Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of patient-reported outcomes as a dialogue-based tool in cancer consultations on patient self-management and health-related quality of life: a clinical, controlled trial

Abstract Background With increased survival among patients with metastatic melanoma and limited time with health care providers, patients are expected to assume a more active role in managing their treatment and care. Activated patients have the knowledge, skills, and confidence to make effective solutions to self-manage health. The use of patient-reported outcomes (PRO) could have the potential to enhance patient activation. However, PRO-based interventions that facilitate an activation in patients with metastatic melanoma are lacking and warranted. Material and methods In this prospective non-randomized controlled, clinical trial, patients with metastatic melanoma were assigned to either the intervention (systematic feedback and discussion of PRO during consultation) given at one hospital or the control group (treatment as usual) if they received treatment from two other hospitals in Denmark. The primary outcome was the patient activation measure (PAM), which reflects self-management. Secondary outcomes were health-related quality of life (HRQoL), self-efficacy, and Patient–Physician interaction. Outcomes were measured at baseline, and after 3, 6, and 12 months. The analysis of the effect from baseline to 12 months employed mixed-effects modeling. Results Between 2017 and 2019, patients were allocated to either the intervention group (n = 137) or the control group (n = 142). We found no significant difference in the course of patient activation between the two groups over time. The course of HRQoL was statistically significantly improved by the intervention compared to the control group. Especially, females in the intervention group performed better than males. The other secondary outcomes were not improved by the intervention. Conclusion The intervention did not improve knowledge, skills, and confidence for self-management for patients with metastatic melanoma. Neither did it improve coping self-efficacy nor perceived efficacy in Patient–Physician interaction. However, the results suggest that the intervention can have a significant impact on HRQoL and in particular social and emotional well-being among the females.
Patients' perceptions of telehealth services for outpatient treatment of substance use disorders during the COVID‐19 pandemic

Abstract Background and Objectives The rapid scale‐up of telehealth services for substance use disorders (SUDs) during the COVID‐19 pandemic presented a unique opportunity to investigate patient experiences with telehealth. This study examined patient perceptions of telehealth in an outpatient SUD treatment program offering individual therapy, group therapy, and medication management. Methods Two hundred and seventy adults receiving SUD outpatient treatment were eligible to complete a 23‐item online survey distributed by clinicians; 58 patients completed/partially completed the survey. Data were summarized with descriptive statistics. Results Participants were predominately male, White, and well‐educated. The majority (86.2%) were “very satisfied” or “satisfied” with the quality of telehealth care. “Very satisfied” ratings were highest for individual therapy (90%), followed by medication management (75%) and group therapy (58%). Top reasons for liking telehealth included the ability to do it from home (90%) and not needing to spend time commuting (83%). Top reasons for disliking telehealth were not connecting as well with other members in group therapy (28%) and the ability for telehealth to be interrupted at home or work (26%). Discussion and Conclusions Telehealth visits were a satisfactory treatment modality for most respondents receiving outpatient SUD care, especially those engaging in individual therapy. Challenges remain for telehealth group therapy. Scientific Significance This is the first study examining patients' perceptions of telehealth for outpatient SUD treatment during the COVID‐19 pandemic by treatment service type. Importantly, while many participants found telehealth more accessible than in‐person treatment, there was variability with respect to the preferred mode of treatment delivery.
Mini‐review: Glucagon responses in type 1 diabetes – a matter of complexity

