Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison of UV‐ and Raman‐based monitoring of the Protein A load phase and evaluation of data fusion by PLS models and CNNs

A promising application of Process Analytical Technology to the downstream process of monoclonal antibodies (mAbs) is the monitoring of the Protein A load phase as its control promises economic benefits. Different spectroscopic techniques have been evaluated in literature with regard to the ability to quantify the mAb concentration in the column effluent. Raman and Ultraviolet (UV) spectroscopy are among the most promising techniques. In this study, both were investigated in an in‐line setup and directly compared. The data of each sensor were analyzed independently with Partial‐Least‐Squares (PLS) models and Convolutional Neural Networks (CNNs) for regression. Furthermore, data fusion strategies were investigated by combining both sensors in hierarchical PLS models or in CNNs. Among the tested options, UV spectroscopy alone allowed for the most precise and accurate prediction of the mAb concentration. A Root Mean Square Error of Prediction (RMSEP) of 0.013 g L−1 was reached with the UV‐based PLS model. The Raman‐based PLS model reached an RMSEP of 0.232 g L−1. The different data fusion techniques did not improve the prediction accuracy above the prediction accuracy of the UV‐based PLS model. Data fusion by PLS models seems meritless when combining a very accurate sensor with a less accurate signal. Furthermore, the application of CNNs for UV and Raman spectra did not yield significant improvements in the prediction quality. For the presented application, linear regression techniques seem to be better suited compared with advanced nonlinear regression techniques, like, CNNs. In summary, the results support the application of UV spectroscopy and PLS modeling for future research and development activities aiming to implement spectroscopic real‐time monitoring of the Protein A load phase.
Questionnaire survey on knowledge, attitudes, and behaviour towards viral hepatitis among the Hong Kong public.

INTRODUCTION We aimed to identify gaps in knowledge, attitudes, and behaviours towards viral hepatitis among the Hong Kong public and provide insights to optimise local efforts towards achieving the World Health Organization's viral hepatitis elimination target. METHODS A descriptive, cross-sectional, self-reported web-based questionnaire was administered to 500 individuals (aged ≥18 years) in Hong Kong. Questionnaire items explored the awareness and perceptions of viral hepatitis-related liver disease(s) and associated risk factors in English or traditional Chinese. RESULTS The majority (>80%) were aware that chronic hepatitis B and/or C could increase the risks of developing liver cirrhosis, cancer, and/or failure. Only 55.8% had attended health screenings in the past 2 years, and 67.6% were unaware of their family's history of liver diseases. Misperceptions surrounding the knowledge and transmission risks of viral hepatitis strongly hint at the presence of social stigmatisation within the community. Many misperceived viral hepatitis as airborne or hereditary, and social behaviours (casual contact or dining with an infected person) as a transmission route. Furthermore, 62.4% were aware of hepatitis B vaccination, whereas 19.0% knew that hepatitis C cannot be prevented by vaccination. About 70% of respondents who were aware of mother-to-child transmission were willing to seek medical consultation in the event of pregnancy. Gaps in knowledge as well as the likelihood of seeking screening were observed across all age-groups and education levels. CONCLUSIONS Comprehensive hepatitis education strategies should be developed to address gaps in knowledge among the Hong Kong public towards viral hepatitis, especially misperceptions relevant to social stigmatisation and the importance of preventive measures, including vaccination and screening, when exposed to risk factors.
Remnant cholesterol predicts cardiovascular disease beyond LDL and ApoB: a primary prevention study.

