Miracle-dz/UniFAR-FTUs huggingface dataset:
Stress hyperglycemia may have higher risk of stroke recurrence than previously diagnosed diabetes mellitus

We aim to evaluate the risk of stroke recurrence among non-diabetes mellitus (non-DM), previously diagnosed diabetes mellitus (PDDM), newly diagnosed diabetes mellitus-related hyperglycemia (NDDM-RH) and stress hyperglycemia after minor stroke or TIA. Totally, 3026 patients with baseline fasting glucose and glycated albumin from the CHANCE trial (Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events) were included. Patients were classified as non-DM, PDDM, NDDM-RH and stress hyperglycemia according to the status of glucose metabolism. The primary outcome was stroke recurrence during 90-day follow up. Cox regression was performed to estimate the relationship between the status of glucose metabolism and risk of 90-day stroke recurrence. Compared with PDDM, NDDM-RH had a similar risk of 90-day stroke recurrence (hazard ratios [HR]1.39, 95% confidence intervals [CI] 0.94-2.04), while stress hyperglycemia had approximately a 5.3-fold increased risk of 90-day stroke recurrence after adjusted for confounding covariates (HR 5.32, 95% CI 3.43-8.26). Parallel results were found for 90-day recurrent ischemic stroke and composite events. Compared with PDDM in minor stroke or TIA, a parallel risk of 90-day stroke recurrence were observed for NDDM-RH, while stress hyperglycemia might relate to higher risk of 90-day stroke recurrence.
Effect of age and frailty on the efficacy and tolerability of once‐weekly selinexor, bortezomib, and dexamethasone in previously treated multiple myeloma

Elderly and frail patients with multiple myeloma (MM) are more vulnerable to the toxicity of combination therapies, often resulting in treatment modifications and suboptimal outcomes. The phase 3 BOSTON study showed that once‐weekly selinexor and bortezomib with low‐dose dexamethasone (XVd) improved PFS and ORR compared with standard twice‐weekly bortezomib and moderate‐dose dexamethasone (Vd) in patients with previously treated MM. This is a retrospective subgroup analysis of the multicenter, prospective, randomized BOSTON trial. Post hoc analyses were performed to compare XVd versus Vd safety and efficacy according to age and frailty status (<65 and ≥65 years, nonfrail and frail). Patients ≥65 years with XVd had higher ORR (OR 1.77, p = .024), ≥VGPR (OR, 1.68, p = .027), PFS (HR 0.55, p = .002), and improved OS (HR 0.63, p = .030), compared with Vd. In frail patients, XVd was associated with a trend towards better PFS (HR 0.69, p = .08) and OS (HR 0.62, p = .062). Significant improvements were also observed in patients <65 (ORR and TTNT) and nonfrail patients (PFS, ORR, ≥VGPR, and TTNT). Patients treated with XVd had a lower incidence of grade ≥ 2 peripheral neuropathy in ≥65 year‐old (22% vs. 37%; p = .0060) and frail patients (15% vs. 44%; p = .0002). Grade ≥3 TEAEs were not observed more often in older compared to younger patients, nor in frail compared to nonfrail patients. XVd is safe and effective in patients <65 and ≥65 and in nonfrail and frail patients with previously treated MM.
Human Rhinovirus Infection Blocks Severe Acute Respiratory Syndrome Coronavirus 2 Replication Within the Respiratory Epithelium: Implications for COVID-19 Epidemiology

Abstract Virus-virus interactions influence the epidemiology of respiratory infections. However, the impact of viruses causing upper respiratory infections on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication and transmission is currently unknown. Human rhinoviruses cause the common cold and are the most prevalent respiratory viruses of humans. Interactions between rhinoviruses and cocirculating respiratory viruses have been shown to shape virus epidemiology at the individual host and population level. Here, we examined the replication kinetics of SARS-CoV-2 in the human respiratory epithelium in the presence or absence of rhinovirus. We show that human rhinovirus triggers an interferon response that blocks SARS-CoV-2 replication. Mathematical simulations show that this virus-virus interaction is likely to have a population-wide effect as an increasing prevalence of rhinovirus will reduce the number of new coronavirus disease 2019 cases.
Health care staff's strategies to preserve dignity of migrant patients in the palliative phase and their families. A qualitative study.

