Miracle-dz/UniFAR-FTUs huggingface dataset:
Using the Apriori Algorithm to Explore Caregivers’ Depression by the Combination of the Patients with Dementia and Their Caregivers

Purpose The purpose of this study was to identify the caring scenarios that result in severe depression in caregivers caring for dementia patients. Patients and Methods A cross-sectional study with 1111 dementia patients and their caregivers in Taiwan from October 2015 to January 2020 was conducted. Gender, age, type of dementia, clinical dementia rating, walking ability, mood symptoms, behavioral symptoms, and psychological symptoms were the variables from the dementia patients. Age, relation to the patient, employment, type of primary care, frequency of care, mood symptoms, and the score from the Center for Epidemiologic Studies Depression Scale were the variables from the caregivers. A comprehensive viewpoint of both dementia patients and their caregivers was evaluated by the Apriori algorithm to find the attributes resulting in different caregiving depressions. Results Forty-seven rules were found with 18 rules of mild depressive symptomatology, 17 rules of moderate depressive symptomatology, and 12 rules of severe depressive symptomatology. A total of 7 general rules were summarized to be the severe depressive symptomatology. The results showed that an unemployed or retired caregiver with the mood symptoms such as helplessness, anger, emotional liability, or anxiety who took care of AD patients or AD patients with a moderate severity would have severe depression. Increased care frequencies (≥6 days per week) and multiple mood problems from caregivers result in severe depression. The composition of adult children, patients’ aggression, and caregivers’ helplessness as well as the combinations of male patients aged 75–84 years with the caregiver’s mood of helplessness or nervousness and hopelessness were highly associated with severe depression. Conclusion For those caring for AD patients, severe depression was associated with the combination of different parameters to constitute each of these seven scenarios. Unlike previous studies which often evaluated one or two variables related to caregiver’s depression, this study provided a more comprehensive viewpoint that enabled the collaborative team to efficiently identify and manage different scenarios by summarizing the rules of caregivers with severe depression from a systematic viewpoint.
The complete chloroplast genome of Glaux maritima, a monotypic species

Abstract Glaux maritima Linnaeus (1753), the monotypic species of the genus Glaux in Primulaceae, with unique physiological characteristics-salt gland, is a typical salt-secreting plant. We sequenced and assembled the complete chloroplast genome of Glaux maritima with a length of 154,939 bp, consisting of a large single-copy region (LSC) of 84,808 bp, a small single-copy region (SSC) of 18,031 bp, and two inverted repeats (IR) region of 26,050 bp. The chloroplast genome contained 111 genes, including 77 protein-coding genes, 4 rRNA genes, and 30 tRNA genes. The phylogenetic tree exhibited that Glaux maritima is nested in the monophyletic clade of Lysimachia hemsleyana, L. congestiflora.
The complete chloroplast genome of Waldheimia glabra

Abstract Waldheimia glabra (Decne.) Rgl. 1879 (family Asteraceae) is a perennial herb with high economic and medicinal values. In this study, we sequenced the complete chloroplast (cp) genome of W. glabra by high-throughput Illumina sequencing. The size of the W. glabra cp genome is 151,499 bp, with overall GC content of 37.3%. It contains a large single copy and a small single copy region of 83,078 bp and 18,457 bp, respectively, separated by a pair of inverted repeats regions of 24,982 bp. We also discovered 131 genes, including 86 protein-coding genes, 37 transfer RNA genes, and 8 ribosomal RNA genes in the genome. The maximum-likelihood phylogenetic tree demonstrated that W. glabra is closely related to Leucanthemella linearis.
Updating search strategies for literature reviews with OUR2D2: an open-source computer application