AIMS Emerging evidence suggests that remnant cholesterol (RC) promotes atherosclerotic cardiovascular disease (ASCVD). We aimed to estimate RC-related risk beyond low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) in patients without known ASCVD. METHODS AND RESULTS We pooled data from 17 532 ASCVD-free individuals from the Atherosclerosis Risk in Communities study (n = 9748), the Multi-Ethnic Study of Atherosclerosis (n = 3049), and the Coronary Artery Risk Development in Young Adults (n = 4735). RC was calculated as non-high-density lipoprotein cholesterol (non-HDL-C) minus calculated LDL-C. Adjusted Cox models were used to estimate the risk for incident ASCVD associated with log RC levels. We also performed discordance analyses examining relative ASCVD risk in RC vs. LDL-C discordant/concordant groups using difference in percentile units (>10 units) and clinically relevant LDL-C targets. The mean age of participants was 52.3 ± 17.9 years, 56.7% were women and 34% black. There were 2143 ASCVD events over the median follow-up of 18.7 years. After multivariable adjustment including LDL-C and apoB, log RC was associated with higher ASCVD risk [hazard ratio (HR) 1.65, 95% confidence interval (CI) 1.45-1.89]. Moreover, the discordant high RC/low LDL-C group, but not the low RC/high LDL-C group, was associated with increased ASCVD risk compared to the concordant group (HR 1.21, 95% CI 1.08-1.35). Similar results were shown when examining discordance across clinical cutpoints. CONCLUSIONS In ASCVD-free individuals, elevated RC levels were associated with ASCVD independent of traditional risk factors, LDL-C, and apoB levels. The mechanisms of RC association with ASCVD, surprisingly beyond apoB, and the potential value of targeted RC-lowering in primary prevention need to be further investigated.
Nursing students' views of using virtual reality in healthcare: A qualitative study.

AIMS AND OBJECTIVES This study explored nursing students' views of using virtual reality in healthcare. BACKGROUND The popularity and use of virtual reality in healthcare delivery and education is on the rise. Yet, the views of future nurses regarding this technology remain underexplored. DESIGN This is a qualitative descriptive study guided by a naturalistic inquiry and reported using the Standards for Reporting Qualitative Research checklist. METHODS Nursing students (n = 26) were recruited using convenience and snowball sampling. They were first exposed to a virtual reality intervention aimed to enhance men's awareness of testicular diseases. This was attempted to familiarise participants with the technology and initiate conversations around its use in healthcare. Participants were then interviewed face-to-face, either individually or within focus groups. Data were analysed using thematic analysis. RESULTS Four themes were identified: (i) positive experiences of virtual reality; (ii) challenges to using virtual reality; (iii) settings where virtual reality can be implemented; and (iv) blue-sky and future applications of virtual reality. Participants described this technology as novel, enjoyable, immersive, memorable and inclusive. They questioned, however, the suitability of virtual reality for older adults, reported minor technical difficulties and stressed the importance of prior preparation in the use of the technology. Virtual reality was recommended for use in outpatient healthcare settings, schools and the community. Participants suggested using virtual reality in health promotion, disease prevention and management, and to promote nurses' empathy towards patients. CONCLUSIONS Findings highlight the potential role of virtual reality in assisting nurses in promoting health and managing disease. Future research is needed to establish the long-term effect of virtual reality interventions among more diverse participants. RELEVANCE TO CLINICAL PRACTICE Virtual reality can be implemented in outpatient, educational and community settings in order to promote health, prevent disease, enhance disease and self-management, and increase nurses' empathy towards patients.
Exploration of Experiences and Perpetration of Identity-Based Bullying Among Adolescents by Race/Ethnicity and Other Marginalized Identities

Key Points Question How are experiences of bullying based on race/ethnicity/national origin and other marginalized identities associated with outcomes for health, mental health, and violence among adolescents? Findings In this cross-sectional study of 3939 high school youth, the highest rates of experiencing and perpetrating identity-based bullying were demonstrated by youth with multiple marginalized identities. Experiences with and perpetration of bullying based on race/ethnicity were associated with all health, mental health, and violence outcomes examined; experiencing multiple forms of identity-based bullying was associated with worse adjustment. Meaning These results suggest that policies that address experiences of race/ethnicity-based bullying and co-occurring mental and physical health outcomes must also attend to other aspects of youths’ social identity.
Safety priority, safety rules, safety participation and safety behaviour: the mediating role of safety training

