Miracle-dz/UniFAR-FTUs huggingface dataset:
Fruit and vegetables consumption among school-going adolescents: Findings from the baseline survey of an intervention program in a semi-urban area of Dhaka, Bangladesh

Introduction Interventions aimed at promoting healthy eating habits in adolescence can help prevent chronic diseases and promote healthy ageing. The aim of this paper is to describe the fruit and vegetables consumption habits of adolescents in Dhaka, Bangladesh as well as to identify the socio-environmental, personal, and behavioral factors that influence these habits. Materials and methods The baseline data from an intervention study involving 823 grade ten students from two randomly selected secondary schools in a semi-urban area of Dhaka were analyzed. The intake of fruit and vegetables was measured in terms of serving size per day. Hierarchical multiple regression was used to assess the ability of socio-environmental factors such as social support, perceived barriers, and living with patient with chronic diseases; personal factors such as knowledge, self-rated practice, behavioral intention, and body mass index; and behavioral factors such as physical activity, sedentary hours, and sleep duration to predict the level of daily fruit and vegetables intake, after controlling the effect of demographic characteristics of adolescents. Results The average daily consumption of fruit and vegetables was 1.22 and 1.99 servings, respectively. Only one-fifth of the respondents (21%) reported eating five servings of fruit and vegetables a day. Inaccessibility at home was reported as the most perceived barrier for both fruit and vegetables intake. Adolescents’ higher fruit and vegetables intake was found to be associated with higher maternal educational attainment, more social support, adequate self-rated practice, positive behavioral intention, higher body mass index, better physical activity, and adequate daily sleeping. Conclusion The findings revealed insufficient fruit and vegetables intake among adolescents in a semi-urban area of Bangladesh and associated socio-environmental, personal, and behavioral factors that were utilized in developing an intervention program for this transient age group. Trial registration Trial was registered at ClinicalTrials.gov (NCT03975335) https://clinicaltrials.gov/ct2/show/NCT03975335 on June 01, 2019.
Short‐ and mid‐term outcomes in percutaneous mitral valve replacement using balloon expandable valves

Due to elevated surgical risk, transcatheter mitral valve replacement (TMVR) is used as an alternative for treating failed bioprosthetic valves, annuloplasty repairs and mitral annular calcification (MAC). We report the procedural and longitudinal outcomes for each subtype: Mitral valve‐in‐valve (MVIV), mitral valve‐in‐ring (MViR), and valve‐in‐MAC (ViMAC).
Intrinsic and extrinsic factors interact during development to influence telomere length in a long‐lived reptile

The mechanisms connecting environmental conditions to plasticity in biological aging trajectories are fundamental to understanding individual variation in functional traits and life history. Recent findings suggest that telomere biology is especially dynamic during early life stages and has long‐term consequences for subsequent reproduction and survival. However, our current understanding is mostly derived from studies investigating ecological and anthropogenic factors separately, leaving the effects of complex environmental interactions unresolved. American alligators (Alligator mississippiensis) are long‐lived apex predators that rely on incubation temperature during a discrete period during development and endocrine cues to determine sex, making them especially vulnerable to current climatic variability and exposure to anthropogenic contaminants interfering with hormone function. Here, we combine field studies with a factorial design to understand how the developmental environment, along with intrinsic biological variation contribute to persistent telomere variation. We found that exposure to a common endocrine disrupting contaminant, DDE, affects telomere length, but that the directionality is highly dependent upon incubation temperature. Variation in hatchling growth, underlies a strong clutch effect. We also assess concentrations of a panel of glucocorticoid hormones and find that contaminant exposure elicits an increase in circulating glucocorticoids. Consistent with emerging evidence linking stress and aging trajectories, GC levels also appear to trend with shorter telomere length. Thus, we add support for a mechanistic link between contaminants and glucocorticoid signalling, which interacts with ecological aspects of the developmental environment to alter telomere dynamics.
Melanocytic lesions ≤ 6mm: Prospective series of 481 melanocytic trunk and limb lesions in Brazil

