Miracle-dz/UniFAR-FTUs huggingface dataset:
Low Health Literacy and Mortality in Individuals with Cardiovascular Disease, Chronic Obstructive Pulmonary Disease, Diabetes, and Mental Illness: A 6-Year Population-Based Follow-Up Study

Background: The objective of the study was to examine the impact of health literacy on mortality in the general population and among individuals with cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), diabetes, and mental illness. Methods: Data from a large Danish health survey (n = 29,473) from 2013 were linked with national mortality registry data to permit a 6-year follow-up. Results: Individuals reporting difficulties in understanding information about health, had higher risk of dying during follow-up (hazard rate (HR) 1.38 (95% CI 1.11–1.73)) compared with those without difficulties. Higher risk was also observed among people reporting CVD (HR 1.47 (95% CI 1.01–2.14)), diabetes (HR 1.91 (95% CI 1.13–3.22)) and mental illness (HR 2.18 (95% CI 1.25–3.81)), but not for individuals with COPD. Difficulties in actively engaging with healthcare providers was not associated with an increase in the risk of dying in the general population or in any of the four long-term condition groups. Conclusions: Aspects of health literacy predict a higher risk of dying during a 6-year follow-up period. Our study serves as a reminder to healthcare organizations to consider the health literacy responsiveness of their services in relation to diverse health literacy challenges and needs.
Tribbles Pseudokinase 3 Contributes to Cancer Stemness of Endometrial Cancer Cells by Regulating β-Catenin Expression

Simple Summary Endometrial cancer (EC) is the second most common female malignancy worldwide, but the pathogenesis is not fully understood. Tribbles pseudokinase 3 (TRIB3) is a kind of scaffold protein that may regulate multiple cellular processes by organizing binding partner proteins involving signaling transduction pathways. The goal of this study is to investigate if TRIB3 is involved in the malignant features of EC. Our data demonstrate that TRIB3 positively regulates the cancer stem-cell activity and in vivo tumorigenicity of EC cells by modulating β-catenin signaling through directly interacting with the ELF4 transcription factor. Our results could lead to new insight for developing a novel therapeutic strategy for EC by targeting TRIB3. Abstract Endometrial cancer (EC) is the second most common gynecological malignancy worldwide. Tribbles pseudokinase 3 (TRIB3) is a scaffolding protein that regulates intracellular signal transduction, and its role in tumor development is controversial. Here, we investigated the biological function of TRIB3 in EC. We found that the messenger RNA (mRNA) expression level of TRIB3 was significantly and positively correlated with shorter overall survival of EC patients in The Cancer Genome Atlas database. The protein expression of TRIB3 was found to be significantly increased in EC cancer stem cells (CSCs) enriched by tumorsphere cultivation. Knockdown of TRIB3 in EC cells suppressed tumorsphere formation, the expression of cancer stemness genes, and the in vivo tumorigenesis. The expression of β-catenin at both the protein and the mRNA levels was downregulated upon TRIB3 silencing. TRIB3 was found to interact with E74 Like ETS transcription factor 4 (ELF4) in the nucleus and bound to ELF4 consensus sites within the catenin beta 1 (CTNNB1) promoter in EC cell lines. These data indicated that TRIB3 may regulate CTNNB1 transcription by enhancing the recruitment of ELF4 to the CTNNB1 promoter. In conclusion, our results suggest that TRIB3 plays an oncogenic role in EC and positively regulates the self-renewal and tumorigenicity of EC-CSCs. Targeting TRIB3 is considered as a potential therapeutic strategy in future EC therapy.
Rheumatologists' Acceptance of Patient Referrals from Physical Therapists.

We surveyed Canadian rheumatologists regarding beliefs about physical therapists' (PTs) ability to refer patients appropriately to rheumatologists and whether they would accept such referrals. Most (86.9%) believed that PTs can appropriately refer to rheumatologists. However, only 48.2% of rheumatologists would be very or extremely likely to accept a referral from a PT they knew, and 23.5% would accept a referral from a PT they did not know. Conversely, 90.5% would accept a referral from a PT if they could bill it as a full consult. We conclude that being able to bill PT referrals as full consults may potentially enhance the acceptance of PT referrals.
Safety and Dose-Dependent Effects of Echinacea for the Treatment of Acute Cold Episodes in Children: A Multicenter, Randomized, Open-Label Clinical Trial

