Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of COVID-19 pandemic lockdown on movement behaviours of children and adolescents: a systematic review

Introduction Several studies have examined how the lockdown restrictions enforced to halt the spread of COVID-19 have affected children and adolescents’ movement behaviours, but there is a need to synthesise these findings. Therefore, we conducted this systematic review to examine the impact of COVID-19 lockdown on children and adolescents’ movement behaviours. Methods We searched eight databases and grey literature for relevant studies of all study designs; and conducted a narrative analysis of the results following synthesis without meta-analysis guidelines. We used appropriate tools to assess the risk of bias in quantitative and qualitative studies. We compared changes in physical activity, screen time and sleep duration and quality from before to during the COVID-19 lockdown. Results This review included 71 studies reporting data from 35 countries and territories, mostly from high-income economies. A majority of the studies used a cross-sectional design and had fair to poor-quality ratings. Most studies reported reduced physical activity, increased screen time and longer sleep hours among children and adolescents. Children and adolescents facing strict lockdowns saw a larger decline in physical activity and a sharper increase in screen time than those under mild restrictions. Conclusion COVID-19-related lockdowns were detrimental to children and adolescents’ movement behaviours, with stricter lockdowns tending to have a bigger impact. Children and adolescents under COVID-19 restrictions are likely to be less active, spend more time on screen, and sleep longer hours than before the lockdown. More studies from low-income and middle-income countries could provide a clearer picture of the impact. PROSPERO registration number CRD42021245924.
Demographic composition, not demographic diversity, predicts biomass and turnover across temperate and tropical forests

The growth and survival of individual trees determine the physical structure of a forest with important consequences for forest function. However, given the diversity of tree species and forest biomes, quantifying the multitude of demographic strategies within and across forests and the way that they translate into forest structure and function remains a significant challenge. Here, we quantify the demographic rates of 1961 tree species from temperate and tropical forests and evaluate how demographic diversity (DD) and demographic composition (DC) differ across forests, and how these differences in demography relate to species richness, aboveground biomass (AGB), and carbon residence time. We find wide variation in DD and DC across forest plots, patterns that are not explained by species richness or climate variables alone. There is no evidence that DD has an effect on either AGB or carbon residence time. Rather, the DC of forests, specifically the relative abundance of large statured species, predicted both biomass and carbon residence time. Our results demonstrate the distinct DCs of globally distributed forests, reflecting biogeography, recent history, and current plot conditions. Linking the DC of forests to resilience or vulnerability to climate change, will improve the precision and accuracy of predictions of future forest composition, structure, and function.
Cancer‐associated fibroblasts at the unfavorable desmoplastic stroma promote colorectal cancer aggressiveness: Potential role of ADAM9

The tumor microenvironment plays a key role in cancer aggressiveness. Desmoplastic reaction (DR), morphologically classified as Mature, Intermediate and Immature types, has previously been shown to be highly prognostic in colorectal cancer (CRC) and it consists to a large extent of cancer‐associated fibroblasts (CAFs). The aim of our study was to characterize the molecular background of DR and understand the effects of CAFs in tumor aggressiveness. The prognostic significance of DR was initially examined in 1497 patients. Then CAFs originating from patient tissues with different DR types were isolated and their impact on tumor growth was examined both in vitro and in vivo. DR was shown to be highly prognostic, with patients within the Immature DR group conferring the worst relapse‐free survival. The conditioned media of CAFs from tumor with Immature‐type DR (CAFsImmature) significantly increased proliferation and migration of CRC cell lines and growth of CRC‐derived organoids compared to that of CAFs from Mature‐type DR (CAFsMature). Subcutaneous or orthotopic implantation of CRC cells together with CAFsImmature in mice significantly promoted tumor growth and dissemination compared to implantation with CAFsMature. Systematic examination of the expression of “a disintegrin and metalloproteinases” (ADAMs) in CAFs isolated from CRC tissues showed that the secreted isoform of ADAM9 (ADAM9s) was significantly higher in CAFsImmature than in CAFsMature. Knockdown of ADAM9s in CAFsImmature abrogated the promoting effects on CRC cell proliferation and migration. CAFs‐derived ADAM9s is implicated in deteriorating survival in CRC patients with Immature‐type DR by increasing tumor cell proliferation and dissemination.
Child Survival and Early Lifetime Exposures to Ambient Fine Particulate Matter in India: A Retrospective Cohort Study

