Miracle-dz/UniFAR-FTUs huggingface dataset:
The economic burden of inpatient diabetic foot ulcers in Toronto, Canada

Objective Diabetic foot ulcer, which often leads to lower limb amputation, is a devastating complication of diabetes that is a major burden on patients and the healthcare system. The main objective of this study is to determine the economic burden of diabetic foot ulcer-related care. Methods We conducted a multicenter study of all diabetic foot ulcer patients admitted to general internal medicine wards at seven hospitals in the Greater Toronto Area, Canada from 2010 to 2015, using the GEMINI database. We compared the mean costs of care per patient for diabetic foot ulcer-related admissions, admissions for other diabetes-related complications, and admissions for the top five most costly general internal medicine conditions, using the Ontario Case Costing Initiative. Regression models were used to determine adjusted estimates of cost per patient. Propensity-score matched analyses were performed as sensitivity analyses. Results Our study cohort comprised of 557 diabetic foot ulcer patients; 2939 non-diabetic foot ulcer diabetes patients; and 23,656 patients with the top 5 most costly general internal medicine conditions. Diabetic foot ulcer admissions incurred the highest mean cost per patient ($22,754) when compared to admissions with non-diabetic foot ulcer diabetes ($8,350) and the top five most costly conditions ($10,169). Using adjusted linear regression, diabetic foot ulcer admissions demonstrated a 49.6% greater mean cost of care than non-diabetic foot ulcer-related diabetes admissions (95% CI 1.14–1.58), and a 25.6% greater mean cost than the top five most costly conditions (95% CI 1.17–1.34). Propensity-scored matched analyses confirmed these results. Conclusion Diabetic foot ulcer patients incur significantly higher costs of care when compared to admissions with non-diabetic foot ulcer-related diabetes patients, and the top five most costly general internal medicine conditions.
Prevalence of Disaccharidase Deficiency in Adults With Unexplained Gastrointestinal Symptoms

Background/Aims Disaccharidase assay is used for assessing carbohydrate intolerance in children, but its usefulness in adults is not known. The aim of this study is to assess the prevalence of disaccharidase deficiency in patients with unexplained gastrointestinal symptoms. Methods A retrospective review of adults with chronic (> 1 year) abdominal symptoms and negative imaging and endoscopy/colonoscopy and who completed bowel symptom questionnaire and duodenal biopsy for lactase, maltase, sucrase, and palatinase was performed. A subset also underwent 25 g lactose breath test (LBT). Results One hundred twenty patients (females = 83) were evaluated, of whom 48 also underwent LBT. Fifty-six (46.7%) patients had enzyme deficiency; 44 (36.7%) had single (either lactase or maltase), 1 had 3 enzyme deficiencies, 11 (9.2 %) had all 4 disaccharidase enzyme (pan-disaccharidase) deficiency, and 64 (53.0%) had normal enzyme levels. Baseline prevalence and severity of 11 gastrointestinal symptoms were similar between normal and single enzyme deficiency groups. The sensitivity and specificity of LBT was 78.3% and 72.0%, respectively and overall agreement with lactase deficiency was 75.0%. Conclusions Isolated disaccharidase deficiency occurs in adults, usually lactase and rarely maltase, and pan-disaccharidase deficiency is rare. Baseline symptoms or its severity did not predict enzyme deficiency.
The Effect of Art Therapy in Women with Gynecologic Cancer: A Systematic Review

Objectives The purpose of this study was to evaluate the evidence of art therapy on the psychological outcome, quality of life (QOL), and cancer-related symptoms in women with gynecological cancer. Methods A systematic literature search was conducted. The randomized controlled trials, quasiexperimental studies, case reports, and qualitative studies were all included. Result 1,587 articles were retrieved. A total of 9 articles met the inclusion criteria. The existing studies provided initial evidence to suggest that art therapy may benefit gynecological cancer patients with respect to improving psychological outcome and QOL, reducing fatigue related to cancer, and improving subjective overall health condition. However, the quality of the current evidence limits the efficacy of these findings. Conclusion Research on art therapy of gynecologic cancer patients is insufficient. We cannot draw the conclusion that art therapy benefits gynecological cancer patients in the psychological outcome, QOL, and cancer-related symptoms. More rigorous research is needed.
A Blackwater Perspective on Riverine Ecosystems

