Miracle-dz/UniFAR-FTUs huggingface dataset:
Children from a rural region in The Chiapas Highlands, Mexico, show an increased risk of stunting and intestinal parasitoses when compared with urban children.

Background The state of Chiapas has held the first place of extreme poverty in Mexico. The majority of Chiapas' municipalities are inhabited by marginalized, indigenous populations, who usually present diarrhea of unknown etiology. We evaluated the nutritional status, intestinal parasites, and common bacterial pathogens, including DEC (diarrheagenic Escherichia coli) strains, in 178 children under five years of age with a high (rural) and a moderate (urban) degree of marginalization. Methods Z-scores for anthropometric indexes from the children were obtained, whereas intestinal parasites were investigated by using a direct coproparasitoscopic analysis and a concentration method. DEC strains were detected by polymerase chain reaction (PCR). Results The stunting prevalence in children from the rural and urban regions was 79.8 and 7.5%, respectively. Only children from rural municipalities were parasitized (72.6%), being Ascaris lumbricoides and Entamoeba histolytica/Entamoeba dispar the most prevalent parasites (57.1 and 38.1%, respectively). More than half of the children presented moderated ascariasis. Besides Giardia intestinalis, these parasites were associated with stunting. The prevalence of DEC strains was similar in both regions. Conclusions Only children from the Chiapas Highlands (rural zone) exhibited high prevalences of stunting and intestinal parasites. A reevaluation of social development programs should be in place to address stunting and intestinal parasitoses, mainly in rural regions of Chiapas, to avoid adverse functional consequences on these children.
Development of a prognostic index based on an immunogenomic landscape analysis of papillary thyroid cancer

Background: Papillary thyroid cancer (PTC) is the most common subtype of thyroid cancer, and inflammation relates significantly to its initiation and prognosis. Systematic exploration of the immunogenomic landscape therein to assist in PTC prognosis is therefore urgent. The Cancer Genome Atlas (TCGA) project provides a large number of genetic PTC samples that enable a comprehensive and reliable immunogenomic study. Methods: We integrated the expression profiles of immune-related genes (IRGs) and progression-free intervals (PFIs) in survival in 493 PTC patients based on the TCGA dataset. Differentially-expressed and survival-associated IRGs in PTC patients were estimated a computational difference algorithm and COX regression analysis. The potential molecular mechanisms and properties of these PTC-specific IRGs were also explored with the help of computational biology. A new prognostic index based on immune-related genes was developed by using multivariable COX analysis. Results: A total of 46 differentially expressed immune-related genes were significantly correlated with clinical outcome of PTC patients. Functional enrichment analysis revealed that these genes were actively involved in a cytokine-cytokine receptor interaction KEGG pathway. A prognostic signature based on RGs (AGTR1, CTGF, FAM3B, IL11, IL17C, PTH2R and SPAG11A) performed moderately in prognostic predictions and correlated with age, tumor stage, metastasis, number of lesions, and tumor burden. Intriguingly, the prognostic index based on IRGs reflected infiltration by several types of immune cells. Conclusions: Together, our results screened several IRGs of clinical significance, revealed drivers of the immune repertoire, and demonstrated the importance of a personalized, IRG-based immune signature in the recognition, surveillance, and prognosis of PTC.
Indications for a single‐stage exchange arthroplasty for chronic prosthetic joint infection: A SYSTEMATIC REVIEW

