Miracle-dz/UniFAR-FTUs huggingface dataset:
A comparison of the performance of normal middle social class Egyptian infants and toddlers with the reference norms of the Bayley Scales -third edition (Bayley III): A pilot study

Background Developmental assessment is an important facility for early detection and intervention of developmental delay in children. Objective: to assess the performance of a sample of middle social class Egyptian infants and toddlers on Bayley Scales of Infant and Toddler Development-third edition (Bayley III), and to compare their cognitive, motor, and communication scores with that of the reference norms. Methods It was a cross-sectional pilot study, included 270 children aged 18–42 months. Mothers filled a questionnaire including questions about family socioeconomic background, perinatal history, and family history. Physical examination and growth assessment of children were performed. Developmental assessment of cognitive, language and motor skills was performed using the Bayley III scales and compared the American norm scores with the Egyptian mean scores. Results The mean cognitive, language and motor composite scores were 92.5+18.5, 91.76+ 15.6, and 95.67+18.9 respectively. All were lower than the American mean (100+ 15) with highly significant differences. About one-fourth of the enrolled Egyptian children had below-average composite scores according to the US cutoff point. The ranks of Egyptian children on the American versus the Egyptian percentile curves were significantly different. Conclusion Mean values of all assessed developmental domains of Egyptian children are within the norm-referenced average of Bayley III, but lower than the recorded American mean. Assessing Egyptian children according to the American norms may result in overestimating developmental delay. This pilot study raised the question about using different cutoff points suitable for the developmental trajectory of Egyptian children. Answering this question needs further studies on Bayley-III after cultural adaptation and standardization, using a larger, more diverse, and representative sample of the Egyptian population.
Quality-adjusted life year comparison at medium term follow-up of endovascular versus open surgical repair for abdominal aortic aneurysm in young patients

Objectives This study aimed to compare the quality of life and cost effectiveness between endovascular aneurysm repair (EVAR) and open surgical repair (OSR) in young patients with abdominal aortic aneurysm (AAA). Design This was a single-center, observational, and retrospective study. Materials and methods A retrospective analysis was conducted of patients with AAA, who were <70 years old and underwent EVAR or OSR between January 2012 and October 2016. Only patients with aortic morphology that was suitable for EVAR were enrolled. Data on the complication rates, medical expenses, and expected quality-adjusted life years (QALYs) were collected, and the cost per QALY at three years was compared. Results Among 90 patients with aortic morphology who were eligible for EVAR, 37 and 53 patients underwent EVAR and OSR, respectively. No significant differences were observed in perioperative cardiovascular events and death between the two groups. However, during the follow-up period, patients undergoing OSR showed a significantly lower complication rate (hazard ratio [HR] = 0.11; P = .021). From the three-year cost-effectiveness analysis, the total sum of costs was significantly lower in the OSR group (P < .001) than that in the EVAR group, and the number of QALYs was superior in the OSR group (P = .013). The cost per QALY at three years was significantly lower in the OSR group than that in the EVAR group (mean: $4038 vs. $10 137; respectively; P < .001) Conclusions OSR had lower complication rates and better cost-effectiveness than EVAR Among young patients with feasible aortic anatomy.
Modeling the Metabolic Costs of Heavy Military Backpacking

ABSTRACT Introduction Existing predictive equations underestimate the metabolic costs of heavy military load carriage. Metabolic costs are specific to each type of military equipment, and backpack loads often impose the most sustained burden on the dismounted warfighter. Purpose This study aimed to develop and validate an equation for estimating metabolic rates during heavy backpacking for the US Army Load Carriage Decision Aid (LCDA), an integrated software mission planning tool. Methods Thirty healthy, active military-age adults (3 women, 27 men; age, 25 ± 7 yr; height, 1.74 ± 0.07 m; body mass, 77 ± 15 kg) walked for 6–21 min while carrying backpacks loaded up to 66% body mass at speeds between 0.45 and 1.97 m·s−1. A new predictive model, the LCDA backpacking equation, was developed on metabolic rate data calculated from indirect calorimetry. Model estimation performance was evaluated internally by k-fold cross-validation and externally against seven historical reference data sets. We tested if the 90% confidence interval of the mean paired difference was within equivalence limits equal to 10% of the measured metabolic rate. Estimation accuracy and level of agreement were also evaluated by the bias and concordance correlation coefficient (CCC), respectively. Results Estimates from the LCDA backpacking equation were statistically equivalent (P < 0.01) to metabolic rates measured in the current study (bias, −0.01 ± 0.62 W·kg−1; CCC, 0.965) and from the seven independent data sets (bias, −0.08 ± 0.59 W·kg−1; CCC, 0.926). Conclusions The newly derived LCDA backpacking equation provides close estimates of steady-state metabolic energy expenditure during heavy load carriage. These advances enable further optimization of thermal-work strain monitoring, sports nutrition, and hydration strategies.
Microbe-based management for colorectal cancer

