Miracle-dz/UniFAR-FTUs huggingface dataset:
How do we provide good mealtime care for people with dementia living in care homes? A systematic review of carer–resident interactions

People with dementia who live in care homes often depend on care home staff for help with eating and drinking. It is essential that care home staff have the skills and support they need to provide good care at mealtimes. Good mealtime care may improve quality of life for residents, and reduce hospital admissions. The aim of this systematic review was to identify good practice in mealtime care for people with dementia living in care homes, by focusing on carer-resident interactions at mealtimes. Robust systematic review methods were followed. Seven databases were searched: AgeLine, BNI, CENTRAL, CINAHL, MEDLINE, PsycINFO and Web of Science. Titles, abstracts, and full texts were screened independently by two reviewers, and study quality was assessed with Joanna Briggs Institute tools. Narrative synthesis was used to analyse quantitative and qualitative evidence in parallel. Data were interrogated to identify thematic categories of carer-resident interaction. The synthesis process was undertaken by one reviewer, and discussed throughout with other reviewers for cross-checking. After title/abstract and full-text screening, 18 studies were included. Some studies assessed mealtime care interventions, others investigated factors contributing to oral intake, whilst others explored the mealtime experience. The synthesis identified four categories of carer-resident interaction important to mealtime care: Social connection, Tailored care, Empowering the resident, and Responding to food refusal. Each of the categories has echoes in related literature, and provides promising directions for future research. They merit further consideration, as new interventions are developed to improve mealtime care for this population.
Sutimlimab in Cold Agglutinin Disease.

BACKGROUND Cold agglutinin disease is a rare autoimmune hemolytic anemia characterized by hemolysis that is caused by activation of the classic complement pathway. Sutimlimab, a humanized monoclonal antibody, selectively targets the C1s protein, a C1 complex serine protease responsible for activating this pathway. METHODS We conducted a 26-week multicenter, open-label, single-group study to assess the efficacy and safety of intravenous sutimlimab in patients with cold agglutinin disease and a recent history of transfusion. The composite primary end point was a normalization of the hemoglobin level to 12 g or more per deciliter or an increase in the hemoglobin level of 2 g or more per deciliter from baseline, without red-cell transfusion or medications prohibited by the protocol. RESULTS A total of 24 patients were enrolled and received at least one dose of sutimlimab; 13 patients (54%) met the criteria for the composite primary end point. The least-squares mean increase in hemoglobin level was 2.6 g per deciliter at the time of treatment assessment (weeks 23, 25, and 26). A mean hemoglobin level of more than 11 g per deciliter was maintained in patients from week 3 through the end of the study period. The mean bilirubin levels normalized by week 3. A total of 17 patients (71%) did not receive a transfusion from week 5 through week 26. Clinically meaningful reductions in fatigue were observed by week 1 and were maintained throughout the study. Activity in the classic complement pathway was rapidly inhibited, as assessed by a functional assay. Increased hemoglobin levels, reduced bilirubin levels, and reduced fatigue coincided with inhibition of the classic complement pathway. At least one adverse event occurred during the treatment period in 22 patients (92%). Seven patients (29%) had at least one serious adverse event, none of which were determined by the investigators to be related to sutimlimab. No meningococcal infections occurred. CONCLUSIONS In patients with cold agglutinin disease who received sutimlimab, selective upstream inhibition of activity in the classic complement pathway rapidly halted hemolysis, increased hemoglobin levels, and reduced fatigue. (Funded by Sanofi; CARDINAL ClinicalTrials.gov number, NCT03347396.).
Classifying ecosystem stressor interactions: Theory highlights the data limitations of the additive null model and the difficulty in revealing ecological surprises

