Miracle-dz/UniFAR-FTUs huggingface dataset:
Association between Type 2 Diabetes Mellitus and Brain Atrophy: A Meta-Analysis

Background Type 2 diabetes mellitus (T2DM) is known to be associated with cognitive decline and brain structural changes. This study systematically reviews and estimates human brain volumetric differences and atrophy associated with T2DM. Methods PubMed, PsycInfo and Cochrane Library were searched for brain imaging studies reporting on brain volume differences between individuals with T2DM and healthy controls. Data were examined using meta-analysis, and association between age, sex, diabetes characteristics and brain volumes were tested using meta-regression. Results A total of 14,605 entries were identified; after title, abstract and full-text screening applying inclusion and exclusion criteria, 64 studies were included and 42 studies with compatible data contributed to the meta-analysis (n=31,630; mean age 71.0 years; 44.4% male; 26,942 control; 4,688 diabetes). Individuals with T2DM had significantly smaller total brain volume, total grey matter volume, total white matter volume and hippocampal volume (approximately 1% to 4%); meta-analyses of smaller samples focusing on other brain regions and brain atrophy rate in longitudinal investigations also indicated smaller brain volumes and greater brain atrophy associated with T2DM. Meta-regression suggests that diabetes-related brain volume differences start occurring in early adulthood, decreases with age and increases with diabetes duration. Conclusion T2DM is associated with smaller total and regional brain volume and greater atrophy over time. These effects are substantial and highlight an urgent need to develop interventions to reduce the risk of T2DM for brain health.
Blood Lead Concentrations of Free-Ranging North Florida Raptors: 2008–17

Abstract: Whole blood samples for lead analysis were collected from 441 raptors admitted to the Zoological Medicine Service at the University of Florida (US) between 1 January 2008 and 31 December 2017. The species included Bald Eagles (Haliaeetus leucocephalus), Ospreys (Pandion haliaetus), Black (Coragyps atratus) and Turkey (Cathartes aura) Vultures, Barred (Strix varia) and Great Horned (Bubo virginianus) Owls, and Red-tailed (Buteo jamaicensis) and Red-shouldered (Buteo lineatus) Hawks. Our hypothesis was that geography, seasonality, and hunting strategies of these species would all affect the blood lead concentrations. Blood lead concentrations were found to vary significantly between species, with known scavengers having higher values. Additionally, seasonal differences were seen between winter and summer, but the county in which these individuals were found did not alter the blood lead concentrations. We found lead contamination to be a common and considerable problem in Bald Eagles and vultures but not as evident in nocturnal and other diurnal raptors in North Florida. Furthermore, concentrations were highest during winter in this temperate location, suggesting a possible relationship with hunting seasons despite a lack of big game.
Loneliness in autistic adults: A systematic review

In this systematic review, we examined quantitative, qualitative and mixed methods studies on loneliness in autistic adults. A total of 1460 articles were identified, and 34 of these met inclusion criteria. Results demonstrated that (1) there is a paucity of qualitative data providing first-hand descriptions of loneliness from autistic adults; (2) few empirical studies have used reliable/valid measures of loneliness developed specifically for autistic adults, and in just one study was a measure of loneliness developed for, and validated in, autistic adults; (3) the collective dimension of loneliness (i.e. belonging in society) has been described by autistic adults, yet has not been investigated as frequently as the intimate (i.e. romantic relationships) or relational (i.e. friend/family relationships) dimensions of loneliness; (4) the factors associated with increased loneliness in autistic adults include autistic characteristics, anxiety, depression and suicidal ideation, negative experiences and learned helplessness, a lack of autism understanding and acceptance, sensory avoidance, camouflaging and unemployment; and (5) the factors associated with decreased loneliness in autistic adults include having relationships, participation in social skill interventions and/or experiencing fewer difficulties with social skills, positive views and acceptance of oneself, being female and time spent engaging in activities (e.g. online gaming). Directions for future research are considered. Lay abstract Recently, researchers have been interested in how autistic people experience loneliness. Yet, most of this research has focused on loneliness in autistic children and young people. We present the results of a systematic review on loneliness in autistic adults. A systematic review is a rigorous way of searching for all existing research on a topic and summarizing the findings about specific questions. We searched for all research published on this topic until 9 April 2021. We found 34 articles that investigated loneliness in autistic adults. This research showed that (1) there is fairly little research that has involved directly asking autistic adults about their first-hand experiences of loneliness (e.g. what loneliness feels like for them); (2) few research studies have used loneliness questionnaires specifically developed for autistic adults (this was attempted in just one research study); (3) collective loneliness (i.e. loneliness associated with how much an autistic person feels they ‘fit in’ to society) seems important to autistic adults but has not been investigated as commonly as other aspects of loneliness (e.g. loneliness associated with romantic relationships or friendships); (4) things that might increase loneliness in autistic adults include anxiety and depression, and a lack of autism understanding and acceptance, for example; and (5) things that might reduce loneliness in autistic adults include having relationships and self-acceptance, for example. In our article, we discuss the kinds of future research on loneliness in autistic adults that might be useful.
Introduction to the special issue “Moral injury care: Practices and collaboration”

