Miracle-dz/UniFAR-FTUs huggingface dataset:
Frailty Is a Risk Factor for Postoperative Mortality in Patients With Cirrhosis Undergoing Diverse Major Surgeries

With a rising burden of cirrhosis surgeries, understanding risk factors for postoperative mortality is more salient than ever. The role of baseline frailty has not been assessed in this context. We evaluated the association between patient frailty and postoperative risk among diverse patients with cirrhosis and determined if frailty improves prognostication of cirrhosis surgical risk scores. This was a retrospective cohort study of U.S. veterans with cirrhosis identified between 2008 and 2016 who underwent nontransplant major surgery. Frailty was ascertained using the Hospital Frailty Risk Score (HFRS). Cox regression analysis was used to investigate the impact of patient frailty on postoperative mortality. Logistic regression was used to identify incremental changes in discrimination for postoperative mortality when frailty was added to the risk prediction models, including the Model for End‐Stage Liver Disease (MELD), MELD–sodium (MELD‐Na), Child‐Turcotte‐Pugh (CTP), Mayo Risk Score (MRS), and Veterans Outcomes and Costs Associated With Liver Disease (VOCAL)–Penn. A total of 804 cirrhosis surgeries were identified. The majority of patients (48.5%) had high‐risk frailty at baseline (HFRS >15). In adjusted Cox regression models, categories of increasing frailty scores were associated with poorer postoperative survival. For example, intermediate‐risk frailty (HFRS 5‐15) conferred a 1.77‐fold increased hazard relative to low‐risk frailty (HFRS, <5; 95% confidence interval [CI], 1.06‐2.95; P = 0.03). High‐risk frailty demonstrated a similarly increased hazard (hazard ratio, 1.74; 95% CI, 1.05‐2.88; P = 0.03), suggesting a threshold effect of frailty on postoperative mortality. The incorporation of frailty improved discrimination of MELD, MELD‐Na, and CTP for postoperative mortality, but did not do so for the MRS or VOCAL‐Penn score. Patient frailty was an additional important predictor of cirrhosis surgical risk. The incorporation of preoperative frailty assessments may help to risk stratify patients, especially in settings where the MELD‐Na and CTP are commonly applied.
Photocurrent Characteristics of Mn-Doped Barium Titanate Ferroelectric Single Crystals

We investigated the photocurrent characteristics of ferroelectric single crystals of nondoped barium titanate (BT) and Mn-doped barium titanate (Mn-BT). The introduction of 90° domain structures into the BT crystals markedly increased the photocurrent, which suggests that the separation of photoinduced carriers is significantly enhanced around 90° domain walls (DWs). The Mn doping led to a drastic increase in photocurrent, with a photon energy less than the band gap. Density functional theory calculations show that the large photocurrent observed for the Mn-BT crystals originates from the electron excitation from the O 2p valence band to the Mn eg defect level followed by carrier (hole) injection.
Modification des propriétés optiques de nanofils à base de GaN par plasma N2/O2

A cylindrical Langmuir probe was used to analyze the spatial distribution of the number density of positive ions and electrons as well as the electron energy distribution function (EEDF) in the flowing afterglow of a 6 Torr N2 and N2/O2 plasma sustained by a propagating electromagnetic surface wave in the microwave regime. In pure N2 discharges, ion densities were in the mid 10 14 m -3 in the pink afterglow and in the mid 10 12 m -3 early in the late afterglow. In both pink and late afterglows, the ion population was much higher than the electron population, indicating non-macroscopically neutral media. The EEDF was close to a Maxwellian with an electron temperature of 0.5±0.1 eV, except in the pink afterglow where the temperature rose to 1.1±0.2 eV. This latter behavior is ascribed to N2 vibration-vibration pumping in the pink afterglow that increases the concentration of high N2 vibrational states and thus rises the electron temperature by vibration-electron collisions. After addition of small amounts of O2 in the nominally pure N2 discharge, the charged particles densities and average electron energy first strongly increased and then decreased with increasing O2 concentration. Based on these data and the evolution of the N2 + (B) band emission intensities, it is concluded
Registered nurses in expanded roles improve care in nursing homes: Swiss perspective based on the modified Delphi method

