Miracle-dz/UniFAR-FTUs huggingface dataset:
Predictors of acute care utilization and acute pain treatment outcomes in adults with sickle cell disease: The role of non‐hematologic characteristics and baseline chronic opioid dose

Despite its rarity in the United States, sickle cell disease accounts for a disproportionate amount of healthcare utilization and costs. The majority of this is due to acute care for painful crises. A small subpopulation of patients accounts for most these costs due to frequent visits to emergency departments and acute care facilities. Previous investigations have found that these high utilizing patients are distinguished by both a more severe disease course and certain non‐hematologic characteristics, which may include higher socioeconomic status and some psychiatric and psychological characteristics. This prospective observational cohort study was undertaken to test the ability of these characteristics to prospectively predict acute pain care outcomes, including visit frequency, total opioid doses, and pain improvement at the Johns Hopkins Sickle Cell Infusion Center (SCIC). Seventy‐three participants were followed for 12 months and SCIC utilization and treatment outcomes were tabulated for 378 visits. Participants who visited the SCIC most frequently had markedly worse pain improvement despite higher within‐visit opioid doses. Higher utilization was associated with indicators of greater illness severity, more aggressive treatment for sickle cell disease, higher baseline opioid doses, higher socioeconomic status, greater pain‐related anxiety, and a history of psychiatric treatment. Overall, poor acute pain treatment response was associated with higher utilization and higher baseline opioid doses. The pattern of association between high utilization, poor acute care outcomes, and higher baseline opioid doses is discussed in terms of prior research and future directions.
Targeting chemo-proton therapy on C6 cell line using superparamagnetic iron oxide nanoparticles conjugated with folate and paclitaxel

Abstract Purpose: This report presents novel nanoparticle-based drug delivery system (NPDDS) aiming to targeting chemo-proton therapy (TCPT) to improve the therapeutic efficacy on brain cancer treatments. Materials and methods: A NPDDS, superparamagnetic iron oxide nanoparticles conjugated with folate and paclitaxel, was synthesized and applied to C6 brain cancer cell line that was prepared for TCPT. The characterization of NPDDS was analyzed by transmission electron microscope (TEM) and Fourier transform infrared (FTIR) spectroscopy. The uptake of NPDDS into the cytoplasm of C6 cells was observed by confocal laser scanning microscopy (CLSM). The therapeutic efficacy of proton beam was quantitatively evaluated by flow cytometry and clonogenic assay at various radiation dose. Results: NPDDS was synthesized in the uniform size distribution with a mean diameter of 5.44 ± 0.70 nm, and it showed no significant cytotoxicity at the concentration lower than 200 ng/mL. Radiosensitization enhancement factors of PTX, D-SPIONs and FA-PTX-D-SPIONs were 1.35, 1.16 and 1.52, respectively. Conclusions: It was demonstrated that TCPT improved the therapeutic efficacy of the proton beam therapy when the synthesized novel NPDDS was administrated. The improvement in therapeutic efficacy was achieved by the synergetic effect of drug delivery increased by FA, radiosensitivity increased by PTX and absorption of proton energy increased by SPIONs.
Exercise modulates the interaction between cognition and anxiety in humans

ABSTRACT Despite interest in exercise as a treatment for anxiety disorders the mechanism behind the anxiolytic effects of exercise is unclear. Two observations motivate the present work. First, engagement of attention control during increased working memory (WM) load can decrease anxiety. Second, exercise can improve attention control. Therefore, exercise could boost the anxiolytic effects of increased WM load via its strengthening of attention control. Anxiety was induced by threat of shock and was quantified with anxiety-potentiated startle (APS). Thirty-five healthy volunteers (19 male, age M = 26.11, SD = 5.52) participated in two types of activity, exercise (biking at 60–70% of heart rate reserve) and control-activity (biking at 10–20% of heart rate reserve). After each activity, participants completed a WM task (n-back) at low- and high-load during safe and threat. Results were not consistent with the hypothesis: exercise vs. control-activity increased APS in high-load (p = .03). However, this increased APS was not accompanied with threat-induced impairment in WM performance (p = .37). Facilitation of both task-relevant stimulus processing and task-irrelevant threat processing, concurrent with prevention of threat interference on cognition, suggests that exercise increases cognitive ability. Future studies should explore how exercise affects the interplay of cognition and anxiety in patients with anxiety disorders.
USO PROBLEMÁTICO DE LOS VIDEOJUEGOS Y RENDIMIENTO ACADÉMICO