In recent years the role of altered alpha cell function and glucagon secretion in type 1 diabetes has attracted scientific attention. It is well established that glucagon responses to hypoglycemia are absent in type 1 diabetes, but more uncertain whether it is intact following other physiological and metabolic stimuli compared with nondiabetic individuals. The aim of this review is to (i) summarize current knowledge on glucagon responses during hypoglycemia in normal physiology and type 1 diabetes, and (ii) review human in vivo studies investigating glucagon responses after other stimuli in individuals with type 1 diabetes and nondiabetic individuals. Available data suggest that in type 1 diabetes the absence of glucagon secretion after hypoglycemia is irreversible. This is a scenario specific to hypoglycemia, since other stimuli, including administration of amino acids, insulin withdrawal, lipopolysaccharide exposure and exercise lead to substantial glucagon responses though attenuated compared to nondiabetic individuals in head‐to‐head studies. The derailed glucagon secretion is not confined to hypoglycemia as individuals with type 1 diabetes, as opposed to nondiabetic individuals display glucagon hypersecretion after meals, thereby potentially contributing to insulin resistance. The complexity of these phenomena may relate to activation of distinct regulatory pathways controlling glucagon secretion i.e., intra‐islet paracrine signaling, direct and autonomic nervous signaling.
Trajectory of treatment response in the child and adolescent migraine prevention (CHAMP) study: A randomized clinical trial

Objective Identify preventive medication treatment response trajectories among youth participating in the Childhood and Adolescent Migraine Prevention study. Methods Data were evaluated from 328 youth (ages 8–17). Childhood and Adolescent Migraine Prevention study participants completed headache diaries during a 28-day baseline period and a 168-day active treatment period during which youth took amitriptyline, topiramate, or placebo. Daily headache occurrence trajectories were established across baseline and active treatment periods using longitudinal hierarchical linear modeling. We tested potential treatment group differences. We also compared final models to trajectory findings from a clinical trial of cognitive behavioral therapy plus amitriptyline for youth with chronic migraine to test for reproducibility. Results Daily headache occurrence showed stability across baseline. Active treatment models revealed decreases in headache frequency that were most notable early in the trial period. Baseline and active treatment models did not differ by treatment group and replicated trajectory cognitive behavioral therapy plus amitriptyline trial findings. Conclusions Replicating headache frequency trajectories across clinical trials provides strong evidence that youth can improve quickly. Given no effect for medication, we need to better understand what drives this clinically meaningful improvement. Results also suggest an expected trajectory of treatment response for use in designing and determining endpoints for future clinical trials. Trial Registration. ClinicalTrials.gov Identifier: NCT01581281
Gambling-Related Intimate Partner Violence Against Women: A Grounded Theory Model of Individual and Relationship Determinants

This study aimed to examine how problem gambling interacts with gendered drivers of intimate partner violence (IPV) against women to exacerbate this violence. Interviews were conducted with 48 female victims of IPV linked to a male partner’s gambling; 24 female victims of IPV linked to their own gambling; and 39 service practitioners from 25 services. Given limited research into gambling-related IPV, but a stronger theoretical base relating to IPV against women, this study used an adaptive grounded theory approach. It engaged with existing theories on gendered drivers of violence against women, while also developing a grounded theory model of individual and relationship determinants based on emergent findings from the data. Gambling-related IPV against women was found to occur in the context of expressions of gender inequality, including men’s attitudes and behaviors that support violence and rigid gender expectations, controlling behaviors, and relationships condoning disrespect of women. Within this context, the characteristics of problem gambling and the financial, emotional and relationship stressors gambling causes intensified the IPV. Alcohol and other drug use, and co-morbid mental health issues, also interacted with gambling to intensify the IPV. Major implications. Reducing gambling-related IPV against women requires integrated, multi-level interventions that reduce both problem gambling and gendered drivers of violence. Gambling operators can act to reduce problem gambling and train staff in responding to IPV. Financial institutions can assist people to limit their gambling expenditure and families to protect their assets. Service providers can be alert to the co-occurrence of gambling problems and IPV and screen, treat, and refer clients appropriately. Public education can raise awareness that problem gambling increases the risk of IPV. Reducing gender inequality is also critical.
Effects of Mental Fatigue Induced by Social Media Use on Volleyball Decision-Making, Endurance, and Countermovement Jump Performance

