Miracle-dz/UniFAR-FTUs huggingface dataset:
The impact of interpersonal reporting heterogeneity on cross-country differences in Healthy Life Years in Europe

Abstract Background The European Union has used Healthy Life Years (HLY) as an indicator to monitor the health of its aging populations. Scholarly and popular interest in HLY across countries has grown, particularly regarding the ranking of countries. It is important to note that HLY is based on self-assessments of activity limitations, raising the possibility that it might be influenced by differences in health reporting behaviours between populations, a phenomenon known as differential item functioning (DIF). Methods We estimated DIF-adjusted HLY at age 50 for Belgium, France, Germany, Greece, Italy, the Netherlands, Spain, and Sweden to determine the extent to which differences in HLY might be influenced by reporting heterogeneity across countries. We used anchoring vignettes, taken from the 2004 Survey of Health, Ageing and Retirement in Europe, to estimate DIF-adjusted prevalence rates of activity limitations measured by the Global Activity Limitations Indicator (GALI). The Sullivan method was used to calculate DIF-adjusted HLY. Results Changes in HLY before and after adjustment ranged from a 1.20-year decrease for men in Italy to a 1.61-year increase for women in Spain. Adjustment for DIF produced changes in the rankings of the countries by HLY, with upward and downward movements of up to three positions. Conclusion Our results show that DIF is likely to affect HLY estimates, thereby posing a challenge to the validity of comparisons of HLY across European countries. The findings suggest that HLY should be used to monitor population health status within a country, rather than to make comparisons across countries.
Symptom profiles and their risk factors in patients with post-COVID-19 condition: a Dutch longitudinal cohort study

Abstract Background To improve research and care for patients with post-COVID-19 condition more insight into different subtypes of post-COVID-19 condition and their risk factors is urgently needed. We aimed to identify risk factors of post-COVID-19 condition in general and for specific symptom profiles. Methods This study is based on data collected within the Lifelines Coronavirus disease 2019 (COVID-19) cohort (N = 76 503). Mean pre- and post-SARS-CoV-2 infection symptom scores were compared to classify post-COVID-19 condition. Latent Profile Analysis was used to identify symptom profiles. Logistic and multinomial regression analyses were used to examine the association between demographic, lifestyle and health-related risk factors and post-COVID-19 condition, and symptom profiles, respectively. Results Of the 3465 participants having had COVID-19, 18.5% (n = 642) classified for post-COVID-19 condition. Four symptom profiles were identified: muscle pain, fatigue, cardiorespiratory and ageusia/anosmia. Female sex was a risk factor for the muscle pain and fatigue profiles. Being overweight or obese increased risk for all profiles, except the fatigue profile. Having a chronic disease increased the risk for all profiles except the ageusia/anosmia profile, with the cardiorespiratory profile being only significant in case of multimorbidity. Being unvaccinated increased risk of the ageusia/anosmia profile. Conclusions Findings from this study suggest that Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may trigger different pathophysiological mechanisms that may result in different subtypes of post-COVID-19 condition. These subtypes have shared and unique risk factors. Further characterization of symptom profiles and quantification of the individual and societal impact of specific symptom profiles are pressing challenges for future research.
Adolescents with ADHD and co‐occurring motor difficulties show a distinct pattern of maturation within the corticospinal tract from those without: A longitudinal fixel‐based study

