Miracle-dz/UniFAR-FTUs huggingface dataset:
Obesity and its association with mental health among Mexican children and adolescents: systematic review

Abstract Context Obesity and mental health issues increasingly affect children and adolescents, but whether obesity is a risk factor for mental health issues is unclear. Objective To systematically review the association between obesity and mental health issues (ie, anxiety and/or depression) among Mexican children and adolescents. Data sourcing, extraction, and synthesis A literature search of 13 databases and 1 search engine was conducted. Population, exposure, comparison, outcomes, and study design data were extracted, analyzed, and narratively synthesized. The JBI critical appraisal tool was used to evaluate evidence quality. Results A total of 16 studies with 12 103 participants between 8 and 18 years old were included. Four studies focused on anxiety outcomes, 10 on depression, and 2 on both (ie, anxiety and depression). Evidence is unclear about the association of obesity with anxiety. However, most evidence shows that Mexican children and adolescents with overweight or obesity are more likely to have depression or report a higher number of depressive symptoms than normal-weight participants. Such likelihood is greater for females. Conclusion Health promotion interventions to treat or prevent obesity could also consider mental health outcomes. Systematic Review Registration PROSPERO registration no. CRD42019154132
Long-Term Effect of Group Support Psychotherapy on Depression and HIV Treatment Outcomes: Secondary Analysis of a Cluster Randomized Trial in Uganda

ABSTRACT Objective We aimed to determine the effect of group support psychotherapy (GSP) compared with group HIV education (GHE) on depression and HIV treatment outcomes 24 months after treatment. We further aimed to investigate the mediating role of depression and antiretroviral therapy (ART) adherence in the relationship between GSP and viral load suppression. Methods Thirty HIV clinics across three districts were randomly assigned to deliver either GSP or GHE for depression. Depression and optimal (≥95%) ART adherence was assessed at baseline and 6, 12, 18, and 24 months after treatment. Viral load was drawn from the medical charts at baseline and 12 and 24 months after treatment. Multilevel mixed-effects regression models and generalized structural equation modeling were used to estimate 24-month outcomes and mediation effects. Results Participants (N = 1140) were enrolled from HIV clinics offering either GSP (n = 578 [51%]) or GHE (n = 562 [49%]). Fewer GSP than GHE participants met the criteria for depression at 24 months after treatment (1% versus 25%; adjusted odds ratio [aOR] = 0.002, 95% confidence interval [CI] = 0.0002–0.018). More GSP than GHE participants reported optimal (≥95%) ART adherence (96% versus 88%; aOR = 20.88, 95% CI = 5.78–75.33) and improved viral suppression (96% versus 88%; aOR = 3.38, 95% CI = 1.02–11.02). The indirect effects of GSP through sequential reduction in depression and improvement in ART adherence at 12 months may partially explain the higher viral suppression rates at 24 months in GSP than GHE groups. Conclusion In settings where the HIV epidemic persists, depression treatment with GSP may be critical for optimal HIV treatment outcomes. Trial Registration: The Pan African Clinical Trials Registry, number PACTR201608001738234.
ISPAD Clinical Practice Consensus Guidelines 2022: Type 2 diabetes in children and adolescents

Since the 2018 ISPAD guidelines on this topic, follow‐up of large cohorts from around the globe have continued informing the current incidence and prevalence of co‐morbidities and complications in young adults with youth‐onset type 2 diabetes (T2D). This chapter focuses on the risk factors, diagnosis and presentation of youth‐onset T2D, the initial and subsequent management of youth‐onset T2D, and management of co‐morbidities and complications. We include key updates from the observational phase of the multi‐center Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial, the SEARCH for Diabetes in Youth (SEARCH) study and new data from the Restoring Insulin Secretion (RISE) study, a head‐to‐head comparison of youth onset vs adult‐onset T2D. We also include an expanded section on risk factors associated with T2D, algorithms and tables for treatment, management, and assessment of co‐morbidities and complications, and sections on recently approved pharmacologic therapies for the treatment of youth‐onset T2D, social determinants of health, and settings of care given COVID‐19 pandemic.
General Anesthesia vs Conscious Sedation for Endovascular Treatment in Patients With Posterior Circulation Acute Ischemic Stroke: An Exploratory Randomized Clinical Trial.

