Bright ultra-broadband fiber-based biphoton source.

In this Letter, we report a first, to the best of our knoqledge, experimental realization of a bright ultra-broadband (180 THz) fiber-based biphoton source with widely spectrally separated signal and idler photons. Such a two-photon source is realized due to the joint use of a broadband two-loop phase-matching of interacting light waves and high optical nonlinearity of a silica-core photonic crystal fiber. The high performance of the developed fiber source identifies it as an important and useful tool for a wide range of optical quantum applications.

Hemodynamic Impact of the Trendelenburg Position: A Systematic Review and Meta-analysis.

OBJECTIVE: To systematically evaluate the impact of the Trendelenburg position on hemodynamic parameters in adult patients. DESIGN: Systematic literature review and meta-analysis using PubMed and Medline. SETTING: All prospective interventional studies comparing the hemodynamic characteristics of patients in the horizontal supine position and Trendelenburg position. MEASUREMENTS AND MAIN RESULTS: A total of 16 studies including 333 patients were found. The Trendelenburg position led to a statistically significant 11% increase in stroke volume compared with the supine position (mean difference [MD] = 8.27, 95% confidence interval [CI]: 1.79; 14.76, p = 0.012). A decrease in stroke volume variation (MD = -1.36, 95% CI: 2.26; -0.46, p = 0.003) and heart rate (MD = -1.65, 95% CI: -2.86; -0.44, p = 0.008) and an increase in cardiac output (MD = 0.33, 95% CI: 0.1; 0.57, p = 0.006), mean arterial pressure (standardized MD, = 0.42, 95% CI: 0.1; 0.74, p = 0.011), central venous pressure (MD = 4.13, 95% CI: 2.42; 5.84, p < 0.001), mean pulmonary artery pressure (MD = 4.25, 95% CI: 2.69; 5.81, p < 0.001), and left ventricular end-diastolic volume (MD = 16.89, 95% CI: 3.17; 30.61, p = 0.016) were found. CONCLUSIONS: The Trendelenburg position significantly increases stroke volume and improves multiple hemodynamic parameters in adult patients. These results confirm the position's potential clinical relevance in hemodynamic management and suggest the possibility of a tailored application in selected clinical settings. The duration of the beneficial effects of the Trendelenburg position and the possible side effects should be the focus of further investigation.

The Absence of Retroelement Activity Is Characteristic for Childhood Acute Leukemias and Adult Acute Lymphoblastic Leukemia.

Retroelements (RE) have been proposed as important players in cancerogenesis. Different cancer types are characterized by a different level of tumor-specific RE insertions. In previous studies, small cohorts of hematological malignancies, such as acute myeloid leukemia, multiple myeloma, and chronic lymphocytic leukemia have been characterized by a low level of RE insertional activity. Acute lymphoblastic leukemia (ALL) in adults and childhood acute leukemias have not been studied in this context. We performed a search for new RE insertions (Alu and L1) in 44 childhood ALL, 14 childhood acute myeloid leukemia, and 14 adult ALL samples using a highly sensitive NGS-based approach. First, we evaluated the method sensitivity revealing the 1% detection threshold for the proportion of cells with specific RE insertion. Following this result, we did not identify new tumor-specific RE insertions in the tested cohort of acute leukemia samples at the established level of sensitivity. Additionally, we analyzed the transcription levels of active L1 copies and found them increased. Thus, the increased transcription of active L1 copies is not sufficient for overt elevation of L1 retrotranspositional activity in leukemia.

Energetic [1,2,5]oxadiazolo [2,3-a]pyrimidin-8-ium Perchlorates: Synthesis and Characterization.

A convenient method to access the above perchlorates has been developed, based on the cyclocondensation of 3-aminofurazans with 1,3-diketones in the presence of HClO4. All compounds were fully characterized by multinuclear NMR spectroscopy and X-ray crystal structure determinations. Initial safety testing (impact and friction sensitivity) and thermal stability measurements (DSC/DTA) were also carried out. Energetic performance was calculated by using the PILEM code based on calculated enthalpies of formation and experimental densities at r.t. These salts exhibit excellent burn rates and combustion behavior and are promising ingredients for energetic materials.

Revealing Word Order: Using Serial Position in Binomials to Predict Properties of the Speaker.

Three studies test the link between word order in binomials and psychological and demographic characteristics of a speaker. While linguists have already suggested that psychological, cultural and societal factors are important in choosing word order in binomials, the vast majority of relevant research was focused on general factors and on broadly shared cultural conventions. In contrast, in this work we are interested in what word order can tell us about the particular speaker. More specifically, we test the degree to which word order is affected by factors such as gender, race, geographic location, religion, political orientation, and consumer preferences. Using a variety of methodologies and different data sources, we find converging evidence that word order is linked to a broad set of features associated with the speaker. We discuss the theoretical implications of these findings and the potential to use word order as a tool for analyzing large text corpora and data on the web.