Abstract Background: Due to the frequency and severity of cold symptoms in children, and the risk of associated complications, effective treatments are urgently needed. Here we evaluated the safety profile and treatment benefits of Echinacea in children with acute cold and flu symptoms. Methods: A total of 79 children (4–12 years) were randomized to a treatment regimen of three or five times daily Echinaforce Junior tablets (total of 1200 or 2000 mg Echinacea extract, EFJ) for the prospective treatment of upcoming cold and flu episodes at first signs. Parents recorded respiratory symptoms daily during episodes in their child and physicians and parents subjectively rated tolerability. Results: EFJ was used to treat 130 cold episodes in 68 children and was very well tolerated by more than 96% positive physician’s ratings. EFJ-treated cold episodes lasted 7.5 days on average, with nine out of 10 episodes being fully resolved after 10 days. Five EFJ tablets daily reduced the average episode duration by up to 1.7 days (p < 0.02) in comparison to three EFJ tablets daily regimen. Effective symptom resolution finally contributed to a low antibiotic prescription rate in this study of 4.6%. Conclusions: EFJ tablets present a valuable option for the treatment of acute cold episodes in children showing a wide safety margin and increased therapeutic benefits at five tablets daily.
Structural basis for inhibition of the type I-F CRISPR–Cas surveillance complex by AcrIF4, AcrIF7 and AcrIF14

Abstract CRISPR–Cas systems are adaptive immune systems in bacteria and archaea to defend against mobile genetic elements (MGEs) and have been repurposed as genome editing tools. Anti-CRISPR (Acr) proteins are produced by MGEs to counteract CRISPR–Cas systems and can be used to regulate genome editing by CRISPR techniques. Here, we report the cryo-EM structures of three type I-F Acr proteins, AcrIF4, AcrIF7 and AcrIF14, bound to the type I-F CRISPR–Cas surveillance complex (the Csy complex) from Pseudomonas aeruginosa. AcrIF4 binds to an unprecedented site on the C-terminal helical bundle of Cas8f subunit, precluding conformational changes required for activation of the Csy complex. AcrIF7 mimics the PAM duplex of target DNA and is bound to the N-terminal DNA vise of Cas8f. Two copies of AcrIF14 bind to the thumb domains of Cas7.4f and Cas7.6f, preventing hybridization between target DNA and the crRNA. Our results reveal structural detail of three AcrIF proteins, each binding to a different site on the Csy complex for inhibiting degradation of MGEs.
Identification of 5 novel feline erythrocyte antigens based on the presence of naturally occurring alloantibodies.

BACKGROUND Since the discovery of the Mik antigen, several studies have described blood incompatibilities unrelated to the AB system in cats. OBJECTIVE To estimate the prevalence of cats with non-AB incompatibilities associated with naturally occurring alloantibodies (NOAb), and to begin mapping the corresponding feline erythrocyte antigens (FEA). ANIMALS Two hundred and fifty-eight type A cats. METHODS Prospectively, cats were evaluated for the presence of NOAb by crossmatching in groups of 4-6 cats. When NOAb were detected in a cat, its plasma was used as reagent to assess for the presence of the corresponding FEA in all cats included thereafter, and agreement observed between results of this extensive blood typing was evaluated. RESULTS The chance of detecting incompatibilities by randomly crossmatching 2 cats was 3.9%, which resulted in at least 7% of type A cats having NOAb. Blood typing and agreement analyses performed with 7 newly detected NOAb allowed the identification of 5 presumably distinct FEA. Feline erythrocyte antigens 1 and 5 were most frequent with prevalence of 84% and 96%, respectively. Only FEA 1-negative status was associated with a higher risk of presenting NOAb; with 16.7% of 42 FEA 1-negative cats having NOAb compared to 5.1% of 216 FEA 1-positive cats. CONCLUSIONS AND CLINICAL IMPORTANCE This study represents a first step of FEA identification outside the AB system. Because of its prevalence and association with NOAb, FEA 1 might correspond to the Mik antigen.
Inspiratory Muscle Training With an Electronic Resistive Loading Device Improves Prolonged Weaning Outcomes in a Randomized Controlled Trial.