Importance No definitive conclusion can be made on the best choice of anesthesia for people with acute posterior circulation stroke during endovascular treatment. Only a few observational studies have focused on this topic in recent years, and they have differing conclusions. Objective To examine whether conscious sedation (CS) is a feasible alternative to general anesthesia (GA) during endovascular treatment in patients with acute posterior circulation stroke. Design, Setting, and Participants A randomized parallel-group exploratory trial with blinded end point evaluation (Choice of Anesthesia for Endovascular Treatment of Acute Ischemic Stroke [CANVAS II]) enrolled adult patients from March 2018 to June 2021 at 2 comprehensive care hospitals in China. Patients with acute posterior circulation stroke were enrolled, randomized, and monitored for 3 months. Of 210 patients admitted with acute ischemic posterior circulation stroke, 93 were recruited and 87 were included in the intention-to-treat (ITT) analysis after exclusions, 43 were assigned to GA and 44 to CS. All analyses were unadjusted or adjusted with the ITT principle. Interventions Participants were randomly assigned to CS or GA in a 1:1 ratio. Main Outcomes and Measures The primary end point was functional independence at 90 days evaluated with the modified Rankin Scale (mRS). Results A total of 87 participants were included in the ITT study (mean [SD] age, 62 [12] years; 16 [18.4%] female and 71 [81.6%] male). Of these, 43 were in the GA group and 44 in the CS group. The overall baseline median (IQR) National Institute of Health Stroke Scale (NIHSS) score was 15 (12-17). In the CS group, 13 people (29.5%) were ultimately transferred to GA. The CS group had a higher incidence of functional independence; however, no significant difference was found between the 2 groups (48.8% vs 54.5%; risk ratio, 0.89; 95% CI, 0.58-1.38; adjusted odds ratio [OR], 0.91; 95% CI, 0.37-2.22). However, GA performed better in successful reperfusion (mTICI 2b-3) under ITT analysis (95.3% vs 77.3%; adjusted OR, 5.86; 95% CI, 1.16-29.53). Conclusion and Relevance The findings in this study suggest that CS was not better than GA for the primary outcome of functional recovery and was perhaps worse for the secondary outcome of successful reperfusion. Trial Registration ClinicalTrials.gov Identifier: NCT03317535.
Sociocultural Moderators of Emotion Regulation in Family Members of the Critically Ill

Coping with a loved one’s critical illness as a surrogate decision-maker (SDM) elicits intense psychological distress. Emotion regulation (ER) may mitigate psychological distress. However, ER tendencies and their effects on psychological distress vary by racial and gender identity, which can inform the tailoring of ER-focused interventions. For this study, we examined between-group differences and the moderating effects of race and gender on ER (reappraisal and suppression) and psychological distress. We recruited 274 SDMs from a Midwestern academic medical center. Men reported a greater tendency to use suppression than women, and SDMs identifying as non-White reported a greater tendency to use reappraisal and suppression. Reappraisal resulted in greater psychological distress for non-White men and less psychological distress for White women. Incorporating tailored ER skill building into supportive interventions may improve the short- and long-term psychological well-being of SDMs, which may improve their ability to make value-concordant decisions and fulfill other informal caregiving responsibilities.
A look at the face of the molten globule: Structural model of the Helicobacter pylori apoflavodoxin ensemble at acidic pH