Early diagnosis when melanoma is still small and thin is essential for improving mortality and morbidity. However, the diagnosis of small size melanoma might be particularly difficult, not only clinically but also dermoscopically. This study aimed to define clinical and dermatoscopic parameters in the diagnosis of suspicious pigmented cutaneous lesions with a diameter of ≤ 6mm and determine the sensitivity, specificity, positive and negative predictive values as well as the accuracy of each clinical and dermatoscopic criterion. This is a transversal, descriptive and analytical study of dermatoscopic analysis with the gold standard being the pathologic examination obtained from the excisional biopsy of suspicious melanocytic lesions with a diameter of ≤ 6mm. Trunk and limb lesion data from a public health service and a private clinic were prospectively collected from 2011 to 2017 by a unique observer. In total, 481 melanocytic lesions were included, with 73.8% being ≤ 4mm in diameter. Overall, 123 were diagnosed as melanoma, 56.0% in situ and 22.0% as thin melanomas (Breslow index 0.1 to 1.0mm). Melanoma presented symmetry in 53.7% of cases, regular borders in 54.5% and a single color in 60.2%. Regarding evolution, 13.8% of melanomas versus 10.9% of benign lesions (p = 0.116) were new by comparing photos from baseline with photos from the follow-up. The majority of melanomas (65%) were found on the limbs compared to 37.2% of the benign lesions at this location (p<0.001). A multiple logistic regression model adjusted for age, gender and location was created. The independent variables associated with the diagnosis of melanoma ≤ 6mm, adjusted for age, gender and location, were: streaks (adjusted Odds Ratio [aOR] 2.5; 95% CI 1.3–4.7; p = 0.006), and the presence of a structureless area (aOR 2.2, 95% CI 1.2–4.0, p = 0.011). Conversely, a symmetric typical pigment network was a protection variable (aOR 0.4, 95% 0.7–0.9, p = 0.040). In conclusion, dermatoscopic criteria have been identified which help to diagnose cases of small size melanoma. These include streaks and structureless areas that can be taken, particularly in consideration for the diagnosis of this subset of small difficult melanomas.
Follicular helper-T cells restore CD8+-dependent antitumor immunity and anti-PD-L1/PD-1 efficacy

Background T follicular helper cells (Tfh) are essential to shape B cell response during germinal center formation. Tfh accumulation has been reported in various human cancers, with positive or negative prognostic roles. However, the mechanisms explaining the accumulation of Tfh and their role in cancer remain obscure. Methods In vitro differentiated and mouse cell sorted Tfh phenotype was evaluated by flow cytometry and quantitative PCR (qPCR). Antitumor effect of Tfh was evaluated by adoptive transfer in different tumor-bearing mice models. The involvement of immune cells, cytokines and chemokines was evaluated, using depleting antibodies. Chemokines and cytokines expression and production were evaluated by qPCR and ELISA. In human, the impact of immune cells and chemokines on survival was evaluated by analyzing transcriptomic data from public databases and from our own patient cohorts. Results In this study, we show that Tfh exert an antitumor immune effect in a CD8+-dependent manner. Tfh produce interleukin-21, which sustains proliferation, viability, cytokine production and cytotoxic functions of exhausted T cells. The presence of Tfh is required for efficacy of antiprogrammed cell death ligand-1 therapy. Tfh accumulate in the tumor bed and draining lymph nodes in different mouse cancer models. This recruitment is due to the capacity of transforming growth factor β to drive Chemokine (C-X-C motif) Ligand 13 expression, a chemoattractant of Tfh, by intratumor CD8+ T cells. Accumulation of Tfh and exhausted CD8+ T cells predicts cancer outcome in various cancer types. In patients treated with anti-programmed cell death-1 mAb, accumulation of Tfh and CD8+ at the tumor site is associated with outcome. Conclusion This study provides evidence that CD8+/Tfh crosstalk is important in shaping antitumor immune response generated by immunotherapy.
Incident Management in Health Care

