Miracle-dz/UniFAR-FTUs huggingface dataset:
Psychometric properties of the Arabic version of the 9-item Shared Decision-Making Questionnaire: the entire process from translation to validation

Objective To translate the German 9-item Shared Decision-Making Questionnaire (SDM-Q-9) to Arabic and assess its psychometric properties for measuring Arabic-speaking patients' perceptions of the shared decision-making (SDM) process. Design Multicentre cross-sectional study. Setting Secondary healthcare settings; outpatient clinics of 10 major hospitals were selected in four emirates in the United Arab Emirates (Abu Dhabi, Dubai, Sharjah and Umm Al Quwain). Participants Patients with chronic diseases who attended outpatient clinics of participating hospitals. Measurements The original German SDM-Q-9 was translated to Arabic. International multiphase translation guidelines and the process of cross-cultural adaptation of self-reported measures were used. Various psychometric properties were assessed, including reliability (internal consistency), and construct validity (exploratory factor analysis [EFA] and confirmatory factor analysis [CFA]). Results The final Arabic version of the SDM-Q-9 was tested among 516 secondary care patients. Internal consistency yielded a Cronbach’s alpha of 0.929 for the whole scale. EFA showed a one-factorial solution, Kaiser-Meyer-Olkin measure of sampling adequacy was 0.907 and Bartlett’s test of sphericity was significant (χ2=3413.69, df=36, p<0.0005). For the CFA, two different models were tested; Model 1 included the nine items and Model 2 was monofactorial that included items 2–9 and thus excluded item 1. Both models were adequate as they produced similar indices. Conclusions The Arabic version of SDM-Q-9 showed excellent reliability and acceptable validity parameters among secondary care patients. The newly translated Arabic questionnaire is the first psychometrically tested tool that can be used in the 22 member states of the Arab league to assess patients’ perspectives on the SDM process.
What are the positive drivers and potential barriers to implementation of hospital at home selected by low-risk DECAF score in the UK: a qualitative study embedded within a randomised controlled trial

Objective Hospital at home (HAH) for chronic obstructive pulmonary disease exacerbation selected by low-risk Dyspnoea, Eosinopenia, Consolidation, Acidaemia and atrial Fibrillation (DECAF) score is clinical and cost-effective; DECAF is a prognostic score indicating risk of mortality. Up to 50% of admitted patients are suitable, a much larger proportion than earlier services. Introduction of new models of care is challenging, but may be facilitated by informed engagement with stakeholders. This qualitative study sought to identify facilitators and barriers to implementation of HAH. Design Semistructured interviews, data were analysed using thematic-construct analysis. Setting Interviews were conducted within patients’ homes and hospitals in North East England. Participants 89 participants were interviewees; 44 patients, 15 carers, 15 physicians, 11 specialist nurses and 4 managers. Results Facilitators include the following: (1) availability of home comforts and maintaining independence (with positive influences on perceived rate of recovery, sleep quality and convenience for friends, family and carers) and (2) confidence in the continuity of HAH care. Barriers include the following: (1) fear of being alone at home; (2) privacy issues and not wanting visitors and (3) resistance to change. Clinician concerns occasionally delayed return home, principally during the early phase of the trial. Nurses cited higher workload and greater responsibility, but with additional resource and training; overall, they viewed HAH positively. Operational concerns included keeping medical records in a patient’s home and inability to capture activity within current payment systems. Conclusion HAH selected by DECAF was preferred to inpatient care by most patients and their families. Implementation in other hospitals will require education, training and service planning, tailored to overcome the identified barriers. Trial registration number ISRCTN29082260.
Retail Investors’ Trading Activity and the Predictability of Stock Return Correlations

