Miracle-dz/UniFAR-FTUs huggingface dataset:
Prognostic value of inflammatory markers for in-hospital mortality in intensive care patients with acute ischemic stroke: a retrospective observational study based on MIMIC-IV

Background Acute ischemic stroke (AIS) is a primary cause of death and disability worldwide. Four markers that can be readily determined from peripheral blood, namely, the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and total bilirubin, were measured in this study. We examined the relationship between the SII and in-hospital mortality after AIS and evaluated which of the above four indicators was most accurate for predicting in-hospital mortality after AIS. Methods We selected patients from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database who were aged >18 years and who were diagnosed with AIS on admission. We collected the patients’ baseline characteristics, including various clinical and laboratory data. To investigate the relationship between the SII and in-hospital mortality in patients with AIS, we employed the generalized additive model (GAM). Differences in in-hospital mortality between the groups were summarized by the Kaplan–Meier survival analysis and the log-rank test. The receiver operating characteristic (ROC) curve analysis was used to assess the accuracy of the four indicators (SII, NLR, PLR, and total bilirubin) for predicting in-hospital mortality in patients with AIS. Results The study included 463 patients, and the in-hospital mortality rate was 12.31%. The GAM analysis showed a positive correlation between the SII and in-hospital mortality in patients with AIS, but the correlation was not linear. Unadjusted Cox regression identified a link between a high SII and an increased probability of in-hospital mortality. We also found that patients with an SII of >1,232 (Q2 group) had a considerably higher chance of in-hospital mortality than those with a low SII (Q1 group). The Kaplan–Meier analysis demonstrated that patients with an elevated SII had a significantly lower chance of surviving their hospital stay than those with a low SII. According to the results of the ROC curve analysis, the in-hospital mortality of patients with AIS predicted by the SII had an area under the ROC curve of 0.65, which revealed that the SII had a better discriminative ability than the NLR, PLR, and total bilirubin. Conclusion The in-hospital mortality of patients with AIS and the SII were positively correlated, but not linearly. A high SII was associated with a worse prognosis in patients with AIS. The SII had a modest level of discrimination for forecasting in-hospital mortality. The SII was slightly better than the NLR and significantly better than the PLR and total bilirubin for predicting in-hospital mortality in patients with AIS.
Case report: desensitization of hypersensitivity against the antisense oligonucleotide volanesorsen

Familial chylomicronemia syndrome (FCS) is a rare autosomal recessive metabolic disorder that causes extremely elevated plasma triglyceride levels, with limited therapeutic options. Volanesorsen is an antisense oligonucleotide approved for its treatment. A 24-year-old woman with genetically diagnosed FCS secondary to a pathogenic variant in APOA5 and a history of recurrent hypertriglyceridemia-induced pancreatitis episodes was being treated with volanesorsen, 285 mg every 2 weeks. Treatment with volanesorsen achieved normalization of triglycerides to <200 mg/dl. However, after the fifth dose of the medication, the patient developed urticaria and volanesorsen was discontinued. In the absence of alternative pharmacological treatments, the patient received a novel desensitization protocol for volanesorsen that allowed continuation of therapy, without evidence of hypersensitivity reactions after subsequent administrations. FCS requires aggressive multimodal therapy and close follow-up. Volanesorsen has shown great efficacy, but a significant rate of discontinuation due to side effects has been observed. Here, the patient presented an immediate hypersensitivity reaction to volanesorsen, but the provision of a desensitization protocol was effective, facilitating continued treatment and impacting the survival and quality of life of the patient.
AI-enabled case detection model for infectious disease outbreaks in resource-limited settings

