Miracle-dz/UniFAR-FTUs huggingface dataset:
Assessing Attitudes and Beliefs Toward HPV Vaccination among Ghanaian Parents with Unvaccinated Adolescents: Application of Multi-Theory Model of Behavior Change

Objective: The purpose of the study was to assess the attitudes and beliefs towards HPV vaccination among Ghanaian parents with unvaccinated adolescents using the Multi-Theory Model (MTM) of behavior change. Additionally, we used MTM constructs to predict the likelihood of parents allowing their adolescents to initiate and complete the recommended HPV vaccine series. Methods: A 44-item validated survey was administered among parents with unvaccinated adolescents living in the Ashanti Region of Ghana. HPV vaccine initiation predictors were perceived beliefs and MTM constructs: participatory dialogue, behavioral confidence, and change in the physical environment. HPV vaccine completion predictors were emotional transformation, social environment, and practice for change. Results: Multiple linear regression analyses showed that perceived beliefs (95% CI: 0.03 – 0.14), change in the physical environment (95% CI: 0.06 – 0.15), and behavioral confidence (95% CI: 0.00 – 0.07), were strongly associated with parents’ likelihood of allowing their adolescents to initiate the HPV vaccine series (p<0.001). Together, perceived beliefs, behavioral confidence, and change in the physical environment accounted for 13.6% of the variance (R2 = 0.136). The emotional transformation (95% CI: 0.04 – 0.10), and social environment (95% CI: 0.25 – 0.35), predictors were both strongly associated with parents’ likelihood of allowing their adolescent to complete the vaccine series (p<0.001). Together, emotional transformation and social environment accounted for 45.8% of the variance (R2 = .458). A sample of 380 parents with unvaccinated adolescents, between the ages of 35 – 60 years, participated in this study. Many of the participants were unaware of HPV (98.7%) and its related vaccinations (96.8%). Conclusion: Our findings underscore the need for comprehensive multi-level interventions to create HPV vaccination awareness among Ghanaian parents with unvaccinated adolescents.
Detection of G Protein–Coupled Receptor Autoantibodies in Postural Orthostatic Tachycardia Syndrome Using Standard Methodology

Background: Postural orthostatic tachycardia syndrome (POTS) is a disorder of orthostatic intolerance that primarily affects women of childbearing age. The underlying pathophysiology of POTS is not fully understood, but it has been suggested that autoimmunity may play a role. The aim of this study was to compare concentrations of autoantibodies to cardiovascular G protein–coupled receptors between patients with POTS and healthy controls. Methods: Sera were collected from 116 patients with POTS (91% female; medium age, 29 years) and 81 healthy controls (84% female; medium age, 27 years) from Calgary, Canada, and Malmö, Sweden. Samples were evaluated for autoantibodies to 11 receptors (adrenergic, muscarinic, angiotensin II, and endothelin) using a commercially available enzyme-linked immunosorbent assay. Results: Autoantibody concentrations against all of the receptors tested were not significantly different between controls and patients with POTS. The majority of patients with POTS (98.3%) and all controls (100%) had α1 adrenergic receptor autoantibody concentrations above the seropositive threshold provided by the manufacturer (7 units/mL). The proportion of patients with POTS versus healthy controls who fell above the diagnostic thresholds was not different for any tested autoantibodies. Receiver operating characteristic curves showed a poor ability to discriminate between patients with POTS and controls. Conclusions: Patients with POTS and healthy controls do not differ in their enzyme-linked immunosorbent assay–derived autoantibody concentrations to cardiovascular G protein–coupled receptors. These findings suggest that these tests are not useful for establishing the role of autoimmunity in POTS.
Bedaquiline, Delamanid, Linezolid, and Clofazimine for Treatment of Pre-extensively Drug-Resistant Tuberculosis

