Miracle-dz/UniFAR-FTUs huggingface dataset:
Health-promotion intervention in a group home: Perspectives of residents, staff and rehabilitation professionals

Promoting healthier lifestyles in people with intellectual disabilities is important in order to improve health and reduce health inequalities. Few studies have explored how health-promotion interventions for people with intellectual disabilities in community-based settings are experienced. The aim of this study was to explore residents’, staff members’ and rehabilitation professionals’ experiences of how a health-promotion intervention affected the habits of people living in a group home regarding eating habits and physical activities and staffs’ ways of working. Semi-structured group interviews were conducted with five residents, six staff members and five rehabilitation professionals. The group discussions were analysed with content analysis separately for each group. Four different categories described residents’, staff members’ and rehabilitation professionals’ views respectively. It is suggested that including people with intellectual disabilities as active parties throughout the process would facilitate implementation of a health-promotion profile in community residences.
Speech Rhythm Convergence as a Social Coalition Signal

Patterns of nonverbal and verbal behavior of interlocutors become more similar as communication progresses. Rhythm entrainment promotes prosocial behavior and signals social bonding and cooperation. Yet, it is unknown if the convergence of rhythm in human speech is perceived and is used to make pragmatic inferences regarding the cooperative urge of the interactors. We conducted two experiments to answer this question. For analytical purposes, we separate pulse (recurring acoustic events) and meter (hierarchical structuring of pulses based on their relative salience). We asked the listeners to make judgments on the hostile or collaborative attitude of interacting agents who exhibit different or similar pulse (Experiment 1) or meter (Experiment 2). The results suggest that rhythm convergence can be a marker of social cooperation at the level of pulse, but not at the level of meter. The mapping of rhythmic convergence onto social affiliation or opposition is important at the early stages of language acquisition. The evolutionary origin of this faculty is possibly the need to transmit and perceive coalition information in social groups of human ancestors. We suggest that this faculty could promote the emergence of the speech faculty in humans.
Stroke Risk as a Function of Atrial Fibrillation Duration and CHA2DS2-VASc Score.

Background: Studies of patients with cardiovascular implantable electronic devices (CIED) show a relationship between atrial fibrillation (AF) duration and stroke risk, though the interaction with CHA2DS2-VASc score is poorly defined. The objective of this study is to evaluate rates of stroke and systemic embolism (SSE) in CIED patients as a function of both CHA2DS2-VASc score and AF duration. Methods: Data from the Optum© electronic health record (EHR) de-identified database (2007-2017) were linked to the Medtronic CareLinkTM database of CIEDs capable of continuous AF monitoring. An index date was assigned as the later of 6 months after device implant or 1 year after EHR data availability. CHA2DS2-VASc score was assessed via EHR data prior to the index date. Maximum daily AF burden (No AF, 6 minutes-23.5 hours, and >23.5 hours) was assessed over the 6 months prior to index date. SSE rates were computed post-index date. Results: Among 21,768 non-anticoagulated CIED patients (68.6±12.7 years, 63% male), increasing AF duration (p<0.001) and increasing CHA2DS2-VASc score (p<0.001) were both significantly associated with annualized risk of SSE. SSE rates were low in CHA2DS2-VASc 0-1 patients regardless of device-detected AF duration. However, stroke risk crossed an actionable threshold defined as >1%/year in CHA2DS2-VASc 2 patients with >23.5 hours of AF, CHA2DS2-VASc 3-4 patients with >6 minutes of AF, and in CHA2DS2-VASc ≥5 patients even with no AF. Conclusions: There is an interaction between AF duration and CHA2DS2-VASc score which can further risk stratify AF patients for SSE and may be useful in guiding anticoagulation therapy.
Rituximab, lenalidomide and pembrolizumab in refractory primary cutaneous diffuse large B‐cell lymphoma, leg type

Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT) is an aggressive malignancy that manifests with several red cutaneous tumour lesions, usually carrying a poor prognosis with a 5-year overall survival of 50% (Willemze et al., 2019). The European Organization for Research and Treatment of Cancer and International Society for Cutaneous Lymphomas consensus recommendations indicate immunochemotherapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) as first-line treatment. Local radiotherapy is regarded a suitable treatment option in patients with solitary skin lesions (Senff et al., 2008). Patients with DLBCL are typically elderly, with multiple comorbidities and impaired organ function, making the choice of the right therapy a challenge for the physician. An 85-year-old man was referred to City of Hope with a 3-year history of PCDLBCL-LT. His medical history included chronic obstructive pulmonary disease (COPD), hypertension, myocardial infarction, atrial fibrillation, pulmonary embolism and pneumonia. He presented with erythematous nodules on upper and lower extremities (Fig 1A) without constitutional symptoms, such as pain, pruritus, fever, chills or night sweats. Lesional skin biopsy showed a dense, diffuse and deep lymphoid infiltrate composed of atypical large lymphocytes with pleomorphic nuclei, finely dispersed chromatin and prominent nucleoli extending into the subcutaneous fat tissue (Fig 2). By immunophenotyping, atypical lymphocytes were strongly positive for CD19, CD20, BCL2, MUM1 and cMYC (98%) with a high proliferation index of 95%, partially positive for PD1 and negative for cyclin D1, BCL6, CD10 and CD30 representing an activated B cell (ABC) phenotype. PD-L1 was partially positive within infiltrating macrophages. In situ hybridisation for Epstein–Barr virus was negative (Fig 2). Fluorescence in situ hybridisation analysis was positive for MYC gene locus rearrangement (Schrader et al., 2018; Zhou et al., 2018) and revealed clonal copy number gains of MYC and BCL2. Monoclonal rearrangement of immunoglobulin heavy (IGH) chain was found and mutational analysis revealed a KRAS point mutation p.A146V, but MYD88 was not mutated (Mareschal et al., 2017). Whole-body positron emission tomography/computed tomography excluded any lymph node or visceral involvement. At diagnosis in 2016, localized lesions on right foot and calf were treated with radiotherapy, with partial response. At disease progression in 2017 he was treated with R-CGOP (rituximab, cyclophosphamide, gemcitabine,
Trajectory of Lean Body Mass Assessed Using the Modified Creatinine Index and Mortality in Hemodialysis Patients.

RATIONALE & OBJECTIVE Although a declining body mass index (BMI) is associated with higher mortality in patients on hemodialysis, BMI cannot distinguish lean body mass from fat mass. It remains unclear whether changes over time in lean body mass are associated with mortality. We examined the prognostic significance of changes in the modified creatinine index, a proxy for lean body mass. STUDY DESIGN Retrospective cohort study. SETTING & PARTICIPANTS Outpatients (n=349; mean age, 67.4 years; 60% men) undergoing maintenance hemodialysis 3 times a week at a treatment center. PREDICTOR Modified creatinine index and BMI trajectories over a 1-year period. OUTCOMES All-cause mortality. ANALYTICAL APPROACH We calculated the percentage of change in modified creatinine index and BMI over a 1-year period. Patients were categorized according to change in modified creatinine index/BMI: no decline (≥0%) or decline (<0%). Kaplan-Meier and Cox proportional hazard analyses were performed to examine whether modified creatinine index and BMI trajectories were associated with mortality. RESULTS During follow-up (median, 1,157 days), 79 patients died. Decreasing modified creatinine index (HR, 1.31; 95% CI, 1.11-1.54) and BMI (HR, 1.25; 95% CI, 1.01-1.54) over time, measured as continuous variables and expressed per 1-standard deviation decrease, were independently associated with higher risk for all-cause mortality. The decline in modified creatinine index/no decline in BMI group (HR, 2.14; 95% CI, 1.04-4.45) and the decline in modified creatinine index/decline in BMI group (HR, 3.05; 95% CI, 1.58-5.90) had higher rates of mortality compared to the no decline in modified creatinine index/decline in BMI group. LIMITATIONS The absence of a direct measure of lean body and fat mass and limited generalizability to non-Japanese hemodialysis populations. CONCLUSIONS The modified creatinine index trajectory is independently associated with mortality and provides additional prognostic information to the BMI trajectory in patients on hemodialysis.
Differences in the need for adalimumab dose optimization between Crohn's disease and ulcerative colitis.