Introduction The utility of non-contact technologies for screening infectious diseases such as COVID-19 can be enhanced by improving the underlying Artificial Intelligence (AI) models and integrating them into data visualization frameworks. AI models that are a fusion of different Machine Learning (ML) models where one has leveraged the different positive attributes of these models have the potential to perform better in detecting infectious diseases such as COVID-19. Furthermore, integrating other patient data such as clinical, socio-demographic, economic and environmental variables with the image data (e.g., chest X-rays) can enhance the detection capacity of these models. Methods In this study, we explore the use of chest X-ray data in training an optimized hybrid AI model based on a real-world dataset with limited sample size to screen patients with COVID-19. We develop a hybrid Convolutional Neural Network (CNN) and Random Forest (RF) model based on image features extracted through a CNN and EfficientNet B0 Transfer Learning Model and applied to an RF classifier. Our approach includes an intermediate step of using the RF's wrapper function, the Boruta Algorithm, to select important variable features and further reduce the number of features prior to using the RF model. Results and discussion The new model obtained an accuracy and recall of 96% for both and outperformed the base CNN model and four other experimental models that combined transfer learning and alternative options for dimensionality reduction. The performance of the model fares closely to relatively similar models previously developed, which were trained on large datasets drawn from different country contexts. The performance of the model is very close to that of the “gold standard” PCR tests, which demonstrates the potential for use of this approach to efficiently scale-up surveillance and screening capacities in resource limited settings.
Increased captures of the critically endangered leatherback turtle (Dermochelys coriacea) around New Zealand: the contribution of warming seas and fisher behavior

Five species of sea turtles are known to occur in New Zealand waters, with the leatherback turtle (Dermochelys coriacea) being the most frequently reported. In New Zealand all sea turtles are protected, but there are currently no fisheries bycatch mitigation measures. We describe fishery captures of leatherbacks from Ministry observer and fisher self-reported data. A generalized additive model (GAM) was then used to evaluate which factors might explain the observed year trend in captures. Between fishing years 2007–08 and 2020–21 (years starting 1 October), there were 217 captures of leatherback turtles, an annual average of 15.5. Reported captures increased substantially to 50 in 2020–21. Nearly all (97.7%) captures were reported from surface longline fisheries. Because of sparse observer coverage most captures (85.3%) were self-reported by fishers. Within the main fishery, just 9.4% of the vessels reported 94.5% of the leatherback captures, and one vessel reported 40.4% of all captures. Some non-reporting of captures seems likely. The GAM estimated a higher probability of capture with increasing SST from a constant-over-time spatial pattern of monthly sea surface temperature, and predicted the increase in captures in 2020–21. Much of the increase in bycatch could therefore be explained by the fleet moving into warmer areas where the probability of leatherback capture was higher. Capture mitigation measures could include restricting fishing in turtle ‘hotspot’ times and areas. New Zealand waters should be recognized as an important seasonal foraging ground for leatherback turtles where capture mitigation measures are necessary.
Factors affecting decision-making in Gaelic Football: a focus group approach

Objectives Research examining decision-making in sports has predominantly used experimental approaches that fail to provide a holistic understanding of the various factors that impact the decision-making process. The current study aimed to explore the decision-making processes of Senior (expert) and Academy (near-expert) Gaelic Football players using a focus group approach. Methods Four focus groups were conducted; two with Senior players (n = 5; n = 6) and two with U17 Academy players (n = 5; n = 6). In each focus group, short video clips of Senior Gaelic football games were played, and the action was paused at key moments. The group then discussed the options available to the player in possession, the decision they would make in that situation, and importantly, what factors influenced the final decision. Thematic analysis was used to identify themes that emerged from the focus groups. Results and discussion Four primary themes emerged that affected the decision-making process. Three themes were related to information sources, namely, pre-match context (coach tactics and instructions, match importance, and opposition status), current match context (score and time remaining), and visual information (player positioning and field space, and visual search strategy), and the fourth theme related to individual differences (self-efficacy, risk propensity, perceived pressure, physical characteristics, action capabilities, fatigue) that moderated the decision-making process. Compared to the near-expert Academy players, the expert Senior players displayed a more sophisticated understanding of the various sources of information and were able to integrate them in a more complex manner to make projections regarding future scenarios. For both groups, the decision-making process was moderated by individual differences. A schematic has been developed based on the study findings in an attempt to illustrate the hypothesized decision-making process.
Analysis on the factors associated with COVID-19 infection among Chinese residents after the implementation of the 10 new rules to optimize COVID-19 response: a cross-sectional study

