Miracle-dz/UniFAR-FTUs huggingface dataset:
AN IMMUNOHISTOCHEMICAL ANALYSIS OF VASCULAR ENDOTHELIAL GROWTH FACTOR RECEPTOR 1 IN HIGH GRADE T1 BLADDER CANCER WITH CONCOMITANT CARCINOMA IN SITU

Vascular endothelial growth factor receptor 1 (VEGFR1) reduces the angiogenic activity of vascular endothelial growth factor (VEGF), acting like decoy receptor for VEGF and limiting its availability for genuine angiogenic receptors. The purpose of this study was to establish the significance of VEGFR1 expression in high grade T1 (HGT1) bladder cancer with concomitant carcinoma in situ (CIS) and to determine possible immunohistochemical marker helpful in the follow-up of "unpredictable" HGT1 bladder cancer patients. The analysis included 137 HGT1 bladder cancer samples. Concomitant CIS was diagnosed in 21 (15.33%) of these patients. Sections of 137 formalin-fixed, paraffin-embedded materials were incorporated in tissue microarrays and then stained with a rabbit monoclonal antibody against VEGFR1 (N-term: Y103/- Epitomics, diluted 1:250). Immunohistochemical reaction was scored as following: negative if ≤ 10% of cells were stained and positive if > 10% were stained. We considered both membra- nous and cytoplasmic expression and staining intensity was scored using a scale of 0 to 3 (0, no staining; 1, weak; 2, moderate; and 3, intense). After a mean follow-up of 50 months, in 137 patients diagnosed with HGT1 urothelial bladder cancer, we found that patients who had concomitant CIS had worse overall survival (p < 0.05), furthermore, those tumour samples had weakly expressed VEGFR1 (p < 0.05). Patients with positive VEGFR1 had longer disease-free (p < 0.01) and overall survival (p < 0.01). Present investigation has revealed that the estimation of VEGFR1 expression could be diagnostic supplement, selecting the HGT1 bladder cancer patients that would require more intensive follow-up, especially if accompanied with CIS. Acta Medica Medianae 2019;58(4):05-11.
Letter to the editor: Backdrop context of the study “Intention to vaccinate young children against COVID-19: a large-scale survey of Hong Kong parents”

ABSTRACT The current letter provides the backdrop context of the study “Intention to vaccinate young children against COVID-19: a large-scale survey of Hong Kong parents” conducted when the COVID-19 vaccination was first made available to young children in Hong Kong during the fifth wave of the outbreak. The study was conducted to examine parents’ intention for informing the development of an effective child COVID-19 vaccine program because parents were speculated to have low intention to vaccinate their children against COVID-19.
Relation-Aggregated Cross-Graph Correlation Learning for Fine-Grained Image–Text Retrieval

Fine-grained image–text retrieval has been a hot research topic to bridge the vision and languages, and its main challenge is how to learn the semantic correspondence across different modalities. The existing methods mainly focus on learning the global semantic correspondence or intramodal relation correspondence in separate data representations, but which rarely consider the intermodal relation that interactively provide complementary hints for fine-grained semantic correlation learning. To address this issue, we propose a relation-aggregated cross-graph (RACG) model to explicitly learn the fine-grained semantic correspondence by aggregating both intramodal and intermodal relations, which can be well utilized to guide the feature correspondence learning process. More specifically, we first build semantic-embedded graph to explore both fine-grained objects and their relations of different media types, which aim not only to characterize the object appearance in each modality, but also to capture the intrinsic relation information to differentiate intramodal discrepancies. Then, a cross-graph relation encoder is newly designed to explore the intermodal relation across different modalities, which can mutually boost the cross-modal correlations to learn more precise intermodal dependencies. Besides, the feature reconstruction module and multihead similarity alignment are efficiently leveraged to optimize the node-level semantic correspondence, whereby the relation-aggregated cross-modal embeddings between image and text are discriminatively obtained to benefit various image–text retrieval tasks with high retrieval performance. Extensive experiments evaluated on benchmark datasets quantitatively and qualitatively verify the advantages of the proposed framework for fine-grained image–text retrieval and show its competitive performance with the state of the arts.
Automated app-based augmented reality cognitive behavioral therapy for spider phobia: Study protocol for a randomized controlled trial