Abstract Since moral injury was introduced in the psychological literature little more than a decade ago, it has received substantial attention from mental health professionals as well as chaplains. This special issue features ways that chaplains are and can be engaged in addressing moral injury within health care contexts, especially the Department of Veterans Affairs. The efforts highlighted in this special issue provide building blocks for advancing moral injury care practices, research agendas, and interdisciplinary collaborations into the future.
An Agile Development Cycle of an Online Memory Program for Healthy Older Adults

Abstract Online interventions for older adults should be tailored to their unique needs to increase the efficacy of and adherence to the intervention. The agile development cycle is a dynamic model to solicit and incorporate feedback from older adults during the design process. We combined this approach with the framework of Harvard University’s clinical and translational phases that provide a clear structure for evaluating new health programs before they are offered in the community. We based our online memory program on the empirically validated in-person Memory and Aging Program. The aim of the present study was to combine the agile development cycle with the clinical and translational phases framework to develop and pilot an online memory program tailored to the unique needs of older adults. Study 1 involved piloting individual program modules on site and integrating participant feedback into the program’s design to optimize usability. Study 2 involved two sequential pilots of the program accessed remotely to evaluate preliminary clinical outcomes and obtain feedback for iterative modifications. Plans for further validation and limitations are discussed. The successful application of the agile development cycle implemented in this series of studies can be adapted by others seeking to offer online content for targeted end users.
Cancer Screening Among Rural and Urban Clinics During COVID-19: A Multistate Qualitative Study

PURPOSE: The effects of COVID-19 have been understudied in rural areas. This study sought to (1) identify cancer screening barriers and facilitators during the pandemic in rural and urban primary care practices, (2) describe implementation strategies to support cancer screening, and (3) provide recommendations. METHODS: A qualitative study was conducted (N = 42) with primary care staff across 20 sites. Individual interviews were conducted through videoconference from August 2020 to April 2021 and recorded, transcribed, and analyzed using deductive and inductive coding (hybrid approach) in NVivo 12 Plus. Practices included federally qualified health centers, tribal health centers, rural health clinics, hospital/health system–owned clinics, and academic medical centers across 10 states including urban (55%) and rural (45%) sites. Staff included individuals serving in the dual role of health care provider and administrator (21.4%), health care administrator (23.8%), physician (19.0%), advanced practice provider (11.9%), or resident (23.8%). The interviews assessed perceptions about cancer screening barriers and facilitators, implementation strategies, and future recommendations. RESULTS: Participants reported multilevel barriers to cancer screening including policy-level (eg, elective procedure delays), organizational (eg, backlogs), and individual (eg, patient cancellation). Several facilitators to screening were noted, such as home-based testing, using telehealth, and strong partnerships with referral sites. Practices used strategies to encourage screening, such as incentivizing patients and providers and expanding outreach. Rural clinics reported challenges with backlogs, staffing, telehealth implementation, and patient outreach. CONCLUSION: Primary care staff used innovative strategies during the pandemic to promote cancer screening. Unresolved challenges (eg, backlogs and inability to implement telehealth) disproportionately affected rural clinics. Rural primary care practices reported unique barriers to implementing cancer screening during the pandemic. Strategies are needed to ensure that rural-urban cancer screening disparities are not exacerbated.
Managing puerperium in patients with systemic autoimmune diseases: an update

ABSTRACT Introduction Puerperium is a critical period for patients affected by autoimmune rheumatic diseases for the risk of disease’s flares and difficulties in treating lactating mothers. We want to summarize the literature data about psychological and pharmacological management of these patients and possible risk factors of disease’s flares. Areas covered We made a narrative review on recent studies about puerperium in rheumatic autoimmune diseases patients. Expert opinion The physicians involved in management of patients during puerperium and in the follow-up of babies need to agree on maternal treatment because they need to reassure mothers about the safety of the prescribed medications. Furthermore, women with rheumatic diseases could present some musculoskeletal limitations and psychological problems, such as postpartum depression, which can lead to a sense of inadequacy to the mother’s task. Families and physicians should be aware of these possible complications and support the new mothers providing correct counseling and practical help.
Prevalence and Clinical Significance of Helicobacter Pylori-negative Chronic Gastritis in Children

