Miracle-dz/UniFAR-FTUs huggingface dataset:
Stem Cell Injection for Complex Refractory Perianal Fistulas in Crohn's Disease: A Single Center Initial Experience

From 30 to 70% of patients with Crohn's disease (CD) may develop perianal fistulas during their lifetime. The medical and surgical management of this complication is challenging, and its treatment still gives unsatisfactory results. However, recent studies on adipose-derived mesenchymal stem cells have proven their anti-inflammatory and immuno-modulatory potential, representing a new promising tool in the treatment of such stubborn disease. We report our initial experience with three patients who had recurrent perianal CD treated with local infiltration of stem cell darvadstrocel (Alofisel). All the patients had a long history of perianal disease refractory to multiple medical and surgical treatments. The preoperative workup included transperineal ultrasound (TP-US), pelvic MRI, and colonoscopy that ruled out active proctitis in all the patients. The post-treatment follow-up included clinical assessment at 1, 3, and 6 months with repeated MRI and TP-US at 6 months. At 6 months, 2 patients had a clinical response despite radiological persistence of fistula tracts, while one patient presented perianal fistula recurrence complicated by perianal abscess. Although our experience is limited to 3 patients and a short follow-up, our results confirm that darvadstrocel injection is a safe procedure, with a good clinical response in most of the patients, but that it apparently had no effect on the anatomical modification of the fistula tracts. Long-term results, with a rigorous assessment of anatomical lesions, are still needed to support the promising data of the literature.
Association Between the Surrogate Markers of Insulin Resistance and Chronic Kidney Disease in Chinese Hypertensive Patients

Background We aim to evaluate the four surrogate markers of insulin resistance (IR), including triglyceride-glucose index (TyG), lipid accumulation product index (LAP), visceral adiposity index (VAI), triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL), on prevalence of chronic kidney disease (CKD) and to examine any possible effect modifiers in Chinese hypertensive patients. Methods A total of 13,055 hypertensive participants were included in this cross-sectional study. In addition, average age of the study population was 63.81 ± 9.46 years, and 47.66% of them are men. The primary outcome was CKD, defined as eGFR <60 ml/min/1.73 m2. Multivariate logistic regression analysis and the generalized additive model and a fitted smoothing curve (penalized spline method) were used to examine the association between the surrogate markers of IR and CKD. Results Four surrogate markers of IR were independently and positively associated with CKD in a dose-response fashion. The association between four surrogate markers of IR and the prevalence of CKD was examined as a continuous variable per one unit increment and also as a categorical variable using tertiles with the tertiles (T1) as the reference group. In the fully adjusted model, multivariate logistic analyses showed that the per one unit increments of the TyG, LAP, VAI, and TG/HDL ratios were all significantly associated with 42, 31, 67, and 78% higher risk for CKD, respectively. Consistently, the adjusted ORs (95% CI) for CKD were 1.48 (1.21, 1.81), 1.34 (1.06, 1.69), 1.26 (1.03, 1.53), 1.35 (1.12, 1.63) when comparing the highest tertile to the lowest tertile of the TyG, LAP, VAI, and TG/HDL ratios, respectively. The stratification analysis showed that a significant positive correlation between TyG, VAI, and TG/HDL and CKD in patients over 65 years old. Conclusion Four surrogate markers of IR were independently and positively correlated with CKD, and LAP was better than the other surrogate markers of IR for predicting CKD. Only among participants aged over 65 years were higher levels of TyG, VAI and TG/HDL found to be closely related to the increased prevalence of CKD.
Gender Differences in Self-Estimated Intelligence: Exploring the Male Hubris, Female Humility Problem