Abstract Background Treatment success rates for multidrug-resistant tuberculosis (MDR-TB) remain low globally. Availability of newer drugs has given scope to develop regimens that can be patient-friendly, less toxic, with improved outcomes. We proposed to determine the effectiveness of an entirely oral, short-course regimen with bedaquiline and delamanid in treating MDR-TB with additional resistance to fluoroquinolones (MDR-TBFQ+) or second-line injectable (MDR-TBSLI+). Methods We prospectively determined the effectiveness and safety of combining 2 new drugs with 2 repurposed drugs—bedaquiline, delamanid, linezolid, and clofazimine—for 24–36 weeks in adults with pulmonary MDR-TBFQ+ and/or MDR-TBSLI+. The primary outcome was a favorable response at end of treatment, defined as 2 consecutive negative cultures taken 4 weeks apart. The unfavorable outcomes included bacteriologic or clinical failure during the treatment period. Results Of the 165 participants enrolled, 158 had MDR-TBFQ+. At the end of treatment, after excluding 12 patients due to baseline drug susceptibility and culture negatives, 139 of 153 patients (91%) had a favorable outcome. Fourteen patients (9%) had unfavorable outcomes: 4 deaths, 7 treatment changes, 2 bacteriological failures, and 1 withdrawal. During treatment, 85 patients (52%) developed myelosuppression, 69 (42%) reported peripheral neuropathy, and none had QTc(F) prolongation >500 ms. At 48 weeks of follow-up, 131 patients showed sustained treatment success with the resolution of adverse events in the majority. Conclusions After 24–36 weeks of treatment, this regimen resulted in a satisfactory favorable outcome in pulmonary MDR-TB patients with additional drug resistance. Cardiotoxicity was minimal, and myelosuppression, while common, was detected early and treated successfully. Clinical Trials Registration ClinicalTrials Registry of India (CTRI/2019/01/017310).
Post-operative atrial fibrillation and risk of heart failure hospitalization.

AIMS Post-operative atrial fibrillation (POAF) is associated with stroke and mortality. It is unknown if POAF is associated with subsequent heart failure (HF) hospitalization. This study aims to examine the association between POAF and incident HF hospitalization among patients undergoing cardiac and non-cardiac surgeries. METHODS AND RESULTS A retrospective cohort study was conducted using all-payer administrative claims data that included all non-federal emergency department visits and acute care hospitalizations across 11 states in the USA. The study population included adults aged at least 18 years hospitalized for surgery without a prior diagnosis of HF. Cox proportional hazards regression models were used to examine the association between POAF and incident HF hospitalization after making adjustment for socio-demographics and comorbid conditions. Among 76 536 patients who underwent cardiac surgery, 14 365 (18.8%) developed incident POAF. In an adjusted Cox model, POAF was associated with incident HF hospitalization [hazard ratio (HR) 1.33; 95% confidence interval (CI) 1.25-1.41]. In a sensitivity analysis excluding HF within 1 year of surgery, POAF remained associated with incident HF hospitalization (HR 1.15; 95% CI 1.01-1.31). Among 2 929 854 patients who underwent non-cardiac surgery, 23 763 (0.8%) developed incident POAF. In an adjusted Cox model, POAF was again associated with incident HF hospitalization (HR 2.02; 95% CI 1.94-2.10), including in a sensitivity analysis excluding HF within 1 year of surgery (HR 1.49; 95% CI 1.38-1.61). CONCLUSIONS Post-operative atrial fibrillation is associated with incident HF hospitalization among patients without prior history of HF undergoing both cardiac and non-cardiac surgeries. These findings reinforce the adverse prognostic impact of POAF and suggest that POAF may be a marker for identifying patients with subclinical HF and those at elevated risk for HF.
Childhood trauma and schizotypy in non-clinical samples: A systematic review and meta-analysis

The association of early life adversities and psychosis symptoms is well documented in clinical populations; however, whether this relationship also extends into subclinical psychosis remains unclear. In particular, are early life adversities associated with increased levels of schizotypal personality traits in non-clinical samples? We conducted a systematic review and meta-analysis of associations between early life adversities and psychometrically defined schizotypal traits in non-clinical samples. The review followed PRISMA guidelines. The search using PubMed, Web of Science and EBSCO databases identified 1,609 articles in total. Twenty-five studies (N = 15,253 participants) met eligibility criteria for the review. An assessment of study quality showed that fewer than half of all studies were rated as methodologically robust. Meta-analyses showed that all forms of childhood abuse (emotional, physical and sexual) and neglect (emotional and physical) were significantly associated with psychometric schizotypy. The association of schizotypy traits with childhood emotional abuse (r = .33: 95%CI .30 to .37) was significantly larger than for all other form of abuse or neglect. Meta-regression analyses showed that the physical abuse-schizotypy relationship was stronger in samples with more women participants; and the sexual abuse-schizotypy relationship was stronger in younger samples. The current review identifies a dose-response relationship between all forms of abuse/neglect and schizotypy scores in non-clinical samples; however, a stronger association emerged for emotional abuse. More research is required to address the relationship of trauma types and specific symptom types. Future research should also address the under-representation of men.
Gynecologic Malignancy-Associated Venous Thromboembolism and Predictive Tool at Thammasat University Hospital