Abstract Colorectal cancer (CRC) is one of the most prevalent, most lethal cancers in the world. Increasing evidence suggests that the intestinal microbiota is closely related to the pathogenesis and prognosis of CRC. The normal microbiota plays an essential role in maintaining gut barrier function and the immune microenvironment. Recent studies have identified carcinogenic bacteria such as enterotoxigenic Bacteroides fragilis (ETBF) and Streptococcus gallolyticus (S. gallolyticus), as well as protective bacterial such as Akkermansia muciniphila (A. muciniphila), as potential targets of CRC treatment. Gut microbiota modulation aims to restore gut dysbiosis, regulate the intestinal immune system and prevent from pathogen invasion, all of which are beneficial for CRC prevention and prognosis. The utility of probiotics, prebiotics, postbiotics, fecal microbiota transplantation and dietary inventions to treat CRC makes them novel microbe-based management tools. In this review, we describe the mechanisms involved in bacteria-derived colorectal carcinogenesis and summarized novel bacteria-related therapies for CRC. In summary, we hope to facilitate clinical applications of intestinal bacteria for preventing and treating CRC.
Suspected primary hyperreninism in a cat with malignant renal sarcoma and global renin‐angiotensin‐aldosterone system upregulation

Abstract A 14‐year‐old male castrated domestic medium‐hair cat with diabetes mellitus was evaluated for vomiting, diarrhea, and anorexia. Two weeks before presentation, the cat had been diagnosed with congestive heart failure and started on furosemide. Initial diagnostic testing identified hypokalemia, systemic hypertension, and hypertrophic cardiomyopathy phenotype, and plasma aldosterone concentration was moderately increased. Abdominal ultrasound examination disclosed bilateral adrenomegaly and a right renal mass, and cytology of a needle aspirate of the mass was consistent with malignant neoplasia. The cat was treated with amlodipine and spironolactone. Because of the unusual presentation for hyperaldosteronism, a comprehensive profile of renin‐angiotensin‐aldosterone system (RAAS) peptides was performed. Results from multiple timepoints indicated persistently and markedly increased plasma renin activity and generalized RAAS upregulation. In addition to the lack of adrenal tumor, the markedly increased plasma renin activity was atypical for primary hyperaldosteronism. These clinical findings are suggestive of primary hyperreninism, a condition previously unreported in cats. The concurrent presence of a renal neoplasm suggests the possibility of a renin‐secreting tumor.
Error-prone, stress-induced 3′ flap–based Okazaki fragment maturation supports cell survival

Description Maturation for survival Although cells with defects in DNA replication usually die under stress conditions, some cells acquire new mutations and survive. Sun et al. identified an error-prone, stress-induced Okazaki fragment maturation pathway that induces tandem duplications and enables the survival of cells that have defects in removing the 5′ RNA-DNA flap during DNA replication. In these cells, stress conditions activate DUN1 signaling and induce conversion of the 5′ flap to a 3′ flap that can form secondary structures and be extended and ligated to the downstream DNA fragment, generating alternative duplication mutations similar to the ones in human cancers. The revealed information is analogous to the mechanism in cancer cell evolution and drug resistance. —DJ Stress-induced DNA replication induces a type of mutation that supports cell survival analogous to mechanisms involved in cancer drug resistance. How cells with DNA replication defects acquire mutations that allow them to escape apoptosis under environmental stress is a long-standing question. Here, we report that an error-prone Okazaki fragment maturation (OFM) pathway is activated at restrictive temperatures in rad27Δ yeast cells. Restrictive temperature stress activated Dun1, facilitating transformation of unprocessed 5′ flaps into 3′ flaps, which were removed by 3′ nucleases, including DNA polymerase δ (Polδ). However, at certain regions, 3′ flaps formed secondary structures that facilitated 3′ end extension rather than degradation, producing alternative duplications with short spacer sequences, such as pol3 internal tandem duplications. Consequently, little 5′ flap was formed, suppressing rad27Δ-induced lethality at restrictive temperatures. We define a stress-induced, error-prone OFM pathway that generates mutations that counteract replication defects and drive cellular evolution and survival.
Ia EPSPs in rat spinal motoneurons are potentiated after a 5-week whole-body vibration.