Considerable theoretical and empirical evidence links price comovements with the behavior of retail investors. Nevertheless, when predicting stock return correlations, research has focused on the leverage effect. We propose a new model of realized covariances that allows exogenous predictors to influence the correlation dynamics while ensuring the predicted matrices' positive definiteness. Using this model, the predictive power of retail investors' sentiment and attention for the correlations of 35 Dow Jones stocks is analyzed. We find retail investors' attention to have predictive power for return correlations, especially for longer forecasting horizons and during the COVID-19 pandemic. Value-at-risk forecasts confirm these results.
Enfermeiros de Reabilitação e as atitudes face à morte em contexto de crise pandémica por COVID-19

Objective: to analyze the differences in the profile of attitudes of rehabilitation nurses towards death before and after the first critical period of the COVID-19 pandemic. Method: quantitative, comparative study, before and after the critical period. Data collection took place through a self-administered questionnaire, in two phases, a first with 102 participants and a second with 100, all specialists in rehabilitation nursing. Results: although with some changes in the scores, the profile of attitudes of rehabilitation nurses towards death before and after the critical period, remained the same. In addition to the slight increase in the fear score, acceptance as an approximation was the one that registered the greatest increase. Regarding avoidance, neutrality and escape, the scores were slightly lower. Conclusion: despite the feelings experienced by rehabilitation nurses, attitudes towards death continue to show concern in responding to the needs of the people they care for, particularly in the final phase of life.
Constitutive STAT5 activation regulates Paneth and Paneth-like cells to control Clostridium difficile colitis

STAT5 controls the intestinal epithelial stem cell niche by regulating Wnt/β-catenin signaling, and lack of active pYSTAT5 induces Clostridium difficile infection. STAT5 may be a transcription factor that restricts niche cell differentiation. Clostridium difficile impairs Paneth cells, driving intestinal inflammation that exaggerates colitis. Besides secreting bactericidal products to restrain C. difficile, Paneth cells act as guardians that constitute a niche for intestinal epithelial stem cell (IESC) regeneration. However, how IESCs are sustained to specify Paneth-like cells as their niche remains unclear. Cytokine-JAK-STATs are required for IESC regeneration. We investigated how constitutive STAT5 activation (Ca-pYSTAT5) restricts IESC differentiation towards niche cells to restrain C. difficile infection. We generated inducible transgenic mice and organoids to determine the effects of Ca-pYSTAT5-induced IESC lineages on C. difficile colitis. We found that STAT5 absence reduced Paneth cells and predisposed mice to C. difficile ileocolitis. In contrast, Ca-pYSTAT5 enhanced Paneth cell lineage tracing and restricted Lgr5 IESC differentiation towards pYSTAT5+Lgr5−CD24+Lyso+ or cKit+ niche cells, which imprinted Lgr5hiKi67+ IESCs. Mechanistically, pYSTAT5 activated Wnt/β-catenin signaling to determine Paneth cell fate. In conclusion, Ca-pYSTAT5 gradients control niche differentiation. Lack of pYSTAT5 reduces the niche cells to sustain IESC regeneration and induces C. difficile ileocolitis. STAT5 may be a transcription factor that regulates Paneth cells to maintain niche regeneration.
A new comprehensive approach for bone remodeling under medium and high mechanical load based on cellular activity

HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L’archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d’enseignement et de recherche français ou étrangers, des laboratoires publics ou privés. A new comprehensive approach for bone remodeling under medium and high mechanical load based on cellular activity Rachele Allena, Daniel George, Céline Bourzac, Stéphane Pallu, Yves Rémond, Morad Bensidhoum, Hugues Portier
Patient Behaviors and Characteristics Related to Weight Regain After Roux-en-Y Gastric Bypass