OBJECTIVES To test if the use of an inspiratory muscle training program with an electronic resistive loading device is associated with benefits as to muscle strength, weaning, and survival in the ICU. DESIGN Prospective randomized controlled trial. SETTINGS Study conducted at the ICU of a Navy's hospital, Rio de Janeiro, Brazil, from January 2016 to September 2018. PATIENTS Tracheostomized patients (18-86 yr) on prolonged weaning. INTERVENTIONS Participants were assigned to inspiratory muscle training (intervention group) or a traditional T-piece protocol (control group). In the inspiratory muscle training group, participants underwent training with an electronic inspiratory training device (POWERbreathe K-5; Technologies Ltd, Birmingham, United Kingdom). MEASUREMENTS AND MAIN RESULTS Changes in respiratory muscle strength and rates of ICU survival and weaning success were compared between groups. Forty-eight participants in the inspiratory muscle training group and 53 ones in the control group were included in the final analysis. The inspiratory muscle training was associated with a substantially higher gain on muscle strength as assessed by the maximal inspiratory pressure (70.5 [51.0-82.5] vs -48.0 cm H2O [36.0-72.0 cm H2O]; p = 0.003) and the timed inspiratory effort index (1.56 [1.25-2.08] vs 0.99 cm H2O/s [0.65-1.71 cm H2O/s]; p = 0.001). Outcomes at the 60th day of ICU were significantly better in the intervention group regarding both survival (71.1% vs 48.9%; p = 0.030) and weaning success (74.8% vs 44.5%; p = 0.001). CONCLUSIONS The use of an inspiratory muscle training program with an electronic resistive loading device was associated with substantial muscle strength gain and positive impacts in two very relevant clinical outcomes: the rates of ICU survival and successful weaning.
High temperatures enhance the microbial genetic potential to recycle C and N from necromass in high‐mountain soils

Climate change is strongly affecting high‐mountain soils and warming in particular is associated with pronounced changes in microbe‐mediated C and N cycling, affecting plant‐soil interactions and greenhouse gas balances and therefore feedbacks to global warming. We used shotgun metagenomics to assess changes in microbial community structures, as well as changes in microbial C‐ and N‐cycling potential and stress response genes and we linked these data with changes in soil C and N pools and temperature‐dependent measurements of bacterial growth rates. We did so by incubating high‐elevation soil from the Swiss Alps at 4°C, 15°C, 25°C, or 35°C for 1 month. We found no shift with increasing temperature in the C‐substrate‐degrader community towards taxa more capable of degrading recalcitrant organic matter. Conversely, at 35°C, we found an increase in genes associated with the degradation and modification of microbial cell walls, together with high bacterial growth rates. Together, these findings suggest that the rapidly growing high‐temperature community is fueled by necromass from heat‐sensitive taxa. This interpretation was further supported by a shift in the microbial N‐cycling potential towards N mineralization and assimilation under higher temperatures, along with reduced potential for conversions among inorganic N forms. Microbial stress‐response genes reacted inconsistently to increasing temperature, suggesting that the high‐temperature community was not severely stressed by these conditions. Rather, soil microbes were able to acclimate by changing the thermal properties of membranes and cell walls as indicated by an increase in genes involved in membrane and cell wall modifications as well as a shift in the optimum temperature for bacterial growth towards the treatment temperature. Overall, our results suggest that high temperatures, as they may occur with heat waves under global warming, promote a highly active microbial community capable of rapid mineralization of microbial necromass, which may transiently amplify warming effects.
Deep neural network modeling based virtual screening and prediction of potential inhibitors for renin protein

Abstract Renin enzyme plays an essential role in the Renin-Angiotensin System (RAS), and it is involved in the pathogenesis of hypertension and several other cardiovascular diseases (CVDs). Inhibition of renin is an effective way to intervene with the pathogenesis of these diseases. Docking-based virtual screening, 3D-Quantitative Structure-Activity Relationship (3D-QSAR), and structure-based drug design are the most frequently used strategies towards discovering novel inhibitors targeting renin. In this study, we have developed a 2D fingerprint-based Deep Neural Network (DNN) classifier for virtual screening and a DNN-QSAR model for biological activity prediction. The resulting hits from the DNN-QSAR model were then subjected to the molecular docking to identify further top hits. Molecular Dynamics (MD) simulation was conducted to get a better insight into the binding mode of identified hits. We have discovered six compounds from the Maybridge chemical database with the predicted IC50 values ranging from 24.2 nM to 83.6 nM. To the best of our knowledge, this is the first study that used a cascaded DNN model to identify potential lead compounds for the inhibition of renin target. Through the results presented in this study, we provide evidence of the DNN method being a useful approach to identify new chemical entities/novel lead compounds that may overcome the limitation of existing conventional strategies used in drug discovery research. Communicated by Ramaswamy H. Sarma
In-and-Out of Tobacco Farming: Shifting Behavior of Tobacco Farmers in Indonesia