Background: Nearly 10% of patients experience a harmful patient safety incident in the hospital setting. Current evidence focuses on incident reporting, whereas little is known about how incidents are managed within organizations. Purpose: The aim of this study was to explore processes, tools, and resources for incident management in Canadian health care organizations. Methods: Qualitative focus groups were conducted with key stakeholders, representing clinicians, managers, executives, governors, patients, and families (n = 45). Results: Qualitative data were thematically analyzed and presented as 3 themes: (1) variations in incident reporting and management; (2) simplification of the incident management process; and (3) need for leadership to support just culture and redefine harm. Conclusion: The study findings support and inform efforts to create a patient safety culture in Canadian and international health care organizations. There is a need to develop a standardized, accessible incident reporting and management system for use across health care sectors to promote continuous learning and improvement about patient safety.
Alcohol use among young Australian adults in May–June 2020 during the COVID‐19 pandemic: a prospective cohort study

Abstract Aims To estimate change in young people's alcohol consumption during COVID‐19 restrictions in Australia in early‐mid 2020, and test whether those changes were consistent by gender and level of consumption prior to the pandemic. Design Prospective longitudinal cohort. Setting Secondary schools in New South Wales, Tasmania and Western Australia. Participants Subsample of a cohort (n = 443) recruited in the first year of secondary school in 2010–11. Analysis data included three waves collected in September 2017–July 2018, September 2018–May 2019 and August 2019–January 2020), and in May–June 2020. Measurements The primary predictors were time, gender and level of consumption prior to the pandemic. Outcome variables, analysed by mixed‐effects models, included frequency and typical quantity of alcohol consumption, binge drinking, peak consumption, alcohol‐related harm and drinking contexts. Findings Overall consumption (frequency × quantity) during the restrictions declined by 17% [incidence rate ratio (IRR) = 0.83; 95% confidence interval (CI) = 0.73, 0.95] compared to February 2020, and there was a 35% decline in the rate of alcohol‐related harms in the same period (IRR = 0.66; 95% CI = 0.54, 0.79). Changes in alcohol consumption were largely consistent by gender. Conclusions From a survey of secondary school students in Australia, there is evidence for a reduction in overall consumption and related harms during the COVID‐19 restrictions.
Associations Between Occupational and Leisure-Time Physical Activity With Employee Stress, Burnout and Well-Being Among Healthcare Industry Workers

Purpose: Examine the associations of occupational and leisure-time physical activity with job stress, burnout, and well-being among healthcare industry workers. Design: Quantitative; cross-sectional. Setting: Healthcare Industry. Sample: US Amazon Mechanical Turk participants (n = 550) employed in the healthcare industry, worked 35 hours or more per week, had ≥ 1 supervisor and ≥ 1 co-worker, and were ≥ 18 years old. Measures: Self-reported measures of occupational physical activity (OPA) and leisure-time physical activity (LTPA), employee well-being, job stress, and burnout operationalized as exhaustion and disengagement. Analysis: Associations between OPA and LTPA with employee well-being, job stress, exhaustion and disengagement were assessed with separate multiple linear regression models. Results: OPA had positive significant associations with job stress (β = 0.10, P value = .003) and exhaustion (β = 0.21, P value < .0001). No significant associations were found between OPA with other psychological outcomes. A significant inverse association was found between LTPA and exhaustion (β = −0.04, P value = .007). Conclusion: In a sample of U.S. health care workers, and consistent with prior epidemiological studies, greater LTPA was associated with lower feelings of exhaustion. In contrast, health care workers with greater OPA reported higher perceptions of job stress and exhaustion. The findings underscore the need for more research aimed at understanding relationships between OPA and psychological health among healthcare workers.
The impact of patient-reported penicillin or cephalosporin allergy on surgical site infections