Understanding how multiple co‐occurring environmental stressors combine to affect biodiversity and ecosystem services is an on‐going grand challenge for ecology. Currently, progress has been made through accumulating large numbers of smaller‐scale empirical studies that are then investigated by meta‐analyses to detect general patterns. There is particular interest in detecting, understanding and predicting ‘ecological surprises’ where stressors interact in a non‐additive (e.g. antagonistic or synergistic) manner, but so far few general results have emerged. However, the ability of the statistical tools to recover non‐additive interactions in the face of data uncertainty is unstudied, so crucially, we do not know how well the empirical results reflect the true stressor interactions. Here, we investigate the performance of the commonly implemented additive null model. A meta‐analysis of a large (545 interactions) empirical dataset for the effects of pairs of stressors on freshwater communities reveals additive interactions dominate individual studies, whereas pooling the data leads to an antagonistic summary interaction class. However, analyses of simulated data from food chain models, where the underlying interactions are known, suggest both sets of results may be due to observation error within the data. Specifically, we show that the additive null model is highly sensitive to observation error, with non‐additive interactions being reliably detected at only unrealistically low levels of data uncertainty. Similarly, plausible levels of observation error lead to meta‐analyses reporting antagonistic summary interaction classifications even when synergies co‐dominate. Therefore, while our empirical results broadly agree with those of previous freshwater meta‐analyses, we conclude these patterns may be driven by statistical sampling rather than any ecological mechanisms. Further investigation of candidate null models used to define stressor‐pair interactions is essential, and once any artefacts are accounted for, the so‐called ‘ecological surprises’ may be more frequent than was previously assumed.
Severe acute malnutrition in childhood, chronic diseases, and human capital in adulthood in the Democratic Republic of Congo: the Lwiro Cohort Study

ABSTRACT Background Little is known about the long-term outcome of children treated for severe acute malnutrition (SAM) after nutritional rehabilitation. Objectives To explore the association between SAM in childhood, noncommunicable diseases (NCDs), and low human capital in adulthood. Methods We identified 524 adults (median age: 22 y) who were treated for SAM during childhood in Eastern Democratic Republic of Congo between 1988 and 2007. They were compared with 407 community unexposed age- and sex-matched subjects with no history of SAM. The variables of interest were cardiometabolic risk markers for NCDs and human capital. For the comparison, we used linear and logistic regressions to estimate the association between SAM in childhood and the risk of NCDs and ordinal logistic regression for the human capital. Results Compared with unexposed subjects, the exposed participants had a higher waist circumference [1.2 (0.02, 2.3) cm; P = 0.015], and a larger waist-to-height ratio [0.01 (0.01, 0.02) cm; P < 0.001]. On the other hand, they had a smaller hip circumference [−1.5 (−2.6, −0.5) cm; P = 0.021]. Regarding cardiometabolic markers for NCDs, apart from a higher glycated hemoglobin (HbA1c) [0.4 (0.2, 0.6); P < 0.001], no difference was observed in other cardiometabolic markers for NCD between the 2 groups. Compared with unexposed participants, exposed participants had a higher risk of metabolic syndrome (crude OR: 2.35; 95% CI: 1.22, 4.54; P = 0.010) and visceral obesity [adjusted OR: 1.44 (1.09, 1.89); P = 0.001]. The prevalence of hypertension, diabetes, overweight, and dyslipidaemia was similar in both groups. Last, the proportion of malnutrition survivors with higher socioeconomic status level was lower. Conclusion SAM during childhood was associated with a high risk of NCDs and lower human capital in adulthood. Thus, policymakers and funders seeking to fight the global spread of NCDs in adults in low-resource settings should consider the long-term benefit of reducing childhood SAM as a preventive measure to reduce the socioeconomic burden attributable to NCDs.
Clinical characterization, cardiovascular risk factor profile and cardiac strain analysis in a Uganda cancer population: The SATRACD study

Background The link between cancer and cardiovascular disease is firmly established. We sought to investigate the prevalence of cardiovascular disease (CVD) risk factors in Uganda cancer patients, their pre-chemotherapy left ventricular strain echocardiographic pattern and its associations with the CVD risk factors. Methods and results Baseline pre-chemotherapy data of patients who were enrolled in the SATRACD study (a cancer cohort, who were planned for anthracycline therapy), were analyzed. The prevalence of cardiovascular risk factors and baseline strain echocardiographic images were assessed. Among the 355 patients who were recruited over a period of 15 months, 283 (79.7%) were female, with a mean age of 43 years. The types of cancer of the study patients included breast cancer (70.6%), lymphomas, sarcomas, leukemias and hepatocellular carcinoma. Hypertension was the most common comorbidity (27.0%). The prevalence of obesity was 12.1% and that of HIV was 18.3%. All patients had a normal left ventricular ejection fraction (LVEF). The mean global longitudinal strain (GLS) was -20.92 ±2.43%, with females having a significantly higher GLS than males (-21.09±2.42 vs -20.25±2.39, p = 0.008). Fifty-three patients (14.9%) had suboptimal GLS (absolute GLS≤18.00%), which was associated with obesity (POR = 3.07; 95% CI, 1.31–6.98; p = 0.003), alcohol use (POR = 1.94; 95% CI, 1.01–3.74; p = 0.044), long QTc interval in electrocardiogram (POR = 2.54; 95% CI, 1.06–5.74; p = 0.015,) and impaired left ventricular relaxation (POR = 2.24; 95% CI, 1.17–4.25; p = 0.007). On multivariable logistic regression analysis, obesity (POR = 2.95; 95% CI, 1.24–7.03; p = 0.014) was the only independent factor associated with suboptimal GLS. Conclusion There is high prevalence and a unique pattern of cardiovascular risk factors in Uganda cancer patients. In cancer patients with cardiovascular risk conditions, there is reduction in GLS despite preserved LVEF. Longitudinal research is needed to study the predictive value of cardiovascular risk factors and baseline GLS for post chemotherapy cardiac dysfunction.
Structural Glycoprotein E2 of Classical Swine Fever Virus Critically Interacts with Host Protein Torsin-1A during the Virus Infectious Cycle

