Miracle-dz/UniFAR-FTUs huggingface dataset:
Opioid use disorder in chronic non-cancer pain in Germany: a cross sectional study

Objectives The DSM-5 diagnosis ‘opioid use disorder’ (OUD) was established to better describe and detect significant impairment or distress related to opioid use. There is no data on rates of OUD in chronic non-cancer pain (CNCP) in European countries. Therefore, our objective was to screen patients in specialised pain centres for signs of OUD. Design Cross-sectional questionnaire study. Setting Four outpatient pain clinics in the area of Bonn, Germany. Participants n=204 patients participated in the study (response rate: 87.9%). All adult patients with opioid pain therapy >6 months for CNCP were included. Excluded were patients with malignant disease, patients who could not collect their prescription themselves due to age or multimorbidity and patients on opioid-maintenance therapy. Primary and secondary outcome measure Primary outcome measure was the proportion of patients with mild to severe OUD. Results One-fourth (26.5%) of participants were diagnosed with OUD. Moderate to severe disorder was found in 9.3. Young age was the only connected risk factor (OR 0.96 [95% CI 0.94 to 0.99], p: 0.003). Conclusions OUD is a relevant diagnosis in patients on long-term opioid therapy for CNCP in the Bonn area. Careful follow-up by the attending physicians is advisable, especially in patients with moderate or severe disorder.
Examination of Barriers to Medication Adherence, Asthma Management, and Control Among Community Pharmacy Patients With Asthma

Objective: To describe the prevalence of common barriers to asthma medication adherence and examine associations between patient-reported asthma controller adherence and asthma control, therapy adherence barriers, and asthma management characteristics. Methods: Previously developed asthma-specific tool was pilot tested on a convenience sample of adult patients with persistent asthma. The following data were collected via patient survey: demographic characteristics and comorbidities, adherence, asthma control, and asthma management characteristics. Descriptive and inferential statistics were used to address the study objective. Results: The patients (N = 93) were 45.4 (17.2) years of age, and 66.7% were female. The majority had poor (68.8%) adherence, with 61.3% of patients having controlled asthma. There was no significant association between adherence and asthma control. The mean number of barriers for good and poor adherence groups differed significantly: 2.0 ± 1.1 and 5.4 ± 2.4, respectively (P < .0001). Having an asthma action plan (AAP) was the only asthma management characteristic significantly related to adherence. The majority of patients with poor adherence did not have an AAP (76.6%), whereas 81.5% of patients with good adherence did have an AAP (P < 0.0001). Conclusions: The use of this survey tool confirmed presence of asthma-specific barriers, thus using this specialized approach may lead to more effective, targeted counseling in community pharmacy settings.
Short-term impact of introducing a soft opt-out organ donation system in Wales: before and after study

Objectives To determine the short-term impact of a soft opt-out organ donation system on consent rates and donor numbers. Design Before and after observational study using bespoke routinely collected data. Setting National Health Service Blood and Transplant. Participants 205 potential organ donor cases in Wales. Interventions The Act and implementation strategy. Primary and secondary outcomes Consent rates at 18 months post implementation compared with 3 previous years, and organ donor numbers 21 months before and after implementation. Changes in organ donor register activity post implementation for 18 months. Results The consent rate for all modes of consent was 61.0% (125/205), showing a recovery from the dip to 45.8% in 2014/2015. 22.4% (46/205) were deemed consented donors: consent rate 60.8% (28/46). Compared with the 3 years before the switch there was a significant difference in Welsh consent rates (χ2 p value=0.009). Over the same time period, rest of the UK consent rates also significantly increased from 58.6% (5256/8969) to 63.1% (2913/4614) (χ2 p value<0.0001), therefore the Wales increase cannot be attributed to the Welsh legislation change. Deceased donors did not increase: 101 compared with 104. Organ donation registration increased from 34% to 38% with 6% registering to opt-out. Conclusion This is the first rigorous initial evaluation with bespoke data collected on all cases. The longer-term impact on consent rates and donor numbers is unclear. Concerns about a potential backlash and mass opting out were not realised. The move to a soft opt-out system has not resulted in a step change in organ donation behaviour, but can be seen as the first step of a longer journey. Policymakers should not assume that soft opt-out systems by themselves simply need more time to have a meaningful effect. Ongoing interventions to further enhance implementation and the public’s understanding of organ donation are needed to reach the 2020 target of 80% consent rates. Further longitudinal monitoring is required.
DPPA2 and DPPA4 are necessary to establish a 2C‐like state in mouse embryonic stem cells