Introduction This study aimed to investigate the status of COVID-19 infection and the associated factors among Chinese residents after the implementation of the 10 New Rules to optimize COVID response. Methods Participants were recruited using convenience sampling. The study used self-filled questionnaires to examine COVID-19 infection and associated factors among Chinese residents, from December 29, 2022, to January 2, 2023. For the statistical analysis, descriptive and quantitative analyses were used. The potential risk factors for COVID-19 infection were identified by multivariable logistic regression analysis. Results After the adjustments in control strategies against COVID-19, the infection rate of COVID-19 was high among respondents, and 98.4% of individuals who tested positive showed symptoms including cough, fever, fatigue, headache, sore throat, nasal congestion, sputum production, muscle and joint pain, and runny nose. The main problems respondents reported were the shortage of drugs and medical supplies, the increased burden on families, and the unreliable information source of COVID-19 infection. Logistic regression showed that isolating patients with COVID-19 at home was associated with a lower risk of COVID-19 infection (OR = 0.58, 95%CI: 0.42–0.81). Conclusion COVID-19 infection among residents is closely related to age, gender, and epidemic prevention measures. The government needs to strengthen education for individuals and centrally manage and properly address difficulties that may arise during COVID-19.
Digital vs. physical ear-nose-and-throat specialist assessment screening for complicated hearing loss and serious ear disorders in hearing-impaired adults prior to hearing aid treatment: a randomized controlled trial

Introduction This study introduces a digital assessment tool for asynchronous and remote ear-nose-and-throat (ENT) specialist assessment screening for complicated hearing loss and serious ear disorders in hearing-impaired adults prior to hearing aid (HA) treatment. The +60 population will nearly double from 12% to 22% between 2015 and 2050 increasing the incidence of age-induced hearing impairment and the need for hearing rehabilitation. If un-diagnosed, age-related hearing loss negatively affects quality of life by accelerating social distancing and early retirement as well as increasing risk of anxiety, depression, and dementia. Therefore, innovative measures are essential to provide timely diagnostics and treatment. Methods A total of 751 hearing-impaired adults without previous HA usage or experience were randomly assigned to digital or physical ENT specialist assessment screening prior to HA treatment initiation in 20 public and private hearing rehabilitation and ENT specialist clinics in the North Denmark Region. A total of 501 test group participants were assigned to digital assessment screening and 250 control group participants to physical assessment screening prior to HA treatment. Results In all, 658 (88%) participants completed the trial and were eligible for analysis. Digital screening sensitivity (0.85, 95% confidence interval (CI) 0.71–0.94) was significantly higher than physical screening sensitivity (0.2, 95% CI: 0.03–0.56). Screening specificity was high for both assessment methods. Discussion In a setting where hearing-impaired adults were assessed for HA treatment, digital ENT specialist assessment screening did not compromise patient safety or increase the risk of misdiagnosis in patients with complicated hearing loss and/or serious ear disorders when compared to physical ENT specialist assessment screening. Clinical Trial registration https://clinicaltrials.gov/ct2/show/NCT05154539, identifier: NCT05154539.
Postoperative adjuvant tyrosine kinase inhibitors combined with anti-PD-1 antibodies improves surgical outcomes for hepatocellular carcinoma with high-risk recurrent factors

