Miracle-dz/UniFAR-FTUs huggingface dataset:
Development of and adherence to an ERAS® and prehabilitation protocol for patients undergoing pancreatic surgery: An observational study

Background and objective: There are still gaps in knowledge concerning the adherence to different multimodal pathways in pancreatic surgery. The aim of this trial was to explore and evaluate an Enhanced Recovery After Surgery (ERAS®) and prehabilitation protocol in patients undergoing open pancreatic surgery. Methods: Three groups of patients were included: two prospective series of 75 patients undergoing open pancreatic surgery following an ERAS® protocol with or without prehabilitation, and one group of 55 historical controls. Variables regarding adherence to, and effects of the protocols, were collected from the local database and the patients’ hospital records. Patients’ adherence to advice given pre-operatively was followed up using a study-specific questionnaire. Results: The patients reported high adherence to remembered advice given. The health care professionals’ adherence to the various parts of the concepts varied. ERAS® implementation resulted in more frequent gut motility stimulation (p < 0.001) and shorter duration of epidural anesthesia, site drains, and urinary catheter (p = 0.001). With prehabilitation, more patients were screened concerning nutritional status and prescribed preoperative training (p < 001). There was a significant change in weight before surgery, a shorter time to first flatus and a shorter length of stay after implementation of the concepts (p < 0.05). Complications were rare in all three groups and there were no significant differences between the groups. Conclusion: The implementation of an ERAS® and a prehabilitation protocol increased adherence to the protocols by both patients and healthcare professionals. An implementation of an ERAS® protocol with and without prehabilitation decreases length of stay and may decrease preoperative weight loss and time to bowel movement.
Continuous action with a neurobiologically inspired computational approach reveals the dynamics of selection history

Everyday perception-action interaction often requires selection of a single goal from multiple possibilities. According to a recent framework of attentional control, object selection is guided not only by the well-established factors of perceptual salience and current goals but also by selection history. Yet, underlying mechanisms linking selection history and visually-guided actions are poorly understood. To examine such interplay and disentangle the impact of target and distractor history on action selection, we employed a priming-of-popout (PoP) paradigm combined with continuous tracking of reaching movements and computational modeling. Participants reached an odd-colored target among homogeneous distractors while we systematically manipulated the sequence of target and distractor colors from one trial to the next. We observed that current reach movements were significantly influenced by the interaction between attraction by the prior target feature and repulsion by the prior distractor feature. With principal component regression, we found that inhibition led by prior distractors influenced reach target selection earlier than facilitation led by the prior target. In parallel, our newly developed computational model validated that current reach target selection can be explained best by the mechanism postulating the preceded impact of previous distractors followed by a previous target. Such converging empirical and computational evidence suggests that the prior selection history triggers a dynamic interplay between target facilitation and distractor inhibition to guide goal-directed action successfully. This, in turn, highlights the necessity of an explicitly integrated approach to determine how visual attentional selection links with adaptive actions in a complex environment.
Progress in Stem Cells-Based Replacement Therapy for Retinal Pigment Epithelium: In Vitro Differentiation to In Vivo Delivery

Abstract Retinal pigment epithelium (RPE) is a critical cell monolayer forming the blood-retina-barrier (BRB) and a permeable bridge between the choriocapillaris and the retina. RPE is also crucial in maintaining photoreceptor function and for completing the visual cycle. Loss of the RPE is associated with the development of degenerative diseases like age-related macular degeneration (AMD). To treat diseases like AMD, pluripotent stem cell-derived RPE (pRPE) has been recently explored extensively as a regenerative module. pRPE like other ectodermal tissues requires specific lineage differentiation and long-term in vitro culturing for maturation. Therefore, understanding the differentiation process of RPE could be useful for stem cell-based RPE derivation. Developing pRPE-based transplants and delivering them into the subretinal space is another aspect that has garnered interest in the last decade. In this review, we discuss the basic strategies currently employed for stem cell-based RPE derivation, their delivery, and recent clinical studies related to pRPE transplantation in patients. We have also discussed a few limitations with in vitro RPE culture and potential solutions to overcome such problems which can be helpful in developing functional RPE tissue.
Bone morphogenetic protein (BMP)9 in cancer development: mechanistic, diagnostic, and therapeutic approaches?