Syntactic Variation in Reduced Registers Through the Lens of the Parallel Architecture.

Diversion from the syntactic norm, as manifested in the absence of otherwise expected lexical and syntactic material, has been extensively studied in theoretical syntax. Such modifications are observed in headlines, telegrams, labels, and other specialized contexts, collectively referred to as "reduced" registers. Focusing on search queries, a type of reduced register, I propose that they are generated by a simpler grammar that lacks a full-fledged syntactic component. The analysis is couched in the Parallel Architecture framework, whose assumption of relative independence of linguistic components-their parallelism-and the rejection of syntactocentrism are essential to explain properties of queries.

Adductor Canal Block Versus Femoral Nerve Block in Total Knee Arthroplasty: Network Meta-Analysis.

OBJECTIVES: The quality of postoperative analgesia in total knee arthroplasty is crucial for patient recovery, rehabilitation, and hospital stay duration. In line with the above, а single-shot adductor canal block has been considered as an improved method over continuous femoral nerve block. However, continuous adductor canal block and single-shot femoral nerve block have been not adequately addressed in the discussion. This study aimed to compare the effectiveness of various types of adductor and femoral nerve blocks on clinically relevant outcomes in patients following total knee arthroplasty. METHODS: A systematic review and network meta-analysis were conducted following "PRISMA-NMA" and Cochrane Handbook guidelines. The eligibility criteria included randomized trials and, where these were lacking for a comparison, nonrandomized studies involving adults undergoing primary total knee arthroplasty, comparing single-shot adductor canal block, continuous adductor canal block, single-shot femoral nerve block, and continuous femoral nerve block. RESULTS: A total of 36 studies involving 3308 patients were included. Single-shot adductor canal block showed higher pain scores and opioid consumption but better functional recovery at 24 h compared with continuous femoral nerve block. However, this trend vanishes by the 48 h assessment postsurgery. Continuous adductor canal block required higher opioid consumption but better functional recovery and shorter hospital stay compared with continuous femoral nerve block. Single-shot adductor canal block showed higher pain scores but comparable opioid consumption and functional recovery to continuous adductor canal block. DISCUSSION: The shift from continuous femoral nerve block to single-shot adductor canal block as the preferred method for pain relief after total knee arthroplasty may be premature. While the latter improves mobility, it falls short in pain control and does not shorten hospital stays. Continuous adductor canal block shows promise but is currently underappreciated, and single-shot femoral nerve block is often overshadowed by other techniques in regional anesthesia. Further high-quality, multicenter randomized controlled trials are needed to validate these findings.

Intraoperative electroencephalogram patterns as predictors of postoperative delirium in older patients: a systematic review and meta-analysis.

Background: Postoperative delirium (POD) significantly affects patient outcomes after surgery, leading to increased morbidity, extended hospital stays, and potential long-term cognitive decline. This study assessed the predictive value of intraoperative electroencephalography (EEG) patterns for POD in adults. Methods: This systematic review and meta-analysis followed the PRISMA and Cochrane Handbook guidelines. A thorough literature search was conducted using PubMed, Medline, and CENTRAL databases focusing on intraoperative native EEG signal analysis in adult patients. The primary outcome was the relationship between the burst suppression EEG pattern and POD development. Results: From the initial 435 articles identified, 19 studies with a total of 7,229 patients were included in the systematic review, with 10 included in the meta-analysis (3,705 patients). In patients exhibiting burst suppression, the POD incidence was 22.1% vs. 13.4% in those without this EEG pattern (p=0.015). Furthermore, an extended burst suppression duration associated with a higher likelihood of POD occurrence (p = 0.016). Interestingly, the burst suppression ratio showed no significant association with POD. Conclusions: This study revealed a 41% increase in the relative risk of developing POD in cases where a burst suppression pattern was present. These results underscore the clinical relevance of intraoperative EEG monitoring in predicting POD in older patients, suggesting its potential role in preventive strategies. Systematic Review Registration: This study was registered on International Platform for Registered Protocols for Systematic Reviews and Meta-Analyses: INPLASY202420001, https://doi.org/10.37766/inplasy2024.2.0001.

Early detection of sepsis using machine learning algorithms: a systematic review and network meta-analysis.

