Miracle-dz/UniFAR-FTUs huggingface dataset:
Machine learning-assisted prediction of pneumonia based on non-invasive measures

Background Pneumonia is an infection of the lungs that is characterized by high morbidity and mortality. The use of machine learning systems to detect respiratory diseases via non-invasive measures such as physical and laboratory parameters is gaining momentum and has been proposed to decrease diagnostic uncertainty associated with bacterial pneumonia. Herein, this study conducted several experiments using eight machine learning models to predict pneumonia based on biomarkers, laboratory parameters, and physical features. Methods We perform machine-learning analysis on 535 different patients, each with 45 features. Data normalization to rescale all real-valued features was performed. Since it is a binary problem, we categorized each patient into one class at a time. We designed three experiments to evaluate the models: (1) feature selection techniques to select appropriate features for the models, (2) experiments on the imbalanced original dataset, and (3) experiments on the SMOTE data. We then compared eight machine learning models to evaluate their effectiveness in predicting pneumonia Results Biomarkers such as C-reactive protein and procalcitonin demonstrated the most significant discriminating power. Ensemble machine learning models such as RF (accuracy = 92.0%, precision = 91.3%, recall = 96.0%, f1-Score = 93.6%) and XGBoost (accuracy = 90.8%, precision = 92.6%, recall = 92.3%, f1-score = 92.4%) achieved the highest performance accuracy on the original dataset with AUCs of 0.96 and 0.97, respectively. On the SMOTE dataset, RF and XGBoost achieved the highest prediction results with f1-scores of 92.0 and 91.2%, respectively. Also, AUC of 0.97 was achieved for both RF and XGBoost models. Conclusions Our models showed that in the diagnosis of pneumonia, individual clinical history, laboratory indicators, and symptoms do not have adequate discriminatory power. We can also conclude that the ensemble ML models performed better in this study.
Multi-utility of therapeutic drug monitoring in inflammatory bowel diseases

Inflammatory bowel disease (IBD) treatment targets have progressed over time from clinical response to clinical and endoscopic remission. Several data have shown a positive correlation between serum biologic drug concentrations and favorable therapeutic outcomes. Therapeutic drug monitoring (TDM) has evolved as an important approach for optimizing the use of immunobiologics, especially antitumor necrosis factor therapy, in patients with IBD. The use of TDM is supported by medical societies and IBD experts in different contexts; however, challenges remain due to knowledge gaps that limit the widespread use of it. The aim of this review is to assess the role of TDM in IBD, focusing on the implementation of this strategy in different scenarios and demonstrating the multi-utility aspects of this approach in clinical practice.
Two thousand years of Landscape—Human interactions at a coastal peninsula in Norway revealed through pollen analysis, shoreline reconstruction, and radiocarbon dates from archaeological sites

Human impact on long-term vegetation and biodiversity changes is often discussed on a general level, connecting palynological data to archaeological time periods. In the present paper we present environmental change during the last 2,400 years on a coastal peninsula in Norway using pollen data from three sites: one lake and two bogs, in addition to 621 radiocarbon dates and in-context pollen samples from archaeological sites. Locally, a close relationship between palynological richness reflecting high landscape, habitat and floristic diversity, and the summed probability distribution of radiocarbon dates was found. During the settlement period 400 BCE–550 CE, concordant with maximum number of dates from archaeological contexts, a mosaic landscape containing infields and outfields developed. Cereals were cultivated and animals were grazing in heathlands that could provide both summer grazing and winter fodder. Additionally, seashores and wetlands were used for grazing. Settlement recession from 350 CE and abandonment following the 536 CE climate event, resulted in vegetation successions toward reforestation, abandonment of arable fields, and marshes turning into ombrotrophic peat. At the same time the distance to the sea, and to species rich shoreline meadows, continued to increase due to continuous postglacial land uplift in a flat landscape. A new increase in the summed probability distribution 900–1250 CE, is reflected in expansion of outfield pastures, heathlands in particular, a management that continued up into modern time. The local development is supported by the results on a regional scale, indicating overall climatic and social causes for observed vegetation changes. Both palynological richness and pollen-based landcover reconstructions indicate reforestation and less habitat diversity in the sixth century. On a regional scale, reforestation in the fifteenth century following the late medieval crises, is more pronounced than on the local scale, although both reflect exploitation of outfield resources.
Neutrophils in malaria: A double-edged sword role