It is well documented that attention‐deficit hyperactivity disorder (ADHD) often presents with co‐occurring motor difficulties. However, little is known about the biological mechanisms that explain compromised motor skills in approximately half of those with ADHD. To provide insight into the neurobiological basis of poor motor outcomes in ADHD, this study profiled the development of white matter organization within the cortico‐spinal tract (CST) in adolescents with ADHD with and without co‐occurring motor problems, as well as non‐ADHD control children with and without motor problems. Participants were 60 children aged 9–14 years, 27 with a history of ADHD and 33 controls. All underwent high‐angular resolution diffusion MRI data at up to three time points (115 in scans total). We screened for motor impairment in all participants at the third time point (≈14 years) using the Developmental Coordination Disorder Questionnaire (DCD‐Q). Following pre‐processing of diffusion MRI scans, fixel‐based analysis was performed, and the bilateral CST was delineated using TractSeg. Mean fiber density (FD) and fiber cross‐section (FC) were extracted for each tract at each time‐point. To investigate longitudinal trajectories of fiber development, linear mixed models were performed separately for the left and right CST, controlling for nuisance variables. To examine possible variations in fiber development between groups, we tested whether the inclusion of group and the interaction between age and group improved model fit. At ≈10 years, those with ADHD presented with lower FD within the bilateral CST relative to controls, irrespective of their prospective motor status. While these microstructural abnormalities persisted into adolescence for individuals with ADHD and co‐occurring motor problems, they resolved for those with ADHD alone. Divergent maturational pathways of motor networks (i.e., the CST) may, at least partly, explain motor problems individuals with ADHD.
Regional setting, geological context and genetic aspects of polymetallic hydrothermal ore deposits from the Kapan ore district, southern Armenia: a contribution to the Mesozoic island arc metallogeny of the Lesser Caucasus

The Lesser Caucasus hosts a variety of ore deposits that formed during successive geodynamic settings and have so far received only little attention in Western literature. Three metallogenic events have been distinguished and range in age from Middle Jurassic to Neogene. This thesis describes in detail ore deposits in the Lesser Caucasus, which formed during the earliest metallogenic event and are hosted by Middle Jurassic rocks. Based on field observations, ore and gangue mineral assemblages, alteration styles and stable and radiogenic isotope analyses, an intrusion-related scenario is proposed for the studied ore deposits with intermediate to high sulfidation state, whereas the involvement of seawater during ore-forming processes cannot be generally discarded in some of the deposits. Geochemical, geochronological, mineralogical and isotopic data of Mesozoic to Cenozoic igneous rocks from different parts of the Lesser Caucasus suggests that similar petrogenetic and ore-forming processes operated along the entire axis of the Lesser Caucasus magmatic arc.
Offline Deep Reinforcement Learning and Off-Policy Evaluation for Personalized Basal Insulin Control in Type 1 Diabetes

Recent advancements in hybrid closed-loop systems, also known as the artificial pancreas (AP), have been shown to optimize glucose control and reduce the self-management burdens for people living with type 1 diabetes (T1D). AP systems can adjust the basal infusion rates of insulin pumps, facilitated by real-time communication with continuous glucose monitoring. Deep reinforcement learning (DRL) has introduced new paradigms of basal insulin control algorithms. However, all the existing DRL-based AP controllers require extensive random online interactions between the agent and environment. While this can be validated in T1D simulators, it becomes impractical in real-world clinical settings. To this end, we propose an offline DRL framework that can develop and validate models for basal insulin control entirely offline. It comprises a DRL model based on the twin delayed deep deterministic policy gradient and behavior cloning, as well as off-policy evaluation (OPE) using fitted Q evaluation. We evaluated the proposed framework on an in silico dataset generated by the UVA/Padova T1D simulator, and the OhioT1DM dataset, a real clinical dataset. The performance on the in silico dataset shows that the offline DRL algorithm significantly increased time in range while reducing time below range and time above range for both adult and adolescent groups. Then, we used the OPE to estimate model performance on the clinical dataset, where a notable increase in policy values was observed for each subject. The results demonstrate that the proposed framework is a viable and safe method for improving personalized basal insulin control in T1D.
Sexualised drug use and chemsex in Italy: A questionnaire study based on a cohort of clients attending a STI outpatient service in Milan

Background Chemsex is a heterogeneous phenomenon with differences in distribution, setting, motivations and type of substances consumed between countries. The lack of data at national level of the Italian situation creates a perception of reduced need for intervention. Methods Anonymous paper questionnaires were distributed to patients who had registered themselves at the STI Department IRCCS Ca’ Granda Policlinico in Milan. Results A significant association was demonstrated between use of sexualised drugs, chemsex and the following variables: (1). Number of partners: in the group of clients with more than five partners, sexualised drug users were more than twice compared with those in the group with less than five partners (35.2% vs 16.2%) p<0.0001. (2). Use of dating apps: more than one out of two persons who used drugs during sex affirmed looking for partners on internet, p = 0.0059. (3). Low condom uses with occasional partners: percentage of individuals who declared not to use condoms or devices during their sexual encounters with occasional partners is more than twice as high in the sexualised drug users group with respect to controls (44.6% vs 21.4%); p = 0.0006). (4). Use of post exposure prophylaxis (PEP): among the PEP users, more than half participants belonged to the sexualised drug users’ group; p = 0.0021. Conclusions Sexualised drug use and chemsex are frequently practiced in Milan. This survey identified a specific population with higher-risk sexual behaviours and increased incidence of acute bacterial STIs.
Beyond sex, gender, and other dilemmas: Human pelvic morphology from an integrative context