source. They provide fresh water to support a growing human population as well as transport and treatment for waste water. They are valuable for recreation and fisheries, providing an essential source of protein in many parts of the globe. Streams and their riparian wetlands are the habitat for diverse assemblages of species. When Europeans first colonized North America, streams and rivers were used for
Synthesis, Characterization, and In Vitro and In Vivo Evaluations of Cellulose Hydrogels Enriched with Larrea tridentata for Regenerative Applications

Introduction Tissue engineering is an elementary necessity for several applications in the biomedical field through the use of several biopolymers derived from plants. Larrea tridentata (LT) is a very used plant for various medicinal applications with interesting properties; however, its use into cellulose hydrogels for possible regenerative therapeutics is still limited. Cellulose films could be applied in medical field as wound healing, scaffold for connective tissue for periodontal applications, and so on. The aim of this study was to evaluate the mechanical properties and in vivo and in vitro biocompatibility of cellulose hydrogels that have been enriched with LT in a rat model. Methods By in vivo and in vitro assays, the concentration of LT was varied from 1 to 5 wt%, respectively. Hydrogel films were implanted intramuscularly into female Wistar rats, 250 g in weight and aged 2 months, to analyze their cytocompatibility and biocompatibility. Results No case showed any evidence of inflammation or toxicity. Regarding cell morphology and adhesion, the prepared LT cellulose films had better cytocompatibility values than when polystyrene (PS) dishes were used as the control. In all cases, the results suggest that the addition of LT to the hydrogel films did not affect their cytocompatibility or biocompatibility properties and increases their clinical application due to the reported uses of LT. Conclusions Cellulose hydrogel films enriched with LT have the potential to be used in the biomedical field acting as regenerative scaffolds.
Dynamics of IgM and IgG responses to the next generation of engineered Duffy binding protein II immunogen: Strain-specific and strain-transcending immune responses over a nine-year period

Background A low proportion of P. vivax-exposed individuals acquire protective strain-transcending neutralizing IgG antibodies that are able to block the interaction between the Duffy binding protein II (DBPII) and its erythrocyte-specific invasion receptor. In a recent study, a novel surface-engineered DBPII-based vaccine termed DEKnull-2, whose antibody response target conserved DBPII epitopes, was able to induce broadly binding-inhibitory IgG antibodies (BIAbs) that inhibit P. vivax reticulocyte invasion. Toward the development of DEKnull-2 as an effective P. vivax blood-stage vaccine, we investigate the relationship between naturally acquired DBPII-specific IgM response and the profile of IgG antibodies/BIAbs activity over time. Methodology/principal findings A nine-year follow-up study was carried-out among long-term P. vivax-exposed Amazonian individuals and included six cross-sectional surveys at periods of high and low malaria transmission. DBPII immune responses associated with either strain-specific (Sal1, natural DBPII variant circulating in the study area) or conserved epitopes (DEKnull-2) were monitored by conventional serology (ELISA-detected IgM and IgG antibodies), with IgG BIAbs activity evaluated by functional assays (in vitro inhibition of DBPII–erythrocyte binding). The results showed a tendency of IgM antibodies toward Sal1-specific response; the profile of Sal1 over DEKnull-2 was not associated with acute malaria and sustained throughout the observation period. The low malaria incidence in two consecutive years allowed us to demonstrate that variant-specific IgG (but not IgM) antibodies waned over time, which resulted in IgG skewed to the DEKnull-2 response. A persistent DBPII-specific IgM response was not associated with the presence (or absence) of broadly neutralizing IgG antibody response. Conclusions/significance The current study demonstrates that long-term exposure to low and unstable levels of P. vivax transmission led to a sustained DBPII-specific IgM response against variant-specific epitopes, while sustained IgG responses are skewed to conserved epitopes. Further studies should investigate on the role of a stable and persistent IgM antibody response in the immune response mediated by DBPII.
Water content and water turnover in beef cattle