Aims Prosthetic joint infections (PJIs) of the hip and knee are associated with significant morbidity and socioeconomic burden. We undertook a systematic review of the current literature with the aim of proposing criteria for the selection of patients for a single‐stage exchange arthroplasty in the management of a PJI. Material and Methods A comprehensive review of the current literature was performed using the OVID‐MEDLINE, EMBASE, and Cochrane Library databases and the search terms: infection and knee arthroplasty OR knee revision OR hip arthroplasty OR hip revision, and one stage OR single stage OR direct exchange. All studies involving fewer than ten patients and follow‐up of less than two years in the study group were excluded as also were systematic reviews, surgical techniques, and expert opinions. Results The initial search revealed 875 potential articles of which 22 fulfilled the inclusion and exclusion criteria. There were 16 case series and six comparative studies; five were prospective and 14 were retrospective. The studies included 962 patients who underwent single stage revision arthroplasty of an infected hip or knee joint. The rate of recurrent infection ranged from 0% to 18%, at a minimum of two years' follow‐up. The rate was lower in patients who were selected on the basis of factors relating to the patient and the local soft‐tissue and bony conditions. Conclusion We conclude that single‐stage revision is an acceptable form of surgical treatment for the management of a PJI in selected patients. The indications for this approach include the absence of severe immunocompromise and significant soft‐tissue or bony compromise and concurrent acute sepsis. We suggest that a two‐stage approach should be used in patients with multidrug resistant or atypical organisms such as fungus.
Predictive Validity of the Three-Factor Model of Impulsivity for Risky Behaviors

Abstract Impulsivity is a multifaceted construct particularly relevant for understanding a wide variety of behaviors, especially risky behaviors. A recent conceptualization of impulsivity identifies three impulsivity factors—pervasive influence of feelings, feelings trigger action, and lack of follow-through—that have been shown to predict different behaviors. In this contribution, we examine the psychometric properties of an Italian version of such a three-factor model on a relatively large sample (N = 845). Moreover, on a subsample (n = 766) we determined whether specific dimensions of impulsivity are related to a series of risky behaviors, assessed 3 weeks later, by testing the predictive validity of the multidimensional inventory also in comparison with a standard measure of personality (HEXACO). An exploratory structural equation model confirmed the original 3-dimension structure and showed that the Italian adaptation has satisfactory psychometric properties. Convergent validity with the HEXACO dimensions was established. Furthermore, only the factors feelings trigger action and lack of follow-through, not pervasive influence of feelings, predicted risky behaviors. Findings provide a clear support to the 3-factor model of impulsivity and demonstrate its usefulness for a better comprehension of risky behaviors.
Reduced protein diet and amino acid concentration alter intestinal barrier function and performance of broiler chickens with or without synthetic glucocorticoid.

Little is known about the effect of low-protein (LP) diets on intestinal barrier function and permeability. In the first part of this study, starting on day 9 of age, the growth performance of the birds fed 3 experimental diets in each phase of feeding (G/F: grower/finisher) was investigated. Three experimental diets were as follows: LP (170/150 g/kg CP) fortified with essential amino acids (EAA), standard protein (SP), (202/190 g/kg), and high protein (HP) (220/210 g/kg). LP and SP diets contained a similar level of EAA concentration, while the HP diet contained 10% above the Ross 308 specifications. Each diet was replicated 6 times (10 male birds per replicate). The second part investigated intestinal permeability (IP) and function on additional 72 birds. On days 14, 16, and 20, a total of 36 birds (12 birds per diet) were injected with dexamethasone (DEX) to induce leaky gut. Birds fed LP diets had lower body weight gain (BWG) and higher feed conversion ratio (FCR) compared with SP and HP diets in both grower and finisher phases of feeding. For the challenge part, DEX increased the FCR independent of diets. Diet and DEX interacted for BWG, whereby the effect of diets was only evident in sham-injected birds. Birds fed LP had a higher fluorescein isothiocyanate dextran (FITC-d) concentration indicating a more permeable intestine compared to HP, but similar to SP. DEX increased FITC-d concentration in all dietary treatments. Birds fed LP had less ileal zonula occludens-2 (ZO-2) expression in comparison with SP, but not HP. DEX increased the expression of Claudin3 and ZO-2 and reduced Claudin1 (P < 0.05) and junctional adhesion molecule 2 in the ileum. Expression of ileal Na+-dependent glucose transporter 1 (SGLT1) was upregulated in LP fed group. It is concluded that compared with SP, IP can be maintained in LP by supplementing EAA. However, when compared with HP, feeding birds with LP may lead to a higher IP. DEX had a profound independent effect on intestinal barrier function.
The neural basis of fatigue in multiple sclerosis: A multimodal MRI approach

