Miracle-dz/UniFAR-FTUs huggingface dataset:
Recurrence of pediatric intussusception: A nationwide population-based descriptive study in Taiwan

Intussusception is frequently observed pediatric emergency that is often followed by recurrent intussusception after initial treatment. This study investigated the risk factors associated with recurrent intussusception in children aged ≤ 3 years. Between January 2007 and December 2015, a cohort study was conducted by linking the Taiwan Maternal and Child Health Database to the Birth Certificate Application database and the National Health Insurance Research Database in Taiwan. Patients aged ≤ 3 years with intussusception diagnosis and related treatment were included in our study. Multivariable logistic regression was used to analyze the risk factors associated with recurrent intussusception. In total, 5341 children with intussusception aged ≤ 3 years were enrolled in our cohort. The adjusted odds ratio (aOR) for recurrent intussusception in children aged 2 to 3 years was 0.62 (95% confidence interval [CI]: 0.47–0.82) compared with children aged < 1 year, and surgery decreased the risk of recurrent intussusception (aOR = 0.64, 95% CI: 0.46–0.88). Male patients had higher risk of recurrent intussusception than female patients had (aOR = 1.41, 95% CI: 1.13–1.75). Higher birth weight may increase the risk of recurrent intussusception, but this association was not statistically significant. Furthermore, gestational age did not seem to affect the risk of recurrent intussusception. Surgical treatment and delayed onset of intussusception are associated with a reduced risk of recurrent intussusception; males are associated with increased risk of recurrent intussusception. In addition, we suggest that in early infancy, patients who received non-surgical treatment as the initial treatment for intussusception should be closely followed up for potential recurrence of intussusception.
Estimating the effect of a rifampicin resistant tuberculosis diagnosis by the Xpert MTB/RIF assay on two-year mortality

Studies assessing patient-centred outcomes of novel rifampicin resistant tuberculosis (RR-TB) diagnostics are rare and mostly apply conventional methods which may not adequately address biases. Even though the Xpert MTB/RIF molecular assay was endorsed a decade ago for simultaneous diagnosis of tuberculosis and RR-TB, the impact of the assay on mortality among people with RR-TB has not yet been assessed. We analysed data of an observational prospective cohort study (EXIT-RIF) performed in South Africa. We applied a causal inference approach using inverse odds of sampling weights to rectify survivor bias and selection bias caused by differing screening guidelines. We also adjusted for confounding using a marginal structural model with inverse probability of treatment weights. We estimated the total effect of an RR-TB diagnosis made by the Xpert assay versus the pre-Xpert diagnostic algorithm (entailing a targeted Line Probe Assay (LPA) among TB-confirmed patients) on two-year mortality and we assessed mediation by RR-treatment initiation. Of the 749 patients diagnosed with RR-TB [247 (33%) by the pre-Xpert diagnostic algorithm and 502 (67%) by the Xpert assay], 42.7% died. Of these, 364 (48.6%) patients died in the pre-Xpert group and 200 (39.8%) in the Xpert group. People diagnosed with RR-TB by the Xpert assay had a higher odds of RR-TB treatment initiation compared to those diagnosed by the targeted LPA-based diagnostic process (OR 2.79; 95%CI 2.19–3.56). Receiving an RR-TB diagnosis by Xpert resulted in a 28% reduction in the odds of mortality within 2 years after presentation to the clinic (ORCI 0.72; 95%CI 0.53–0.99). Causal mediation analysis suggests that the higher rate of RR-TB treatment initiation in people diagnosed by the Xpert assay explains the effect of Xpert on 2-year mortality [natural indirect effect odds ratio 0.90 (95%CI 0.85–0.96). By using causal inference methods in combination with high quality observational data, we could demonstrate that the introduction of the Xpert assay caused a 28% reduction in 2-year odds of mortality of RR-TB. This finding highlights the need for advocacy for a worldwide roll-out of rapid molecular tests. Because the effect is mainly caused by increased RR-TB treatment initiation, health care systems should also ensure timely initiation of effective treatment upon an RR-TB diagnosis.
A robot intervention for adults with ADHD and insomnia–A mixed-method proof-of-concept study