Abstract Aim To define both competencies and envisaged outcomes for registered nurses in expanded roles in Swiss nursing homes to be implemented and evaluated within a new model of care. Background In regions where Advanced Practice Nurses are rare or absent, registered nurses take up clinical leadership and expanded roles. To allow effective implementation, monitoring and evaluation of these nurses, stakeholders need a shared understanding of the competencies they require and what outcomes they should achieve. Design RAND/UCLA Appropriateness Method – a modified Delphi method. Methods A critical literature review and case studies were conducted to identify possible competencies and outcomes for registered nurses in expanded roles. In 2017, a two‐round rating process and an in‐person panel discussion was completed by a group of multi‐professional stakeholders. Findings Two rounds generated 190 competencies and 72 outcomes relevant to registered nurses in expanded roles. Conclusion The relevant competencies and outcomes of registered nurses in expanded roles indicate their support for care teams and development of nursing care in nursing homes. Their geriatric expertise allows them to function as role models and innovators, reinforcing overall perceptions of nursing as a profession. These nurses are especially important in countries and settings where Advanced Practice Nurses are scarce or unavailable. Impact The identified competencies clarify the duties of expanded‐role registered nurses, thereby differentiating them from other care providers. Although conducted in the Swiss healthcare system, our methods and findings can be adapted to other healthcare settings. The results of this study will guide the development of an educational programme in a multi‐centre study to reduce avoidable hospitalizations, while the defined outcomes guide the evaluation of their impact.
Centrosome defects cause microcephaly by activating the 53BP1‐USP28‐TP53 mitotic surveillance pathway

Mutations in centrosome genes deplete neural progenitor cells (NPCs) during brain development, causing microcephaly. While NPC attrition is linked to TP53‐mediated cell death in several microcephaly models, how TP53 is activated remains unclear. In cultured cells, mitotic delays resulting from centrosome loss prevent the growth of unfit daughter cells by activating a pathway involving 53BP1, USP28, and TP53, termed the mitotic surveillance pathway. Whether this pathway is active in the developing brain is unknown. Here, we show that the depletion of centrosome proteins in NPCs prolongs mitosis and increases TP53‐mediated apoptosis. Cell death after a delayed mitosis was rescued by inactivation of the mitotic surveillance pathway. Moreover, 53BP1 or USP28 deletion restored NPC proliferation and brain size without correcting the upstream centrosome defects or extended mitosis. By contrast, microcephaly caused by the loss of the non‐centrosomal protein SMC5 is also TP53‐dependent but is not rescued by loss of 53BP1 or USP28. Thus, we propose that mutations in centrosome genes cause microcephaly by delaying mitosis and pathologically activating the mitotic surveillance pathway in the developing brain.
Alpha-lipoic acid ameliorates cytarabine-induced developmental anomalies in rat fetus

Cytarabine (Ara-C) is a nucleoside analogue used in the treatment of cancers and viral infections. It has teratogenic potential and causes a variety of birth defects in fetuses. Alpha-lipoic acid (ALA) is a natural antioxidant offers protection against the developmental toxicity induced by drug- or toxicant-exposure or pathological conditions. This study was aimed at evaluating the protective effect of ALA against Ara-C induced developmental toxicity in rat fetus. Pregnant rats divided into five groups and received normal saline, ALA200 mg/kg, Ara-C12.5 mg/kg, Ara-C25 mg/kg and, Ara-C25 mg/kg plus ALA200 mg/kg respectively from gestational day (GD) 8 to GD14 and sacrificed on GD21. Ara-C treatment led to a significant and dose-dependent decrease in food intake, weight gain, placental weight, and an increase in oxidative stress in pregnant rats. Further, the in-utero exposure to Ara-C led to an increase in fetal mortality, resorptions, oxidative stress, external morphological anomalies and limb abnormalities, and impaired ossification. Co-administration of ALA resulted in amelioration of the footprints of Ara-C induced toxicity in pregnant rats as well as the fetus. These findings indicate that the ALA supplementation offers protection against developmental toxicity caused by Ara-C prenatal exposure in rats.
Krebs von den Lungen 6 decreased in the serum and muscle of GNE myopathy patients