Molten globule (MG) is the name given to a compact, non‐native conformation of proteins that has stimulated the imagination and work in the protein folding field for more than 40 years. The MG has been proposed to play a central role in the folding reaction and in important cell functions, and to be related to the onset of misfolding diseases. Due to its inherent intractability to high‐resolution studies, atomistic structural models have not yet been obtained. We present here an integrative atomistic model of the MG formed at acidic pH by the apoflavodoxin from the human pathogen Helicobacter pylori. This MG has been previously shown to exhibit the archetypical expansion, spectroscopic and thermodynamic features of a molten conformation. To obtain the model, we have analyzed the stability of wild‐type and 55 apoflavodoxin mutants to derive experimental equilibrium Φ values that have been used in biased molecular dynamics simulations to convert the native conformation into an MG ensemble. The ensemble has been refined to reproduce the experimental hydrodynamic radius and circular dichroism (CD) spectrum. The refined ensemble, deposited in PDB‐Dev, successfully explains the characteristic 1H‐nuclear magnetic resonance (NMR) and near‐UV CD spectral features of the MG as well as its solvent‐accessible surface area (SASA) change upon unfolding. This integrative model of an MG will help to understand the energetics and roles of these elusive conformations in protein folding and misfolding. Interestingly, the apoflavodoxin MG is structurally unrelated to previously described partly unfolded conformations of this protein, exemplifying that equilibrium MGs need not to reflect the properties of kinetic intermediates.
Coping in Anger Episodes: Developmental Differences and Self-Efficacy Beliefs

Abstract Anger has been recognized as a natural emotion; however, its poor management in adolescence is associated with some adverse developmental outcomes. The aims of this study were to compare the antecedents and coping strategies of anger episodes between adolescents and adults and the role of perceived self-efficacy on the coping strategies. A total of 88 adolescents (44 female, Mage = 16.81 years, SD = 1.21) and 94 adults (49 female, Mage = 28.11 years, SD = 5.82) reported an anger episode and the coping strategy adopted. Participants also filled in the Regulatory Emotional Self-Efficacy Scale (RESE). The results show that there are no specific antecedents among only adolescents or adults, although there are differences between the two age groups. Furthermore, the results indicate a different use of coping strategies between adolescents and adults. Specifically, a greater propensity of adolescents to use more often maladaptive strategies such as avoidance and denial emerged, but in addiction inaction, considered an adaptive strategy, can also be found. However, although adults use less maladaptive coping strategies they report a high frequency of feeling of powerlessness. The adaptive differences in coping also are explained by the different levels of self-efficacy beliefs of the participants. These findings are discussed in the light of the adaptive role of the coping strategies.
Suicidality Among People Living With HIV From 2010 to 2021: A Systematic Review and a Meta-regression

ABSTRACT Objective The association between human immunodeficiency virus (HIV)/AIDS and suicidality is not well understood, partly because of variability in results. This meta-analysis aimed to investigate the predictive value of HIV/acquired immune deficiency syndrome for incident suicidality. Methods A literature review was conducted of articles published between January 1, 2010, and October 31, 2021. The following databases were searched: Embase, MEDLINE, CINAHL, Web of Science, and Scopus. The search terms included human immunodeficiency virus (HIV), suicidal behavior, auto mutilation, and self-injurious behavior. Observational studies were screened following a registered protocol, and eligible ones were meta-analyzed and followed by meta-regression. Results A total of 43 studies were included in this systematic review, and a meta-regression included 170,234 participants. The pooled prevalence estimates of suicidal ideation, attempted suicide, and deaths by suicide were 22.3%, 9.6%, and 1.7%, respectively. The following significant risk factors for suicide ideation were found: substance use, depression, low quality of life, low social support, without HIV status disclosure, living alone, low level of memory problems, family history of suicide, and stage III of HIV. Risk factors for suicide attempts were depression and family history of suicide. An elevated risk for suicide-related death was found for people living with HIV (PLHIV) who had a psychiatric disorder and in studies conducted in hospital-based settings (versus national database studies or HIV clinic settings). Conclusions The risk of suicidality is high among PLHIV within all six World Health Organization regions during the modern antiretroviral therapy era. Assessment of socioeconomic and psychological factors is recommended for further management to prevent suicide among PLHIV. The present findings are useful for design of intervention protocols and development of clinical practice guidelines intended to manage the well-being of PLHIV worldwide.
Stories of Hope and Health: Wisdom From Older Mexican–American Women Who Broke Free From the Entangled Web of Love and Violence