Background Fatigue is a frequent disabling symptom in multiple sclerosis (MS), but its pathophysiology remains incompletely understood. This study aimed to explore the underlying neural basis of fatigue in patients with MS. Methods We enrolled 60 consecutive patients with MS and 60 healthy controls (HC) matched on age, sex, and education. Fatigue was assessed using the Portuguese version of the Modified Fatigue Impact Scale (MFIS). All participants underwent 3T brain MRI (conventional and diffusion tensor imaging [DTI] sequences). White matter (WM) focal lesions were identified and T1/T2 lesion volumes were computed. Tract-based spatial statistics were applied for voxel-wise analysis of DTI metrics fractional anisotropy and mean diffusivity (MD) on normal-appearing WM (NAWM). Using Freesurfer software, total and regional volumes of cortical and subcortical gray matter (GM) were calculated. Results Compared to HC, patients with MS scored significantly higher on MFIS (33.8 ± 19.7 vs 16.5 ± 15.1, p < 0.001). MFIS scores were not significantly correlated with T1/T2 lesion volumes, total GM volume, or any regional volume of cortical and subcortical GM. Significant correlations were found between global scores of MFIS and MD increase of the NAWM skeleton, including corona radiata, internal capsule, external capsule, corticospinal tract, cingulum, corpus callosum, fornix, superior longitudinal fasciculus, superior fronto-occipital fasciculus, sagittal stratum, posterior thalamic radiation, cerebral peduncle, and uncinate fasciculus. Conclusions In this study, fatigue was associated with widespread NAWM damage but not with lesion load or GM atrophy. Functional disconnection, caused by diffuse microstructural WM damage, might be the main neural basis of fatigue in MS.
Elective nodal irradiation provides a superior therapeutic modality for lymph node positivity esophageal squamous cell carcinoma patients receiving definitive radiotherapy versus involved-field irradiation

Abstract This retrospective study was conducted to evaluate the efficacy and safety of elective nodal irradiation (ENI) and involved-field irradiation (IFI) for esophageal squamous cell carcinoma (ESCC) patients treated with intensity-modulated radiotherapy (IMRT). From January 2006 to December 2012, 644 patients (ENI = 157, IFI = 487) with stage I to IVa ESCC (AJCC 2010) at our institution were analyzed. Propensity score matching (PSM) was used to identify 471 (ENI = 157, IFI = 314) well-balanced patients for comparison. Overall survival (OS) was the primary outcome of the study. After PSM, the median OS was 26.8 (95% confidence interval [CI], 17.9–35.7) for the ENI arm versus 21.5 (95% CI: 17.9–25.1) months in the IFI arm. The 1-, 3-, 5-year OS were 77.1%, 42.0%, and 26.1% for the ENI arm versus 73.2%, 32.2%, and 19.0% for the IFI arm (P = .020). ENI was a significant independent predictor of 5-year OS (1.301 [1.052–1.609]; P = .015). Furthermore, patients with stage I/II ESCC or lymph node (LN) positivity in the ENI arm had significantly better 5-year OS than their counterparts in the IFI arm. In addition, for LN positivity patients treated with definitive radiotherapy alone, ENI tended to prolong OS compared with IFI (P = .035). The 2 arms were comparable in toxicities. Using IMRT, ENI is superior to IFI in improving OS of ESCC patients, with acceptable toxicities that were comparable to those to IFI, especially for LN positivity ESCC patients treated with definitive irradiation alone. These results should be confirmed in a large randomized study comparing these 2 modalities.
Differences in theta coherence between spatial and nonspatial attention using intracranial electroencephalographic signals in humans