AIMS To determine registered nurses' and care assistants' difficulties and strategies for preserving dignity of migrant patients in the last phase of life and their families. BACKGROUND Preserving dignity of patients in a palliative phase entails paying attention to the uniqueness of patients. Migrant patients often have particular needs and wishes that care staff find difficult to address, or meet, and hence the patient's dignity might be at stake. METHODS We performed five focus group discussions with care staff and one with key figures with diverse ethnic backgrounds in the Netherlands (2018-2020). Thematic analysis was used. RESULTS Care staff creatively safeguarded the patient's dignity in daily care by attending to personal needs concerning intimate body care and providing non-verbal attention. Care staff had difficulties to preserve dignity, when the patient's family engaged themselves in the patient's choices or requests. According to care staff, the interference of family impeded the patient's quality of life or threatened the patient's dignity in the last days, or family member's choices (seemingly) prevailed over the patient's wishes. Care staff safeguarded dignity by catering to cultural or religious practices at the end of life and employing cultural knowledge during decision making. Key figures emphasized to make decisions with patient and family together and to listen more carefully to what patients mean. Bypassing family was experienced as harmful, and repetitively informing family, about, for example, the patient's disease or procedures in the nursing home, was experienced as ineffective. CONCLUSION To preserve the patient's dignity, attention is needed for relational aspects of dignity and needs of family, next to patients' individual needs. IMPACT Care staff should be supported to employ strategies to engage family of migrant patients, by, for example, acknowledging families' values, such as giving good care to the patient and the importance of religious practices for dignity.
Broad phenotypic alterations and potential dysfunction of lymphocytes in individuals clinically recovered from COVID-19

Abstract Although millions of patients have clinically recovered from COVID-19, little is known about the immune status of lymphocytes in these individuals. In this study, the peripheral blood mononuclear cells of a clinically recovered (CR) cohort were comparatively analyzed with those of an age- and sex-matched healthy donor cohort. We found that CD8+ T cells in the CR cohort had higher numbers of effector T cells and effector memory T cells but lower Tc1 (IFN-γ+), Tc2 (IL-4+), and Tc17 (IL-17A+) cell frequencies. The CD4+ T cells of the CR cohort were decreased in frequency, especially the central memory T cell subset. Moreover, CD4+ T cells in the CR cohort showed lower programmed cell death protein 1 (PD-1) expression and had lower frequencies of Th1 (IFN-γ+), Th2 (IL-4+), Th17 (IL-17A+), and circulating follicular helper T (CXCR5+PD-1+) cells. Accordingly, the proportion of isotype-switched memory B cells (IgM−CD20hi) among B cells in the CR cohort showed a significantly lower proportion, although the level of the activation marker CD71 was elevated. For CD3−HLA-DR− lymphocytes in the CR cohort, in addition to lower levels of IFN-γ, granzyme B and T-bet, the correlation between T-bet and IFN-γ was not observed. Additionally, by taking into account the number of days after discharge, all the phenotypes associated with reduced function did not show a tendency toward recovery within 4‒11 weeks. The remarkable phenotypic alterations in lymphocytes in the CR cohort suggest that severe acute respiratory syndrome coronavirus 2 infection profoundly affects lymphocytes and potentially results in dysfunction even after clinical recovery.
Projections from the ventral nucleus of the lateral lemniscus to the cochlea in the mouse

Auditory efferents originate in the central auditory system and project to the cochlea. Although the specific anatomy of the olivocochlear (OC) efferents can vary between species, two types of auditory efferents have been identified based upon the general location of their cell bodies and their distinctly different axon terminations in the organ of Corti. In the mouse, the relatively small somata of the lateral (LOC) efferents reside in the lateral superior olive (LSO), have unmyelinated axons, and terminate around ipsilateral inner hair cells (IHCs), primarily against the afferent processes of type I auditory nerve fibers. In contrast, the larger somata of the medial (MOC) efferents are distributed in the ventral nucleus of the trapezoid body (VNTB), have myelinated axons, and terminate bilaterally against the base of multiple outer hair cells (OHCs). Using in vivo retrograde cell body marking, anterograde axon tracing, immunohistochemistry, and electron microscopy, we have identified a group of efferent neurons in mouse, whose cell bodies reside in the ventral nucleus of the lateral lemniscus (VNLL). By virtue of their location, we call them dorsal efferent (DE) neurons. Labeled DE cells were immuno‐negative for tyrosine hydroxylase, glycine, and GABA, but immuno‐positive for choline acetyltransferase. Morphologically, DEs resembled LOC efferents by their small somata, unmyelinated axons, and ipsilateral projection to IHCs. These three classes of efferent neurons all project axons directly to the cochlea and exhibit cholinergic staining characteristics. The challenge is to discover the contributions of this new population of neurons to auditory efferent function.
Fully Distributed Adaptive Event-Triggered Control of Networked Systems With Actuator Bias Faults