Supplemental Digital Content is available in the text Objective: To identify patient behaviors and characteristics related to weight regain after Roux-en-Y gastric bypass surgery (RYGB). Background: There is considerable variation in the magnitude of weight regain after RYGB, highlighting the importance of patient-level factors. Methods: A prospective cohort study of adults who underwent bariatric surgery in 6 US cities between 2006 and 2009 included presurgery, and 6-month and annual assessments for up to 7 years. Of 1573 eligible participants, 1278 (81%) with adequate follow-up were included (80% female, median age 46 years, median body mass index 46 kg/m2). Percentage of maximum weight lost was calculated each year after weight nadir. Results: Weight was measured a median of 8 (25th–75th percentile, 7–8) times over a median of 6.6 (25th–75th percentile, 5.9–7.0) years. β coefficients, that is, the mean weight regain, compared with the reference, and 95% confidence interval, are reported. Postsurgery behaviors independently associated with weight regain were: sedentary time [2.9% (1.2–4.7), for highest vs lowest quartile], eating fast food [0.5% (0.2–0.7) per meal/wk], eating when feeling full [2.9% (1.2–4.5)], eating continuously [1.6% (0.1–3.1)], binge eating and loss-of-control eating [8.0% (5.1–11.0) for binge eating; 1.6 (−0.1 to 3.3) for loss of control, vs neither], and weighing oneself <weekly [4.2% (2.9–5.4)]. Postsurgery characteristics independently associated with greater weight regain included: younger age, venous edema, poorer physical function, and more depressive symptoms. Conclusion: Several behaviors and characteristics associated with greater weight regain were identified, which inform integrated healthcare approaches to patient care and identify high-risk patients to improve long-term weight loss maintenance after RYGB.
Personality Types in Learning Enterprise Resource Planning (ERP) Systems

ABSTRACT This research explores the influence of personality types on ERP system learning performance in a university setting. Four personality types (labeled Type 1 to 4) were identified using cluster analysis of 176 survey respondents’ Big Five personality traits, i.e., conscientiousness, neuroticism, extraversion, openness, and agreeableness. These four personality types were found to be significantly associated with ERP system learning performance. Additionally, prior knowledge, user affect, demographic factors (such as gender, age, year in school), and environmental factors (such as ethnicity, location, English proficiency) were found to moderate the relationships between the four personality types and ERP learning performance. These findings can provide valuable insights into the organizational success of ERP systems by helping to identify which users may effectively learn to utilize these systems.
Loss-of-function approaches in comparative physiology: is there a future for knockdown experiments in the era of genome editing?

ABSTRACT Loss-of-function technologies, such as morpholino- and RNAi-mediated gene knockdown, and TALEN- and CRISPR/Cas9-mediated gene knockout, are widely used to investigate gene function and its physiological significance. Here, we provide a general overview of the various knockdown and knockout technologies commonly used in comparative physiology and discuss the merits and drawbacks of these technologies with a particular focus on research conducted in zebrafish. Despite their widespread use, there is an ongoing debate surrounding the use of knockdown versus knockout approaches and their potential off-target effects. This debate is primarily fueled by the observations that, in some studies, knockout mutants exhibit phenotypes different from those observed in response to knockdown using morpholinos or RNAi. We discuss the current debate and focus on the discrepancies between knockdown and knockout phenotypes, providing literature and primary data to show that the different phenotypes are not necessarily a direct result of the off-target effects of the knockdown agents used. Nevertheless, given the recent evidence of some knockdown phenotypes being recapitulated in knockout mutants lacking the morpholino or RNAi target, we stress that results of knockdown experiments need to be interpreted with caution. We ultimately argue that knockdown experiments should not be discontinued if proper control experiments are performed, and that with careful interpretation, knockdown approaches remain useful to complement the limitations of knockout studies (e.g. lethality of knockout and compensatory responses). Summary: We discuss the merits and pitfalls of current knockdown and knockout approaches and advocate for the continued use of knockdown experiments in order to maintain progress in physiological research.
Spiritual care provided by nursing home physicians: a nationwide survey

