Miracle-dz/UniFAR-FTUs huggingface dataset:
Explaining the barriers to donor participation in the field of health: a qualitative study

Background: Iran’s health system is facing increasing costs and a lack of resources. Developing the financial participation of donors is one of the ways to strengthen the financial health system. Objective: This research was done to explain the barriers to donors’ participation in the field of health. Method: This qualitative study was conducted in 2022 using semi-structured interviews with 22 experts, health donors, policymakers, and managers in Iran. The conventional content analysis method was also used for data analysis. Results: The review and classification of the interviews showed that the participation of donors in the health system includes four main issues: the incompleteness of legal processes, the lack of continuous communication with the charity, management, and resources problems, and the insufficient awareness of the donors about the problems and needs of the health system and 18 subtopics. Conclusions: Donors play an important role in financing, developing resources, providing health services, and financially supporting patients in Iran’s health system. Therefore, by recognizing and removing obstacles to the participation of donors, policymakers and managers of the health system should target the participation of donors with proper planning, organization, guidance, and supervision, and avoid parallel work and waste of resources.
Tumour budding in cutaneous squamous cell carcinoma: A novel prognosis risk factor

Most cutaneous squamous cell carcinomas (cSCC) have a good prognosis, there is a small group where metastasis and death occur and the evaluation of this risk is still cause for controversy. Tumour budding is a pattern of histological invasion that is an emerging risk factor in other solid tumours.
The Early Pleistocene Equidae from Pirro Nord (Apricena, Southern Italy)

Fossil horse remains from Pirro Nord (Southern Italy) are described and compared with the late Early to Middle Pleistocene equids from the main sites ofWestern and Central Europe (Spain, France, Italy and Germany). Morphological features and dimensions indicate the unequal occurrence of two horses, close in morphology but different in size as supported by the statistical analyses (PCA and DA) performed including the most significant samples of Spain (VentaMicena, Barranco Leon-5, Fuente Nueva-3, Huescar-1, Cullar de Baza-1), France (Soleilhac), Italy (Venosa Loreto, Ponte Galeria), and Germany (Susenborn, Untermasfeld). The middle-sized horse is identified as Equus altidens altidens von Reichenau, 1915, its similarity with to the late early to Early Middle Pleistocene specimens from Guadix-Baza basin and Susenborn is briefly discussed in order to chronologically assess the Pirro Nord “population”. The second species Equus suessenbornensisWust, 1900, poorly represented, is larger and close to the type population of Susenborn, as well to the latest Early-earlyMiddle Pleistocene large equids from South-Eastern Spain (Cullar de Baza-1 andHuescar-1), and Italy (Venosa Loreto).
Ablate and pace: Comparison of outcomes between conduction system pacing and biventricular pacing

Conduction system pacing (CSP), including His‐bundle pacing (HBP) and left bundle branch area pacing (LBBAP), have been proposed as alternatives to biventricular pacing (BVP) in patients scheduled for ablate and pace (A&P) strategy. The aim of this study was to compare the clinical outcomes, including the rate and nature of device‐related complications, between BVP and CSP in a cohort of patients undergoing A&P.
Latent factor model for multivariate functional data

For multivariate functional data, a functional latent factor model is proposed, extending the traditional latent factor model for multivariate data. The proposed model uses unobserved stochastic processes to induce the dependence among the different functions, and thus, for a large number of functions, may provide a more parsimonious and interpretable characterization of the otherwise complex dependencies between the functions. Sufficient conditions are provided to establish the identifiability of the proposed model. The performance of the proposed model is assessed through simulation studies and an application to electroencephalography data.
Changes in mental health problems during the COVID-19 pandemic in Mexican youth: Insights from the Voces-19 study

