Miracle-dz/UniFAR-FTUs huggingface dataset:
Changing school start times: impact on sleep in primary and secondary school students

Abstract Study Objectives To examine the impact of changing school start times on sleep for primary (elementary school: ES) and secondary (middle and high school: MS/HS) students. Methods Students (grades 3–12) and parents (grades K-12) were surveyed annually, before and for 2 years after school start time changes (ES: 60 min earlier, MS: 40–60 min later; HS: 70 min later). Student sleep and daytime sleepiness were measured with school-administered student surveys and parent-proxy online surveys. Results Approximately 28,000 students annually completed surveys (~55% White, ~21% free/reduced lunch [FRL]). One-year post-change, weekday bedtimes and wake times were slightly earlier for ES students, with an 11-min decrease in sleep duration. MS and HS students reported slightly later weekday bedtimes, significantly later wake times, and significantly longer sleep duration (MS: 29 min; HS: 45 min). The percent of ES students reporting sufficient sleep duration, poor sleep quality, or daytime sleepiness did not change, but the percent of MS and HS students reporting sufficient sleep duration significantly increased and clinically significant daytime sleepiness decreased. All results were maintained at the 2-year follow-up. Benefits of later start times were similar across racial and free/reduced lunch groups. Conclusions This is the first large scale, longitudinal, and representative study to concurrently examine the impact of changing school start times across students in primary/secondary school. Findings suggest a minimal impact of earlier start times on ES students’ sleep or daytime sleepiness, while further supporting the significant benefits of delaying MS and HS start times on student sleep and daytime sleepiness.
Impact of the COVID-19 pandemic on the social and educational aspects of Saudi university students’ lives

The COVID-19 pandemic led to surprising and unexpected experiences for Saudi university students. Precautionary and preventive measures taken to contain this pandemic impacted the social and educational aspects of these students’ lives. All Umm Al-Qura University (UQU) students were invited to participate in an online survey on 30 impacts, both positive and negative, of the COVID-19 pandemic on their lives. Social impact theory (SIT) was applied to illustrate these impacts. The survey yielded 1,360 responses. The results showed high to moderate levels of agreement regarding students’ perceptions of the positive and negative impact of the COVID-19 pandemic on their lives, with social aspects impacted more than educational ones; and no statistically significant gender differences. Weak correlations were found between the social aspects and the educational aspects of students’ lives in relation to the impact of the pandemic, although all aspects were correlated positively. The SIT framework provided insights into how the COVID-19 pandemic impacted students’ lives.
Improving the reproductive, immunity and health status of rabbit does using honey bee venom.

The aim of the present study was to investigate the long-term effect of using bee venom (BV) on the reproductive performance, immune, and health status of rabbit does and its effect on their litters. Sixty mature does, from Spanish V-line rabbit stock, were randomly assigned to four homogeneous groups with 15 does each. The 1st , 2nd and 3rd groups were injected twice weekly under the neck skin with 0.1 ml solution contains 0.1, 0.2 and 0.3 mg BV/rabbit respectively. The 4th group served as a control group. From the results, litter size at birth, litter weight and survival rate at weaning age as well as milk yield were significantly (p ≤ 0.05) increased in BV groups than in the control group. Serum estradiol 17-β (E2) was significantly (p ≤ 0.05) higher (15%) in the rabbit does treated with BV compared to the control group. The treated does with BV at any study doses showed a gradual and significant (p ≤ 0.05) decrease (12%) in serum progesterone levels (P4) compared to the control. They also showed a significant (p≤0.05) increase in conception (17%) and fertility rates (10%) compared to the control does. Treatment of rabbit does with BV caused a gradual and significant (p ≤ 0.05) reduction in both aspartate aminotransferase (AST) (16%) and alanine aminotransferase (ALT) (37%) liver enzyme activities. Additionally, results have shown that BV resulted in a gradual and significant (p ≤ 0.05) increase in total antioxidant capacity (TAC), antioxidative enzymes such as glutathione S-transferase (GST) and glutathione peroxidase (GPx), serum IgG, IgM and IgA levels with significant (p ≤ 0.05) decrease in malondialdehyde (MDA) and thiobarbituric acid reactive substances (TBARS) in BV groups compared to the control group. Results suggest that BV can be used in rabbit farming as an effective and safe alternative to artificial chemical drugs (sexual-stimulants) to improve certain reproductive traits, immune response and health.
Histopathological atlas of desmoplastic reaction characterization in colorectal cancer