Structural glycoprotein E2 is an important structural component of the CSFV particle. E2 is involved in several virus functions, particularly virus-host interactions. ABSTRACT The classical swine fever virus (CSFV) glycoprotein E2 is the major structural component of the virus particle. E2 is involved in several functions, such as virus adsorption to the cell, the elicitation of protective immune responses, and virus virulence in swine. Using a yeast two-hybrid system, we previously identified the swine host protein Torsin-1A, an ATPase protein residing in the endoplasmic reticulum and inner nucleus membrane of the cell, as a specific binding partner for E2. The interaction between Torsin-1A and E2 proteins was confirmed to occur in CSFV-infected swine cells using three independent methods: coimmunoprecipitation, confocal microscopy, and proximity ligation assay (PLA). Furthermore, the E2 residue critical to mediate the protein-protein interaction with Torsin-1A was identified by a reverse yeast two-hybrid assay using a randomly mutated E2 library. A recombinant CSFV E2 mutant protein with a Q316L substitution failed to bind swine Torsin-1A in the yeast two-hybrid model. In addition, a CSFV infectious clone harboring the E2 Q316L substitution, although expressing substantial levels of E2 protein, repetitively failed to produce virus progeny when the corresponding RNA was transfected into susceptible SK6 cells. Importantly, PLA analysis of the transfected cells demonstrated an abolishment of the interaction between E2 Q316L and Torsin-1A, indicating a critical role for that interaction during CSFV replication. IMPORTANCE Structural glycoprotein E2 is an important structural component of the CSFV particle. E2 is involved in several virus functions, particularly virus-host interactions. Here, we characterized the interaction between CSFV E2 and swine protein Torsin-1A during virus infection. The critical amino acid residue in E2 mediating the interaction with Torsin-1A was identified and the effect of disrupting the E2–Torsin-1A protein-protein interaction was studied using reverse genetics. It is shown that the amino acid substitution abrogating E2–Torsin-1A interaction constitutes a lethal mutation, demonstrating that this virus-host protein-protein interaction is a critical factor during CSFV replication. This highlights the potential importance of the E2–Torsin-1A protein-protein interaction during CSFV replication and provides a potential pathway toward blocking virus replication, an important step toward the potential development of novel virus countermeasures.
In Vitro Identification and In Vivo Confirmation of Inhibitors for Sweet Potato Chlorotic Stunt Virus RNA Silencing Suppressor, a Viral RNase III

We report here a high-throughput inhibitor identification method that targets a severe sweet potato virus disease caused by coinfection with two viruses (SPCSV and SPFMV). The disease is responsible for up to 90% yield losses. ABSTRACT Sweet potato virus disease (SPVD), caused by synergistic infection of Sweet potato chlorotic stunt virus (SPCSV) and Sweet potato feathery mottle virus (SPFMV), is responsible for substantial yield losses all over the world. However, there are currently no approved treatments for this severe disease. The crucial role played by RNase III of SPCSV (CSR3) as an RNA silencing suppressor during the viruses’ synergistic interaction in sweetpotato makes it an ideal drug target for developing antiviral treatment. In this study, high-throughput screening (HTS) of small molecular libraries targeting CSR3 was initiated by a virtual screen using Glide docking, allowing the selection of 6,400 compounds out of 136,353. We subsequently developed and carried out kinetic-based HTS using fluorescence resonance energy transfer technology, which isolated 112 compounds. These compounds were validated with dose-response assays including kinetic-based HTS and binding affinity assays using surface plasmon resonance and microscale thermophoresis. Finally, the interference of the selected compounds with viral accumulation was verified in planta. In summary, we identified five compounds belonging to two structural classes that inhibited CSR3 activity and reduced viral accumulation in plants. These results provide the foundation for developing antiviral agents targeting CSR3 to provide new strategies for controlling sweetpotato virus diseases. IMPORTANCE We report here a high-throughput inhibitor identification method that targets a severe sweetpotato virus disease caused by coinfection with two viruses (SPCSV and SPFMV). The disease is responsible for up to 90% yield losses. Specifically, we targeted the RNase III enzyme encoded by SPCSV, which plays an important role in suppressing the RNA silencing defense system of sweetpotato plants. Based on virtual screening, laboratory assays, and confirmation in planta, we identified five compounds that could be used to develop antiviral drugs to combat the most severe sweetpotato virus disease.
Participation in a rehabilitation program based on adapted physical activities in Norway: a qualitative study of experiences of immigrant parents and their children with disabilities

