantages/disadvantages for use by a clinician in an outpatient setting; and answer some commonly asked questions relating to opioid tapering. METHODS Relevant references were identified by a search strategy utilizing the terms tapering, tapering protocols, detoxification, detoxification protocols, withdrawal, dependence, addiction, and drug rehabilitation. These were explored with the term opioids. Identified abstract were reviewed for any study relating to the objectives of this review. Those studies were then included in this review. As this is a narrative review, no quality ratings of these references were performed. RESULTS Of 1,922 abstracts identified by this search strategy, 301 were reviewed in detail for potential inclusion. Of these, 104 were utilized in this review. Nine types of opioid tapering protocols were identified and compared in tabular form. Twenty-two questions in reference to opioid tapering were addressed. CONCLUSIONS Based on this review, the protocol utilizing the opioid of current use is the simplest to use as it requires no rotation to another opioid and thereby avoids rotation errors. It also has behavior advantages.
Does cognitive decline occur decades after moderate to severe traumatic brain injury? A prospective controlled study

ABSTRACT This prospective controlled study examined long-term trajectories of neuropsychological performance in individuals with traumatic brain injury (TBI) compared to healthy controls, and the impact of IQ, age at injury, time since injury, and injury severity on change over time. Fifty-three individuals with moderate to severe TBI (60.37% male; M = 59.77 yrs, SD = 14.03), and 26 controls (46.15% male; M = 63.96 yrs, SD = 14.42) were studied prospectively (M = 12.72 yrs between assessments). Participants completed measures of premorbid IQ (Weschler Test of Adult Reading), processing speed (Digit Symbol Coding Test), working memory (Digit Span Backwards), memory (Rey Auditory Verbal Learning Test) and executive function (Trail Making Test Part B; Hayling Errors), at a mean of 10.62 yrs (Initial) and 23.91 yrs (Follow-Up) post injury. Individuals with TBI did not show a significantly greater decline in neuropsychological performance over time compared with demographically similar controls. There was no association between change over time with IQ, time since injury or injury severity. Being older at injury had a greater adverse impact on executive function at follow-up. In this small sample, a single moderate to severe TBI was not associated with ongoing cognitive decline up to three decades post injury. Changes in cognitive function were similar between the groups and likely reflect healthy aging.
Familial thrombocytopenia due to a complex structural variant resulting in a WAC-ANKRD26 fusion transcript

Wahlster, Verboon, et al. identify and functionally characterize a complex structural variant in a family with thrombocytopenia that results in a WAC-ANKRD26 fusion transcript encoding a shortened form of ANKRD26, whose expression during hematopoiesis is deregulated, thereby resulting in disease.
Autoimmune Concept of Schizophrenia: Historical Roots and Current Facets.

BACKGROUND The review analyzes the possible role of autoimmune processes in the pathogenesis of schizophrenia and the evolution of concepts on this issue from its origin to the present. RESULTS Risks of autoimmune processes causing schizophrenia are associated with several factors: an impaired functioning of dopaminergic and glutamatergic systems in the brain, kynurenine pathway disorder with overproduction of quinolinic, anthranilic, and kynurenic acids (possibly altering both neurons and T-regulators), increased intestinal permeability, as well as food antigens' effects, stress and infections with various pathogens at different stages of ontogenesis. An increase in the levels of proinflammatory cytokines and chemokines as well as a decrease in the levels of anti-inflammatory ones also may contribute to schizophrenia risks. Schizophrenia often occurs in those patients having various autoimmune diseases and their first-degree relatives. CONCLUSION Cases of schizophrenia resulted from autoimmune pathogenesis (including autoimmune encephalitis caused by autoantibodies against various neuronal antigens) are characterized by quite severe cognitive and psychotic symptoms and a less favorable prognosis. This severe course may result from the chronic immune damage of the neuronal receptors such as NMDA, GABA, and others and depend on hyperprolactinemia, induced by antipsychotics, but aggravating autoimmune processes.
Giant Ferroelectric Resistance Switching Controlled by a Modulatory Terminal for Low‐Power Neuromorphic In‐Memory Computing