El objetivo del estudio consiste identificar el grado de prevalencia del uso problematico de los videojuegos en una muestra de ninos y adolescentes de la ciudad de Ibague. El estudio permitio estudiar psicometricamente el instrumento Problem Video Game Playing Questionnaire (PVP) (Tejeiro y Bersabe, 2002). Se implemento una muestra de tipo aleatoria de 200 participantes entre las edades de 12 a 18 anos, para poder relacionar el uso problematico de los videojuegos con el rendimiento academico, entre estudiantes de primaria y secundaria de la Escuela Normal Superior de la ciudad de Ibague. Los resultados sugieren que el PVP, no mide una sola dimension sino tres dimensiones las cuales son: “respuestas psicofisiologicas relacionadas con el uso de los videojuegos”, “ocultar o mentir para el uso de los videojuegos” y por ultimo “factores relacionados con no jugar videojuegos”, asi mismo no se presenta una relacion significativa entre la percepcion del rendimiento academico y el uso de los videojuegos
COMP report: CPQR technical quality control guidelines for Gamma Knife radiosurgery

Abstract The Canadian Organization of Medical Physicists (COMP), in close partnership with the Canadian Partnership for Quality Radiotherapy (CPQR), has developed a series of Technical Quality Control (TQC) guidelines for radiation treatment equipment. These guidelines outline the performance objectives that equipment should meet in order to ensure an acceptable level of radiation treatment quality. The TQC guidelines have been rigorously reviewed and field tested in a variety of Canadian radiation treatment facilities. The development process enables rapid review and update to keep the guidelines current with changes in technology (the most updated version of this guideline can be found on the CPQR website). This particular TQC details recommended quality control testing for Gamma Knife radiosurgery.
Expected consequences of including methane footprint into the breeding goals in beef cattle. A Spanish Blonde d'Aquitaine population as a case of study

This study evaluates two potential scenarios for including methane (CH4 ) emissions in the breeding objectives of beef cattle, using the Spanish population of Blonde d'Aquitaine as a case of study. First, CH4 emissions were included as a cost using a shadow carbon price of 1.22€/CH4 kg (0.044€/CO2 kg) (carbon tax scenario). In the other scenario, a CH4 quota was applied, optimizing emissions per unit of product. The current production system was used as benchmark scenario (Scenario 1). The economic value of CH4 was calculated under all scenarios using a bioeconomic model that translated the production system into a mathematical function. Then, CH4 emissions were included with proper relative weight in the selection index under each scenario. The economic value of CH4 production from cows was -0.54€/year and -0.16€/year in a carbon tax and in a CH4 quota scenario, respectively. Economic values for CH4 production from fattening calves were -1.22€/year and -0.34€/year in a carbon tax and a quota scenario, respectively. The relative weights of total CH4 traits in the indices were 4.9% and 1.8% in a carbon tax and quota scenario. The carbon tax scenario led to smaller cows (-7.59 kg of mature weight) and a decrease in carcass weight gain of calves (-4.78 g/day) involving a reduction in emissions in comparison with Scenario 1 (-0.76 CH4 kg/slaughtered calf/year). However, it also led to a lower expected gain in profit per unit of product (-7.86 €/slaughtered calf/year). A carbon quota scenario would select slightly smaller cows (-0.48 kg) with similar responses in maternal abilities (age at first calving, calving interval, maternal weaning weight, and calving ease) and growth, and lower emissions (-0.22 CH4 kg/slaughtered calf/year) regarding the benchmark scenario. Profit per cow would increase by +1.52€/slaughtered calf/year although this scenario implies a reduction in the number of cows per herd. In a carbon tax scenario, higher reduction in emissions implied a reduction of profitability per animal.
An end in sight? Xrn2 and transcriptional termination by RNA polymerase II

ABSTRACT Every transcription cycle ends in termination when RNA polymerase dissociates from the DNA. Although conceptually simple, the mechanism has proven somewhat elusive in eukaryotic systems. Gene-editing and high resolution polymerase mapping now offer clarification of important steps preceding transcriptional termination by RNA polymerase II in human cells.
Multivariate species boundaries and conservation of harlequin poison frogs

In this study, we present an iterative method for delimiting species under the general lineage concept (GLC) based on the multivariate clustering of morphological, ecological and genetic data. Our rationale is that distinct multivariate groups correspond to evolutionarily independent metapopulation lineages because they reflect the common signal of different secondary defining properties (environmental and genetic distinctiveness, phenotypic diagnosability, etc.) that imply the existence of barriers preventing or limiting gene exchange. We applied this method to study a group of endangered poison frogs, the Oophaga histrionica complex. In our study case, we used next‐generation targeted amplicon sequencing to obtain a robust genetic data set that we combined with patterns of morphological and ecological features. Our analyses revealed the existence of at least five different species in the histrionica complex (three, new to science), some of them, occurring in small isolated populations outside any protected areas. The lineage delimitation proposed here has important conservation implications as it revealed that some of the Oophaga species should be considered among the most vulnerable of the Neotropical frogs. More broadly, our study exemplifies how multiple‐amplicon and multivariate statistical techniques can be integrated to successfully identify species and their boundaries.
Effects of Organized Colorectal Cancer Screening on Cancer Incidence and Mortality in a Large Community-Based Population.