Background: Ambient fine particulate matter [PM ≤2. 5μm in aerodynamic diameter (PM2.5)] is a major health risk for children, particularly in South Asia, which currently experiences the highest PM2.5 levels globally. Nevertheless, there is comparatively little epidemiological evidence from this region to quantify the effects of PM2.5 on child survival. Objectives: We estimated the association between PM2.5 exposure and child survival in India. Methods: We constructed a large, retrospective, and nationally representative cohort of children <5 years of age, born between 2009–2016, from the publicly available, cross-sectional 2015–2016 Demographic Health Surveys in India. In utero and post-delivery lifetime average ambient PM2.5 exposures were estimated with data from satellite remote sensing, meteorology, and land use information (model R2= 0.82). We used Cox proportional hazards regression to estimate the association between both average in utero and post-delivery lifetime PM2.5 and all-cause child mortality, controlling for individual- and household-level covariates, seasonality, location, and meteorology. Results: Over 7,447,724 child-months of follow-up, there were 11,559 deaths at <5 years of age reported by the children’s mothers. The mean concentrations of 9-month in utero and post-delivery lifetime average ambient PM2.5 exposure were 71.1 μg/m3 (range: 20.9–153.5 μg/m3) and 73.7 μg/m3 (range: 14.0–247.3 μg/m3), respectively. Estimated child mortality adjusted hazard ratios were 1.023 [95% confidence interval (CI): 1.008, 1.038] and 1.013 (95% CI: 1.001, 1.026) per 10-μg/m3 increase of in utero and post-delivery lifetime PM2.5, with both exposures in the model. Discussion: This study adds to the growing body of evidence about the adverse health effects of PM2.5 by demonstrating the association between exposure, both in utero and post-delivery, on child survival at the national level in India. Strategies to reduce ambient air pollution levels, including steps to minimize in utero and early life exposures, are urgently needed in India and other countries where exposures are above recommended guideline values. https://doi.org/10.1289/EHP8910
A Children’s Health Perspective on Nano- and Microplastics

Background: Pregnancy, infancy, and childhood are sensitive windows for environmental exposures. Yet the health effects of exposure to nano- and microplastics (NMPs) remain largely uninvestigated or unknown. Although plastic chemicals are a well-established research topic, the impacts of plastic particles are unexplored, especially with regard to early life exposures. Objectives: This commentary aims to summarize the knowns and unknowns around child- and pregnancy-relevant exposures to NMPs via inhalation, placental transfer, ingestion and breastmilk, and dermal absorption. Methods: A comprehensive literature search to map the state of the science on NMPs found 37 primary research articles on the health relevance of NMPs during early life and revealed major knowledge gaps in the field. We discuss opportunities and challenges for quantifying child-specific exposures (e.g., NMPs in breastmilk or infant formula) and health effects, in light of global inequalities in baby bottle use, consumption of packaged foods, air pollution, hazardous plastic disposal, and regulatory safeguards. We also summarize research needs for linking child health and NMP exposures and address the unknowns in the context of public health action. Discussion: Few studies have addressed child-specific sources of exposure, and exposure estimates currently rely on generic assumptions rather than empirical measurements. Furthermore, toxicological research on NMPs has not specifically focused on child health, yet children’s immature defense mechanisms make them particularly vulnerable. Apart from few studies investigating the placental transfer of NMPs, the physicochemical properties (e.g., polymer, size, shape, charge) driving the absorption, biodistribution, and elimination in early life have yet to be benchmarked. Accordingly, the evidence base regarding the potential health impacts of NMPs in early life remains sparse. Based on the evidence to date, we provide recommendations to fill research gaps, stimulate policymakers and industry to address the safety of NMPs, and point to opportunities for families to reduce early life exposures to plastic. https://doi.org/10.1289/EHP9086
Association of the Charlson index with risk classification, clinical aspects, and emergency outcomes

