Miracle-dz/UniFAR-FTUs huggingface dataset:
Geographic Disparities in Case Fatality and Discharge Disposition Among Patients With Primary Intracerebral Hemorrhage

Background We evaluate nationwide trends and urban–rural disparities in case fatality (in‐hospital mortality) and discharge dispositions among patients with primary intracerebral hemorrhage (ICH). Methods and Results In this repeated cross‐sectional study, we identified adult patients (≥18 years of age) with primary ICH from the National Inpatient Sample (2004–2018). Using a series of survey design Poisson regression models, with hospital location–time interaction, we report the adjusted risk ratio (aRR), 95% CI, and average marginal effect (AME) for factors associated with ICH case fatality and discharge dispositions. We performed a stratified analysis of each model among patients with extreme loss of function and minor to major loss of function. We identified 908 557 primary ICH hospitalizations (overall mean age [SD], 69.0 [15.0] years; 445 301 [49.0%] women; 49 884 [5.5%] rural ICH hospitalizations). The crude ICH case fatality rate was 25.3% (urban hospitals: 24.9%, rural hospitals:32.5%). Urban (versus rural) hospital patients had a lower likelihood of ICH case fatality (aRR, 0.86 [95% CI, 0.83–0.89]). ICH case fatality is declining over time; however, it is declining faster in urban hospitals (AME, −0.049 [95% CI, −0.051 to −0.047]) compared with rural hospitals (AME, −0.034 [95% CI, −0.040 to −0.027]). Conversely, home discharge is increasing significantly among urban hospitals (AME, 0.011 [95% CI, 0.008–0.014]) but not significantly changing in rural hospitals (AME, −0.001 [95% CI, −0.010 to 0.007]). Among patients with extreme loss of function, hospital location was not significantly associated with ICH case fatality or home discharge. Conclusions Improving access to neurocritical care resources, particularly in resource‐limited communities, may reduce the ICH outcomes disparity gap.
Estradiol and the Catechol-o-methyltransferase Gene Interact to Predict Working Memory Performance: A Replication and Extension

Abstract Decades of evidence across taxa have established the importance of dopamine (DA) signaling in the pFC for successful working memory performance. Genetic and hormonal factors can shape individual differences in prefrontal DA tone. The catechol-o-methyltransferase (COMT) gene regulates basal prefrontal DA, and the sex hormone 17β-estradiol potentiates DA release. E. Jacobs and M. D’Esposito [Estrogen shapes dopamine-dependent cognitive processes: Implications for women’s health. Journal of Neuroscience, 31, 5286–5293, 2011] investigated the moderating role of estradiol on cognition using the COMT gene and COMT enzymatic activity as a proxy for pFC DA tone. They found that increases in 17β-estradiol within women at two time points during the menstrual cycle influenced working memory performance in a COMT-dependent manner. Here, we aimed to replicate and extend the behavioral findings of Jacobs and D'Esposito by employing an intensive repeated-measures design across a full menstrual cycle. Our results replicated the original investigation. Within-person increases in estradiol were associated with improved performance on 2-back lure trials for participants with low basal levels of DA (Val/Val carriers). The association was in the opposite direction for participants with higher basal levels of DA (Met/Met carriers). Our findings support the role of estrogen in DA-related cognitive functions and further highlight the need to consider gonadal hormones in cognitive science research.
Bladder cancer risk in relation to occupations held in a nationwide case‐control study in Iran

Globally, bladder cancer has been identified as one of the most frequent occupational cancers, but our understanding of occupational bladder cancer risk in Iran is less advanced. This study aimed to assess the risk of bladder cancer in relation to occupation in Iran. We used the IROPICAN case‐control study data including 717 incident cases and 3477 controls. We assessed the risk of bladder cancer in relation to ever working in major groups of the International Standard Classification of Occupations (ISCO‐68) while controlling for cigarette smoking, opium consumption. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI). In men, decreased ORs for bladder cancer were observed in administrative and managerial workers (OR 0.4; CI: 0.2, 0.9), and clerks (OR 0.6; CI: 0.4, 0.9). Elevated ORs were observed in metal processors (OR 5.4; CI: 1.3, 23.4), and workers in occupations with likely exposure to aromatic amines (OR 2.2; CI: 1.2, 4.0). There was no evidence of interactions between working in aromatic amines‐exposed occupations and tobacco smoking or opium use. Elevated risk of bladder cancer in men in metal processors and workers likely exposed to aromatic amines aligns with associations observed outside Iran. Other previously confirmed associations between high‐risk occupations and bladder cancer were not observed, possibly due to small numbers or lack of details on exposure. Future epidemiological studies in Iran would benefit from the development of exposure assessment tools such as job exposure matrices, generally applicable for retrospective exposure assessment in epidemiological studies.
Diversity, phylogeny and intraspecific variability of Paradiplozoon species (Monogenea: Diplozoidae) parasitizing endemic cyprinoids in the Middle East

