Miracle-dz/UniFAR-FTUs huggingface dataset:
The effect of a support program on the burden of spouses caring for their partners with breast cancer: a randomized controlled trial

Objective This study aimed to determine the effect of a support program on burden of spouses caring for their partners with breast cancer. Methods This randomized controlled trial was conducted among spouses of women with breast cancer undergoing chemotherapy at a referral chemotherapy center in Iran. They were assigned to intervention (n=40) and control (n=40) groups using permuted block randomization. Three small group sessions lasted 45–60 minutes, followed by three telephone-based sessions, lasting 15–20 minutes (twice a week). The intervention sessions included defining stress management strategies in different situations: strengthening creativity, optimism, and management in planning, and defining the role of the caregiver. Primary outcome was care burden, and secondary outcomes were spouses’ stress, satisfaction with intervention, and partners’ quality of life (QOL). The caregiver burden inventory, depression anxiety stress questionnaire, World Health Organization QOL brief version, and client satisfaction questionnaire were completed before and after the intervention and at a 6-week follow-up. Results Thirty-eight participants in each group with a mean age of 44.24±9.01 years completed the study. Repeated measures analysis of variance showed a significant difference in the care burden (P<0.05; effect size, 0.70), stress (P<0.05; effect size, 0.64), and women’s QOL (P<0.05; effect size, 0.67) before and after the intervention. Conclusion The results of this study can be used to develop interventions, targeting the care burden and stress of spouses of women with breast cancer undergoing chemotherapy.
Use of Impella Devices for Acute Cardiogenic Shock in the Perioperative Period of Cardiac Surgery

Introduction The Impella ventricular support system is a device that can be inserted percutaneously or directly across the aortic valve to unload the left ventricle. The purpose of this study is to determine the role of Impella devices in patients with acute cardiogenic shock in the perioperative period of cardiac surgery. Methods A retrospective single-surgeon review of 11 consecutive patients who underwent placement of Impella devices in the perioperative period of cardiac surgery was performed. Patient records were evaluated for demographics, indications for placement, and postoperative outcomes. Results Impella devices were placed for refractory cardiogenic shock preoperatively in 6 patients, intraoperatively in 4 patients, and postoperatively as a rescue in 1 patient. Seven patients received Impella CP, 1 Impella RP, 1 Impella CP and RP, and 2 Impella 5.0. Additionally, 3 patients required preoperative venovenous extracorporeal membrane oxygenation (VV-ECMO), and 1 patient required intraoperative venoarterial extracorporeal membrane oxygenation (VA-ECMO). All Impella devices were removed 1 to 28 days after implantation. Length of stay in the intensive care unit stay ranged from 2 to 53 days (average 23.9±14.6). The 30-day and 1-year mortality were 0%. Ten of 11 patients were alive at 2 years. Also, 1 patient died 18 months after surgery from complications of coronavirus disease (Covid-19). Device-related complications included varying degrees> of hemolysis in 8 patients (73%) and device malfunction in 1 patient (9%). Conclusions The Impella ventricular support system can be combined with other mechanical support devices for additional hemodynamic support. All patients demonstrated myocardial recovery with no deaths in the perioperative period and in 1-year of follow-up. Larger studies are necessary to validate these findings.
“Life-altering”: A qualitative analysis of social media birth stories from mothers of children with Down syndrome

Perinatal depression/anxiety is a significant concern for mothers of children with Down syndrome. This is influenced by the way the Down syndrome diagnosis is shared with parents. This study examined social media posts from mothers regarding experiences of the birth of their child with Down syndrome. Forty-three total stories were coded using thematic content analysis. Results highlighted the experiences of mother’s who received a diagnosis of Down syndrome for their newborn. Two themes were found with relevant subthemes (i.e., receiving the diagnosis—mother’s intuition, confirmation of the diagnosis, influence of potential health concerns, initial emotions, impact of the medical professional; Processing the diagnosis—life-altering, child not meeting expectations, reframing the diagnosis, impact of partner and others). Findings highlight the need for medical personnel to understand this identity-changing process, as perinatal depression/anxiety looks different for these mothers. There is also a need to help them engage in services accordingly.
Regional versus general anesthesia for ambulatory total hip and knee arthroplasty

