Miracle-dz/UniFAR-FTUs huggingface dataset:
An end-to-end CNN with attentional mechanism applied to raw EEG in a BCI classification task

Objective. Motor-imagery (MI) classification base on electroencephalography (EEG) has been long studied in neuroscience and more recently widely used in healthcare applications such as mobile assistive robots and neurorehabilitation. In particular, EEG-based MI classification methods that rely on convolutional neural networks (CNNs) have achieved relatively high classification accuracy. However, naively training CNNs to classify raw EEG data from all channels, especially for high-density EEG, is computationally demanding and requires huge training sets. It often also introduces many irrelevant input features, making it difficult for the CNN to extract the informative ones. This problem is compounded by a dearth of training data, which is particularly acute for MI tasks, because these are cognitively demanding and thus fatigue inducing. Approach. To address these issues, we proposed an end-to-end CNN-based neural network with attentional mechanism together with different data augmentation (DA) techniques. We tested it on two benchmark MI datasets, brain–computer interface (BCI) competition IV 2a and 2b. In addition, we collected a new dataset, recorded using high-density EEG, and containing both MI and motor execution (ME) tasks, which we share with the community. Main results. Our proposed neural-network architecture outperformed all state-of-the-art methods that we found in the literature, with and without DA, reaching an average classification accuracy of 93.6% and 87.83% on BCI 2a and 2b, respectively. We also directly compare decoding of MI and ME tasks. Focusing on MI classification, we find optimal channel configurations and the best DA techniques as well as investigate combining data across participants and the role of transfer learning. Significance. Our proposed approach improves the classification accuracy for MI in the benchmark datasets. In addition, collecting our own dataset enables us to compare MI and ME and investigate various aspects of EEG decoding critical for neuroscience and BCI.
Social Contact, Emotional Support, and Anxiety during the COVID-19 Pandemic among Older Adults with Chronic Conditions

ABSTRACT Objectives The COVID-19 pandemic may contribute to heightened anxiety among older adults with chronic conditions, which might be attenuated by social resources. This study examined how social contact and emotional support were linked to anxiety symptoms among adults aged 50 and older with chronic conditions, and whether these links varied by age. Methods Participants included 705 adults (M = 64.61 years, SD = 8.85, range = 50– 94) from Michigan (82.4%) and 33 other U.S. states who reported at least one chronic condition and completed an anonymous online survey between May 14 and July 9, 2020. Results Multiple regression models revealed among younger people, those reporting more frequent social contact had significantly lower anxiety symptoms. Emotional support was not significantly associated with anxiety symptoms. Conclusions More frequent social contact was linked to lower anxiety symptoms for younger but not older individuals. Emotional support was not significantly associated with anxiety symptoms. Clinical Implications Interventions to manage anxiety during the pandemic among older adults with chronic conditions may benefit from strategies to safely increase social contact, especially for middle-aged adults.
Totally Robotic Esophagectomy

Totally robotic esophagectomy is performed using a robotic technique without additional thoracoscopy or laparoscopy. However, most robotic esophagectomies are currently performed in a hybrid form combining robotic and other endoscopic techniques. Laparoscopic stomach mobilization and thoracoscopic esophagogastric anastomosis are commonly used methods in robotic esophagectomy. In this paper, totally robotic esophagectomy without thoracoscopic or laparoscopic assistance is presented.
The role of preimplantation genetic testing for aneuploidy in a good prognosis IVF population across different age groups