Background: While writing a scoping review, we needed to update our search strategy. We wanted to capture articles generated by our additional search terms and articles published since our original search. Simultaneously, we strove to optimize project resources by not rescreening articles that had been captured in our original results. Case presentation: In response, we created Open Update Re-run Deduplicate (OUR2D2), a computer application that allows the user to compare search results from a variety of library databases. OUR2D2 supports extensible markup language (XML) files from EndNote and comma-separated values (CSV) files using article titles for comparisons. We conducted unit tests to ensure appropriate functionality as well as accurate data extraction and analysis. We tested OUR2D2 by comparing original and updated search results from PubMed, Embase, Clarivate Web of Science, CINAHL, Scopus, ProQuest Dissertation and Theses, and Lens and estimate that this application saved twenty-one hours of work during the screening process. Conclusions: OUR2D2 could be useful for individuals seeking to update literature review strategies across fields without rescreening articles from previous searches. Because the OUR2D2 source code is freely available with a permissive license, we recommend this application for researchers conducting literature reviews who need to update their search results over time, want a powerful and flexible analysis framework, and may not have access to paid subscription tools.
Hospital-Acquired Blood Stream Infection in an Adult Intensive Care Unit

Background Hospital-acquired blood stream infections are a common and serious complication in critically ill patients. Methods A retrospective case series was undertaken investigating the incidence and causes of bacteraemia in an adult intensive care unit with a high proportion of postoperative cardiothoracic surgical and oncology patients. Results 405 eligible patients were admitted to the intensive care unit over the course of nine months. 12 of these patients developed a unit-acquired blood stream infection. The average Acute Physiology And Chronic Health Evaluation II (APACHE II) score of patients who developed bacteraemia was greater than that of those who did not (19.8 versus 16.8, respectively). The risk of developing bacteraemia was associated with intubation and higher rates of invasive procedures. The mortality rate amongst the group of patients that developed bacteraemia was 33%; this is in contrast to the mortality rate in our unit as 27.2%. There was a higher proportion of Gram-negative bacteria isolated on blood cultures (9 out of 13 isolates) than in intensive care units reported in other studies. Conclusion Critical-care patients are at risk of secondary bloodstream infection. This study highlights the importance of measures to reduce the risk of infection in the intensive-care setting, particularly in patients who have undergone invasive procedures.
Sensory Stimulation Threshold: A Viable Tool to Improve the Outcome of Lumbar Facet Radiofrequency Denervation?

Background Sensory stimulation threshold (SST) has been used as a surrogate marker to target a nerve branch for radiofrequency (RF) denervation; however, the validity of SST as a prognostic marker is still under debate. Objective To assess whether lower SST values correlate with better outcomes of radiofrequency denervation for facetogenic low back pain. Design Prospective cohort study. Patients Sixty-seven patients who underwent radiofrequency denervation for low back pain. Methods Correlations, between the average percentage of pain relief from diagnostic medial branch block (MBB) and RF denervation procedure outcome, and between SST and RF denervation procedure outcome, were analyzed using Spearman correlation coefficient (rs). Wilcoxon rank sum test was performed to assess whether magnitude and duration of pain relief following RF denervation differed by the levels of SST (<0.5 and ≥0.5) or pain relief (<80% and ≥80%) from diagnostic MBB. Results There was a positive correlation between pain relief after diagnostic MBB and pain relief 2 weeks after denervation (rs 0.31, 95% CI 0.08 to 0.51, p < 0.01), but not between pain relief after MBB and pain relief 6 months after denervation, nor pain relief duration after denervation. There was a negative correlation between SST and pain relief 6 months after denervation (rs −0.41, 95% CI −0.59 to −0.18, p < 0.001). There was also a negative correlation between SST and pain relief duration after denervation (rs −0.33, 95% CI −0.53 to −0.09, p < 0.01). Conclusion SST is a viable measurement with which to guide needle placement during RF denervation for lumbar facet pain, and enhances pain relief outcomes.
Extended-spectrum β-lactamases: an update on their characteristics, epidemiology and detection