Whole-body vibration (WBV) is often applied as an alternative method for strength training or to prevent muscle force decrease. Previous studies indicated that WBV induced: 1) changes in the contractile parameters predominantly of fast motor units, 2) higher motoneuron excitability, and 3) higher motoneuron firing rates at lower stimulus intensities compared with the control. In this study, we evaluated the influence of WBV on Ia monosynaptic input from muscle spindles because the tonic vibration reflex is responsible for the enhancement of muscle activity observed after WBV. The aim was to answer the question of whether repeated activation of muscle spindles during WBV may result in altered synaptic excitation of motoneurons. WBV was performed on adult male Wistar rats, 5 days per week, for 5 weeks, and each daily session consisted of four 30-s runs of vibration at 50 Hz. Fast-type medial gastrocnemius motoneurons were investigated intracellularly in deeply anesthetized animals in the experimental (n=7, 34 motoneurons) and control (n=7, 32 motoneurons) groups. Monosynaptic Ia EPSPs were evoked by electrical stimulation of afferent fibers from the synergistic lateral gastrocnemius and soleus muscles. Data were analyzed using a mixed linear model. WBV induced an increase of the mean EPSP amplitude by 28% (P=0.025), correlated with the resting membrane potential and input resistance, and a shortening of the mean EPSP rise time by 11% (P=0.012). The potentiation of synaptic excitation of motoneurons indicates that WBV may support rehabilitation or training processes aimed at increasing muscle strength on the basis of increased motoneuronal drive.
Serial measurement of cytokines strongly predict COVID-19 outcome

Purpose Cytokines are major mediators of COVID-19 pathogenesis and several of them are already being regarded as predictive markers for the clinical course and outcome of COVID-19 cases. A major pitfall of many COVID-19 cytokine studies is the lack of a benchmark sampling timing. Since cytokines and their relative change during an infectious disease course is quite dynamic, we evaluated the predictive value of serially measured cytokines for COVID-19 cases. Methods In this single-center, prospective study, a broad spectrum of cytokines were determined by multiplex ELISA assay in samples collected at admission and at the third day of hospitalization. Appropriateness of cytokine levels in predicting mortality were assessed by receiver-operating characteristic (ROC) analyses for both sampling times in paralel to conventional biomarkers. Results At both sampling points, higher levels of IL-6, IL-7, IL-10, IL-15, IL-27 IP-10, MCP-1, and GCSF were found to be more predictive for mortality (p<0.05). Some of these cytokines, such as IL-6, IL-10, IL-7 and GCSF, had higher sensitivity and specificity in predicting mortality. AUC values of IL-6, IL-10, IL-7 and GCSF were 0.85 (0.65 to 0.92), 0.88 (0.73 to 0.96), 0.80 (0.63 to 0.91) and 0.86 (0.70 to 0.95), respectively at hospital admission. Compared to hospital admission, on the 3rd day of hospitalization serum levels of IL-6 and, IL-10 decreased significantly in the survivor group, unlike the non-survivor group (IL-6, p = 0.015, and IL-10, p = 0.016). Conclusion Our study results suggest that single-sample-based cytokine analyzes can be misleading and that cytokine levels measured serially at different sampling times provide a more precise and accurate estimate for the outcome of COVID-19 patients.
Icariin accelerates cartilage defect repair by promoting chondrogenic differentiation of BMSCs under conditions of oxygen‐glucose deprivation