Abstract Objective: To determine the impact of a documented penicillin or cephalosporin allergy on the development of surgical site infections (SSIs). Background: Appropriate preoperative antibiotic prophylaxis reduces SSI risk, but documented antibiotic allergies influence the choice of prophylactic agents. Few studies have examined the relationship between a reported antibiotic allergy and risk of SSI and to what extent this relationship is modified by the antibiotic class given for prophylaxis. Methods: We conducted a retrospective cohort study of adult patients undergoing coronary artery bypass, craniotomy, spinal fusion, laminectomy, hip arthroplasty and knee arthroplasty at 3 hospitals from July 1, 2013, to December 31, 2017. We built a multivariable logistic regression model to calculate the adjusted odds ratio (aOR) of developing an SSI among patients with and without patient-reported penicillin or cephalosporin allergies. We also examined effect measure modification (EMM) to determine whether surgical prophylaxis affected the association between reported allergy and SSI. Results: We analyzed 39,972 procedures; 1,689 (4.2%) with a documented patient penicillin or cephalosporin allergy, and 374 (0.9%) resulted in an SSI. Patients with a reported penicillin or cephalosporin allergy were more likely to develop an SSI compared to patients who did not report an allergy to penicillin or cephalosporins (adjusted odds ratio, 3.26; 95% confidence interval, 2.71–3.93). Surgical prophylaxis did not have significant EMM on this association. Conclusions: Patients who reported a penicillin or cephalosporin allergy had higher odds of developing an SSI than nonallergic patients. However, the increase in odds is not completely mediated by the type of surgical prophylaxis. Instead, a reported allergy may be a surrogate marker for a more complicated patient population.
Lifetime post-traumatic stress disorder in older individuals with a history of institutional upbringing in childhood: the role of social acknowledgement and stressful life events

ABSTRACT Background: Child maltreatment (CM), particularly in institutional contexts, can affect the development of post-traumatic stress disorder (PTSD). Research suggests that factors during CM (e.g. severity, variety, duration) and in the aftermath of CM (e.g. stressful life events, and social acknowledgement, i.e. the degree to which an individual feels validated and supported following a traumatic event) can explain some of the heterogeneity in PTSD development. However, there is a lack of research on long-term correlates of CM and mitigating factors, with only a few studies having been conducted with older survivors of institutional upbringing. Such research is relevant, given the long-term associations between CM and the older age status of many survivors. Objective: The current study examined the link between CM and PTSD in older individuals with a history of institutional upbringing (risk group; RG) and a matched control group (CG). Differences in stressful life events and social acknowledgement were also investigated. Method: Participants were n = 116 RG (M age = 70.25 years, 41% female) and n = 122 CG (M age = 70.71 years, 51% female). Data was assessed using self-report questionnaires and a clinical interview. Results: The RG reported higher levels of exposure to CM. Lifetime PTSD showed a bigger association with the level of exposure to CM, compared to having an institutional upbringing. Participants with higher CM levels reported more stressful life events. High levels of social acknowledgement mediated the relationship between CM and PTSD in the CG. Conclusions: Exposure to CM had a stronger association with PTSD than a history of institutional upbringing. In the CG, the survivors’ perception of social acknowledgement ameliorated lifetime PTSD to a small extent. A critical issue for policy makers should be to enhance safeguarding measures against CM exposure, not only in institutional contexts, but also more generally, given the link to PTSD. HIGHLIGHTS In the present study individuals with a history of institutional upbringing reported high levels of child maltreatment. Furthermore, social acknowledgement was found to be meaningfully associated with post-traumatic stress disorders in child maltreatment survivors.
Evidence of a Blood Pressure Reduction During the COVID-19 Pandemic and Associated Lockdown Period: Insights from e-Health Data.

Background: Despite widespread investigation into the incidence of acute myocardial infarction during the coronavirus disease 2019 (COVID-19) pandemic and associated lockdown, no study has examined the situation's impact on blood pressure (BP) levels. Methods: Measurements of BP and heart rate (HR) were obtained from persons living in the Paris urban area using connected home BP monitors (accessible to patients and health providers through a secured server). Three time periods of e-health recordings were compared: during the pandemic before the lockdown, during the lockdown, and the same time period in 2019. Results: A total of 297,089 BP recordings from 2,273 participants (age 56.3 ± 12.8 years, 81.1% male) were made. During confinement, systolic BP gradually decreased by 3 mmHg (-2.4 to -3.9), and diastolic BP by 1.5 mmHg (-1.4 to -2.2) (all p < 0.001); this decrease was greater for participants with higher BP (p < 0.0001 each). No significant variation in HR was noted. Conclusion: Among a very large cohort, we observed a significant decrease in home BP measured with e-health devices during the first lockdown period. This study emphasizes the research potential of e-health during the COVID-19 crisis.
The parental role before and after SIDS

