Miracle-dz/UniFAR-FTUs huggingface dataset:
Male Perception and Participation in Family Planning Among Tribal Communities of Maharashtra, India: A Mixed-Method Study

This study examined male perceptions and awareness about family planning. The study also investigated male involvement in family planning and contraceptive use decision-making. Furthermore, in this study, we assessed men’s awareness, attitude, and practice of modern contraceptive methods and determined the level of spousal communication. In this study, a field survey was conducted among the tribal population of Maharashtra. Both qualitative and quantitative methods were used for data collection. A sample of 385 men whose wives had given birth in the last 2 years were interviewed. Almost two thirds of the surveyed men (64%) had heard about modern family planning. The main source of information for family planning was the multipurpose worker in the village for 48% of men, followed by friends 16% and the auxiliary nurse midwife and accredited social health activist for 11% and 10%, respectively. Results show that the current use of any modern family planning method, including male and female methods, was 18.4%. Among the currently used modern methods, the major modern family planning method was male sterilization (67%), followed by oral pills (11%) and male condom use (10%). This study indicated that the acceptance of male modern family planning methods is very high.
Navigation in Unknown Dynamic Environments Based on Deep Reinforcement Learning

In this paper, we propose a novel Deep Reinforcement Learning (DRL) algorithm which can navigate non-holonomic robots with continuous control in an unknown dynamic environment with moving obstacles. We call the approach MK-A3C (Memory and Knowledge-based Asynchronous Advantage Actor-Critic) for short. As its first component, MK-A3C builds a GRU-based memory neural network to enhance the robot’s capability for temporal reasoning. Robots without it tend to suffer from a lack of rationality in face of incomplete and noisy estimations for complex environments. Additionally, robots with certain memory ability endowed by MK-A3C can avoid local minima traps by estimating the environmental model. Secondly, MK-A3C combines the domain knowledge-based reward function and the transfer learning-based training task architecture, which can solve the non-convergence policies problems caused by sparse reward. These improvements of MK-A3C can efficiently navigate robots in unknown dynamic environments, and satisfy kinetic constraints while handling moving objects. Simulation experiments show that compared with existing methods, MK-A3C can realize successful robotic navigation in unknown and challenging environments by outputting continuous acceleration commands.
Low Serum Vitamin D Concentrations Are Associated with Insulin Resistance in Mexican Children and Adolescents

Previous studies in the Mexican adult population have suggested a relationship between low levels of serum concentrations of serum vitamin D with impaired glucose tolerance, metabolic syndrome, and diabetes, regardless of the presence of obesity. The aim of this study is to investigate the relationship between serum vitamin D levels and the factors linked to insulin resistance. A total of 533 children and adolescents from the “Reference Values of Body Composition in the Pediatric Population of Mexico City” study are assessed. Body composition, dietary, and lifestyle data are obtained. Serum vitamin D, insulin, and glucose are also measured. Associations are tested using multiple linear and logistic regression models. Approximately 90% of children and adolescents in this study have sub-optimal vitamin D levels (<30 ng/mL). An inverse relationship between insulin resistance and serum vitamin D is observed (OR (odds ratios) = 2.9; 95% CI (95% confidence intervals): 1.1, 7.2; p-trend 0.03). Low serum vitamin D levels are associated with insulin resistance in the pediatric population. The present study provides additional evidence for the role of vitamin D in insulin resistance. Our findings suggest the supplementation of vitamin D may be helpful in preventing insulin resistance and subsequent diabetes.
Probabilistic Human Health Risk Assessment of Heavy Metal Intake via Vegetable Consumption around Pb/Zn Smelters in Southwest China