In this article, the problem of distributed synchronization of networked systems with actuator bias faults is investigated. To effectively use the limited network bandwidth and avoid the requirement of global information, a novel adaptive event-triggered state feedback controller and a dynamic triggering law are designed jointly by employing a projection operator approach. The proposed synchronization scheme is different from existing ones that have focused on designing controllers and triggering laws independently. Besides, our scheme is extended to design an observer-based distributed adaptive event-triggered controller and corresponding dynamic triggering law when the system states are unmeasurable. Theoretical analysis shows that under the two different distributed event-triggered synchronization schemes, the following three results can be obtained: 1) fully distributed synchronization can be achieved without knowing global information associated with the underlying communication topology and node’s scale; 2) continuous communication among adjacent nodes can be avoided for both designed controllers and dynamic triggering laws; and 3) exclusion of Zeno phenomenon is shown by contradiction. Finally, the effectiveness of the proposed algorithms is verified through three numerical examples.
Socioeconomic status and vitamin D deficiency among women of childbearing age: a population-based, case–control study in rural northern China

Objective To explore the association between socioeconomic status (SES) and vitamin D deficiency/insufficiency of women of childbearing age in rural northern China. Design A population-based, case–control study was conducted. Setting Four counties of Henan Province, China from 2009 to 2010. Participants 1151 non-pregnant healthy women between 18 and 40 years old. Primary and secondary outcome measures Serum 25-hydroxyvitamin D (25(OH)D) levels were measured using high-performance liquid chromatography-tandem mass spectrometry. Vitamin D insufficiency was defined as serum 25(OH)D ≥20 ng/mL and <30 ng/mL, deficiency as ≥10 ng/mL and <20 ng/mL, and severe deficiency as <10 ng/mL. SES was measured separately by women’s and their husbands’ education level and occupation, household income and expenditure, as well as aggregately by SES index constructed with principal component analysis. Results The median serum 25(OH)D level was 20.90 (13.60–34.60) ng/mL, and the prevalence of vitamin D insufficiency, deficiency and severe deficiency was 20.16%, 31.80% and 15.99%, respectively. After adjustment, household annual income <¥10 000 was associated with increased risk of vitamin D insufficiency (adjusted OR (aOR): 2.10, 95% CI 1.41 to 3.14), deficiency (aOR: 1.58, 95% CI 1.09 to 2.29) and severe deficiency (aOR: 2.79, 95% CI 1.78 to 4.38); inadequate household income for expenditure was associated with elevated risk of vitamin D insufficiency (aOR: 1.66, 95% CI 1.08 to 2.54) and deficiency (aOR: 1.81, 95% CI 1.26 to 2.62); low SES index was associated with elevated risk of vitamin D insufficiency (aOR: 2.40, 95% CI 1.52 to 3.80) and deficiency (aOR: 1.64, 95% CI 1.08 to 2.50); and both middle and low SES index were associated with increased risk of vitamin D severe deficiency (aOR: 1.70, 95% CI 1.02 to 2.84; aOR: 2.45, 95% CI 1.45 to 4.14). Conclusions Lower SES was associated with higher risk of vitamin D deficiency/insufficiency in women of childbearing age in rural northern China. More should be done to explore potential mechanisms and to narrow down SES inequalities in vitamin D status.
LIFE IN THE HYPOXIC AND ANOXIC ZONES: METABOLISM AND PROXIMATE COMPOSITION OF CARIBBEAN TROGLOBITIC CRUSTACEANS WITH OBSERVATIONS ON THE WATER CHEMISTRY OF TWO ANCHIALINE CAVES