Background: With machine learning (ML) carving a niche in diverse medical disciplines, its role in sepsis prediction, a condition where the 'golden hour' is critical, is of paramount interest. This study assesses the factors influencing the efficacy of ML models in sepsis prediction, aiming to optimize their use in clinical practice. Methods: We searched Medline, PubMed, Google Scholar, and CENTRAL for studies published from inception to October 2023. We focused on studies predicting sepsis in real-time settings in adult patients in any hospital settings without language limits. The primary outcome was area under the curve (AUC) of the receiver operating characteristic. This meta-analysis was conducted according to PRISMA-NMA guidelines and Cochrane Handbook recommendations. A Network Meta-Analysis using the CINeMA approach compared ML models against traditional scoring systems, with meta-regression identifying factors affecting model quality. Results: From 3,953 studies, 73 articles encompassing 457,932 septic patients and 256 models were analyzed. The pooled AUC for ML models was 0.825 and it significantly outperformed traditional scoring systems. Neural Network and Decision Tree models demonstrated the highest AUC metrics. Significant factors influencing AUC included ML model type, dataset type, and prediction window. Conclusion: This study establishes the superiority of ML models, especially Neural Network and Decision Tree types, in sepsis prediction. It highlights the importance of model type and dataset characteristics for prediction accuracy, emphasizing the necessity for standardized reporting and validation in ML healthcare applications. These findings call for broader clinical implementation to evaluate the effectiveness of these models in diverse patient groups. Systematic review registration: https://inplasy.com/inplasy-2023-12-0062/, identifier, INPLASY2023120062.

Sevoflurane multiple Wash In/Wash Out at the end of anesthesia to reduce agitation: A multicenter double-blind randomized controlled trial.

Background: Postoperative agitation is common after non-cardiac surgery. It is associated with postoperative delirium and cognitive dysfunction, leading to prolonged hospital stay and delayed social readjustment. Prevention and treatment strategies are lacking. We assessed the efficacy of a novel approach, the Wash In/Wash Out procedure, in reducing post-anesthetic agitation. Methods: This multicenter, parallel-group, double-blind randomized controlled trial is enrolling 200 patients undergoing open abdominal surgery. Participants are randomly assigned to either a control group receiving standard recovery methods or an investigational group undergoing the Wash In/Wash Out procedure. In the Wash In/Wash Out procedure group, sevoflurane is stopped and then promptly restarted when the patient shows the first signs of awakening to achieve an end-tidal concentration of 1 minimum alveolar concentration (MAC) for 5 min. This stop-and-restart cycle is performed three times. The trial's primary outcome is the rate of postoperative agitation. Secondary outcomes include rate of postoperative delirium and cognitive dysfunction, postoperative nausea and vomiting, and length of intensive care and hospital stay. Discussion: The OPERA trial investigates the effect of the Wash In/Wash Out procedure to reduce post-anesthetic agitation in non-cardiac surgery. This study could offer a significant contribution to improving patient outcomes and optimizing recovery protocols in surgical settings.

Two-dimensional high-throughput on-cell screening of immunoglobulins against broad antigen repertoires.

Identifying high-affinity antibodies in human serum is challenging due to extremely low number of circulating B cells specific to the desired antigens. Delays caused by a lack of information on the immunogenic proteins of viral origin hamper the development of therapeutic antibodies. We propose an efficient approach allowing for enrichment of high-affinity antibodies against pathogen proteins with simultaneous epitope mapping, even in the absence of structural information about the pathogenic immunogens. To screen therapeutic antibodies from blood of recovered donors, only pathogen transcriptome is required to design an antigen polypeptide library, representing pathogen proteins, exposed on the bacteriophage surface. We developed a two-dimensional screening approach enriching lentiviral immunoglobulin libraries from the convalescent or vaccinated donors against bacteriophage library expressing the overlapping set of polypeptides covering the spike protein of SARS-CoV-2. This platform is suitable for pathogen-specific immunoglobulin enrichment and allows high-throughput selection of therapeutic human antibodies.

Novel bimodal TRBD1-TRBD2 rearrangements with dual or absent D-region contribute to TRB V-(D)-J combinatorial diversity.