ABSTRACT Preimplantation genetic testing for aneuploidy is associated with increased pregnancy success and reduced miscarriage in women 35 years and older when embryos are available for transfer. In this retrospective cohort study our objective was to evaluate if this holds true in good prognosis patients and across all age groups. Data were obtained from the Society for Assisted Reproductive Technology between 2014–2015. We included only the first single frozen embryo transfer where indication for corresponding ‘stimulation/freeze-all cycle’ was for reducing risk of ovarian hyperstimulation syndrome and performance of PGT-A for selecting euploid embryos. Our main outcomes were live birth and miscarriage rates. Among <35 age group, no difference in LBR was observed between cycles who underwent single embryo FET using non-PGT-A tested vs. tested embryos (51.7% vs. 50.9%, aOR 1.03, 95% CI 0.87–1.21). Additionally, the miscarriage rates (8.7% vs. 8.8%, aOR 0.97, 95% CI 0.72–1.30) were not different. Among 35–37 years old, no difference was observed between non-PGT-A tested and tested groups in LBR (50.4% vs. 54.7%, aOR 1.26, 95% CI 0.96–1.67) or miscarriage rates (8.3% vs. 10%; aOR 1.11, 95% CI 0.68–1.82). Similarly, among > 37 year old, no difference was observed between non-PGT-A tested and tested groups in LBR (48.1% vs. 53.2%, aOR 1.27, 95% CI 0.8–2.02) and miscarriage rates (6.2% vs. 8.5%, aOR1.34, 95% CI 0.52–3.43). To conclude, PGT-A tested embryos did not improve LBR and miscarriage rates in a good prognosis IVF population across all age groups. Abbreviations: PGT-A: preimplantation genetic testing for aneuploidy; FET: frozen embryo transfer; LBR: live birth rate; OHSS: ovarian hyperstimulation syndrome; SART: society for assisted reproductive technology
Quality of life of patients with pulmonary arterial hypertension: a meta-analysis.

OBJECTIVE Pulmonary arterial hypertension (PAH) is a rare condition, with an incidence of 15-50 cases per million annually. Available studies demonstrate that despite the longer survival of PAH patients, their quality of life (QoL) deteriorates as the condition progresses. Consequently, the goals of PAH therapy have expanded from increasing survival to improving health-related quality of life. The objective of this systematic review and meta-analysis was to summarize the available evidence about the level of QoL in patients with PAH. MATERIALS AND METHODS A systematic search was performed using the Cochrane guidelines for conducting meta-analysis following the PRISMA statement. The meta-analysis includes findings from 11 studies evaluating the QoL of PAH patients at baseline and at follow-up (12 weeks) using the Short Form (36) Health Survey (SF-36), the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR). RESULTS The mean physical component score (SF-36) for the group was 37.2 points (95% CI: 33.24-41.16) and the heterogeneity coefficient was I²=97.71% (p < 0.001). The mean mental component score (SF-36) was 46.38 (95% CI: 44.21-48.56) and the heterogeneity coefficient was I²=87.92% (p < 0.001). The result indicates improved QoL 12 weeks after the intervention, though three papers did not fully confirm this. The greatest improvement in QoL was found in patients treated with bosentan and iloprost and the smallest improvement in QoL was found in patients treated with epoprostenol sodium. The heterogeneity coefficient was I²=91.36%, p < 0.001 for CAMPHOR and I²=97.65%, p < 0.001 for MLHFQ. CONCLUSIONS PAH patients tend to have a poor QoL, mainly in the physical functioning domain, less so in the psychological functioning domain. QoL may be improved by therapeutic interventions, mainly pharmaceutical ones. Patients with PAH also tend to suffer from depression, anxiety, stress, or sleep disorders. All these factors are significantly correlated with poorer QoL.
Morphological basis for maternal nutrient provision to embryos in the viviparous fish Ataeniobius toweri (Teleostei: Goodeidae)

In viviparous Mexican fishes of the family Goodeidae, embryos develop in the maternal ovarian lumen. They typically absorb maternal nutrients during gestation by means of “trophotaeniae,” that is, specialized, elongated extensions of the hindgut that are exposed to the fluids, which occupy the ovarian lumen. The sole exception is Ataeniobius toweri, whose embryos lack trophotaeniae but are nevertheless matrotrophic. Thus, how its embryos obtain maternal nutrients is unclear. We studied a series of non‐pregnant and pregnant ovaries of A. toweri using histology to identify the mechanism of maternal–embryo nutrient transfer. By early‐gestation, embryos have depleted their yolk supplies. Yolks are released into the ovarian lumen and are ingested by the developing embryos, as shown by yolk material in their digestive tracts. The embryonic gut is lined by an epithelium consisting of columnar cells with apical microvilli, providing a means for nutrient absorption. Contrary to statements in the literature, embryos develop minuscule trophotaenial rudiments that extend slightly into the ovarian lumen. These structures are formed of an absorptive epithelium that overlies a vascular stroma, similar to the trophotaeniae of other goodeids. Through late gestation, vitellogenic follicles form and oocytes are discharged into the ovarian lumen, contributing to embryonic nutrition. Thus, histological evidence suggests that embryos chiefly obtain nutrients from ingestion of yolk and maternal secretions released into the ovarian lumen. This function possibly is supplemented by uptake via the small hindgut protrusions and other absorptive surfaces (e.g., the skin and the gill epithelium). Our observations are consistent with two evolutionary interpretations of the hindgut protrusions: (a) that they are rudimentary, evolutionary precursors of trophotaeniae formed by exteriorized hindgut; and (b) that they are vestigial remnants of trophotaeniae that were lost during a switch to a form of matrotrophy involving nutrient ingestion.
A comparison of the modified Broström procedure and modified Karlsson procedure in treating chronic lateral ankle instability: a systematic review and meta-analysis.