Abstract The interaction of freshwater, seawater, and limestone creates the unique environment of the anchialine cave. Anchialine cave systems are characterized by the presence of several strong density interfaces that isolate the cave system into components: regions of freshwater at the surface, a hydrogen sulfide layer, and a warm oceanic intrusion that is devoid of oxygen. These unusual physical parameters provide a challenging environment for the organisms that reside there. Within the hypoxic and anoxic regions of the cave system, a unique community of macrofauna has adapted to cope with constant low oxygen conditions and a depauperate food supply. We examined respiration rates and proximate compositions of individuals representing seven orders of troglobitic crustaceans collected from two Bahamian anchialine caves. In addition, we examined the physical conditions of both caves to determine ambient oxygen concentrations. Mass-specific respiration rates of the troglobites were more than an order of magnitude lower than those of comparably sized pelagic crustaceans. When compared to organisms residing in oxygen minimum zones, respiration rates of the troglobites were similar, or in some cases, lower. Enzymes of the troglobites were anaerobically poised with lactate dehydrogenase activities exceeding those of citrate synthase in all species. Malate dehydrogenase activities were greater than lactate dehydrogenase activities, indicating further evolutionary adaptations to an anaerobic environment.
Carbon and Nitrogen Mineralization in Soil Amended with Value-added Manures and Fertilizers under Varying Temperature and Soil Moisture Regimes

The main aim of this study was to quantify the C and N mineralization rates in soil from organic and inorganic fertilizers as affected by temperature and moisture regimes. Laboratory incubation experiment was carried out with eight treatments consisting of combinations of value-added organic manures namely, vermicompost, NADEP compost, FYM and inorganic fertilizers. Soil (40 g) was mixed thoroughly with required quantities of organic manures and chemical fertilizers and placed in 500 mL hermetically sealed flasks and incubated at two temperatures viz., 20 and 35°C and two soil moisture regimes viz., 0.33 bar (field capacity) and 1.0 bar for 7, 15, 30, 60 and 90 days. Destructive samplings were done and C mineralization and mineral N were determined at each interval. Data emanated were fitted to first-order exponential equation to predict the potential mineralizable C (CO) and N (NO) as well as mineralization constants (kC and kN). Results indicated that highest values of C mineralization and mineral N were associated with treatment containing value-added organic manures in combination with fertilizers. Across the incubation periods and treatments, around 15.4% increase in C mineralization was observed due to increase in temperature from 20 to 35°C while 73.3% increase was observed as the soil moisture regime shifted from 1.0 bar to field capacity. Similarly, around 5.7% increase in mineral N was recorded due to increase in temperature from 20 to 35°C while 10.2% increase was observed as the soil moisture regime shifted from 1.0 bar to field capacity. Data on C and N mineralization were well fitted to exponential equation as evidenced from their correlation coefficients (R2) values. Potential mineralizable C and N as well as mineralization constants were significantly influenced by the application of organic manures in combination with fertilizers.
Religiosity and work engagement: Workload as a moderator.

Based on job demands-resources (JD-R) theory, this study examines the relationship between religiosity-from an Islamic lens-and work engagement, and the moderating role of workload on the relationship between these constructs. The results of a survey of 381 Muslim employees in Jordanian telecoms reveal that religiosity is positively related to work engagement. The findings also illustrate the importance of differentiating between challenge and hindrance demands in stressful contexts where workload influences the benefits of religiosity for work engagement. This study highlights the applicability of JD-R theory and extends the theoretical framework by examining the relationship between religiosity and work engagement. It contributes to work engagement literature by introducing religiosity as a personal resource which enhances work engagement and improves well-being. This article is protected by copyright. All rights reserved.
New cytotoxic principles from Datisca glomerata

Datisca glomerata has been systematically fractionated by following cellular toxicity in an effort to identify previously uncharacterized cytotoxic principles. Several new cucurbitacin glycosides, including datiscosides B(8), C(3), D(9), E(4), F(5), G(6), and H(10) and the known compound datiscoside (1), as well as cucurbitacins B(11), D(2), and F(7) have been isolated and characterized. Structures were assigned to the compounds on the basis of their high field 1H n.m. r. , 13C n.m. r. , high-resolution mass spectra (CI, EI, and FD) and chemical interconversions. The structure of datiscoside C(3) was independently established by single-crystal X-ray analysis at 193 and 293 K.
The mediating effect of media usage on the relationship between anxiety/fear and physician–patient trust during the COVID-19 pandemic