Abstract Emergent scientific evidence indicates the central role of cancer-associated fibroblasts in determining whether the microenvironment of cancer works as friend or foe of the host; however, there is no unified histological evaluation framework of fibrotic stroma in colorectal cancers. Myxoid stroma and keloid-like collagen are site-specific histopathological features generated by cancer-associated fibroblasts, which appear exclusively in the tumor front during desmoplastic reaction. On the basis of these two stromal components, desmoplastic reaction is categorized into three patterns—immature, intermediate and mature—using hematoxylin and eosin staining. In January 2020, a prospective randomized clinical trial, JCOG1805, to elucidate the value of adjuvant chemotherapy in stage II colorectal cancer patients with pathological risk factors of recurrence was launched in Japan, in which intermediate/immature desmoplastic reaction is one of the four risk factors selected as inclusion criteria. This paper covers the diagnostic criteria for the desmoplastic reaction classification being used in the JCOG1805 study.
Impact of the COVID‐19 pandemic lockdown on weight status and factors associated with weight gain among adults in Massachusetts

The study aims to examine the impact of the coronavirus disease‐2019 (COVID‐19) pandemic lockdown on weight, overweight and obesity, and identify factors associated with weight gain. At a safety net health system in Massachusetts, 11 534 adults were retrospectively followed within 3 months of the COVID‐19 lockdown. Chi‐square and 95% confidence intervals (CI) were reported for categorical and continues variables, respectively. Multivariate analyses were performed to identify factors associated with weight gain (≥0.01 kg and 5%). During the lockdown period, greater proportion of women gained weight compared to men (46.1% vs 40.6%, P < .01). The obesity rate after the lockdown increased among women (40.7%‐41.7, P < .01) but decreased among men (39.6%‐38.6, P < .01) compared to before the lockdown. Post‐lockdown obesity rates increased among Haitian (51.2%‐55.0%, P < .01) and Hispanic women (50.7%‐51.8%, P < .01). More than 5% weight gain was associated with 18 to 39 vs ≥60 years of age (OR = 1.45, 95% CI = 1.07, 1.97), food and housing insecurity (OR = 1.44, 95% CI = 1.05, 1.97) and tobacco use (OR = 1.38, 95% CI = 1.07, 1.78) among men; and 18 to 39 vs ≥60 years of age (OR = 1.55, 95% CI = 1.25, 1.91), Hispanics (OR = 1.25, 95% CI = 1.01, 1.54), Brazilians (OR = 1.22, 95% CI = 1.03, 1.45), and tobacco use (OR = 1.36, 95% CI = 1.10, 1.69) among women. During the COVID‐19 lockdown, significant proportion of participants gained weight, but subgroup variations existed. Our study can inform healthcare professionals about the impact of the lockdown on unhealthy weight gain and identify vulnerable populations. Strategies are needed to combat unhealthy weight gain during and beyond the pandemic.
Parental dementia and subjective memory impairment in the health and retirement study

Abstract Objectives To examine relationships between subjective memory impairment (SMI) and parental dementia among in older adults while considering the interactive influence of depressive symptoms, ethnicity, and race. Method The sample was drawn from the Health and Retirement Study, a nationally representative longitudinal study of aging (n = 3,809; M age = 66.09; SD = 1.88; 84.20% White; 12.23% Black; 7.88% Hispanic). Biennial assessments included two measures of SMI (current memory problems and perceived memory decline), depressive symptoms, and parental dementia, over periods of up to sixteen years. Multilevel modeling analyses examined longitudinal relationships between parental dementia and SMI and whether depressive symptoms, ethnicity, and race interactively influenced this association. Results Results showed that when older adults reported parental dementia, they were more likely to report a decline in memory in the past two years. They also reported poorer current memory problems, especially when they experienced increased depressive symptoms. Associations of parental dementia were consistent across ethnicity and race. Conclusions Results demonstrate the importance of considering parental dementia as a factor that may contribute to SMI in older adults.
Effects of a Web-Based Pediatric Oncology Legacy Intervention on Parental Coping.