BACKGROUND This study sought to compare the efficacy and surgery complications of the modified Broström procedure and the modified Karlsson procedure in treating patients with chronic lateral ankle instability (CLAI). METHODS Full-text publications on the clinical efficacy of Broström's and Karlsson's procedures were retrieved from multiple databases. Review Manager 5.0 was adopted for the meta-analysis, sensitivity analysis, and bias analysis. RESULTS Nine studies comprising a total of 643 patients were identified. The meta-analysis suggested that the American Orthopedic Foot and Ankle Society (AOFAS) scores of patients in the Karlsson group were higher than those of patients in the Broström group [mean deviation (MD) =6.31, 95% confidence interval (CI): 2.31-10.30, P=0.002; P for heterogeneity <0.00001, I2=58%]. The Tegner scores of patients in the Karlsson group were higher than those of patients in the Broström group (MD =0.72, 95% CI: 0.48-0.95, P=0.24; P for heterogeneity <0.00001, I2=23%). Operation times in the Broström group were higher than those in the Karlsson group (MD =-15.50, 95% CI: -19.98--11.02, P<0.00001; P for heterogeneity <0.00001, I2=63%). Patients in the Karlsson group had higher levels of satisfaction than those in the Broström group (MD =0.63, 95% CI: 0.47-0.79, P<0.00001; P for heterogeneity =0.91, I2=0%). No significant difference was observed in surgery complications between the Karlsson and Broström groups [odds ratio (OR) =1.71, 95% CI: 0.79-3.71, P=0.18; P for heterogeneity =0.99, I2=0%]. DISCUSSION Based on the heterogeneity analysis results, this study showed that Karlsson's procedure was more efficient and safer than Broström's treatment in the treatment of CLAI patients.
Assessment of Helicobacter pylori status by examination of gastric mucosal patterns: diagnostic accuracy of white-light endoscopy and narrow-band imaging

Objectives Helicobacter pylori infection is a common cause of chronic gastritis worldwide and an established risk factor for developing gastric malignancy. The endoscopic appearances predicting H. pylori status are an ongoing area of research, as are their diagnostic accuracies. This study aimed to establish the diagnostic accuracy of several mucosal features predictive of H. pylori negative status and formulate a simple prediction model for use at the time of endoscopy. Design Patients undergoing high-definition upper gastrointestinal (GI) endoscopy without magnification were recruited prospectively. During the endoscopy, the presence or absence of specific endoscopic findings was noted. Sydney protocol biopsies were used as the diagnostic reference standard, and urease test if taken. The results informed a logistic regression model used to produce a simple diagnostic approach. This model was subsequently validated using a further cohort of 30 patients. Results 153 patients were recruited and completed the study protocol. The prevalence of active H. pylori infection was 18.3% (28/153). The overall diagnostic accuracy of the simple prediction model was 80.0%, and 100% of patients with active H. pylori infection were correctly classified. The presence of regular arrangement of collecting venules (RAC) showed a positive predictive value for H. pylori naïve status of 90.7%, rising to 93.6% for patients under the age of 60. Conclusion A simple endoscopic model may be accurate for predicting H. pylori status of a patient, and the need for biopsy-based tests. The presence of RAC in the stomach is an accurate predictor of H. pylori negative status, particularly in patients under the age of 60. Trial registration number The study was registered with ClinicalTrials.gov, No. NCT02385045.
Evaluating health-related quality of life in gastric cancer patients in Suzhou, China.