BACKGROUND & AIMS Little information is available on the effectiveness of organized colorectal cancer (CRC) screening on screening uptake, incidence, and mortality in community-based populations. METHODS We contrasted screening rates, age-adjusted annual CRC incidence, and incidence-based mortality rates before (baseline year 2000) and after (through 2015) implementation of organized screening outreach, from 2007 through 2008 (primarily annual fecal immunochemical testing and colonoscopy), in a large community-based population. Among screening-eligible individuals 51-75 years old, we calculated annual up-to-date status for cancer screening (by fecal test, sigmoidoscopy, or colonoscopy), CRC incidence, cancer stage distributions, and incidence-based mortality. RESULTS Initiation of organized CRC screening significantly increased the up-to-date status of screening, from 38.9% in 2000 to 82.7% in 2015 (P < .01). Higher rates of screening were associated with a 25.5% reduction in annual CRC incidence between 2000 and 2015, from 95.8 to 71.4 cases/100,000 (P < .01), and a 52.4% reduction in cancer mortality, from 30.9 to 14.7 deaths/100,000 (P < .01). Increased screening was initially associated with increased CRC incidence, due largely to greater detection of early-stage cancers, followed by decreases in cancer incidence. Advanced-stage CRC incidence rates decreased 36.2%, from 45.9 to 29.3 cases/100,000 (P < .01), and early-stage CRC incidence rates decreased 14.5%, from 48.2 to 41.2 cases/100,000 (P < .04). CONCLUSIONS Implementing an organized CRC screening program in a large community-based population rapidly increased screening participation to the ≥80% target set by national organizations. Screening rates were sustainable and associated with substantial decreases in CRC incidence and mortality within short time intervals, consistent with early detection and cancer prevention.
A safety review of proton pump inhibitors to treat acid-related digestive diseases

ABSTRACT Introduction: Proton pump inhibitors (PPIs) have become the first choice medical treatment of acid-related disease and, as with any pharmacological agent, they have been reported to be associated with some adverse events mainly linked to their chronic use. The most important postulated harms are represented by serum electrolyte alterations, vitamin B12 and iron deficiency, gastric tumors, enteric infections, spontaneous bacterial peritonitis, pneumonia, ischemic heart attacks, bone fractures, chronic kidney disease, dementia, and Alzheimer disease. Specific pathophysiological mechanisms have been identified for some of them and not for other manifestations. Areas covered: However, studies on PPIs safety have generally important limitations because of their frequent retrospective design and other methodological drawbacks, such as patients’ selection and residual confounders. Expert opinion: Obviously, in the vast majority of the cases, adverse drug reactions cannot be assessed by means of randomized clinical trials due to the high costs, ethical reasons, and difficulties in performing prospective observational studies. So far, assessment of retrospective observational investigations remains the only method to evaluate adverse events with any drug in general and, although the weaknesses of these studies are evident, the awareness of the reported associations with the medications analyzed is important for physicians in order to manage adequately their individual patients.
High-spatial-resolution x-ray fluorescence tomography with spectrally matched nanoparticles

Present macroscopic biomedical imaging methods provide either morphology with high spatial resolution (e.g. CT) or functional/molecular information with lower resolution (e.g. PET). X-ray fluorescence (XRF) from targeted nanoparticles allows molecular or functional imaging but sensitivity has so far been insufficient resulting in low spatial resolution, despite long exposure times and high dose. In the present paper, we show that laboratory XRF tomography with metal-core nanoparticles (NPs) provides a path to functional/molecular biomedical imaging with ~100 µm resolution in living rodents. The high sensitivity and resolution rely on the combination of a high-brightness liquid-metal-jet x-ray source, pencil-beam optics, photon-counting energy-dispersive detection, and spectrally matched NPs. The method is demonstrated on mice for 3D tumor imaging via passive targeting of in-house-fabricated molybdenum NPs. Exposure times, nanoparticle dose, and radiation dose agree well with in vivo imaging.
Dystonia: diagnosis and management