We studied the effects of repeated inducements of mental fatigue (MF) from using social media on smartphones immediately before training sessions by young male volleyball athletes, focusing specifically on their decision-making, endurance, and countermovement jump performance (CMJ). We pair-matched 24 participants according to their decision-making abilities and then, randomly assigned them to one of two 4-week block training groups: control (CON) and smartphone use (SMA). For a 30-minute period before each training session, the CON group watched TV and the SMA group used social media apps on smartphones. We found a significant group x time interaction effect for decision making (attack, p = 0.03; passing, p = 0.02) during training blocks. More specifically, only the CON group improved their decision making (attack, p = 0.03; passing, p = 0.02). Both groups significantly improved their CMJ performance (p = .01), with no significant group x time interaction effect for CMJ (p = 0.91). Neither group significantly improved their endurance (p = 0.56). We concluded that 30-minutes of repetitive social media app use on a smartphone immediately before 4-weeks of volleyball training sessions negatively affected decision-making in young male volleyball athletes.
Stromal cell-derived DEL-1 inhibits Tfh cell activation and inflammatory arthritis.

The secreted protein DEL-1 regulates inflammatory cell recruitment and protects against inflammatory pathologies in animal models. Here, we investigated DEL-1 in inflammatory arthritis using collagen-induced arthritis (CIA) and collagen Ab-induced arthritis (CAIA). In both models, mice with endothelial-specific overexpression of DEL-1 were protected from arthritis relative to WT controls, while arthritis was exacerbated in DEL-1-deficient mice. Compared to WT controls, mice with collagen VI promoter-driven overexpression of DEL-1 in mesenchymal cells were protected against CIA but not CAIA, suggesting a role for DEL-1 in the induction of the arthritogenic Ab response. Indeed, DEL-1 was expressed in perivascular stromal cells of the lymph nodes and inhibited T follicular helper (Tfh) and germinal center B cell responses. Mechanistically, DEL-1 inhibited dendritic cell-dependent induction of Tfh cells by targeting the LFA-1 integrin on T cells. Overall, DEL-1 restrained arthritis through a dual mechanism, one acting locally in the joints and associated with the anti-recruitment function of endothelial cell-derived DEL-1; the other mechanism acting systemically in the lymph nodes and associated with the ability of stromal cell-derived DEL-1 to restrain Tfh responses. DEL-1 may thus be a promising novel therapeutic for the treatment of inflammatory arthritis.
Outcomes following single, caudally based bilateral versus unilateral frontonasal sinusotomy for treatment of equine paranasal sinus disease

Abstract Background Bilateral sinus disease is relatively uncommon in horses, accounting for 3%–4.5% of horses with sinonasal disease, but may require bilateral paranasal surgery for complete resolution. Complications and recurrence following bilateral sinusotomy have not been reported or compared to those following unilateral procedures. Objective To describe clinical features and outcomes in horses undergoing standing single, caudally based bilateral frontonasal sinusotomy compared to unilateral frontonasal surgery. Methods Records of horses (n = 37) undergoing surgical treatment for sinus disease (five bilateral, 32 unilateral) were retrospectively reviewed (2010–2017) for signalment, presenting complaint, duration of signs preoperatively, diagnostic imaging, treatments administered, duration hospitalization, complications, and owner satisfaction with the procedure. Mann–Whitney testing was used to compare age, duration of hospitalization, and follow‐up time in horses undergoing unilateral or bilateral procedures. Fisher's exact testing was used to determine if sex predilection was present for unilateral or bilateral disease. Survival time and time to recurrence were compared by Kaplan–Meier survival curves and log‐rank curve comparison testing. Significance was assessed at p < 0.05. Results Length of signs prior to admission did not differ between horses with unilateral and bilateral disease (p = 0.09), but there was a tendency for horses with bilateral disease to have clinical signs for longer. Age (p = 0.19) and hospitalization duration (p = 0.53) did not differ between horses undergoing unilateral versus bilateral procedures. Recurrence or failure to resolve signs was reported in 11/32 (34%) of unilateral and 0/5 bilateral cases (p = 0.07). Conclusions The bilateral single, caudally based sinusotomy approach may be considered to effectively treat bilateral paranasal sinus disease without concern for increased risk of life‐threatening complications or longer hospitalization duration than would be typical for unilateral sinusotomy procedures.
Nomogram for predicting cancer-specific survival in undifferentiated pleomorphic sarcoma: A Surveillance, Epidemiology, and End Results -based study

