Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of Total Neoadjuvant Therapy vs. Standard Chemoradiotherapy in Locally Advanced Rectal Cancer: A Systematic Review and Meta-Analysis of Randomized Trials

Simple Summary Multimodality therapy is the standard of care for patients with locally advanced rectal cancer (LARC). The optimal treatment sequence is, however, a matter of debate. Neoadjuvant radiotherapy with concurrent fluoropyrimidines followed by surgery and adjuvant chemotherapy has been the standard treatment for the past years. Alternative therapeutic strategies such as total neoadjuvant treatment (TNT) are gaining momentum, although results from individual clinical trials are not conclusive regarding its impact on survival. In this context, we aimed to systematically review available evidence from randomized trials comparing different sequencing strategies. The results from our meta-analysis show that TNT not only provides increased complete pathological response rates, but also improves disease-free and overall survival at 3 years compared to standard neoadjuvant chemoradiotherapy, with no substantial increase in severe adverse events. These results support the use of induction or consolidation chemotherapy before surgery in LARC and TNT as a valuable treatment strategy in these patients. Abstract Multimodality treatment is a standard of care for LARC, but the optimal sequencing of the treatment modalities remains unclear. Several randomized clinical trials (RCTs) compared total neoadjuvant treatment (TNT) vs. standard neoadjuvant chemoradiotherapy (CRT) with inconsistent results. A systematic review and meta-analysis was performed to evaluate the efficacy of TNT in terms of complete pathological response (pCR) rate, disease-free and overall survival vs. standard CRT in LARC. A systematic search was performed through MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and meeting abstracts up to May 2020. RCTs comparing CRT vs. TNT followed by surgery in LARC were eligible for the study. Study selection and data extraction were done following PRISMA guidelines by two independent reviewers. The Mantel–Haenzel method was used to obtain a fixed-effects model of pooled odds or hazard ratios for the main outcomes. Eight RCTs, including 2301 patients, met the eligibility criteria. TNT significantly improved pCR rate (OR = 1.99, 95% confidence interval (CI) 1.59–2.49; p < 0.001), 3-year disease-free-survival (DFS) (HR = 0.82, 95%CI 0.71–0.95; p = 0.01) and 3-year overall survival (OS) (hazard ratio (HR) = 0.81, p = 0.04). Grade 3–4 adverse events were not significantly different in both strategies (OR = 1.58; p = 0.14). An improved pCR rate was documented regardless of the type of radiotherapy administered (long vs. short fractionation schedules). No significant heterogeneity was found. The results of this meta-analysis show that TNT improves pCR and survival rates vs. standard preoperative CRT in patients with LARC. TNT may become a new standard of care in LARC, although longer follow-up is needed to properly assess its long-term impact on survival.
The relationship between paternal education, self-esteem, resilience, future orientation, and career aspirations

Career aspirations are considered to be one of the most important motivation variables in the study of psychology and career development, as well as being connected to an individual’s career-related goals, intentions or options. The aims of this study were: (a) to develop and validate a model for predicting career aspirations, and (b) to investigate direct and indirect links between paternal education, self-esteem, resilience, future orientation, and career aspirations of university students. The participants were 445 students from two universities in Thailand. Confirmatory factor analysis confirmed that the factor structure of four measurement models presented in the study was suitable and compatible. To achieve the intended research objectives, the empirical data were analyzed using structural equation modeling with decomposition analysis of total effects in direct and indirect effects. Results showed that paternal education, resilience, and future orientation have significant direct effects on students’ career aspirations, while self-esteem has an indirect effect. This suggests that self-esteem can help students develop their resilience, as well as promoting their development of a positive future orientation, which also helps foster a higher level of career aspiration. These results can be fundamental to supporting the continued use of the structural equation model in future research on career development.
Establishment of a Vegetation Cover on Tundra Kimberlite Mine Tailings: 1. A Greenhouse Study