AIM to compare the need for and time to adalimumab dose escalation and de-escalation between patients with Crohn's disease (CD) and ulcerative colitis (UC). METHODS this observational cohort study included patients with luminal CD or patients with UC treated with adalimumab. Adalimumab dose optimization was decided based on the Harvey-Bradshaw index (CD) or the partial Mayo score (UC). The co-primary endpoints were the differences in the rate of dose escalation and the cumulative probability of escalation-free survival between cohorts. We also evaluated the rates of de-escalation and predictors of adalimumab dose escalation and de-escalation. RESULTS twenty-four of 43 CD patients (56%) and 28 of 43 UC patients (65%) required adalimumab dose escalation. UC patients had a higher adjusted rate of dose escalation (hazard ratio [HR] 2.33, 95% confidence interval [CI] 1.19-4.56; p = 0.013) than CD patients. The median time to dose escalation was significantly shorter for UC than CD patients (3.2 months, interquartile range [IQR]: 2.0-10.3 vs 12.2 months, IQR: 6.1-35.7; p = 0.001). Survival curves showed that UC patients had an increased probability of dose escalation (p < 0.001). Prior anti-TNF therapy was associated with dose escalation (HR 2.13, 95% CI 1.05-4.34; p = 0.037). Adalimumab dose de-escalation was attempted in 32% of UC patients and 50% of CD patients. Survival curves showed that CD patients had an increased probability of dose de-escalation (p = 0.030). CONCLUSION UC patients more frequently required adalimumab dose escalation than CD patients. UC patients required optimization earlier than CD patients. More CD patients than UC patients can be dose de-escalated later on during treatment.
Closing the survivorship gap in children and adolescents with Hodgkin lymphoma

The treatment of Hodgkin lymphoma (HL) is one of early success. However, disease‐free survival (DFS) does not reflect latent organ injury and its impact on health status and well‐being beyond 5 years. In fact, we are at a crossroads, in terms of needing individualized approaches to maintain DFS, while minimizing late effects and preserving health‐related quality of life (HRQoL). Premature morbidity and mortality translate to a high societal cost associated with the potential number of productive life years ahead in this population who are young at diagnosis. The discordance between short‐term lymphoma‐free survival and long‐term health and HRQoL creates a “survivorship gap” which can be characterized for individuals and for subgroups of patients. The current review delineates contributors to compromised outcomes and health status in child and adolescent (paediatric) HL and frames the survivorship gap in terms of primary and secondary prevention. Primary prevention aims to titrate therapy. Secondary prevention entails strategies to intervene against late effects. Bridging the survivorship gap will be attained with enhanced knowledge of and attention to biology of the tumour and microenvironment, host genetic factors, HRQoL and sub‐populations with disparate outcomes.
Mutated TP53 is a marker of increased VEGF expression: analysis of 7,525 pan-cancer tissues

ABSTRACT Anti-angiogenic therapies are an important class of anti-cancer treatment drugs. However, their efficacy is limited to certain tumors and would benefit from identifying a biomarker predictive of therapeutic response. TP53 (tumor protein p53) is a tumor suppressor gene frequently mutated in cancer and implicated in cell-cycle regulation, apoptosis, and angiogenesis. Data from 7,525 unique tumor samples (representing 30 tumor cohorts) were retrieved from the TCGA database to analyze the relationship between TP53-mutation status and VEGFA (vascular endothelial growth factor A) expression. Univariate analyses were done using a Mann-Whitney univariate test or Fisher’s exact test. Parameters with a p-value (p)≤0.1 in univariate analysis were selected for follow-up multivariate analyses, including TP53-mutation status, cancer cohorts, cancer subtypes, and VEGFA expression. Our analysis demonstrates statistically significant increases in VEGFA mRNA tissue expression in TP53-mutated adenocarcinomas (but not in squamous cancers) compared to TP53 wild-type tumors. This association holds true in multivariate analyses and remains independent of HIF-1α and MDM2 overexpression. Our findings provide additional evidence that TP53 mutations are linked to the VEGF pathway, potentially offering insight into the mechanism behind increased sensitivity to anti-angiogenic therapies observed in some TP53-mutant tumors.
Differential distributions of trafficking and signaling proteins of the maize ER-Golgi apparatus