Purpose of review With the removal of both total knee and total hip arthroplasty from the Centers for Medicare and Medicaid Services’ inpatient-only list, efforts to improve efficiency of the perioperative management of total joint patients have increased recently. The publication of several recent studies examining the impact of anesthesia type on outcomes has prompted the need to review the overall state of evidence for spinal versus general anesthesia for outpatient total joint arthroplasty. Recent findings Overall complication rates are low in this carefully selected patient population. The majority of patients who are preselected for outpatient total joint arthroplasty appear to successfully achieve this outcome. Some retrospective studies have suggested a benefit for spinal anesthesia in terms of same-day discharge success but direct comparisons in prospective studies are lacking. Summary The type of anesthesia used for total joint arthroplasty may have an important effect on outcomes. Until randomized control trials are performed we must rely on existing evidence, which suggests that both spinal and general anesthesia can lead to successful outcomes after ambulatory total joint arthroplasty.
Transwoman Elite Athletes: Their Extra Percentage Relative to Female Physiology

There is increasing debate as to whether transwoman athletes should be included in the elite female competition. Most elite sports are divided into male and female divisions because of the greater athletic performance displayed by males. Without the sex division, females would have little chance of winning because males are faster, stronger, and have greater endurance capacity. Male physiology underpins their better athletic performance including increased muscle mass and strength, stronger bones, different skeletal structure, better adapted cardiorespiratory systems, and early developmental effects on brain networks that wires males to be inherently more competitive and aggressive. Testosterone secreted before birth, postnatally, and then after puberty is the major factor that drives these physiological sex differences, and as adults, testosterone levels are ten to fifteen times higher in males than females. The non-overlapping ranges of testosterone between the sexes has led sports regulators, such as the International Olympic Committee, to use 10 nmol/L testosterone as a sole physiological parameter to divide the male and female sporting divisions. Using testosterone levels as a basis for separating female and male elite athletes is arguably flawed. Male physiology cannot be reformatted by estrogen therapy in transwoman athletes because testosterone has driven permanent effects through early life exposure. This descriptive critical review discusses the inherent male physiological advantages that lead to superior athletic performance and then addresses how estrogen therapy fails to create a female-like physiology in the male. Ultimately, the former male physiology of transwoman athletes provides them with a physiological advantage over the cis-female athlete.
Phylogenomics Supports the Monophyly of Aphelids and Fungi and Identifies New Molecular Synapomorphies.

The supergroup Holomycota, composed of Fungi and several related lineages of unicellular organisms (Nucleariida, Rozellida, Microsporidia, and Aphelida), represents one of the major branches in the phylogeny of eukaryotes. Nevertheless, except for the well-established position of Nucleariida as the first holomycotan branch to diverge, the relationships among the other lineages have so far remained unresolved largely owing to the lack of molecular data for some groups. This was notably the case aphelids, a poorly known group of endobiotic phagotrophic protists that feed on algae with cellulose walls. The first molecular phylogenies including aphelids supported their sister relationship with Rozellida and Microsporidia which, collectively, formed a new group called Opisthosporidia (the 'Opisthosporidia hypothesis'). However, recent phylogenomic analyses including massive sequence data from two aphelid genera, Paraphelidium and Amoeboaphelidium, suggested that the aphelids are sister to fungi (the 'Aphelida+Fungi hypothesis'). Should this position be confirmed, aphelids would be key to understanding the early evolution of Holomycota and the origin of Fungi. Here, we carry out phylogenomic analyses with an expanded taxonomic sampling for aphelids after sequencing the transcriptomes of two species of the genus Aphelidium (A. insulamus and A. tribonematis) in order to test these competing hypotheses. Our new phylogenomic analyses including species from the three known aphelid genera strongly rejected the Opisthosporidia hypothesis. Furthermore, comparative genomic analyses further supported the Aphelida+Fungi hypothesis via the identification of 19 orthologous genes exclusively shared by these two lineages. Seven of them originated from ancient horizontal gene transfer events predating the aphelid-fungal split and the remaining 12 likely evolved de novo, constituting additional molecular synapomorphies for this clade. Ancestral trait reconstruction based on our well-resolved phylogeny of Holomycota suggests that the progenitor of both fungi and rozellids, was aphelid-like, having an amoeboflagellate state and likely preying endobiotically on cellulose-containing, cell-walled organisms. Two lineages, which we propose to call Phytophagea and Opisthophagea, evolved from this ancestor. Phytophagea, grouping aphelids and classical fungi, mainly specialized in endobiotic predation of algal cells. Fungi emerged from this lineage after losing phagotrophy in favour of osmotrophy. Opisthophagea, grouping rozellids and Microsporidia, became parasites, mostly of chitin-containing hosts. This lineage entered a progressive reductive process that resulted in a unique lifestyle, especially in the highly derived Microsporidia.
The impact of environmental and climate parameters on the incidence and mortality of COVID-19 in the six Gulf Cooperation Council countries: A cross-country comparison study

