Miracle-dz/UniFAR-FTUs huggingface dataset:
The Interplay Between Tobacco Dependence and Sleep Quality Among Young Adults

ABSTRACT Objective/Background: Sleep disturbances are considered among the negative consequences of smoking. However, the relationship between sleep quality and smoking among young adults, a population in which the prevalence of smoking is highest, has scarcely been examined. The current study aimed at examining differences in sleep indices, assessed by both subjective and objective (actigraphy) measures, between smokers and nonsmokers, and whether such differences are associated with levels of nicotine dependence. Participants: Eighty-six young (19–28 years old) volunteers, of them 46 nonsmokers (69.6% women) and 40 regular smokers (70.0% women) smoking at least 10 cigarettes a day. Methods: The participants completed the State-Trait Anxiety Inventory, Beck Depression Inventory, Brief Questionnaire on Smoking Urges, the Fagerstrom Test for Nicotine Dependence, and the Pittsburgh Sleep Quality Index. Their sleep was monitored objectively for one week using an actigraph. Results: Smokers’ self-reported sleep quality was similar to that of nonsmokers. However, actigraphy data pointed to lower sleep continuity in smokers compared to nonsmokers as reflected by increased wake time after sleep onset (Mean ± SD: 18.56 ± 15.29 vs. 11.21 ± 11.19, p < .01) and decreased sleep efficiency (Mean ± SD: 95.63 ± 3.53 vs. 97.23 ± 2.62, p < .012). Total sleep time and sleep onset latency did not differ between the groups. Notably, severity of nicotine dependence was negatively associated with sleep efficiency (β = −.32; p < .05). Conclusion: Young adult smokers have lower sleep continuity without necessarily subjectively experiencing their sleep as poor. Nevertheless, their lower sleep continuity is related to their level of nicotine dependence.
Predictors of postpartum HIV care engagement for women enrolled in prevention of mother-to-child transmission (PMTCT) programs in Tanzania

ABSTRACT Prevention of mother-to-child transmission of HIV (PMTCT) is a foundational component of a comprehensive HIV treatment program. In addition to preventing vertical transmission to children, PMTCT is an important catch-point for universal test-and-treat strategies that can reduce community viral load and slow the epidemic. However, systematic reviews suggest that care engagement in PMTCT programs is sub-optimal. This study enrolled a cohort of 200 women initiating PMTCT in Kilimanjaro, Tanzania, and followed them to assess HIV care engagement and associated factors. Six months after delivery, 42/200 (21%) of participants were identified as having poor care engagement, defined as HIV RNA >200 copies/mL or, if viral load was unavailable, being lost-to-follow-up in the clinical records or self-reporting being out of care. In a multivariable risk factor analysis, younger women were more likely to have poor postpartum care engagement; with each year of age, women were 7% less likely to have poor care engagement (aRR: 0.93; 95% CI: 0.89, 0.98). Additionally, women who had told at least one person about their HIV status were 47% less likely to have poor care engagement (aRR: .53; 95% CI: 0.29, 0.97). Among women who entered antenatal care with an established HIV diagnosis, those who were pregnant for the first time had increased risk of poor care engagement (aRR 4.16; 95% CI 1.53, 11.28). The findings suggest that care engagement remains a concern in PMTCT programs, and must be addressed to realize the goals of PMTCT. Comprehensive counseling on HIV disclosure, along with community-based stigma reduction programs to provide a supportive environment for people living with HIV, are crucial to address barriers to care engagement and support long-term treatment. Women presenting to antenatal care with an established HIV status require support for care engagement during the crucial period surrounding childbirth, particularly those pregnant for the first time.
Editor’s presentation

The need to improve risk stratification above the existing tools has been highlighted. In a study evaluating 4720 normal individuals from the Multi-Ethnic Study of Atherosclerosis, the combined use of carotid artery intima-media thickness and coronary calcium score further refined the risk calculation for ischaemic stroke/ transient ischaemic attack prevention and seemed to identify those individuals in most need of statin therapy. However, the number to be treated was quite high (292), making these procedures a costly intervention.
Mortality Characteristics of Two Populations in the Northern Mediterranean (Croatia) in the Period 1960–2012: An Ecological Study