T-cell receptor (TR) diversity of the variable domains is generated by recombination of both the alpha (TRA) and beta (TRB) chains. The textbook process of TRB chain production starts with TRBD and TRBJ gene rearrangement, followed by the rearrangement of a TRBV gene to the partially rearranged D-J gene. Unsuccessful V-D-J TRB rearrangements lead to apoptosis of the cell. Here, we performed deep sequencing of the poorly explored pool of partial TRBD1-TRBD2 rearrangements in T-cell genomic DNA. We reconstructed full repertoires of human partial TRBD1-TRBD2 rearrangements using novel sequencing and validated them by detecting V-D-J recombination-specific byproducts: excision circles containing the recombination signal (RS) joint 5'D2-RS - 3'D1-RS. Identified rearrangements were in compliance with the classical 12/23 rule, common for humans, rats, and mice and contained typical V-D-J recombination footprints. Interestingly, we detected a bimodal distribution of D-D junctions indicating two active recombination sites producing long and short D-D rearrangements. Long TRB D-D rearrangements with two D-regions are coding joints D1-D2 remaining classically on the chromosome. The short TRB D-D rearrangements with no D-region are signal joints, the coding joint D1-D2 being excised from the chromosome. They both contribute to the TRB V-(D)-J combinatorial diversity. Indeed, short D-D rearrangements may be followed by direct V-J2 recombination. Long D-D rearrangements may recombine further with J2 and V genes forming partial D1-D2-J2 and then complete V-D1-D2-J2 rearrangement. Productive TRB V-D1-D2-J2 chains are present and expressed in thousands of clones of human antigen-experienced memory T cells proving their capacity for antigen recognition and actual participation in the immune response.

The use of non-functional clonotypes as a natural calibrator for quantitative bias correction in adaptive immune receptor repertoire profiling.

High-throughput sequencing of adaptive immune receptor repertoires is a valuable tool for receiving insights in adaptive immunity studies. Several powerful TCR/BCR repertoire reconstruction and analysis methods have been developed in the past decade. However, detecting and correcting the discrepancy between real and experimentally observed lymphocyte clone frequencies are still challenging. Here, we discovered a hallmark anomaly in the ratio between read count and clone count-based frequencies of non-functional clonotypes in multiplex PCR-based immune repertoires. Calculating this anomaly, we formulated a quantitative measure of V- and J-genes frequency bias driven by multiplex PCR during library preparation called Over Amplification Rate (OAR). Based on the OAR concept, we developed an original software for multiplex PCR-specific bias evaluation and correction named iROAR: immune Repertoire Over Amplification Removal (https://github.com/smiranast/iROAR). The iROAR algorithm was successfully tested on previously published TCR repertoires obtained using both 5' RACE (Rapid Amplification of cDNA Ends)-based and multiplex PCR-based approaches and compared with a biological spike-in-based method for PCR bias evaluation. The developed approach can increase the accuracy and consistency of repertoires reconstructed by different methods making them more applicable for comparative analysis.

Global public health intelligence: World Health Organization operational practices.

Early warning and response are key to tackle emerging and acute public health risks globally. Therefore, the World Health Organization (WHO) has implemented a robust approach to public health intelligence (PHI) for the global detection, verification and risk assessment of acute public health threats. WHO's PHI operations are underpinned by the International Health Regulations (2005), which require that countries strengthen surveillance efforts, and assess, notify and verify events that may constitute a public health emergency of international concern (PHEIC). PHI activities at WHO are conducted systematically at WHO's headquarters and all six regional offices continuously, throughout every day of the year. We describe four interlinked steps; detection, verification, risk assessment, and reporting and dissemination. For PHI operations, a diverse and interdisciplinary workforce is needed. Overall, PHI is a key feature of the global health architecture and will only become more prominent as the world faces increasing public health threats.

Contraception information on the websites of student health centers in the United States.

OBJECTIVE: As University Student Health Centers are considered reputable sources of information by many young adults, we evaluate the presence of contraceptive information on their websites. STUDY DESIGN: We used a software tool (Quantitative Measures of Online Health Information), designed for public health research to examine online information access on four broad categories of contraception and reproductive health (LARC/injectables, Contraception, Condom, Pap test) on student health center websites from all (591) public four-year universities across the United States between July to September 2020. Using a logistic regression model, we documented factors that are associated with information disparities. RESULTS: Our sample consisted of 545 public universities after excluding those for which information was unavailable. In 357 (66%) of the universities in our sample, we found evidence of some information related to contraception. A one percentage point increase in the student population that are Pell grant recipients, an indicator of the proportion of low-income students enrolled, is associated with a 3% to 6% (0.01

Quantifying the Quality of Web-Based Health Information on Student Health Center Websites Using a Software Tool: Design and Development Study.