Abstract Extended-spectrum β-lactamase (ESBL)-producing Gram-negative pathogens are a major cause of resistance to expanded-spectrum β-lactam antibiotics. Since their discovery in the early 1980s, they have spread worldwide and an are now endemic in Enterobacterales isolated from both hospital-associated and community-acquired infections. As a result, they are a global public health concern. In the past, TEM- and SHV-type ESBLs were the predominant families of ESBLs. Today CTX-M-type enzymes are the most commonly found ESBL type with the CTX-M-15 variant dominating worldwide, followed in prevalence by CTX-M-14, and CTX-M-27 is emerging in certain parts of the world. The genes encoding ESBLs are often found on plasmids and harboured within transposons or insertion sequences, which has enabled their spread. In addition, the population of ESBL-producing Escherichia coli is dominated globally by a highly virulent and successful clone belonging to ST131. Today, there are many diagnostic tools available to the clinical microbiology laboratory and include both phenotypic and genotypic tests to detect β-lactamases. Unfortunately, when ESBLs are not identified in a timely manner, appropriate antimicrobial therapy is frequently delayed, resulting in poor clinical outcomes. Several analyses of clinical trials have shown mixed results with regards to whether a carbapenem must be used to treat serious infections caused by ESBLs or whether some of the older β-lactam-β-lactamase combinations such as piperacillin/tazobactam are appropriate. Some of the newer combinations such as ceftazidime/avibactam have demonstrated efficacy in patients. ESBL-producing Gram-negative pathogens will continue to be major contributor to antimicrobial resistance worldwide. It is essential that we remain vigilant about identifying them both in patient isolates and through surveillance studies.
PTCOG Head and Neck Subcommittee Consensus Guidelines on Particle Therapy for the Management of Head and Neck Tumors

Purpose: Radiation therapy is a standard modality in the treatment for cancers of the head and neck, but is associated with significant short- and long-term side effects. Proton therapy, with its unique physical characteristics, can deliver less dose to normal tissues, resulting in fewer side effects. Proton therapy is currently being used for the treatment of head and neck cancer, with increasing clinical evidence supporting its use. However, barriers to wider adoption include access, cost, and the need for higher-level evidence. Methods: The clinical evidence for the use of proton therapy in the treatment of head and neck cancer are reviewed here, including indications, advantages, and challenges. Results: The Particle Therapy Cooperative Group Head and Neck Subcommittee task group provides consensus guidelines for the use of proton therapy for head and neck cancer. Conclusion: This report can be used as a guide for clinical use, to understand clinical trials, and to inform future research efforts.
Developing, Validating, and Implementing a Tool for Measuring the Readiness of Medical Teachers for Online Teaching Post-COVID-19: A Multicenter Study

Background While online education is by no means a new concept, it was recently thrust into the spotlight after school campuses all over the world were forced to close because of the COVID-19 pandemic. The sudden need to shift revealed emerging challenges to online teaching, both logistic and personal. One important challenge is the ability to assess the readiness of educators for online teaching, so that appropriate and specific feedback/training can be offered to those in need. This study aims at developing, validating, and implementing a tool to measure the teachers’ readiness for online teaching in three medical schools from three different countries. Methods This was a multi-center, cross-sectional study that involved developing a survey through review of literature and previous studies, item development and revision, and pilot testing. The survey was then distributed electronically to a convenient sample of 217 teaching faculty members of different academic ranks from three medical schools in Egypt, Saudi Arabia, and Bahrain. Exploratory factor analysis and reliability study were performed. Descriptive statistics were applied, and the statistical significance level was set at 0.05. Results Factor analysis produced the following five factors: “Online Teaching and Course Design Skills”, “Digital Communication”, “Basic Computer Skills”, “Advanced Computer Skills” and “Using Learning Management Systems”. The tool showed high reliability (alpha = 0.94). Survey results showed highest mean scores for Basic Computer Skills with lower scores for Online Teaching and Course Design Skills and Using Learning Management Systems. ANOVA revealed statistically significant differences between the three studied schools regarding Digital Communication (F=5.13; p=0.007) and Basic Computer Skills (F=4.47; p=0.012) factors. Conclusion The tool proved to be reliable and valid. Results indicated an overall acceptable readiness in the three involved schools, with a need for improvement in “Online Teaching and Course Design” and Using Learning Management Systems.
Effects of the Na+/H+ Ion Exchanger on Susceptibility to COVID-19 and the Course of the Disease