Twenty-four steers, comprising British (Hereford and Hereford x Shorthorn), Zebu (Africander), and Zebu cross (British x Brahman or Africander) breeds, were either maintained on pasture, or yarded and fed on diets of a low and a high nutritional value. Tritiated water was injected into the animals on five occasions at intervals of 3 months. The body water content and the water turnover rate were calculated, and some of the sources of variation defined. Observed differences in the water content are attributable to nutritional factors rather than to breed differences. The mean body water content ranged from 615 to 809 ml/kg fasting body weight, where the higher values were associated with a poor diet. The mean half-life of tritiated water was lower in summer (as low as 58 hr) than in winter (up to 128 hr) in grazing and well-fed yarded steers. On a poor diet, however, the half-life in yarded cattle remained high and almost constant throughout the year, dropping to below 100 hr on only a single occasion. Occasionally the half-life was breed dependent, but generally no significant differences between breeds could be found. While mean turnover rates of up to 7.1 ml kg-1 hr-1 were found in better-fed cattle in summer, the value in poorly fed animals was almost constant throughout the year at about 3.3 ml kg-1 hr-1. There was, however, a winter minimum in the well-fed yarded and grazing groups. The turnover rate was also influenced by breed only to a limited extent. The results are interpreted in the light of their possible significance in the adaptation to a tropical environment, and in relation to their value in predicting the body composition.
Proton pump inhibitors act with unprecedented potencies as inhibitors of the acetylcholine biosynthesizing enzyme—A plausible missing link for their association with incidence of dementia

Several pharmacoepidemiological studies indicate that proton pump inhibitors (PPIs) significantly increase the risk of dementia. Yet, the underlying mechanism is not known. Here, we report the discovery of an unprecedented mode of action of PPIs that explains how PPIs may increase the risk of dementia.
Characteristics and Clinical Outcomes of Adult Patients Hospitalized with COVID-19 — Georgia, March 2020

SARS-CoV-2, the novel coronavirus that causes coronavirus disease 2019 (COVID-19), was first detected in the United States during January 2020 (1). Since then, >980,000 cases have been reported in the United States, including >55,000 associated deaths as of April 28, 2020 (2). Detailed data on demographic characteristics, underlying medical conditions, and clinical outcomes for persons hospitalized with COVID-19 are needed to inform prevention strategies and community-specific intervention messages. For this report, CDC, the Georgia Department of Public Health, and eight Georgia hospitals (seven in metropolitan Atlanta and one in southern Georgia) summarized medical record-abstracted data for hospitalized adult patients with laboratory-confirmed* COVID-19 who were admitted during March 2020. Among 305 hospitalized patients with COVID-19, 61.6% were aged <65 years, 50.5% were female, and 83.2% with known race/ethnicity were non-Hispanic black (black). Over a quarter of patients (26.2%) did not have conditions thought to put them at higher risk for severe disease, including being aged ≥65 years. The proportion of hospitalized patients who were black was higher than expected based on overall hospital admissions. In an adjusted time-to-event analysis, black patients were not more likely than were nonblack patients to receive invasive mechanical ventilation† (IMV) or to die during hospitalization (hazard ratio [HR] = 0.63; 95% confidence interval [CI] = 0.35-1.13). Given the overrepresentation of black patients within this hospitalized cohort, it is important for public health officials to ensure that prevention activities prioritize communities and racial/ethnic groups most affected by COVID-19. Clinicians and public officials should be aware that all adults, regardless of underlying conditions or age, are at risk for serious illness from COVID-19.
Cultivo de brócolos de inflorescência única no verão em plantio direto