Background Fear of spiders, or Arachnophobia, is one of the most common specific phobias. The gold standard treatment, in vivo exposure therapy, is effective, but comes with significant limitations, including restricted availability, high costs, and high refusal rates. Novel technologies, such as augmented reality, may help to overcome these limitations and make Exposure Therapy more accessible by using mobile devices. Objective This study will use a Randomized Controlled Trial design to investigate whether ZeroPhobia: Arachnophobia, a 6-week Augmented Reality Exposure Therapy smartphone self-help application, can effectively reduce spider phobia symptoms. Additionally, we will examine user-friendliness of the application and the effect of usage intensity and presence on treatment outcome. Methods This study is registered in the Netherlands Trial Registry under NL70238.029. 19 (Trial NL9221). Ethical approval was received on October 11, 2019. One-hundred-twelve participants (age 18–64, score ≥ 59) on the Fear of Spiders Questionnaire [FSQ] will be recruited from the general Dutch population and randomly assigned to a treatment or waitlist control group. The ZeroPhobia application can be accessed on users’ smartphone. Baseline, post-test (i.e., at six weeks), 3- and 12-month follow-up assessments will be done, each including the Fear of Spiders Questionnaire as the main outcome measure as well as additional measures of anxiety, depression, user-friendliness, and presence as secondary measures and covariates. Results The study was funded on September 25, 2018. Data collection started in September 2021 and the study is expected to run until September 2022. Conclusions Our study will improve our understanding of the efficacy and feasibility of providing Exposure Therapy for spider phobia using an Augmented Reality self-help application, with the intention of making mental health care more accessible.
Evaluation of moral sensitivity and moral courage in intensive care nurses in Turkey during the COVID‐19 pandemic

Abstract Background During the COVID‐19 pandemic, intensive care nurses may experience ethical issues related to fear of transmission, limited resources, and increased workload. Nurses' moral sensitivity and courage may have a role in dealing with these problems. Aim and Objective The purpose of this study was to assess intensive care nurses' moral sensitivity and moral courage during the COVID‐19 pandemic. Design Descriptive cross‐sectional survey. Methods A total of 362 nurses working in the intensive care units of pandemic hospitals in Turkey participated in the study between January and March 2021. Data were obtained using a personal information form, the Moral Sensitivity Questionnaire, and the Nurses' Moral Courage Scale. A link to the online data collection tools was sent to the management of participating institutions, who forwarded it to nurses. Reporting followed the CHERRIES guidelines. Results In this study, the response rate of nurses was 89%. The nurses' total mean moral sensitivity score was 90.70 ± 28.89 and their mean moral courage score was 82.08 ± 13.51. A weak inverse correlation was found between the nurses' moral sensitivity and moral courage scores (r = −.176, p = .001). Total moral sensitivity score differed significantly according to years of Intensive care unit (ICU) experience (p = .007). Total moral courage scores increased significantly with education level (p = .012), years of nursing experience (p = .016), and willingness to work in the ICU (p < .001). Conclusion The study suggests that nurses working in the intensive care unit during the pandemic had moderate moral sensitivity and high levels of moral courage. Nurses' sociodemographic characteristics and ICU work conditions may affect their moral sensitivity and moral courage. Relevance to Clinical Practice The results of this study can help guide efforts to improve moral courage and sensitivity and address ethical issues among ICU nurses.
Spinal Cord fMRI: A New Window into the Central Nervous System

