Miracle-dz/UniFAR-FTUs huggingface dataset:
Distress Tolerance is Indirectly Related to Nicotine Use through the Smoking Motives

Abstract Background and objectives Previous research has shown that low ability to tolerate distress is indirectly related to problematic substance use through the substance use motives. This topic has been previously researched in alcohol and cannabis use; however, it has not yet been explored in tobacco use. We studied whether distress tolerance is indirectly associated with nicotine dependence through motives of tension reduction and habitual smoking. Design and Methods A total sample of 451 (230 of which were women) daily and occasional Polish smokers (aged from 18 to 60 years) reported distress tolerance, motives for smoking, and nicotine dependence. We then conducted a mediation analysis with bootstrapping using PROCESS macro. Results Distress tolerance was indirectly related to nicotine dependence through both motives independently. In terms of the sequential model, there was a significant indirect effect of distress tolerance on nicotine dependence through smoking motives: tension reduction and habit. The total effect of distress tolerance on nicotine dependence was insignificant. Conclusions Our findings suggest that individuals with low distress tolerance are especially prone to nicotine dependence if they use smoking as a coping mechanism and it becomes habitual. The current study highlights the importance of a multidimensional approach in dealing with nicotine dependence.
The One-Man-Crowd: Single User Generation of Crowd Motions Using Virtual Reality

Crowd motion data is fundamental for understanding and simulating realistic crowd behaviours. Such data is usually collected through controlled experiments to ensure that both desired individual interactions and collective behaviours can be observed. It is however scarce, due to ethical concerns and logistical difficulties involved in its gathering, and only covers a few typical crowd scenarios. In this work, we propose and evaluate a novel Virtual Reality based approach lifting the limitations of real-world experiments for the acquisition of crowd motion data. Our approach immerses a single user in virtual scenarios where he/she successively acts each crowd member. By recording the past trajectories and body movements of the user, and displaying them on virtual characters, the user progressively builds the overall crowd behaviour by him/herself. We validate the feasibility of our approach by replicating three real experiments, and compare both the resulting emergent phenomena and the individual interactions to existing real datasets. Our results suggest that realistic collective behaviours can naturally emerge from virtual crowd data generated using our approach, even though the variety in behaviours is lower than in real situations. These results provide valuable insights to the building of virtual crowd experiences, and reveal key directions for further improvements.
Physician Assistant Student Training in Question Formulation: A Quasi-Experiment

Purpose To measure improvement in evidence-based practice (EBP) question formulation skills in physician assistant (PA) students using a new approach that included a rubric. Methods Quasi-experiment study design featuring pre- and posttests in which the participants are their own controls using a paired t-test to measure skills improvement. Results Physician assistant students increased their skills in formulating EBP questions by a statistically significant margin. Conclusions This new approach to teaching EBP question formulation with its rubric offers a vehicle for training PA students in question formulation skills that is potentially more versatile than the conventional PICO (Population, Intervention, Comparison, and Outcomes) approach.
Appropriate use of transthoracic echocardiography in the investigation of general medicine patients presenting with syncope or presyncope

Study purpose Routine transthoracic echocardiography (TTE) in patients with syncope or presyncope is resource-intensive. We assessed if risk thresholds defined by a validated risk score may identify patients at low risk of cardiac abnormality in whom TTE is unnecessary. Study design We conducted a retrospective study of all general medicine patients with syncope/presyncope presenting to a tertiary hospital between July 2016 and September 2020 and who underwent TTE. The Canadian Syncope Risk Score (CSRS) was used to categorise patients as low to very low risk (score −3 to 0) or moderate to high risk (score ≥1) for serious adverse events at 30 days. A cut-point of 0 was used to calculate the sensitivity, specificity, positive and negative predictive values (PPV and NPV) for CSRS and the odds ratio (OR) of a clinically significant finding on TTE in patients with CSRS ≥1 compared with all patients. Results Among 157 patients, the CSRS categorised 69 (44%) as very low to low risk in whom TTE was normal. In 88 patients deemed moderate to high risk, TTE detected a cardiac abnormality in 24 (27%). A CSRS ≥1 yielded a sensitivity of 100% (95% CI 85.7% to 100%), specificity of 51.1% (95% CI 42.3% to 59.8%), PPV of 26.5% (95% CI 26.3% to 30.1%) and NPV of 100% (95% CI 92.5% to 100%) for cardiac abnormalities and doubled the odds of an abnormality (OR=2.05, 95% CI 1.08 to 3.87, p=0.028). Conclusion In general medicine patients with syncope/presyncope, using the CSRS to stratify risk of a cardiac abnormality on TTE can almost halve TTE use.
Effects of COVID-19 on Patients in Adult Ambulatory Psychiatry: Using Patient-Rated Outcome Measures and Telemedicine