Objective To investigate individual effects of a three-week sleep robot intervention in adults with ADHD and insomnia, and to explore participants’ experiences with the intervention. Methods A proof-of-concept study with a mixed-methods design (n = 6, female = 4) where a repeated ABA single-case study was combined with interviews. Data were collected with the Consensus Sleep Diary, wrist actigraphy, questionnaires on symptoms of insomnia, arousal, emotional distress, and ADHD, and through individual interviews. Results Visual analysis of the sleep diary and actigraphy variables did not support any effects from the robot intervention. Half of participants reported clinically relevant reductions on the Insomnia Severity Index from pre- to post-intervention. No changes regarding ADHD or arousal. Thematic analysis of the interviews resulted in three themes: (1) A pleasant companion, (2) Too much/not enough, and (3) A new routine. Conclusion Adjustments of the intervention ought to be made to match the needs of patients with both ADHD and insomnia before the next trial is conducted.
Food habits of 3 myrmecophilous bug species on myrmecophytic Macaranga (Malpighiales: Euphorbiaceae) vary from herbivory to predation

Abstract Myrmecophytes have mutualistic relationships with symbiotic ants. Although myrmecophytic Macaranga (Malpighiales: Euphorbiaceae) species are well protected by aggressive Crematogaster (Hymenoptera: Formicidae) ants, some bug species occur on the myrmecophytes. To clarify the associations of these bugs with the plants and the ants, we studied the food habits of 3 bug species, Pilophorus lambirensis Nakatani et Komatsu, 2013 (Hemiptera: Miridae: Phylinae), Phylinae sp. 1, and Arbela sp. 1 (Hemiptera: Nabidae). We conducted field observations in a Bornean rainforest. First, we located these bugs and studied their behavioral responses to the ants on Macaranga species; we then conducted stable isotope analyses. All bugs avoided direct contact with ants, but they occurred only on trees with active ants. Pilophorus lambirensis and Phylinae sp. 1 were most commonly observed on the apical parts of host trees, whereas Arbela sp. 1 was mainly in areas distant from the apical parts where ants were sparse. The stable isotope ratios indicated that Phylinae sp. 1 fed on food bodies, which are nutrient-rich spherical bodies produced by Macaranga trees on the apical parts for ants. Although the main diet of the other 2 species remains unclear, nitrogen isotopic signatures demonstrated that P. lambirensis is herbivorous, whereas Arbela sp. 1 is carnivorous. However, the distant location from ants and its isotopic signatures indicated that Arbela sp. 1 rarely fed on the ants. At least 2 mirid bug species might obtain enemy-free space in addition to the food provided by the myrmecophytes.
Workplace bullying and violence in health sector in Saudi Arabia

Workplace bullying violence (BV), with psychological and physical impacts, is increasing globally. However, studies from Saudi Arabia investigating which specialties are most exposed, and linking them with other factors, such as sociodemographic conditions, are scarce. This study aimed to estimate the prevalence of workplace BV over a 12-month period and determine the circumstances related to the event, consequences for the attacker, and targeted personnel among all healthcare providers in the Kingdom of Saudi Arabia (KSA). This analytical cross-sectional study included all health providers registered with the Saudi Commission for Health Specialties who worked for more than 1 year in the healthcare sector (governmental or private) in the KSA until May 2019. In total, 7398 healthcare workers were electively enrolled in the study; 51.3% were men, and 48.7% were women, with a mean age of 40 ± 8.62 years. They were mostly (60%) non-Saudi. Overall, 26.6% encountered BV. Those who worked in the private sector, in shifts, especially evening shifts, were significantly more exposed. Furthermore, pharmacists had the highest prevalence of workplace violence. The prevalence of BV is moderately high; however, it is a serious issue faced by healthcare workers, especially those working night shifts. Pharmacists were more likely to experience bullying. This demonstrates that more support, specific strategies, and policies are required to reduce the occurrence of workplace BV, protect healthcare providers, and prevent attacks. Underreporting these situations may give an incorrect indication of the magnitude of the problem; thus, more education and further studies in the KSA are needed.
Investigating Neurologic Improvement After IV Thrombolysis