BACKGROUND Health-related quality of life (HRQOL) has become an important part of the evaluation of clinical efficacy and prognosis in gastric cancer. This study aimed to assess the HRQOL of patients with gastric cancer using the a five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) and explore the factors influencing patients' perceived quality of life. For those significant factors, we can take appropriate measures to intervene to extend patient survival and improve the quality of life. METHODS A cross-sectional questionnaire survey was administered to 243 patients with gastric cancer in the First Affiliated Hospital of Suzhou University from December 2018 to December 2020. HRQOL was measured by the Chinese version of the EQ-5D-5L. Nonparametric test analyses and a Tobit regression model were used to identify the independent variables associated with the EQ-5D-5L utility scores. RESULTS In this research, the mean score was 0.810, and the median was 0.893. Approximately 25% of patients reported no problems at all in any of the five dimensions. Problems in pain and discomfort were the most frequently reported (64.2%). Nonparametric test analyses showed that patients who did not have health insurance, or who had a history of alcohol use, a family history of cancer, had received surgery only, or had an interval of less than 1 week between taking this survey and their last treatment, demonstrated lower EQ-5D-5L scores. The Tobit regression model confirmed that health insurance, family history, and treatment were significantly associated with EQ-5D-5L scores. CONCLUSIONS The HRQOL of gastric cancer patients can be measured by EQ-5D-5L, and the results may provide a guide for choosing an appropriate individualized treatment plan.
The construction of the structural equation model of burden, benefit finding, and anxiety-depression of esophageal cancer caregivers based on Lazarus stress and coping theory.

BACKGROUND A large number of studies have shown that the assignment of long-term care duties brings great pressure and negative emotions to caregivers of cancer patients, and also affects the quality of care. Lazarus and Folkman's stress and coping theory holds that the process of cognition and evaluation of stress is key to the stress response when a stressor acts on individuals. This study is to explore the mediating effect of benefit finding between caregiver burden and anxiety-depression of esophageal cancer caregivers, according to a model hypothesis constructed based on stress and coping theory. The design of this study involved correlation and theoretical testing using a structural equation model. METHODS A total of 228 pairs of esophageal cancer patients from 2 tertiary hospitals and their family caregivers were recruited in this study from May 2020 to January 2021. A questionnaire survey was conducted using the general information questionnaire, the caregiver burden inventory (CBI), the benefit finding scale (BFS), and the hospital anxiety and depression scale (HADS). RESULTS A good fitting model [chi-square (χ2)/degrees of freedom (df) =2.212, root mean square error of approximation (RMSEA) =0.07, comparative fit index (CFI) =0.976, Tucker-Lewis index (TLI) =0.964, goodness of fit (GFI) =0.954, normed fit index (NFI) =0.957] indicated the mediating effect of benefit finding between caregiver burden and anxiety-depression of esophageal cancer caregivers. A higher level of benefit finding had a negative effect on caregiver burden and anxiety-depression, which reduced the burden and psychological distress of caregivers. The theoretical hypothesis was validated. CONCLUSIONS Clinical nurses should pay attention to the benefit finding level of caregivers. For caregivers with low-level of benefit finding, intervention measures should be taken to improve the psychological cognitive level of caregivers, which can ultimately improve the quality of life of patients.
Anxious temperament and cyberchondria as mediated by fear of COVID-19 infection: A cross-sectional study