Introduction: To examine the effects of coronavirus disease 2019 (COVID-19) on patients in an academic psychiatric ambulatory clinic, data from a measurement-based care (MBC) system were analyzed to evaluate impacts on psychiatric functioning in patients using telemedicine. Psychiatric functioning was evaluated for psychological distress (brief adjustment scale [BASE]-6), depression (patient health questionnaire [PHQ]-9), and anxiety (generalized anxiety disorder [GAD]-7), including initial alcohol (U.S. alcohol use disorders identification test) and substance use (drug abuse screening test-10) screening. Methods: This observational study included MBC data collected from November 2019 to March 2021. Patient-Reported Outcome Measures (PROMs) were examined to determine changes in symptomatology over the course of treatment, as well as symptom changes resulting from the pandemic. Patients were included in analyses if they completed at least one PROM in the MBC system. Results: A total of 2,145 patients actively participated in the MBC system completing at least one PROM, with engagement ranging from 35.07% to 83.50% depending on demographic factors, where completion rates were significantly different for age, payor status, and diagnostic group. Average baseline scores for new patients varied for the GAD-7, PHQ-9, and BASE-6. Within-person improvements in mental health before and after the pandemic were statistically significant for anxiety, depression, and psychological adjustment. Discussion: MBC is a helpful tool in determining treatment progress for patients engaging in telemedicine. This study showed that patients who engaged in psychiatric services incorporating PROMs had improvements in mental health during the COVID-19 pandemic. Additional research is needed exploring whether PROMs might serve as a protective or facilitative factor for those with mental illness during a crisis when in-person visits are not possible.
Prognostic Value of Sequential Organ Failure Assessment (SOFA) Score in Critically-Ill Combat-Injured Patients

Background: Infection is a frequent and serious complication after combat-related trauma. The Sequential Organ Failure Assessment (SOFA) score has been shown to have predictive value for outcomes, including sepsis and mortality, among various populations. We evaluated the prognostic ability of SOFA score in a combat-related trauma population. Methods: Combat casualties (2009–2014) admitted to Landstuhl Regional Medical Center (LRMC; Germany) intensive care unit (ICU) within 4 days post-injury followed by transition to ICUs in military hospitals in the United States were included. Multivariate logistic regression was used to determine predictive effect of selected variables and receiver operating characteristic (ROC) curve analysis was used to evaluate overall accuracy of SOFA score for infection prediction. Results: Of the 748 patients who met inclusion criteria, 436 (58%) were diagnosed with an infection (32% bloodstream, 63% skin and soft tissue, and 40% pulmonary) and were predominantly young (median 24 years) males. Penetrating trauma accounted for 95% and 86% of injuries among those with and without infections, respectively (p < 0.001). Median LRMC admission SOFA score was 7 (interquartile range [IQR]: 4–9) in patients with infections versus 4 (IQR: 2–6) in patients without infections (p < 0.001). Thirty-day mortality was 2% in both groups. On multivariate regression, LRMC SOFA score was independently associated with infection development (odds ratio: 1.2; 95% confidence interval: 1.1–1.3). The ROC curve analysis revealed an area under the curve of 0.69 for infection prediction, and 0.80 for mortality prediction. Conclusions: The SOFA scores obtained up to 4 days post-injury predict late onset infection occurrence. This study revealed that for every 1 point increase in LRMC SOFA score, the odds of having an infection increases by a factor of 1.2, controlling for other predictors. The use of SOFA score in admission assessments may assist clinicians with identifying those at higher risk of infection following combat-related trauma.
Propofol Anesthesia Concentration Rather Than Abrupt Behavioral Unresponsiveness Linearly Degrades Responses in the Rat Primary Auditory Cortex.