Recent research on the pelvis has clarified the flexibility of pelvic bones to manage nearly infinite possibilities in terms of selection and drift, while still maintaining excellent bipedalism. Despite this work, and the studies outlining the diversity of pelvic morphology across the hominin lineage, conversations continue to be stymied by distractions related to purported trade‐offs that the different functions the pelvis must either allow for (e.g., parturition) or directly perform (e.g., attachment sites of muscles). Here we show that tight constraints on morphology are not evident in the pelvic variation of multiple human populations. We thus provide further evidence that human pelves are not geometrically similar and that pelvic morphology successfully balances the intersection of population history, active selective, and drift.
Ischemic Preconditioning, But Not Priming Exercise, Improves Exercise Performance in Trained Rock Climbers

Abstract MacDougall, KB, McClean, ZJ, MacIntosh, BR, Fletcher, JR, and Aboodarda, SJ. Ischemic preconditioning, but not priming exercise, improves exercise performance in trained rock climbers. J Strength Cond Res 37(11): 2149–2157, 2023—To assess the effects of ischemic preconditioning (IPC) and priming exercise on exercise tolerance and performance fatigability in a rock climbing–specific task, 12 rock climbers completed familiarization and baseline tests, and constant-load hangboarding tests (including 7 seconds on and 3 seconds off at an intensity estimated to be sustained for approximately 5 minutes) under 3 conditions: (a) standardized warm-up (CON), (b) IPC, or (c) a priming warm-up (PRIME). Neuromuscular responses were assessed using the interpolated twitch technique, including maximum isometric voluntary contraction (MVC) of the finger flexors and median nerve stimulation, at baseline and after the performance trial. Muscle oxygenation was measured continuously using near-infrared spectroscopy (NIRS) across exercise. Time to task failure (Tlim) for IPC (316.4 ± 83.1 seconds) was significantly greater than CON (263.6 ± 69.2 seconds) (p = 0.028), whereas there was no difference between CON and PRIME (258.9 ± 101.8 seconds). At task failure, there were no differences in MVC, single twitch force, or voluntary activation across conditions; however, recovery of MVC and single twitch force after the performance trial was delayed for IPC and PRIME compared with CON (p < 0.05). Despite differences in Tlim, there were no differences in any of the NIRS variables assessed. Overall, despite exercise tolerance being improved by an average of 20.0% after IPC, there were no differences in neuromuscular responses at task failure, which is in line with the notion of a critical threshold of peripheral fatigue. These results indicate that IPC may be a promising precompetition strategy for rock climbers, although further research is warranted to elucidate its mechanism of action.
Pre-hospital Prognostic Factors of 30-Day Survival in Sepsis Patients; a Retrospective Cohort Study