Abstract Bone morphogenetic protein (BMP)-9 is considered a member of the transforming growth factor (TGF)β superfamily. It was first found as an inducer of bone and cartilage formation and then discovered that this factor mediates several physiologic functions and hemostasis. Besides physiological conditions, BMP9 has also been elucidated that it is involved in several pathological situations, especially cancer. In various cancers, dysregulation of BMP9 has raised the issue that BMP9 might play a conflicting role in tumour development. BMP9 binding to its receptors (BMPRs), including ALKs and BMPRII, induces canonical SMAD-dependent and non-canonical PI3K/AKT and MAPK signalling pathways in tumour cells. BMP9, via inducing apoptosis, inhibiting tumour-promoting cell signalling pathways, suppressing epithelial-mesenchymal transition (EMT) process, blocking angiogenesis, and preventing cross-talk in the tumour microenvironment, mainly exerts tumour-suppressive functions. In contrast, BMP9 triggers tumour-supportive signalling pathways, promotes EMT, and enhances angiogenesis, suggesting that BMP9 is also involved in tumour development. It has been demonstrated that modulating BMP9 expression and functions might be a promising approach to cancer treatment. It has also been indicated that evaluating BMP9 expression in cancers might be a biomarker for predicting cancer prognosis. Overall, BMP9 would provide a promising target in cancer management.
Resolution of overlapping ultrasonic echoes using consistent frequency domain amplitude-phase relationships

We introduce a new post-processing ultrasonic echo identification algorithm for the special case of two overlapping echoes. Compared to dictionary-based deconvolution, the algorithm has a reduced solution space and can reconstruct echoes that have a better fit with the acquired data. We have tested the algorithm using a synthetic test case using two dissimilar echoes and the algorithm was able to reconstruct the constituent echoes with good accuracy.
A Universal Framework for Finding Anomalous Objects at the LHC

Search for new physics events at the LHC mostly rely on the assumption that the events are characterized in terms of standard-reconstructed objects such as isolated photons, leptons, and jets initiated by QCD-partons. While such strategy works for a vast majority of physics beyond the standard model scenarios, there are examples aplenty where new physics give rise to anomalous objects (such as collimated and equally energetic particles, decays due to long lived particles etc.) in the detectors, which can not be classified as any of the standard-objects. Varied methods and search strategies have been proposed, each of which is trained and optimized for specific models, topologies, and model parameters. Further, as LHC keeps excluding all expected candidates for new physics, the need for a generic method/tool that is capable of finding the unexpected can not be understated. In this paper, we propose one such method that relies on the philosophy that all anomalous objects are $\it{not}$ standard-objects. The anomaly finder, we suggest, simply is a collection of vetoes that eliminate all standard-objects upto a pre-determined acceptance rate. Any event containing at least one anomalous object (that passes all these vetoes), can be identified as a candidate for new physics. Subsequent offline analyses can determine the nature of the anomalous object as well as of the event, paving a robust way to search for these new physics scenarios in a model-independent fashion. Further, since the method relies on learning only the standard-objects, for which control samples are readily available from data, one can build the analysis in an entirely data-driven way.
Adversarial Invariant Feature Learning

Learning meaningful representations that maintain the content necessary for a particular task while filtering away detrimental variations is a problem of great interest in machine learning. In this paper, we tackle the problem of learning representations invariant to a specific factor or trait of data, leading to better generalization. The representation learning process is formulated as an adversarial minimax game. We analyze the optimal equilibrium of such a game. On three benchmark tasks, namely fair classifications that are bias-free, language-independent generation, and lighting-independent image classification, we show that the proposed framework induces an invariant representation, and leads to better generalization evidenced by the improved test performance.
Association of circulatory PCSK-9 with biomarkers of redox imbalance and inflammatory cascades in the prognosis of diabetes and associated complications: a pilot study in the Indian population