High erosion potential of dewatered kimberlite mine tailings after diamond extraction has prompted research at the Ekati Diamond Mine in the Canadian subarctic heath tundra ecosystem. Coarse texture, no organic component, lack of available macronutrients, and a serpentine chemistry are the principal limitations of these kimberlite tailings to plant colonization. Structure‐improving (peat moss, lake sediment, sewage sludge, Agri‐Boost, and composted papermill sludge) and nutrient‐providing (fertilizer, calcium carbonate, gypsum, and rock phosphate) amendments were tested in the greenhouse to ameliorate these limitations, thereby facilitating the field establishment of a permanent vegetation cover, which would stabilize the surface materials and promote natural colonization by the surrounding tundra vegetation. Seven native grass species (Arctagrostis latifolia, Calamagrostis canadensis, Poa glauca, Poa alpina, Deschampsia beringensis, Deschampsia caespitosa, and Festuca rubra) were used to measure amendment success. With the addition of structure‐improving and nutrient‐providing amendments, plant growth on kimberlite tailings was significantly enhanced. Tailings properties, including cation exchange capacity, percentage of organic carbon, and macronutrient availability, were also improved by amendment addition.
Persistent Functional Decline Following Hospitalization with Influenza or Acute Respiratory Illness

Influenza is associated with significant morbidity and mortality, particularly for older adults. Persistent functional decline following hospitalization has important impacts on older adults' wellbeing and independence, but has been under‐studied in relation to influenza. We aimed to investigate persistent functional change in older adults admitted to hospital with influenza and other acute respiratory illness (ARI).
Boredom Proneness and Self-Control as Unique Risk Factors in Achievement Settings

The state of boredom arises when we have the desire to be engaged in goal pursuit, but for whatever reason we cannot fulfil that desire. Boredom proneness is characterized by both frequent and intense feelings of boredom and is an enduring individual difference trait associated with a raft of negative outcomes. There has been some work in educational settings, but relatively little is known about the consequences of boredom proneness for learning. Here we explored the unique contributions of boredom proneness, self-control and self-esteem to undergraduate self-reported higher grade point average (GPA). Within educational settings, prior research has shown self-control and self-esteem to be associated with better academic performance. In contrast, boredom proneness is associated with lower levels of self-control and self-esteem. Our analyses replicate those previous findings showing that self-control acts as a positive predictor of GPA. Importantly, we further demonstrated, for the first time, that boredom proneness has a unique contribution to GPA over and above the contribution of self-control, such that as boredom proneness increases, GPA decreases. We discuss potential mechanisms through which boredom proneness may influence academic performance.
The Use of Scattering Data in the Study of the Molecular Organisation of Polymers in the Non-Crystalline State

Scattering data for polymers in the non-crystalline state, i.e., the glassy state or the molten state, may appear to contain little information. In this work, we review recent developments in the use of scattering data to evaluate in a quantitative manner the molecular organization of such polymer systems. The focus is on the local structure of chain segments, on the details of the chain conformation and on the imprint the inherent chemical connectivity has on this structure. We show the value of tightly coupling the scattering data to atomistic-level computer models. We show how quantitative information about the details of the chain conformation can be obtained directly using a model built from definitions of relatively few parameters. We show how scattering data may be supplemented with data from specific deuteration sites and used to obtain information hidden in the data. Finally, we show how we can exploit the reverse Monte Carlo approach to use the data to drive the convergence of the scattering calculated from a 3d atomistic-level model with the experimental data. We highlight the importance of the quality of the scattering data and the value in using broad Q scattering data obtained using neutrons. We illustrate these various methods with results drawn from a diverse range of polymers.
A model integrating donor gene polymorphisms predicts fibrosis after liver transplantation