Understanding the variables that affect farmers’ decisions as to whether to grow tobacco and/or other crops provides important insights into their economic lives and can help to inform the development and implementation of policies that shape both tobacco production and tobacco control, such as increasing tobacco excise taxes. This study employs complementary quantitative and qualitative methodologies to identify variables that affect tobacco farmers’ economic decision making in Indonesia, a major tobacco producer. The research focuses on the variables that affect tobacco farmers’ decisions to continue tobacco farming or shift to non-tobacco farming. It finds that tobacco farmers’ decision making is complex but also predictable. The results of the quantitative analysis suggest that farming profits and positive rainfall shocks are two of the key variables that affect the decision to cultivate tobacco. The qualitative results confirm these findings and further illuminate that access to credit, education (agricultural and otherwise) and information play substantial roles in farmers’ economic decision making. Most of these variables are affected by the unequal relationship between the tobacco firms that buy tobacco and the farmers, wherein the farmers are consistently at a disadvantage in terms of negotiating key parameters such as prices and evaluation of leaf quality.
Cognitive behavioral therapy for misophonia: A randomized clinical trial

Abstract Background Patients with misophonia suffer from anger or disgust confronted with specific sounds such as smacking or breathing. Avoidance of cue‐related situations results in social isolation and significant functional impairment. This is the first randomized, controlled cognitive behavioral therapy (CBT) trial for misophonia, evaluating the short‐ and long‐term efficacy. Methods The evaluator‐blinded, randomized clinical trial was conducted from May 2017 until December 2018 at an academic outpatient clinic. Misophonia patients were randomly assigned to 3 months of weekly group‐CBT or a waiting list and tested at baseline, 3 months (following CBT or waiting list), 6 months (after cross‐over), and 15/18 months (1‐year follow‐up). CBT consisted of task concentration and arousal reduction, positive affect labeling, and stimulus manipulation. Co‐primary outcomes were symptom severity assessed by the Amsterdam Misophonia Scale‐Revised (AMISOS‐R) and improvement on the Clinical Global Impression‐Improvement (CGI‐I). Secondary outcomes were self‐assessed ratings of general psychopathology (Symptom Checklist‐90‐Revised [SCL‐90‐R]) and quality of life (five‐dimensional EuroQol [EQ5‐D], Sheehan Disability Scale [SDS], WHO Quality of Life‐BREF [WHOQoL‐BREF]). Results In all, 54 out of 71 patients were included (mean age, 33.06 [SD, 14.13] years; 38 women [70.4%]) and 46 (85%) completed the study. In the randomized phase, CBT resulted in statistically significant less misophonia symptoms in the short‐term (−9.7 AMISOS‐R; 95% CI, −12.0 to −7.4; p < .001, d = 1.97). The CBT group had an observed clinical improvement (CGI‐I < 3) in 37% compared to 0% in the waiting list group (p < .001). The effect of CBT was maintained at 1‐year follow‐up on primary and secondary outcomes. Conclusions This first randomized control trial shows both short‐term and long‐term efficacy of CBT for misophonia.
Dose‐dependent sensorimotor impairment in human ocular tracking after acute low‐dose alcohol administration

Oculomotor behaviours are commonly used to evaluate sensorimotor disruption due to ethanol (EtOH). The current study demonstrates the dose‐dependent impairment in oculomotor and ocular behaviours across a range of ultra‐low BACs (<0.035%). Processing of target speed and direction, as well as pursuit eye movements, are significantly impaired at 0.015% BAC, suggesting impaired neural activity within brain regions associated with the visual processing of motion. Catch‐up saccades during steady visual tracking of the moving target compensate for the reduced vigour of smooth eye movements that occurs with the ingestion of low‐dose alcohol. Saccade dynamics start to become ‘sluggish’ at as low as 0.035% BAC. Pupillary light responses appear unaffected at BAC levels up to 0.065%.
Cholera Risk: A Machine Learning Approach Applied to Essential Climate Variables