BACKGROUND: Previous research suggests that the mental health impacts of the COVID-19 pandemic were stronger during the first months of it. It has also been proposed that those impacts depended on gender and other social determinants. AIMS: We aim to describe the change in prevalence of mental health problems (symptoms of common mental disorders [CMD], alcohol, and drug use) between two time periods during the pandemic, and the association of mental health problems with social determinants, in adolescents and young adults in Mexico. METHODS: We conducted a repeated cross-section analysis of data from VoCes-19, an online survey in November 2020 to February 2021 and November 2021 to March 2022 (combined n = ×224,099). We assessed the change in the prevalence of mental health problems, the differences in prevalence and change in the prevalence by gender, and the association of social determinants and pandemic-related variables with mental health problems, by means of multivariate regression models. RESULTS: The prevalence of CMD decreased (46.0% vs. 42.4%), while the prevalence of alcohol (frequent use 8.4% vs. 10.3%) and drug use (4.6% vs. 7.7%) increased. The three conditions increased more among girls/young women and trans/queer/non-binary participants than among boys/young men. CONCLUSIONS: The results point to the importance of considering the gendered social context of young people. A better understanding of the social circumstances that relate with mental health is required to inform interventions for these age groups.
Inhalable spray-dried polycaprolactone-based microparticles of Sorafenib Tosylate with promising efficacy on A549 cells

Abstract The study developed and evaluated Sorafenib Tosylate (SRT)-loaded polymeric microparticles (MPs) using biodegradable polymer polycaprolactone (PCL) as a potential inhalable carrier for NSCLC. MPs were prepared by spray-drying an oil-in-water (o/w) emulsion. The optimized MPs demonstrated excellent flowability, particle size of 2.84 ± 0.5 μm, zeta potential of −14.0 ± 1.5 mV, and 85.08 ± 5.43% entrapment efficiency. ATR-FTIR/DSC studies revealed a lack of characteristic peaks of the crystalline drug signifying good entrapment of the drug. MPs were spherical and uniform in SEM pictures. The MPs showed a biphasic release pattern up to 72h. The Anderson cascade impactor (ACI) investigation demonstrated the highest drug deposition at stage 4, which revealed that the MPs can reach the lungs’ secondary and terminal bronchi. Inhalable MPs had an efficient aerodynamic property with a mass median aerodynamic diameter (MMAD) of 2.63 ± 1.3 μm, a geometric standard deviation (GSD) of 1.93 ± 0.2 μm, and a fine particle fraction (FPF) of 87 ± 2.5%. Finally, in cytotoxicity studies on A549 cancer cells, MPs had an IC50 value of 0.6011 ± 0.8 μM, which was 85.68% lower than free drug. These findings suggest SRT-loaded inhalable PCL-based MPs as a novel NSCLC treatment.
Factor Structure and Measurement Invariance of the Self-discipline Model Using the Different-length Questionnaires: Application of Multiple Matrix Sampling

The purposes of this study were to test the structural validity and to test the parameters invariance of the self-discipline measurement model for good student citizenship among the models, using the data from the 1,047 complete questionnaires and the reducing length questionnaires with multiple matrix sampling technique. The sample size of this study was 1,047 bachelor's degree students selected by means of a multi-stage sampling technique. A set of 5 rating scale and 89-item questionnaires, divided into two versions, 44 and 45 each. The data were analyzed by confirmatory factor analysis and multiple group analysis. The research findings were as follows: 1) the model can be used to confirm the self-discipline construct validity of 4 components as responsibility, honesty, compliance and patience with ambition and intention, and 2) patterns and parameters of the model were varied between the models using the data from the full questionnaire and the data that reduced the length of the questionnaire. However, the measurement model is consistent with the empirical data in both cases.
Beta cell primary cilia mediate somatostatin responsiveness via SSTR3

ABSTRACT Somatostatin is a paracrine modulator of insulin secretion and beta cell function with pleotropic effects on glucose homeostasis. The mechanism of somatostatin-mediated communication between delta and beta cells is not well-understood, which we address in this study via the ciliary somatostatin receptor 3 (SSTR3). Primary cilia are membrane organelles that act as signaling hubs in islets by virtue of their subcellular location and enrichment in signaling proteins such as G-protein coupled receptors (GPCRs). We show that SSTR3, a ciliary GPCR, mediates somatostatin suppression of insulin secretion in mouse islets. Quantitative analysis of calcium flux using a mouse model of genetically encoded beta cell-specific GCaMP6f calcium reporter shows that somatostatin signaling alters beta cell calcium flux after physiologic glucose stimulation, an effect that depends on endogenous SSTR3 expression and the presence of intact primary cilia on beta cells. Comparative in vitro studies using SSTR isoform antagonists demonstrate a role for SSTR3 in mediating somatostatin regulation of insulin secretion in mouse islets. Our findings support a model in which ciliary SSTR3 mediates a distinct pathway of delta-to-beta cell regulatory crosstalk and may serve as a target for paracrine modulation. Graphical abstract
Seasonal variations of precipitation d 18 O in eastern Asia

