Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluating Point-of-Care Nucleic Acid Tests in Adult Human Immunodeficiency Virus Diagnostic Strategies: A Côte d’Ivoire Modeling Analysis

Abstract Background The World Health Organization (WHO) human immunodeficiency virus (HIV) diagnostic strategy requires 6 rapid diagnostic tests (RDTs). Point-of-care nucleic acid tests (POC NATs) are costlier, less sensitive, but more specific than RDTs. Methods We simulated a 1-time screening process in Côte d’Ivoire (CI; undiagnosed prevalence: 1.8%), comparing WHO- and CI-recommended RDT-based strategies (RDT-WHO, RDT-CI) and an alternative: POC NAT to resolve RDT discordancy (NAT-Resolve). Costs included assays (RDT: $1.47; POC NAT: $27.92), antiretroviral therapy ($6–$22/month), and HIV care ($27–$38/month). We modeled 2 sensitivity/specificity scenarios: high-performing (RDT: 99.9%/99.1%; POC NAT: 95.0%/100.0%) and low-performing (RDT: 91.1%/82.9%; POC NAT: 93.3%/99.5%). Outcomes included true-positive (TP), false-positive (FP), true-negative (TN), or false-negative (FN) results; life expectancy; costs; and incremental cost-effectiveness ratios (ICERs: $/year of life saved [YLS]; threshold ≤$1720/YLS [per-capita gross domestic product]). Results Model-projected impacts of misdiagnoses were 4.4 years lost (FN vs TP; range, 3.0–13.0 years) and a $5800 lifetime cost increase (FP vs TN; range, $590–$14 680). In the high-performing scenario, misdiagnoses/10 000 000 tested were lowest for NAT-Resolve vs RDT-based strategies (FN: 409 vs 413–429; FP: 14 vs 21–28). Strategies had similar life expectancy (228 months) and lifetime costs ($220/person) among all tested; ICERs were $3450/YLS (RDT-CI vs RDT-WHO) and $120 910/YLS (NAT-Resolve vs RDT-CI). In the low-performing scenario, misdiagnoses were higher (FN: 22 845–30 357; FP: 83 724–112 702) and NAT-Resolve was cost-saving. Conclusions We projected substantial clinical and economic impacts of misdiagnoses. Using POC NAT to resolve RDT discordancy generated the fewest misdiagnoses and was not cost-effective in high-performing scenarios, but may be an important adjunct to existing RDT-based strategies in low-performing scenarios.
Efficacy and Safety Profile of Ivosidenib in the Management of Patients with Acute Myeloid Leukemia (AML): An Update on the Emerging Evidence

Abstract The isocitrate dehydrogenase enzyme, catalyzing isocitrate conversion to α-ketoglutarate (αKG) in both the cell cytoplasm and mitochondria, contributes to the production of dihydronicotinamide-adenine dinucleotide phosphate (NADPH) as a reductive potential in various cellular processes. IDH1 gene mutations are revealed in up to 20% of the patients with acute myeloid leukemia (AML). A mutant IDH enzyme, existing in the cell cytoplasm and possessing neomorphic activity, converts αKG into oncometabolite R-2-hydroxyglutarate (R-2-HG) that accumulates in high amounts in the cell and inhibits αKG-dependent enzymes, including epigenetic regulators. The resultant alteration in gene expression and blockade of differentiation ultimately lead to leukemia development. Myeloid differentiation capacity can be restored by obstruction of the mutant enzyme, inducing substantial reduction in R-2-HG levels. Ivosidenib, a potent selective inhibitor of mutant IDH1, is a differentiating agent shown to be clinically effective in newly diagnosed AML (ND-AML) and relapsed/refractory (R/R) AML harboring this mutation. The drug is approved by the Food and Drug Administration (FDA) as a single-agent treatment for R/R AML. Significance of mutated IDH1 targeting and a potential role of ivosidenib in AML management, when used either as a single agent or as part of combination therapies, will be reviewed herein.
The Phenomenon of Gene Rearrangement is Frequently Associated with TP53 Mutations and Poor Disease-Free Survival in Hepatocellular Carcinoma