Neutrophils are the most abundant leukocytes in human peripheral blood. They form the first line of defense against invading foreign pathogens and might play a crucial role in malaria. According to World Health Organization (WHO), malaria is a globally significant disease caused by protozoan parasites from the Plasmodium genus, and it’s responsible for 627,000 deaths in 2020. Neutrophils participate in the defense response against the malaria parasite via phagocytosis and reactive oxygen species (ROS) production. Neutrophils might also be involved in the pathogenesis of malaria by the release of toxic granules and the release of neutrophil extracellular traps (NETs). Intriguingly, malaria parasites inhibit the anti-microbial function of neutrophils, thus making malaria patients more susceptible to secondary opportunistic Salmonella infections. In this review, we will provide a summary of the role of neutrophils during malaria infection, some contradicting mouse model neutrophil data and neutrophil-related mechanisms involved in malaria patients’ susceptibility to bacterial infection.
Cerebello-Thalamo-Cortical Network Dynamics in the Harmaline Rodent Model of Essential Tremor

Essential Tremor (ET) is a common movement disorder, characterised by a posture or movement-related tremor of the upper limbs. Abnormalities within cerebellar circuits are thought to underlie the pathogenesis of ET, resulting in aberrant synchronous oscillatory activity within the thalamo-cortical network leading to tremors. Harmaline produces pathological oscillations within the cerebellum, and a tremor that phenotypically resembles ET. However, the neural network dynamics in cerebellar-thalamo-cortical circuits in harmaline-induced tremor remains unclear, including the way circuit interactions may be influenced by behavioural state. Here, we examined the effect of harmaline on cerebello-thalamo-cortical oscillations during rest and movement. EEG recordings from the sensorimotor cortex and local field potentials (LFP) from thalamic and medial cerebellar nuclei were simultaneously recorded in awake behaving rats, alongside measures of tremor using EMG and accelerometery. Analyses compared neural oscillations before and after systemic administration of harmaline (10 mg/kg, I.P), and coherence across periods when rats were resting vs. moving. During movement, harmaline increased the 9–15 Hz behavioural tremor amplitude and increased thalamic LFP coherence with tremor. Medial cerebellar nuclei and cerebellar vermis LFP coherence with tremor however remained unchanged from rest. These findings suggest harmaline-induced cerebellar oscillations are independent of behavioural state and associated changes in tremor amplitude. By contrast, thalamic oscillations are dependent on behavioural state and related changes in tremor amplitude. This study provides new insights into the role of cerebello-thalamo-cortical network interactions in tremor, whereby neural oscillations in thalamocortical, but not cerebellar circuits can be influenced by movement and/or behavioural tremor amplitude in the harmaline model.
The impact of implicit theories on resilience among Chinese nurses: The chain mediating effect of grit and meaning in life

Implicit theories refer to assumptions people hold about different domains, also known as mindsets. There are two implicit theories on the malleability of one’s ability: entity theory and incremental theory. They constrain and regulate people’s understanding and responses to an individual’s behavior, leading to different social cognitive patterns and behavioral responses. Resilience is a positive adaptation in highly stressful situations that represents mechanisms for coping with and transcending difficult experiences, i.e., a person’s ability to successfully adapt to change, resist the adverse effects of stressors, avoid significant dysfunction, and be chronically affected by considered a protective factor for mental health. Although previous studies showed that individuals’ implicit theories are associated with resilience, this relationship has received little attention in the nursing population. It is unclear which variables may contribute to explaining the relationship between implicit theories and resilience. Therefore, the current study aims to deeply explore the relationship between implicit theories and the resilience of Chinese nurses. In addition, we also seek to demonstrate the chain mediating effects of grit and meaning in life on this relationship. We surveyed 709 Chinese nurses through online questionnaires using the self-made demographic questionnaire, the Implicit Theories Scale, the Short Grit Scale, the Meaning in Life Questionnaire, and the 10-item Connor-Davidson Resilience Scale. After controlling for demographic variables such as age, gender, educational background, marital status, professional title, and working years, the results reveal positive associations between Chinese nurses’ implicit theories and their resilience, and grit and meaning in life play a partial mediating role in this relationship, respectively. Furthermore, grit and meaning in life play a chain mediating role between implicit theories and resilience. These findings contribute to understanding the psychological impact mechanism of implicit theories on nurses’ resilience and provide a theoretical basis for nursing managers to formulate strategies to improve nurses’ psychological resilience.
Warm beach, warmer turtles: Using drone-mounted thermal infrared sensors to monitor sea turtle nesting activity