UDP‐N‐acetylglucosamine 2‐epimerase/N‐acetylmannosamine kinase (GNE) is necessary for sialic acid biosynthesis. GNE myopathy is caused by a defect in GNE, and hyposialylation is a key factor in the pathomechanism of GNE myopathy. Although candidates for evaluating hyposialylation have been reported, it is difficult to measure them in routine clinical practice. Sialylation is necessary for synthesis of various glycoproteins, including Krebs von den Lungen‐6 (KL‐6)/mucin 1 (MUC1). Here we report that KL‐6/MUC1 is decreased in GNE myopathy. We observed that KL‐6 levels were decreased in the serum of patients with GNE myopathy, and that KL‐6 and MUC1‐C were also decreased in muscle biopsy specimens from these patients. An immunofluorescent study revealed that KL‐6 and MUC1‐C were not present in the sarcolemma but were, instead, localized in rimmed vacuoles in specimens from patients with GNE myopathy. KL‐6 is already used to detect lung diseases in clinical practice, and this glycoprotein may be a novel candidate for evaluating hyposialylation in GNE myopathy.
24‐h ambulatory blood pressure variability and hypertensive nephropathy in Han Chinese hypertensive patients

Blood pressure (BP) is characterized by spontaneous oscillation over time, which is described as BP variability (BPV). The current study aimed to investigate whether short‐term BPV was correlated with hypertensive nephropathy in Han Chinese individuals with hypertension. A single‐center prospective cohort study of 300 Han Chinese participants with hypertension was conducted in Taiwan. Five different BPV parameters were derived from ambulatory BP monitoring (ABPM), including standard deviation (SD), weighted SD (wSD), coefficient of variation (CoV), successive variation (SV), and average real variability (ARV). Renal event was defined as > 50% reduction in baseline estimated glomerular filtration rate (eGFR). The average age of the participants was 63.5 years. The baseline eGFR was 84.5 mL/min/1.73 m2. The participants were divided into two groups according to the wSD of systolic BP (SBP). Survival was assessed via a Kaplan‐Meier analysis. During the 4.2‐year follow‐up, the participants with the highest SBP wSD tertile had a greater number of renal events (6.0%) than their counterparts (0.5%) (log‐rank test, p = .007). The Cox proportional hazard regression model was used to assess the independent effects of BPV, and results showed that 24‐h SBP (HR = 1.105; 95% CI = 1.020–1.197, p = .015) and 24‐h DBP (HR = 1.162; 95% CI = 1.004–1.344, p = .044) were independently associated with renal events. However, BPV parameters were only associated with renal events univariately, but not after adjusting for baseline characteristics, 24‐h mean BP, and office BP. Therefore, the risk of hypertensive nephropathy was independently associated with 24‐h mean BP, but not with ambulatory BPV, in Han Chinese participants with hypertension.
A randomised controlled trial assessing the effect of a Mediterranean diet on the symptoms of depression in young men (the ‘AMMEND’ study): a study protocol

Abstract Depression affects approximately 350 million people worldwide. Evidence suggests that diet plays an important role with the Mediterranean diet (MD) displaying promising preliminary results. Currently, most of the research is conducted on women and older adults; however, the majority of mental illnesses occur before the age of 25 years. Men are less likely to seek help than women with only 13 % of young men aged 15–24 years seeking help for their mental health. Young men are hugely underrepresented in the current research which poses a significant issue. A 12-week randomised controlled trial will be conducted to examine the effect of a MD on the symptoms of depression in young men aged 18–25 years. Participants will be randomised to either follow a MD or receive the inactive control therapy befriending. Participants will attend three appointments at baseline, week 6 and week 12. The main outcome will be changes to the Beck’s Depression Inventory score. This research aims to answer the question of whether diet can be used effectively in this population. This will be the first trial to examine the effect of a MD on the symptoms of depression in young men. This trial will help fill a significant research gap, contribute to the growing field of nutritional psychiatry, guide future research and inform advice given by clinicians to this specific demographic.
Hip precautions after primary total hip arthroplasty: a qualitative exploration of clinical reasoning