Abstract Objective: To exam the association of the age-adjusted Charlson comorbidity index with the categories of risk classification, the clinical aspects, and the patient outcomes in the emergency department. Method: Cross-sectional, analytical study that analyzed the medical records of 3,624 patients seen in the emergency department. Charlson index scores greater than 2 showed a high rate of comorbidity (mortality risk). T-test and analysis of variance were applied in the analyses. Results: There was a significant difference between the Charlson comorbidity index and the risk classification, with higher scores found in patients classified in the white (2.57) and red (2.06) categories. Patients with vascular, endocrine, neurological, cardiologic, or device problems, and those who underwent a head tomography had a high rate of comorbidity. In addition, those admitted, transferred, or who died in the emergency room had significantly higher index scores compared to those who were discharged from the hospital. Conclusion: The high rate of comorbidity was associated with the categories of risk classification, main and nonspecific complaints, performance of a head tomography, and patient outcomes in the emergency room.
Association of Social Integration with Cognitive Status in a Multi-Ethnic Cohort: Results From the Kaiser Healthy Aging and Diverse Life Experiences Study

We evaluated overall and race-specific relationships between social integration and cognition in older adults. Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) cohort participants included 1343 Asian, Black, Latino, or non-Latino White Kaiser Permanente Northern California members. We estimated the effect of social integration on verbal episodic memory, semantic memory, and executive function derived from the Spanish and English Neuropsychological Assessment (SENAS) Scales. Social integration scores included marital status; volunteer activity; and contact with children, relatives, friends, and confidants. We estimated covariate-adjusted linear mixed-effects models for baseline and 17-month follow-up cognition. Social integration was associated with higher baseline cognitive scores (average β = 0.066 (95% confidence interval: 0.040, 0.092)) overall and in each racial/ethnic group. The association did not vary by race/ethnicity. Social integration was not associated with the estimated rate of cognitive change. In this cohort, more social integration was similarly associated with better late-life cognition across racial/ethnic groups.
Revise the Uniform Determination of Death Act to Align the Law With Practice Through Neurorespiratory Criteria

Although the Uniform Determination of Death Act (UDDA) has served as a model statute for 40 years, there is a growing recognition that the law must be updated. One issue being considered by the Uniform Law Commission's Drafting Committee to revise the UDDA is whether the text “all functions of the entire brain, including the brainstem” should be changed. Some argue that the absence of diabetes insipidus indicates that some brain functioning continues in many individuals who otherwise meet the “accepted medical standards” like the American Academy of Neurology's. The concern is that the legal criteria and the medical standards used to determine death by neurologic criteria are not aligned. We argue for the revision of the UDDA to more accurately specify legal criteria that align with the medical standards: brain injury leading to permanent loss of the capacity for consciousness, the ability to breathe spontaneously, and brainstem reflexes. We term these criteria neurorespiratory criteria and show that they are well-supported in the literature for physiologic and social reasons justifying their use in the law.
Model of an Advanced Practice Provider–Led Head and Neck Cancer Survivorship Clinic: Evaluation of a 4-Year Experience

Objective To report the efficacy and safety of an advanced practice provider–led head and neck cancer survivorship clinic. Study Design Retrospective chart review. Setting Tertiary academic medical center. Methods Patients were enrolled into the survivorship clinic after undergoing 1-year follow-up with the primary head and neck surgeon. Those enrolled between December 2016 and October 2020 were retrospectively reviewed for diagnosis, staging, pattern of recurrence, visit frequency, and compliance. Surgical respectability of recurrent disease was used as a surrogate for timely diagnosis. Results An overall 570 patients were followed within the survivorship clinic. The mean length of follow-up was 13.6 months. Mucosal primaries represented 72.6% of patients. A majority of the primary malignancies were squamous cell carcinoma (77.7%). The most common primary subsites were the oropharynx (26.7%), oral cavity (25.1%), cutaneous (17.0%), and larynx (15.3%). Recurrence was detected in 50 patients (8.8%): 26 local, 12 regional, and 14 distant. Two patients had multiple synchronous recurrences. Twelve (2.1%) second primary cancers were detected. Of the 36 cases of locoregional recurrence, 32 (88.9%) were deemed amenable to salvage surgical intervention, with or without adjuvant therapy. Negative margins were obtained in 21 of the 23 (91.3%) local recurrences that underwent salvage resection. Conclusion Advanced practice provider–based surveillance of head and neck cancer, without risk stratification, appears to be a sound model but needs further prospective evaluation. Consistent with literature, 88.9% of patients with locoregional recurrence were candidates for curative-intent salvage surgery, emphasizing that recurrences are identified in a timely fashion.
A Motion and Illumination Resistant Non-Contact Method Using Undercomplete Independent Component Analysis and Levenberg-Marquardt Algorithm