Purpose Gene rearrangements (GRs) have been reported to be related to adverse prognosis in some tumours, but the relationship in hepatocellular carcinoma (HCC) remains less studied. The objective of our study was to explore the clinicopathological characteristics and prognosis of HCC patients (HCCs) with GRs (GR-HCCs). Patients and Methods This retrospective study included 297 HCCs who underwent hepatectomy and had their tumours sequenced by next-generation sequencing. Categorical variables between groups were compared by the chi-square test. The impact of variables on disease-free survival (DFS) and survival after relapse (SAR) was analysed by the Kaplan–Meier method and Cox regression. Results We observed four repetitive GR events in 297 HCCs: BRD9/TERT, ARID2/intergenic, CDKN2A/intergenic and OBSCN truncation. GR-HCCs frequently presented with low tumour differentiation, tumour necrosis, microvascular invasion, elevated AFP and gene mutations (TP53, NTRK3 and BRD9). The 1-, 2-, and 3-year cumulative DFS rates in GR-HCCs were 45.1%, 31.9%, 31.9%, respectively, which were significantly lower than those of GR-negative HCCs (NGR-HCCs) (72.5%, 57.9%, and 49.0%, respectively; P = 0.001). GR was identified as an independent risk factor for inferior DFS in HCCs (HR = 1.980, 95% CI = 1.246–3.147; P = 0.004). However, there was no significant difference in SAR between GR-HCCs and NGR-HCCs receiving targeted therapy or immunotherapy. Conclusion GR is frequently associated with TP53 mutations and significantly affects DFS following radical resection for HCC. We recommend that GR-HCCs should be closely followed up as a high-risk group for postoperative recurrence.
Measuring Quality of Life Following Robot-Assisted Radical Prostatectomy

Background Prostate cancer (PCa) represents the most common solid organ malignancy in men. Fortunately, at the time of diagnosis, the majority of cases are staged as localized or regional disease, conferring excellent 5- and 10-year cure rates. There are several first line treatment options including surgical approaches such as robot-assisted radical prostatectomy (RARP) and radiation therapy (RT) available to patients with localized disease that offer similar PCa oncologic outcomes but are associated with potentially significant side effects which may impact health-related quality of life (HRQOL) domains. Recently, clinicians and investigators have sought to better understand these changes in HRQOL metrics with the utilization of patient-reported outcomes (PRO). Given that RARP represents the most common surgical treatment for PCa in the United States, there has been a particular interest in assessing these outcomes derived by patient perspectives to more fully appreciate treatment-related impact on quality of life following RARP. Objective This narrative review sought to explore the instruments available to measure quality of life after RARP, a review of the PRO data after RARP, and future directions for assessing and improving quality of life outcomes following this surgery. Clinical Use There are several treatment options for men diagnosed with local and regional prostate cancer with similar oncologic outcomes but differing patterns of side effects affecting post-treatment quality of life. Understanding data reported directly by patients following RARP about their side effects and quality of life gives providers additional information for appropriate preoperative counseling for patients choosing between treatment options for their prostate cancer.
Serum Folate and All-Cause Mortality is of Non-Linear Relationship Among Population with Chronic Kidney Disease: A Retrospective Cohort Study

Aim A transition toward high serum folate concentrations has been noticed following the mandatory folate fortification. To explore this further, we studied the relationship between folate and health outcomes in population with chronic kidney disease (CKD). Methods We retrospectively explored the relationships between serum folate and risk of all-cause death in this population. We analyzed data of 2142 subjects with CKD who participated in the National Health and Nutrition Examination Survey (NHANES) 1999–2006. Vital status was followed through December 31, 2006. Results Cox regression was used to estimate hazard ratios (HRs) of mortality for individuals with serum folate in rest quintiles compared with individuals with the fourth quintile. After an average follow-up of 57.4 months with 157 deaths recorded, a reversed J-shaped association was revealed after conducting multivariable adjustment. The mortality rate in population with lower and higher folate levels were 8.29% and 12.67%, respectively, and the corresponding adjusted HRs were 2.41 (95% confidence interval, CI=1.32–4.40) and 2.10 (1.20–3.70). Kaplan–Meier curve showed survival benefits for the fourth quintile of serum folate as compared to the first and fifth quintile. Conclusion Serum folate concentrations may influence all-cause mortality in a non-linear pattern in the CKD population. It is reasonable to recommend periodic surveillance in the CKD population to maintain the serum folate concentration in an appropriate level.
Early childhood education and care (ECEC) during COVID‐19 boosts growth in language and executive function