Ferroelectrics have been demonstrated as excellent building blocks for high‐performance nonvolatile memories, including memristors, which play critical roles in the hardware implementation of artificial synapses and in‐memory computing. Here, it is reported that the emerging van der Waals ferroelectric α‐In2Se3 can be used to successfully implement heterosynaptic plasticity (a fundamental but rarely emulated synaptic form) and achieve a resistance‐switching ratio of heterosynaptic memristors above 103, which is two orders of magnitude larger than that in other similar devices. The polarization change of ferroelectric α‐In2Se3 channel is responsible for the resistance switching at various paired terminals. The third terminal of α‐In2Se3 memristors exhibits nonvolatile control over channel current at a picoampere level, endowing the devices with picojoule read‐energy consumption to emulate the associative heterosynaptic learning. The simulation proves that both supervised and unsupervised learning manners can be implemented in α‐In2Se3 neutral networks with high image recognition accuracy. Moreover, these heterosynaptic devices can naturally realize Boolean logic without an additional circuit component. The results suggest that van der Waals ferroelectrics hold great potential for applications in complex, energy‐efficient, brain‐inspired computing systems and logic‐in‐memory computers.
Aging Increases Prosocial Motivation for Effort

Social cohesion relies on prosociality in increasingly aging populations. Helping other people requires effort, yet how willing people are to exert effort to benefit themselves and others, and whether such behaviors shift across the life span, is poorly understood. Using computational modeling, we tested the willingness of 95 younger adults (18–36 years old) and 92 older adults (55–84 years old) to put physical effort into self- and other-benefiting acts. Participants chose whether to work and exert force (30%–70% of maximum grip strength) for rewards (2–10 credits) accrued for themselves or, prosocially, for another. Younger adults were somewhat selfish, choosing to work more at higher effort levels for themselves, and exerted less force in prosocial work. Strikingly, compared with younger adults, older people were more willing to put in effort for others and exerted equal force for themselves and others. Increased prosociality in older people has important implications for human behavior and societal structure.
Determining the ambient influences and configuration of optimised environments for emotional wellbeing of older adults

Abstract It is now widely recognised that aspects such as tiredness or mood state can have an impact on an individual’s wellbeing. However, there also exist other less studied factors that might be influential, and whose analysis is important to maximise personal wellbeing. The aim of this study was to determine the influence of a set of 12 selected factors. Using the analysis of a 20-experiment case study by soft computing techniques the intention was to establish the most appropriate configuration for each factor to compose an optimal living environment to foster wellbeing. The analysis revealed that ambient lighting and stress level are the factors that most impact emotional wellbeing. To a lesser extent, being able to take a break, ambient temperature and ambient noise play a relatively determining role. The findings of this work can be used to establish a living environment for older persons that favours their emotional wellbeing. Practitioner summary: This study analyses the level of influence of a set of ambient factors on the emotional wellbeing of older people, conducting, to this end, a series of controlled experiments, and concluding that ambient lighting and stress level are the factors most relevant to promote a better living environment. KEY POINTS Older adults’ emotional interpretation of pictures depends on the environment and ambient factors. Ambient factors, such as lighting and stress, have a significant, positive effect on visual interpretation of stimuli and greater wellbeing. The use of soft computing techniques facilitates the quantification of the influence of factors affecting emotional wellbeing.
UNIVERSIDADE ESTADUAL PAULISTA Programa de Pós-Graduação em Ciência e Tecnologia de Materiais

Tin dioxide, SnO2, is a wide bandgap semiconductor. For the bulk, the bandgap energy may vary in the range 3.6 to 4.2eV, depending on the method used for its preparation or on the theoretical method employed for the bandgap calculation. The combination of its optical, electrical and structural properties is responsible by the large number of technological applications, such as gas sensors, opto-electronic devices, varistors and liquid crystal displays, among others. The bandgap nature has been the focus of controversy among many published papers, either experimental as well as theoretical. In this work, we present a review of published theoretical and experimental papers, selected from the literature, concerning the direct or indirect bandgap nature. A study of optical and structural properties of SnO2 thin films, deposited by the sol-gel-dip-coating technique, on glass and mainly quartz substrates, is also shown. The influence of doping is also analyzed by the structural characterization through X-ray diffraction data as well as optical absorption measurements. Besides, band structure calculation is also shown, performed on bulk, besides (110) and (101) surfaces, using the First Principles method. These results are compared to experimentally obtained bandgap, through experimental data of optical absorption and photoconductivity as function of light wavelength.
An autofluorescence-based survey of late follicular atresia in ovaries of a teleost fish (Thunnus thynnus).