Abstract Objective Our study explored whether and how media usage can mediate the path from anxiety and fear to physician–patient trust. Design Study 1 was a population-based, longitudinal study using nationally representative data from 29 provinces in mainland China. The baseline sample (N = 3233) was obtained from February 1 to 9, 2020. Follow-up (N = 1380) took place during March 17 to 24, 2020. Study 2 was a machine learning-based sentiment analysis in which data were captured from Sina Weibo, a Chinese microblogging website, among the most popular official, unofficial, and health-related media accounts. The screened blogs from November to December 2019 and February to March 2020 were scored by Google APIs for positivity and magnitude. Main Outcome Measures Physician-patient trust. Results Study 1 showed fear and anxiety affected changes in physician–patient trust through media usage, the indirect effect of which was 0.14 (0.03) and the 95% CI was [0.08, 0.19]. Study 2 indicated a more positive image of physicians after the outbreak compared to before [F (2, 3537) = 3.646, p = 0.026, partial η2 =0.002]. Conclusion The negative impact of anxiety and fear on physician–patient trust was mediated by media use, which can be explained by the more positive media image during the pandemic.
Pacritinib Combined with Sirolimus and Low-Dose Tacrolimus for GVHD Prevention after Allogeneic Hematopoietic Cell Transplantation: Preclinical and Phase I Trial Results

Purpose: In this first-in-human, phase I, GVHD prevention trial (NCT02891603), we combine pacritinib (PAC), a JAK2 inhibitor, with sirolimus to concurrently reduce T-cell costimulation via mTOR and IL6 activity. We evaluate the safety of pacritinib when administered with sirolimus plus low-dose tacrolimus (PAC/SIR/TAC) after allogeneic hematopoietic cell transplantation. Patients and Methods: The preclinical efficacy and immune modulation of PAC/SIR were investigated in xenogeneic GVHD. Our phase I trial followed a 3+3 dose-escalation design, including dose level 1 (pacritinib 100 mg daily), level 2 (pacritinib 100 mg twice daily), and level 3 (pacritinib 200 mg twice daily). The primary endpoint was to identify the lowest biologically active and safe dose of pacritinib with SIR/TAC (n = 12). Acute GVHD was scored through day +100. Allografts included 8/8 HLA-matched related or unrelated donor peripheral blood stem cells. Results: In mice, we show that dual JAK2/mTOR inhibition significantly reduces xenogeneic GVHD and increases peripheral regulatory T cell (Treg) potency as well as Treg induction from conventional CD4+ T cells. Pacritinib 100 mg twice a day was identified as the minimum biologically active and safe dose for further study. JAK2/mTOR inhibition suppresses pathogenic Th1 and Th17 cells, spares Tregs and antileukemia effector cells, and exhibits preliminary activity in preventing GVHD. PAC/SIR/TAC preserves donor cytomegalovirus (CMV) immunity and permits timely engraftment without cytopenias. Conclusions: We demonstrate that PAC/SIR/TAC is safe and preliminarily limits acute GVHD, preserves donor CMV immunity, and permits timely engraftment. The efficacy of PAC/SIR/TAC will be tested in our ongoing phase II GVHD prevention trial.
Multi-Class Skin Lesion Detection and Classification via Teledermatology

Teledermatology is one of the most illustrious applications of telemedicine and e-health. In this field, telecommunication technologies are utilized to transfer medical information to the experts. Due to the skin's visual nature, teledermatology is an effective tool for the diagnosis of skin lesions especially in rural areas. Furthermore, it can also be useful to limit gratuitous clinical referrals and triage dermatology cases. The objective of this research is to classify the skin lesion image samples, received from different servers. The proposed framework is comprised of two module, which include the skin lesion localization/segmentation and the classification. In the localization module, we propose a hybrid strategy that fuses the binary images generated from the designed 16-layered convolutional neural network model and an improved high dimension contrast transform (HDCT) based saliency segmentation. To utilize maximum information extracted from the binary images, a maximal mutual information method is proposed, which returns the segmented RGB lesion image. In the classification module, a pre-trained DenseNet201 model is re-trained on the segmented lesion images using transfer learning. Afterward, the extracted features from the two fully connected layers are down-sampled using the t-distribution stochastic neighbor embedding (t-SNE) method. These resultant features are finally fused using a multi canonical correlation (MCCA) approach and are passed to a multi-class ELM classifier. Four datasets (i.e., ISBI2016, ISIC2017, PH2, and ISBI2018) are employed for the evaluation of the segmentation task, while HAM10000, the most challenging dataset, is used for the classification task. The experimental results in comparison with the state-of-the-art methods affirm the strength of our proposed framework.