Abstract High‐quality, centre‐based education and care during the early years benefit cognitive development, especially in children from disadvantaged backgrounds. During the COVID‐19 pandemic and its associated lockdowns, access to early childhood education and care (ECEC) was disrupted. We investigate how this period affected the developmental advantages typically offered by ECEC. Using parent‐report data from 189 families living in the UK, we explore associations between time spent in ECEC by 8‐to‐36‐month‐olds, their socioeconomic background, and their growth in language and executive functions between Spring and Winter 2020. Receptive vocabulary growth was greater in children who continued to attend ECEC during the period, with a stronger positive effect for children from less advantaged backgrounds. The growth of cognitive executive functions (CEFs) was boosted by ECEC attendance during the period, regardless of socioeconomic background. Our findings highlight the importance of high‐quality ECEC for the development of key skills and for levelling socioeconomic inequalities.
Niche differentiation in a postglacial colonizer, the bank vole Clethrionomys glareolus

Abstract Species‐level environmental niche modeling has been crucial in efforts to understand how species respond to climate variation and change. However, species often exhibit local adaptation and intraspecific niche differences that may be important to consider in predicting responses to climate. Here, we explore whether phylogeographic lineages of the bank vole originating from different glacial refugia (Carpathian, Western, Eastern, and Southern) show niche differentiation, which would suggest a role for local adaptation in biogeography of this widespread Eurasian small mammal. We first model the environmental requirements for the bank vole using species‐wide occurrences (210 filtered records) and then model each lineage separately to examine niche overlap and test for niche differentiation in geographic and environmental space. We then use the models to estimate past [Last Glacial Maximum (LGM) and mid‐Holocene] habitat suitability to compare with previously hypothesized glacial refugia for this species. Environmental niches are statistically significantly different from each other for all pairs of lineages in geographic and environmental space, and these differences cannot be explained by habitat availability within their respective ranges. Together with the inability of most of the lineages to correctly predict the distributions of other lineages, these results support intraspecific ecological differentiation in the bank vole. Model projections of habitat suitability during the LGM support glacial survival of the bank vole in the Mediterranean region and in central and western Europe. Niche differences between lineages and the resulting spatial segregation of habitat suitability suggest ecological differentiation has played a role in determining the present phylogeographic patterns in the bank vole. Our study illustrates that models pooling lineages within a species may obscure the potential for different responses to climate change among populations.
Physical and Mental Fatigue in Subjects Recovered from COVID-19 Infection: A Case–Control Study

Purpose Much effort has been directed toward studying COVID-19 symptoms; however, the post–COVID-19 phase remains mysterious. The aim of this work was to conduct a clinical and neurophysiological evaluation of physical and mental fatigue in COVID-19 long-haulers and to study whether markers of COVID-19 severity are able to predict the likelihood of developing postinfectious fatigue syndrome (PIFS) in such patients. Patients and Methods This case–control study was conducted on 46 COVID-19 long-haulers who met the criteria for PIFS and 46 recovered COVID-19 subjects without any residuals. Clinical assessment of fatigue was done using a fatigue questionnaire. Repetitive nerve stimulation and single-fiber electromyography were done after excluding neuropathy and myopathy. Results The median value for physical fatigue was 4 (IQR 2–7), while that for mental fatigue was 2 (IQR 0–3). Each day’s increase in the period of COVID-19 illness increased the odds of PIFS in COVID-19 long-haulers 1.104-fold, and each unit increase in ferritin increased the odds of PIFS 1.006-fold. A significant decrement in at least one muscle was observed in 50% of patients. Patients with PIFS had significantly higher mean consecutive difference (MCD) in the extensor digitorum communis than the control group. There were statistically significant positive correlations between MCD values and physical, mental, and total fatigue scores. Conclusion Higher ferritin levels and prolonged COVID-19 infection were independent predictors of PIFS in COVID-19 long-haulers. There was electrophysiological evidence of abnormalities in the peripheral portion of the motor unit in COVID-19 long-haulers with PIFS.
The Psychological Impacts During the Initial Phase of the COVID-19 Outbreak, and its Associated Factors Among Pastoral Community in West Omo Zone, South-West Ethiopia, 2020: A Community-Based Study