Despite evidence from cognitive psychology that men and women are equal in measured intelligence, gender differences in self-estimated intelligence (SEI) are widely reported with males providing systematically higher estimates than females. This has been termed the male hubris, female humility effect. The present study explored personality factors that might explain this. Participants (N = 228; 103 male, 125 female) provided self-estimates of their general IQ and for Gardner’s multiple intelligences, before completing the Cattell Culture Fair IQ test as an objective measure of intelligence. They also completed the Bem Sex Role Inventory (BSRI) as a measure of sex-role identification, and measures of general and academic self-esteem. Both gender and sex-role differences were observed for SEI, with males and participants of both genders who scored high in masculinity offering higher self-estimates. By comparing estimated and observed IQ, we were able to rule out gender differences in overall accuracy but observed a pattern of systematic underestimation in females. An hierarchical multiple regression showed significant independent effects of gender, masculinity, and self-esteem. Mixed evidence was observed for gender differences in the estimation of multiple intelligences, though moderately sized sex-role differences were observed. The results offer a far more nuanced explanation for the male hubris, female humility effect that includes the contribution of sex role identification to individual and group differences.
Universal Health Insurance Coverage and the Economic Burden of Disease in Eastern China: A Pooled Cross-Sectional Analysis From the National Health Service Survey in Jiangsu Province

China has achieved universal social health insurance coverage, but it is unclear whether this has alleviated the economic burden of disease for individuals. This was investigated in the present study by analyzing National Health Service Survey (2008–2018) data from Jiangsu province. Ordinary least squares and binary multivariate logistic regression of pooled cross-sectional data were carried out to evaluate the effect of universal health insurance coverage and other socioeconomic factors on the economic burden of disease. Total health expenses (THE) first increased and then decreased during the survey period while out-of-pocket health expenses (OOP) decreased except for urban residents, for whom OOP increased after 2013. Household catastrophic health expenditure (HCHE) was stable between 2008 and 2013 but increased after 2013. Social health insurance had a significant positive effect on the annual THE and OOP and a negative effect on HCHE, however, universal health insurance coverage could alleviated THE and the economic burden of disease on individuals (OOP) while it was insufficient to protect against the economic risk of diseases (HCHE), with greater benefits for urban as compared to rural residents. Other socioeconomic factors including age, marital status, education, income, and health status also influenced the economic burden of disease.
Bacterial Genes Encoding Resistance Against Antibiotics and Metals in Well-Maintained Drinking Water Distribution Systems in Finland

Information on the co-occurrence of antibiotic resistance genes (ARGs) and metal resistance genes (MRGs) among bacterial communities in drinking water distribution systems (DWDSs) is scarce. This study characterized ARGs and MRGs in five well-maintained DWDSs in Finland. The studied DWDSs had different raw water sources and treatment methods. Two of the waterworks employed artificially recharged groundwater (ARGW) and used no disinfection in the treatment process. The other three waterworks (two surface and one groundwater source) used UV light and chlorine during the treatment process. Ten bulk water samples (two from each DWDS) were collected, and environmental DNA was extracted and then sequenced using the Illumina HiSeq platform for high-throughput shotgun metagenome sequencing. A total of 430 ARGs were characterized among all samples with the highest diversity of ARGs identified from samples collected from non-disinfected DWDSs. Furthermore, non-disinfected DWDSs contained the highest diversity of bacterial communities. However, samples from DWDSs using disinfectants contained over double the ratio of ARG reads to 16S rRNA gene reads and most of the MRG (namely mercury and arsenic resistance genes). The total reads and types of ARGs conferring genes associated with antibiotic groups namely multidrug resistance, and bacitracin, beta-lactam, and aminoglycoside and mercury resistance genes increased in waterworks treating surface water with disinfection. The findings of this study contribute toward a comprehensive understanding of ARGs and MRGs in DWDSs. The occurrence of bacteria carrying antibiotic or metal resistance genes in drinking water causes direct exposure to people, and thus, more systematic investigation is needed to decipher the potential effect of these resistomes on human health.
Field Calibration and Evaluation of an Internet-of-Things-Based Particulate Matter Sensor