In the second half of the 20th century, the town of Bakar (Primorje-Gorski Kotar County, Croatia), where a coking plant was operational 1978–1994, experienced intensive industrialisation. The town of Mali Lošinj (Primorje-Gorski Kotar County, Croatia) in this period based its economy on non-industrial sectors. The study goal was comparing mortality characteristics of these populations in the northern Mediterranean for 1960–2012. An ecological study design was used. Data were analysed for 1960–2012 for the deceased with recorded place of residence in the study area. Data on the deceased for 1960–1993 were taken from death reports, for 1994–2012 from digital archives of the Teaching Institute of Public Health, Primorje-Gorski Kotar County. Data on causes of death for 1960–1994 were recoded to the three-digit code of underlying cause of death according to the International Classification of Diseases (ICD–10). Among studied populations significant difference was found among the causes of deaths coded within ICD–10 chapters: neoplasms (particularly stomach carcinoma), mental and behavioural disorders and diseases of the respiratory system (particularly chronic obstructive pulmonary disease, (COPD)). Increase in mortality from neoplasms, increase in respiratory diseases for the area exposed to industrial pollution, also stomach carcinoma and COPD particularly in the town Bakar require further research.
Challenging management of chorioamnionitis with placental listeriosis: lessons from 2 cases

Listeriosis is a rare foodborne infection caused by Listeria monocytogenes. It is 12–20 times more prevalent in pregnant women compared to the general population, with a 20–40% mortality rate in neonates. Early treatment with appropriate antimicrobial agents is critical for pregnancy outcomes; however, the infection is difficult to control because the nonspecific clinical manifestations and rarity of the disease often preclude early diagnosis. We encountered 2 cases of pregnancy-associated listeriosis that occurred at 29 and 37 weeks of gestation. Both neonates were delivered by emergent cesarean section due to fetal condition, and one of the preterm infants died immediately after birth. Pregnancy-associated listeriosis should be considered in the management of unexplained fever or inflammatory conditions in pregnant women.
SIRT6 overexpression induces apoptosis of nasopharyngeal carcinoma by inhibiting NF-κB signaling

Background Previous reports show that SIRT6 serves as a critical modulator of the development of multiple malignancies as well as other disorders. However, its role in nasopharyngeal carcinoma (NPC) is unknown. Thus, we elucidated the effects of SIRT6 on the survival of NPC cells, and modulation of cell death. Methods We found that expression of SIRT6 is downregulated in ten human NPC specimens as well as in the human NPC cell lines, 5-8 F and CNE1, as compared with that in healthy tissues and normal nasopharyngeal NP69 cells. The MTT assay and colony formation assay revealed that upregulation of SIRT6 impaired the proliferation, as well as the survival of 5-8 F and CNE1 cells. The TUNEL assay, annexin V-FITC/propidium iodide, and flow cytometry were performed to detect apoptosis. The results revealed that the expression of SIRT6 resulted in increased apoptosis. Results Western blotting results showed that SIRT6 overexpression decreased anti-apoptotic Bcl-2 levels, whereas it promoted an increase in pro-apoptotic Bax and cleaved caspase-3 levels. Moreover, NF-κB levels were markedly reduced in cells expressing SIRT6, whereas they were increased in cells transfected with shRNA-SIRT6. Recovery of NF-κB expression was found to counter the suppressive influence of SIRT6 on NPC cell survival, whereas, NF-κB knockdown increased apoptosis of NPC cells. Conclusion Thus, the findings of our study offer insight into the biological and molecular mechanisms underlying the development of NPC and may lead to the development of new and innovative strategies for the treatment of NPC.
Transcranial magnetic stimulation predicts cognitive decline in patients with Alzheimer’s disease