Objective To examine perceptions and experiences regarding providing spiritual care at the end of life of elderly care physicians practising in nursing homes in the Netherlands, and factors associated with spiritual care provision. Methods A cross-sectional survey was sent to a representative sample of 642 elderly care physicians requesting information about their last patient who died and the spiritual care they provided. We compared their general perception of spiritual care with spiritual and other items abstracted from the literature and variables associated with the physicians’ provision of spiritual care. Self-reported reasons for providing spiritual care were analysed with qualitative content analysis. Results The response rate was 47.2%. Almost half (48.4%) provided spiritual end-of-life care to the last resident they cared for. Half (51.8%) identified all 15 spiritual items, but 95.4% also included psychosocial items in their perception of spirituality and 49.1% included other items. Physicians who included more non-spiritual items reported more often that they provided spiritual care, as did more religious physicians and those with additional training in palliative care. Reasons for providing spiritual care included a request by the resident or the relatives, resident’s religiousness, fear of dying and involvement of a healthcare chaplain. Conclusion Most physicians perceived spirituality as a broad concept and this increased self-reported spiritual caregiving. Religious physicians and those trained in palliative care may experience fewer barriers to providing spiritual care. Additional training in reflecting upon the physician’s own perception of spirituality and training in multidisciplinary spiritual caregiving may contribute to the quality of end-of-life care for nursing home residents.
Autologous111Indium‐oxinate‐labelled platelet sequestration study in patients with immune thrombocytopenia treated by thrombopoietin receptor‐agonists

Additional supporting information may be found online in the Supporting Information section at the end of the article. Data S1. Supplementary material. Table SI. Patient baseline characteristics. Table SII. Baseline characteristics of patients with stable disease as best response to pembrolizumab (10 mg/kg Q2W and 200 mg Q3W groups pooled). Table SIII. Adverse events occurring in at least two patients. Figure S1. CONSORT (study flow) diagram. Q2W, every 2 weeks; Q3W, every 3 weeks. Figure S2. Kaplan-Meier estimates of duration of stable disease based on International Myeloma Working Group uniform response criteria per site review. Figure S3. Change from baseline in maximum M-protein or free light chain in the 27 of 30 patients for whom data were evaluable. Figure S4. Kaplan-Meier estimates of (A) progression-free survival and (B) overall survival based on International Myeloma Working Group uniform response criteria per site review.
HIV pre-exposure prophylaxis uptake by advanced practice nurses: interplay of agency, community, and attitudinal factors.

AIMS To identify associations among agency, community, personal and attitudinal factors that affect advanced practice nurses' uptake of HIV pre-exposure prophylaxis, an intervention consists of emtricitabine/tenofovir once-daily pill, along with sexual risk reduction education. DESIGN Cross-sectional. METHODS During March-May 2017, randomly-selected Indiana advanced practice nurses were invited to complete an online survey, consisted of several validated self-rating measures (N=1,358; response=32.3%). Final sample (N=369) was predominantly White, non-Hispanic, female advanced practice nurses in urban practices (mean age=46). Conceptual model for structural equation model included 29 original/composite variables and 5 latent factors. RESULTS Final model consisted of 11 variables and 4 factors: agency, community, HIV prevention practices (including screening) and motivation to adopt evidence-based practices overall. Community had direct effects on HIV prevention practices (estimate=0.28) and agency (estimate=0.29). Agency had direct effects on HIV prevention practices (estimate=0.74) and motivation to adopt evidence-based practices (estimate=0.24). Community had indirect effects, through agency, on the two remaining factors. CONCLUSION Barriers exist against pre-exposure prophylaxis implementation, although practice guidelines are available. HIV prevention practices must be integrated across organizational structures, especially in high-risk communities, whereas practice change is more effective when focused on changing providers' attitudes toward intervention. When planning a pre-exposure prophylaxis intervention, advancing inputs from healthcare professionals, organizational leadership and community members, is crucial to success. IMPACT In settings where advanced practice nurses are primary contact points for healthcare, they may be best positioned to have an impact on implementation of HIV risk reduction strategies. Further research is needed to optimize their contributions to pre-exposure prophylaxis implementation. This article is protected by copyright. All rights reserved.
Acne Vulgaris : Current Status and Future Directions