This interpretive qualitative study explores the lived experience of intimate partner violence (IPV) among 12 older Mexican–American women aged 55–85 with past experiences of IPV to understand how it shaped their lives. Sociocultural factors that influenced the IPV experience and sustained health amidst adversity were explored. Denzin’s interpretive interactionism along with Antonovsky’s salutogenic theory guided this study. These women survived IPV and discovered ways to foster health and thrive in later years. They all vowed to break the cycle of violence for future generations. Their wisdom offers hope and has implications for healthcare professionals, future research, and advocacy efforts.
Area Postrema Syndrome in Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy

Background and Objectives To report the frequency of area postrema syndrome (APS) in glial fibrillary acidic protein-immunoglobulin G (GFAP-IgG)–positive patients and emphasize the importance of APS among the phenotypes in autoimmune GFAP astrocytopathy. Methods Eight GFAP-IgG–positive cases with APS were retrospectively identified during 2015–2021. The APS phenotypes were described. A literature review of 8 previously reported cases was also included in analysis. Results A total of 8 patients (11%) (1 woman, 7 men; mean age: 52.4 ± 18.4 years) presented with APS in a cohort of 74 GFAP-IgG–positive patients, 3 of whom (4%) had disease onset with APS. All patients had hiccups, and hiccups was the unique symptom of APS in 5 patients. The median time from disease onset to APS occurrence was 2 days (range 0–20), and the mean duration of APS episodes was 23.6 ± 11.4 days. No patient had isolated APS attack. All episodes were completely resolved with a mean duration of 9.3 ± 5.4 days after immunotherapy. APS manifestations of 8 cases in previous studies showed similar features with our cases. In total, coexisting aquaporin-4-IgG was only detected in one of the 16 cases. Discussion APS could be an early, but not isolated clinical manifestation of autoimmune GFAP astrocytopathy. Hiccups was the predominant symptom of APS in this disorder. APS attacks of autoimmune GFAP astrocytopathy have good response to immunotherapy.
Galaxy pairs in the Sloan Digital Sky Survey - IV: Interactions trigger AGN

Galaxy-galaxy interactions are predicted to cause gas inflows leading to enhanced nuclear star formation. In this paper we test the further prediction that the gas inflows lead to enhanced accretion onto the central supermassive black hole, triggering activity in the nucleus. Based on a sample of 11,060 SDSS galaxies with a close companion (rp < 80 kpc, Delta V < 200 km/s), we classify AGN based either on emission line ratios or on spectral classification as a quasar. The AGN fraction in the close pairs sample is compared to a control sample of 110,600 mass- and redshift-matched control galaxies with no nearby companion. We find a clear increase in the AGN fraction in close pairs of galaxies with projected separations < 40 kpc by up to a factor of 2.5 relative to the control sample (although the enhancement depends on the chosen S/N cut of the sample). The increase in AGN fraction is strongest in equal mass galaxy pairings, and weakest in the lower mass component of an unequal mass pairing. The increased AGN fraction at small separations is accompanied by an enhancement in the number of `composite' galaxies whose spectra are the result of photoionization by both AGN and stars. Our results indicate that AGN activity occurs (at least in some cases) well before final coalescence and concurrently with ongoing star formation. Finally, we find a marked increase at small projected separations of the fraction of pairs in which BOTH galaxies harbour AGN. We demonstrate that the fraction of double AGN exceeds the expected random fraction, indicating that some pairs undergo correlated nuclear activity. Taken together with complimentary studies, we favour an interpretation where interactions trigger AGN, but are not the only cause of nuclear activity.
Risk factors for suicidal behavior: A Romanian mixed methods study