The Na+/H+ ion exchanger (NHE) pumps Na+ inward the cell and H+ ion outside the cell. NHE activity increases in response to a decrease in intracellular pH, and it maintains intracellular pH in a narrow range. Patients with obesity, diabetes, and hypertension and the elderly are prone to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The angiotensin II (Ang II) level is high in chronic diseases such as diabetes, hypertension, and obesity. Ang II is the main stimulator of NHE, and an increased Ang II level causes prolonged NHE activation in these patients. The long-term increase in NHE activity causes H+ ions to leave the cell in patients with diabetes, hypertension, and obesity. Increasing H+ ions outside the cell lead to an increase in oxidative stress and reactive oxygen species. H+ ion flows into the cell due to the increased oxidative stress. This vicious circle causes intracellular pH to drop. Although NHE is activated when intracellular pH decreases, there is prolonged NHE activation in chronic diseases such as aforementioned. Novel coronavirus disease 2019 (COVID-19) progression may be more severe and mortal in these patients. SARS-CoV-2 readily invades the cell at low intracellular pH and causes infection. The renin-angiotensin system and NHE play a vital role in regulating intracellular pH. The reduction of NHE activity or its prolonged activation may cause susceptibility to SARS-CoV-2 infection by lowering intracellular pH in patients with diabetes, hypertension, and obesity. Prolonged NHE activation in these patients with COVID-19 may worsen the course of the disease. Scientists continue to investigate the mechanism of the disease and the factors that affect its clinical progression.
Methodologies to Increase the Level of Evidence of Real-life Proton Therapy in Head and Neck Tumors

This review aims to present and assess available and new methodologies to increase the clinical evidence of proton therapy data for patients with head and neck cancer. Despite the increasing number of scientific reports showing the feasibility and effectiveness of proton therapy in head and neck cancer, clinical evidence on the potential benefits of its use remains low for several reasons. In this article, the pros and cons of consolidated and new methodologies in this setting such as randomized clinical trials, the model-based approach, and the use of prospective multicentric registries will be detailed.
Aflibercept versus Ranibizumab as a Second Line Therapy After Bevacizumab for Diabetic Macular Edema

Purpose To compare the visual and anatomic outcomes of aflibercept versus ranibizumab as a second line treatment for persistent diabetic macular edema (DME) after initial bevacizumab injections. Methods In this retrospective cohort study, patients with center-involved DME of ≥ 300 μm thickness after bevacizumab intravitreal injections in 2015–2019 were included. Those treated with ranibizumab (R) and aflibercept (A) were grouped as group R and group A, respectively. The change in central macular thickness (CMT) measured by optical coherence tomography (OCT) and the best corrected distance visual acuity (BCVA) before and after three-monthly anti-VEGF injections (anti-VEGF) in group R and group A were compared and reviewed. Results There were 80 eyes of 75 patients in group R and 80 eyes of 72 patients in group A. The initial bevacizumab injections in group R and group A varied significantly (p = 0.01). The median change of the CMT after the three injections was not significantly different in group R (80 μm) and group A (81.5μm) (p = 0.7). The improvement of BCVA in group R and group A was not significant (p = 0.5). Dry macula was noted in 1 vs 14 eyes in group R vs group A. Conclusion After treating refractory DME with initial bevacizumab injections, 3 injections of either aflibercept or ranibizumab had similar anatomic and functional outcomes. Aflibercept achieved dry macula in more eyes with refractory DME compared to ranibizumab.
The Effect of Mesenchymal Stem Cell-Enriched Scaffolds on MMP-8 and TGF-β Levels of Vertebrae Postlaminoplasty in Rabbit Model