Despite extensive knowledge of its molecular and cellular effects, how anesthesia affects sensory processing remains poorly understood. In particular, it remains unclear whether anesthesia modestly or robustly degrades activity in primary sensory regions, and whether such changes are linked to anesthesia drug concentration versus behavioral unresponsiveness, which are typically confounded. Here, we used slow gradual intravenous propofol anesthesia induction together with auditory stimulation and intermittent assessment of behavioral responsiveness while recording epidural electroencephalogram, and neuronal spiking activity in primary auditory cortex (PAC) of eight rats. We found that all main components of neuronal activity including spontaneous firing rates, onset response magnitudes, onset response latencies, postonset neuronal silence duration, late-locking to 40 Hz click-trains, and offset responses, gradually changed in a dose-dependent manner with increasing anesthesia levels without showing abrupt shifts around loss of righting reflex or other time-points. Thus, the dominant factor affecting PAC responses is the anesthesia drug concentration rather than any sudden, dichotomous behavioral state changes. Our findings explain a wide array of seemingly conflicting results in the literature that, depending on the precise definition of wakefulness (vigilant vs. drowsy) and anesthesia (light vs. deep/surgical), report a spectrum of effects in primary regions ranging from minimal to dramatic differences.
Intralesional bivalent human papilloma virus vaccine as a treatment for anogenital warts versus topical podophyllin resin 25%: A pilot study

A role of human papilloma virus (HPV) vaccines as a therapy for genital warts was suggested, nevertheless; it has not been established in clinical trials and has yet to be determined. The objective of this study is to evaluate a potential benefit of intralesional injection of bivalent HPV (Cervarix) vaccine as a treatment for anogenital warts versus topical podophyllin resin 25%. Forty‐four patients with anogenital warts were included in the study, 22 patients received intralesional Cervarix every 2 weeks until clearance of lesions or for a maximum of five sessions. The other 22 patients received topical podophyllin resin 25% twice weekly until complete resolution or for a maximum of 4 weeks. Follow up was done for 6 months. Dermatology life quality index (DLQI) was measured. Complete clearance of warts was achieved in 10 patients (45.5%) in Cervarix group versus six patients (27.3%) in Podophyllin group. The difference was statistically insignificant. No recurrence of warts was reported in Cervarix group while two patients (33.3%) showed recurrence in Podophyllin group. Both treatments were well tolerated. All patients reported significant improvement of their DLQI. Intralesional Cervarix is a promising modality showing higher rates of complete response, high safety, and no recurrence.
Salvage radiotherapy following HiFU: An institutional series and literature review

Algorithms for the treatment of prostate cancer (PrCa) rely on risk grouping, and those who fall into low (LR) and favourable intermediate risk (FIR) categories have multiple options for treatment. High‐intensity focused ultrasound (HiFU) is a local treatment modality that uses ultrasound waves to ablate prostate cancer. In case of treatment failure, optimal salvage modality after HiFU remains unclear.
Facilitators and barriers to status disclosure and partner testing of women living with HIV in Indonesia: a mixed methods study