This study explored the role played by combined ICA and bone mesenchymal stem cells (BMSCs) in repairing rabbit knee cartilage defects. Firstly, rabbit BMSCs were isolated and used to construct an in vitro cellular model of oxygen‐glucose deprivation/reoxygenation (OGD/R). Subsequently, ICA processing, Alcian blue staining, immunofluorescence and Western blot studies were performed to evaluate the ability of BMSCs to display signs of chondrogenic differentiation. Furthermore, a rabbit knee cartilage injury model was established in vivo. International Cartilage Repair Society (ICRS) macroscopic evaluations, H&E, Alcian blue and EdU staining, as well as immunohistochemistry, were analysed cartilage repair and pathological condition of the knee cartilage tissue. Our in vitro results showed that ICA promoted the chondrogenic differentiation of BMSCs, as well as aggrecan (AGR), bone morphogenetic protein 2 (BMP2) and COL2A1 protein expression in BMSCs. In vivo experiments showed that rabbits in the BMSCs or ICA treatment group had higher ICRS scores and displayed a better restoration of cartilage‐like tissue and chondrocyte expression on the surface of their cartilage defects. In conclusion, ICA or BMSCs alone could repair rabbit knee cartilage damage, and combined treatment with ICA and BMSCs showed a better ability to repair rabbit knee cartilage damage.
ImpulsePal: The systematic development of a smartphone app to manage food temptations using intervention mapping

Background Impulsive processes driving eating behaviour can often undermine peoples’ attempts to change their behaviour, lose weight and maintain weight loss. Aim To develop an impulse management intervention to support weight loss in adults. Methods Intervention Mapping (IM) was used to systematically develop the “ImpulsePal” intervention. The development involved: (1) a needs assessment including a qualitative study, Patient and Public advisory group and expert group consultations, and a systematic review of impulse management techniques; (2) specification of performance objectives, determinants, and change objectives; (3) selection of intervention strategies (mapping of change techniques to the determinants of change); (4) creation of programme materials; (5) specification of adoption and implementation plans; (6) devising an evaluation plan. Results Application of the IM Protocol resulted in a smartphone app that could support reductions in unhealthy (energy dense) food consumption, overeating, and alcoholic and sugary drink consumption. ImpulsePal includes inhibition training, mindfulness techniques, implementation intentions (if-then planning), visuospatial loading, use of physical activity for craving management, and context-specific reminders. An “Emergency Button” was also included to provide access to in-the-moment support when temptation is strong. Conclusions ImpulsePal is a novel, theory- and evidence-informed, person-centred app that aims to support impulse management for healthier eating. Intervention Mapping facilitated the incorporation of app components that are practical operationalisations of change techniques targeting our specific change objectives and their associated theoretical determinants. Using IM enabled transparency and provided a clear framework for evaluation, and enhances replicability and the potential of the intervention to accomplish the desired outcome of facilitating weight loss through dietary change.
Scaling of spectral displacement ordinates with damping ratios

The next generation of seismic design codes, especially those adopting the framework of performance‐based design, will include the option of design based on displacements rather than forces. For direct displacement‐based design using the substitute structure approach, the spectral ordinates of displacement need to be specified for a wide range of response periods and for several levels of damping. The code displacement spectra for damping values higher than the nominal value of 5% of critical will generally be obtained, as is the case in Eurocode 8 and other design codes, by applying scaling factors to the 5% damped ordinates. These scaling factors are defined as functions of the damping ratio and, in some cases, the response period, but are independent of the nature of the expected ground shaking. Using both predictive equations for spectral ordinates at several damping levels and stochastic simulations, it is shown that the scaling factors for different damping levels vary with magnitude and distance, reflecting a dependence of the scaling on the duration of shaking that increases with the damping ratio. The options for incorporating the influence of this factor into design code specifications of displacement response spectra are discussed. Copyright © 2004 John Wiley & Sons, Ltd.
Sutureless technique for repositioning and scleral fixation of the capsular bag–intraocular lens complex with permanent use of iris retractors