Introduction: According to excising findings, if the emergency management system (EMS) operation will be developed, the survival outcome of sepsis patients might improve. This study aimed to evaluate the pre-hospital associated factors of survival in sepsis patients. Methods: This retrospective cohort study was conducted on patients diagnosed with sepsis, coded with the Thailand emergency medical triage protocol and criteria-based dispatch symptom group 17. Information on the 30-day survival rate of patients was obtained from the electronic medical records. Pre-hospital factors associated with 30-day survival were analyzed using univariate and multivariate logistic regression analyses and were reported using odds ratio (OR) with 95% confidence interval (CI). Results: 300 patients diagnosed with sepsis were enrolled. Among them, 232 (77.3%) survived within 30 days. Non-survived cases had significantly older age (p = 0.019), lower oxygen saturations (92.5% vs. 95.0%; p = 0.003), higher heart rate (p = 0.001), higher respiratory rate (p < 0.001), lower level of consciousness (p < 0.001), higher disease severity based on qSOFA score (p = 0.001), and higher need for invasive airway management (p = 0.001) and supplementary oxygen (p = 0.001). The survival rate improved by 3.5% with every 1% increase in pre-hospital oxygen saturation (adjusted OR = 1.035, 95% CI: 1.005–1.066, p = 0.020) and the survival probabilities of patients who responded to voice (adjusted OR = 0.170, 95% CI: 0.050–0.579, p = 0.005), those who responded to pain (adjusted OR = 0.130, 95% CI: 0.036–0.475, p = 0.002), and those who were unresponsive (adjusted OR = 0.086, 95% CI: 0.026–0.278, p-value < 0.001) were lower than patients who were alert. Conclusion: The 30-day survival rate of patients with sepsis managed by the EMS team was 77.3%. Pre-hospital oxygen saturation and level of consciousness were associated with the survival of patients with sepsis who were managed in the pre-hospital setting.
Safety of the One Step Percutaneous Endoscopic Gastrostomy (Push-PEG) Button in Pediatric Patients

Objectives: Percutaneous endoscopic gastrostomy (PEG)-systems are essential tools for enteral feeding in a broad variety of pediatric patients. The One Step (“Push-PEG”) technique allows the direct introduction of a PEG-Button. The aim of the study was to investigate the safety and parental view of the Push-PEG technique. Methods: We conducted a single-center retrospective data and questionnaire (SDC, http://links.lww.com/MPG/D296) based study including all pediatric patients receiving a PEG via push or pull technique between 2015 until end of 2020 and compared these 2 groups. The primary outcome was the detection of minor and major complications. Secondary outcomes were growth, thriving, and parental contentment using a Likert-scaled questionnaire. Results: Eighty-three patients were included in the analysis. There were no significant differences in the basic data regarding age, weight, or diagnosis category. Overall complication rate was 34.9%. The Push-PEG group showed a lower rate of complications (32.7% vs 38.7%) and a lower rate of major complications (4.1% vs 8.8%), although the difference is not significant. Thirty-four families completed the questionnaire (SDC, http://links.lww.com/MPG/D296) (response rate 40%). There were no significant differences between the 2 groups regarding answers of the Likert-scaled questions. Conclusion: Push-PEG placement seems to be as safe as placement via traditional pull technique, even in small infants more than 2.8 months and 4 kg. As Push-PEG placement requires less follow-up interventions it may show significant advantages and could be the method of first choice in many cases.
Emergence of GII.4 Sydney[P16]-like Norovirus-Associated Gastroenteritis, China, 2020–2022

Newly evolved GII.4 Sydney[P16] norovirus with multiple residue mutations, already circulating in parts of China, became predominant and caused an abrupt increase in diagnosed norovirus cases among children with gastroenteritis in Shanghai during 2021–2022. Findings highlight the need for continuous long-term monitoring for GII.4 Sydney[P16] and emergent GII.4 norovirus variants.
Festivals, tourism and social change: remaking worlds.