OBJECTIVES To examine the effects of a legacy intervention for children with advanced cancer and their parents on parental coping strategies. SAMPLE & SETTING The authors recruited 150 children with advanced cancer and their parents via Facebook. METHODS & VARIABLES Child-parent dyads were randomly assigned to the intervention or usual care. Children in the intervention group created electronic digital storyboards to assist in documenting their legacies. Parents completed the Responses to Stress Questionnaire at baseline/preintervention (T1) and postintervention (T2). Linear regressions were used to test for differences between the groups in the amount of change from T1 to T2 for each parent coping score. RESULTS Although not statistically significant, the legacy intervention showed trends toward increasing use of primary control and disengagement coping strategies in parents over time relative to usual care. IMPLICATIONS FOR NURSING Nurses can help to facilitate opportunities for parents to use adaptive coping strategies. More work is needed to determine how legacy interventions in pediatric oncology can facilitate adaptive coping strategies for parents of children with cancer.
An Integrative Review of Experiences Parenting Transgender and Gender Diverse Children

Transgender and gender diverse (TGD) children face increased behavioral health risks including suicidal behaviors and substance abuse. Parental affirmation is associated with behavioral health outcomes similar to non-TGD peers. This integrative review synthesizes and appraises evidence regarding experiences of parenting a TGD child in the United States or Canada from 2008 to 2018. Most parents across these 15 studies described affirming their child’s gender at time of interview. Parents reported initial interpersonal processes (emotions, concerns, beliefs), sought education (frequently online), and described interactions with family members and professionals that were not always affirming. Parents accessed support groups but described their own well-being as a low priority relative to the child’s needs. Parents’ own needs for well-being may affect the process of parenting a TGD child and should be explored. Future research should address the experiences of non-parent family members and participants from more diverse backgrounds. Nursing education must consistently address gender affirming care.
Neurovascular coupling dysfunction in end-stage renal disease patients related to cognitive impairment

We aimed to investigate the neurovascular coupling (NVC) dysfunction in end-stage renal disease (ESRD) patients related with cognitive impairment. Twenty-five ESRD patients and 22 healthy controls were enrolled. To assess the NVC dysfunctional pattern, resting-state functional MRI and arterial spin labeling were explored to estimate the coupling of spontaneous neuronal activity and cerebral blood perfusion based on amplitude of low-frequency fluctuation (ALFF)-cerebral blood flow (CBF), fractional ALFF (fALFF)-CBF, regional homogeneity (ReHo)-CBF, and degree centrality (DC)-CBF correlation coefficients. Multivariate partial least-squares correlation and mediation analyses were used to evaluate the relationship among NVC dysfunctional pattern, cognitive impairment and clinical characteristics. The NVC dysfunctional patterns in ESRD patients were significantly decreased in 34 brain regions compared with healthy controls. The decreased fALFF-CBF coefficients in the cingulate gyrus (CG) were associated positively with lower kinetic transfer/volume urea (Kt/V) and lower short-term memory scores, and were negatively associated with higher serum urea. The relationship between Kt/V and memory deficits of ESRD patients was partially mediated by the fALFF-CBF alteration of the CG. These findings reveal the NVC dysfunction may be a potential neural mechanism for cognitive impairment in ESRD. The regional NVC dysfunction may mediate the impact of dialysis adequacy on memory function.
Clinical Applications of Dual-Energy CT

Dual-energy CT (DECT) provides insights into the material properties of tissues and can differentiate between tissues with similar attenuation on conventional single-energy imaging. In the conventional CT scanner, differences in the X-ray attenuation between adjacent structures are dependent on the atomic number of the materials involved, whereas in DECT, the difference in the attenuation is dependent on both the atomic number and electron density. The basic principle of DECT is to obtain two datasets with different X-ray energy levels from the same anatomic region and material decomposition based on attenuation differences at different energy levels. In this article, we discuss the clinical applications of DECT and its potential robust improvements in performance and postprocessing capabilities.
Implementation of an Analgesia-Sedation Protocol Is Associated With Reduction in Midazolam Usage in the PICU