A number of previous studies revealed the importance of the frontoparietal network for attention and preparatory top‐down control. Here, we investigated the theta (7–9 Hz) coherence of the right frontoparietal networks to explore the differences in connectivity changes for the right frontoparietal regions during spatial attention (i.e., attention to a specific location rather than a specific feature) and nonspatial attention (i.e., attention to a specific feature rather than a specific location) tasks. The theta coherence in both tasks was primarily maintained at a preparatory state, decreases after stimulus onset, and recovers to the level of the preparatory state after the response time. However, the theta coherence of the frontoparietal network during spatial attention was immediately maintained after cue‐onset, whereas for the case of nonspatial attention, it was immediately decreased after cue‐onset. In addition, the connectivity of the right frontoparietal network, including the middle frontal gyrus and superior parietal lobe, were significantly higher for spatial attention rather than for nonspatial attention, suggesting that the dorsal parts of right frontoparietal network are more engaged in spatial‐specific attention from the preparatory state. These findings also suggest that these two attention systems involve the use of different regional connectivity patterns, not only in the cognitive state, but in the preparatory state as well.
Turkish validation of the Jefferson scale of empathy for nurses seeking kidney donations in intensive care units

Abstract Aim To find the answer to the question: is a high level of empathy of intensive care nurses effective in increasing organ donation? Materials and Methods This study was performed with nurses who had been working in intensive care units for at least 1 year in 17 hospitals in 8 provinces in Turkey. Jefferson Scale of Empathy and the other questionnaire forms were sent to the nurses by email, and completed forms from those who accepted to participate in the study were also received by email. Results There was a positive significant relationship between donor declaration and empathy score. An increase was observed in empathy score as donor declaration increased. Cronbach’s alpha coefficient of Jefferson Scale of Empathy (JSE) in general was α = 0.71. JSE is an acceptable tool of measurement in terms of internal consistency. Turkish validation of JSE was provided. Discussion There was a direct relationship between empathy levels of intensive care nurses and donor declarations and organ finding. Therefore, it can be assumed that a preference for nurses with a high level of empathy to work in intensive care units would be effective in increasing organ donations. Alternatively, empathy increasing trainings during in-service trainings and seminars for intensive care nurses may increase organ donation and thus provide hope for patients awaiting organ donations.
Exploring social ecological pathways from resilience to quality of life among women living with HIV in Canada

ABSTRACT Resilience, positive growth in contexts of stress and adversity, is shaped by social ecological factors. Among people living with HIV, resilience is associated with myriad positive health benefits and improved health-related quality of life (HR-QoL). Identifying contextual factors associated with resilience among women living with HIV (WLWH) is particularly important as this population experiences many stressors and inequalities. We examined social-ecological factors associated with resilience and its relationship with HR-QoL among WLWH. We utilized baseline survey data from a national cohort of WLWH (n = 1424) in Canada. We conducted structural equation modelling using maximum likelihood estimation methods to test the direct effects of social support and women-centred HIV care (WCHC) on resilience, and the direct effects of resilience on mental and physical HR-QoL. We also tested the indirect effects of resilience on HR-QoL via HIV disclosure concerns and economic insecurity. Participant median age was 43 years (IQR = 35–50); most participants were women of colour (29% Black; 22% Indigenous; 7% other ethnicities; 41% Caucasian). Social support and WCHC were associated with increased resilience. The direct path from resilience to mental HR-QoL was significant, accounting for the mediation effects of economic insecurity and social support. The direct path from resilience to physical HR-QoL was significant, accounting for the mediation effects of economic insecurity. Economic insecurity partially mediated the relationship between resilience and mental HR-QoL and physical HR-QoL. HIV disclosure concerns partially mediated the relationship between resilience and mental-HR-QoL. Model fit indices suggested that the model fit the data well (χ2[14] = 160.378, P < 0.001; CFI = 0.987; RMSE = 0.048 [90% CI:0.042–0.080]; SRMR = 0.036). Findings suggest social (social support) and structural (WCHC) factors increase resilience. While resilience is associated with improved HR-QoL, social (HIV disclosure concerns) and structural (economic insecurity) factors partially mediate these associations and threaten HR-QoL. Multi-level interventions can address social ecological contexts to advance resilience and HR-QoL among WLWH.
Early and late relapses of cutaneous melanoma patients