A new sutureless technique used for repositioning and scleral fixation of the capsular bag–intraocular lens (IOL) complex in the surgical treatment of subluxated lenses is described. Iris retractors were used not only to induce a tent effect on the capsule but also to permanently fix the capsular bag to the sclera in this method, without the need to prepare scleral or conjunctival flaps. Surgery with the use of a capsular tension ring (CTR) and iris retractors, the ends of which were brought out through the sclera and cauterized, was performed in 7 eyes of 7 patients with moderate or severe subluxation of the crystalline lens. In all cases, simultaneous use of a CTR and iris retractors ensured good centration of the capsular bag–IOL complex. The method was safe and effective in fixing the capsule to the sclera in the case of significant damage to the ligamentous apparatus of the lens.
Longitudinal changes in Super League match locomotor and event characteristics: A league-wide investigation over three seasons in rugby league

The 2019 and 2020 Super League (SL) seasons included several competition rule changes. This study aimed to quantify the difference between the 2018, 2019 and 2020 SL seasons for duration, locomotor and event characteristics of matches. Microtechnology and match event data were analysed from 11 SL teams, comprising 124 players, from 416 competitive matches across a three-year data collection period. Due to an enforced suspension of league competition as a consequence of COVID-19 restrictions, and subsequent rule changes upon return to play, season 2020 was divided into season 2020a (i.e. Pre-COVID suspension) and season 2020b (i.e. Post-COVID suspension). Duration, locomotor variables, and match events were analysed per whole-match and ball-in-play (BIP) periods with differences between seasons determined using mixed-effects models. There were significant (ρ ≤ 0.05) reductions in whole-match and BIP durations for adjustables and backs in 2019 when compared to 2018; albeit the magnitude of reduction was less during BIP analyses. Despite reduced duration, adjustables reported an increased average speed suggesting reduced recovery time between bouts. Both forwards and adjustables also experienced an increase in missed tackles between 2018 and 2019 seasons. When comparing 2019 to 2020a, adjustables and backs increased their average speed and distance whilst all positional groups increased average acceleration both for whole-match and BIP analyses. When comparing 2020a to 2020b, all positional groups experienced reduced average speed and average acceleration for both whole-match and BIP analyses. Forwards experienced an increased number of tackles and carries, adjustables experienced an increased number of carries, and backs experienced an increased number of missed tackles when comparing these variables between season 2020a and 2020b. Rule changes have a greater effect on whole-match duration and locomotor characteristics than those reported during BIP periods which suggests the implemented rule changes have removed stagnant time from matches. Amendments to tackle related rules within matches (e.g., introduction of the ‘six-again’ rule) increases the number of collision related events such as carries and tackles.
Terrestrial venomous animals, the envenomings they cause, and treatment perspectives in the Middle East and North Africa

The Middle East and Northern Africa, collectively known as the MENA region, are inhabited by a plethora of venomous animals that cause up to 420,000 bites and stings each year. To understand the resultant health burden and the key variables affecting it, this review describes the epidemiology of snake, scorpion, and spider envenomings primarily based on heterogenous hospital data in the MENA region and the pathologies associated with their venoms. In addition, we discuss the venom composition and the key medically relevant toxins of these venomous animals, and, finally, the antivenoms that are currently in use to counteract them. Unlike Asia and sub-Saharan Africa, scorpion stings are significantly more common (approximately 350,000 cases/year) than snakebites (approximately 70,000 cases/year) and present the most significant contributor to the overall health burden of envenomings, with spider bites being negligible. However, this review also indicates that there is a substantial lack of high-quality envenoming data available for the MENA region, rendering many of these estimates speculative. Our understanding of the venoms and the toxins they contain is also incomplete, but already presents clear trends. For instance, the majority of snake venoms contain snake venom metalloproteinases, while sodium channel–binding toxins and potassium channel–binding toxins are the scorpion toxins that cause most health-related challenges. There also currently exist a plethora of antivenoms, yet only few are clinically validated, and their high cost and limited availability present a substantial health challenge. Yet, some of the insights presented in this review might help direct future research and policy efforts toward the appropriate prioritization of efforts and aid the development of future therapeutic solutions, such as next-generation antivenoms.