Background The clinical value of postoperative adjuvant therapy (PAT) for hepatocellular carcinoma (HCC) remains unclear. This study aimed to explore the effect of PAT with tyrosine kinase inhibitors (TKIs) and anti-PD-1 antibodies on the surgical outcomes of HCC patients with high-risk recurrent factors (HRRFs). Methods HCC patients who underwent radical hepatectomy at Tongji Hospital between January 2019 and December 2021 were retrospectively enrolled, and those with HRRFs were divided into PAT group and non-PAT group. Recurrence-free survival (RFS) and overall survival (OS) were compared between the two groups after propensity score matching (PSM). Prognostic factors associated with RFS and OS were determined by Cox regression analysis, and subgroup analysis was also conducted. Results A total of 250 HCC patients were enrolled, and 47 pairs of patients with HRRFs in the PAT and non-PAT groups were matched through PSM. After PSM, the 1- and 2-year RFS rates in the two groups were 82.1% vs. 40.0% (P < 0.001) and 54.2% vs. 25.1% (P = 0.012), respectively. The corresponding 1- and 2-year OS rates were 95.4% vs. 69.8% (P = 0.001) and 84.3% vs. 55.5% (P = 0.014), respectively. Multivariable analyses indicated that PAT was an independent factor related to improving RFS and OS. Subgroup analysis demonstrated that HCC patients with tumor diameter > 5 cm, satellite nodules, or vascular invasion could significantly benefit from PAT in RFS and OS. Common grade 1-3 toxicities, such as pruritus (44.7%), hypertension (42.6%), dermatitis (34.0%), and proteinuria (31.9%) were observed, and no grade 4/5 toxicities or serious adverse events occurred in patients receiving PAT. Conclusions PAT with TKIs and anti-PD-1 antibodies could improve surgical outcomes for HCC patients with HRRFs.
Obstacles and facilitators of cancer-related dyadic efficacy experienced by couples coping with non-metastatic cancers

Introduction Cancer-related dyadic efficacy is an individual’s confidence to work together with a partner to conjointly manage the effects of cancer and its treatment. In other health contexts, higher levels of dyadic efficacy have been associated with fewer symptoms of psychological distress and higher ratings of relationship satisfaction. The aim of the current study was to explore patient and partner perspectives on what obstructs and facilitates cancer-related dyadic efficacy. Methods These aims were accomplished through a secondary analysis of data collected as a part of a collective qualitative case study. Participants (N = 17 participants) were patients undergoing treatment or recently completed treatment (within 6 months) for a non-metastatic cancer and their partners. To enable in-depth discussions among participants, data was collected through five focus groups. Participants described obstacles and facilitators of dyadic efficacy as dimensions of a common influence. Consistent with these descriptions, reflexive thematic analysis was used to identify influences on cancer-related dyadic efficacy and their subsequent obstructive and facilitative dimensions. Results Four main categories of influence with the potential to obstruct or facilitate cancer-related dyadic efficacy were identified along with their subthemes: appraisals of the couple relationship (quality and togetherness), communication (pattern and interest in information), coping (strategy and evaluation), and responses to change (in tasks and roles and sex life). Eight obstructive and seven facilitative dimensions of these subthemes were described.Discussion: This first analysis of obstacles and facilitators of couples’ cancer-related dyadic efficacy capitalized on the experiential expertise of individuals with cancer and their partners. These thematic results are instructive for the design of dyadic efficacy-enhancing interventions for couples coping with cancer.
Peripherally-administered amphetamine induces plasticity in medial prefrontal cortex and nucleus accumbens in rats with amygdala lesions: implications for neural models of memory modulation