With the brain, the spinal cord forms the central nervous system. Initially considered a passive relay between the brain and the periphery, the spinal cord is now recognized as being active and plastic. Yet, it remains largely overlooked by the human neuroscience community, in stark contrast with the wealth of research investigating the brain. In this review, we argue that fMRI, traditionally used to image cerebral function, can be extended beyond the brain to help unravel spinal mechanisms involved in human behaviors. To this end, we first outline strategies that have been proposed to tackle the challenges inherent to spinal cord fMRI. Then, we discuss how they have been utilized to provide insights into the functional organization of spinal sensorimotor circuits, highlighting their potential to address fundamental and clinical questions. By summarizing guidelines and applications of spinal cord fMRI, we hope to stimulate and support further research into this promising yet underexplored field.
Fabrication and in vitro characterization of luffa-based composite scaffolds incorporated with gelatin, hydroxyapatite and psyllium husk for bone tissue engineering

Abstract Bone tissue engineering is an emerging technology that has been developed in recent years to address bone abnormalities by repairing, regenerating and replacing damaged/injured tissues. In present work, we report the fabrication and characterization of porous luffa-based composite scaffolds composed of Luffa cylindrica (sponge gourd) powder (LC)/hydroxyapatite (HA), psyllium husk (PH) and gelatin (G) in various combinations (w/v) i.e. 3% LC, 5% LC and control (C) (without luffa powder) by using freeze-drying method. The structural stability of the scaffolds was obtained after chemically crosslinking them with glutaraldehyde (GTA), which was identified via scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy and differential scanning calorimetry (DSC). The hydrophilic behavior of the samples was quantified by water contact angle measurements. The average pore size of the scaffolds was observed in a range of 20–240 µm. As per the obtained data, the apparent and effective porosities were estimated as ∼57.08 ± 4.38%, ∼50.58 ± 4.09%, ∼59.45 ± 1.60% and 51.37 ± 3.36%, 47.94 ± 4.57% and 53.09 ± 5.45% for 3% LC, 5% LC and control (C) scaffolds, respectively. The scaffolds were found to be noticeably stable for 50 days at 37 °C in a lysozyme solution. The liquid retention capacity of the scaffolds revealed that the luffa-based scaffolds gained lower retention capacity compared to the control (C) scaffold; indicating an increase in scaffold stiffness due to the addition of luffa. Compressive strength study demonstrated that the mechanical stability of the fabricated luffa-based scaffolds got increased significantly from ∼1.5 to ∼9.5 MPa, which is comparable to that of trabecular bone. In addition, proliferation and viability analysis of MG-63 osteoblast-like cells revealed a significant level of cellular compatibility i.e. approaching ∼64% proliferation by 6th day in vitro compared to control. Thus, the obtained results demonstrate that the fabricated novel luffa-based scaffolds exhibit good cytocompatibility, remarkable porosity and excellent mechanical strength comparable to native human bone. Therefore, we anticipate that the developed luffa-based scaffolds could be a promising candidate for bone tissue engineering applications.
A Privacy-Preserving Audit and Feedback System for the Antibiotic Prescribing of General Practitioners: Survey Study

Background Antibiotic resistance is a worldwide public health problem that is accelerated by the misuse and overuse of antibiotics. Studies have shown that audits and feedback enable clinicians to compare their personal clinical performance with that of their peers and are effective in reducing the inappropriate prescribing of antibiotics. However, privacy concerns make audits and feedback hard to implement in clinical settings. To solve this problem, we developed a privacy-preserving audit and feedback (A&F) system. Objective This study aims to evaluate a privacy-preserving A&F system in clinical settings. Methods A privacy-preserving A&F system was deployed at three primary care practices in Norway to generate feedback for 20 general practitioners (GPs) on their prescribing of antibiotics for selected respiratory tract infections. The GPs were asked to participate in a survey shortly after using the system. Results A total of 14 GPs responded to the questionnaire, representing a 70% (14/20) response rate. The participants were generally satisfied with the usefulness of the feedback and the comparisons with peers, as well as the protection of privacy. The majority of the GPs (9/14, 64%) valued the protection of their own privacy as well as that of their patients. Conclusions The system overcomes important privacy and scaling challenges that are commonly associated with the secondary use of electronic health record data and has the potential to improve antibiotic prescribing behavior; however, further study is required to assess its actual effect.
The impact of flooding on firm performance and economic growth