Abstracts Besides the profound role of proprotein convertase subtilisin/kexin type-9 (PCSK-9) in LDL-C regulation, its association with other metabolic complications cannot be disregarded. The co-existence of redox imbalance and inflammatory cascades has greatly reflected the etiology of hyperglycemia. Therefore, we studied the association of PCSK-9 with inflammation and oxidative stress biomarkers to predict its role in the prognosis of diabetes and its associated complications in the Indian population. This pilot study examined a total of n = 187 subjects: healthy controls (HC; n = 50), diabetic without complication (T2DM; n = 49), diabetic nephropathy (T2DM-N; n = 43), and diabetic dyslipidemic (T2DM-DL; n = 45) subjects. The relationship between circulatory PCSK-9 levels and inflammation and redox imbalance biomarkers has been explored. The significant positive association of elevated PCSK-9 level with the inflammatory (i.e. IL-1β, IL-6, TNF-α, and CRP) and oxidative stress marker (i.e. XOD, CD, LOOH, and MDA) was observed in T2DM-N and T2DM-DL subjects. Whereas single regression analysis depicted that PCSK-9 was inversely associated with the FRAP and PON-1 in T2DM-N and T2DM-DL subjects. Furthermore, no significant correlation was detected in both T2DM and HC subjects. We found a significant relationship between these prognostic biomarkers with an elevated level of PCSK-9 in T2DM-N and T2DM-DL subjects. PCSK-9 is a nontraditional biomarker in diabetes that may help identify patients at risk of developing secondary complications of diabetes in the Indian population. However, further large cohort validation studies are needed.
Acute Hemodynamics in the Fontan Circulation: Open-Label Study of Vasopressin*

OBJECTIVE: To describe the acute hemodynamic effect of vasopressin on the Fontan circulation, including systemic and pulmonary pressures and resistances, left atrial pressure, and cardiac index. DESIGN: Prospective, open-label, nonrandomized study (NCT04463394). SETTING: Cardiac catheterization laboratory at Lucile Packard Children’s Hospital, Stanford. PATIENTS: Patients 3–50 years old with a Fontan circulation who were referred to the cardiac catheterization laboratory for hemodynamic assessment and/or intervention. INTERVENTIONS: A 0.03 U/kg IV (maximum dose 1 unit) bolus of vasopressin was administered over 5 minutes, followed by a maintenance infusion of 0.3 mU/kg/min (maximum dose 0.03 U/min). MEASUREMENTS AND MAIN RESULTS: Comprehensive cardiac catheterization measurements before and after vasopressin administration. Measurements included pulmonary artery, atrial, and systemic arterial pressures, oxygen saturations, and systemic and pulmonary flows and resistances. There were 28 patients studied. Median age was 13.5 (9.1, 17) years, and 16 (57%) patients had a single or dominant right ventricle. Following vasopressin administration, systolic blood pressure and systemic vascular resistance (SVR) increased by 17.5 (13.0, 22.8) mm Hg (Z value −4.6, p < 0.001) and 3.8 (1.8, 7.5) Wood Units (Z value −4.6, p < 0.001), respectively. The pulmonary vascular resistance (PVR) decreased by 0.4 ± 0.4 WU (t statistic 6.2, p < 0.001), and the left atrial pressure increased by 1.0 (0.0, 2.0) mm Hg (Z value −3.5, p < 0.001). The PVR:SVR decreased by 0.04 ± 0.03 (t statistic 8.1, p < 0.001). Neither the pulmonary artery pressure (median difference 0.0 [−1.0, 1.0], Z value −0.4, p = 0.69) nor cardiac index (0.1 ± 0.3, t statistic −1.4, p = 0.18) changed significantly. There were no adverse events. CONCLUSIONS: In Fontan patients undergoing cardiac catheterization, vasopressin administration resulted in a significant increase in systolic blood pressure, SVR, and left atrial pressure, decrease in PVR, and no change in cardiac index or pulmonary artery pressure. These findings suggest that in Fontan patients vasopressin may be an option for treating systemic hypotension during sedation or general anesthesia.
Relationship of Circulating Levels of Long-Chain Fatty Acids to Persistent Organ Failure in Acute Pancreatitis.