Oceanic and coastal ecosystems have undergone complex environmental changes in recent years, amid a context of climate change. These changes are also reflected in the dynamics of water-borne diseases as some of the causative agents of these illnesses are ubiquitous in the aquatic environment and their survival rates are impacted by changes in climatic conditions. Previous studies have established strong relationships between essential climate variables and the coastal distribution and seasonal dynamics of the bacteria Vibrio cholerae, pathogenic types of which are responsible for human cholera disease. In this study we provide a novel exploration of the potential of a machine learning approach to forecast environmental cholera risk in coastal India, home to more than 200 million inhabitants, utilising atmospheric, terrestrial and oceanic satellite-derived essential climate variables. A Random Forest classifier model is developed, trained and tested on a cholera outbreak dataset over the period 2010–2018 for districts along coastal India. The random forest classifier model has an Accuracy of 0.99, an F1 Score of 0.942 and a Sensitivity score of 0.895, meaning that 89.5% of outbreaks are correctly identified. Spatio-temporal patterns emerged in terms of the model’s performance based on seasons and coastal locations. Further analysis of the specific contribution of each Essential Climate Variable to the model outputs shows that chlorophyll-a concentration, sea surface salinity and land surface temperature are the strongest predictors of the cholera outbreaks in the dataset used. The study reveals promising potential of the use of random forest classifiers and remotely-sensed essential climate variables for the development of environmental cholera-risk applications. Further exploration of the present random forest model and associated essential climate variables is encouraged on cholera surveillance datasets in other coastal areas affected by the disease to determine the model’s transferability potential and applicative value for cholera forecasting systems.
Polymerization of 2-Oxazolines. III. Influence of Polymerization Media on the Propagation Reaction in the Cationic Polymerization of 2-Phenyl-2-oxazoline

Abstract The influence of solvent on the cationic polymerization of 2-phenyl-2-oxazoline initiated with 2-phenyl-2-oxazalinium perchlorate was studied in connection with the physical properties of the solvents used. The polymerizations in all solvents used proceeded successively with little termination and transfer reactions. The propagation rate constant in polar solvents was larger than in nonpolar solvents. The propagation rate constant increased with a decrease in nucleophilicity of the solvent used. In binary solvent systems composed of components with similar nucleophilicities and with different dielectric constants, the propagation rate constant increased with an amount of the polar solvent. In binary solvent systems composed of components with similar dielectric constants and with different nucleophilicities, the propagation rate constant decreased with the amount of the solvent having more nucleophilicity. The activation energy (Ea) of the propagation reaction was about 17-27 kcal/mole, and the a.
The effect of lockdown on intentional and nonintentional injury during the COVID-19 pandemic in Cape Town, South Africa: A preliminary report.

BACKGROUND In response to the coronavirus pandemic, lockdown restrictions and a ban on alcohol sales were introduced in South Africa. Objectives. To investigate the impact of lockdown measures on the number of patients who visited a tertiary urban trauma centre. Methods. The period of investigation was from 1 February to 30 June 2020 and was segmented into three intervals: pre-lockdown (February and March 2020), hard lockdown (April and May 2020) and immediately post lockdown (June 2020). The electronic HECTIS health record registry was interrogated for the total number of patients that were seen per month. These were further categorised according to mechanism of injury (stab, gunshot, blunt assault and road traffic injuries). Penetrating (stab and gunshot) and blunt assault victims were collectively grouped as violent trauma. Results. The mean total number of patients seen decreased by 53% during the hard lockdown period. There was a moderate reduction (15%) in patients with gunshot injuries seen during the hard lockdown phase, but there was an 80% increase in the post-lockdown period. The proportion of patients injured in road traffic collisions pre lockdown, hard lockdown and immediate post lockdown was 16.4%, 8.9% and 11.1%, respectively. Patients injured in road traffic collisions decreased by 74% during the hard lockdown period and maintained a reduction of 32% during the immediate post-lockdown period. The mean total number of patients who visited the trauma unit returned to pre-lockdown levels in June. Conclusions. There was an overall trend of reduced number of patients who visited the trauma unit during the hard lockdown period; however, these numbers returned to pre-lockdown levels during the immediate post-lockdown period. The number of road traffic injury admissions remained reduced during all three phases of lockdown, while the number of gunshot victims increased substantially during the post-lockdown period.