Background COVID-19 is a global pandemic and a major health crisis affecting several nations. Such outbreaks are associated with adverse mental health consequences to any group of the population. Despite its negative effects, no study has addressed the potential psychological impacts of the COVID-19 outbreak among the pastoral community. This study aims to assess psychological experiences during the early stages of the COVID-19 outbreak and the factors that contributed to it among pastoral community residents in West Omo, South-West Ethiopia. Methods A community-based cross-sectional study was carried out from May to June 2020. The study subjects were selected through a multistage sampling technique. Data were collected through face-to-face interviews, and entered into EpiData 3.1, then exported to SPSS version 24 for statistical analysis. The psychological impact was assessed by the Depression, Anxiety and Stress Scale (DASS-21). P-value < 0.20 during bi-variable analysis was considered as a candidate for multivariable logistic regression. Independent factors of depression, anxiety, and stress were assessed using adjusted odds ratio with 95% confidence level s at P-value < 0.05 cut-off point. Results A total of 845 eligible pastoral residents were interviewed, with a 94.4% response rate. The prevalence of a positive response for anxiety, depression and stress was 30.8%, 26.3% and 24.4%, respectively. Being female was highly associated with developing anxiety and depression. Anxiety was found to be three times more prevalent among the respondents with ≥ 3 family members. Furthermore, participants with a history of mental illness, poor social support, and a high perceived life threat were also at a higher risk of experiencing anxiety, depression, and stress. Conclusion The prevalence of positive depression, anxiety and stress results were high. As a result, special attention should be paid, by governmental and non-governmental health organizations, to psychosocial and mental health programs for pastoral residentsduring the COVID-19 pandemic.
Processes underlying complex patterns of song trait evolution in a Setophaga hybrid zone

Abstract During secondary contact between two species when hybrids are less fit than parents, mating signals are expected to diverge, while aggressive signals are expected to converge. If a single signal trait is used in both mating and aggression, then the dynamics between these two forces could influence the evolutionary trajectory of that trait. We studied such a situation in an avian hybrid zone between two Setophaga species, where birdsong is used in both mate attraction and territory defense. We hypothesized that song modules of the two species will show separate and distinct geographic patterns due to the influence of selective pressures for effective territorial aggression and for effective mate attraction. We conducted geographic cline analyses and playback experiments across this hybrid zone. We found an unexpected geographic pattern of asymmetric introgression of song rhythm, which may be explained by results of the playback experiments that suggest that differences in song rhythm serve a greater role in mate attraction than in territory defense. In contrast, differences in syllable morphology show little evidence of importance in mate attraction or territorial defense. Song features converge in the hybrid zone, yet patterns of trait change suggest that the song production modules may vary in their modes of development and inheritance. Syringeal motor gesturing, which gives rise to syllable morphology, shows a nonclinal mosaic pattern, suggesting that this trait may be predominantly learned. In contrast, respiratory patterning, which forms song rhythm, shows a clinal geographic transition, suggesting that this trait could be more innate. The results indicate that opposing forces act independently on song via distinct modules of the song production mechanism, driving complex patterns of song trait evolution.
A study of knowledge management alignment with production management: A study of carpet manufacture in Kurdistan region of Iraq