Objectives: Aims were to investigate the prevalence and risk factors of venous thromboembolism (VTE) in gynecologic malignancy cases. Value of screening tool (Caprini) for prediction of VTE was also assessed. Study design: A retrospective study of gynecologic malignancy subjects who underwent major gynecological operation via exploratory laparotomy at Thammasat University Hospital, Pathum Thani, Thailand from January 2015 to December 2020. Participants were categorized into VTE and non-VTE groups. Caprini score, associated laboratory and clinical factors of both groups were evaluated. Results: A total of 392 subjects were recruited into the study. Prevalence of VTE was 7.4 (29/392) percent. VTE was diagnosed in subjects with endometrial, ovarian and cervical cancer at percentage of 7.8 (15/192), 7.9 (11/138) and 5.7 (3/53), respectively. Demographic characters of both groups were comparable. VTE group had significant more Caprini score, platelets count and platelet lymphocyte ratio (PLR) than non-VTE group. Modified Caprini score (2 multiply Caprini score plus 1 multiply PLR) was generated for better VTE prediction. Sensitivity and specificity of Caprini (≥5.5) and modified Caprini scores (≥22.8) were 72.4 vs 39.4, and 79.3 vs 52.1 percent, respectively. Conclusion: Prevalence of VTE among gynecologic malignancy cases was 7.4 percent. The modified Caprini score was an alternative VTE predictive tool. Cut-off point of modified Caprini score at equal or more than 22.8 was proposed.
AP1/2β-mediated exocytosis of tapetum-specific transporters is required for pollen development in Arabidopsis thaliana

Abstract AP-1 and AP-2 adaptor protein (AP) complexes mediate clathrin-dependent trafficking at the trans-Golgi network (TGN) and the plasma membrane, respectively. Whereas AP-1 is required for trafficking to plasma membrane and vacuoles, AP-2 mediates endocytosis. These AP complexes consist of four subunits (adaptins): two large subunits (β1 and γ for AP-1 and β2 and α for AP-2), a medium subunit μ, and a small subunit σ. In general, adaptins are unique to each AP complex, with the exception of β subunits that are shared by AP-1 and AP-2 in some invertebrates. Here, we show that the two putative Arabidopsis thaliana AP1/2β adaptins co-assemble with both AP-1 and AP-2 subunits and regulate exocytosis and endocytosis in root cells, consistent with their dual localization at the TGN and plasma membrane. Deletion of both β adaptins is lethal in plants. We identified a critical role of β adaptins in pollen wall formation and reproduction, involving the regulation of membrane trafficking in the tapetum and pollen germination. In tapetal cells, β adaptins localize almost exclusively to the TGN and mediate exocytosis of the plasma membrane transporters such as ATP-binding cassette (ABC)G9 and ABCG16. This study highlights the essential role of AP1/2β adaptins in plants and their specialized roles in specific cell types.
Navicular bursoscopy in the horse: a comparative study.

OBJECTIVES To compare the proportion of the proximal recess of the navicular bursa that could be examined through a single endoscopic portal and the severity of iatrogenic lesions between conventional and modified approaches. DESIGN Descriptive study. SAMPLE POPULATION Equine cadaver forelimbs (n=16). METHODS Arthroscopic access to the navicular bursa in 1 limb of each pair was by a conventional approach and in the other limb, by a modified approach using sharp dissection through the distal digital flexor sheath, immediately palmar to the T ligament. The time required to access the bursa and the estimated proportion of the navicular bone that could be seen with each approach were recorded. Iatrogenic damage to the navicular bone and the deep digital flexor tendon (DDFT) were quantified. RESULTS The mean access time to the navicular bursa using the conventional approach was 1.21+/-0.41 minutes compared with 2.09+/-0.86 minutes using the modified technique. The estimated proportions of the bursa visible through a single endoscopic portal using the conventional and modified approaches were 60% and 80%, respectively. Scores for navicular bone (P=.003) and DDFT (P=.012) damage using the conventional approach were significantly higher than those using the modified approach. CONCLUSIONS A modified, transthecal approach to the navicular bursa under direct observation resulted in significantly less iatrogenic damage than the conventional approach. CLINICAL RELEVANCE With experience, the modified approach is straightforward, reasonably rapid, and allows near-complete examination of the navicular bursa through a single portal, with minimal iatrogenic damage to the intrabursal structures.
Association between hypotension during 24 h ambulatory blood pressure monitoring and reflex syncope: the SynABPM 1 study