Vegetable contamination in mining and smelting areas has resulted in high dietary intakes of heavy metals, which pose potential health risks to local residents. In this study, paired soil-vegetable samples were collected around Pb/Zn smelters in Southwest China. Probabilistic risks to local residents via vegetable consumption were evaluated with a Monte Carlo simulation. The mean concentrations of As, Cd, Cu, Pb, and Zn in the soils were 116.76, 3.59, 158.56, 196.96, and 236.74 mg/kg, respectively. About 38.18%, 58.49%, and 52.83% of the vegetable samples exceeded the maximum allowable concentrations for As, Cd, and Pb, respectively. The daily dietary intake of As, Cd, and Pb exceeded the provisional tolerable daily intakes for local residents, with children showing the highest intake via vegetable consumption. The percentages of the target hazard quotients of As, Cd, and Pb for local residents exceeding the safe value of one were about 95%, 50%, and 25%, respectively. The 95th percentiles of the hazard index for children, adolescents, and adults were 15.71, 11.15, and 9.34, respectively, indicating significant risks to local residents, especially children. These results highlight a need to develop effective strategies to reduce heavy metal contamination and exposure to protect human health.
Identification of Resistance Pathways Specific to Malignancy Using Organoid Models of Pancreatic Cancer

Purpose: KRAS is mutated in the majority of pancreatic ductal adenocarcinoma. MAPK and PI3K-AKT are primary KRAS effector pathways, but combined MAPK and PI3K inhibition has not been demonstrated to be clinically effective to date. We explore the resistance mechanisms uniquely employed by malignant cells. Experimental Design: We evaluated the expression and activation of receptor tyrosine kinases in response to combined MEK and AKT inhibition in KPC mice and pancreatic ductal organoids. In addition, we sought to determine the therapeutic efficacy of targeting resistance pathways induced by MEK and AKT inhibition in order to identify malignant-specific vulnerabilities. Results: Combined MEK and AKT inhibition modestly extended the survival of KPC mice and increased Egfr and ErbB2 phosphorylation levels. Tumor organoids, but not their normal counterparts, exhibited elevated phosphorylation of ERBB2 and ERBB3 after MEK and AKT blockade. A pan-ERBB inhibitor synergized with MEK and AKT blockade in human PDA organoids, whereas this was not observed for the EGFR inhibitor erlotinib. Combined MEK and ERBB inhibitor treatment of human organoid orthotopic xenografts was sufficient to cause tumor regression in short-term intervention studies. Conclusions: Analyses of normal and tumor pancreatic organoids revealed the importance of ERBB activation during MEK and AKT blockade primarily in the malignant cultures. The lack of ERBB hyperactivation in normal organoids suggests a larger therapeutic index. In our models, pan-ERBB inhibition was synergistic with dual inhibition of MEK and AKT, and the combination of a pan-ERBB inhibitor with MEK antagonists showed the highest activity both in vitro and in vivo.
Sport injury prevention in-school and out-of-school? A qualitative investigation of the trans-contextual model

Objective To investigate junior secondary school students’ experiences and perspectives of in-school and out-of-school sport-safety, with a particular focus on the meaning and content that they applied to the motivational and social cognitive factors of sport injury prevention. Design Focus-group interview. Method Participants were 128 junior secondary school students (Form 1 to Form 3) aged between 12 and 16 years from two secondary schools. We organised focus-group interviews by class (group size = six to nine students). Seventeen groups completed semi-structured interviews regarding their experience, beliefs, and motives for injury prevention in-school and out-of-school. We analysed data by thematic content analysis using a typological approach. Results Higher order themes (N = 7) including in-school and out-of-school motives and social cognitive factors and associated lower-order themes (N = 16), emerged from the analysis corresponding to constructs from trans-contextual model tenets. Conclusions The current study is the first qualitative study to explore junior secondary school students’ experience and perspectives on sport injury prevention, using trans-contextual model as a framework for investigation. The findings contribute to a better understanding on their motivational and social cognitive factors in adopting sport injury prevention. The content of the theme behavior also indicated the inadequacy of students’ knowledge of effective sport injury prevention techniques, and underscored the importance of sport safety education.
Romantic relationship and psychological wellbeing: the experiences of young individuals with visual impairment