This paper presents a field evaluation of IoT-enabled Plantower PMS5003 particulate matter sensors in Birmingham, United Kingdom. Commercial, off the shelf, sensors were adapted to utilise Low Power Wide Area Network (LPWAN) IoT technology enabling batteries to be used as a power source. The devices are capable of measuring and communicating data to an online platform with a battery life of ∼2 months, at a measurement interval of 15 min, allowing for automated air quality monitoring for extended periods at high density. The sensors demonstrate success at being integrated into a wireless sensor network, with a high presence of readings. The average correlation coefficients (r2) between raw PMS device data and reference instrumentation are 0.718, 0.703, and 0.543 for PM1, PM2.5, and PM10, respectively. The devices also demonstrate good intersensor consistency, with Pearson’s r values between pairs ranging from 0.92 to 0.99 across all size ranges. Relative humidity (RH) clearly influences the response of the sensors, especially for RH >85%, in keeping with previous laboratory evaluations and evaluations of similar devices. The development of a multi-linear correction factor that accounts for humidity effects on the performance of the sensors is described; using this model, Pearson’s r values range from 0.81 to 0.91 compared to 0.73–0.85 from uncorrected values. There is also some evidence of drift at high humidity over an 8-week period, suggesting that such sensors will (at least currently) need recalibration approximately bimonthly. The limit of detection (LoD) (1.60–4.75 μg m−3) calculated from this study also demonstrates that the sensors are suitable for capturing concentrations typical of a moderately polluted United Kingdom urban environment—LoDs of PM2.5 in this study would have allowed for capture of 94.7% of the concentrations recorded at a typical United Kingdom urban roadside monitoring site between 2017 and 2020.
Implementation of a Delirium Bundle for Pediatric Intensive Care Patients

Background and Objective Delirium represents the most common form of acute cerebral dysfunction in critical illness. The prevention, recognition, and treatment of delirium must become the focus of modern pediatric intensive care, as delirium can lead to increased morbidity and mortality. The aim of this study is to evaluate the impact of a delirium bundle consisting of mainly non-pharmacological measures. Material and Methods This is a pre-/post-implementation study in an interdisciplinary pediatric intensive care unit of a tertiary care university hospital. In the pre-implementation period, pediatric intensive care delirium was monitored using the Sophia Observation withdrawal Symptoms and Pediatric Delirium scale. After introduction of a delirium bundle consisting of non-pharmacological prevention and treatment measures a period of 4 months was interposed to train the PICU staff and ensure that the delirium bundle was implemented consistently before evaluating the effects in the post-implementation period. Data collection included prevalence of delirium and withdrawal, length of PICU stay, duration of mechanical ventilation, and cumulative dose of sedatives and analgesics. Results A total of 792 critically ill children aged 0–18 years were included in this study. An overall delirium prevalence of 30% was recorded in the pre-implementation group and 26% in the post-implementation group (p = 0.13). A significant reduction in the prevalence of pediatric delirium from was achieved in the subgroup of patients under 5 years of age (27.9 vs. 35.8%, p = 0.04) and in patients after surgery for congenital heart disease (28.2 vs. 39.5%, p = 0.04). Young age, length of PICU stay, and iatrogenic withdrawal syndrome were found to be risk factors for developing delirium. Conclusions Based on a validated delirium monitoring, our study gives new information regarding the prevalence of pediatric delirium and the characteristics of intensive care patients at risk for this significant complication. Especially young patients and patients after surgery for congenital heart disease seem to benefit from the implementation of non-pharmacological delirium bundles. Based on our findings, it is important to promote change in pediatric intensive care—toward a comprehensive approach to prevent delirium in critically ill children as best as possible.
Foraging Behavior Shows Individual-Consistency Over Time, and Predicts Range Use in Slow-Growing Free-Range Male Broiler Chickens