BACKGROUND: The internet has become a major source of health information, especially for adolescents and young adults. Unfortunately, inaccurate, incomplete, or outdated health information is widespread on the web. Often adolescents and young adults turn to authoritative websites such as the student health center (SHC) website of the university they attend to obtain reliable health information. Although most on-campus SHC clinics comply with the American College Health Association standards, their websites are not subject to any standards or code of conduct. In the absence of quality standards or guidelines, monitoring and compliance processes do not exist for SHC websites. Thus, there is no oversight of the health information published on SHC websites by any central governing body. OBJECTIVE: The aim of this study is to develop, describe, and validate an open-source software that can effectively and efficiently assess the quality of health information on SHC websites in the United States. METHODS: Our cross-functional team designed and developed an open-source software, QMOHI (Quantitative Measures of Online Health Information), that assesses information quality for a specified health topic from all SHC websites belonging to a predetermined list of universities. The tool was designed to compute 8 different quality metrics that quantify various aspects of information quality based on the retrieved text. We conducted and reported results from 3 experiments that assessed the QMOHI tool in terms of its scalability, generalizability in health topics, and robustness to changes in universities' website structure. RESULTS: Empirical evaluation has shown the QMOHI tool to be highly scalable and substantially more efficient than manually assessing web-based information quality. The tool's runtime was dominated by network-related tasks (98%), whereas the metric computations take <2 seconds. QMOHI demonstrated topical versatility, evaluating SHC website information quality for four disparate and broad health topics (COVID, cancer, long-acting reversible contraceptives, and condoms) and two narrowly focused topics (hormonal intrauterine device and copper intrauterine device). The tool exhibited robustness, correctly measuring information quality despite changes in SHC website structure. QMOHI can support longitudinal studies by being robust to such website changes. CONCLUSIONS: QMOHI allows public health researchers and practitioners to conduct large-scale studies of SHC websites that were previously too time- and cost-intensive. The capability to generalize broadly or focus narrowly allows a wide range of applications of QMOHI, allowing researchers to study both mainstream and underexplored health topics. QMOHI's ability to robustly analyze SHC websites periodically promotes longitudinal investigations and allows QMOHI to be used as a monitoring tool. QMOHI serves as a launching pad for our future work that aims to develop a broadly applicable public health tool for web-based health information studies with potential applications far beyond SHC websites.

SeqURE - a new copy-capture based method for sequencing of unknown Retroposition events.

BACKGROUND: Retroelements (REs) occupy a significant part of all eukaryotic genomes including humans. The majority of retroelements in the human genome are inactive and unable to retrotranspose. Dozens of active copies are repressed in most normal tissues by various cellular mechanisms. These copies can become active in normal germline and brain tissues or in cancer, leading to new retroposition events. The consequences of such events and their role in normal cell functioning and carcinogenesis are not yet fully understood. If new insertions occur in a small portion of cells they can be found only with the use of specific methods based on RE enrichment and high-throughput sequencing. The downside of the high sensitivity of such methods is the presence of various artifacts imitating real insertions, which in many cases cannot be validated due to lack of the initial template DNA. For this reason, adequate assessment of rare (< 1%) subclonal cancer specific RE insertions is complicated. RESULTS: Here we describe a new copy-capture technique which we implemented in a method called SeqURE for Sequencing Unknown of Retroposition Events that allows for efficient and reliable identification of new genomic RE insertions. The method is based on the capture of copies of target molecules (copy-capture), selective amplification and sequencing of genomic regions adjacent to active RE insertions from both sides. Importantly, the template genomic DNA remains intact and can be used for validation experiments. In addition, we applied a novel system for testing method sensitivity and precisely showed the ability of the developed method to reliably detect insertions present in 1 out of 100 cells and a substantial portion of insertions present in 1 out of 1000 cells. Using advantages of the method we showed the absence of somatic Alu insertions in colorectal cancer samples bearing tumor-specific L1HS insertions. CONCLUSIONS: This study presents the first description and implementation of the copy-capture technique and provides the first methodological basis for the quantitative assessment of RE insertions present in a small portion of cells.

Deletion of BST2 Cytoplasmic and Transmembrane N-Terminal Domains Results in SARS-CoV, SARS-CoV-2, and Influenza Virus Production Suppression in a Vero Cell Line.

SARS-CoV-2, which emerged in Wuhan (China), has become a great worldwide problem in 2020 and has led to more than 1,000,000 deaths worldwide. Many laboratories are searching for ways to fight this pandemic. We studied the action of the cellular antiviral protein tetherin, which is encoded by the BST2 gene. We deleted the transmembrane domain-encoding part of the gene in the Vero cell line. The transmembrane domain is a target for virus-antagonizing proteins. We showed a decrease in SARS-CoV-2 in cells with deleted transmembrane BST2 domains compared to the initial Vero cell line. Similar results were obtained for SARS-CoV and avian influenza virus. This finding may help the development of antiviral therapies competitively targeting the transmembrane domain of tetherin with viral-antagonizing proteins.