Abstract This mixed-methods study investigated HIV status disclosure and partner testing of women living with HIV (WLWH) in a concentrated epidemic setting in Bandung, Indonesia. The qualitative exploratory strand used theoretical sampling to carry out semi-structured interviews with 47 HIV-infected women with varying anti-retroviral therapy status. The quantitative strand included 122 female patients receiving HIV care at a referral clinic. HIV diagnosis made women reassess their sexual partnerships. Some lost their partner due to death or divorce. Women with a longstanding HIV infection often formed new partnerships. They disclosed their status to new partners without assistance from health providers; the type and stability of the partnership influenced decision to disclose. Fear of rejection prevented initial disclosure prior to bringing the new partners to a health provider. Disclosure did not always result in partner testing because of low risk-awareness or denial of the partner. Despite a similar proportion of status disclosure to partner (92.8%), only 53.7% of new partners of WLWH were tested in contrast to 89.7% of partners tested among WLWH who stayed with the same partner. In antenatal care, where same-day testing was often done for pregnant couples, more partners were tested. Overall, consistent condom use was low and HIV status forced WLWH who continued sex work to work at settings where condom use was not enforced. WLWH face barriers to HIV status disclosure and partner testing and would benefit from partnership counselling. Guidelines for partner notification and testing should include specific strategies for women with longstanding HIV infection.
Patterns of performance of children with neurofibromatosis type 1 on the K-CPT and K-CPT 2

ABSTRACT Children with neurofibromatosis type 1 (NF1) often have attention difficulties with emerging evidence that these difficulties can be seen even in early childhood. This study aimed to explore the relative utility of two versions of a commonly used computerized attention measure for young children with NF1 and to explore relations with parent-reported attention in young children with NF1. Two independent samples of young children with NF1 participated. One sample (Study 1; N = 22; M age = 4.95 (SD = 0.66)) completed the Conner’s Kiddie Continuous Performance Test (K-CPT). A second and separate sample (Study 2; N = 19; M age = 5.46 (SD = 0.74)) completed the K-CPT second edition (K-CPT 2). Relations of the K-CPT and K-CPT 2 with concurrent parent-reported attention (Kiddie Disruptive Behavior Disorder Schedule; Conners parent report questionnaires) were explored. The K-CPT sample’s scores significantly differed from the normative median on Commissions, Hit Rate Standard Error, Variability, Detectability, Perseverations, and Hit Rate Inter Stimulus Interval. No relations with parent-report were identified. The K-CPT 2 sample’s scores were significantly worse than normative data on every score except Hit Rate Block Change. Multiple scores on the K-CPT 2 were significantly related to parent-report of inattention and hyperactivity with some evidence of construct validity for the distinction between inattention and hyperactivity. The K-CPT 2 may be more useful for the assessment of attention problems in young children with NF1 as more challenges were observed and performance was more closely related to parent-reported attention difficulties than its predecessor the K-CPT.
Corneal Perforation associated with "Silent Brain Syndrome".

This case report describes the clinical characteristics and ophthalmic management of a patient who developed corneal perforation due to severe enophthalmos consistent with "silent brain syndrome. " A 27-year-old man with a history of congenital hydrocephalus and ventriculoperitoneal shunt was referred with complaints of "sinking of the eyeballs" and progressively decreasing vision in the left eye. Examination revealed severe bilateral enophthalmos in addition to superonasal corneal perforation with iris prolapse in the left eye. The patient underwent therapeutic keratoplasty the next day. Orbital reconstruction with costochondral graft and shunt revision of the intracranial hypotension were performed the next month to prevent further progression.
Individual differences in social attachment: A multi‐disciplinary perspective

Social behavior varies across both individuals and species. Research to explain this variation falls under the purview of multiple disciplines, each with its own theoretical and empirical traditions. Integration of these disciplinary traditions is key to developing a holistic perspective. Here, we review research on the biology of social attachment, a phenomena in which individuals develop strong affective connections to one another. We provide a historical overview of research on social attachment from psychological, ethological and neurobiological perspectives. As a case study, we describe work on pair‐bonding in prairie voles, a socially monogamous rodent. This specific topic takes advantage of many biological perspectives and techniques to explain social bonds. Lastly, we conclude with an overview of multi‐dimensional conceptual frameworks that can be used to explain social phenomena, and we propose a new framework for research on individual variation in attachment behavior. These conceptual frameworks originate from philosophy, physics, ethology, cognitive science and neuroscience. The application and synthesis of such frameworks offers a rich opportunity to advance understanding of social behavior and its mechanisms.
Association between fluoride exposure and blood pressure in children and adolescents aged 6 to19 years in the United States: NHANES, 2013–2016