Recent research on free-range chickens shows that individual behavioral differences may link to range use. However, most of these studies explored individual behavioral differences only at one time point or during a short time window, assessed differences when animals were out of their social group and home environment (barn and range), and in specific tests or situations. Therefore, it is yet unclear how different behaviors relate to range use and how consistent these behaviors are at the individual level. To fill this gap, we here aimed to describe the behavioral budget of slow-growing male broiler chickens (S757N) when in their social group and home environment during the whole rearing period (from the second week of life to the twelfth week, before slaughter), and to relate observed behavioral differences to range use. For this, we followed a sample of individuals in two flocks (n = 60 focal chickens out of 200 chickens per flock), over two seasons, during three periods: before range access (from 14 to 25 days old), during early range access (first weeks of range access, from 37 to 53 days old), and during late range access (last weeks of range access, from 63 to 87 days old). By the end of each period, individual tests of exploration and social motivation were also performed, measuring exploration/activity and sociability propensities. Our results show that foraging (i.e., pecking and scratching at the ground) was the only behavior that correlated to range use for all three rearing periods, independent of the season. Foraging was also the only behavior that showed within-individual consistency from an early age and across the three rearing periods. Foraging may, therefore, serve as a useful behavioral predictor of range use in free-range broiler chickens. Our study increases the knowledge of how behaviors develop and relate to each other in a domesticated and intensely selected species, and improves our understanding of the biology of free-range broiler chickens. These findings can, ultimately, serve as a foundation to increase range use and improve chicken welfare.
The Yin and Yang of Immunity in Stem Cell Decision Guidance in Tissue Ecologies: An Infection Independent Perspective

The impact of immune system and inflammation on organ homeostasis and tissue stem cell niches in the absence of pathogen invasion has long remained a conundrum in the field of regenerative medicine. The paradoxical role of immune components in promoting tissue injury as well as resolving tissue damage has complicated therapeutic targeting of inflammation as a means to attain tissue homeostasis in degenerative disease contexts. This confound could be resolved by an integrated intricate assessment of cross-talk between inflammatory components and micro- and macro-environmental factors existing in tissues during health and disease. Prudent fate choice decisions of stem cells and their differentiated progeny are key to maintain tissue integrity and function. Stem cells have to exercise this fate choice in consultation with other tissue components. With this respect tissue immune components, danger/damage sensing molecules driving sterile inflammatory signaling cascades and barrier cells having immune-surveillance functions play pivotal roles in supervising stem cell decisions in their niches. Stem cells learn from their previous damage encounters, either endogenous or exogenous, or adapt to persistent micro-environmental changes to orchestrate their decisions. Thus understanding the communication networks between stem cells and immune system components is essential to comprehend stem cell decisions in endogenous tissue niches. Further the systemic interactions between tissue niches integrated through immune networks serve as patrolling systems to establish communication links and orchestrate micro-immune ecologies to better organismal response to injury and promote regeneration. Understanding these communication links is key to devise immune-centric regenerative therapies. Thus the present review is an integrated attempt to provide a unified purview of how inflammation and immune cells provide guidance to stem cells for tissue sculpting during development, organismal aging and tissue crisis based on the current knowledge in the field.
Development of a Risk Model for Predicting Microalbuminuria in the Chinese Population Using Machine Learning Algorithms

Objective Microalbuminuria (MAU) occurs due to universal endothelial damage, which is strongly associated with kidney disease, stroke, myocardial infarction, and coronary artery disease. Screening patients at high risk for MAU may aid in the early identification of individuals with an increased risk of cardiovascular events and mortality. Hence, the present study aimed to establish a risk model for MAU by applying machine learning algorithms. Methods This cross-sectional study included 3,294 participants ranging in age from 16 to 93 years. R software was used to analyze missing values and to perform multiple imputation. The observed population was divided into a training set and a validation set according to a ratio of 7:3. The first risk model was constructed using the prepared data, following which variables with P <0.1 were extracted to build the second risk model. The second-stage model was then analyzed using a chi-square test, in which a P ≥ 0.05 was considered to indicate no difference in the fit of the models. Variables with P <0.05 in the second-stage model were considered important features related to the prevalence of MAU. A confusion matrix and calibration curve were used to evaluate the validity and reliability of the model. A series of risk prediction scores were established based on machine learning algorithms. Results Systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), triglyceride (TG) levels, sex, age, and smoking were identified as predictors of MAU prevalence. Verification using a chi-square test, confusion matrix, and calibration curve indicated that the risk of MAU could be predicted based on the risk score. Conclusion Based on the ability of our machine learning algorithm to establish an effective risk score, we propose that comprehensive assessments of SBP, DBP, FBG, TG, gender, age, and smoking should be included in the screening process for MAU.
MicroRNAs as Potential Biomarkers for the Diagnosis of Chronic Kidney Disease: A Systematic Review and Meta-Analysis