Heart Rate (HR) estimation is of utmost importance due to its applicability in diverse fields. Conventional methods for HR estimation require skin contact and are not suitable in certain scenarios such as sensitive skin or prolonged unobtrusive HR monitoring. Therefore remote photoplethysmography (rPPG) methods have become an active area of research. These methods utilize the facial videos acquired using a camera followed by extracting the Blood Volume Pulse (BVP) signal for heart rate calculation. The existing rPPG methods either utilized a single color channel or weighted color differences, which has certain limitations dealing with motion and illumination artifacts. This study considered BVP extraction as an undercomplete problem and proposed a method resistant to motion and illumination variation artifacts. This method is based on an undercomplete independent component analysis, aiming to estimate the unmixing matrix using a non-linear Cumulative Density Function (CDF) that has been optimized using the customized Levenberg-Marquardt algorithm. Therefore, the method is named U-LMA. The proposed method was tested under three scenarios: constrained, motion, and illumination variations scenarios. High Pearson correlation coefficient values and smaller lower-upper statistical limits of Bland-Altman plots justified the outstanding performance of the proposed U-LMA. Furthermore, its comparative analysis with the state-of-the-art methods demonstrated its efficacy and reliability, which was proven by the lowest error and highest correlation values (0.01 significance level). Additionally, higher accuracy satisfying the clinically accepted error differences also justified its clinical relevance.
COVID‐19 vaccines and risks of hematological abnormalities: Nested case–control and self‐controlled case series study

Several studies reported hematological abnormalities after vaccination against the coronavirus disease 2019 (COVID‐19). We evaluated the association between COVID‐19 vaccines (CoronaVac and BNT162b2) and hematological abnormalities. We conducted nested case–control and self‐controlled case series analyses using the data from the Hong Kong Hospital Authority and the Department of Health, HKSAR. Outcomes of interest were thrombocytopenia, leukopenia, and neutropenia. Adjusted odds ratios (aORs), incidence rate ratios (IRRs), and 95% confidence intervals (CIs) were estimated using conditional logistic regression. In total, 1 643 419 people received COVID‐19 vaccination (738 609 CoronaVac; 904 810 BNT162b2). We identified 457 and 422 cases after CoronaVac and BNT162b2 vaccination, respectively. For CoronaVac, the incidence of thrombocytopenia, leukopenia, and neutropenia was 2.51, 1.08, and 0.15 per 10 000 doses. For BNT162b2, the corresponding incidence was 1.39, 1.17, and 0.26 per 10 000 doses. The incidence per 10 000 COVID‐19 cases were 1254, 2341, and 884, respectively. We only observed an increased risk of leukopenia following the second dose of BNT162b2 (aOR 1.58, 95% CI 1.24–2.02; day 0–14, IRR 2.21; 95% CI 1.59–3.08). There was no increased risk of any hematological abnormalities after CoronaVac vaccination. We observed an increased risk of leukopenia shortly after the second dose of BNT162b2. However, the incidence was much lower than the incidence following severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infections. There was no association between CoronaVac and hematological abnormalities. The benefits of vaccination against COVID‐19 still outweigh the risk of hematological abnormalities.
Intercellular transfer of mitochondria via tunneling nanotubes protects against cobalt nanoparticle-induced neurotoxicity and mitochondrial damage