ABSTRACT Objectives: The clinical significance of Helicobacter pylori-negative chronic gastritis (HPNCG) in children is unclear. We examined this issue in patients who had undergone esophagogastroduodenoscopy with systematic gastric sampling. Methods: Data of 1178 consecutive children who underwent diagnostic esophagogastroduodenoscopy were collected. Baseline characteristics and long-term outcomes were compared between children with active and inactive HPNCG and those with normal gastric histology. Follow-up data were available for up to 13 years. Results: Altogether 24 (2.0%) children had active and 235 (19.9%) inactive HPNCG, 27 (2.3%) were Hpylori-positive, 46 (3.9%) had other gastric pathology, and 846 (71.8%) normal histology. Diarrhea (31.3% vs 25.1%, P = 0.033), poor growth (23.6% vs 14.7%, P < 0.001), bloody stools (13.9% vs 7.2%, P < 0.001), anemia (46.5% vs 23.4%, P < 0.001), hypersedimentation (39.7% vs 21.4%, P < 0.001), hypoalbuminemia (40.4% vs 16.2%, P < 0.001), and elevated fecal calprotectin (62.4% vs 31.5%, P < 0.001) were more common and heartburn (13.9% vs 22.9%, P = 0.002) less common in the HPNCG group than in the controls. Both active (OR 3.64,95% CI 1.35–9.82) andinactive (2.98, 2.18–4.08) HPNCG predicted a diagnosis in the initial investigations. Crohn disease (41.7%) was the most common diagnosis in active HPNCG and celiac disease (37.4%) in inactive HPNCG. During follow-up, 7 (9.9%) of the 71 initially nondiagnosed HPNCG children received a diagnosis. Conclusions: HPNCG is a frequent finding in children undergoing EGD, the active form being associated especially with Crohn disease and the inactive with celiac disease. The long-term prognosis of patients with HPNCG who do not receive an initial diagnosis is good.
Knowledge, attitudes, practices (KAP) and control of rabies among community households and health practitioners at the human-wildlife interface in Limpopo National Park, Massingir District, Mozambique

Background Rabies is a viral zoonotic disease that kills more than 26,000 people each year in Africa. In Mozambique, poverty and inadequate surveillance result in gross underreporting and ineffective control of the disease in animals and people. Little is known of the role of human attitudes and behaviour in prevention or control of rabies, thus this study was undertaken to assess the knowledge, attitudes and practices amongst selected households and health practitioners in one affected area, the Limpopo National Park (LNP), Massingir district. Methodology A cross-sectional study was conducted among 233 households in eight villages in LNP and among 42 health practitioners from eight health facilities in Massingir district between 2016 and 2018. Consenting household representatives aged 18 years or over were purposively selected. A KAP survey was administered to obtain information on dog ownership and knowledge of rabies, host species affected, modes of transmission, symptoms, recommended treatment and preventive methods. Similar to household study participants, health practitioners were purposively selected and completed the questionnaire during the investigators’ visit. The questionnaire sought information on knowledge of rabies, management of bite wounds, vaccination sites and schedules of pre- and post-exposure prophylaxis. Descriptive and inferential data analyses were performed using SPSS software version 18.0. Results Approximately twenty per cent (18.9%; 95% CI: 14.3–24.3) and 13.3% (95% CI: 9.4–18.1) of households had good knowledge and practices of rabies, respectively. For health practitioners, only 16.7% (95% CI: 7.5–31.9) had good knowledge, whilst 33.3% (95% CI: 20.0–49.7) adopted adequate attitudes/practices towards the disease. Conclusions/Significance In conclusion, both households and health practitioners displayed poor levels of knowledge and adopted bad attitudes and practices towards rabies. The former, had more gaps in their attitudes and practices towards the disease. Village location and education level (P < .05) and similarly, sex and occupation, were found to be statistically associated with good knowledge of rabies among households as compared to HPs. Overall, a lack of community-based education and professional retraining courses contribute significantly to poor awareness of rabies in the LNP of Mozambique. Enhancing public health knowledge should consequently reduce dog-mediated human rabies deaths in this country.
Programming of cardiometabolic health: the role of maternal and fetal hyperinsulinaemia

Obesity and gestational diabetes during pregnancy have multiple short- and long-term consequences for both mother and child. One common feature of pregnancies complicated by maternal obesity and gestational diabetes is maternal hyperinsulinaemia, which has effects on the mother and her adaptation to pregnancy. Even though insulin does not cross the placenta insulin can act on the placenta as well affecting placental growth, angiogenesis and lipid metabolism. Obese and gestational diabetic pregnancies are often characterised by maternal hyperglycaemia resulting in exposure of the fetus to high levels of glucose, which freely crosses the placenta. This leads to stimulation of fetal ß-cells and insulin secretion in the fetus. Fetal hyperglycaemia/hyperinsulinaemia has been shown to cause multiple complications in fetal development, such as altered growth trajectories, impaired neuronal and cardiac development and early exhaustion of the pancreas. These changes could increase the susceptibility of the offspring to develop cardiometabolic diseases later in life. In this review, we aim to summarize and review the mechanisms by which maternal and fetal hyperinsulinaemia impact on (i) maternal health during pregnancy; (ii) placental and fetal development; (iii) offspring energy homeostasis and long-term cardiometabolic health; (iv) how interventions can alleviate these effects.
Associations of the audited residential neighborhood built-environment attributes with objectively-measured sedentary time among adults: a systematic review