Abstract Purpose The sense of vision plays a dominant role in entering a romantic partnership. However, the romantic experiences of individuals with visual impairment have received scant research attention. The study aimed to describe the lived romantic experiences of young adults with visual impairment from various cultural backgrounds and to understand the implications of these experiences on their psychological wellbeing. Method The study was conducted in the Israeli multicultural society. We conducted in-depth semi-structured interviews with 24 Jewish and Arab adults (aged 18-40 years) with visual impairment about their romantic experiences and the meanings they attribute to these experiences. We used an inductive thematic analysis. Results Singlehood seemed to be a distressing situation for the Muslim female participants compared to the Jewish participants. Having a romantic partner contributed to the participants' self-acceptance and psychological well-being, especially for Muslim individuals. Conclusions The findings demonstrate the intersection of lifelong disability, gender, and culture in the context of romantic relationships. The findings also highlight the need to support the romantic opportunities and experiences of young individuals with visual impairment, especially those from Arab society. IMPLICATIONS FOR REHABILITATION Young adults with visual impairment often face physical and social barriers in entering and maintaining a romantic relationship. Having a romantic partner contributes to the self-acceptance and psychological wellbeing of young adults with visual impairment. Rehabilitation practitioners should take into consideration personal and environmental factors, such as gender and cultural background, when providing support in a romantic and intimate relationship, for individuals with lifelong disabilities. Rehabilitation practitioners should also engage family members, especially from religious families, to support their relatives with visual impairment in developing a romantic relationship.
Different Original and Biosimilar TNF Inhibitors Similarly Reduce Joint Destruction in Rheumatoid Arthritis—A Network Meta-Analysis of 36 Randomized Controlled Trials

The effect of five approved tumour necrosis factor inhibitors (TNFi: infliximab, etanercept, adalimumab, certolizumab, and golimumab) on joint destruction in rheumatoid arthritis (RA) have been compared versus methotrexate (MTX) in randomized controlled trials (RCTs) but have not been compared directly to each other or to an otherwise untreated placebo control. The present analysis compares effects of standard doses, high doses, and low doses of TNFis on radiographic joint destruction in RA and relate these effects to MTX and placebo by means of a Bayesian network meta-analysis. We identified 31 RCTs of the effect of TNFis on joint destruction and 5 RCTs with controls, which indirectly could link otherwise untreated placebo controls to the TNFi treatments in the network. The previously untested comparison with placebo was performed to estimate not only the effect relative to another drug, but also the absolute attainable effect. Compared to placebo there was a highly significant inhibitory effect on joint destruction of infliximab, etanercept, adalimumab, certolizumab, and golimumab, which was about 0.9% per year as monotherapy and about 1.2% per year when combined with MTX. Although significantly better than MTX and placebo, golimumab seemed inferior to the remaining TNFis. There was no difference between original reference drugs (Remicade, Enbrel) and the almost identical copy drugs (biosimilars).
Burden of CKD and Cardiovascular Disease on Life Expectancy and Health Service Utilization: a Cohort Study of Hong Kong Chinese Hypertensive Patients.

BACKGROUND The relative effects of combinations of CKD, heart disease, and stroke on risk of mortality, direct medical costs, and life expectancy are unknown. METHODS In a retrospective cohort study of 506,849 Chinese adults in Hong Kong with hypertension, we used Cox regressions to examine associations between all-cause mortality and combinations of moderate CKD (eGFR of 30-59 ml/min per 1.73 m2), severe CKD (eGFR of 15-29 ml/min per 1.73 m2), heart disease (coronary heart disease or heart failure), and stroke, and modeling to estimate annual public direct medical costs and life expectancy. RESULTS Over a median follow-up of 5.8 years (2.73 million person-years), 55,666 deaths occurred. Having an increasing number of comorbidities was associated with incremental increases in mortality risk and medical costs and reductions in life expectancy. Compared with patients who had neither CKD nor cardiovascular disease, patients with one, two, or three conditions (heart disease, stroke, and moderate CKD) had relative risk of mortality increased by about 70%, 160%, and 290%, respectively; direct medical costs increased by about 70%, 160%, and 280%, respectively; and life expectancy at age 60 years decreased by about 5, 10, and 15 years, respectively. Burdens were higher with severe CKD. CONCLUSIONS This study demonstrated extremely high mortality risk and medical cost increases for severe CKD, exceeding the combined effects from heart disease and stroke. Mortality risks and costs for moderate CKD, heart disease, and stroke were similar individually and roughly multiplicative for any combination. These findings suggest that to reduce mortality and health care costs in patients with hypertension, CKD prevention and intervention merits priority equal to that of cardiovascular disease.
Indirect Calorimetry in Clinical Practice