ABSTRACT The Endoplasmic Reticulum (ER)-Golgi apparatus of plants is the site of synthesis of non-cellulosic polysaccharides that then traffic to the cell wall. A two-step protocol of flotation centrifugation followed by free-flow electrophoresis (FFE) resolved ER and Golgi proteins into three profiles: an ER-rich fraction, two Golgi-rich fractions, and an intermediate fraction enriched in cellulose synthases. Nearly three dozen Rab-like proteins of eight different subgroups were distributed differentially in ER- vs. Golgi-rich fractions, whereas seven 14-3-3 proteins co-fractionated with cellulose synthases in the intermediate fraction. FFE offers a powerful means to classify resident and transient proteins in cell-free assays of cellular location.
How to perform a meta-analysis with R: a practical tutorial

Objective Meta-analysis is of fundamental importance to obtain an unbiased assessment of the available evidence. In general, the use of meta-analysis has been increasing over the last three decades with mental health as a major research topic. It is then essential to well understand its methodology and interpret its results. In this publication, we describe how to perform a meta-analysis with the freely available statistical software environment R, using a working example taken from the field of mental health. Methods R package meta is used to conduct standard meta-analysis. Sensitivity analyses for missing binary outcome data and potential selection bias are conducted with R package metasens. All essential R commands are provided and clearly described to conduct and report analyses. Results The working example considers a binary outcome: we show how to conduct a fixed effect and random effects meta-analysis and subgroup analysis, produce a forest and funnel plot and to test and adjust for funnel plot asymmetry. All these steps work similar for other outcome types. Conclusions R represents a powerful and flexible tool to conduct meta-analyses. This publication gives a brief glimpse into the topic and provides directions to more advanced meta-analysis methods available in R.
Naturopathic Oncology Care for Pediatric Cancers: A Practice Survey

Background: The majority of pediatric oncology patients report use of complementary and alternative medicine. Some naturopathic doctors (NDs) provide supportive pediatric oncology care; however, little information exists to formally describe this clinical practice. A survey was conducted with members of the Oncology Association of Naturopathic Physicians (OncANP.org) to describe recommendations across four therapeutic domains: natural health products (NHPs), nutrition, physical medicine, and mental/emotional support. Results: We had 99 respondents with a wide variance of clinical experience and aptitude to treat children with cancer. Of the majority (52.5%) of respondents who choose not to treat these children, the three primary reasons for this are lack of public demand (45.1%), institutional or clinic restrictions (21.6%), and personal reasons/comfort (19.6%). The 10 most frequently considered NHPs by all NDs are fish-derived omega-3 fatty acid (83.3%), vitamin D (83.3%), probiotics (82.1%), melatonin (73.8%), vitamin C (72.6%), homeopathic Arnica (69.0%), turmeric/curcumin (67.9%), glutamine (66.7%), Astragalus membranaceus (64.3%), and Coriolus versicolor/PSK (polysaccharide K) extracts (61.9%). The top 5 nutritional recommendations are anti-inflammatory diets (77.9%), dairy restriction (66.2%), Mediterranean diet (66.2%), gluten restriction (61.8%), and ketogenic diet (57.4%). The top 5 physical modality interventions are exercise (94.1%), acupuncture (77.9%), acupressure (72.1%), craniosacral therapy (69.1%), and yoga (69.1%). The top 5 mental/emotional interventions are meditation (79.4%), art therapy (77.9%), mindfulness-based stress reduction (70.6%), music therapy (70.6%), and visualization therapy (67.6%). Conclusion: The results of our clinical practice survey highlight naturopathic interventions across four domains with a strong rationale for further inquiry in the care of children with cancer.
Critical considerations for targeting colorectal liver metastases with nanotechnology

Abstract Colorectal cancer remains a significant cause of morbidity and mortality worldwide. Half of all patients develop liver metastases, presenting unique challenges for their treatment. The shortcomings of conventional chemotherapy has encouraged the use of nanomedicines; the application of nanotechnology in the diagnosis and treatment of disease. In spite of technological improvements in nanotechnology, the complexity of biological systems hinders the prospect of nanomedicines being applied in cancer therapy at the present time. This review highlights current biological barriers and discusses aspects of tumor biology together with the physicochemical features of the nanocarrier, that need to be considered in order to develop effective nanotherapeutics for colorectal cancer patients with liver metastases. It becomes clear that incorporating an interdisciplinary approach when developing nanomedicines should assure appropriate disease‐driven design and that this will form a critical step in improving their clinical translation. This article is characterized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease
Microbial safety status of Serro artisanal cheese produced in Brazil.