The objective of this work was to evaluate single head broccoli cultivars production in summer under no-tillage (NT). The experimental design was randomized blocks with a split-plot design and three replicates. The plots were constituted by the cover crops: pearl millet (Pennisetum glaucum), corn (Zea mays), a mix of corn and black velvet-bean (Estilozobium aterrimum), sorghum sudangrass (Sorghum bicolor X S. sudanense), besides the conventional tillage (CT) - soil after fallow prepared with plow and disk harrow. Cultivars Avenger, Demoledor, Grandisimo, Green Storm Bonanza, Legacy and the material HECB-01-06, represented the sub-plots. No differences were found among NT and CT concerning broccoli yield. There were significant differences between cultivars for the evaluated variables. The cultivar Avenger presented the highest yield (13.2 t ha-1), average weight (458 g), diameter (15.3 cm) and quality of the curds (index for visual aspect of 4.0). Therefore, considering the benefits proportionated by NT, with the maintenance of high productive levels, equivalent at CT, its adoption is recommended.
Triggering receptor expressed on myeloid cells-1 (TREM-1) as a therapeutic target in infectious and noninfectious disease: a critical review

Abstract The triggering receptor expressed on myeloid cells-1 (TREM-1) is an innate immune receptor found in the surface of several immune and non-immune cells. Since its first description in 2000, this molecule and its soluble form (sTREM-1) have been implicated in many diseases with infectious and noninfectious origins. As an amplifier of inflammation, the membrane-associated TREM-1 (mTREM-1) isoform induces the production of pro-inflammatory mediators, thus contributing to the pathogenesis of diseases such as sepsis, arthritis, colitis and infections. In this context, many studies have used molecules capable of inhibiting TREM-1 activity as anti-inflammatory drugs. In this regard, a few peptides have been showing promising results in the amelioration of detrimental immune responses. Some commercially available drugs, including corticosteroids and antibiotics, with known anti-inflammatory effects, have also shown activity in TREM-1 signaling. Therefore, considering the potential of this receptor as a therapeutic target, the present review encompasses the main compounds explored so far in TREM-1 modulation, highlighting and critically discussing its effects and major drawbacks of such approaches.
Artificial intelligence techniques in asthma: a systematic review and critical appraisal of the existing literature

Artificial intelligence (AI) when coupled with large amounts of well characterised data can yield models that are expected to facilitate clinical practice and contribute to the delivery of better care, especially in chronic diseases such as asthma. The purpose of this paper is to review the utilisation of AI techniques in all aspects of asthma research, i.e. from asthma screening and diagnosis, to patient classification and the overall asthma management and treatment, in order to identify trends, draw conclusions and discover potential gaps in the literature. We conducted a systematic review of the literature using PubMed and DBLP from 1988 up to 2019, yielding 425 articles; after removing duplicate and irrelevant articles, 98 were further selected for detailed review. The resulting articles were organised in four categories, and subsequently compared based on a set of qualitative and quantitative factors. Overall, we observed an increasing adoption of AI techniques for asthma research, especially within the last decade. AI is a scientific field that is in the spotlight, especially the last decade. In asthma there are already numerous studies; however, there are certain unmet needs that need to be further elucidated. Artificial intelligence algorithms are able to analyse large amounts of complex data and extract meaningful patterns that can be utilised in clinical practice and contribute to the provision of better care, especially in chronic diseases such as asthma https://bit.ly/2SC6c3q
Mechanistic Understanding of Cell Recognition and Immune Reaction via CR1/CR3 by HAP- and SiO2-NPs

Nanodrug carrier will eventually enter the blood when intravenously injected or in other ways. Meanwhile, a series of toxic effects were caused to the body with the formation of nanoparticle protein corona. In our studies, we try to reveal the recognition mechanism of nanoparticle protein corona by monocyte and the damage effect on immune cells by activated complement of hydroxyapatite nanoparticles (HAP-NPs) and silicon dioxide nanoparticles (SiO2-NPs). So expressions of TLR4/CR1/CR were analyzed by flow cytometry (FCM) in order to illuminate the recognition mechanism of nanoparticle protein corona by monocyte. And the expression of ROS, cytokines, adhesion molecules, and arachidonic acid was measured when THP-1 and HUVECs were stimulated by NP-activated complement. The results showed that HAP-NPs can be recognized by the opsonin receptor (iC3b/CR3) model, while plasma protein, opsonin receptor, and Toll-like receptors are all likely launch cell recognition of SiO2-NPs. And it was considerate that NP-activated complement can damage THP-1 and HUVECs, including oxidative stress, inflammation, and increased vascular permeability. So the surface of nanodrug carrier can be modified to avoid being clear and reduce the efficacy according to the three receptors (TLR4/CR1/CR3).
The integration of social and neural synchrony: a case for ecologically valid research using MEG neuroimaging