For decades sea turtle projects around the world have monitored nesting females using labor-intensive human patrolling techniques. Here we describe the first empirical testing of a drone-mounted thermal infrared sensor for nocturnal sea turtle monitoring; on the Osa peninsula in Costa Rica. Preliminary flights verified that the drone could detect similar sea turtle activities as identified by on-the-ground human patrollers – such as turtles, nests and tracks. Drone observers could even differentiate tracks of different sea turtle species, detect sea turtle hatchlings, other wildlife, and potential poachers. We carried out pilot flights to determine optimal parameters for detection by testing different thermal visualization modes, drone heights, and gimbal angles. Then, over seven nights, we set up a trial to compare the thermal drone and operators’ detections with those observed by traditional patrollers. Our trials showed that thermal drones can record more information than traditional sea turtle monitoring methods. The drone and observer detected 20% more sea turtles or tracks than traditional ground-based patrolling (flights and patrols carried out across the same nights at the same time and beach). In addition, the drone operator detected 39 other animals/predators and three potential poachers that patrollers failed to detect. Although the technology holds great promise in being able to enhance detection rates of nesting turtles and other beach activity, and in helping to keep observers safer, we detail challenges and limiting factors; in drone imagery, current cost barriers, and technological advances that need to be assessed and developed before standardized methodologies can be adopted. We suggest potential ways to overcome these challenges and recommend how further studies can help to optimize thermal drones to enhance sea turtle monitoring efforts worldwide.
Analysis of routine blood parameters in patients with amyotrophic lateral sclerosis and evaluation of a possible correlation with disease progression—a multicenter study

Objective Amyotrophic lateral sclerosis (ALS) pathogenesis is still unclear, its course is considerably variable, and prognosis is hard to determine. Despite much research, there is still a lack of easily accessible markers predicting prognosis. We investigated routine blood parameters in ALS patients regarding correlations with disease severity, progression rate, and survival. Additionally, we analyzed disease and patients' characteristics relating to baseline blood parameter levels. Methods We analyzed creatine kinase (CK), albumin (ALB), creatinine (CREA), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), and triglycerides (TG) levels around time of diagnosis in 1,084 ALS patients. We carried out linear regression analyses including disease and patients' characteristics with each blood parameter to detect correlations with them. Linear regression models were performed for ALSFRS-R at study entry, its retrospectively defined rate of decay and prospectively collected progression rate. Different survival analysis methods were used to examine associations between blood parameters and survival. Results We found higher CK (p-value 0.001), ALB (p-value <0.001), CREA (p-value <0.001), and HDL levels (p-value 0.044) at time of diagnosis being associated with better functional status according to ALSFRS-R scores at study entry. Additionally, higher CREA levels were associated with lower risk of death (p-value 0.003). Conclusions Our results indicate potential of CK, ALB, CREA, and HDL as disease severity or progression markers, and may also provide clues to ALS pathogenesis. However, these values are highly dependent on other variables, and further careful, longitudinal analyses will be necessary to prove the relevance of our findings.
Vagus nerve stimulation for refractory posttraumatic epilepsy: Efficacy and predictors of seizure outcome

Background Traumatic brain injury (TBI) has been recognized as an important and common cause of epilepsy since antiquity. Posttraumatic epilepsy (PTE) is usually associated with drug resistance and poor surgical outcomes, thereby increasing the burden of the illness on patients and their families. Vagus nerve stimulation (VNS) is an adjunctive treatment for medically refractory epilepsy. This study aimed to determine the efficacy of VNS for refractory PTE and to initially evaluate the potential predictors of efficacy. Methods We retrospectively collected the outcomes of VNS with at least a 1-year follow-up in all patients with refractory PTE. Subgroups were classified as responders and non-responders according to the efficacy of VNS (≥50% or <50% reduction in seizure frequency). Preoperative data were analyzed to screen for potential predictors of VNS efficacy. Results In total, forty-five patients with refractory PTE who underwent VNS therapy were enrolled. Responders were found in 64.4% of patients, and 15.6% of patients achieved seizure freedom at the last follow-up. In addition, the responder rate increased over time, with 37.8, 44.4, 60, and 67.6% at the 3-, 6-, 12-, and 24-month follow-ups, respectively. After multivariate analysis, generalized interictal epileptic discharges (IEDs) were found to be a negative predictor (OR: 4.861, 95% CI: 1.145–20.632) of VNS efficacy. Conclusion The results indicated that VNS therapy was effective in refractory PTE patients and was well tolerated over a 1-year follow-up period. Patients with focal or multifocal IEDs were recognized to have better efficacy after VNS therapy.
Impact of Covid-19 on the global orthopaedic research output

The pandemic led to a significant change in the clinical routine of many orthopaedic surgeons. To observe the impact of the pandemic on scientific output all studies published in the fields of orthopaedics listed in the Web of Science databases were analysed regarding the scientific merit of the years 2019, 2020, and 2021. Subsequently, correlation analyses were performed with parameters of regional pandemic situation (obtained from WHO) and economic strength (obtained from the World Bank). The investigations revealed that the Covid-19 pandemic led to a decrease in the annual publication rate for the first time in 20 years (2020 to 2021: –5.69%). There were regional differences in the publication rate, which correlated significantly with the respective Covid-19 case count (r = –.77, p < 0.01), associated death count (r = –.63, p < 0.01), and the gross domestic product per capita (r = –.40, p < 0.01) but not with the number of vaccinations (r = .09, p = 0.30). Furthermore, there was a drastic decrease in funding from private agencies (relative share: 2019: 36.43%, 2020: 22.66%, 2021: 19.22%), and a balanced decrease in publication output for research areas of acute and elective patient care. The Covid-19 pandemic resulted in a decline in orthopaedic annual publication rates for the first time in 20 years. This reduction was subject to marked regional differences and correlated directly with the pandemic load and was associated with decreased research funding from the private sector.
Weight change and fracture risk in patients with diabetic kidney disease: A nationwide population-based study