Considering the growing consumption of artisanal foods worldwide, we aimed to evaluate the microbial safety of Serro artisanal cheese (SAC), produced in Minas Gerais State, Brazil. This cheese is produced with raw milk using 1 of 2 natural starter cultures: "pingo" and "rala. " A total of 53 SAC samples (pingo = 8; rala = 45) were obtained from different farmers and subjected to conventional and molecular assays to detect and enumerate Listeria monocytogenes, Salmonella spp. , coagulase-positive staphylococci (CPS), diarrheagenic Escherichia coli, Mycobacterium tuberculosis, and Brucella abortus. The SAC samples were also subjected to an ELISA to detect classical staphylococcal enterotoxins (CSE: SEA, SEB, SEC, SED, SEE) and to PCR assays to detect staphylococcal enterotoxin-related genes (sea, seb, sec, sed, see). Coagulase-positive staphylococci isolates were obtained and tested by the same assays to detect their potential in CSE production and presence of CSE-related genes. None of the SAC samples showed any of the screened food-borne pathogens and zoonotic agents, and none showed the presence of CSE by phenotypic and genotypic approaches. Despite the absence of microbial hazards, mean counts of CPS in SAC samples were 5.2 log cfu/g (pingo starter) and 4.6 log cfu/g (rala starter), indicating poor hygiene practices during production. None of the tested CPS isolates (n = 116) produced CSE or presented CSE-related genes. Despite the relative microbial safety, hygienic conditions during SAC production must be improved to meet official guidelines established in Brazil.
Impact of Hospice on Spending and Utilization Among Patients With Lung Cancer in Medicare

Objectives: To compare patterns and understand drivers of spending and utilization by month in the last 6 months of life between patients with lung cancer who used hospice versus those who did not. Study Design: Retrospective cohort analysis using 2009 to 2013 Medicare claims. Methods: We used a 10% random sample of Medicare fee-for-service beneficiaries with lung cancer who died between 2010 and 2013 (43 789 beneficiaries). Patients were assigned to 2 groups depending on whether they used hospice care in the last 6 months of life. The following outcomes were constructed by month: (1) all-cause Medicare spending, (2) indicator of hospitalization, (3) indicator of emergency department (ED) visit, (4) number of part B chemotherapy claims, and (5) number of radiation therapy sessions. We used a combination of propensity score matching and regression analysis to compare outcomes between the 2 groups. Results: Patients who used hospice had significantly lower spending in the last month of life compared to nonusers (US$16 907 vs US$26 906, P < .00). The spending differences in the last month of life between the 2 groups were largely driven by lower likelihood of hospitalization (54% vs 80%, P < .01) and ED visits (15% vs 22%, P < .01) and fewer chemotherapy (0.12 vs 0.32, P < .01) and radiation therapy sessions (0.80 vs 1.26, P < .01). During the other months in the 6-month period, spending was similar between the 2 groups. Conclusions: Timely hospice enrollment of patients with lung cancer—the group suffering from high morbidity and mortality among patients with cancer—may lead to significant cost savings.
Poly(ADP-ribose)-dependent chromatin unfolding facilitates the association of DNA-binding proteins with DNA at sites of damage

Abstract The addition of poly(ADP-ribose) (PAR) chains along the chromatin fiber due to PARP1 activity regulates the recruitment of multiple factors to sites of DNA damage. In this manuscript, we investigated how, besides direct binding to PAR, early chromatin unfolding events controlled by PAR signaling contribute to recruitment to DNA lesions. We observed that different DNA-binding, but not histone-binding, domains accumulate at damaged chromatin in a PAR-dependent manner, and that this recruitment correlates with their affinity for DNA. Our findings indicate that this recruitment is promoted by early PAR-dependent chromatin remodeling rather than direct interaction with PAR. Moreover, recruitment is not the consequence of reduced molecular crowding at unfolded damaged chromatin but instead originates from facilitated binding to more exposed DNA. These findings are further substantiated by the observation that PAR-dependent chromatin remodeling at DNA lesions underlies increased DNAse hypersensitivity. Finally, the relevance of this new mode of PAR-dependent recruitment to DNA lesions is demonstrated by the observation that reducing the affinity for DNA of both CHD4 and HP1α, two proteins shown to be involved in the DNA-damage response, strongly impairs their recruitment to DNA lesions.