BACKGROUND During acute pancreatitis (AP), free fatty acids (FFAs) are liberated from circulating triglycerides (TG) and injured adipocytes by pancreatic lipase. Circulating FFAs have been suspected as a source of systemic lipotoxicity in AP. However, assessment of FFAs is difficult and time-consuming, and little is known about relative levels of FFAs between patients with different severities of AP and controls. OBJECTIVE This study's aims were to assess early circulating levels of FFAs, (both saturated and unsaturated) in AP patients versus controls, and associations between FFA levels and AP severity. METHODS Serum samples from AP patients were collected at enrollment (Day 1 of hospital stay); serum samples were also collected from controls. FFAs including palmitic, palmitoleic, stearic, oleic, and linoleic acid were extracted and quantitated using gas chromatography separation. Severity of AP was determined by Revised Atlanta Classification. Differences in FFA levels and percentages of total FFAs were assessed between AP patients and controls and AP patients of different severity grades. RESULTS A total of 93 AP patients (48 female, 52%) and 29 controls (20 female, 69%) were enrolled. Of the AP patients, 74 had mild/moderate and 19 had severe AP. Serum levels of all FFAs except stearic acid were significantly higher in AP patients compared to controls. A strong and independent association between elevated palmitoleic acid levels and severe AP was found. CONCLUSION Serum unsaturated FFA levels, specifically palmitoleic acid, appear to correlate with severe AP. These findings have potential clinical implications for targeted AP therapies.
Densified vertically lamellar electrode architectures for compact energy storage

Significance Simultaneously, high energy and power are required in thick electrodes to meet increasing energy storage demands. However, currently, there are few effective strategies to address the charge transport issue while maintaining high density in thick electrodes. Herein, we developed the bidirectional freeze-casting method to build the vertically lamellar architectures with a thickness beyond one millimeter and densified the thick electrodes via decreasing the interlamellar spacing. Via decoupling the lithium-ion transport in the interlamellar and intralamellar regions, both high areal capacity and high-rate capability could be achieved with a porosity as low as conventional electrodes. The demonstrated methodology here offers insights into the future electrode architecture designs for compact yet efficient electrochemical energy storage.
Definiteness and Indefiniteness of Nouns in English and Albanian: A Contrastive Analysis

Abstract Different languages have different ways of indicating the definiteness and indefiniteness of nouns. In English, as in most languages, the category of definiteness and indefiniteness is not a grammatical category of nouns. It is rather a semantic category that is mainly conveyed by means of two articles: the definite article the and the indefinite article a/an. In Albanian, on the other hand, the category of definiteness and indefiniteness is a grammatical category realised mainly by case endings and the indefinite article një (a/an) which, along with the case endings, is used to indicate only the indefiniteness, as the definiteness relies exclusively on case endings. The main purpose of this paper was to indicate that, in spite of the difference in the ways they express the definiteness and indefiniteness which account for some of their functional differences, definite and indefinite nouns in English and Albanian also show some similarities. The contrastive analysis indicates that the definite nouns in English and Albanian share their main functions, namely the specific reference and the generic reference, although they do not certainly share the cataphoric reference, whereas the indefinite nouns share the descriptive, classifying, and categorising function as well as the numerical function, but they do not share the generic function.
Evaluation of psychometric properties of the Dental Anxiety Inventory (DAI‐36) questionnaire using iterative hybrid ordinal logistic: Differential item functioning (DIF)

Dental Anxiety Inventory (DAI‐36) questionnaire is an instrument for assessing dental anxiety. The different perceptions of the questionnaire items in the individual at the same level of underlying dental anxiety may lead to different reported dental anxieties. This study aims to determine the differential item functioning (DIF) of the DAI‐36 measure items.
Psychometric properties of Fullerton Advanced Balance Scale in patients with stroke