Supplemental Digital Content is available in the text. OBJECTIVES: Examine the association of a revised analgesia-sedation protocol with midazolam usage in the PICU. DESIGN: A single-center nonrandomized before-after study. SETTING: PICU at a quaternary pediatric hospital (Boston Children’s Hospital, Boston, MA). PATIENTS: Children admitted to the PICU who were mechanically ventilated for greater than 24 hours. The preimplementation cohort included 190 eligible patients admitted between July 29, 2017, and February 28, 2018, and the postimplementation cohort included 144 patients admitted between July 29, 2019, and February 28, 2020. INTERVENTIONS: Implementation of a revised analgesia-sedation protocol. MEASUREMENTS AND MAIN RESULTS: Our primary outcome, total dose of IV midazolam administered in mechanically ventilated patients up to day 14 of ventilation, decreased by 72% (95% CI [61–80%]; p < 0.001) in the postimplementation cohort. Dexmedetomidine usage increased 230% (95% CI [145–344%]) in the postimplementation cohort. Opioid usage, our balancing metric, was not significantly different between the two cohorts. There were no significant differences in ventilator-free days, PICU length of stay, rate of unplanned extubations, failed extubations, cardiorespiratory arrest events, and 24-hour readmissions to the PICU. CONCLUSIONS: We successfully implemented an analgesia-sedation protocol that primarily uses dexmedetomidine and intermittent opioids, and it was associated with significant decrease in overall midazolam usage in mechanically ventilated patients in the PICU. The intervention was not associated with changes in opioid usage or prevalence of adverse events.
Arabic Translation and Validation of the Acceptance of Illness Scale and Person-Centered Dermatology Self-care Index

ABSTRACT OBJECTIVE To translate the Acceptance of Illness Scale (AIS) and Person-Centered Dermatology Self-care Index (PeDeSI) from English to Arabic and validate their use among Arabic-speaking patients with psoriasis. METHODS Forward-backward translation was used to translate AIS and PeDeSI from English to Arabic language. Validation of the developed Arabic versions was performed using a cross-sectional study design. Arabic-speaking psoriatic patients were asked to complete the Arabic AIS and PeDeSI tools. Patients were also asked to complete the Dermatology Life Quality Index (DLQI), which was used as a reference to study external validity. The correlation between questionnaires was tested using Spearman rank correlation test. Factor analysis was used to study the dimensionality of the various tools. Cronbach α coefficient was used to evaluate internal consistency of Arabic versions of AIS and PeDeSI. Floor or ceiling effects were detected if more than 15% of patients achieved the lowest or the highest possible scores, respectively. RESULTS A total of 116 Arabic patients with psoriasis submitted the questionnaires. Both translated questionnaires were unidimensional. The internal consistencies of the AIS and PeDeSI were excellent (α coefficient = .90) and good (α coefficient = .87), respectively. There was a significant negative moderate correlation between the AIS and DLQI (ρ = −0.44), whereas the PeDeSI and DLQI were significantly weakly correlated (ρ = −0.23). No floor or ceiling effects were detected. CONCLUSIONS The results suggest that the Arabic versions of the AIS and PeDeSI questionnaires fulfilled the criteria for validation and may be used in research and routine clinical practice with Arabic speakers.
Overview of the actions to combat bacterial resistance in large hospitals*