Background and Objectives Time from stroke onset is associated with clinical response to intravenous thrombolysis (IVT) with alteplase and is therefore used to select patients for treatment. Alternatively, neuroimaging may be used for treatment in the uncertain or extended time window. We hypothesized that the patient-specific imaging indicator of ischemic lesion progression (“tissue clock”) using CT perfusion (CTP) or quantitative net water uptake (NWU) is a predictor of early neurologic improvement (ENI) independent of time. Methods Observational study of anterior circulation ischemic stroke patients with proximal vessel occlusion and known time from symptom onset triaged by multimodal CT undergoing endovascular treatment. Quantitative NWU using an established threshold (11.5%) or CTP lesion core mismatch (EXTEND criteria) was used to estimate ischemic lesion progression. The treatment effect of IVT depending on lesion progression defined by tissue clock vs time clock was assessed by inverse probability weighting (IPW). End points were binarized ENI and functional independence at day 90. Results Four hundred nine patients were included, of which 223 (54.5%) received IVT. The proportion of patients within an early time window (<4.5 hours), low NWU, and CTP mismatch were 45.0%, 86.5%, and 80.3%. In IPW, IVT was associated with higher rates of ENI (%-difference: 7.3%, p = 0.02). For patients with CTP mismatch or low NWU, IVT was associated with a 9.6% or 7.2% higher rate of ENI, which was different than the effect of IVT in patients without CTP mismatch or high NWU (−9.3%/−7.3%; p = 0.004/p = 0.03), whereas early treatment window did not modify the effect of IVT. Discussion CT-based measures of the “tissue clock” might identify patients who benefit from IVT more accurately than conventional time windows. Considering the high number of patients with early “tissue clock” (low NWU/CTP mismatch) within an extended time window, considerable benefit from IVT using imaging indicators of the “tissue clock” may be achieved.
Not only for Christmas: Prophylactic oral application of trans-cinnamaldehyde alleviates acute murine campylobacteriosis

Abstract The prevalence of Campylobacter jejuni infections is increasing worldwide and responsible for significant morbidities and socioeconomic expenses. The rise in antimicrobial resistance of C. jejuni underscores the urge for evaluating antibiotics-independent compounds as therapeutic and preventive treatment options of human campylobacteriosis. Given its well-known anti-microbial and immune-modulatory properties we here surveyed the disease-modifying effects of trans-cinnamaldehyde pretreatment in experimental campylobacteriosis. Therefore, secondary abiotic IL-10−/− mice were orally challenged with trans-cinnamaldehyde starting 7 days prior C. jejuni infection. Whereas gastrointestinal colonization properties of the enteropathogens remained unaffected, trans-cinnamaldehyde pretreatment did not only improve clinical signs in infected mice, but also alleviated colonic epithelial cell apoptosis on day 6 post-infection. Furthermore, trans-cinnamaldehyde application resulted in less pronounced T cell responses in the colon that were accompanied by dampened proinflammatory mediator secretion in distinct intestinal compartments. Notably, the immune-modulatory effects of trans-cinnamaldehyde were not restricted to the intestinal tract but could also be observed in extra-intestinal organs such as the liver and kidneys. In conclusion, our preclinical placebo-controlled intervention study provides first evidence that due to its immune-modulatory effects, trans-cinnamaldehyde constitutes a promising prophylactic option to alleviate campylobacteriosis.
Randomized Phase III Study Comparing Neoadjuvant Chemotherapy Followed by Surgery Versus Chemoradiation in Stage IB2-IIB Cervical Cancer: EORTC-55994