Abstract Purpose Hip precautions are movement restrictions that are often advised following primary total hip arthroplasty (PTHA) for osteoarthritis (OA), but there is limited evidence supporting their effectiveness in preventing dislocation. This study aimed to explore the clinical reasoning behind the continuation and discontinuation of hip precautions following PTHA for OA. Materials and methods Semi-structured interviews were conducted with therapists and surgeons at six centres using precautions and six centres not using precautions across secondary or tertiary NHS sites in England. Interviews were transcribed verbatim and thematically analysed. Results Interviews were conducted with fourteen surgeons and eighteen therapists. Of these clinicians, eight surgeons and ten therapists routinely advised precautions. Clinicians continued to use precautions to avoid dislocation by creating a boundary to movement, particularly important when dealing with patients who “push” these boundaries. Clinicians discontinued precautions because of a perceived negative impact on patients and the lack of supporting evidence. In the absence of a rise in dislocation rates for these centres, others have now changed practice. Conclusion This study offers insight into the clinical reasoning behind the continuation and discontinuation of hip precautions following PTHA for OA. The use of precautions remains controversial and further work is required to determine whether or not they should be advised. IMPLICATIONS FOR REHABILITATION Redesign of future rehabilitation pathways for primary total hip arthroplasty should take into account viewpoints from across the multidisciplinary team to aid decision making. Concern for patient behaviours, dislocation and litigation may be barriers to changing practice for rehabilitation after primary total hip arthroplasty. Clinicians may be discontinuing hip precautions because of known surgical advances, a perceived negative impact on patients and a lack of supporting evidence for historical practice. Individualised rehabilitation considerations are necessary for patients with risk factors that predispose them to dislocation after primary total hip arthroplasty, regardless of whether hip precautions are advised as standard at their given centre.
Rectifying the Mischaracterization of Logic by Mental Model Theorists

Khemlani et al. (2018) mischaracterize logic in the course of seeking to show that mental model theory (MMT) can accommodate a form of inference ( I , let us label it) they find in a high percentage of their subjects. We reveal their mischaracterization and, in so doing, lay a landscape for future modeling by cognitive scientists who may wonder whether human reasoning is consistent with, or perhaps even capturable by, reasoning in a logic or family thereof. Along the way, we note that the properties touted by Khemlani et al. as innovative aspects of MMT-based modeling (e.g., nonmonotonicity) have for decades been, in logic, acknowledged and rigorously specified by families of (implemented) logics. Khemlani et al. (2018) further declare that I is "invalid in any modal logic. " We demonstrate this to be false by our introduction (Appendix A) of a new propositional modal logic (within a family of such logics) in which I is provably valid, and by the implementation of this logic. A second appendix, B, partially answers the two-part question, "What is a formal logic, and what is it for one to capture empirical phenomena? "
Host-association as major driver of microbiome structure and composition in Red Sea seagrass ecosystems.

The role of the microbiome in sustaining seagrasses has recently been highlighted. However, our understanding of the seagrass microbiome lacks behind that of other organisms. Here, we analyze the endophytic and total bacterial communities of leaves, rhizomes, and roots of six Red Sea seagrass species and their sediments. The structure of seagrass bacterial communities revealed that the 1% most abundant OTUs accounted for 87.9 and 74.8 % of the total numbers of reads in sediment and plant tissue samples, respectively. We found taxonomically distinct bacterial communities in vegetated and bare sediments. Yet, our results suggest that lifestyle (i.e. free-living or host-association) is the main driver of bacterial community composition. Seagrass bacterial communities were tissue- and species-specific and differed from those of surrounding sediments. We identified OTUs belonging to genera related to N and S cycles in roots, and members of Actinobacteria, Bacteroidetes, and Firmicutes phyla as particularly enriched in root endosphere. The finding of highly similar OTUs in well-defined sub-clusters by network analysis suggests the co-occurrence of highly connected key members within Red Sea seagrass bacterial communities. These results provide key information towards the understanding of the role of microorganisms in seagrass ecosystem functioning framed under the seagrass holobiont concept. This article is protected by copyright. All rights reserved.
PIDDosome‐induced p53‐dependent ploidy restriction facilitates hepatocarcinogenesis