Abstract Aims Diagnostic criteria for ambulatory blood pressure monitoring (ABPM) in patients with suspected reflex syncope are lacking. The study hypothesis was that patients with reflex syncope have a higher prevalence of systolic blood pressure (SBP) drops on ABPM. Methods and results ABPM data from reflex syncope patients and controls, matched by average 24 h SBP, age, sex, and hypertension were compared. Patients with constitutional hypotension, orthostatic hypotension, and predominant cardioinhibition during carotid sinus massage or prolonged electrocardiogram monitoring or competing causes of syncope were excluded. Daytime and nighttime SBP drops (<110, 100, 90, 80 mmHg) were assessed. Findings were validated in an independent sample. In the derivation sample, daytime SBP drops were significantly more common in 158 syncope patients than 329 controls. One or more daytime drops <90 mmHg achieved 91% specificity and 32% sensitivity [odds ratio (OR) 4.6, P < 0.001]. Two or more daytime drops <100 mmHg achieved 84% specificity and 40% sensitivity (OR 3.5, P = 0.001). Results were confirmed in the validation sample of 164 syncope patients and 164 controls: one or more daytime SBP drops <90 mmHg achieved 94% specificity and 29% sensitivity (OR 6.2, P < 0.001), while two or more daytime SBP drops <100 mmHg achieved 83% specificity and 35% sensitivity (OR 2.6, P < 0.001) Conclusion SBP drops during ABPM are more common in reflex syncope patients than in controls. Cut-off values that may be applied in clinical practice are defined. This study expands the current indications for ABPM to patients with reflex syncope.
The impact of engaging leadership on employee engagement and team effectiveness: A longitudinal, multi-level study on the mediating role of personal- and team resources

Most research on the effect of leadership behavior on employees’ well-being and organizational outcomes is based on leadership frameworks that are not rooted in sound psychological theories of motivation and are limited to either an individual or organizational levels of analysis. The current paper investigates whether individual and team resources explain the impact of engaging leadership on work engagement and team effectiveness, respectively. Data were collected at two time points on N = 1,048 employees nested within 90 work teams. The Multilevel Structural Equation Modeling results revealed that personal resources (i.e., optimism, resiliency, self-efficacy, and flexibility) partially mediated the impact of T1 individual perceptions of engaging leadership on T2 work engagement. Furthermore, joint perceptions of engaging leadership among team members at T1 resulted in greater team effectiveness at T2. This association was fully mediated by team resources (i.e., performance feedback, trust in management, communication, and participation in decision-making). Moreover, team resources had a significant cross-level effect on individual levels of engagement. In practical terms, training and supporting leaders who inspire, strengthen, and connect their subordinates could significantly improve employees’ motivation and involvement and enable teams to pursue their common goals successfully.
Growth hormone deficiency and NAFLD: An overlooked and underrecognized link

Growth hormone and its mediator insulin‐like growth factor‐1 exert their effect on different organs and control various physiologic metabolic processes. Adult growth hormone deficiency (AGHD) presents with one or more components of metabolic syndrome and can be associated with nonalcoholic fatty liver disease (NAFLD). AGHD is present in spectrum of hypothalamic/pituitary disorders as well as cranial radiation of brain tumors and often remains underdiagnosed or untreated due to its nonspecific symptoms, relatively difficult diagnosis in some clinical scenarios, and various barriers to treatment. NAFLD usually develops soon after diagnosis of AGHD and might progress rapidly to nonalcoholic steatohepatitis (NASH) with advanced fibrosis, eventually requiring liver transplantation. A timely initiation of growth hormone replacement therapy might be important, although studies so far have demonstrated controversial results on NAFLD, primarily due to small sample size and different diagnostic methods of NAFLD. Increased awareness of the association between AGHD and NAFLD would facilitate early diagnosis of NAFLD and NASH if present. Therefore, a multidisciplinary approach involving hepatology and endocrinology should become a standard of care for these patients.
A novel limb‐salvage reconstruction strategy with a custom hemipelvic endoprosthesis and preserved femoral head following the resection of periacetabular tumors: A preliminary study