Objective To determine the ability of transcranial magnetic stimulation (TMS) in detecting synaptic impairment in patients with Alzheimer’s disease (AD) and predicting cognitive decline since the early phases of the disease. Methods We used TMS-based parameters to evaluate long-term potentiation (LTP)-like cortical plasticity and cholinergic activity as measured by short afferent inhibition (SAI) in 60 newly diagnosed patients with AD and 30 healthy age-matched subjects (HS). Receiver operating characteristic (ROC) curves were used to assess TMS ability in discriminating patients with AD from HS. Regression analyses examined the association between TMS-based parameters and cognitive decline. Multivariable regression model revealed the best parameters able to predict disease progression. Results Area under the ROC curve was 0.90 for LTP-like cortical plasticity, indicating an excellent accuracy of this parameter in detecting AD pathology. In contrast, area under the curve was only 0.64 for SAI, indicating a poor diagnostic accuracy. Notably, LTP-like cortical plasticity was a significant predictor of disease progression (p=0.02), while no other neurophysiological, neuropsychological and demographic parameters were associated with cognitive decline. Multivariable analysis then promoted LTP-like cortical plasticity as the best significant predictor of cognitive decline (p=0.01). Finally, LTP-like cortical plasticity was found to be strongly associated with the probability of rapid cognitive decline (delta Mini-Mental State Examination score ≤−4 points at 18 months) (p=0.04); patients with AD with lower LTP-like cortical plasticity values showed faster disease progression. Conclusions TMS-based assessment of LTP-like cortical plasticity could be a viable biomarker to assess synaptic impairment and predict subsequent cognitive decline progression in patients with ADs.
Gut microbiota dynamics and uraemic toxins: one size does not fit all

With great interest we have read the work of Bang et al , comparing the efficacy of lumen-apposing metal stents (LAMS) and double-pigtail plastic stents (DPS) for endoscopic drainage of walled-off necrosis (WON). 1 We congratulate the authors on completing the first randomised controlled trial comparing these two drainage strategies. They found no difference in the total number of procedures needed to achieve treatment success at 6-month follow-up. However, we feel that three important limitations have not been mentioned in the discussion. First, we question whether the …
Hormonal responses to striking combat sports competition: a systematic review and meta-analysis

Striking combat sports are challenging, commonly stressing the endocrinological system based on a mixture of body-contact actions and physiological efforts. The aims of this systematic review and meta-analysis were to discuss the hormonal responses related to striking combat sports competitions and to investigate the moderator and mediator variables of the hormonal response-competition/outcome relationship. Three electronic databases (i.e., PubMed, Google Scholar and ScienceDirect) were systematically searched (up to February 2016) followed by a manual search of retrieved papers. The data showed a moderate increase in cortisol (C) (ES = 0.79; 95% CI 0.31–1.28; p = 0.001), an extremely large increase in adrenaline (ES = 4.22; 95% CI 2.62–5.82; p < 0.001), and a very large increase in noradrenaline (ES = 3.40; 95% CI 1.03–5.76; p = 0.005) and human growth hormone (HGH) levels (ES = 3.69; 95% CI 1.96–5.42; p < 0.001) immediately following the combat events, compared to the control condition i.e., “pre-combat”. Furthermore, amateur athletes had a larger increase in C levels compared to highly trained athletes (ES = 2.91 [very large] vs ES = 0.56 [small]), while evening events showed greater alterations in C levels compared to morning events (ES = 1.91 [large] vs ES = 0.48 [small]), without significant differences between them (p = 0.26 and p = 0.06, respectively). The present meta-analysis also showed a small, insignificant increase in testosterone (T) (ES = 0.47 [small]; 95% CI -0.45–0.99; p = 0.074) and a decrease in insulin-like growth factor 1 levels (ES = -0.20 [trivial]; 95% CI -0.78–0.37; p = 0.486) immediately following the combat events, compared to the control condition. The type of combat sports practised, participants’ gender, and the nature of competition contests (i.e., official vs simulation) did not moderate the relationship between competition and hormonal response. Additionaly, sub-analysis results showed a significant difference between younger and older athletes (Q = 4.05, p = 0.044), suggesting that after combat, younger individuals (less than 17 years of age) had a small decrease in T levels (ES = -0.58), compared with the moderate increase observed in older individuals (ES = 0.76). In conclusion, irrespective of striking combat sports types, the results showed that both official and simulated bouts are a real stressor of the hormonal system of practitioners. Coaches and applied practitioners should adopt “pre-competitive cognitive/coping strategies” to improve the psychological state that mediates the hormonal changes-competition/outcome relationship of their athletes in order to mitigate athletes’ stress.
Öğretmenlerin Örgütsel Güven ile Örgütsel Bağlılık Düzeyleri Arasındaki İlişki