The manufacturing sector has been profoundly impacted by advances in project management knowledge. As a result, it is critical to optimize service development processes in every project. The aim of this research was to increase cement manufacturing production by applying knowledge management concepts and Knowledge management as a mediator. The study was conducted at various cement manufacturing facilities in Iraq's Kurdistan province. To quantify production improvement in cement companies, the researchers examined four facets of knowledge management: Knowledge creation, Knowledge storage management, knowledge sharing, and Knowledge application, with Knowledge management serving as a mediator. To conduct the current analysis, the researchers used a quantitative research approach in the form of a survey. The questionnaire was randomly distributed to 140 administrative employees of various cement manufacturing companies in the Kurdistan region. The researchers did, however, collect 128 completed questionnaires. To assess developed research hypotheses, the study used hierarchical multiple regression analysis and the Sobel test. The findings indicated that all knowledge management elements (Knowledge creation, Knowledge storage development, knowledge sharing, and Knowledge application) had a clear and important positive relationship with increased production at carpet manufacturers in Iraq's Kurdistan region. Additionally, the findings indicated that all knowledge management concepts with a mediator (project management development program) had an indirect positive and important relationship with increased production at cement manufacturing facilities in Iraq's Kurdistan region.
The Opinions of Patients Diagnosed Diabetes on Medical Nutrition Therapy: A Phenomenological Study

Background: For patients with type 2 diabetes mellitus, medical nutrition therapy is one of the most essential components of a healthy life. The aim of this study was to investigate participants’ perceptions of the process of medical nutrition therapy. Material and methods: In this study, a qualitative phenomenological approach was adopted in order to explore in depth the experiences of patients with type 2 diabetes mellitus during the medical nutrition therapy process, which is the most important component of diabetes treatment. This study was conducted in the endocrine and metabolism outpatient clinic of the state university hospital. A qualitative phenomenological study design using Colaizzi’s (1978) strategy of descriptive phenomenological data analysis was done in order to explore the subjective perceptions of these patients on medical nutrition therapy. Face-to-face interviews were conducted with 10 participants, using semi-structured open-ended questions. In this way, themes were determined from the data about the medical nutrition therapy process. Results: The results were collected under three main themes with 23 subcategories: Participants’ views on the medical nutrition therapy process, the obstacles they experienced and how they overcame and how they reached medical nutrition therapy. The sub-theme about medical nutrition therapy barriers of social pressure was the first in rank. Participants also stated the self-efficiency, importance of balanced dieting instead of restrictions in achieving medical nutrition therapy and the importance of social support. Conclusions: According to the results of this study, the process of adaptation to medical nutrition therapy should be arranged by taking into account the perspectives, individual preferences and cultural values of patients with type 2 diabetes mellitus. The treatment process can be successful if these patients are integrated into their lifestyle.
Hemisphere-specific Parietal Contributions to the Interplay between Working Memory and Attention

Abstract To achieve our moment-to-moment goals, we must often keep information temporarily in mind. Yet, this working memory (WM) may compete with demands for our attention in the environment. Attentional and WM functions are thought to operate by similar underlying principles, and they often engage overlapping fronto-parietal brain regions. In a recent fMRI study, bilateral parietal cortex BOLD activity displayed an interaction between WM and visual attention dual-task demands. However, prior studies also suggest that left and right parietal cortices make unique contributions to WM and attentional functions. Moreover, behavioral performance often shows no interaction between concurrent WM and attentional demands. Thus, the scope of reciprocity between WM and attentional functions, as well as the specific contribution that parietal cortex makes to these functions, remain unresolved. Here, we took a causal approach, targeting brain regions that are implicated in shared processing between WM and visual attention, to better characterize how those regions contribute to behavior. We first examined whether behavioral indices of WM and visual search differentially correlate with left and right parietal dual-task BOLD responses. Then, we delivered TMS over fMRI-guided left and right parietal sites during dual-task WM–visual search performance. Only right-parietal TMS influenced visual search behavior, but the stimulation either helped or harmed search depending on the current WM load. Therefore, whereas the left and right parietal contributions were distinct here, attentional and WM functions were codependent. Right parietal cortex seems to hold a privileged role in visual search behavior, consistent with prior findings, but the current results reveal that behavior may be sensitive to the interaction between visual search and WM load only when normal parietal activity is perturbed. The parietal response to heightened WM and attentional demands may therefore serve to protect against dual-task interference.