Introduction Some laminoplasty procedures still have restenosis because of bony-bridging failure of the laminar hinge. The present study aimed to determine the effect of mesenchymal stem cell (MSC)-enriched scaffolds on vertebral regeneration after laminoplasty on the basis of the number of osteoblasts, matrix metalloproteinase-8 (MMP-8), and transforming growth factor-beta (TGF-β) levels. Methods Laminoplasty procedure using the Hirabayashi technique was conducted at the lumbar level in 32 rabbits that were divided into four and three groups of the control (C) and treatment groups, respectively, with different types of laminoplasty spacer (T1, autograft; T2, scaffold; and T3, scaffold with MSCs). Histopathological studies were conducted to calculate the number of osteoblasts and enzyme-linked immunosorbent assay tests to detect MMP-8 and TGF-β 4 weeks after the surgery. Results The results showed a significant decrease in MMP-8 level in the T3 group compared with that in the control group (p < 0.05). A significant difference exists between the average number of newly formed osteoblasts in the control group compared with that in the T3 group (p < 0.05) with a higher mean blood TGF-β level of all experimental groups compared with that of the control group (p = 0.58). Conclusion The significant decrease in MMP-8 levels, increase in TGF-β levels, and increased number of osteoblasts on MSC-seeded polylactic acid scaffolds could be useful to support the laminoplasty procedure to prevent restenosis because it was biocompatible and promoted the bone healing process.
Aerosol Generation in Ear Canal and Air-Fluid Interface Suction

Objective The identification of aerosol-generating procedures (AGPs) is important during the current SARS-CoV-2 pandemic due to aerosol-mediated virus transmission. Aerosol measurement during clinical procedures using particle counting may be confounded by variable natural background aerosol levels or limited by partial volume sampling. The study objective was to quantify any significant aerosol generated from simulated suction clearance procedures. Study Design Prospective quantification of aerosol generation during clinical suction simulation. Setting Clean chamber. Methods We created a clean environment for particle counting in a transparent neutralized polypropylene chamber. Air was passed through a HEPA 14 class filter to maintain a constant chamber inlet pressure. An optical particle counter was connected in line to the chamber exhaust vent to measure all of the vented particles. The chamber background count was 1 particle ≥0.3 µm per 15 minutes at a flow rate of 1 chamber air change per minute. We used this system to quantify very low aerosol counts generated from suction clearance of a silicone ear canal and at an open air-fluid interface. Results No clinically significant aerosol generation was found by particle counting of the whole chamber air volume during simulated suction procedures. Conclusion Simulated ear suction clearance and air-fluid interface suction does not generate any significant aerosol. It appears likely that any aerosol potentially generated at the suction tube tip is entrained by incoming air flow. This is the first study to quantify aerosols generated by suction in a controlled environment; further research is required to determine its clinical implications.
Mycotic Popliteal Artery Aneurysm With Rapid Enlargement Post-Bypass

Popliteal artery aneurysms (PAAs) are the most common type of peripheral artery aneurysms. Mycotic aneurysms involving the popliteal artery are quite rare and can occur as either a primary de novo infection or a secondary infection from another site. To our knowledge, there are no previous case reports on mycotic PAA in which Staphylococcus epidermidis was the primary etiologic pathogen. We present the case of a 55-year-old male who presented with complaints of lower extremity pain and swelling, malaise, and low-grade temperatures for two weeks and was found to have a PAA. He underwent left femoral-popliteal bypass grafting with expanded polytetrafluoroethylene (ePTFE) graft and ligation of the aneurysm. On postoperative day 10, he experienced acute swelling and pain in his lower extremity with foot drop and was found to have rapid enlargement of his aneurysm sac on imaging. He was returned to the operating room emergently where he underwent aneurysmectomy via a posterior fossa approach. Cultures and gram staining of the aneurysm sac were consistent with Staphylococcus epidermidis. As noted above, this case of mycotic PAA was treated with standard vascular surgical techniques, yet it proceeded to enlarge acutely. PAAs that rapidly expand or rupture after surgical interventions may be a sign of infection.
Enhanced Mental Health with Virtual Reality Mental Hygiene by a Veteran Suffering from PTSD

This paper describes the application and feasibility of the use of Virtual Reality Mental Hygiene (VRMH) as a mean to reduce anxiety and stress in a Danish veteran suffering from posttraumatic stress disorder (PTSD) and enduring personality change after a catastrophic experience. The results from this case study provide preliminary evidence that VRMH can be used as a mean to reduce arousal in patients with severe PTSD.