[1] Climate change often occurs through changes in seasonal influences, but paleoclimate records rarely have intra-annual resolution. The precipitation δ18O, either directly measured or indirectly inferred from other datable materials, is one of the most widely used proxies for paleoclimate studies. It is important, therefore, that we understand the seasonal distribution of meteoric δ18O in relation to climate dynamics. In most midlatitude and high-latitude land areas, the precipitation is 18O enriched in the summer and depleted in the winter. However, this isotopic seasonality is reversed in the coastal regions of east Asia, while farther inland it returns to a summer-enriched/winter-depleted seasonal distribution. This spatial distribution of the isotopic seasonality in east Asia has been previously observed, but the mechanisms causing it have not been adequately explained. In this paper, we discuss nine climatic factors that influence isotopic seasonality, either summer-enriched or the reverse. Using a simple two-dimensional δ18O model, we show that one of the important mechanisms for the observed isotopic pattern in Asia may be interseasonal variations in vertical atmospheric stability. These variations are reflected in the large-scale vertical advection of the Walker circulation and in small-scale diffusional mixing, both of which are modulated by the greater stability of air above land relative to that above the ocean in the winter and the opposite in the summer. Our results indicate that the complex causes of interseasonal, interannual, and interepochal variations of meteoric δ18O require considerable caution in the attribution of records of past δ18O variations to changes in specific climate variables.
Relationship between metalloproteinase-9 (MMP-9) expression and clinicopathology in colorectal cancer: a cross-sectional study

Introduction: According to the WHO’s GLOBOCAN database, ~1,931,590 new colorectal cancer (CRC) cases and 915,607 CRC-related deaths occurred in 2020. The incidence of CRC in Indonesia is 8.6%, making it the fourth most common cancer. With CRC, matrix metalloproteinase-9 (MMP-9) has a role in tumour development and progression, such that patients with a higher MMP-9 expression had poorer survival. This study aimed to analyze the relationship between MMP-9 expression and clinicopathology in CRC patients. Methods: This was an analytic observational study with a cross-sectional research design. It was conducted from November 2021 to June 2022 with 52 patient tissue samples: these were subjected to MMP-9 immunohistochemistry stain, with the GeneTex (Irvine) MMP-9 monoclonal antibody. Patient data were collected with clinical variables based on medical records and histopathological examination by anatomy pathologists. Results: Primary tumour location, cancer staging, and histopathology grading were associated with MMP-9 (P=0.016, P=0.001, P=0.049). The more proximal to the primary tumour, the higher the stage of cancer, and the higher the histopathological grade, thus the greater the expression of MMP-9. Conclusion: A significant relationship existed of primary tumour location, cancer staging, and histopathology grading with MMP-9 expression in CRC patients. MMP-9 expression could be a useful indicator for the clinical assessment of tumour biologic behaviour and prognosis in CRC patients.
“Dogs on Call”: A Community-Engaged Human Subjects Training with Hospital Based Therapy Dog Teams

Problem: As community-engaged research (CER) methods evolve, Institutional Review Boards (IRBs) must adapt policies to facilitate CER research. This paper describes a novel collaboration between hospital-based therapy dog volunteer teams (CERs), academic faculty, and an IRB. Subjects: CER volunteers delivered a canine-assisted intervention to hospitalized adults in a clinical trial. Methods: IRB members and faculty developed a human subjects protections training tailored to the volunteer handlers’ role as study interventionists including an interactive video- and discussion-based training with a knowledge assessment. Findings: Fourteen volunteer handlers were trained. The expedited IRB review period was similar to national average rates (18 days.) Volunteer handlers have conducted 107 research visits with little patient attrition. Conclusion: Tailored human subjects trainings facilitate research with interventions delivered by people who are not typically involved in research. Bespoke CER human subjects training requires collaboration between researchers and IRBs and flexibility in IRB policy regarding CER.
Differences and similarities in false interpretations by AI CAD and radiologists in screening mammography