Post-transplant liver fibrosis (PTLF) is a common and severe complication in liver recipients. In this study, we assessed the impact of donor liver genetics on the development of PTLF. A total of 232 patients undergoing liver transplantation were included. Twenty-two single nucleotide polymorphisms (SNPs) associated with liver fibrosis were analyzed. Univariate analysis revealed seven donor SNPs to be associated with PTLF. In a multivariate analysis, independent risk factors of PTLF were genetic variation of donor GRP78 rs430397 (OR = 8.99, p = 0.003), GSTP1 rs1695 (OR = 0.13, p = 0.021), miRNA-196a rs12304647 (OR = 16.01, p =0.001), and TNF-α rs1800630 (OR = 79.78, p = 0.001); blood tacrolimus levels at maintenance > 7 ng/ml (OR =7.48, p <0.001); and post-transplant diabetes mellitus (OR = 7.50, p = 0.001). A predictive model that included donor SNPs showed better prognostic ability for PTLF than a model with only clinical parameters (AUROC: 0.863 vs 0.707, P < 0.001). Given that donor gene SNPs are associated with an increased risk of PTLF, this model integrated with donor gene polymorphisms may help clinicians predict PTLF.
Understanding Pseudomonas aeruginosa–Host Interactions: The Ongoing Quest for an Efficacious Vaccine

Pseudomonas aeruginosa is a leading cause of chronic respiratory infections in people with cystic fibrosis (CF), bronchiectasis or chronic obstructive pulmonary disease (COPD), and acute infections in immunocompromised individuals. The adaptability of this opportunistic pathogen has hampered the development of antimicrobial therapies, and consequently, it remains a major threat to public health. Due to its antimicrobial resistance, vaccines represent an alternative strategy to tackle the pathogen, yet despite over 50 years of research on anti-Pseudomonas vaccines, no vaccine has been licensed. Nevertheless, there have been many advances in this field, including a better understanding of the host immune response and the biology of P. aeruginosa. Multiple antigens and adjuvants have been investigated with varying results. Although the most effective protective response remains to be established, it is clear that a polarised Th2 response is sub-optimal, and a mixed Th1/Th2 or Th1/Th17 response appears beneficial. This comprehensive review collates the current understanding of the complexities of P. aeruginosa-host interactions and its implication in vaccine design, with a view to understanding the current state of Pseudomonal vaccine development and the direction of future efforts. It highlights the importance of the incorporation of appropriate adjuvants to the protective antigen to yield optimal protection.
An Agar Dilution Method for the Determination of the Minimum Inhibitory Concentration of Essential Oils

Abstract Methods for the measurement of the minimum inhibitory concentration (MIC) of antibacterial agents have been developed for water-soluble substances and require adaptation for use with water-insoluble essential oils. This paper reports a standardized agar dilution MIC method, using 0.5% v/v Tween 20 as a dispersant, which provides a reliable and reproducible technique. The method was tested using two Melaleuca alternifolia oil samples with two different levels of terpinen-4-ol (37% and 45% v/v). The MIC values of die tea tree oil samples against a wide selection of bacteria, moulds and yeast are reported.
Prevalence and factors associated with the consumption of psychoactive substances by health care workers.

OBJECTIVE to estimate prevalence and factors associated with the consumption of psychoactive substances among health care workers in hospitals. METHOD cross-sectional study, with a sample of 289 health care professionals in a large hospital in Teresina, Piauí, Brazil. RESULTS 243 (84.1%) reported consumption of psychoactive substances; 124 (86.7%) of professionals who classed their level of satisfaction as moderate had double the chance (OR = 1.98 CI95% 1.02- 3.85) of consuming psychoactive substances; 40 (93%) of those with low level of satisfaction showed a four times higher chance (OR = 4.05 CI95% 1.15-14.26) of consumption; and 72 (75.8%) of those who reported a "good" state of health before work had a 54% lower chance of consumption (OR= 0.46 CI95% 0.234-0919). CONCLUSION consumption of psychoactive substances was associated with factors related to level of job satisfaction and perceived health status before work.
Nematicidal Effect and Histological Modifications Induced by Hydrolysable Tannin Extract on the Third-Stage Infective Larvae of Haemonchus contortus

