Miracle-dz/UniFAR-FTUs huggingface dataset:
Risk factors and outcomes of lower respiratory tract infections after traumatic brain injury: a retrospective observational study

Background Traumatic brain injury (TBI) is a public health problem with a high burden in terms of disability and death. Infections are a common complication, with respiratory infections being the most frequent. Most available studies have addressed the impact of ventilator-associated pneumonia (VAP) after TBI; therefore, we aim to characterize the hospital impact of a broader entity, lower respiratory tract infections (LRTIs). Methods This observational, retrospective, single-center cohort study describes the clinical features and risk factors associated with LRTIs in patients with TBI admitted to an intensive care unit (ICU). We used bivariate and multivariate logistic regressions to identify the risk factors associated with developing LRTI and determine its impact on hospital mortality. Results We included 291 patients, of whom 77% (225/291) were men. The median (IQR) age was 38 years (28–52 years). The most common cause of injury was road traffic accidents 72% (210/291), followed by falls 18% (52/291) and assault at 3% (9/291). The median (IQR) Glasgow Coma Scale (GCS) score on admission was 9 (6–14), and 47% (136/291) were classified as severe TBI, 13% (37/291) as moderate TBI, and 40% (114/291) as mild TBI. The median (IQR) injury severity score (ISS) was 24 (16–30). Nearly 48% (141/291) of patients presented at least one infection during hospitalization, and from those, 77% (109/141) were classified as LRTIs, which included tracheitis 55% (61/109), ventilator-associated pneumonia (VAP) 34% (37/109), and hospital-acquired pneumoniae (HAP) 19% (21/109). After multivariable analysis, the following variables were significantly associated with LRTIs: age (OR 1.1, 95% CI 1.01–1.2), severe TBI (OR 2.7, 95% CI 1.1–6.9), AIS thorax (OR 1.4, 95 CI 1.1–1.8), and mechanical ventilation on admission (OR 3.7, 95% CI 1.1–13.5). At the same time, hospital mortality did not differ between groups (LRTI 18.6% vs. No LRTI 20.1%, p = 0.7), and ICU and hospital length of stay (LOS) were longer in the LRTI group (median [IQR] 12 [9–17] vs. 5 [3–9], p < 0.01) and (median [IQR] 21 [13–33] vs. 10 [5–18], p = 0.01), respectively. Time on the ventilator was longer for those with LRTIs. Conclusion The most common site/location of infection in patients with TBI admitted to ICU is respiratory. Age, severe TBI, thoracic trauma, and mechanical ventilation were identified as potential risk factors. LRTI was associated with prolonged ICU, hospital stay, and more days on a ventilator, but not with mortality.
Overview of the hypnodensity approach to scoring sleep for polysomnography and home sleep testing

Human experts scoring sleep according to the American Academy of Sleep Medicine (AASM) rules are forced to select, for every 30-second epoch, one out of five stages, even if the characteristics of the neurological signals are ambiguous, a very common occurrence in clinical studies. Moreover, experts cannot score sleep in studies where these signals have not been recorded, such as in home sleep apnea testing (HSAT). In this topic review we describe how artificial intelligence can provide consistent and reliable scoring of sleep stages based on neurological signals recorded in polysomnography (PSG) and on cardiorespiratory signals recorded in HSAT. We also show how estimates of sleep stage probabilities, usually displayed as hypnodensity graph, can be used to quantify sleep stage ambiguity and stability. As an example of the application of hypnodensity in the characterization of sleep disordered breathing (SDB), we compared 49 patients with sleep apnea to healthy controls and revealed a severity-depending increase in ambiguity and decrease in stability during non-rapid eye movement (NREM) sleep. Moreover, using autoscoring of cardiorespiratory signals, we show how HSAT-derived apnea-hypopnea index and hypoxic burden are well correlated with the PSG indices in 80 patients, showing how using this technology can truly enable HSATs as alternatives to PSG to diagnose SDB.
Visualizing the IKEA effect: experiential consumption assessed with fNIRS-based neuroimaging