The EORTC-55994 trial compared neoadjuvant chemotherapy (NACT) followed by radical surgery with concomitant chemoradiation (CCRT) in patients with Stage IB2-IIB cervical cancer. This trial took almost 12 years to recruit 626 patients with a median follow-up of 8.7 years. PURPOSE This multicenter trial by the European Organisation for Research and Treatment of Cancer Gynecological Cancer Group was motivated by conflicting evidence on the value of neoadjuvant chemotherapy before surgery compared with concomitant chemoradiotherapy (CCRT) in stage IB2-IIB cervical carcinoma. METHODS Between May 2002 and January 2014, 626 patients with International Federation of Gynecology and Obstetrics stage IB2-IIb were randomly assigned between neoadjuvant chemotherapy followed by surgery (NACT-S; n = 314) and standard CCRT (n = 312). The primary end point was 5-year overall survival (OS) rate. Secondary end points were progression-free survival, OS, toxicity, and health-related quality of life (HRQOL). RESULTS After a median follow-up of 8.7 years, 198 patients (31.6%) died. Age, stage, and cell type were balanced in both arms. Protocol treatment was completed in 223 of 314 (71%) patients in NACT-S and 257 of 312(82%) in CCRT arms. Main reasons for incomplete protocol treatment were toxicity (30 of 314; 9.6%) and progressive disease (21 of 314; 6.7%) in the NACT-S arm and toxicity (23 of 312; 7.4%) and patient refusal (13 of 312; 4.2%) in the CCRT arm. Additional radiotherapy after completed NACT-S was given to 107 patients (48%), and additional surgery to 20 patients (8%) after completed CCRT. Short-term adverse events (AEs) ≥grade 3 occurred more frequently with NACT-S (41% v 23%), and long-term AEs ≥grade 3 more often with CCRT (21% v 15%). The 5-year OS was not significantly different between NACT-S (72%; 95% CI, 66 to 77) and CCRT (76%; 95% CI, 70 to 80). CONCLUSION This trial failed to demonstrate superiority in favor of the NACT-S arm but resulted in acceptable morbidity and HRQOL in both arms.
Theory-based Trial to Promote Uptake and Sustained Use of Face Coverings During the COVID-19 Pandemic

Abstract Background Transmission of airborne viruses can be mitigated by wearing face coverings but evidence suggests that face covering declines with the removal of relevant legislation, partly due to low automatic motivation. Purpose Test whether an intervention based on implementation intentions could support people’s automatic motivation and promote face covering during the COVID-19 pandemic. Methods Randomized controlled design. At baseline (May 20 to June 6, 2022), 7,835 UK adults reported how much time they spent wearing face coverings in work, public transport, and indoor leisure settings as well as their capabilities, opportunities, and motivations. 3,871 participants were randomized to form implementation intentions; 3,964 control participants completed questionnaires only. Measures were repeated 6 months postbaseline (November 1 to November 14, 2022). Data were analyzed using mixed measures ANOVAs and Bayes Factors to examine whether the observed data supported the experimental hypothesis. Results The proportion of time spend wearing face coverings declined substantially across the 6-month study period, from 15.28% to 9.87% in work settings, 38.31% to 24.55% on public transport, and 9.58% to 7.85% in leisure settings. Bayes Factors indicated moderate relative evidence of no effect of implementation intentions on behavior in work and leisure settings, and inconclusive evidence of a positive effect on public transport. Conclusions In the context of declining COVID-19 rates and removal of legal mandates, implementation intentions were not effective in sustaining face covering. Further research is required to ensure that evidence-based interventions are prepared and deployed in the event of future pandemics.
Comparison of disability level between Early and Late Onset Parkinson’s Disease using WHODAS 2

Background: Parkinson's disease (PD) is a degenerative neurological disorder that usually affects people over the age of 60. However, 10-20% of patients have an early onset of PD (EOPD). Objectives: To compare disability levels according to the World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2) between people with EOPD and those with late-onset PD (LOPD). Methods: We conducted a cross-sectional study with 95 EOPD patients (mean-age 44.51{+/-}4.63, H&Y 1.93{+/-}0.93) and 255 LOPD patients (mean-age 63.01{+/-}7.99, H&Y 2.02{+/-}0.95). Demographic information, clinical characteristics, cognitive evaluation by Telephone-Montreal-Cognitive-Assessment (T-MoCA), functionality self-evaluation by WHODAS-2 and the Unified-Parkinson's-Disease-Rating-Scale (MDS-UPDRS), parts I and II, were documented for each patient by an individual remote interview. Results: Analysis showed a statistically significant difference between EOPD and LOPD in the cognition and activities of daily-living-related to work/school domains of WHODAS-2. T-MoCA scores confirmed more impaired cognition capacity in LOPD. The two groups had no significant differences in levodopa daily dosage, Hoehn and Yahr (H&Y) stages, disease time duration, and MDS-UPDRS I and II scores. Conclusion: People living with EOPD face similar disability levels as those with LOPD, except for cognition, where LOPD patients exhibited higher levels of disability than EOPD and for work activities where the EOPD exhibited higher levels of disability than LODP. These results highlight the challenges faced by people with EOPD in interacting with society and living with the disease for a longer time. The WHODAS-2 can be a useful tool to assess disability and tailor interventions for people with PD of different age groups.
Sertoli cell-enriched proteins in mouse and human testicular interstitial fluid