Background Environmental factors can influence the epidemiological dynamics of COVID-19. To estimate the true impact of these factors on COVID-19, climate and disease data should be monitored and analyzed over an extended period of time. The Gulf Cooperation Council (GCC) countries are particularly lacking in such studies. This ecological study investigates the association between climate parameters and COVID-19 cases and deaths in the GCC. Methods Data on temperature, wind-speed and humidity and COVID-19 cases and deaths from the six countries of the GCC were collected between 29/1/2020 and 30/3/2021. Using Spearman’s correlation coefficient, we examined associations between climate parameters and COVID-19 cases and deaths by month, over four different time periods. A two-step cluster analysis was conducted to identify distinct clusters of data using climate parameters and linear regression analysis to determine which climate parameters predicted COVID-19 new cases and deaths. Results The United Arab Emirates (UAE) had the highest cumulative number of COVID-19 cases while Bahrain had the highest prevalence rate per 100,000. The Kingdom of Saudi Arabia (KSA) reported the highest cumulative number of deaths while Oman recorded the highest death rate per 100,000. All GCC countries, except the UAE, reported a positive correlation between temperature and cases and deaths. Wind speed was positively correlated with cases in Qatar, but negatively correlated with cases in the UAE and deaths in KSA. Humidity was positively correlated with cases and deaths in Oman, negatively correlated in Bahrain, Kuwait, Qatar and KSA but there was no correlation in the UAE. The most significant predictors in cluster analysis were temperature and humidity, while in the regression analysis, temperature, humidity and wind speed predicted new COVID-19 cases and deaths. Conclusion This study provides comprehensive epidemiological information on COVID-19 and climate parameters and preliminary evidence that climate may play a key role in the transmission of the COVID-19 virus. This study will assist decision makers in translating findings into specific guidelines and policies for the prevention and elimination of COVID-19 transmission and infection.
On two circular inclusions in harmonic problems

In this paper, we derive the solution for two circular cylindrical elastic inclusions perfectly bonded to an elastic matrix of infinite extent, under anti-plane deformation. The two inclusions have different radii and possess different elastic properties. The matrix is subjected to arbitrary loading. The solution is obtained, via iterations of Mobius transformations, as a rapidly convergent series with an explicit general term involving the complex potential of the corresponding homogeneous problem, i.e., when the inclusions are absent and the matrix material occupies the entire space and is subjected to the same loading. This procedure has been termed "heterogenization. " The technique used can be applied to problems governed by Laplace's equation. Finally some remarks are included concerning the relation of our solution to the theory of discontinuous groups and automorphic functions and possible generalizations to multiple inclusions.
Pharmacokinetics and anti‐nausea effects of intravenous ondansetron in hospitalized dogs exhibiting clinical signs of nausea