Introduction In recent years, experiential consumption, which refers to purchases involving hedonic experiences, has been gathering attention in marketing research. Experiential consumption is closely related to cognitive biases, and among them, we focus on the IKEA effect, which is a cognitive bias in which the maximum willingness to pay (WTP) for a product is high because the experience of assembling the product is highly valued. Since no studies have examined the neural mechanism behind the IKEA effect, here we present the first study exploring the neural substrates of the IKEA effect using functional near-infrared spectroscopy (fNIRS). During the WTP evaluation, we expect the attachment to and memory retrieval of DIY products to be the cognitive mechanism for the IKEA effect. Methods Thirty healthy students, of which 24 were confirmed to have undergone the IKEA effect, were asked to perform a WTP evaluation task after assembling three types of do-it-yourself (DIY) products and handling three types of Non-DIY products. Their cerebral hemodynamic responses during the evaluation were measured using fNIRS. In order to adjust for temporal variability of cortical responses among participants, a personalized adaptive general linear model (GLM) analysis was adopted. Then, one-sample t-tests were performed for each DIY and Non-DIY condition for the obtained β values, and a paired t-test was performed between DIY and Non-DIY conditions. Results We identified brain regions, including the left-inferior frontal gyrus (L-IFG) and left-middle frontal gyrus (L-MFG), which were probably related to cognitive processing related to the IKEA effect. Among them, the L-MFG exhibited more activation during the DIY condition than during the Non-DIY condition. Conclusion To our knowledge, the current study is the first to reveal the neural basis of the IKEA effect. The cortical activation during evaluation of WTP for DIY and Non-DIY products exhibited marked differences. In addition to the R-IFG activation often reported for WTP evaluations, we revealed that other regions, in particular the L-IFG and L-MFG, were activated during the DIY condition. These areas are considered to be related to memory and attachment, which would serve as reasonable cognitive constituents for the IKEA effect. In conclusion, this study suggests that the value of experiential consumption can be assessed using fNIRS-based neuroimaging and provides a novel approach to consumer neuroergonomics. It is predicted that visualization the value of experiential consumption will create marketing opportunities for more and more companies and the visualization will become an indispensable method in the future.
Prevalence, incidence, and mortality rates of breast cancer in Kazakhstan: data from the Unified National Electronic Health System, 2014–2019

Background Although there are numerous sources of epidemiologic information on breast cancer in Kazakhstan, none of them have specifically examined the burden of this disease. Therefore, this article aims to provide an overview of the breast cancer prevalence, incidence, mortality, and distribution and changes over time in Kazakhstan based on nationwide large-scale healthcare data from the National Registry in order to encourage more research on the impact of various diseases at the regional and national levels. Methods The study cohort included all adult women older than 25 years who were diagnosed with breast cancer in any clinical setting of the Republic of Kazakhstan during the period of 2014–2019. The data were extracted from the Unified Nationwide Electronic Health System (UNEHS) to get an overview of descriptive statistics, incidence, prevalence, and mortality rate calculations and the Cox proportional hazards regression model. All survival functions and factors associated with mortality were tested for significance. Results The cohort population (n = 55,465) comprised subjects with the age at the diagnosis of breast cancer from 25 to 97 years, with a mean of 55.7 ± 12.0 years. The majority of the study population belonged to the age group 45–59 years, which is 44.8% of the cohort. The all-cause mortality rate of the cohort is 16%. The prevalence rate increased from 30.4 per 10,000 population in 2014 to 50.6 in 2019. The incidence rate varied from 4.5 per 10,000 population in 2015 to 7.3 in 2016. Mortality rates were stable and high in the senile age patients (75–89 years old). Breast cancer mortality was positively associated with women who had been diagnosed with diabetes, HR 1.2 (95% CI, 1.1–2.3), whereas it was negatively associated with arterial hypertension, HR 0.4 (95% CI, 0.4–0.5). Conclusion Overall, Kazakhstan is experiencing an increase in the incidence of breast cancer cases, but the mortality rate has started to decline. The switch to population mammography screening could reduce the breast cancer mortality rate. These findings should be utilized to help Kazakhstan determine what cancer control priorities should be utilized, including the need to implement efficient and affordable screening and prevention programs.
Tumor PD-L1 expression and molecular profiling are not associated with immune checkpoint inhibitor-induced thyroid dysfunction in advanced NSCLC patients