Bu arastirmanin temel amaci ogretmenlerin orgutsel guven ile orgutsel baglilik duzeyleri arasindaki iliskiyi incelemektir. Arastirma verileri Tokat ilindeki ilkokul ve orta okullarda gorev yapan 378 sinif ve brans ogretmeninden toplanmistir. Ogretmenlerin okul ortaminda algiladiklari guven, Erdogan (2012) tarafindan gelistirilen Okulda Iliskilerde Guven Kulturu Olcegi ile olculmustur. Ogretmenlerin orgute bagliliklarini olcmek amaciyla Balay’in (2000) gelistirdigi ve Erdem’in (2008) faktor yapisini tekrar sinadigi Orgutsel Baglilik Olcegi kullanilmistir. Arastirma bulgulari ogretmenlerin okuldaki iliskilerinde buyuk olcude guven duyduklarini, orgutsel bagliliklarinin ise orta duzeyde oldugunu gostermektedir. Ogretmenlerin uyum boyutunda orgutsel bagliliklari ile guven duzeyleri negatif yonde anlamli iliskili iken ozdeslesme ve icsellestirme boyutlarinda orgutsel bagliliklari ile guven duzeyleri pozitif yonde anlamli iliskilidir. Coklu dogrusal regresyon analizi sonuclari ogretmenlerin okulda duyduklari guvenin orgutsel bagliliklarinin anlamli yordayicisi oldugunu gostermektedir. Anahtar Kelimeler: Orgutsel guven, Orgutsel baglilik, Ogretmen
Caregiver Out-of-Pocket Costs for Octogenarian Intensive Care Unit Patients in Canada

RÉSUMÉ Les problèmes médicaux affectant la population vieillissante sont de plus en plus préoccupants et ont des impacts sur les patients et leurs soignants familiaux. Cette étude a permis de déterminer les coûts directs et indirects encourus par les soignants familiaux de personnes âgées hospitalisées en unités de soins intensifs (USI) au Canada. Les soignants familiaux de patients hospitalisés en USI ont répondu à un sondage portant à la fois sur les coûts directs qu’ils assumaient pour les soins de ces patients et sur les coûts indirects, tels que les heures de travail et de loisirs perdues lors de la prestation de ces soins. Les coûts totaux mensuels des soins ont été stratifiés selon le sexe, l’âge et la région géographique du soignant. La moyenne des coûts directs pour les soignants était de 791 $ ($CA en 2016) par patient au cours du premier mois de soins intensifs. Le coût total quotidien moyen par patient était de 162 $ par jour pour ces soignants. Les hommes ayant le rôle de soignant principal ont payé davantage de frais que les femmes. Des programmes de subvention seraient nécessaires pour aider les soignants familiaux à couvrir les frais considérables liés aux soins qu’ils apportent à des patients en USI, en incluant aussi les frais de déplacements, de repas, d’hébergement et de stationnement. ABSTRACT Medical issues facing the aging population are of growing concern with consequences for patients and their caregivers. This study determined the indirect and out-of-pocket costs incurred by the caregivers of elderly patients in Canadian Intensive Care Units (ICUs). Primary family caregivers were surveyed capturing out-of-pocket costs, hours of work, and hours of leisure forgone in providing patient care while the patient was in the ICU. Total costs of care per month were reported across caregiver sex, age, and geographic region. Average out-of-pocket costs were $791 (2016 Canadian dollars) in the first month of ICU care. The mean total cost to family caregivers per patient was $162 per day. Male primary caregivers had higher mean out-of-pocket costs than female caregivers. Subsidization programs covering expenses such as travel, meals, accommodation, and parking are needed to support family caregivers of elderly ICU patients who are incurring considerable out-of-pocket costs.
Mechanisms of NF-κB p65 and strategies for therapeutic manipulation