Abstract Abstract Diplozoidae are common monogenean ectoparasites of cyprinoid fish, with the genus Paradiplozoon being the most diversified. Despite recent studies on Diplozoidae from Europe, Africa and Asia, the diversity, distribution and phylogeny of this parasite group appears to be still underestimated in the Middle East. The objective of this study was to investigate the diversity, endemism and host specificity of diplozoids parasitizing cyprinoid fish from the Middle East, considering this region as an important historical interchange of fish fauna, and to elucidate the phylogenetic position of Middle Eastern Paradiplozoon species within Diplozoidae. Four Paradiplozoon species were collected from 48 out of 94 investigated cyprinoid species. Three known species, Paradiplozoon homoion, Paradiplozoon bliccae and Paradiplozoon bingolensis, were recorded on new cyprinoid host species, and a new species, Paradiplozoon koubkovae n. sp. , was recorded on Luciobarbus capito and Capoeta capoeta from the Caspian Sea basin in Iran and Turkey. Paradiplozoon bliccae, exhibiting a wide host range in the Middle East, expressed both morphological and genetic intraspecific variabilities. The four Paradiplozoon species collected in the Middle East were placed in divergent clades, showing the rich evolutionary history of diplozoid parasites in the Middle East. Our study also revealed that two lineages of African diplozoids have a Middle Eastern origin. We stress the importance of applying an integrative approach combining morphological, ecological and molecular methods to reveal the real diversity of diplozoids.
A tale of two copies: Evolutionary trajectories of moth pheromone receptors

Significance Moths have served as historical models for animal communication studies. As their sex pheromone system is expected to be fine-tuned and under stabilizing selection, understanding its evolution has attracted interest for a long time. In the species Spodoptera littoralis and S. litura, the major component of the sex pheromone is an unusual compound, lacking in other species of the same genus. Building on the recent identification of a receptor narrowly tuned to this compound in S. littoralis, we investigated its evolution in the genus Spodoptera. We found that gene duplication followed by mutations that modified the binding pocket of the receptor led to the emergence of a new pheromone system in the common ancestor of S. littoralis and S. litura.
Diagnostic Peritoneal Aspiration or Lavage in Stratified Groups of Hypotensive Blunt Trauma Patients

Background Some reports suggest Diagnostic peritoneal aspiration (DPA) or lavage (DPL) may better select which hypotensive blunt trauma patients (BTPs) require operation, compared to ultrasonography. However, whether both moderately hypotensive (systolic blood pressure [SBP] < 90 mmHg) and severely hypotensive (SBP < 70 mmHg) patients benefit from DPA/DPL is unclear. We hypothesized DPA/DPL used within the first hour increases risk of death for severely vs moderately hypotensive BTPs. Methods The 2017-2019 Trauma Quality Improvement Program database was queried for BTPs ≥ 18 years old with hypotension upon arrival. We compared moderately and severely hypotensive groups. A multivariable logistic regression analysis was performed controlling for age, comorbidities, emergent operation, blood transfusions, and injury profile. Results From 134 hypotensive patients undergoing DPA/DPL, 66 (49.3%) had severe hypotension. Patients in both groups underwent an emergent operation (43.9% vs 58.8%, P = .09) in a similar amount of time (median, 42-min vs 54-min, P = .11). Compared to the moderately hypotensive group, severely hypotensive patients had a higher rate and associated risk of death (84.8% vs 50.0%, P < .001) (OR 5.40, CI 2.07-14.11, P < .001). The strongest independent risk factor for death was age ≥ 65 (OR 24.81, CI 4.06-151.62, P < .001). Discussion Among all BTPs undergoing DPA/DPL within the first hour of arrival, an over 5-fold increased risk of death for patients with severe hypotension was demonstrated. As such, DPA/DPL within this group should be used with caution, particularly for older patients, as they may be better served by immediate surgeries. Future prospective research is needed to confirm these findings and elucidate the ideal DPA/DPL population in the modern era of ultrasonography.
Relevance of vitamin D on NAFLD and liver fibrosis detected by vibration controlled transient elastography in US adults: a cross-sectional analysis of NHANES 2017–2018