Abstract The purpose of this study was to evaluate the pharmacokinetics of intravenous (IV) ondansetron in a population of hospitalized dogs exhibiting clinical signs of nausea. The causes of nausea included pancreatitis, gastroenteritis, endocarditis, chemotherapy‐induced nausea, diabetes mellitus and ketoacidosis, acute kidney injury with aspiration pneumonia, pyometra, uroabdomen, neoplasia, and hepatopathy. Twenty‐four dogs were randomly assigned to one of the following IV ondansetron protocols: 1 mg/kg q12h, 0.5 mg/kg q12h, 1 mg/kg q8h, 0.5 mg/kg q8h. Serum was collected at 0, 0.25, 0.5, 1, 2, 4, 8, 16, and 24 h after the first dose, and nausea scores were recorded at multiple time points. Ondansetron and arginine vasopressin (AVP) concentrations were measured via high‐performance liquid chromatography coupled to tandem mass spectrometry and ELISA, respectively. Noncompartmental pharmacokinetic modeling and dose interval modeling were performed. Ondansetron displayed linear pharmacokinetics. In the 0.5 mg/kg group, mean C max = 214 ng/ml, AUC0–8h = 463 ng/ml*h, and calculated half‐life was 1.9 h. In the 1 mg/kg group, mean C max = 541 ng/ml, AUC0–8h = 1057 ng/ml*h and calculated half‐life was 1.6 h. Serum ondansetron concentrations were not significantly different between dogs that required rescue anti‐nausea medication (non‐responders) and dogs that did not require rescue therapy (responders). In total, 83.3% of patients in the 0.5 mg/kg q8h, 0.5 mg/kg q12h, and 1 mg/kg q8h groups had improvement in nausea scores. In total, 66.7% of patients in the 1 mg/kg q12h group had improvement in nausea scores. In total, 33% of patients had resolution of nausea in the 0.5 mg/kg q8h, 1 mg/kg q8h, and 1 mg/kg q12h groups, and 16% of patients had resolution of nausea in the 0.5 mg/kg q12h group. AVP concentrations were highly variable and did not correlate with nausea scores. Nausea scores significantly decreased regardless of dosage protocol. AVP was not a reliable biomarker of nausea in this group of dogs.
An analytical and numerical approach to the determination of thermal necrosis in cortical bone drilling

In the process of repairing fractures in the bone region with orthopedic injuries, the application of supporting and strengthening the bone tissue with screws, wires, rods, and plates is a widely preferred internal fixation method. In this treatment process, it is necessary to drill the bone tissue to fix the screws. Due to the heat generated in the drilling process, mechanical and thermal damage occurs in the bone tissue. In this study, it is focused that the effect of different cutting conditions on the temperature distribution and necrosis zones in the drilling of human cortical bone. In this context, by selecting variable drill geometry (diameter, point angle, and helix angle) and variable cutting parameters (cutting speed and feed rate), temperature distribution and necrosis zones were investigated with finite element analyses and analytical calculations. When the findings were evaluated, it was understood that drill diameter and cutting speed did not have a significant effect on temperatures and necrosis zone at low cutting speeds. At high cutting speeds, it was observed that the feed rate and drill point angle had an indeterminate effect on the temperatures. The lowest temperature values were obtained at cutting speed of 750 rpm and a feed rate of 0.1 mm/rev for low cutting speeds, and cutting speed of 1500 rpm, helix angle of 10° and drill bit diameter of 2 mm for high cutting speeds. The narrowest necrosis zones were obtained at cutting speed of 250 rpm and feed rate of 0.1 mm/rev for both drill diameters. As a result, the effects of different drill geometry and cutting parameters were determined in order to obtain low temperature distribution and narrow necrosis zone in cortical bone drilling.
Impact of COVID-19 Containment Strategies and Meningococcal Conjugate ACWY Vaccination on Meningococcal Carriage in Adolescents

Objectives: To examine if COVID-19 containment strategies were associated with reduced pharyngeal carriage of meningococci in adolescents. Also, to observe if carriage prevalence of meningococcal A, C, W and Y differed in meningococcal conjugate ACWY vaccinated and unvaccinated adolescents. Design: Repeat cross-sectional study of pharyngeal carriage. Setting: In 2020, recruitment commenced from February to March (pre-COVID-19) and recommenced from August to September (during COVID-19 measures) in South Australia. Participants: Eligible participants were between 17 and 25 years of age and completed secondary school in South Australia in 2019. Results: A total of 1338 school leavers were enrolled in 2020, with a mean age of 18.6 years (standard deviation 0.6). Pharyngeal carriage of disease-associated meningococci was higher during the COVID-19 period compared with the pre-COVID-19 period (41/600 [6.83%] vs. 27/738 [3.66%]; adjusted odds ratio [aOR], 2.03; 95% CI: 1.22–3.39; P = 0.01). Nongroupable carriage decreased during COVID period (1.67% vs. 3.79%; aOR, 0.45; 95% CI: 0.22–0.95). Pharyngeal carriage of groups A, C, W and Y was similar among school leavers vaccinated with meningococcal conjugate ACWY (7/257 [2.72%]) compared with those unvaccinated (29/1081 [2.68%]; aOR, 0.86; 95% CI: 0.37–2.02; P = 0.73). Clonal complex 41/44 predominated in both periods. Conclusions: Meningococcal carriage prevalence was not impacted by public health strategies to reduce severe acute respiratory syndrome coronavirus 2 transmission and is unlikely to be the mechanism for lower meningococcal disease incidence. As international travel resumes and influenza recirculates, clinicians must remain vigilant for signs and symptoms of meningococcal disease. Vaccinating people at the highest risk of invasive meningococcal disease remains crucial despite containment strategies.
Urgent air transfers for acute respiratory infections among children from Northern Canada, 2005–2014