Objectives. This study explores the effects of employee perception of the management’s safety priority, safety rules and safety training on safety participation and safety behaviour decided by management, as well as the mediating role of safety training on the other four dimensions. Methods. The study covers employees working in 27 metal companies classed as hazardous/very hazardous in Turkey. The research data were collected by surveying 822 employees in the metal sector. Collected data were tested through explanatory and confirmatory factor analyses, in that order. Results. The findings of this analysis indicated statistically direct, positive effects of safety priority on safety rules and safety training, such an effect of safety rules on safety training, and again such effects of safety training on safety participation and safety behaviour. Besides, indirect relationships were detected between safety priority and safety rules and safety participation, and safety behaviour through the mediating role of safety training. Conclusion. Employee participation in health and safety issues as well as safe behaviour in the workplace depend on management prioritizing health and safety issues as much as production, formulating safe working rules, procedures and practices using comprehensive and regular training programmes.
Habitat selection by wolves and mountain lions during summer in western Montana

In the Northern Rockies of the United States, predators like wolves (Canis lupus) and mountain lions (Puma concolor) have been implicated in fluctuations or declines in populations of game species like elk (Cervus canadensis) and mule deer (Odocoileus hemionus). In particular, local distributions of these predators may affect ungulate behavior, use of space, and dynamics. Our goal was to develop generalizable predictions of habitat selection by wolves and mountain lions across western Montana. We hypothesized both predator species would select habitat that maximized their chances of encountering and killing ungulates and that minimized their chances of encountering humans. We assessed habitat selection by these predators during summer using within-home range (3rd order) resource selection functions (RSFs) in multiple study areas throughout western Montana, and tested how generalizable RSF predictions were by applying them to out-of-sample telemetry data from separate study areas. Selection for vegetation cover-types varied substantially among wolves in different study areas. Nonetheless, our predictions of 3rd order selection by wolves were highly generalizable across different study areas. Wolves consistently selected simple topography where ungulate prey may be more susceptible to their cursorial hunting mode. Topographic features may serve as better proxies of predation risk by wolves than vegetation cover-types. Predictions of mountain lion distribution were less generalizable. Use of rugged terrain by mountain lions varied across ecosystem-types, likely because mountain lions targeted the habitats of different prey species in each study area. Our findings suggest that features that facilitate the hunting mode of a predator (i.e. simple topography for cursorial predators and hiding cover for stalking predators) may be more generalizable predictors of their habitat selection than features associated with local prey densities.
Analysis of the association and predictive value of hyperhomocysteinaemia for obstructive coronary artery disease

Objective To investigate the predictive value of hyperhomocysteinaemia (HHcy) for obstructive coronary artery disease (CAD) in an Asian population in northern China. Methods This retrospective study enrolled patients at their first cardiac assessment and assigned them to an obstructive CAD group or a non-obstructive CAD group according to the coronary angiography results. HHcy was defined as a homocysteine (Hcy) level > 15 µmol/l. Results This study enrolled 2987 participants: 1172 in the non-obstructive CAD group and 1815 in the obstructive CAD group. Hcy level in the obstructive CAD group was significantly higher than in the non-obstructive CAD group. The proportion of patients with HHcy in the obstructive CAD group was significantly greater than in the non-obstructive CAD group. Multivariate logistic regression analysis demonstrated that HHcy was independently correlated with obstructive CAD in both young (aged ≤ 55 years) and old patients (aged > 55 years). HHcy showed a higher sensitivity (93.1%), specificity (86.1%) and accuracy (90.0%) for obstructive CAD. The odds ratio for HHcy was 84.2. The Kappa value (0.8) showed substantial agreement between obstructive CAD and HHcy. Conclusions HHcy was associated with obstructive CAD and may be a potentially independent risk factor for obstructive CAD with good predictive value.
Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania

Objectives The primary aims of this study were to investigate if exposure to antenatal corticosteroids (ACS) was associated with lower rates of perinatal mortality (primary outcome) and other adverse perinatal outcomes (i.e., stillbirth, early neonatal mortality, APGAR score of < 7 at 5 mins, neonatal sepsis and respiratory distress syndrome) in preterm infants in hospitals in Tanzania. We also examine factors associated with administration of ACS among women at risk of preterm delivery. Methods A hospital-based prospective chart review study was undertaken in four hospitals located in Nyamagana and Sengerema districts, Tanzania. The study population included all stillborn and live born preterm infants delivered between 24 to 34 weeks of gestation between July 2019 to February 2020. A total 1125 preterm infants were delivered by 1008 women (895 singletons, 230 multiple). Sociodemographic and medical data were recorded from participants’ medical records. Results Three hundred and fifty-six (35.3%) women were administered at least one dose of ACS between 24 to 34 weeks’ gestation and 385 (34.2%) infants were exposed to ACS. Infants exposed to ACS had a lower rate of perinatal mortality (13.77%) compared to those who were not exposed (28.38%). Multivariate analysis indicated that infants exposed to ACS were less likely to die during perinatal period, aRR 0.34 (95%CI 0.26-0.44). Only one-third of the sample was provided with ACS. Administration of ACS was associated with maternal education, attending antenatal care more than 3 times, method used to assess gestational age, maternal infection, exposure to maternal antibiotics, delivery mode and level of health facility. Conclusion ACS significantly reduced the risk in perinatal mortality among infants born preterm in a limited resource setting. However, only about one-third of eligible women were provided with ACS, indicating low usage of ACS. Numerous factors were associated with low usage of ACS in this setting.
Ultra-proactive therapeutic drug monitoring of infliximab based on point-of-care-testing in inflammatory bowel disease: results of a pragmatic trial.

BACKGROUND With point of care testing (POCT) for infliximab (IFX), ultraproactive therapeutic drug monitoring (TDM) with ad-hoc dose optimisation is possible in patients with inflammatory bowel disease (IBD). AIM To compare the clinical outcomes of an ultraproactive TDM algorithm of IFX based on POCT with reactive TDM in patients with IBD, in a pragmatic clinical trial. METHODS All patients with IBD and maintenance IFX treatment were included between June and August 2018 in two centers. Center A applied an ultra-proactive TDM algorithm incorporating POCT, while center B applied reactive TDM. Primary endpoint was failure of IFX therapy after one year. Secondary endpoints included sustained clinical remission and mucosal remission. RESULTS In total 187 patients (n=115/72 cohort A/B) were included. Cohort A had more TL measurements compared with cohort B (8.8 vs 1/patient/year; p<.0001), leading to a significant higher number of dose optimizations. POCT testing was required in 27% after the first round of ultraproactive TDM and in a mean of 6.3% (SD 1.9) in the subsequent rounds. Ad-hoc extra dosing was needed in 13% of the POCT. After one year, no difference was seen between cohort A and cohort B in IFX failure (19% vs 10%; p=.08), nor in sustained clinical remission (75% vs 83%; p=.17). Mucosal remission was evaluated in 71 patients (38%), and was more frequent in the reactive TDM cohort (p=.02). CONCLUSION Ultraproactive TDM in patients with IBD and maintenance IFX treatment leads to equal clinical outcomes as reactive TDM after one year of follow-up.
Effects of achromatic and chromatic lights on pupillary response, endocrinology, activity, and milk production in dairy cows

Artificial light can be used as a management tool to increase milk yield in dairy production. However, little is known about how cows respond to the spectral composition of light. The aim of this study was to investigate how dairy cows respond to artificial achromatic and chromatic lights. A tie-stall barn equipped with light-emitting diode (LED) light fixtures was used to create the controlled experimental light environments. Two experiments were conducted, both using dairy cows of Swedish Red and light mixtures with red, blue or white light. In experiment I, the response to light of increasing intensity on pupil size was evaluated in five pregnant non-lactating cows. In experiment II 16h of achromatic and chromatic daylight in combination with dim, achromatic night light, was tested on pregnant lactating cows during five weeks to observe long term effects on milk production, activity and circadian rhythms. Particular focus was given to possible carry over effects of blue light during the day on activity at night since this has been demonstrated in humans. Increasing intensity of white and blue light affected pupil size (P<0.001), but there was no effect on pupil size with increased intensity of red light. Milk yield was maintained throughout experiment II, and plasma melatonin was higher during dim night light than in daylight for all treatments (P<0.001). In conclusion, our results show that LED fixtures emitting red light driving the ipRGCs indirectly via ML-cones, blue light stimulating both S-cones and ipRGCs directly and a mixture of wavelengths (white light) exert similar effects on milk yield and activity in tied-up dairy cows. This suggests that the spectral composition of LED lighting in a barn is secondary to duration and intensity.
Effects of an articular cartilage lubrication with a viscosupplement in vitro and in vivo following osteochondral fractures in horses.