The amygdala has been implicated in a variety of functions linked to emotions. One popular view is that the amygdala modulates consolidation in other brain systems thought to be mainly involved in learning and memory processes. This series of experiments represents a further exploration into the role of the amygdala in memory modulation and consolidation. One interesting line of research has shown that drugs of abuse, like amphetamine, produce dendritic changes in select brain regions and these changes are thought to be equivalent to a usurping of normal plasticity processes. We were interested in the possibility that this modulation of plasticity processes would be dependent on interactions with the amygdala. According to the modulation view of amygdala function, amphetamine would activate modulation mechanisms in the amygdala that would alter plasticity processes in other brain regions. If the amygdala was rendered dysfunctional, these effects should not occur. Accordingly, this series of experiments evaluated the effects of extensive neurotoxic amygdala damage on amphetamine-induced dendritic changes in the nucleus accumbens and prefrontal cortex. The results showed that rats with large lesions of the amygdala showed the normal pattern of dendritic changes in these brain regions. This pattern of results suggests that the action of not all memory modulators, activated during emotional events, require the amygdala to impact memory.
Fibre amplifier based on an ytterbium-doped active tapered fibre for the generation of megawatt peak power ultrashort optical pulses

We report a new ytterbium-doped active tapered fibre used in the output amplifier stage of a fibre laser system for the generation of megawatt peak power ultrashort pulses in the microjoule energy range. The tapered fibre is single-mode at its input end (core and cladding diameters of 10 and ) and multimode at its output end (diameters of 45 and ), but ultrashort pulses are amplified in a quasi-single-mode regime. Using a hybrid Er/Yb fibre system comprising an erbium master oscillator and amplifier at a wavelength near , a nonlinear wavelength converter to the range and a three-stage ytterbium-doped fibre amplifier, we obtained pulses of energy and duration, which were then compressed by a grating-pair dispersion compressor with 60 % efficiency to a duration, approaching the transform-limited pulse duration. The present experimental data agree well with numerical simulation results for pulse amplification in the three-stage amplifier.
Outcomes in children with rheumatic diseases following COVID-19 vaccination and infection: data from a large two-center cohort study in Thailand

Introduction Vaccination against coronavirus disease 2019 (COVID-19) is effective in protecting patients from severe COVID-19 infection. Disease flare-up following immunization in children with rheumatic disorders may result in patient reluctance to receive the vaccine. Underlying rheumatic diseases or the use of immunosuppressive drugs may influence the outcomes of COVID-19 vaccination and infection. We aimed to describe outcomes in children with rheumatic diseases following COVID-19 immunization and infection. Methods This retrospective study was performed at two large academic centers in Thailand. During the COVID-19 pandemic, all patients were routinely queried about COVID-19-related conditions. We included patients with rheumatic diseases aged <18 years who received at least one dose of a COVID-19 vaccine or had a history of COVID-19 infection with more than 6 months of recorded follow-up after the last vaccine dose or COVID-19 illness. Demographic information and data on clinical symptoms, disease activity, treatment, outcomes, and COVID-19 vaccination and infection were collected. Results A total of 479 patients were included. Most (229; 47.81%) patients had juvenile idiopathic arthritis, followed by connective tissue diseases (189; 39.46%), vasculitis syndromes (42; 8.76%), and other rheumatic diseases (19; 3.97%). Approximately 90% of patients received at least one dose of COVID-19 vaccination, and half of the patients had COVID-19 infection. Among patients, 10.72% and 3.27% developed a flare after COVID-19 vaccination and COVID-19 illness, respectively. Flare severity after COVID immunization and infection was mainly mild to moderate. The predictor of flare after COVID-19 vaccination was the use of prednisolone ≥10 mg/day before vaccination (hazard ratio: 2.04, 95% confidence interval: 1.05–3.97, p = 0.037). Inactive disease before receiving the COVID-19 vaccination was a predictor of inactive status after a flare (hazard ratio: 2.95, 95% confidence interval: 1.04–8.40; p = 0.043). Overall, 3.36% and 1.61% of patients experienced a new onset of rheumatic disease after receiving the COVID-19 vaccine and after COVID-19 infection, respectively. Conclusion The COVID-19 vaccine is recommended for children with rheumatic disease, particularly those who are in stable condition. After COVID-19 vaccination, patients—especially those with active disease before vaccination or those receiving concurrent prednisolone doses of ≥10 mg/day—should be closely monitored.