Abstract Broad applications of cobalt nanoparticles (CoNPs) have raised increased concerns regarding their potential toxicity. However, the underlining mechanisms of their toxicity have yet to be characterized. Here, we demonstrated that CoNPs reduced cell viability and induced membrane leakage. CoNPs induced oxidative stress, as indicated by the generation of reactive oxygen species (ROS) secondary to the increased expression of hypoxia-induced factor 1 alpha. Moreover, CoNPs led to mitochondrial damage, including generation of mitochondrial ROS, reduction in ATP content, morphological damage and autophagy. Interestingly, exogenous mitochondria were observed between neurons and astrocytes upon CoNPs exposure. Concomitantly, tunneling nanotubes (TNTs)-like structures were observed between neurons and astrocytes upon CoNPs exposure. These structures were further verified to be TNTs as they were found to be F-actin rich and lacking tubulin. We then demonstrated that TNTs were utilized for mitochondrial transfer between neurons and astrocytes, suggesting a novel crosstalk phenomenon between these cells. Moreover, we found that the inhibition of TNTs (using actin-depolymerizing drug latrunculin B) intensified apoptosis triggered by CoNPs. Therefore, we demonstrate, for the first time, that the inhibition of intercellular mitochondrial transfer via TNTs aggravates CoNPs-induced cellular and mitochondrial toxicity in neuronal cells, implying a novel intercellular protection mechanism in response to nanoparticle exposure.
Comparative Analysis of Blood T2 Values Measured by T2‐TRIR and TRUST

Venous blood oxygenation (Yv), which can be derived from venous blood T2 (T2b), combined with oxygen‐extraction fraction (OEF) and cerebral metabolic rate of oxygen, is considered indicative for tissue viability and brain functioning and frequently assessed in patients with sickle cell disease. Recently, T2‐Prepared‐Blood‐Relaxation‐Imaging‐with‐Inversion‐Recovery (T2‐TRIR) was introduced allowing for simultaneous measurements of blood T2 and T1 (T1b), potentially improving Yv estimation by overcoming the need to estimate hematocrit.
肺部微生物群与肺癌关系的研究进展

微生物群在人体生物学功能中发挥着重要作用，与炎症（胃炎、肝炎）、癌症（胃癌、宫颈癌、肝癌）等多种疾病状态有关。 人类微生物组计划在第一阶段描绘了人体微生物的全景图，纳入鼻腔、口腔、肠道、阴道和皮肤等人体部位，而肺部被认为是无菌环境。 但近些年研究证实肺部存在丰富的微生物群落，该肺部微生物群与肺部疾病的关联成为研究热点。 目前研究发现，与健康人或肺部疾病患者相比，肺癌患者具有特异的微生物群。 即使在肺癌患者体内，肿瘤部位也存在特有的肺部微生物群。 此外，不同病理类型和转移状态的肺癌也会导致微生物群的差异。 机制学研究发现，肺部微生物群可能通过影响免疫反应影响肺癌的发生。 目前肺部微生物与免疫治疗的临床研究仍处于初步阶段。 未来需要更多相关研究来提供高质量的证据，进一步了解肺部微生物群的致癌机制，为临床治疗提供新思路。 本文对肺部微生物群与肺癌的相关性研究，可能的分子机制和临床治疗中的应用，简要综述了肺部微生物群研究进展，并对今后研究提出展望。
Recurrence Following Endoscopic Laser Wedge Excision and Triple Medical Therapy for Idiopathic Subglottic Stenosis

Objective We present the outcomes for patients with idiopathic subglottic stenosis (iSGS) following their first carbon dioxide laser wedge excision (LWE) procedure, additionally examining the effect of compliance with adjuvant medical therapy (triple therapy) after the operation. Study Design Retrospective chart review. Setting Tertiary center. Methods A retrospective review was performed on 183 patients with iSGS following their first LWE and their compliance to adjuvant medical therapy (inhaled corticosteroid, proton pump inhibitor, trimethoprim-sulfamethoxazole) following the operation, with all reviewed to December 31, 2020. The primary outcome variable was median time to recurrence (MTR). Patients were stratified by whether the LWE was their first operation (LWE primary or secondary), by compliance to triple therapy, and by compliance with trimethoprim-sulfamethoxazole. Kaplan-Meier analysis and Cox proportional hazards were used to evaluate the MTR across the stratifications. Results An overall 113 patients underwent their first LWE, while 70 received the procedure after having undergone 1 to 13 procedures. The MTR between LWE primary and secondary was 4.6 and 2.9 years, respectively. Adjusted Cox proportional hazards comparing these 2 groups revealed the number of prior operations to be a confounding variable. A statistically increased MTR was demonstrated with greater degrees of medical compliance. Conclusion LWE conferred an MTR of 4.1 years in the iSGS cohort. The number of prior procedures preceding LWE behaved as a confounding variable. Patients who were completely or partially compliant to triple therapy appear to demonstrate increased intervals prior to recurrence.