Abstract Background The connection between vitamin D to non-alcoholic fatty liver disease (NAFLD) is still unclear. Herein, the relationship of vitamin D with NAFLD and liver fibrosis (LF) detected by vibration controlled transient elastography was investigated in US adults. Methods The National Health and Nutrition Examination Survey of 2017–2018 was employed for our analysis. Participants were categorized as having either vitamin D deficiency (<50 nmol/L) or vitamin D sufficiency (≥50 nmol/L). A controlled attenuation parameter score of ≥ 263 dB/m was employed to define NAFLD. Significant LF was identified by the liver stiffness measurement value of ≥ 7.9 kPa. Multivariate logistic regression was adopted to explore the relationships. Results Among the 3407 participants, the prevalence of NAFLD and LF was 49.63% and 15.93% respectively. Compared to participants without NAFLD, no significant difference in serum vitamin D was observed in NALFD participants (74.26 vs. 72.24 nmol/L; p = 0.21). Using multivariate logistic regression analysis, no obvious connection of vitamin D status to NAFLD (sufficiency vs. deficiency, OR 0.89, 95%CI 0.70–1.13) was discovered. However, among NAFLD participants, the sufficiency of vitamin D represents a lower LF risk (OR 0.56, 95%CI 0.38–0.83). When evaluated in quartiles, in comparison to the lowest quartile, high vitamin D represents low LF risk in a dose-dependent manner (Q2 vs. Q1, OR 0.65, 95%CI 0.37–1.14; Q3 vs. Q1, OR 0.64, 95%CI 0.41–1.00; Q4 vs. Q1, OR 0.49, 95%CI 0.30–0.79). Conclusions No relationship was found between vitamin D and CAP-defined NAFLD. However, a positive connection of the high serum vitamin D to the reduced LF risk was found among NAFLD subjects. Key messages: Our study found no relationship between vitamin D and CAP-defined NAFLD in US adults. High serum vitamin D was inversely associated with liver fibrosis in a dose-dependent manner among NAFLD participants.
Scanning electron microscopic analysis of adherent bacterial biofilms associated with peri‐implantitis

Peri‐implantitis (PI) is caused by bacteria in the peri‐implant space but the consensus on microbial profile is still lacking. Current microbial sampling of PI lesions has largely focused on analyzing bacterial species that have been shed from the implant surface and captured in the pocket fluid. The purpose of the present study was to investigate the morphotypes of bacteria in biofilm covering the implant threads and explore whether certain morphotypes were associated with PI.
Association between delayed cesarean section and severe maternal and adverse newborn outcomes in the Somaliland context: a cohort study in a national referral hospital

ABSTRACT Background In a critical obstetric situation, the time interval between the decision of performing a caesarean section (CS) and delivery can influence maternal and newborn outcomes. In Somaliland, consent for surgical procedures, such as CS needs to be sought from family members. Objective To determine the association between a delay in performing a CS and severe maternal and newborn outcomes in a national referral hospital in Somaliland. The type of barriers leading to delayed performance of CS after a doctor’s decision were also explored. Methods Women were followed from the time of decision to perform CS until discharge from the hospital between 15 April 2019 and 30 March 2020. No delay was defined as < 1 hour and delayed CS was defined as 1–3 hours and >3 hours from decision of CS to delivery. Information was collected on barriers leading to delayed CS and maternal and newborn outcomes. Data was analysed using binary and multivariate logistic regression. Results Overall, 1255 women were recruited from a larger cohort of 6658 women. A delay in CS >3 hours was associated with higher odds of severe maternal outcomes (aOR 1.58, 95% CI [1.13–2.21]). On the contrary, delay in performing a CS >3 hours was associated with lower odds of stillbirth (aOR 0.48, 95% CI [0.32–0.71]) compared to women without delay. Further, family decision-making for consent was the most important barrier leading to delays of >3 hours as compared to financial factors and barriers related to healthcare providers (48% vs 26% and 15%, respectively, p < 0.001). Conclusions In this setting, delay in performing CS >3 hours was associated with higher risk of severe maternal outcomes. A standardised system of performing a CS by primarily addressing the barriers associated with family decision-making, financial aspects and healthcare providers is needed.
Pan‐cancer efficacy and safety of anlotinib plus PD‐1 inhibitor in refractory solid tumor: A single‐arm, open‐label, phase II trial