ABSTRACT Background Patients experience falls frequently after stroke. Preserved or acquired balance skills decrease fall risk and improve independence. Feasibility of Fullerton Advanced Balance Scale (FAB) has been shown in balance assessment in some neurological diseases except stroke. Objectives The purpose of this study was to investigate the reliability and validity of Turkish version of FAB (FAB-T) in patients with stroke (PwS). Methods This cross-sectional study included 51 PwS (60.64 ± 7.66 years). Reliability analyses were conducted with Cronbach’s alpha, intraclass correlation coefficient (ICC), and Spearman correlation analysis. Intra-rater and inter-rater reliability were assessed with three raters. FAB-T, Stroke Rehabilitation Assessment of Movement (STREAM), Brunnstrom Recovery Stages (BRS), Barthel Index (BI), and 36-Item Short Form Health Survey (SF-36) were used for convergent validity. Correlations of FAB-T with Berg Balance Scale (BBS) and Mini-Balance Evaluation Systems Test (Mini-BESTest) were measured for concurrent validity. Spearman correlation analysis was used for convergent and concurrent validity. For predictive validity patients’ self-reports of falling were analyzed with ROC. Results Intra-rater (ICC = 0.998) and inter-rater reliability (ICCs = 0.984; 0.984; 0.990), and internal consistency (Cronbach’s alpha = 0.930) were excellent. FAB-T had good correlations with STREAM (ρ = 0.677) and BI (ρ = 0.628), moderate correlations with BRS (ρ = 0.504 and ρ = 0.579) and physical function of SF-36 (ρ = 0.436). FAB-T excellently correlated with Mini-BESTest and BBS (ρ = 0.928 and ρ = 0.942). The cutoff score of FAB-T was determined to be 21.5 points, with sensitivity of 84% and specificity of 61% (AUC = 0.749). Conclusions FAB-T is a reliable and valid balance assessment tool with an acceptable accuracy of fall prediction in PwS.
Predictive profiling of gram-negative antibiotics in CagA oncoprotein inactivation: a molecular dynamics simulation approach

ABSTRACT Gastric cancer (GC) is the fifth most prevalent form of cancer worldwide. CagA - positive Helicobacter pylori infects more than 60% of the human population. Moreover, chronic infection of CagA-positive H. pylori can directly affect GC incidence. In the current study, we have repurposed FDA-approved antibiotics that are viable alternatives to current regimens and can potentially be used as combination therapy against the CagA of H. pylori. The 100 FDA-approved gram negative antibiotics were screened against CagA protein using the AutoDock 4.2 tool. Further, top nine compounds were selected based on higher binding affinity with CagA. The trajectory analysis of MD simulations reflected that binding of these drugs with CagA stabilizes the system. Nonetheless, atomic density map and principal component analysis also support the notion of stable binding of antibiotics to the protein. The residues ASP96, GLN100, PRO184, and THR185 of compound cefpiramide, doxycycline, delafloxacin, metacycline, oxytetracycline, and ertapenem were involved in the binding with CagA protein. These residues are crucial for the CagA that aids in entry or pathogenesis of the bacterium. The screened FDA-approved antibiotics have a potential druggability to inhibit CagA and reduce the progression of H. pylori borne diseases.
FLORA OF TARNOVSKI HEIGHTS (NORTHERN BULGARIA).

Dimcho Zahariev 1 and Lidiya Taneva 2 . 1. Faculty of Natural Sciences, Department of Plant Protection, Botany and Zoology, University of Shumen, Bulgaria. 2. Master Student in Faculty of Natural Sciences, University of Shumen, Bulgaria. Manuscript Info Abstract . Manuscript History
Healing potential of curcumin nanomicelles in cutaneous burn wounds: an in vitro and in vivo study

ABSTRACT Purpose/Aim of the study Curcumin is the active substance of turmeric and has been shown to enhance the healing potential of burn wounds. However, its high hydrophobicity and rapid degradability are great challenges for its clinical applications. The development of new curcumin formulations may provide a potential solution to these issues. Methods and Results In this study, we investigated the use of curcumin nanomicelles for wound dressing and evaluated their effects on fibroblast migration and proliferation in vitro. We found that the application of curcumin nanomicelles to the wounds significantly improved wound contraction and increased the expression of transforming growth factor-1 and basic fibroblast growth factor at day 14 of the healing process. Furthermore, curcumin nanomicelles reduced the expression of interleukin-1 at days 7 and 14 post-wounding. Histopathological analysis revealed that the curcumin nanomicelles-treated burn wounds exhibited more organized granulation tissue, improved angiogenesis, and enhanced re-epithelialization. Additionally, the curcumin treatment led to increased hydroxyproline content and enhanced TGF-β1 expression level in the wounds. The in vitro studies also demonstrated that the curcumin nanomicelles induced proliferation and migration of fibroblasts. Conclusion Overall, our findings suggest that curcumin nanomicelles can be a promising candidate for the treatment of burn wounds.