After fertilization of the transcriptionally silent oocyte, expression from both parental chromosomes is launched through zygotic genome activation (ZGA), occurring in the mouse at the 2‐cell (2C) stage. Among the first elements to be transcribed are the Dux gene, the product of which induces a wide array of ZGA genes, and a subset of evolutionary recent LINE‐1 retrotransposons that regulate chromatin accessibility in the early embryo. The maternally inherited factors that activate Dux and LINE‐1 transcription have so far remained unknown. Mouse embryonic stem cells (mESCs) recapitulate some aspects of ZGA in culture, owing to their ability to cycle through a 2C‐like stage when Dux, its target genes, and LINE‐1 integrants are expressed. Here, we identify the paralog proteins DPPA2 and DPPA4 as necessary for the activation of Dux and LINE‐1 expression in mESCs. Since their encoding RNAs are maternally transmitted to the zygote, it is likely that these factors are important upstream mediators of murine ZGA.
Children’s and caregivers’ perspectives about mandatory reporting of child maltreatment: a meta-synthesis of qualitative studies

Objective To systematically synthesise qualitative research that explores children’s and caregivers’ perceptions of mandatory reporting. Design We conducted a meta-synthesis of qualitative studies. Data sources Searches were conducted in Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Criminal Justice Abstracts, Education Resources Information Center, Sociological Abstracts and Cochrane Libraries. Eligibility criteria English-language, primary, qualitative studies that investigated children’s or caregivers’ perceptions of reporting child maltreatment were included. All healthcare and social service settings implicated by mandatory reporting laws were included. Data extraction and synthesis Critical appraisal of included studies involved a modified checklist from the Critical Appraisal Skills Programme (CASP). Two independent reviewers extracted data, including direct quotations from children and caregivers (first-order constructs) and interpretations by study authors (second-order constructs). Third-order constructs (the findings of this meta-synthesis) involved synthesising second-order constructs that addressed strategies to improve the mandatory reporting processes for children or caregivers—especially when these themes addressed concerns raised by children or caregivers in relation to the reporting process. Results Over 7935 citations were retrieved and 35 articles were included in this meta-synthesis. The studies represent the views of 821 caregivers, 50 adults with histories of child maltreatment and 28 children. Findings suggest that children and caregivers fear being reported, as well as the responses to reports. Children and caregivers identified a need for improvement in communication from healthcare providers about mandatory reporting, offering preliminary insight into child-driven and caregiver-driven strategies to mitigate potential harms associated with reporting processes. Conclusion Research on strategies to mitigate potential harms linked to mandatory reporting is urgently needed, as is research that explores children’s experiences with this process.
The mRNA-bound Proteome of Leishmania mexicana: Novel Genetic Insight into an Ancient Parasite*

A comprehensive, quantified identification of the mRNA-binding and whole cell proteomes in the three main Leishmania lifecycle stages, the first such comparison in kinetoplastid parasites, demonstrates trans-regulator RBPs select distinct, specific mRNA target pools in a stage-regulated manner despite equivalent, constitutive transcript levels available. Results further indicate that in L. mexicana parasites, mRNA levels are not a strong predictor of whole cell expression or RNA binding potential of encoded proteins. Included are the first proteomes from the human-infective metacyclic promastigote stage. Graphical Abstract Highlights Comprehensive, quantified mRNA-binding and whole cell proteomes of the three main Leishmania spp. lifecycle stages. Decisive evidence that trans-regulator RBPs can selectively bind distinct mRNA target pools in a stage-regulated manner despite equivalent transcript levels. Quantified evidence that in L. mexicana parasites, mRNA levels are not a strong predictor of whole cell expression or RNA binding potential of encoded proteins. Use of Histone H4 as the first marker of procyclic stage cells in Leishmania spp. Leishmania parasite infections, termed the leishmaniases, cause significant global infectious disease burden. The lifecycle of the parasite embodies three main stages that require precise coordination of gene regulation to survive environmental shifts between sandfly and mammalian hosts. Constitutive transcription in kinetoplastid parasites means that gene regulation is overwhelmingly reliant on post-transcriptional mechanisms, yet strikingly few Leishmania trans-regulators are known. Using optimized crosslinking and deep, quantified mass spectrometry, we present a comprehensive analysis of 1400 mRNA binding proteins (mRBPs) and whole cell proteomes from the three main Leishmania lifecycle stages. Supporting the validity, although the crosslinked RBPome is magnitudes more enriched, the protein identities of the crosslinked and non-crosslinked RBPomes were nearly identical. Moreover, multiple candidate RBPs were endogenously tagged and found to associate with discrete mRNA target pools in a stage-specific manner. Results indicate that in L. mexicana parasites, mRNA levels are not a strong predictor of the whole cell expression or RNA binding potential of encoded proteins. Evidence includes a low correlation between transcript and corresponding protein expression and stage-specific variation in protein expression versus RNA binding potential. Unsurprisingly, RNA binding protein enrichment correlates strongly with relative replication efficiency of the specific lifecycle stage. Our study is the first to quantitatively define and compare the mRBPome of multiple stages in kinetoplastid parasites. It provides novel, in-depth insight into the trans-regulatory mRNA:Protein (mRNP) complexes that drive Leishmania parasite lifecycle progression.
Shared decision-making experienced by Canadians facing health care decisions: a Web-based survey.