Indirect calorimetry (IC) is considered as the gold standard to determine energy expenditure, by measuring pulmonary gas exchanges. It is a non-invasive technique that allows clinicians to personalize the prescription of nutrition support to the metabolic needs and promote a better clinical outcome. Recent technical developments allow accurate and easy IC measurements in spontaneously breathing patients as well as in those on mechanical ventilation. The implementation of IC in clinical routine should be promoted in order to optimize the cost–benefit balance of nutrition therapy. This review aims at summarizing the latest innovations of IC as well as the clinical indications, benefits, and limitations.
Parenting and Self-Control Across Early to Late Adolescence: A Three-Level Meta-Analysis

Self-control plays a significant role in positive youth development. Although numerous self-control challenges occur during adolescence, some adolescents control themselves better than others. Parenting is considered a critical factor that distinguishes adolescents with good self-control from those with poor self-control, but existing findings are inconsistent. This meta-analysis summarizes the overall relationship between parenting and self-control among adolescents aged 10 to 22 years. The analysis includes 191 articles reporting 1,540 effect sizes (N = 164,459). The results show that parenting is associated with adolescents’ self-control both concurrently (r = .204, p < .001) and longitudinally (r = .157, p < .001). Longitudinal studies also reveal that adolescents’ self-control influences subsequent parenting (r = .155, p < .001). Moderator analyses show that the effect sizes are largely invariant across cultures, ethnicities, age of adolescents, and parent and youth gender. Our results point to the importance of parenting in individual differences in adolescent self-control and vice versa.
Mixing Sows into Alternative Lactation Housing Affects Sow Aggression at Mixing, Future Reproduction and Piglet Injury, with Marked Differences between Multisuckle and Sow Separation Systems

Simple Summary Alternative lactation housing could reduce aggression when sows are mixed. We aimed to compare the effects of mixing sows during lactation (with or without piglets) at weaning and after insemination and determine the effects of mixing strategies and lactation housing on the piglet. Sows in the multisuckle treatment were the least aggressive, had the fewest injuries around mixing, and gave birth to the most piglets at the subsequent litter, with multisuckle housing having no apparent ill effects on the piglets. There was greater aggression in sows separated from their piglets for seven hours daily in lactation (SEP) than any other method. Multisuckle housing appears to be an effective way of decreasing aggression at the point of mixing, whilst optimizing sow reproduction. The behavioural response to mixing was similar when it occurred at weaning or after insemination, with the highest incidence of aggression observed in sows mixed without their piglets during lactation. Abstract Alternative lactation housing could reduce aggression when sows are mixed. We aimed to compare the effects of mixing sows in lactation (with or without piglets), at weaning or after insemination, and determine the effects of lactation housing on the piglet. This study used 120 multiparous Large White × Landrace sows and 54 focal litters. The sows were mixed into groups of six and allocated to multisuckle from day 21 lactation (MS), separated from litter and housed in groups, with piglets left in the crate for seven hours daily from day 21 lactation (SEP), mixed at weaning (day 28 lactation) (WEAN) and mixed after artificial insemination (AI) (MAI; 4 ± 1 day after last AI). Behaviour, saliva for free salivary cortisol concentration and injury counts were taken on M-1 (before mixing), M0 (mixing), M1 and M6. Piglets were weighed, injury-scored and bloods taken for cortisol. There was reduced aggression, seen as fights, bites and knocks in MS compared to the other treatments on all days (p < 0.05). MS sows had no fights on M1 and M6 and had more piglets born in the subsequent farrowing. Piglet weight, cortisol and mortality were unaffected by treatment (p > 0.05). MS piglets had greater injury scores immediately after moving to multisuckle and lower injuries around weaning (p > 0.001). Multisuckle housing could decrease aggression and stress at mixing in sows, with changes in the time of peak piglet injury (at mixing rather than at weaning) but overall no negative effects on the piglets.
The Paradoxical Role of Uric Acid in Osteoporosis