Background The increased risk of fracture has been associated with weight loss in patients with diabetes or chronic kidney disease. However, the relationship between weight changes over time and fracture risk in patients with diabetic kidney disease is still unknown. Methods A total number of 78,922 patients with diabetic kidney disease, aged ≥ 40 years, were selected using the Korean National Health Insurance Service database, between 2009 and 2012. They were followed up until the end of 2018. Weight change was defined as the difference in body weight from the index year to 2 years later. Weight changes were then divided into five categories, ranging from weight loss of ≥10% to weight gain of ≥10%. Results Fractures were identified in 9,847 patients with diabetic kidney disease, over a median follow-up of 5.2 years. The risk of composite fracture of the vertebral, hip, or other sites increased as the weight change increased. Specifically, patients with ≥10% weight loss (hazard ratio [HR], 1.286; 95% confidence interval [CI], 1.184–1.398) and ≥10% weight gain (HR, 1.198; 95% CI, 1.080–1.330) showed a higher HR compared to those with ≤ 5% weight change after adjusting for several confounding factors. Higher HR of vertebral and hip fractures was also seen with increased weight loss or gain. In particular, patients with ≥10% weight loss showed the highest HR for hip fractures (HR, 1.738; 95% CI, 1.489–2.028). Conclusions Both weight loss and weight gain increase the risk of fracture in patients with diabetic kidney disease. Therefore, patients with diabetic kidney disease who experience weight changes should be made aware of the risk of fracture.
Ride-hailing services: Competition or complement to public transport to reduce accident rates. The case of Madrid

Introduction The transport and mobility sector is experiencing profound transformations. These changes are mainly due to: environmental awareness, the increase in the population of large urban areas and the size of cities, the aging of the population and the emergence of relevant technological innovations that have changed consumption habits, such as electronic commerce or the sharing economy. The introduction of new services such as Uber or Cabify is transforming urban and metropolitan mobility, which has to adapt to this new scenario and the very concept of mobility. Objective Thus, the purpose of this study was to evaluate whether ride-hailing platforms substitute or complement public transport to reduce accident rates, considering the two basic transport zones of Madrid: “The Central Almond” and the periphery. Methods The data were collected from the 21 districts of Madrid for the period 2013–2019, and they were analyzed by a Random Effects Negative Binominal model. Results The results obtained in this study suggest that since the arrival of Uber and Cabify to the municipality of Madrid the number of fatalities and serious injuries in traffic accidents has been reduced. Traffic accidents on weekends and holidays, with at least one serious injury or death, have also been reduced. However, the number of minor injuries has increased in the central districts of Madrid. Conclusion Overall, what was found in this study supports the hypothesis that these services replace the urban buses. However, these services improve the supply to users with greater difficulties to access taxis or public transport, constituting an alternative mode of transport for high-risk drivers. Therefore, such findings may be quite useful for policy makers to better define regulatory policies for these services.
Ketamine as a prophylactic resilience-enhancing agent

Stress exposure is one of the greatest risk factors for psychiatric illnesses, including major depressive disorder (MDD) and posttraumatic stress disorder (PTSD). Enhancing stress resilience could potentially protect against the development of stress-induced psychiatric disorders, yet no resilience-enhancing pharmaceuticals have been developed to date. This review serves to consider the existing evidence for a potential pro-resilience effect of ketamine in rodents as well as the preliminary evidence of ketamine as a prophylactic treatment for postpartum depression (PPD) in humans. Several animal studies have demonstrated that ketamine administered 1 week prior to a stressor (e.g., chronic social defeat and learned helplessness) may protect against depressive-like behavior. A similar protective effect has been demonstrated against PTSD-like behavior following Contextual Fear Conditioning (CFC). Recent work has sought to explore if the administration of ketamine prevented the development of postpartum depression (PPD) in humans. Researchers administered ketamine immediately following caesarian-section and found a significantly reduced prevalence of PPD in the ketamine-treated groups compared to the control groups. Utilizing ketamine as a resilience-enhancing treatment may have unique applications, including leading to a deeper understanding of the neurobiological mechanism underlying resilience. Future trials aiming to translate and replicate these findings with humans are warranted.