Objective: We aimed to evaluate the false interpretations between artificial intelligence (AI) and radiologists in screening mammography to get a better understanding of how the distribution of diagnostic mistakes might change when moving from entirely radiologist-driven to AI-integrated breast cancer screening. Methods and materials: This retrospective case–control study was based on a mammography screening cohort from 2008 to 2015. The final study population included screening examinations for 714 women diagnosed with breast cancer and 8029 randomly selected healthy controls. Oversampling of controls was applied to attain a similar cancer proportion as in the source screening cohort. We examined how false-positive (FP) and false-negative (FN) assessments by AI, the first reader (RAD 1) and the second reader (RAD 2), were associated with age, density, tumor histology and cancer invasiveness in a single- and double-reader setting. Results: For each reader, the FN assessments were distributed between low- and high-density females with 53 (42%) and 72 (58%) for AI; 59 (36%) and 104 (64%) for RAD 1 and 47 (36%) and 84 (64%) for RAD 2. The corresponding numbers for FP assessments were 1820 (47%) and 2016 (53%) for AI; 1568 (46%) and 1834 (54%) for RAD 1 and 1190 (43%) and 1610 (58%) for RAD 2. For ductal cancer, the FN assessments were 79 (77%) for AI CAD; with 120 (83%) for RAD 1 and with 96 (16%) for RAD 2. For the double-reading simulation, the FP assessments were distributed between younger and older females with 2828 (2.5%) and 1554 (1.4%) for RAD 1 + RAD 2; 3850 (3.4%) and 2940 (2.6%) for AI+RAD 1 and 3430 (3%) and 2772 (2.5%) for AI+RAD 2. Conclusion: The most pronounced decrease in FN assessments was noted for females over the age of 55 and for high density-women. In conclusion, AI could have an important complementary role when combined with radiologists to increase sensitivity for high-density and older females. Advances in knowledge: Our results highlight the potential impact of integrating AI in breast cancer screening, particularly to improve interpretation accuracy. The use of AI could enhance screening outcomes for high-density and older females.
Risk factors and early outcomes of chylothorax following congenital cardiac surgery: A single-center experience

Background This study aims to investigate the incidence and risk factors for chylothorax and to evaluate the effect of chylothorax on the early postoperative outcomes following congenital cardiac surgery. Methods A total of 1,053 patients (606 males, 447 females; median age: 12 months; range, 3 days to 48 years) who underwent surgery for congenital heart disease at our institute between January 2018 and December 2019 were retrospectively analyzed. Patients with chylothorax were identified and the data of this cohort was compared with the entire study population. Following the diagnosis of chylothorax, a standardized management protocol was applied to all patients. Results Of 1,053 patients operated, 78 (7.4%) were diagnosed with chylothorax. In the univariate analysis, younger age, peritoneal dialysis, preoperative need for mechanical ventilation, surgical complexity, delayed sternal closure, high vasoactive inotrope score in the first 24 h after operation, residual or additional cardiac lesions which required reoperations were found to be the risk factors for chylothorax (p<0.05). In the multivariate analysis, the correlation persisted with only younger age, infections, and peritoneal dialysis requirement (p<0.05). In the chylothorax group, ventilation times were longer, and re-intubation and infection rates were higher (p<0.05). Although the length of intensive care unit and hospital stay was significantly longer in this patient group, there was no significant association between the development of chylothorax and in-hospital mortality (p>0.05). Conclusion Chylothorax following congenital cardiac surgery is a significant problem which prolongs the length of hospital stay and increases the infection rates. Complex cardiac pathologies which require surgery at early ages and re-operations are risk factors for chylothorax. Although there is no consensus on the most optimal therapeutic strategy, standardizing the management protocol may improve the results.
Associations between religious/spiritual beliefs and behaviours and dietary patterns: analysis of the parental generation in a prospective cohort study (ALSPAC) in Southwest England