Simple Summary Haemonchus contortus is the most frequent and most important nematode parasite in the ruminants production of tropical and subtropical regions. The conduction of research to find resources that allow effective control of this parasitic disease, preferably focusing on green production, is necessary. Hydrolysable tannins (HT) are an important group of compounds synthetized by plants, some of them exhibit anti-cancer, antioxidant, anti-inflammatory, anti-ulcerative, or antiparasitic properties. We evaluated the effect of hydrolysable tannin extract (HTE) on larvae of H. contortus (L3). L3 were exposed to different HTE concentrations and times to analyze the mortality, and microscopically we explored physical damage on L3 caused by HTE. After 72 h of incubation with 2 mg/mL of HTE, we found a half of death larvae, and by microscopy we observed larvae destruction. Our results suggest that hydrolysable tannin extracted from chestnut could be considered as an alternative for parasitic control as a food additive in cattle. Abstract Haemonchus contortus is the most frequent and most important nematode parasite in the ruminants production of tropical and subtropical regions. There are strains resistant to all families of available anthelmintics. Consequently, the conduction of research to find other resources that allow effective control of this parasitic disease, preferably focusing on green production, is necessary. The aim of this study was to evaluate the effect of hydrolysable tannin extract (HTE) on larvae 3 (L3) of H. contortus in vitro. L3 were exposed to different HTE concentrations and times. In addition, both light and scanning electron microscopy were used to explore physical damage on L3 subjected to HTE activity. After 72 h of incubation, the mean lethal concentration of HTE was 2 mg/mL; this concentration has been previously referred to as safe for consumption in cattle. Scanning electron microscopy revealed H. contortus L3 destruction, damage was evident by separation of the sheath mainly in the cervical and caudal regions of the larva and by rupture of the cuticle with larval evisceration. Our results suggest that hydrolysable tannin extract from chestnut could be considered as a green alternative for parasitic control in ruminants.
Impaired muscle mitochondrial energetics is associated with uremic metabolite accumulation in chronic kidney disease.

Chronic kidney disease (CKD) results in a progressive skeletal myopathy involving atrophy, weakness, and fatigue. Mitochondria have been thought to contribute to skeletal myopathy, however, the molecular mechanisms underlying changes in muscle metabolism in CKD are unknown. This study employed a comprehensive mitochondrial phenotyping platform to elucidate the mechanisms of skeletal muscle mitochondrial impairment in mice with adenine-induced CKD. CKD mice displayed significant reductions in mitochondrial oxidative phosphorylation (OXPHOS), which was strongly correlated with glomerular filtration rate, suggesting a link between kidney function and muscle mitochondrial health. Biochemical assays uncovered that OXPHOS dysfunction was driven principally by reduced activity of matrix dehydrogenases. Untargeted metabolomics analyses in skeletal muscle revealed a distinct metabolite profile in CKD muscle including accumulation of uremic toxins that strongly associated with the degree of mitochondrial impairment. Additional muscle phenotyping found that CKD mice experienced muscle atrophy and increased muscle protein degradation, but only male CKD mice had lower maximal contractile force. CKD mice also had morphological changes indicative of destabilization in the neuromuscular junction. This study provides the first comprehensive evaluation of mitochondrial health in murine CKD muscle and uncovers several unknown uremic metabolites that are strongly associated with the degree of mitochondrial impairment.
The Effect of Ageist Behaviors on Home Care Workers’ Job Satisfaction and Retention in Long-Term Care

Objectives: This study aimed to examine how intrinsic and extrinsic factors of job satisfaction affect home care workers’ intention to stay and determine whether ageist behaviors moderate the relation between job satisfaction and intention to stay. Method: We recruited 380 participants to complete measures of job satisfaction, ageist behaviors, and intention to stay. Results: Monthly wages, extrinsic and intrinsic factors, and positive and negative ageist behaviors were significantly related to home care workers’ retention. Both positive and negative ageist behaviors negatively moderated the relation between job satisfaction and retention. Conclusion: Home care workers’ retention may be increased by providing reasonable extrinsic rewards and enhancing the intrinsic nature of the job itself. Reducing negative ageist behaviors and increasing positive ones for those with low job satisfaction could be related to higher retention. The harmful effects of positive behaviors should be addressed. These findings could contribute to workforce retention in long-term care.
Early Serum Biomarkers for Intensive Care Unit Treatment within the First 24 Hours in Patients with Intracerebral Hemorrhage