ABSTRACT This study systematically reviewed the relevant studies and summarized the associations of objective measures of residential neighborhood built-environment attributes with sedentary time among adults. Published studies were obtained from PubMed and Scopus, restricting to those published in English language peer-reviewed journals to Oct. 2021. There were nine studies and 48 instances of estimated associations. Most instances showed no statistical-significant associations; by contrast, few instances showed that adults living in a neighborhood characterized by a high density of local destinations and connected intersections were associated with less sedentary time. The findings suggest that a high density of destinations and street intersections around residence may provide opportunities to transfer and access to services, thus reducing the sedentary time. Future research strengthening the research design and measurements are needed to investigate the potential explanations of the associations between residential neighborhood built environments and sedentary time in adults.
Prediction of long‐term morbidity and mortality after liver transplantation using two‐dimensional shear wave elastography compared with liver biopsy

The role of noninvasive liver disease assessment by two‐dimensional shear wave elastography (2D‐SWE) to diagnose fibrosis is well described in patients with chronic liver disease. However, its role in prognosis, especially after liver transplantation (LT) has not been adequately examined. We hypothesized that elevated liver stiffness measurement (LSM) as measured by 2D‐SWE after LT predicts future morbidity and mortality independent of fibrosis by liver biopsy. In a prospective cohort study, consecutive LT recipients underwent concomitant protocol 2D‐SWE and protocol liver biopsy (2012–2014), with the assessor blinded to biopsy findings. We examined the baseline correlation of LSM with fibrosis stage and the association between elevated LSM and the development of subsequent clinical outcomes and all‐cause mortality. A total of 187 LT recipients (median age 58 years, 38.5% women, median body mass index 26.5 kg/m2, 55.1% hepatitis C virus, 17.6% nonalcoholic steatohepatitis/cryptogenic) were examined. Median time between LT and biopsy/2D‐SWE assessment was 4.0 years, and the median follow‐up time after LSM determination was 3.5 years. Median LSM was 9 kPa (8 kPa [F0/F1], 11.5 kPa [F2], 12 kPa [F3/F4]). There was a positive correlation between LSM and fibrosis stage (rs = 0.41; p < 0.001). LSM ≥11 kPa was associated with lower survival within 3 years (84.8 vs. 93.7%; p = 0.04). After adjusting for age, sex, and fibrosis stage, LSM ≥11 kPa was independently associated with mortality (hazard ratio, 2.45; 95% confidence interval, 1.08–5.60). Elevated LSM by 2D‐SWE is associated with increased mortality after LT independent of hepatic fibrosis. Given the overall decrease in the use of liver biopsy in the current era, 2D‐SWE may serve as a novel noninvasive prognostic tool to predict relevant outcomes late after LT.
Assessment of knowledge, attitude, perceptions and risk assessment among workers in e-waste recycling shops, Thailand

To study the knowledge, attitudes and perceptions, to study the health effects, and to investigate the concentration of Pb and Cd in indoor dust samples, drinking water samples, and personal air samples and to assess the health risk among workers who worked at e-waste recycling shops in the southern region, Thailand. This cross-sectional descriptive study was conducted among workers from 136 electronic waste recycling stores in Southern Thailand, between January and July 2021. The study questionnaire was given to the 272 e-waste workers participating. Indoor dust, drinking water, and personal air samples were collected 27 e-waste shops and the concentrations of Pb and Cd in all samples were determined by graphite furnace atomic absorption spectrometry. Descriptive statistics and the simple linear regression were used to analyze. Overall, 176 employees (64.7%) suffered nasal irritation, 181 employees (66.5%) reported coughing/sneezing, and 163 employees (59.9%) had inconvenient breathing/jamming symptoms. Also, 158 employees (58.1%) had skin peeling symptoms, and 188 employees (69.1%) had muscle aches. The results indicate the positive influence of increasing knowledge and attitudes on the average practice score. The hazardous index (HI)-values of indoor dust samples, drinking water samples, and personal air samples were less than 1, was considered health-protective. The results will provide the direct evidence needed by e-waste managers to warn learners. Thus, there is a need for education programme to increase knowledge among the workers. In addition, information dissemination, involvement with organizations and associations is a necessity for workers in this study.