Background: Immune-checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced non-small cell lung cancer (NSCLC), however are frequently associated with thyroid immune-related adverse events (IRAEs). We investigated the association between patient characteristics, tumor PD-L1 expression and molecular profile with the development of thyroid IRAEs in NSCLC patients. Methods: Single center, retrospective study including 107 NSCLC patients treated with PD-1/PD-L1 inhibitors from April 2016 to July 2020. All patients were euthyroid at baseline with at least two TSH measurements post-treatment initiation. The primary outcome was the difference in tumor PD-L1 expression in patients who developed any thyroid IRAEs versus those who remained euthyroid. Additional outcomes included development of overt thyroid dysfunction, the association of specific molecular alterations with thyroid IRAEs, and onset of thyroid IRAEs as a function of tumor PD-L1 expression. Results: Overall, 37 (34.6%) patients developed any thyroid dysfunction and 18 (16.8%) developed overt thyroid dysfunction. Tumor PD-L1 staining intensity was not associated with thyroid IRAEs. TP53 mutation was less likely to be associated with any thyroid dysfunction (p < 0.05) and no association was found between EGFR, ROS, ALK or KRAS mutations. There was no association between PD-L1 expression and time to develop thyroid IRAEs. Conclusion: PD-L1 expression is not associated with the development of thyroid dysfunction in advanced NSCLC patients treated with ICIs, suggesting that thyroid IRAEs are unrelated to tumor PD-L1 expression.
Isotopic niche modelling of the Pondaung mammal fauna (middle Eocene, Myanmar) shows microhabitat differences. Insights into paleoecology and early anthropoid primate habitats

The late Middle Eocene Pondaung Fm. is a window to understand the environment and ecosystem dynamics of a past greenhouse world and the paleoenvironments where modern mammal clades such as anthropoid primates originated. Previous studies focused on the overall climate and vegetation of this Eocene habitat and provided first evidence for an early monsoon onset before the orogenesis of the Himalayan-Tibetan range. Here, we wanted to investigate how the mammal fauna used this habitat and which different ecological niches and microhabitats they occupied. We analyzed the carbonate fraction of dental enamel of a fossil mammal assemblage from various localities of the Pondaung Fm. in Myanmar. Bayesian niche modelling of the δ13C and δ18O values allowed us to quantify aspects of the ecological core niches occupied by these taxa, to calculate niche overlap and to use these data to infer directional competition potential in this mammal assemblage. Furthermore, comparison of different areas of the Pondaung Fm. revealed two different microhabitats whose distribution is consistent with existing vegetation models. Most primate taxa were found in both described environments, which gives a first indication about their ecological flexibility.
A Velocity Decomposition Approach for Lifting and Free-Surface Flows.