Contents:Remaking Worlds: Festivals, Tourism and Change - David Picard and Mike Robinson (Sheffield Hallam University) 2. La Cavalcata Sarda: Performing Identities in a Contemporary Sardinian Festival - Iride Azara (University of Derby) and David Crouch (University of Derby) 3. Gardening the Past and Being in the World: A Popular Celebration of the Abolition of Slavery in La Reunion - David Picard 4. Gauchos, Pachamama Queens and Tourists in the Remaking of an Andean Festival - Patricia Mathews-Salazar (City University of New York) 5. The 'Freedom of the Slaves to Walk the Streets': Celebration, Spontaneity and Revelry versus Logistics at the Notting Hill Carnival - Angela Burr (London Metropolitan University) 6. The Making of Community Identity through Historic Festive Practice: The Case of Ashbourne Royal Shrovetide Football - Scott McCabe (Sheffield Hallam University) 7. Days of Radunica: A Street Festival in the Croatian Town of Split - Anka Misetic and Ines Sabotic (Institute of Social Sciences Ivo Pilar, Croatia) 8. Enhancing Vitality or Compromising Integrity? Festivals, Tourism and the Complexities of Performing Culture - Melanie Smith and Kathryn Forest (ECOTEC) 9. Creating the 'Rainbow Nation': The National Women's Art Festival in Durban, South Africa - Sabine Marschall (University of KwaZulu-Natal) 10. Kyrgyzstan's Manas Epos Millennium Celebrations: Post-Colonial Resurgence of Turkic Culture and the Marketing of Cultural Tourism - Karen Thompson (University of Strathclyde), Peter Schofield (University of Salford), Nicola Foster, Gulnara Bakieva 11. The Camp Oven Festival and Australian Identity - Shirley Chappel and Gregory Loades (University of South Australia) 12.Christmas Markets in the Tyrolean Alps: Representing Regional Traditions in a Newly Created World of Christmas - Oliver Haid (University of Innsbruck) 13. The Placeless Festival: Identity and Place in the Post-Modern Festival - Nicola E. MacLeod (University of Greenwich) 14. Gay and Lesbian Festivals: Tourism in the Change from Politics to Party - Howard L Hughes (Manchester Metropolitan University) 15. Mobility, Diaspora and the Hybridisation of Festivity: The Case of the Edinburgh Mela - Elizabeth Carnegie (Sheffield University) and Melanie Smith (University of Greenwich) 16. Taking Quebec City: Protest, Carnival and Tourism at the Summit of the Americas - Kirsty Robertson (Queen's University, Canada)
Identification of Selective ATP-Competitive CMG Helicase Inhibitors for Cancer Intervention that Disrupt CMG-Replisome Function

Abstract The human CMG helicase (Cdc45-MCM-GINS) is a novel target for anti-cancer therapy due to tumor-specific weaknesses in CMG function induced by oncogenic changes and the need for CMG function during recovery from replicative stresses such as chemotherapy. Here, we developed an orthogonal biochemical screening approach and identified selective CMG inhibitors (CMGi) that inhibit ATPase and helicase activities in an ATP-competitive manner at low micromolar concentrations. Structure-activity information and in silico docking indicate that CMGi occupy ATP binding sites and channels within MCM subunits leading to the ATP clefts, which are likely used for ATP/ADP ingress or egress. CMGi inhibit cell growth and DNA replication using multiple molecular mechanisms. CMGi block helicase assembly steps that require ATP binding/hydrolysis by the MCM complex, specifically MCM ring assembly on DNA and GINS recruitment to DNA-loaded MCM hexamers. During S-phase, inhibition of MCM ATP binding/hydrolysis by CMGi causes a ‘reverse allosteric’ dissociation of Cdc45/GINS from the CMG that destabilizes the replisome and disrupts interactions with Ctf4, Mcm10, and DNA polymerase-α, -δ, -ε, resulting in DNA damage. These novel CMGi are selectively toxic toward tumor cells and define a new class of CMG helicase-targeted anti-cancer compounds with distinct mechanisms of action.
Clinical perspectives on the optimal use of lenalidomide plus bortezomib and dexamethasone for the treatment of newly diagnosed multiple myeloma

To improve the outcomes of patients with the otherwise incurable hematologic malignancy of multiple myeloma (MM), a key paradigm includes initial treatment to establish disease control rapidly followed by maintenance therapy to ensure durability of response with manageable toxicity. However, patients’ prognosis worsens after relapse, and the disease burden and drug toxicities are generally more challenging with subsequent lines of therapy. It is therefore particularly important that patients with newly diagnosed multiple myeloma (NDMM) receive optimal frontline therapy. The combination of lenalidomide, bortezomib, and dexamethasone (RVd) has consistently demonstrated a tolerable safety profile with significant and clinically relevant benefit, including deep and durable responses with improved survival in patients with NDMM regardless of their transplant eligibility. Furthermore, comparative studies evaluating this triplet regimen against both doublet and other triplet regimens have established RVd as a standard of care in this setting based upon its remarkable and concordant efficacy. Given the breadth of clinical data, physician familiarity, inclusion in treatment guidelines, and the emerging potential of RVd-containing quadruplet regimens, RVd will likely continue as a key cornerstone of the treatment of NDMM, and its role will therefore likely continue to grow as a therapeutic backbone in the initial treatment of MM.