ABSTRACT Objectives: Recurrence may most likely develop during the course of the disease in patients presented with early stage melanoma at initial diagnosis. The specific risk factors for early and late recurrences following definitive surgical excision have yet to be determined. The aim of this study was to analyze the early and late relapses in stage I-III cutaneous melanoma patients. Methods: Of 365 patients with relapses, 189 developed within the first 18 months following surgical intervention (early relapse [ER]) and the remaining 176 occurred later (late relapse [LR]) were analyzed. Results: ER patients were found to have thicker and ulcerated lesions with higher mitotic rates and lymphovascular invasion, and they were found to be more significantly associated with node involvements. Nearly half of the first recurrences were locoregional (49.9%) that were followed by distant metastases alone (26.6%). The distribution of the initial relapse patterns was similar between the ER and the LR groups. The lung was the most frequently metastasized site (43.1%), and it was followed by bone (21.0%), liver (20.7%) and brain (15.1%). On multivariate analysis risk factors in association with both ER and LR were found as follows: ulcerated lesions, high mitotic rate, and node-positive disease; however nodular histopathological subtype and lymphovascular invasion were found to have impact merely on ER, and male gender merely on LR. Conclusion: The current study has detected potential risk factors for relapse of patients who developed ER and LR. These indicators may be useful for rational follow-up programs of the patients.
The multikinase inhibitor EC‐70124 synergistically increased the antitumor activity of doxorubicin in sarcomas

Cytotoxic drugs like doxorubicin remain as the most utilized agents in sarcoma treatment. However, advanced sarcomas are often resistant, thus stressing the need for new therapies aimed to overcome this resistance. Multikinase inhibitors provide an efficient way to target several pro‐tumorigenic pathways using a single agent and may constitute a valuable strategy in the treatment of sarcomas, which frequently show an aberrant activation of pro‐tumoral kinases. Therefore, we studied the antitumor activity of EC‐70124, an indolocarbazole analog that have demonstrated a robust ability to inhibit a wide range of pro‐survival kinases. Evaluation of the phospho‐kinase profile in cell‐of‐origin sarcoma models and/or sarcoma primary cell lines evidenced that PI3K/AKT/mTOR, JAK/STAT or SRC were among the most highly activated pathways. In striking contrast with the structurally related drug midostaurin, EC‐70124 efficiently prevented the phosphorylation of these targets and robustly inhibited proliferation through a mechanism associated to the induction of DNA damage, cell cycle arrest and apoptosis. In addition, EC‐70124 was able to partially reduce tumor growth in vivo. Importantly, this compound inhibited the expression and activity of ABC efflux pumps involved in drug resistance. In line with this ability, we found that the combined treatment of EC‐70124 with doxorubicin resulted in a synergistic cytotoxic effect in vitro and an increased antitumor activity of this cytotoxic drug in vivo. Altogether, these results uncover the capability of the novel multikinase inhibitor EC‐70124 to counteract drug resistance in sarcoma and highlight its therapeutic potential when combined with current treatments.
Reply: Radiation Dose Does Matter: Mechanistic Insights into DNA Damage and Repair Support the Linear No-Threshold Model of Low-Dose Radiation Health Risks

suggesting that the radiometal chelated into the DOTA moiety affects the uptake and perhaps binding of both DOTA-TATE and EB-DOTA-TATE. The authors concluded that ‘‘As a consequence of the different uptake, only different isotopes of the same element (such as 86Y/90Y or 64Cu/67Cu) can be used for assessment of biokinetic data. ’’ Although the data presented by the authors are intriguing, we would like to argue that: (1) These results are not specific to EBDOTA-TATE but are seen with DOTA-TATE as well. It is common practice to use 68Ga-DOTA-TATE to detect tumor somatostatin receptor 2 expression before radionuclide therapy with 177LuDOTA-TATE, and so far this practice seems to prove itself. Moreover, 68Ga-DOTA-TATE scanning has significantly lower radiation exposure to the patient than other longer-lived isotopes labeled with the same ligand. It would be unreasonable in our opinion to use 86Y for imaging when a much safer option is available (2). The authors derive their conclusion from in vitro cell uptake and extrapolated the result to predict the in vivo pharmacokinetics. It would be more appropriate to draw a conclusion from actual in vivo studies. We look forward to seeing data from more in-depth in vivo studies done, perhaps, by Dr. Kotzerke and colleagues.