Because of its high prevalence worldwide, osteoporosis is considered a serious public health concern. Many known risk factors for developing osteoporosis have been identified and are crucial if planning health care needs. Recently, an association between uric acid (UA) and bone fractures had been explored. Extracellular UA exhibits antioxidant properties by effectively scavenging free radicals in human plasma, but this benefit might be disturbed by the hydrophobic lipid layer of the cell membrane. In contrast, intracellular free oxygen radicals are produced during UA degradation, and superoxide is further enhanced by interacting with NADPH oxidase. This intracellular oxidative stress, together with inflammatory cytokines induced by UA, stimulates osteoclast bone resorption and inhibits osteoblast bone formation. UA also inhibits vitamin D production and thereby results in hyper-parathyroidism, which causes less UA excretion in the intestines and renal proximal tubules by inhibiting the urate transporter ATP-binding cassette subfamily G member 2 (ABCG2). At normal or high levels, UA is associated with a reduction in bone mineral density and protects against bone fracture. However, in hyperuricemia or gout arthritis, UA increases bone fracture risk because oxidative stress and inflammatory cytokines can increase bone resorption and decrease bone formation. Vitamin D deficiency, and consequent secondary hyperparathyroidism, can further increase bone resorption and aggravated bone loss in UA-induced osteoporosis.
Anticancer Action of Psilostachyin-A in 5-Fluorouracil-Resistant Human Liver Carcinoma are Mediated Through Autophagy Induction, G2/M Phase Cell Cycle Arrest and Inhibiting Extracellular-Signal-Regulated Kinase/Mitogen Activated Protein Kinase (ERK/MAPK) Signaling Pathway

Background Liver cancer is one of the most common malignancies around the world and one of the major causes of cancer related mortality. The objective of this study was to evaluate the anticancer effect of the natural compound psilostachyin-A on 5-fluorouracil-resistant human liver carcinoma cells and its effects on autophagy, cell cycle, caspase activation, and the ERK/MAPK signaling pathway. Material/Methods Cell Counting Kit 8 (CCK-8) assay was used to evaluate the effects on HepG2 cell viability at different doses of psilostachyin-A. Cell cycle analysis was performed using flow cytometry, and Transwell assay was used to check effects on cell invasion. Transmission electron microscopic studies were done to evaluate autophagy induced by psilostachyin-A, and the western blot method was carried out to evaluate the effects on autophagy and the ERK/MAPK signaling pathway. Results CCK-8 assay revealed that the psilostachyin-A reduced the cell viability of HepG2 cancer cells in a dose dependent manner. Psilostachyin-A also reduced the colony forming potential of HepG2 cells, concentration dependently. The IC50 of psilostachyin was found to be 25 μM. The anticancer effects of psilostachyin-A were due to the induction of autophagy which was accompanied by enhancement of LC3B II expression. Psilostachyin also caused cell cycle arrest by enhancing the accumulation of HepG2 cells in the G2/M phase. Transwell assay showed that psilostachyin-A suppressed the invasion of HepG2 cells. The results also showed that psilostachyin-A could block the ERK/MAPK pathway, indicative of the cytotoxic effects of psilostachyin-A on liver cancer. Conclusions These preliminary observations suggested that psilostachyin-A might prove beneficial in the treatment of liver cancer.
Navigating monoclonal antibody use in breastfeeding women

Many neurologic diseases disproportionately affect women, particularly during their reproductive years. For many of these diseases, monoclonal antibodies (mAbs) are becoming widely available as a treatment option, for example, in migraine, multiple sclerosis, and myasthenia gravis. Yet, despite how common pregnancy is (latest estimates suggest that 86% of US women ages 40–44 have given birth), there is a paucity of research on the safety of prescription medications, including mAbs, during the peripartum period. In this article, we focus on the safety of mAbs during breastfeeding. We summarize how pregnancy affects the trajectory of these diseases and explore the benefit derived from mAb therapies. We posit that as neurologists, we are uniquely poised to lead the study of peripartum safety for the mAbs now on the market and provide a framework for their future study.