Clinical practice in dystonia has greatly evolved in recent years; a synthetic review on patient management is provided here. Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures or both. A recent classification has innovated clinical practice and serves as guidance for clinical assessment: Axis I describes clinical features, whereas Axis II indicates etiology. Dystonia presents with different syndromic aggregations with varied somatic involvement and some common features. There are five recognizable physical signs of dystonia: two main signs (dystonic postures and movements) and three additional signs (gestes antagonistes or tricks, mirror dystonia and overflow dystonia). There is still no validation of diagnostic criteria for the different dystonia syndromes, and many cases with mild phenomenology remain undiagnosed. Patients with dystonia also present non‐motor features that are variably combined with the movement disorder. The features of the most common inherited and acquired dystonia syndromes are reviewed here. There is clear evidence of genetic–environmental interaction in the determinism of dystonia. The diagnostic process is guided by clinical examination and based on specific laboratory examinations. Symptomatic treatments are available for dystonia: botulinum neurotoxin injections are the primary choice for most focal dystonia syndromes; deep brain stimulation is useful in some generalized and non‐generalized syndromes. Additional treatment strategies are currently being assessed.
Ion Densities in the Nightside Ionosphere of Mars: Effects of Electron Impact Ionization

We use observations from the Mars Atmosphere and Volatile EvolutioN (MAVEN) mission to show how superthermal electron fluxes and crustal magnetic fields affect ion densities in the nightside ionosphere of Mars. We find that due to electron impact ionization, high electron fluxes significantly increase the CO 2+ , O+, and O 2+ densities below 200 km but only modestly increase the NO+ density. High electron fluxes also produce distinct peaks in the CO 2+ , O+, and O 2+ altitude profiles. We also find that superthermal electron fluxes are smaller near strong crustal magnetic fields. Consequently, nightside ion densities are also smaller near strong crustal fields because they decay without being replenished by electron impact ionization. Furthermore, the NO+/O 2+ ratio is enhanced near strong crustal fields because, in the absence of electron impact ionization, O 2+ is converted into NO+ and not replenished. Our results show that electron impact ionization is a significant source of CO 2+ , O+, and O 2+ in the nightside ionosphere of Mars.
Exploring the characteristics and context that allow Master Adaptive Learners to thrive

Abstract Because change is ubiquitous in healthcare, clinicians must constantly make adaptations to their practice to provide the highest quality care to patients. In a previous article, Cutrer et al. described a metacognitive approach to learning based on self-regulation, which facilitates the development of the Master Adaptive Learner (MAL). The MAL process helps individuals to cultivate and demonstrate adaptive expertise, allowing them to investigate new concepts (learn) and create new solutions (innovate). An individual’s ability to learn in this manner is driven by several internal characteristics and is also impacted by numerous aspects of their context. In this article, the authors examine the important internal and contextual factors that can impede or foster Master Adaptive Learning.
Achieving the first 90 for key populations in sub‐Saharan Africa through venue‐based outreach: challenges and opportunities for HIV prevention based on PLACE study findings from Malawi and Angola

Providing outreach HIV prevention services at venues (i.e. “hotspots”) where people meet new sex partners can decrease barriers to HIV testing services (HTS) for key populations (KP) in sub‐Saharan Africa (SSA). We offered venue‐based HTS as part of bio‐behavioural surveys conducted in urban Malawi and Angola to generate regional insights into KP programming gaps and identify opportunities to achieve the “first 90” for KP in SSA.
Painless Swelling of the Left Jaw in a Two-Year-Old Boy

We present a case of a 2-year-old boy with chronic suppurative osteomyelitis of the left jaw. A computed tomography (CT) scan demonstrated a periosteal reaction on the left side of the mandible with cortical destruction of the left mandibular head. The diagnosis could be confirmed histologically. During biopsy of the mandibular lesion, a purulent exudate was withdrawn.
Genetic Determinants of Vitamin D-Related Disorders; Focus on Vitamin D Receptor.

BACKGROUND The endocrine system of vitamin D is involved in an extensive variety of biological processes such as bone metabolism, regulation of cell proliferation and differentiation and modulation of the immune response. The active form of vitamin D, 25-hydroxyvitamin D, binds to vitamin D receptor (VDR) controlling the synthesis of many different proteins. Although numerous studies reported polymorphism in the VDR gene, the impact of the polymorphic alleles on VDR protein function remains unknown. METHODS We presented a comprehensive review of the evidence on the role of genetic polymorphisms, especially those of VDR, in vitamin D-related disorders including their clinical implications. Relevant papers we identified be an extensive search of bibliographic databases using appropriate keywords. RESULTS VDR gene variants seem to influence many biological endpoints, including those related to osteoporosis. BsmI, ApaI, and TaqI are the three adjacent single nucleotide polymorphisms in the VDR gene which have been most frequently studied so far. These polymorphisms are apparently nonfunctional, and one or more functional polymorphism elsewhere in the VDR gene, and linkage disequilibrium may explain the association between VDR genes polymorphisms and common diseases. CONCLUSION In different study populations, different alleles of the anonymous restriction fragment length polymorphisms can be found associated with the same endpoint. This effect probably reflects that linkage disequilibrium, between the anonymous marker alleles and the causative alleles in (or very near) the VDR gene, is likely to be different between populations.