Polyploidization frequently precedes tumorigenesis but also occurs during normal development in several tissues. Hepatocyte ploidy is controlled by the PIDDosome during development and regeneration. This multi‐protein complex is activated by supernumerary centrosomes to induce p53 and restrict proliferation of polyploid cells, otherwise prone for chromosomal instability. PIDDosome deficiency in the liver results in drastically increased polyploidy. To investigate PIDDosome‐induced p53‐activation in the pathogenesis of liver cancer, we chemically induced hepatocellular carcinoma (HCC) in mice. Strikingly, PIDDosome deficiency reduced tumor number and burden, despite the inability to activate p53 in polyploid cells. Liver tumors arise primarily from cells with low ploidy, indicating an intrinsic pro‐tumorigenic effect of PIDDosome‐mediated ploidy restriction. These data suggest that hyperpolyploidization caused by PIDDosome deficiency protects from HCC. Moreover, high tumor cell density, as a surrogate marker of low ploidy, predicts poor survival of HCC patients receiving liver transplantation. Together, we show that the PIDDosome is a potential therapeutic target to manipulate hepatocyte polyploidization for HCC prevention and that tumor cell density may serve as a novel prognostic marker for recurrence‐free survival in HCC patients.
Platelet-rich plasma for genital lichen sclerosus: analysis and results of 94 patients. Are there gender-related differences in symptoms and therapeutic response to PRP?

Abstract Background Lichen sclerosus is a chronic relapsing inflammatory dermatosis with a predilection for anogenital skin in 85%–98% of cases and is more prevalent in women (3%) than in men (> 0.07%). Objectives The purpose of this study was to investigate gender differences in clinical presentation and therapeutic response to treatment with platelet-rich plasma (PRP), an emerging innovative strategy for LS. Methods Forty-three male and 51 female patients affected by LS were evaluated. Each patient was subjected to PRP treatment (1 infiltration every 15 days, for 3 times). Results The PRP procedure was well tolerated by all patients and an overall significant decrease in symptoms was reported 6 months after PRP infiltration. Reduction in pain and burning sensation was significant in both gender but more accentuated in women than in men, whereas reduction of itching was similar. On the contrary, dyspareunia evidenced sex-related difference since a significant diminution was observed only in male. Conclusions This study demonstrates that PRP based therapy may exert a relevant role in LS patient management due to its effect on Quality of Life (QoL) and sexual function in both gender. In addition, the study underlined gender-related differences in severity of symptoms and disease age onset.
Use of biochar by sheep: Impacts on diet selection, digestibility and performance.

The objective of this study was to determine the influence of biochar obtained from exothermic production of lodgepole pine (Pinus contorta) and quaking aspen (Populus tremuloides) on sheep performance and diet digestibility, and on preference for a ration enriched with this carbon-based material. Twenty-four lambs were housed in individual pens and assigned to one of three treatment groups (8 animals/group), where they received: 1) a 60:40 ration of alfalfa:barley (Control), 2) an isoenergetic and isonitrogenous ration with alfalfa, barley and 2% biochar (BC), and 3) a simultaneous offer of the Control and BC rations (Choice). Lambs were exposed to two consecutive feeding periods (Periods 1-13 d, and 2-21d), representing time intervals where the evolution of intake, animal performance and rumen parameters were assessed; in vivo digestibility was determined during the last 5 d of the study. Ration intake did not differ among groups of lambs (P > 0.10), although during some days in Period 2 intake was greater for the BC and Choice groups than for the Control group (P < 0.05). Lambs in Choice had a lower preference for BC than for the Control ration (Period 1: P < 0.05; Period 2: P < 0.10), although they incorporated a substantial amount of BC (39 and 40%, for Periods 1 and 2, respectively) into their diets. No differences in body weight gains (ADG) or gain-to-feed ratios were found among groups of animals (P > 0.10), although DMD and DDMI was greater for lambs in the BC group than for lambs in Control (P < 0.05). The ruminal concentration of the volatile acid acetate in Period 2 was greater for BC than for Choice (P < 0.05). During the same period, the concentration of valerate and ruminal pH values were greater in BC than in Control (P < 0.05). Thus, the addition of biochar to grain-based diets enhanced diet digestibility and influenced some ruminal parameters in lambs. Nevertheless, these positive effects were not reflected in significant improvements on ADG or feed conversion efficiencies. Lambs offered choices between Control and BC rations formed a diet with concentrations of biochar of ~1.2%, suggesting that these animals would tolerate such levels without reductions in ration palatability.