Using comprehensive flood data from China, we find a significant, negative impact of flooding on firm performance, which is mainly driven by unexpected flooding. We use multiple identification strategies to address endogeneity concerns and find that the documented impact of flooding on firm performance is likely causal. The impact is more pronounced for firms with more tangible asset investment, firms located in cities with low government quality, firms facing tight financial constraints, firms controlled by non-government entities and firms with low geographic diversification. Flood-exposed firms react to the threat by altering their investment, financial, cash, payout and executive compensation policies. Finally, flooding also exerts a significant impact on local economic and employment growth.
The Prevalence of Food Insecurity and its Association with Non-Communicable Diseases Risk Factors: a Cross-Sectional Study in Alborz Province, Iran

ABSTRACT Food insecurity (FI) is a public health concern that affects health status. In this study, we aimed to investigate the FI status, and the probable link between FI and a number of risk factors related to Non-Communicable Diseases (NCDs) in Alborz Province, Iran. This was a cross-sectional study in which 983 housewives living in Alborz Province, with the age range of 18–65 years were selected randomly using a multi-stage cluster sampling method, between 2018 and 2019. Demographic Questionnaire, Household Food Insecurity Access Scale (HFIAS), International Physical Activity Questionnaire (IPAQ), Anthropometric Measurements (weight, body mass index (BMI), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and waist, hip, and Neck Circumferences (WC,HC, and NC)), and systolic and diastolic blood pressure (SBP and DBP) were measured. Multivariable binary logistic regressions were used to evaluate the association between mentioned variables and FI status. The prevalence of FI in the study population was 61.24 percent (95 percent CI: 58.11–64.30). In a Multivariable binary logistic regressions model, participants in the highest stages of FI had significantly lower risk of BMI (OR: 0.62 95 percent CI 0.45–1.10) (p .007), NC (OR: 0.51; 95 percent CI 0.28–0.95) (p .03), and WHR (OR: 0.50; 95 percent CI 0.29–0.88) (p .011) in comparison with food secure group. FI was highly prevalent in our study population. Despite the high prevalence of overweight and obesity, there were no significant differences in terms of weight between groups.
Utility of hematological and inflammatory biomarkers in predicting recovery in critical Covid-19 patients: Our experience in the largest Covid-19 treating center in Lebanon

Background COVID-19 pandemic has led to a catastrophic shortage of ICU beds. This has resulted in the need to identify patients that can be discharged early before full clinical recovery. We designed this study to determine if in changes routine tests like CBCD and CRP can be a useful complement to clinical status when deciding to discharge patients from ICU. Methods This retrospective study was conducted in Rafic Hariri University Hospital. Levels of biomarkers measured at admission (T1) and within 3 days of outcome (T2) were collected and ratios (T2/T1) were calculated. The Odds Ratios of association between the changes in these biomarkers and outcome were estimated. Multivariate analysis and AUC for the performance of these biomarkers were also conducted. Results We found on multivariate analysis that reduction in counts of lymphocyte and platelets and elevation in counts of neutrophils and level of CRP (T2/T1 ratio > 1) are strongly associated with mortality with respective ORs estimated at 6.74, 3.26, 5.65 and 4.34 [p-values < 0.001]. AUCs were found to lie in a range of 0.68 to 0.81 indicating fair to good performance. Other factors found to impact survival were AKI, AF and ACS [p-values < 0.01]. In contrast to other studies, risk factors didn’t show an association with survival when adjusted for effects of complications and changes in biomarker levels. Conclusions Our results confirm that inexpensive tests like lymphocyte count and CRP can be reliably used to follow COVID-19 patients in ICU and to support the decision to discharge patients.
Predictors of psychological risk and resilience among Syrian refugee children