The transcription factor NF-κB is a critical regulator of immune and inflammatory responses. In mammals, the NF-κB/Rel family comprises five members: p50, p52, p65 (Rel-A), c-Rel, and Rel-B proteins, which form homo- or heterodimers and remain as an inactive complex with the inhibitory molecules called IκB proteins in resting cells. Two distinct NF-κB signaling pathways have been described: 1) the canonical pathway primarily activated by pathogens and inflammatory mediators, and 2) the noncanonical pathway mostly activated by developmental cues. The most abundant form of NF-κB activated by pathologic stimuli via the canonical pathway is the p65:p50 heterodimer. Disproportionate increase in activated p65 and subsequent transactivation of effector molecules is integral to the pathogenesis of many chronic diseases such as the rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis, and even neurodegenerative pathologies. Hence, the NF-κB p65 signaling pathway has been a pivotal point for intense drug discovery and development. This review begins with an overview of p65-mediated signaling followed by discussion of strategies that directly target NF-κB p65 in the context of chronic inflammation.
Defining the role of neutrophil-to-lymphocyte ratio in COPD: a systematic literature review

COPD is characterized by a pulmonary and systemic inflammatory process. Several authors have reported the elevation of multiple inflammatory markers in patients with COPD; however, their use in routine clinical practice has limitations. The neutrophil-to-lymphocyte ratio (NLR) is a useful and cost-effective inflammatory marker derived from routine complete blood count. We performed a systematic literature review using the PRISMA statement. Twenty-two articles were included, recruiting 7,601 COPD patients and 784 healthy controls. Compared with controls, COPD patients had significantly higher NLR values. We found a significant correlation between the NLR and clinical/functional parameters (FEV1, mMRC, and BODE index) in COPD patients. Elevation of the NLR is associated with the diagnosis of acute exacerbation of COPD (pooled data propose a cut-off value of 3.34 with a median sensitivity, specificity, and area under the curve of 80%, 86%, and 0.86, respectively). Additionally, increased NLR is also associated with the diagnosis of a bacterial infection in exacerbated patients, with a cut-off value of 7.30, although with a low sensitivity and specificity. The NLR is an independent predictor of in-hospital and late mortality after exacerbation. In conclusion, the NLR could be a useful marker in COPD patients; however, further studies are needed to better identify the clinical value of the NLR.
Detection of Mirai by Syntactic and Behavioral Analysis

The largest botnet distributed denial of service attacks in history have been executed by devices controlled by the Mirai botnet trojan. To prevent Mirai from spreading, this paper presents and evaluates techniques to classify binary samples as Mirai based on their syntactic and behavioral properties. Syntactic malware detection is shown to have a good detection rate and no false positives, but to be very easy to circumvent. Behavioral malware detection is resistant to simple obfuscation and has better detection rate than syntactic detection, while keeping false positives to zero. This paper demonstrates these results, and concludes by showing how to combine syntactic and behavioral analysis techniques for the detection of Mirai.
Women, Culture and Africa’s Land Reform Agenda

Pre-colonial Africa prides itself on adherence to diverse cultural affinity and traditional belief systems, which defines the place of women in respect to land access, use and ownership. Land resources continue to play important roles in both agrarian and industrial societies; thus the absence of effective land management and gender construction in land allocations has deepened gender inequality, restricted women’s capacity building and agricultural development in Africa. This article explores the impact of traditional African practices and cultural beliefs on women’s land ownership and use, and also reconciles women’s land rights (access and control) with the realities of land reform in post-colonial Africa. It explores how gender inequalities, in terms of land ownership and rights, have jeopardized attempts at agricultural productivity and sustainable development in Africa. However, it is tasking to ‘universalize’ African culture and locate it in a center, due to the diverse cultural values found in Africa. However, there are certain belief systems that run through most African communities, such as the denial of women’s land rights and the patriarchal nature of societies. Thus, the article found that, despite the development of legal frameworks that expand women’s property rights, cases of cultural impediments to the exercise of land rights abound in Africa.