We examined late atretic follicles in ovaries of Atlantic bluefin tuna, Thunnus thynnus (Linnaeus 1758), at different times of the year using transmitted light and epifluorescence microscopy. Atresia (degeneration and resorption of developing ovarian follicles) is a natural process involved in fecundity downregulation in teleosts, and is substantially enhanced in stressful conditions. Early (α and β) atretic stages of yolked oocytes have a relatively short duration in seasonally reproducing species, whereas later (γ and δ) atretic follicles (LAF) persist for longer time in the ovary, serving as a sign of previous vitellogenic activity. LAF can thus be used as reliable markers of maturity during non-reproductive periods. Lipofuscin granules accumulate in the cytoplasm of LAF cells as a result of lysosomal digestion of oocyte components. Taking advantage of the well-known autofluorescent properties of lipofuscins, LAF may be identified in unstained histological sections under fluorescence microscopy using appropriate excitation and emission wavelengths. We explore here the applicability of fluorescence microscopy to provide a fast and effective method to assess late atresia in fishes. This method may be particularly useful to determine sexual maturity in individuals sampled long after the spawning season, where LAF are difficult to detect in standard histological sections. Furthermore, LAF autofluorescence provides a rapid way to quantify late atresia in fishes using image analysis.
急性B淋巴细胞白血病自体CD19 CAR-T制备中CD19 CAR转入体系残留白血病细胞的体外研究

目的 分析复发/难治性急性B淋巴细胞白血病（R/R B-ALL）自体CD19嵌合抗原受体T细胞（CAR-T细胞）制备过程中，培养体系中残留白血病细胞导致CD19 CAR转入白血病细胞的特征和体外杀伤研究。 方法 ①收集30例接受CD19 CAR-T细胞治疗的R/R B-ALL患者及6例健康志愿者外周血单个核细胞（PBMC）；②流式细胞术分析R/R B-ALL患者PBMC经CD3磁珠分选后及体外培养过程中体系白血病细胞残留情况；③患者及健康志愿者PBMC CD3+ T细胞转染CD19 CAR及CD22CAR慢病毒，制备CD19 CAR-T、CD22 CAR-T细胞；④复苏Nalm-6细胞株，CD19 CAR慢病毒转染Nalm-6细胞，制备CD19 CAR-Nalm-6细胞，同时转染患者原代ALL细胞；⑤流式细胞术检测转染率；⑥CCK-8法检测细胞增殖；⑦乳酸脱氢酶（LDH）法检测CD19 CAR-T、CD22 CAR-T细胞对Nalm-6细胞及CD19 CAR-Nalm-6细胞杀伤活性。 结果 ①30例接受CD19 CAR-T细胞治疗的R/R B-ALL患者中，2例CD3+ T细胞中发现3. 32％、2.04％的白血病细胞残留，随体外培养时间延长，在培养第4天，白血病细胞完全消失。 ②体外培养中CD19 CAR-Nalm-6细胞增殖率高于Nalm-6细胞。 ③效靶比为1∶1且共培养24、48、72 h，CD19 CAR-T细胞对Nalm-6细胞的杀伤活性高于CD19 CAR-Nalm-6细胞；与CD19 CAR-T细胞相比，CD22 CAR-T细胞对CD19 CAR-Nalm-6细胞的杀伤活性更高。 ④相同效靶比情况，单独应用CD22 CAR-T细胞对CD19 CAR-Nalm-6细胞的杀伤活性高于CD19 CAR-T联合CD22CAR-T细胞。 结论 CD19 CAR-T细胞制备过程中培养体系残留白血病细胞可能会导致CD19 CAR被引入白血病细胞中而导致CD19 CAR-T细胞治疗失败，在细胞制备过程中需要检测培养体系中白血病细胞的残留情况。 CD22 CAR-T细胞治疗可作为上述情况的挽救治疗措施之一。