This study’s main goal was to evaluate the association between anxious temperament and the fear of COVID-19-related self-infection and infection in loved ones (family members, friends, relatives) and cyberchondria. The sample consisted of 499 men and women aged between 18 and 72 who were gathered from the general population via an online recruitment platform. A numerical rating scale comprising 11 degrees of fear was used to assess participants’ COVID-19-related fear, and affective temperaments were evaluated using Akiskal’s Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) scales. Cyberchondria was assessed using McElroy and Shevlin’s Cyberchondria Severity Scale (CSS). Small to medium positive correlations were found between depressive, cyclothymic, irritable and anxious temperaments and cyberchondria and between depressive and anxious temperaments and COVID-19 fears. However, no correlation was observed between the hyperthymic temperament and cyberchondria. Cyberchondria positively correlated with both COVID-19 fears scales, though the correlation coefficients were medium. Based on the results of linear regression analysis, only anxious temperament and COVID-19 fear of self-infection were significant predictors of cyberchondria. The analysis also revealed a significant indirect effect of anxious temperament on cyberchondria through fear of COVID-19 self-infection as a mediator between anxious temperament and cyberchondria.
Differential impacts of natural L2 immersion and intensive classroom L2 training on cognitive control

The relationship between bilingualism and cognitive control has been controversial. We believe that the discrepant findings are likely driven by the complexities of the bilingual experience, which is consistent with the Adaptive Control Hypothesis. The current study investigates whether the natural language immersion experience and the classroom intensive language training experience have differential impacts on cognitive control. Among unbalanced Chinese-English bilingual students, a natural L2 (second language) immersion group, an L2 public speaking training group, and a control bilingual group without immersion or training experience were compared on their cognitive control abilities, with the participants’ demographic factors strictly controlled. The results showed that the L2 immersion group and the L2 speaking group had faster speed than the control group in the Flanker task, whereas the L2 immersion group had fewer errors than the other two groups in the Wisconsin Card Sorting Test (WCST). These results generally provide evidence in favour of the Adaptive Control Hypothesis, specifying that natural L2 immersion and L2 public speaking training experiences are distinctively related to cognitive control. The current study is the first of its kind to link specific bilingual experiences (natural L2 immersion vs. intensive L2 public speaking) with different components of cognitive control.
Perceptions, awareness on snakebite envenoming among the tribal community and health care providers of Dahanu block, Palghar District in Maharashtra, India.

INTRODUCTION India has remarkably the highest number of snakebite cases contributing to nearly 50% of the global snakebite deaths. Despite this fact, there is limited knowledge and awareness regarding the management practices for snakebite in the Indian population. The study aimed to explore the knowledge, awareness, and perception of snakes and snakebites, first aid, and treatment amongst the community and the frontline health workers in a tribal block of Dahanu, Maharashtra, India. METHODS A cross-sectional study was carried out from June 2016 to October 2018 in the Dahanu Block, Maharashtra. Perceptions, knowledge, awareness, and first-aid practices on the snakebites among the community were studied through focus group discussions (FGDs). Semi-structured questionnaires were used to assess the knowledge, awareness, and experience of the traditional faith healers, snake rescuers, frontline health workers on the snakebites and their management. A facility check survey was conducted using pre-tested questionnaires for different levels of the government health care facilities. RESULTS Most of the tribal community was aware of the commonly found snakes and their hiding places. However, there was inadequate knowledge on the identification and classification of venomous snakes. Belief in a snake god, the perception that snakes will not come out during thunderstorms, change in taste sensation, the ability of tamarind seeds or magnet to reduce the venom effect were some of the superstitions reported by the tribal community. The application of a harmful method (Tourniquet) as the first aid for snakebite was practiced by the tribal community. They preferred herbal medicines and visiting the traditional faith healers before shifting the patient to the government health facility. The knowledge on the ability to identify venomous snakebites and anti-venom was significantly higher amongst nurses and accredited social health activists (ASHAs) than auxiliary nurse midwives (ANMs) and multi-purpose workers (MPWs) (p < 0.05). None of the traditional faith healers; but nearly 60% of snake rescuers were aware of anti-venom. Fifty percent of the medical officers in Dahanu block did not have correct knowledge about the Krait bite symptoms, and renal complications due to the Russell viper bite. CONCLUSIONS Inappropriate perception, inadequate awareness, and knowledge about snakes and snakebites may predispose the tribal community to increased risks of venomous snakebites. Unproven and harmful methods for snakebite treatment practiced by the community and traditional faith healers could be dangerous leading to high mortality. Therefore, a multi-sectoral approach of community awareness, mapping of vulnerable populations, capacity building of health care facility, empowerment of health care workers (HCWs) could be useful for reducing the mortality and morbidity due to snakebite envenoming in India.