The principle of velocity decomposition is used to efficiently and accurately solve the Navier-Stokes problem for lifting and free-surface flows. The total fluid velocity is decomposed as the sum of irrotational and solenoidal components. The irrotational component is modeled using a velocity potential which satisfies the Laplace equation. It is shown that the conventional inviscid velocity potential does not satisfy the Navier-Stokes problem, even in the irrotational regions of the flow. Whereas, the viscous velocity potential is the solution to a modified boundary-value problem which satisfies the Navier-Stokes problem everywhere except where the flow is rotational. If a viscous potential can be found which satisfies the Navier-Stokes problem directly outside of the rotational regions of the fluid, then the fluid domain over which the Navier-Stokes equations must be solved can be greatly reduced. The viscous potential is the Dirichlet boundary condition for the total velocity on the boundaries of the reduced fluid domain. The primary development in this work is the formulation of the viscous potential for lifting and free-surface flows. Previously, the viscous potential was developed by Edmund (2012) for deeply-submerged, non-lifting bodies. In Edmund (2012), the body-boundary condition was modified to include viscous effects from the body and wake. The viscous potential for lifting flows is modified further to account for the loss of lift due to separation by introducing a condition on the total body-bound circulation. The viscous potential is also modified to account for the presence of an asymmetric flow, such as that which exists downstream of a lifting foil. Finally, free-surface effects are incorporated by implementing a linear free-surface solver into the viscous potential formulation. The velocity decomposition approach is used to solve for the flow over a deeply-submerged 2D NACA0012 foil. It is demonstrated that by using the viscous potential, the fluid domain on which the Navier-Stokes equations are solved can be reduced to only include the region within approximately two chord lengths from the body. A computational speed-up of up to 7.5x is demonstrated. The velocity decomposition approach is also applied to the free-surface flow over a bottom-mounted bump and a fully-submerged foil.
Subcortical volumes in cerebral amyloid angiopathy compared with Alzheimer’s disease and controls

Background Previous reports have suggested that patients with cerebral amyloid angiopathy (CAA) may harbor smaller white matter, basal ganglia, and cerebellar volumes compared to age-matched healthy controls (HC) or patients with Alzheimer’s disease (AD). We investigated whether CAA is associated with subcortical atrophy. Methods The study was based on the multi-site Functional Assessment of Vascular Reactivity cohort and included 78 probable CAA (diagnosed according to the Boston criteria v2.0), 33 AD, and 70 HC. Cerebral and cerebellar volumes were extracted from brain 3D T1-weighted MRI using FreeSurfer (v6.0). Subcortical volumes, including total white matter, thalamus, basal ganglia, and cerebellum were reported as proportion (%) of estimated total intracranial volume. White matter integrity was quantified by the peak width of skeletonized mean diffusivity. Results Participants in the CAA group were older (74.0 ± 7.0, female 44%) than the AD (69.7 ± 7.5, female 42%) and HC (68.8 ± 7.8, female 69%) groups. CAA participants had the highest white matter hyperintensity volume and worse white matter integrity of the three groups. After adjusting for age, sex, and study site, CAA participants had smaller putamen volumes (mean differences, −0.024% of intracranial volume; 95% confidence intervals, −0.041% to −0.006%; p = 0.005) than the HCs but not AD participants (−0.003%; −0.024 to 0.018%; p = 0.94). Other subcortical volumes including subcortical white matter, thalamus, caudate, globus pallidus, cerebellar cortex or cerebellar white matter were comparable between all three groups. Conclusion In contrast to prior studies, we did not find substantial atrophy of subcortical volumes in CAA compared to AD or HCs, except for the putamen. Differences between studies may reflect heterogeneity in CAA presenting syndromes or severity.
Myomectomy in infertile women: More harm than good?

Adhesion formation following gynecological surgery remains a challenge. The adoption of minimally invasive surgical approaches, such as conventional or robotic-assisted laparoscopy combined with meticulous microsurgical principles and the application of adhesion–reducing substances, is able to reduce the risk of de novo adhesion formation but do not eliminate it entirely. Myomectomy is the most adhesiogenic surgical procedure and postoperative adhesions can have a significant impact on the ability to conceive. Therefore, when surgery is performed as infertility treatment, attention should be paid to whether the benefits outweigh the risks. Among several factors, the size and the location of fibroids are the most accountable factors in terms of adhesion development and post surgical infertility; therefore, the search for effective strategies against adhesion formation in this setting is of paramount importance. The purpose of this review is to evaluate the incidence and factors of adhesion formation and the best preventive measures current available.
Mammals’ sperm microbiome: current knowledge, challenges, and perspectives on metagenomics of seminal samples