BACKGROUND Despite health policy that promotes shared decision-making, it is not yet the norm in clinical practice. We aimed to assess how much shared decision-making Canadians experienced in health-related decisions in 2017. METHODS We conducted a cross-sectional online survey in January 2018 with a Web-based panel of Canadians representing all 10 provinces. We assessed their involvement in health-related decisions made with a health care professional over the previous year by asking about 1) discussion of choice of treatment or care plan, 2) presentation of advantages and disadvantages, 3) exploration of ideas and preferences, 4) discussion of preferred option and 5) match between preferred and actual level of participation. We computed an average shared decision-making score (range 1 [never] to 5 [always]). We presented characteristics of participants and responses using descriptive statistics and explored variations across sociodemographic factors, jurisdictions, geographical areas and care settings (home care or not) using multivariate weighted regressions. RESULTS Of the 1591 participants surveyed, 1010 (63.5%) reported receiving health care in the previous 12 months. The mean of the average shared decision-making score was 2.25/5 (standard deviation [SD] 1.16). After weighting, 42.8% of respondents reported that their health care professional often or always mentioned that they had a choice of treatment or care plan, 45.4% reported that advantages and disadvantages were often or always presented, 38.8% reported that they were often or always asked for their ideas or preferences, 40.2% reported that they were often or always asked about their preferred option, and 54.1% stated that their level of participation in decision-making often or always matched their preferred level of participation. Increasing age, rural setting, living in the province of Quebec and not being white significantly decreased the level of shared decision-making experienced. Older respondents (age ≥ 65 yr) receiving home care reported the least shared decision-making (mean score 1.7 [SD 0.5]). INTERPRETATION Canadians in all 10 provinces experienced a low degree of shared decision-making in 2017, with variations across sociodemographic factors, jurisdictions, care settings and geographical areas. Further efforts to foster implementation of shared decision-making are needed and should take these variations into account.
Gadd45α modulates aversive learning through post‐transcriptional regulation of memory‐related mRNAs

Learning is essential for survival and is controlled by complex molecular mechanisms including regulation of newly synthesized mRNAs that are required to modify synaptic functions. Despite the well‐known role of RNA‐binding proteins (RBPs) in mRNA functionality, their detailed regulation during memory consolidation is poorly understood. This study focuses on the brain function of the RBP Gadd45α (growth arrest and DNA damage‐inducible protein 45 alpha, encoded by the Gadd45a gene). Here, we find that hippocampal memory and long‐term potentiation are strongly impaired in Gadd45a‐deficient mice, a phenotype accompanied by reduced levels of memory‐related mRNAs. The majority of the Gadd45α‐regulated transcripts show unusually long 3′ untranslated regions (3′UTRs) that are destabilized in Gadd45a‐deficient mice via a transcription‐independent mechanism, leading to reduced levels of the corresponding proteins in synaptosomes. Moreover, Gadd45α can bind specifically to these memory‐related mRNAs. Our study reveals a new function for extended 3′UTRs in memory consolidation and identifies Gadd45α as a novel regulator of mRNA stability.
Analysis of the Factors Associated with Negative Conversion of Severe Acute Respiratory Syndrome Coronavirus 2 RNA of Coronavirus Disease 2019

AIM: To understand the factors associated with negative conversion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, targeted surveillance and control measures can be taken to provide scientific basis for the treatment of the disease and to improve the prognosis of the disease. METHODS: Using the method of retrospective cohort study, we collected the data of Coronavirus Disease 2019 (COVID-19) patients in Tongji Hospital of Wuhan, China from 10 January to 25 March, 2020. Among the data of 282 cases, 271 patients, according to whether the negative conversion happened, were divided into negative conversion group and control group. We made the quantitative variables into classification; Chi-square test single-factor and Cox regression were used in univariate analysis and extracted 30 meaningful variables, then through the collinearity diagnosis, excluded the existence of collinear variables. Finally, 22 variables were included in Cox regression analysis. RESULTS: The gender distribution was statistically significant between two groups (p < 0.05). While in the negative conversion group, the patients of non-severe group occupied a large proportion (p < 0.001). The median time for the negative conversion group was 17 days, and at the end of the observation period, the virus duration in control group was 24 days (p < 0.05). A total of 55 variables were included in univariate analysis, among which 30 variables were statistically different between the two groups. After screening variables through collinearity diagnosis, 22 variables were included in the Cox regression analysis. Last, lactate dehydrogenase (LDH), age, fibrinogen (FIB), and disease severity were associated with negative conversion of SARS-CoV-2 RNA. CONCLUSION: Our results suggest that in the treatment of COVID-19, focus on the age of more than 65 years old, severe, high level of LDH, FIB patients, and take some targeted treatment, such as controlling of inflammation, reducing organ damage, so as to provide good conditions for virus clearance in the body.
Comparative population genomics identified genomic regions and candidate genes associated with fruit domestication traits in peach