The treatment of periacetabular malignancy frequently challenges surgeons. To simplify the surgical procedure, we performed a novel reconstruction strategy preserving the femoral head for patients with periacetabular malignancies. We retrospectively reviewed 14 patients who underwent total en bloc resection of a periacetabular tumor and reconstruction of the hip joint with an individualized hemipelvic endoprosthesis and remaining femoral head from July 2015 to January 2019 at our center. Regions of pelvic resection: region II—4 (28.6%), region I + II—5 (35.7%), region II + III—2 (14.3%) and region I + II + III—3 (21.4%). The oncological outcomes were that 13 patients survived without disease and one patient survived with lung metastasis. None of the patients experienced local recurrence (range: 20–62 months; mean: 32 months). The incidence of postoperative complications was 35.7%, including delayed wound healing and deep venous thrombosis. No prosthesis‐related complications occurred until the last follow‐up in this study (range: 20–62 months; mean: 32 months). The mean Musculoskeletal Tumor Society functional outcome score was 23.2. The mean Toronto Extremity Salvage Score of the patients was 75.7 points, with a mean limb discrepancy of 1.51 cm (range: 0.5–3.2 cm). Reconstruction with preservation of the femoral head showed acceptable early functional and oncological outcomes, and it had an acceptable complication rate.
Sex differences among endurance athletes in the pre-race relationships between sleep, and perceived stress and recovery

ABSTRACT This study examined sex differences among endurance athletes in pre-race relationships between sleep, and perceived stress and recovery. Thirty-six athletes completed the Short Recovery and Stress Scale, and had sleep monitored via actigraphy, over four consecutive days prior to an ultra-marathon. Overall, compared with males, females had shorter wake after sleep onset (mean ± SD, 50 ± 23 vs 65 ± 23 min, p = .04) and lower emotional balance (3.9 ± 1.1 vs 4.8 ± 1.1 arbitrary units, p = .001). The day before the race, females scored higher for all stress-related items (p < 0.05). Among females, higher scores for emotional balance (β = −31 min, p = .01) and negative emotional state (β = −21 min, p < .001) were associated with reduced sleep duration. Among males, higher scores for overall stress were associated with increased sleep duration (β = 22 min, p = .01). Across all athletes, longer sleep duration was associated with improved overall recovery (β = 0.003 arbitrary units, p = .02). Females experienced greater pre-race stress than males, and their sleep duration was associated with emotional factors. The SRSS may help identify female athletes at risk of sleep difficulties prior to competition.
Gut dysbacteriosis attenuates resistance to Mycobacterium bovis infection by decreasing cyclooxygenase 2 to inhibit endoplasmic reticulum stress

ABSTRACT The role of gut microbiota has been described as an important influencer of the immune system. Gut-lung axis is critical in the prevention of mycobacterium infection, but the specific mechanism, by which dysbiosis affects tuberculosis, has not been reported. In this study, we attempted to provide more information on how the gut-lung axis contributes to Mycobacterium bovis (M. bovis) infection. Mice are pre-treated with broad-spectrum antibiotics cocktail (Abx) to induce gut dysbiosis. Interestingly, dysbiosis of microbes showed a significant increase in the bacterial burden in the lungs and inhibited the level of COX-2. After faecal transplantation, cyclooxygenase 2 (COX-2) expression was restored and the inflammatory lesion in the lungs was reduced. Further research found that the deficiency of COX-2 inhibited endoplasmic reticulum stress (ER stress). This mechanism was completed by COX-2 interaction with BIP. Moreover, we found a positive feedback mechanism by which blocking ER stress could reduce COX-2 levels by the NF-κB pathway. Taken together, we reveal for the first time gut dysbacteriosis exacerbates M. bovis disease by limiting the COX-2/ER stress pathway. The finding strengthens the foundation of gut microbiota-targeted therapy for tuberculosis treatment.