Abstract Background The prognostic significance of serum biomarkers in patients with intracerebral hemorrhage (ICH) is not well investigated concerning inhospital mortality (IHM) and cardiopulmonary events within the first 24 hours of intensive care unit (ICU) treatment. The influence of troponin I (TNI) value and cortisol value (CV) on cardiopulmonary events within the first 24 hours of ICU treatment was reported in subarachnoid hemorrhage patients, but not in ICH patients up to now. The aim of this study was to investigate the role of early serum biomarkers on IHM and TNI value and CV on cardiopulmonary events within the first 24 hours of ICU treatment. Patients and Methods A total of 329 patients with spontaneous ICH were retrospectively analyzed. Blood samples were taken on admission to measure serum biomarkers. The TNI value and CV were defined as biomarkers for cardiopulmonary stress. Demographic data, cardiopulmonary parameters, including norepinephrine application rate (NAR) in microgram per kilogram per minute and inspiratory oxygen fraction (FiO2) within the first 24 hours, and treatment regime were analyzed concerning their impact on ICU treatment and in hospital outcome. Binary logistic analysis was used to identify independent prognostic factors for IHM. Results Patients with initially nonelevated CVs required higher NAR (p = 0.01) and FiO2 (p = 0.046) within the first 24 hours of ICU treatment. Lower cholinesterase level (p = 0.004), higher NAR (p = 0.002), advanced age (p < 0.0001), larger ICH volume (p < 0.0001), presence of intraventricular hemorrhage (p = 0.007) and hydrocephalus (p = 0.009), raised level of C-reactive protein (p = 0.024), serum lactate (p = 0.003), and blood glucose (p = 0.05) on admission were significantly associated with IHM. In a multivariate model, age (odds ratio [OR]: 1.055; 95% confidence interval [CI]: 1.026–1.085; p < 0.0001), ICH volume (OR: 1.016; CI: 1.008–1.025; p < 0.0001), and Glasgow Coma Scale (GCS) score (OR: 0.680; CI: 0.605–0.764; p < 0.0001) on admission as well as requiring NAR (OR: 1.171; CI: 1.026–1.337; p = 0.02) and FiO2 (OR: 0.951; CI: 0.921–0.983, p = 0.003) within the first 24 hours were independent predictors of IHM. Conclusion Higher levels of C-reactive protein, serum lactate, blood glucose, and lower cholinesterase level on admission were significantly associated with IHM. Patients with initially nonelevated CVs required higher NAR and FiO2 within the first 24 hours of ICU treatment. Furthermore, requiring an NAR > 0.5 µg/kg/min or an FiO2 > 0.21 were identified as additional independent predictors for IHM. These results could be helpful to improve ICU treatment in ICH patients.
Prognostic Factors of COVID-19 Infection in Elderly Patients: A Multicenter Study

The outbreak of the COVID-19 pandemic is a substantial threat to the health of all populations worldwide, and old age is a robust risk factor for poor prognosis of COVID-19 infection. To reduce the fatality rate of COVID-19 infection, further understanding of elderly patients with COVID-19 is necessary. We aimed to investigate the prognostic factors in elderly patients with COVID-19. This was a multicenter and retrospective study. Overall, 340 elderly patients with COVID-19 were enrolled in 3 hospitals in Daegu, South Korea. Death and severe pneumonia requiring oxygen treatment were defined as poor clinical outcomes. Of the patients studied, 15% died and 35.2% were classified as having severe pneumonia. In binary logistic regression analysis, activities of daily living (ADL) impairment, fever during hospitalization, initial infiltration on chest radiograph, and initial increased C-reactive protein (CRP) were significantly associated with severe pneumonia (OR = 5.33, p < 0.001; OR = 3.2, p = 0.002; OR = 2.32, p = 0.044; and OR = 1.33, p < 0.001, respectively). ADL impairment, comorbidity, fever during hospitalization, and initial increased CRP were significantly associated with death (OR = 7.13, p < 0.001; OR = 3.28, p = 0.005; OR = 3.15, p = 0.032, and OR = 1.18, p < 0.001, respectively). ADL impairment, fever, and initial CRP were poor prognostic factors in elderly patients with COVID-19. Understanding these poor prognostic factors is necessary to control the disease in elderly patients.