Sertoli cells support the development of sperm and the function of various somatic cells in the interstitium between the tubules. Sertoli cells regulate the function of the testicular vasculature and the development and function of the Leydig cells that produce testosterone for fertility and virility. However, the Sertoli cell-derived factors that regulate these cells are largely unknown. To define potential mechanisms by which Sertoli cells could support testicular somatic cell function, we aimed to identify Sertoli cell-enriched proteins in the testicular interstitial fluid (TIF) between the tubules. We previously resolved the proteome of TIF in mice and humans and have shown it to be a rich source of seminiferous tubule-derived proteins. In the current study, we designed bioinformatic strategies to interrogate relevant proteomic and genomic datasets to identify Sertoli cell-enriched proteins in mouse and human TIF. We analysed proteins in mouse TIF that were significantly reduced after one week of acute Sertoli cell ablation in vivo and validated which of these are likely to arise primarily from Sertoli cells based on relevant mouse testis RNASeq datasets. We used a different, but complementary, approach to identify Sertoli cell-enriched proteins in human TIF, taking advantage of high-quality human testis genomic, proteomic and immunohistochemical datasets. We identified a total of 47 and 40 Sertoli cell-enriched proteins in mouse and human TIF, respectively, including 15 proteins that are conserved in both species. Proteins with potential roles in angiogenesis, the regulation of Leydig cells or steroidogenesis, and immune cell regulation were identified. The data suggests that some of these proteins are secreted, but that Sertoli cells also deposit specific proteins into TIF via the release of extracellular vesicles. In conclusion, we have identified novel Sertoli cell-enriched proteins in TIF that are candidates for regulating somatic cell-cell communication and testis function.
Identification of a novel inhibitor of SARS‐CoV‐2 main protease: an in silico, biochemical, and cell‐based approach

The recurrent nature of coronavirus outbreaks, severity of the COVID‐19 pandemic, rapid emergence of novel variants, and concerns over the effectiveness of existing vaccines against novel variants have highlighted the need to develop therapeutic interventions. Targeted efforts to identify inhibitors of crucial viral proteins are the preferred strategy. In this study, we screened FDA‐approved and natural product libraries using in silico approach for potential hits against the SARS‐CoV‐2 main protease (Mpro) and experimentally validated their potency using in vitro biochemical and cell‐based assays. Seven potential hits were identified through in silico screening and were subsequently evaluated in SARS‐CoV‐2‐based cell‐free assays, followed by testing in the HCoV‐229E‐based culture system. Of the tested compounds, 4‐(3,4‐dihydroxyphenyl)‐6,7‐dihydroxy‐1‐isopropyl‐1H‐benzofuro[3,2‐b]pyrazolo[4,3‐e]pyridin‐3(2H)‐one (PubChem CID:71755304, hereafter referred to as STL522228) exhibited significant antiviral activity. Subsequently, its potential as a novel COVID therapeutic molecule was validated in the SARS‐CoV‐2‐culture system, where STL522228 demonstrated superior antiviral activity (EC50 = 0.44 μm) compared to Remdesivir (EC50 = 0.62 μm). Based on these findings, we report the strong anti‐coronavirus activity of STL522228, and propose that it as a promising pan‐coronavirus Mpro inhibitor for further experimental and preclinical validation.