Introduction The purpose of this study was to construct and validate a nomogram for predicting cancer-specific survival (CSS) in undifferentiated pleomorphic sarcoma (UPS) patients at 3, 5, and 8 years after the diagnosis. Methods Data for UPS patients were extracted from the SEER (Surveillance, Epidemiology, and End Results) database. The patients were randomly divided into a training cohort (70%) and a validation cohort (30%). The backward stepwise Cox regression model was used to select independent prognostic factors. All of the factors were integrated into the nomogram to predict the CSS rates in UPS patients at 3, 5, and 8 years after the diagnosis. The nomogram’ s performance was then validated using multiple indicators, including the area under the time-dependent receiver operating characteristic curve (AUC), consistency index (C-index), calibration curve, decision-curve analysis (DCA), integrated discrimination improvement (IDI), and net reclassification improvement (NRI). Results This study included 2,009 UPS patients. Ten prognostic factors were identified after analysis of the Cox regression model in the training cohort, which were year of diagnosis, age, race, primary site, histological grade, T, N, M stage, surgery status, and insurance status. The nomogram was then constructed and validated internally and externally. The relatively high C-indexes and AUC values indicated that the nomogram has good discrimination ability. The calibration curves revealed that the nomogram was well calibrated. NRI and IDI values were both improved, indicating that our nomogram was superior to the AJCC (American Joint Committee on Cancer) system. DCA curves demonstrated that the nomogram was clinically useful. Conclusions The first nomogram for predicting the prognosis of UPS patients has been constructed and validated. Its usability and performance showed that the nomogram can be applied to clinical practice. However, further external validation is still needed.
Antennapedia‐derived positively‐charged peptide faces multiple problems upon their usage as targeting ligand for liposomal doxorubicin

The positively‐charged peptide antp derived from Antennapedia transcription protein is demonstrated to mediate the liposome translocation across the cell membrane. In the current investigation, we prepared a stable liposomal doxorubicin (Dox) formulation and targeted it with the antp peptide from 0 to 200 ligand/liposome. These antp‐containing liposomes were investigated in terms of physical stability on storage in the refrigerator and upon incubation in blood. Also, other features like cell binding, uptake, biodistribution, and treatment efficiency were evaluated in C26 colon carcinoma BALB/c mice. The Antp in liposomes resulted in enhanced particle growth with the development of the enormously large liposomes from 2000 to 6000 nm. Upon incubation in blood, these large liposomes were removed. The antp also enhanced the cell binding affinity and cell uptake rate of the liposomes and resulted in the restriction of the cancer cell proliferation, but it failed to improve the chemotherapeutic property of the Dox‐liposome. The i.v. injection of antp‐liposomes (15 mg Dox/kg) caused severe body weight loss and early death incidence due to probably increased toxicity. The antp targeting offered no advantage to the Dox‐liposome in the delivery of Dox to the tumor, and failed to enhance the treatment efficiency of the liposomes.
IL‐23/IL‐17 axis and soluble receptors isoforms sIL‐23R and sIL‐17RA in patients with rheumatoid arthritis‐presenting periodontitis

Rheumatoid arthritis (RA) and periodontitis (P) are chronic inflammatory diseases characterized by joint and radiographic bone loss, respectively. IL‐23 and IL‐17 have an essential role in the immunopathogenesis of RA, and P. IL‐23 stimulates Th17 cells through which produces IL‐17, IL‐21, and RANKL. IL‐17 stimulates fibroblasts to produce RANKL, which initiates bone loss in the joints in RA and the periodontal tissue in periodontitis. The aim of this study was to determine the expression pattern of IL‐23/IL‐17 axis and soluble receptors isoforms sIL‐23R and sIL‐17RA of patients with RA presenting P (RAP).
Eating away from home in Canada: impact on dietary intake.