The combination of immunotherapy and antiangiogenic agents for the treatment of refractory solid tumor has not been well investigated. Thus, our study aimed to evaluate the efficacy and safety of a new regimen of anlotinib plus PD‐1 inhibitor to treat refractory solid tumor. APICAL‐RST is an investigator‐initiated, open‐label, single‐arm, phase II trial in patients with heavily treated, refractory, metastatic solid tumor. Eligible patients experienced disease progression during prior therapy without further effective regimen. All patients received anlotinib and PD‐1 inhibitor. The primary endpoints were objective response and disease control rates. The secondary endpoints included the ratio of progression‐free survival 2 (PFS2)/PFS1, overall survival (OS) and safety. Forty‐one patients were recruited in our study; 9 patients achieved a confirmed partial response and 21 patients had stable disease. Objective response rate and disease control rate were 22.0% and 73.2% in the intention‐to‐treat cohort, and 24.3% and 81.1% in the efficacy‐evaluable cohort, respectively. A total of 63.4% (95% confidence interval [CI]: 46.9%‐77.4%) of the patients (26/41) presented PFS2/PFS1 >1.3. The median OS was 16.8 months (range: 8.23‐24.4), and the 12‐ and 36‐month OS rates were 62.8% and 28.9%, respectively. No significant association was observed between concomitant mutation and efficacy. Thirty‐one (75.6%) patients experienced at least one treatment‐related adverse event. The most common adverse events were hypothyroidism, hand‐foot syndrome and malaise. This phase II trial showed that anlotinib plus PD‐1 inhibitor exhibits favorable efficacy and tolerability in patients with refractory solid tumor.
Microbial contamination and bacterial treatment of cutting fluid s from selected metal workshops in Ibadan, Nigeria

Studies were carried out on the microbial contamination and bio treatment of cutting fluid samples collected from nine different metal workshops within Ibadan metropolis. Isolation was done using the pour plate technique while the heavy metal concentration of the cutting fluids was monitored using the Atomic Absorption Spectrop hotometer. The T otal O rganic C arbon (TOC) and B iochemical O xygen D emand (BOD) which were used as indices for the biotreatment of the fluids by the bacteria isolates were monitored using different analytical procedures. A total of thirty bacteria were isola ted from the cutting fluids samples. They include Bacillus sp , Proteus sp , Staphylococcus sp, Citrobacter sp, Corynebacterium sp, Enterobacter sp, Acinetobacter sp, Alcaligenes sp, Flavobacterium sp, Klebsiella sp with Pseudomonas sp being the most prevale nt. T he highest concentration of Pb was observed in the cutting fluid sample from the Physics Department (7.02µg/g), while the sample from Maintenance Department had 1. 30µg/g Ni. The Zn and Cr level were detected to be highest in the sample from Tat metal workshop with concentration of 0. 91µg/g and 0. 19µg/g respectively. The ability of the isolates to treat the fluids (singly or in consortium) was assesse d using the TOC and BOD of the cutting fluid after treatment using the bacteria species. The heavy metal concentration was lowered by all the treatment, however the highest reduction of the metal levels was observed in the fluid treated with the consortium ( Pseudomonas aeruginosa and Bacillus sp.). The same trend was observed in the TOC and BOD values after treatment with the bacterial isolates. The consortium reduced the TOC of the fresh cutting fluids by 43.80% compared to 39.31% and 31.15% by Pseudomonas aeruginosa and Bacillus sp . respectively. The BOD value of the fresh fluid was reduced by 62.01% using the consortium as against the 51.42% and 41.27% reduction by the singular organism. The BOD and TOC of the spent cutting fluid, in similar vein w ere reduced effectively by the consortium with percentage reduction of 64.35% and 61.00% respectively . These ba cteria can prove to be very effective in the biotreatment of environment contaminated with pollutants especially heavy metals. (Ogunjobi A.A., Adekanmbi A.O., Fadare A.D. Microbial contamination and bacterial treatment of cutting fluids from selected metal workshops in Ibadan, Nigeria. Academ Arena 2013;5(12): 47 - 54 ) (ISSN 1553 - 992X). http://www.sciencepub. net/academia . 6
An Evaluation of an Advanced Practice Provider Led Weight Intervention in Liver Disease (WILD) Pathway