OBJECTIVE To assess whether the combination of hyaluronan, sodium chondroitin sulfate, and N-acetyl-d-glucosamine (HCSG) lubricates articular cartilage in vitro and modulates joint lubrication in vivo. ANIMALS 16 healthy adult horses. PROCEDURES The effects of HCSG injections on SF lubricant properties and joint health, immediately after injury and 2 weeks later, were analyzed by use an equine osteochondral fracture model of post-traumatic osteoarthritis (OA). Middle carpal joints of adult horses were randomly assigned to 1 of 4 surgical treatment groups as follows: normal nonsurgical group (n = 8), normal sham-surgical group (8), OA-induced surgical group with HCSG injection (8), or OA-induced surgical group with saline (0.9% NaCl) solution injection (8). Synovial fluid was aspirated periodically and analyzed for boundary lubrication function and lubricant molecules. At 17 days, joints were screened for gross pathological changes. RESULTS Induction of OA led to an impairment of SF lubrication function and diminished hyaluronan concentration in a time-dependent manner following surgery, with HCSG injection lessening these effects. Certain friction coefficients approached those of unaffected normal equine SF. Induction of OA also caused synovial hemorrhage at 17 days, which was lower in joints treated with HCSG. CONCLUSIONS AND CLINICAL RELEVANCE After induction of OA, equine SF lubricant function was impaired. Hyaluronan-sodium chondroitin sulfate-N-acetyl-d-glucosamine injection restored lubricant properties at certain time points and reduced pathological joint changes.
The effect of bearing and rearing a child on blood pressure: a nationally representative instrumental variable analysis of 444 611 mothers in India

Abstract Background At the individual level, it is well known that pregnancies have a short-term effect on a woman’s cardiovascular system and blood pressure. The long-term effect of having children on maternal blood pressure, however, is unknown. We thus estimated the causal effect of having children on blood pressure among mothers in India, a country with a history of high fertility rates. Methods We used nationally representative cross-sectional data from the 2015–16 India National Family and Health Survey (NFHS-4). The study population comprised 444 611 mothers aged 15–49 years. We used the sex of the first-born child as an instrumental variable (IV) for the total number of a woman’s children. We estimated the effect of an additional child on systolic and diastolic blood pressure in IV (two-stage least squares) regressions. In additional analyses, we stratified the IV regressions by time since a mother last gave birth. Furthermore, we repeated our analyses using mothers' husbands and partners as the regression sample. Results On average, mothers had 2.7 children [standard deviation (SD): 1.5], a systolic blood pressure of 116.4 mmHg (SD: 14.4) and diastolic blood pressure of 78.5 mmHg (SD: 9.4). One in seven mothers was hypertensive. In conventional ordinary least squares regression, each child was associated with 0.42 mmHg lower systolic [95% confidence interval (CI): –0.46 to –0.39, P < 0.001] and 0.13 mmHg lower diastolic (95% CI: –0.15 to –0.11, P < 0.001) blood pressure. In the IV regressions, each child decreased a mother’s systolic blood pressure by an average of 1.00 mmHg (95% CI: –1.26 to –0.74, P < 0.001) and diastolic blood pressure by an average of 0.35 mmHg (95% CI: –0.52 to –0.17, P < 0.001). These decreases were sustained over more than a decade after childbirth, with effect sizes slightly declining as the time since last birth increased. Having children did not influence blood pressure in men. Conclusions Bearing and rearing a child decreases blood pressure among mothers in India.