BACKGROUND Public health measures related to the COVID-19 pandemic have upended the way Canadians eat and shop for food. Since the pandemic began, many Canadians have reported consuming food away from home (FAFH) less often. FAFH tends to be less healthful than food prepared at home. Little is known about patterns of Canadians' FAFH consumption before the pandemic. This study used 2015 national-level nutrition data, the most recent available, to characterize patterns of FAFH consumption and selected markers of dietary intake. DATA AND METHODS National-level food intake data came from the first 24-hour dietary recall provided by 20,475 respondents aged 1 or older to the 2015 Canadian Community Health Survey-Nutrition. Mean daily intakes of selected food subgroups and nutrients, adjusted for total energy intake, were compared between those who had consumed any food in a restaurant on the previous day and those who had not. Estimates were generated overall and for eight age and sex groups. RESULTS In 2015, overall, 21.8% of Canadians had consumed FAFH in a restaurant on the previous day. Eating out was most common among males aged 19 to 54 (27.7%) and least common among young children aged 1 to 5 (8.4%). Compared with Canadians who had not eaten out on the previous day, those who had eaten out had consumed, on that day, fewer servings of whole fruit; whole grains; dark green and orange vegetables; other vegetables (excluding potatoes); milk and fortified soy-based beverages; and legumes, nuts and seeds, on average. Those who had eaten out had consumed, on average, less fibre and total sugar, and more total fat, saturated fat and sodium on that day. There were few differences for meat and poultry, fish and seafood, and protein intake. DISCUSSION On the day that Canadians ate out in a restaurant, their dietary intake was generally less favourable than that of Canadians who did not eat out. If Canadians continue to eat at home more and to consume less FAFH, as early pandemic-period reports suggest, then results can be used to gauge the potential dietary implications of these shifts.
Rare NOTCH3 Variants in a Chinese Population-Based Cohort and Its Relationship With Cerebral Small Vessel Disease

Supplemental Digital Content is available in the text. Background and Purpose: Researches on rare variants of NOTCH3 in the general Chinese population are lacking. This study aims to describe the spectrum of rare NOTCH3 variants by whole-exome sequencing in a Chinese community-based cohort and to investigate the association between rare NOTCH3 variants and age-related cerebral small vessel disease. Methods: The cross-sectional study comprised 1065 participants who underwent whole-exome sequencing and brain magnetic resonance imaging. NOTCH3 variants with minor allele frequency<1% in all 4 public population databases (1000 Genomes, ESP6500siv2_ALL, GnomAD_ALL, and GnomAD_EAS) were defined as rare variants. Multivariable linear and logistic regressions were used to investigate the associations between rare NOTCH3 variants and volume of white matter hyperintensities and cerebral small vessel disease burden. Clinical and imaging characteristics of rare NOTCH3 variant carriers were summarized. Results: Sixty-five rare NOTCH3 variants were identified in 147 of 1065 (13.8%) participants, including 57 missense single nucleotide polymorphisms (SNPs), 5 SNPs in splice branching sites, and 3 frameshift deletions. A significantly higher volume of white matter hyperintensities and heavier burden of cerebral small vessel disease was found in carriers of rare NOTCH3 EGFr (epidermal growth factor-like repeats)-involving variants, but not in carriers of EGFr-sparing variants. The carrying rate of rare EGFr-involving NOTCH3 variants in participants with dementia or stroke was significantly higher than those without dementia or stroke (12.4% versus 6.6%, P=0.041). Magnetic resonance imaging signs suggestive of CADASIL were found in 3.4% (5/145) rare EGFr cysteine-sparing NOTCH3 variant carriers but not in 2 cysteine-altering NOTCH3 variant carriers. Conclusions: Carriers of rare NOTCH3 variants involving the EGFr domain may be genetically predisposed to age-related cerebral small vessel disease in the general Chinese population.