Bacterial growth is highly detrimental to sperm quality and functionality. However, during the last few years, using sequencing techniques with a metagenomic approach, it has been possible to deepen the study of bacteria-sperm relationships and describe non-culturable species and synergistic and antagonistic relationships between the different species in mammalian animals. We compile the recent metagenomics studies performed on mammalian semen samples and provide updated evidence to understand the importance of the microbial communities in the results of sperm quality and sperm functionality of males, looking for future perspectives on how these technologies can collaborate in the development of andrological knowledge.
C9ORF72 knockdown triggers FTD-like symptoms and cell pathology in mice

The GGGGCC intronic repeat expansion within C9ORF72 is the most common genetic cause of ALS and FTD. This mutation results in toxic gain of function through accumulation of expanded RNA foci and aggregation of abnormally translated dipeptide repeat proteins, as well as loss of function due to impaired transcription of C9ORF72. A number of in vivo and in vitro models of gain and loss of function effects have suggested that both mechanisms synergize to cause the disease. However, the contribution of the loss of function mechanism remains poorly understood. We have generated C9ORF72 knockdown mice to mimic C9-FTD/ALS patients haploinsufficiency and investigate the role of this loss of function in the pathogenesis. We found that decreasing C9ORF72 leads to anomalies of the autophagy/lysosomal pathway, cytoplasmic accumulation of TDP-43 and decreased synaptic density in the cortex. Knockdown mice also developed FTD-like behavioral deficits and mild motor phenotypes at a later stage. These findings show that C9ORF72 partial loss of function contributes to the damaging events leading to C9-FTD/ALS.
Improved professional practices in social services through Emotional Labor strategies

The present study provides an analysis of Emotional Labor (EL) and its consequences for professional social work practitioners in Georgia. This mixed-methods study comprised two stages. First, a qualitative study was conducted to determine the organizational characteristics defined by social work practitioners (N = 70). Second, a quantitative study was undertaken among the members of the Georgian Association of Social Workers (N = 165) to determine the direct and indirect influences of organizational characteristics on EL and work outcomes, namely, personal accomplishment and burnout. The results are pragmatic and applicable for organizations providing social services to gain positive results at the individual and organizational levels.
Factors associated with sleep disorders among adolescent students in rural areas of China

Background This study aimed to determine sleep patterns and the prevalence and association factors of sleep disorders in a regionally representative sample in Mo Jiang, China. Methods A total of 2,346 (participation rate 93.5%) Grade 7 students (aged 13–14 years) from 10 middle schools, including 1,213 (51.7%) boys and 1,133 (48.3%) girls, participated in the study. All the participants were invited to complete questionnaires that acquired information on sleep patterns, academic performance, academic stress, and sociodemographic factors. Sleep disorders were assessed using the Chinese version of the Children’s Sleep Habits Questionnaire. Logistic regression models were used to investigate factors associated with sleep disorders. Results The prevalence of sleep disorders among rural adolescents was 76.4%, which is higher than that among urban adolescents. Compared with previous findings in urban areas, our results indicate that sleep loss is much more severe in rural adolescents. Sleep disorders were positively associated with factors, such as watching TV [odds ratio (OR) = 1.22, p = 0.001], academic performance (OR = 1.80, p < 0.001), and academic stress (OR = 1.38, p = 0.04). In addition, girls were more likely to suffer from sleep disorders than boys (OR = 1.36, p = 0.01). Conclusion Insufficient sleep and sleep disorders have become common health problems in rural Chinese adolescents.
Transient behavior of coverage processes by applications to the infinite-server queue

We obtain the distribution of the length of a clump in a coverage process where the first line segment of a clump has a distribution that differs from the remaining segments of the clump. This result allows us to provide the distribution of the busy period in an M/G/∞ queueing system with exceptional first service, and applications are considered. The result also provides the tool necessary to analyze the transient behavior of an ordinary coverage process, namely the depletion time of the ordinary M/G/∞ system.