ABSTRACT To examine the association between fluoride exposure and childhood blood pressure (BP), we used data involving 3260 subjects participating in the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2016. Both plasma and water fluoride concentrations were measured using the ion-specific electrode. Outcome variables were systolic blood pressure (SBP) and diastolic blood pressure (DBP). For a 1-mg/L increase in water fluoride concentration, the participantsʻ SBP decreased by 0.473 mm Hg (95% CI: −0.860, −0.087). Specifically, inverse associations were found between water fluoride and SBP in girls (β= −0.423, 95% CI: −0.886, −0.021), adolescents (β= −0.623, 95% CI: −0.975, −0.272), and non-Hispanic whites (β= −0.694, 95% CI: −1.237, −0.151). Also, every 1-μmol/L increase in plasma fluoride concentration was associated with a 1.183 mm Hg decrease in SBP among other races (95% CI: −2.258, −0.108). This study suggested that fluoride exposure may affect childhood blood pressure.
Genetic Homology between Bacteria Isolated from Pulmonary Abscesses or Pyothorax and Bacteria from the Oral Cavity

We present direct genetic evidence that some of the bacteria in pulmonary abscesses and pyothorax are derived from the oral flora. This is the first report describing the presence of genetically homologous strains both in pus from pulmonary abscesses and pyothorax and in swab samples from the mouth. ABSTRACT Pulmonary abscesses and pyothorax are bacterial infections believed to be caused primarily by oral microbes. However, past reports addressing such infections have not provided genetic evidence and lack accuracy, as they used samples that had passed through the oral cavity. The aim of this study was to determine whether genetically identical bacterial strains exist in both the oral microbiota and pus specimens that were obtained percutaneously from pulmonary abscesses and pyothorax, without oral contamination. First, bacteria isolated from pus were identified by 16S rRNA gene sequencing. It was then determined by quantitative PCR using bacterial-species-specific primers that DNA extracted from paired patient oral swab sample suspensions contained the same species. This demonstrated sufficient levels of bacterial DNA of the targeted species to use for further analysis in 8 of 31 strains. Therefore, the whole-genome sequences of these eight strains were subsequently determined and compared against an open database of the same species. Five strain-specific primers were synthesized for each of the eight strains. DNA extracted from the paired oral swab sample suspensions of the corresponding patients was PCR amplified using five strain-specific primers. The results provided strong evidence that certain pus-derived bacterial strains were of oral origin. Furthermore, this two-step identification process provides a novel method that will contribute to the study of certain pathogens of the microbiota. IMPORTANCE We present direct genetic evidence that some of the bacteria in pulmonary abscesses and pyothorax are derived from the oral flora. This is the first report describing the presence of genetically homologous strains both in pus from pulmonary abscesses and pyothorax and in swab samples from the mouth. We developed a new method incorporating quantitative PCR and next-generation sequencing and successfully prevented contamination of pus specimens with oral bacteria by percutaneous sample collection. The new genetic method would be useful for enabling investigations on other miscellaneous flora; for example, detection of pathogens from the intestinal flora at the strain level.
Giant epidermoid splenic cyst associated with elevated serum marker CA 19‐9

Splenic cysts are rare pathology with an overall incidence of 0.07% in a large autopsy series and 0.5% among all the splenectomies. 1 Two types of splenic cysts are distinguished: primary cysts or true cysts including hydatic cysts and no parasitic cysts. Primary or true cysts account for 10% of all splenic cysts and have epithelial ependyma (epidermoid, dermoid and mesothelial) or endothelial cover (hemangioma and lymphangioma) 2,3 and they are encoun-tered more commonly in young adults. False cysts are described as a cyst without ependyma in wall structure occur 10 times more fre-quently than primary ones. 4 Epidermoid splenic cysts are extremely rare cases in clinical practice and constitute 10% of all non-parasitic cysts. 3 In order to familiarize with this extremely rare entity and to identify the adequate treatment, we expose this rare case report of a giant epidermoid cyst.