Summary Crop evolution is a long‐term process involving selection by natural evolutionary forces and anthropogenic influences; however, the genetic mechanisms underlying the domestication and improvement of fruit crops have not been well studied to date. Here, we performed a population structure analysis in peach (Prunus persica) based on the genome‐wide resequencing of 418 accessions and confirmed the presence of an obvious domestication event during evolution. We identified 132 and 106 selective sweeps associated with domestication and improvement, respectively. Analysis of their tissue‐specific expression patterns indicated that the up‐regulation of selection genes during domestication occurred mostly in fruit and seeds as opposed to other organs. However, during the improvement stage, more up‐regulated selection genes were identified in leaves and seeds than in the other organs. Genome‐wide association studies (GWAS) using 4.24 million single nucleotide polymorphisms (SNPs) revealed 171 loci associated with 26 fruit domestication traits. Among these loci, three candidate genes were highly associated with fruit weight and the sorbitol and catechin content in fruit. We demonstrated that as the allele frequency of the SNPs associated with high polyphenol composition decreased during peach evolution, alleles associated with high sugar content increased significantly. This indicates that there is genetic potential for the breeding of more nutritious fruit with enhanced bioactive polyphenols without disturbing a harmonious sugar and acid balance by crossing with wild species. This study also describes the development of the genomic resources necessary for evolutionary research in peach and provides the large‐scale characterization of key agronomic traits in this crop species.
Acute Effect Between Verbal Instruction and Video Modelling on Underhand Volleyball Serve Among Novice Volleyball Players

The purpose of this study was to examine the acute effect between verbal instructions and video modelling on underhand volleyball serve among novice volleyball players. Thirty novice volleyball players (N=30) aged between 16 to 17 years old were recruited and randomly assigned into two groups; verbal instructions and video modelling. The results from the acute effects between verbal instructions and video modelling on underhand volleyball serve among novice volleyball players was found significant in pre-test, post-test 1 and post-test 2 for both verbal instructions and video modelling. Significant improvements (p<0.05) were recorded after being exposed to different types of learning aids in the post-test. The results also showed that there was no significant difference reported between both groups of verbal instructions and video modelling. In conclusion, verbal instructions and video modelling are both effective in order to improve the underhand volleyball serve among novice volleyball players.
Efficacy of an educational intervention on students' attitudes regarding spirituality in healthcare: a cohort study in the USA

Objective To determine if an educational intervention focused on the role of spirituality in healthcare positively affects medical students' attitudes and perceptions relating to this topic. Design A pre-post cohort study. Setting An undergraduate medical institution affiliated with an academic medical center in the USA. Participants A total of 110 medical students currently on their clinical rotations received the educational intervention, of whom 71 (65%) completed both the presurvey and postsurvey. Demographic variables did not significantly differ from the national average of medical students, or from a comparison group. All students who attended the intervention were given the opportunity to participate in the survey. Interventions The educational intervention consisted of a 60-minute lecture focusing on religion/spirituality (R/S) in healthcare, followed by a 90-minute case discussion in a small group setting. Primary and secondary outcome measures Assessment consisted of 18-item preintervention and postintervention survey quantifying student’s attitudes towards, comfort with, and perceptions of R/S in healthcare. Results Attitudes towards, comfort with, and perceptions of R/S in healthcare were generally positive preintervention. Following the intervention, students expressed an increased willingness to include R/S competency in their future practice (p=0.001), were more comfortable sharing their own R/S beliefs with a patient when appropriate (p=0.02), and were more willing to approach a patient with R/S concern (p=0.04). The other surveyed attitudes demonstrated positive, but non-significant improvement. Conclusion An educational intervention focusing on approaching patients with R/S concerns has the ability to improve the attitudes and comfort of medical students. By incorporating a total of 150 minutes of education about R/S, medical schools can help develop this particular area of cultural competence, preparing a generation of physicians to professionally approach R/S concerns of patients. Future research should move beyond quantifying attitudes and strive to understand changes in knowledge and student behaviour.