Objectives: This study had two purposes: to explore the main socio-demographic and medical characteristics of the psychiatric patients with a history of suicidal behavior, and to identify the main risk factors underlying the suicidal ideation and acts among psychiatric patients, in the light of two recent theories of suicidal behavior. Methods: The study is based on a mixed methodological design. During 2019 to 2021, 65 hospitalized psychiatric patients, who committed at least one non-lethal suicide attempt, were investigated using a questionnaire a scales for data collection. Medical records were used to gather data about certain socio-demographic characteristics and the health status of the respondents. Patients also participated in a narrative interview aimed at disclosing their subjective experiences about their past suicidal behavior. Results: The typical psychiatric patient with a history of suicidal behavior, as highlighted by the quantitative analysis, portraits a young old male from an urban environment, childless, educated, having experienced employment problems, being involved in religious activities. The clinical picture of the patient with suicidal antecedents included a moderate or severe level of depression, the presence of socio-emotional loneliness, the manifestation of frequent and long episodes of suicidal ideation, and the intention of committing suicide in order to stop the pain, whose acts resulted in minor injuries. Findings from the qualitative data revealed four major risk factors for the non-lethal suicidal attempts: family disruptions and social problems; economic burdens; a mixture of psychiatric pathologies; and, to a lesser extent, somatic pathologies. Conclusion: This study is the first to explore the triggers of suicide acts conducted in a clinical environment in the Balkan region. Implications of the pandemic are also discussed. The findings are useful for designing prevention strategies based on individual psychotherapy and therapeutic or support groups, addressing the main risk factors behind the suicidal ideation and gestures.
Study of H-mode access conditions on the Alcator C-Mod Tokamak

Usually when sufficient heating power is injected, tokamak plasma will make an abrupt transition into a state with improved confinement, known as the high-confinement mode, or H-mode. Given the greatly enhanced fusion yield, H-mode is foreseen as the baseline scenario for the future plasma operation of the International Thermonuclear Experimental Reactor (ITER). Many research efforts have been given to understand the criteria for Hmode access. To further contribute to this research, a primary focus of this thesis is characterizing the H-mode access conditions in the Alcator C-Mod tokamak, across a broad range of plasma density, magnetic field, and plasma current. In addition, dedicated experiments were designed and executed on C-Mod, to explore the effects of divertor geometry, ICRF resonance location, and main ion species on H-mode access conditions. Results from these experiments will be included in this thesis. The underlying physics of H-mode access is very complex, and the critical mechanisms remain largely unresolved. To promote our understanding, some models proposed for the H-mode transition are tested, using well documented local plasma conditions, obtained in C-Mod experiments. In particular, this thesis pioneers the test of a recently developed model for H-mode threshold power predictions. Thesis supervisor: Earl S. Marmar Title: Senior Research Scientist, Department of Physics Thesis supervisor: Jerry W. Hughes Title: Research Scientist, Plasma Science and Fusion Center Thesis reader: Jan Egedal-Pedersen Title: Associate Professor of Physics, Department of Physics Thesis reader: Nuh Gedik Title: Assistant Professor of Physics, Department of Physics
Prevalence of non-Alcoholic Fatty Liver Disease and Associated Factors in Patients with Moderate or Severe Hemophilia: A Multicenter-Based Study

Introduction Liver health is essential for persons with hemophilia (PWH) in order to maintain access to new therapies, such as gene therapy. Non-alcoholic fatty liver disease (NAFLD) is seldom reported in the hemophilia population. The study aimed to investigate the prevalence of NAFLD and associated factors in PWH. Methods Data of this cross-sectional study were obtained from a multicenter collaborative registry database. Results A total of 163 moderate or severe PWH with a complete data of liver examination were analyzed. There were 77 (47.2%) PWH diagnosed with NAFLD. The multivariate analysis showed that overweight/obesity was associated with NAFLD (OR, 4.31, P < .001). In comparison with hemophilia B patients, hemophilia A patients showed a weaker correlation with NAFLD, (OR, 0.30, P = .009). A total of 17 (25.8%) PWH with NAFLD had an elevated level of alanine transaminase (ALT). Both overweight/obesity and presence of inhibitor to clotting factor were independently associated with elevated ALT in PWH with NAFLD. Conclusions The study indicated that a high prevalence of NAFLD existed in the hemophilia population. Overweight/obesity was an independent factor for NAFLD and elevated ALT.