Objective: to analyze, in the clinical practice of large hospitals, how the adoption of measures to prevent and control the spread of bacterial resistance has occurred, and to propose a score for the institutions’ adherence. Method: a cross-sectional study carried out in 30 large hospitals of Minas Gerais, from February 2018 to April 2019, after approval by the Ethics and Research Committee. Interviews were conducted with hospital managers, with Hospital Infection Control Services coordinators, and with the care coordinators of the Inpatient Units and Intensive Care Center. In addition, observations were made of the adoption of preventive measures by the multidisciplinary team in the care units. Results: in the 30 participating hospitals, 93.3% (N=28) had protocols for prophylactic antibiotics, and 86.7% (N=26) performed their audit, 86.7% (N=26) for therapeutic antibiotics and 83.3% (N=25) their audit; 93.3% (N=56) used gloves and cloaks for patients in contact precautions, and 78.3% (N=47) of the professionals were unaware of or answered incompletely on the five moments for hand hygiene. In the score to identify the adoption of measures to control bacterial resistance, 83.3% (N=25) of the hospitals were classified as partially compliant, 13.3% (N=04) as deficient, and 3.4% (N=01) as non-adoption. Conclusion: it was found that the recommended measures to contain bacterial resistance are not consolidated in the clinical practice of the hospitals.
Comparative ultrastructural‐functional characterizations of the skin in three reptile species; Chalcides ocellatus, Uromastyx aegyptia aegyptia, and Psammophis schokari aegyptia (FORSKAL, 1775): Adaptive strategies to their habitat

The current investigation was planned utilizing SEM, histological, and furthermore cytokeratin immunohistochemical to give a full depiction of skin of three reptiles species; Chalcides ocellatus (Scincidae), Uromastyx aegyptia aegyptia (Agamidae), and Psammophis schokari aegyptia (Colubridae) captured from Egypt with various ecological environment. Our SEM results showed different scales covered epidermis of three reptile's species with diverse surface microstructure. Overlapped rhomboid scales with numerous lenticular sense organs with numerous pores and oberhäutchen layer with microridges in C. ocellatus. In U. aegyptia, scales were overlapped elliptical‐shaped possess lens‐like sense structure with several scattered pits and oberhäutchen layer with polygonal outlined cells. While in P. schokari aegyptia, smooth scales flattened with two large dome‐shaped scale receptors/sensilla and lens‐like sense structure, moreover polygonal‐shaped micro‐ornamentation in scale hinge joints were observed. Histologically, skin of three species had outer epidermis with stratum germinativum, stratum corneum (α‐keratin, β‐keratin layer) capped by surface Oberhäutchen and inner dermis. Osteoderms were observed with dermis of C. ocellatus. There are marked variation within pigment cells types among examined species. Melanophores observed in dermal layer of C. ocellatus, while in U. aegyptia, three pigment cells in tegument dermis; melanophores, xanthophores, and iridophores whereas, P. schokari aegyptia had two forms of chromatophore cells (melanophores and iridophores) in dermis and few melanophores scattered between stratum germinativum cells. The highest cytokeratin immunostaining observed in epidermal cell layer of U. aegyptia aegyptia than two other species. Conclusion, dry scaly skin of reptiles reflects a great range of functional aspects and success to adapt with terrestrial life.
A pilot study on the adequacy of the TOMM in detecting invalid performance in patients with substance use disorders

ABSTRACT Objective: The validity of neuropsychological test performance has scarcely been studied in patients with substance use disorders (SUD), despite the possibility that some SUD individuals may distort their performance for compensation seeking (e.g., work leave, permanent or total disability, or the designation of services such as sheltered housing). Thus, the aim of the present study is to determine: (i) the possible utility of the Test of Memory Malingering (TOMM) in detecting invalid test results among SUD patients, and (ii) the percentage of individuals that underperform the TOMM among SUD patients seeking compensation. Method: Seventy-seven patients (59 men and 18 women) with SUD in outpatient treatment with an age range between 20 and 59 years were divided into two groups: SUD patients without compensation seeking (n = 41), and SUD patients with compensation seeking (n = 36). Participants performed a neuropsychological assessment with measures of processing speed, working memory, inhibition, verbal memory, cognitive flexibility, and decision-making, that also included the TOMM. Results: Our results demonstrate that there were no significant differences on TOMM performance between the two groups. Only one participant underperformed the TOMM (1.3% of the sample). Results showed cognitive impairment in the sample, but no differences between the groups on the different neuropsychological measures. Conclusions: This constitutes the first study to explore the capacity of a forced-choice test to detect invalid test results in an SUD population. There was a high performance on the TOMM among the SUD participants of our study despite their cognitive impairment, indicating adequate effort in their neuropsychological test performance. Further, these findings suggest that the probability of showing invalid neuropsychological performance among SUD compensation seeking patients is much lower than what has been found in other populations, such as in mild brain injury patients.