Within the scope of their practice, advanced practice providers provide similar patient care as physicians, but in some cases have outperformed physicians in terms of health outcomes, satisfaction, and cost-effectiveness. At an academic medical center, hepatology trained advanced practice providers, who were also certified in obesity management, led an interprofessional team to develop the Weight Intervention in Liver Disease pathway. In September 2018, patients who were seen in the hepatology practice and met criteria for enrollment were referred to the Weight Intervention in Liver Disease program for comprehensive care of obesity and related metabolic disorders. A program evaluation was conducted in 2021 to identify whether the effectiveness of the advanced practice provider-led structure and process, and the Weight Intervention in Liver Disease pathway, supported weight loss goals as well as improvement in alanine aminotransferase levels, patient satisfaction, and provider satisfaction. Results found that the structure of the pathway and the implementation are resulting in positive outcomes of 100% patient satisfaction, 80% provider satisfaction, and a total average sustained weight loss of 5.05% (SD = 7.98, p < .01). A weight loss pathway led by trained advanced practice providers proves successful in long-term weight loss goals.
Excess Mortality Among Patients in the Veterans Affairs Health System Compared With the Overall US Population During the First Year of the COVID-19 Pandemic

Key Points Question How did changes in rates of death among patients in the Veterans Affairs (VA) health system that occurred during the first year of the COVID-19 pandemic compare with changes in rates of death among the general US population? Findings This cohort study found that changes in death rates between the VA population and the general US population were comparable after accounting for demographic differences between the populations. The changes varied by race and ethnicity in both populations; these disparities changed over time. Meaning This study suggests that the COVID-19 pandemic had a large association with rates of death in the US and, specifically, among veterans.
Country and policy factors influencing the implementation of primary care-based alcohol screening: A comparison of Colombia, Mexico and Peru

ABSTRACT Researchers and practitioners recognise the importance of context when implementing healthcare interventions, but the influence of wider environment is rarely mapped. This paper identifies the country and policy-related factors potentially explaining the country differences in outcomes of an intervention focused on improving detection and management of heavy alcohol use in primary care in Colombia, Mexico and Peru. Qualitative data obtained through interviews, logbooks and document analysis are used to explain quantitative data on number of alcohol screenings and screening providers in each of the countries. Existing alcohol screening standards in Mexico, and policy prioritisation of primary care and consideration of alcohol as a public health issue in Colombia and Mexico positively contributed to the outcome, while the COVID-19 pandemic had a negative impact. In Peru, the context was unsupportive due to a combination of: political instability amongst regional health authorities; lack of focus on strengthening primary care due to the expansion of community mental health centres; alcohol considered as an addiction rather than a public health issue; and the impact of COVID-19 on healthcare. We found that wider environment-related factors interacted with the intervention implemented and can help explain country differences in outcomes.
Hybrid Contextual Semantic Network for Accurate Segmentation and Detection of Small-Size Stroke Lesions From MRI

Stroke is a cerebrovascular disease with high mortality and disability rates. The occurrence of the stroke typically produces lesions of different sizes, with the accurate segmentation and detection of small-size stroke lesions being closely related to the prognosis of patients. However, the large lesions are usually correctly identified, the small-size lesions are usually ignored. This article provides a hybrid contextual semantic network (HCSNet) that can accurately and simultaneously segment and detect small-size stroke lesions from magnetic resonance images. HCSNet inherits the advantages of the encoder–decoder architecture and applies a novel hybrid contextual semantic module that generates high-quality contextual semantic features from the spatial and channel contextual semantic features through the skip connection layer. Moreover, a mixing-loss function is proposed to optimize HCSNet for unbalanced small-size lesions. HCSNet is trained and evaluated on 2D magnetic resonance images produced from the Anatomical Tracings of Lesions After Stroke challenge (ATLAS R2.0). Extensive experiments demonstrate that HCSNet outperforms several other state-of-the-art methods in its ability to segment and detect small-size stroke lesions. Visualization and ablation experiments reveal that the hybrid semantic module improves the segmentation and detection performance of HCSNet.