Objectives War‐exposed refugee children are at elevated risk for mental health problems, but a notable proportion appear resilient. We aimed to investigate the proportion of Syrian refugee children who can be considered resilient, and applied a novel approach to identify factors predicting individual differences in mental health outcomes following war exposure. Methods The sample included 1,528 war‐exposed Syrian refugee children and their primary caregiver living in refugee settlements in Lebanon. Children were classed as having low symptoms (LS) if they scored below clinically validated cut‐offs for post‐traumatic stress disorder (PTSD), depression and externalising behaviour problems. Children scoring above any cut‐off were classified as having high symptoms (HS). Each LS child was matched with one HS who reported similar war exposure, to test what differentiates children with similar exposures but different outcomes. Results 19.3% of the children met our resilience criteria and were considered LS. At the individual level, protective traits (e.g. self‐esteem; OR = 1.51, 95% CI [1.25, 1.81]) predicted LS classification, while environmental sensitivity (OR = 0.69, 95% CI [0.59, 0.82]), poorer general health (OR = 0.71, 95% CI [0.58, 0.87]) and specific coping strategies (e.g. avoidance; OR = 0.90, 95% CI [0.85, 0.96]) predicted HS classification. Social/environmental predictors included perceived social support (OR = 1.23, 95% CI [1.02, 1.49]), loneliness and social isolation (OR = 0.85, 95% CI [0.80, 0.90]), child maltreatment (OR = 0.96, 95% CI [0.94, 0.97]), and caregiver mental and general health (e.g. caregiver depression; OR = 0.94, 95% CI [0.92, 0.97]). Conclusions Future research should take multiple dimensions of functioning into account when defining risk for mental health problems and consider the identified predictors as potential targets for interventions.
Isolation and characterization of Yersinia enterocolitica from foods in Apulia and Basilicata regions (Italy) by conventional and modern methods

Yersiniosis is the third most reported food-borne zoonosis in Europe. The aim of the present study was to perform the search for Yersinia enterocolitica in food samples collected from Apulia and Basilicata regions (Southern Italy) and to characterize any isolates by classical and modern analytical methods. A total of 130 samples were analyzed between July 2018 and July 2019: most of them were raw milk and dairy products made from it. Furthermore, 8 out of 130 samples were individual milk samples collected from bovines reared in a Brucella-free farm which showed false positive serological reaction for brucellosis due to the presence of pathogenic Y. enterocolitica O:9 biotype 2 in faeces. The Real Time PCR targeting the ail gene and the culture method were performed to detect pathogenic Y. enterocolitica. Isolates were subjected to API 20E (Biomerieux) and MALDI-TOF MS (Matrix Assisted Laser Desorption Ionization Time-of-Flight) for species identification. All samples were negative for the ail gene. The culture method allowed to isolate suspicious colonies from 28 samples. The API 20E system and the MALDI-TOF MS technique identified 20 Y. enterocolitica and 1 Y. intermedia in a concordant way. The remaining 7 strains were all identified as Y. enterocolitica by the API 20E system, while the MALDI-TOF MS recognized 4 Y. intermedia, 1 Y. bercovieri and 2 Y. massiliensis. Genotypic characterization of the discordant strains was performed by rMLST and it confirmed the MALDI-TOF MS’ results. Only non-pathogenic Y. enterocolitica biotype 1A strains were found, although with a non-negligible prevalence (P = 0.15 with CI 95% = ± 0.06). This study indicates a poor circulation of pathogenic Y. enterocolitica in food products made and marketed in the investigated areas. However, the small number of samples, insufficient for some food categories such as meat and vegetable, does not allow to exclude the presence of pathogenic strains at all.