Abstract The recent decade has seen a shift from artificial and environmentally deprived experiments in neuroscience to real-life studies on multiple brains in interaction, coordination and synchrony. In these new interpersonal synchrony experiments, there has been a growing trend to employ naturalistic social interactions to evaluate mechanisms underlying synchronous neuronal communication. Here, we emphasize the importance of integrating the assessment of neural synchrony with measurement of nonverbal behavioral synchrony as expressed in various social contexts: relaxed social interactions, planning a joint pleasurable activity, conflict discussion, invocation of trauma, or support giving and assess the integration of neural and behavioral synchrony across developmental stages and psychopathological conditions. We also showcase the advantages of magnetoencephalography neuroimaging as a promising tool for studying interactive neural synchrony and consider the challenge of ecological validity at the expense of experimental rigor. We review recent evidence of rhythmic information flow between brains in interaction and conclude with addressing state-of-the-art developments that may contribute to advance research on brain-to-brain coordination to the next level.
Extinction probabilities as a function of temperature for populations of tsetse (Glossina spp.)

Significant reductions in populations of tsetse (Glossina spp) in parts of Zimbabwe have been attributed to increases in temperature over recent decades. Sustained increases in temperature might lead to local extinctions of tsetse populations. Extinction probabilities for tsetse populations have not so far been estimated as a function of temperature. We develop a time-homogeneous branching process model for situations where tsetse live at different levels of fixed temperature. We derive a probability distribution pk(T) for the number of female offspring an adult female tsetse is expected to produce in her lifetime, as a function of the fixed temperature at which she is living. We show that pk(T) can be expressed as a geometric series: its generating function is therefore a fractional linear type. We obtain expressions for the extinction probability, reproduction number, time to extinction and growth rates. The results are valid for all tsetse, but detailed effects of temperature will vary between species. No G. m. morsitans population can escape extinction if subjected, for extended periods, to temperatures outside the range 16°C–32°C. Extinction probability increases more rapidly as temperatures approach and exceed the upper and lower limits. If the number of females is large enough, the population can still survive even at high temperatures (28°C–31°C). Small decreases or increases in constant temperature in the neighbourhoods of 16°C and 31°C, respectively, can drive tsetse populations to extinction. Further study is needed to estimate extinction probabilities for tsetse populations in field situations where temperatures vary continuously.
Losing the wait: improving patient cycle time in primary care

Inefficient clinic systems leading to prolonged wait times at primary care clinics are a source of frustration for patients, physicians, staff and administration. Measuring and shortening cycle time has the potential to improve patient experience, staff satisfaction and patient access by moving more patients through in a shorter cycle time. Limited studies have demonstrated that improvements can be made to cycle time and may result in improved patient satisfaction. Most of these studies have focused their efforts on improving efficiency at the front end of the cycle. Our aim was to improve cycle time for the whole visit to less than 60 min within 1 year by engaging our team in brainstorming solutions, presenting regular measurements to our team for review and holding regular meetings to plan rapid improvement cycles. Over the course of 1 year (2017), we were able to reduce cycle time by 12% from 71 to 65 min and to improve patient satisfaction with care. Despite the reduction in cycle time, we maintained high satisfaction scores from patients who felt that the doctor spent enough time with them. We learnt the value of engaging our team, frequent measurement for reporting, adequate staffing at the beginning of clinic, and the value of MA staff acting in a flow coordinator role. We have not only maintained this improvement but also made further small gains over the subsequent 2 years, and by April 2019, our cycle time is at 60 min, despite a marked increase in patient volume. Additional work on the time after the patient is roomed and waiting for a doctor, and further analysis of the physician workflow would be important next steps to drive further improvement.