For Chronic Kidney Disease (CKD), the study of microRNA as a biomarker has become an exciting area, so we carried out a meta-analysis to investigate the potential diagnostic values of miRNAs in CKD. We searched Pubmed, Cochrane Library, Embase, and Web of science databases to identify relevant publications published from the establishment of the database to April 30, 2021. We included a total of 26 articles containing 56 studies. There were 4,098 patients with CKD and 2,450 patients without CKD. We found that the overall sensitivity and specificity of miRNAs in CKD diagnosis were 0.86 (95% CI: 0.83–0.89) and 0.79 (95% CI: 0.75–0.83), respectively. In addition, we plotted the summary receiver operator characteristic (SROC) curve to assess diagnostic accuracy, with the area under the curve (AUC) of 0.90 (95% CI: 0.87–0.92). Subgroup analysis showed that sensitivity, specificity, and AUC of miRNAs in plasma and serum were 0.84, 0.78, 0.88; and 0.79, 0.76, 0.83, respectively, while miRNAs in urine were 0.89 for sensitivity, 0.82 for specificity, and 0.92 for AUC. Moreover, we found that the panel of microRNAs (miRNAs) could improve the pooled sensitivity (0.88, 0.81, and 0.91 for sensitivity, specificity, and AUC, respectively). We believe that miRNAs have great potential to become an effective diagnostic biomarker for CKD. Panels of miRNA have higher accuracy than single miRNAs. Additionally, miRNAs in both blood and urine have significant accuracy in the diagnosis of CKD; nevertheless, urine is superior.
Using the Extended Acceptance Model to Understand Continuance Intention of Dockless Bike-Sharing

Despite the fact that dockless bike-sharing (DBS) usage first experienced explosive growth, its continuous usage rate remains low. The ultimate success of a DBS service is more dependent on its continued usage rather than its initial adoption. Following the extended technology acceptance model (TAM), this study aims to explore factors that influence the continuance intention of DBS users. The framework of research was validated using a sample of 369 DBS users in China. The results show that perceived usefulness and perceived ease of use positively influence a user’s intention to continue using DBS. Both descriptive social norms and injunctive social norms are positively related to the continuance intention of DBS users. Moreover, environmental concern significantly affects the continuance intention of a user indirectly via perceived usefulness and perceived ease of use. Furthermore, the extended TAM has stronger prediction ability than the original TAM in the context of DBS services.
Modified Long-Axis In-plane Technique for Radial Artery Cannulation in Children: A Randomized Controlled Trial

Background Radial artery catheterization is a challenge for anesthetists in the pediatric population. The purpose of this study was to determine whether the modified long-axis in-plane (MLAX-IP) technique increased the success rate of radial artery catheterization in children. Methods This study involved 80 children who required arterial catheterization and were randomly divided into the MLAX-IP group and dynamic needle tip positioning (DNTP) group (40 cases in each group). Radial artery catheterization was performed using either the MLAX-IP technique or the DNTP technique. Results The first-attempt cannulation success rate was higher in the MLAX-IP group than in the DNTP group (95 vs. 80%, P = 0.043). The imaging time of the artery in the MLAX-IP group was longer than in the DNTP group (19.1 ± 3.1 vs. 9.6 ± 2.4 s, P < 0.001). While the total catheterization time was similar between the 2 groups (88.1 ± 23 vs. 86.9 ± 46.1 s, P = 0.475). Conclusion The first-attempt cannulation success rate with the MLAX-IP technique is increased, while the total catheterization time is similar between the 2 groups and puncture-related complications are fewer.