Abstract Role confusion is a prominent constituent symptom of Prolonged Grief Disorder in parents after their infants die from sudden infant death syndrome (SIDS). We interviewed 31 parents of SIDS infants 2–5 years post-loss examining the parental role before death, at the time of loss, and in bereavement. Thematic analysis found disruption of the role and re-imagined responsibilities for their child’s physical security, emotional security, and meaning. Tasks within these domains changed from concrete and apparent to representational and self-generated. Parents in bereavement locate ongoing, imperative parental responsibilities, particularly asserting their child’s meaningful place in the world and in their family.
Effects of Online Heterosexist Experiences on Physical and Mental Health in Sexual Minorities: An Examination of the Cognitive and Affective Mechanisms

Cyber violence has emerged as a new source of minority stress over the past decade. Due to the anonymous and unrestrictive nature of the internet, cyber violence is even more blatant and pervasive than in person violence for sexual minority individuals. The present study aimed to examine whether and how online and offline experiences of heterosexism are related to physical and mental health. A total of 941 sexual minority individuals participated in a community-based online survey study. The findings indicated that online heterosexist experiences explained variance in physical and mental health, beyond the contribution of offline heterosexist experiences. Among sexual minority young adults, the effect of online heterosexist experiences on mental health was stronger than that of offline heterosexist experiences, whereas the association between online heterosexist experiences and health problems was not observed in the adult sample. The results of mediation analysis showed that heterosexist experiences were related to heightened expectations of rejection, which, in turn, were related to poor physical and mental health. The association of heterosexist experiences and mental health was also mediated by negative affect. Given the detrimental effect of online heterosexist experiences, effective interventions are needed to combat cyber violence motivated by sexual orientation and enhance the coping and confrontation strategies in response to harmful online content.
Stimulus Contrast Affects Spatial Integration in the Lateral Geniculate Nucleus of Macaque Monkeys

Gain-control mechanisms adjust neuronal responses to accommodate the wide range of stimulus conditions in the natural environment. Contrast gain control and extraclassical surround suppression are two manifestations of gain control that govern the responses of neurons in the early visual system. Understanding how these two forms of gain control interact has important implications for the detection and discrimination of stimuli across a range of contrast conditions. Here, we report that stimulus contrast affects spatial integration in the lateral geniculate nucleus of alert macaque monkeys (male and female), whereby neurons exhibit a reduction in the strength of extraclassical surround suppression and an expansion in the preferred stimulus size with low-contrast stimuli compared with high-contrast stimuli. Effects were greater for magnocellular neurons than for parvocellular neurons, indicating stream-specific interactions between stimulus contrast and stimulus size. Within the magnocellular pathway, contrast-dependent effects were comparable for ON-center and OFF-center neurons, despite ON neurons having larger receptive fields, less pronounced surround suppression, and more pronounced contrast gain control than OFF neurons. Together, these findings suggest that the parallel streams delivering visual information from retina to primary visual cortex, serve not only to broaden the range of signals delivered to cortex, but also to provide a substrate for differential interactions between stimulus contrast and stimulus size that may serve to improve stimulus detection and stimulus discrimination under pathway-specific lower and higher contrast conditions, respectively. SIGNIFICANCE STATEMENT Stimulus contrast is a salient feature of visual scenes. Here we examine the influence of stimulus contrast on spatial integration in the lateral geniculate nucleus (LGN). Our results demonstrate that increases in contrast generally increase extraclassical suppression and decrease the size of optimal stimuli, indicating a reduction in the extent of visual space from which LGN neurons integrate signals. Differences between magnocellular and parvocellular neurons are noteworthy and further demonstrate that the feedforward parallel pathways to cortex increase the range of information conveyed for downstream cortical processing, a range broadened by diversity in the ON and OFF pathways. These results have important implications for more complex visual processing that underly the detection and discrimination of stimuli under varying natural conditions.