Acne patients may have significant quality-of-life (QoL) impairment, therefore assessment of health-related QoL (HRQoL) in acne patients is recommended by several national and international guidelines as an integral part of acne management. The inclusion of QoL assessment in core outcome sets is now a popular idea. Several acne-specific QoL questionnaires are available but none cover all topics presented in other instruments. The impact of acne on different aspects of QoL may vary between patients from different age groups. The European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes has initiated a study on the relevance of the different QoL topics in acne patients. Detailed recommendations on treatment goals and changes of treatment approaches based on a validated banding system and a minimal clinically important difference in HRQoL questionnaires (such as the Dermatology Life Quality Index) may be an important and promising approach. Key Points Several different acne-specific instruments are available to assess quality of life (QoL) in patients with acne vulgaris. None of the acne-specific instruments cover the whole spectrum of topics included in other acne-specific instruments. It is important to study which QoL items are relevant for different groups of acne patients (age, sex, disease severity).
Treatment of elderly breast cancer patients in a breast center in India.

CONTEXT The management of breast cancer in older patients is challenging due to factors such as comorbidities, limited mobility, functional dependence, cognitive functions, and socioeconomic aspects. Data about the outcomes in elderly patients with breast cancer in our country are sparse. AIMS The aim of this study was to evaluate and compare the clinical and pathological variables, treatment, and survival outcomes of elderly women (those of 70 years and above) with women under 50 years and those between the ages of 50 and 69 years treated at our center. SUBJECTS AND METHODS Prospectively collected clinical and pathological data from January 2007 to December 2014 were recorded and entered into OncoCollect™ software. Statistical analysis was done using Microsoft R Open software. Survival analysis was estimated using Kaplan-Meier curves. RESULTS A total of 1226 Stage I-III breast cancer patients were treated between January 2007 and December 2014. Of these, 11.3% (139) were aged 70 years and above. Invasive ductal carcinoma was predominant and majority had Stage II disease and grade 1 tumors. Receptor positivity was observed in 79% of elderly patients and 9% had triple-negative disease. Primary hormone therapy was given to 7% of the patients and chemotherapy was administered to 12%. The 5-year overall survival for patients 70 years and older is 85%. CONCLUSIONS Elderly patients are more likely to have an indolent course with low grade and estrogen receptor-positive tumors. For healthy older women, treatment according to standard guidelines including surgery, chemotherapy, and radiation should be followed. However, for those who are unfit and cannot tolerate surgery, primary endocrine therapy is a suitable option.
Phylogenetic and Functional Analysis of CesA Genes in Cotton

Background: Cotton (Gossypium hirsutum) is widely distributed all over the world, and improving the quality of its fiber is one of the most important tasks in cotton breeding. Cotton fibers are primarily composed of cellulose, which is synthesized and regulated by cellulose synthase (CesAs). But the molecular mechanism of CesA genes in cotton was unclear. Results: In this study, the phylogenetic history and purifying selection of CesA genes were investigated along with their functions. CesA3 and CesA6 are the two largest subgroups in G. arboreum, comprising 52.8% of the whole CesA family. These two CesA subgroups were then chosen for further research, and the results showed that they are highly differentiated in dicot groups. The two subgroups were also discriminated with the use of a Ka/Ks analysis. This indicated that they may play an important role in fiber development based on their unique phylogenetic status. Functional studies were subsequently conducted using the most purified genes (Gohir.A08G144300.1 in CesA3 subgroup). The silencing of Gohir.A08G144300. 1 visibly inhibits the growth of cotton fiber, showing that it is critical for the growth of cotton fibers. Conclusions: The results presented here a target gene Gohir.A08G144300. 1 based on the analysis of CesA gene members, and it is found that this gene was crucial to the growth of cotton fibers. This study provides more information for the understanding of the molecular mechanism of cotton fiber development.