Abstract Objective: Religious/spiritual beliefs and behaviours (RSBB) have been associated with health outcomes, with diet a potential mediator of this relationship. We therefore explored whether RSBB were associated with differences in diet. Design: Dietary patterns and nutrient intakes were derived from food frequency questionnaire completed by pregnant women in 1991–1992 (mean age = 28·3 years, range = 15–46) and by the mothers and partners 4 years post-partum (mothers mean age = 32·3, range = 19–49; partners mean age = 34·5, range = 18–74). RSBB exposures measured in pregnancy included religious belief, affiliation and attendance. We first explored whether RSBBs were associated with dietary patterns in confounder-adjusted linear regression models. If associations were found, we examined whether RSBB were associated with nutrient intake (linear regression) and following nutrient intake guidelines (logistic regression). Setting: Prospective birth cohort study in Southwest England (Avon Longitudinal Study of Parents and Children; ALSPAC). Participants: 13 689 enrolled mothers and their associated partners. Results: In pregnant women, RSBB were associated with higher ‘traditional’ (i.e. ‘meat and two veg’) and lower ‘vegetarian’ dietary pattern scores. Religious attendance and non-Christian religious affiliation were associated with higher ‘health-conscious’ dietary pattern scores. Religious attendance was associated with increased micronutrient intake and following recommended micronutrient intake guidelines, with weaker effects for religious belief and affiliation. Comparable patterns were observed for mothers and partners 4 years post-partum, although associations between RSBB and nutrient intakes were weaker for partners. Conclusions: RSBBs are associated with broad dietary patterns and nutrient intake in this cohort. If these reflect causal relationships, diet may potentially mediate the pathway between RSBB and health.
Are the directions of both eyes integrated before or after the perception of direct gaze? Evidence from simulated mild strabismus

The cone of gaze is a looker's range of gaze directions that is accepted as direct by an observer. The present research asks how the condition of mild strabismus, that is, when the two eyes point in slightly different directions, influences the cone of gaze. Normally, both eyes are rotated in a coordinated manner such that both eyes are directed to the same fixation point. With strabismus, there are two fixation points, and, therefore, two directions into which the two eyes point. This raises the question of the direction and the shape (i.e., width) of the gaze cone. Two experiments are conducted with simulated mild strabismus. Three conditions are tested, the two strabismic conditions of esotropia, and exotropia and one orthotropic (nonstrabismic) condition. Results show that the direction of the gaze cone is roughly the average of the directions of the two eyes. Furthermore, the width of the gaze cone is not affected by simulated strabismus and is thus the same for the strabismic and the orthotropic conditions. The results imply a model where at first the direction of gaze based on both eyes is perceived, and where the gaze cone is implied on the basis of the combined gaze direction.
Prevalence and impact of diabetes mellitus in hospitalized COVID-19 patients in a Tunisian Center: a cross-sectional study

Background: The outbreak of the coronavirus disease 2019 (COVID-19) has become an evolving worldwide health crisis. With the rising prevalence of diabetes mellitus has come an increasing awareness of their impacts on infectious diseases, and the risk for postinfection complications and mortality from critical infections. Objective: The objective of this study was to evaluate the prevalence and impact of diabetes mellitus on the severity and mortality of COVID-19. Methods: Data of laboratory-confirmed hospitalized patients at the COVID-19 unit between September 2020 and August 2021 were analyzed, in a cross-sectional study. The population was classified into two groups: COVID-19 patients with and without diabetes. Primary outcomes were the overall length of hospital stay, the admission to the ICU, and death. The association between diabetes and death was assessed in a Cox proportional hazards model. Results: A total of 866 patients were included. There were 270 (31.2%) patients with diabetes. Diabetic patients were more likely to have hypertension (58.1 vs. 33.4%), cardiovascular disease (18.5 vs. 10.4%), and dyslipidaemia (17.8 vs. 7.2). Overall, 263 patients died, among them only 86 in the diabetic group (P=0.523). Patients with diabetes had a higher risk of developing complications (P<0.001). Multivariate Cox regression analysis showed that diabetes was not significantly associated with death [HR (95% CI): 1.253 (0.963–1.631)]. Conclusion: Diabetes was associated with a greater risk of complications in patients with COVID-19. Special attention to diabetic patients during treatment must be given to avoid these complications.