Background The incidence of hospitalizations for acute respiratory infections (ARI) among young Indigenous children from Northern Canada is consistently high. ARIs requiring urgent air transfer can be life-threatening and costly. We aimed to describe their epidemiology, estimate age-specific incidences, and explore factors associated with level of care required. Methods We undertook a retrospective cohort study of children <5 years old from Northern Canada transferred by urgent air transport for ARI from 2005 through 2014 to 5 pediatric tertiary care centers in Vancouver, Edmonton, Winnipeg, Ottawa and Montreal. Admissions were identified via ARI-related ICD-9/10 coding and forward sortation area. Descriptive statistics and univariable analyses were performed. Results Among 650 urgent air transfers, the majority were from Nunavut (n = 349, 53.7%) or Nunavik (n = 166, 25.5%), <6 months old (n = 372, 57.2%), and without underlying comorbidity (n = 458; 70.5%). Estimated annual tertiary care ARI admission rates in infants <1 year old from Nunavut (40.7/1000) and Nunavik (44.5/1000) were tenfold higher than in children aged 1 to 4 years. Bronchiolitis (n = 333, 51.2%) and pneumonia (n = 208, 32.0%) were the most common primary discharge diagnoses. Nearly half required critical care (n = 316, 48.6%); mechanical ventilation rates ranged from 7.2% to 55.9% across centres. The most common primary pathogen was respiratory syncytial virus (n = 196, 30.1%). Influenza A or B was identified in 35 cases (5.4%) and vaccine-preventable bacterial infections in 27 (4.1%) cases. Interpretation Urgent air transfers for ARI from Northern Canada are associated with high acuity. Variations in levels of care were seen across referral centers, age groups and pathogens.
Free energy simulations to study mutational effect of a conserved residue, Trp24, on stability of human serum retinol-binding protein

Abstract Human serum retinol-binding protein (RBP) is a plasma transport protein for vitamin A. RBP is a prime subclass of lipocalins, which bind nonpolar ligands within a β-barrel. To understand the role of Trp 24, one of the highly conserved residues in RBP, free energy simulations have been carried out to understand the effects of the mutations from Trp at position 24 to Leu, Phe, and Tyr in the apo-RBP on its thermal stability. We examine various unfolded systems to study the dependence of the free energy differences on the denatured structure. Our calculated free energy difference values for the three mutations are in excellent agreement with the experimental values when the initial coordinates of the seven-residue peptide segments truncated from the crystal structure are used for the denatured systems. Our free energy change differences for the Trp→Leu, Trp→Phe, and Trp→Tyr mutations are 2.50 ± 0.69, 2.58 ± 0.50, and 2.49 ± 0.48 kcal/mol, respectively, when the native-like seven-residue peptides are used as models for the denatured systems. The main contributions to the free energy change differences for the Trp24→Leu and Trp24→Phe mutations are mainly from van der Waals and covalent interactions, respectively. Electrostatic, van der Waals and covalent terms equally contribute to the free energy change difference for the Trp24→Tyr mutation. The free energy simulation helps understand the detailed microscopic mechanism of the stability of the RBP mutants relative to the wild type and the role of the highly conserved residue, Trp24, of the human RBP. Communicated by Ramaswamy H. Sarma