Abstract Purpose By exploring immigrant families’ experiences of participating in a three-week rehabilitation program focused on adapted physical activity in Norway, this study investigated how beneficial, culturally adapted, and accessible the services were from the families’ perspectives. Methods A hermeneutic design with semi-structured interviews supplemented by participant observation was applied. Inductive thematic analysis was conducted. Results Three themes were identified: “learning through participating,” “sharing the same experience,” and “gaps in service delivery. ” By participating in physical activities together with their children, parents became aware of their children’s capabilities and interests, as well as the available resources. Parents also socialized and exchanged experiences and information with each other. Children learned new skills, became aware of their preferences and capabilities, built friendships, and improved their social skills. However, a lack of cultural adaptation, such as insufficient information, as well as the location of the rehabilitation center, language barriers, and exclusion of siblings affected accessibility of the services to immigrant families. Conclusions Although the beneficial aspects of the services were demonstrated, the cultural adaptation and accessibility of the services were limited. Providing flexible and culturally adapted services that meet immigrant families’ needs may improve the accessibility of rehabilitation services to immigrant families. IMPLICATIONS FOR REHABILITATION Making information available to immigrant families, mapping their resources and needs well before the intervention may improve the accessibility of the services for these families. Rehabilitation professionals need to consider families’ perceptions of their own role through the goal-setting process when engaging with families from cultural backgrounds different from their own. When planning the intervention, grounding physical activities in the diverse cultural background of participants may increase immigrant families’ sense of belonging and inclusion, and thereby facilitate interaction between families regardless of cultural differences.
Inferior outcomes with reduced intensity conditioning followed by allogeneic hematopoietic cell transplantation in fit individuals with acute lymphoblastic leukemia: a Canadian single-center study and a comparison to registry data

Abstract Allogeneic hematopoietic cell transplantation (HCT) can offer cure to some patients with acute lymphoblastic leukemia (ALL). It remains unclear how conditioning intensity affects transplant outcomes in ALL. In this retrospective study, we compared outcomes between 27 patients <60 who received reduced intensity conditioning (RIC) at Princess Margaret Hospital Cancer Center (PMCC) and 226 Cell Therapy Transplant Canada (CTTC) age-matched controls who received myeloablative conditioning (MAC) between 2007 and 2018. Compared to CTTC patients, PMCC patients had an inferior 2-y OS: 0.29 (95% CI: 0.11–0.49) vs 0.63 (0.56–0.70), HR = 2.10 (1.23–3.55), p = 0.006, higher TRM: 0.41 (0.22–0.60) vs 0.24 (0.18–0.30), HR = 2.00 (1.05–3.81), p = 0.04 and a trend toward increased risk of relapse: 0.36 (0.17–0.56) versus 0.17 (0.12–0.22), HR = 1.72 (0.82–3.62), p = 0.15. In multivariate analysis, RIC and the use of T-cell depletion (TCD) were associated with inferior OS. In ALL patients <60, the use of RIC with TCD is associated with inferior allogeneic HCT outcomes.
Association between the HLA genotype and the severity of COVID‐19 infection among South Asians

Regional variations are found in the incidence and severity of the COVID‐19 infection. Human leukocyte antigen (HLA) polymorphism is one of the genetic factors that might have an impact on the outcome of the disease. This study explored the association between the HLA genotype and the severity of COVID‐19 among patients from South Asia. Blood samples from 95 Asians (Bangladeshis, Indians, and Pakistanis) with COVID‐19 were collected. The patients were divided according to the severity of their infection: mild (N = 64), severe (N = 31), and fatal (N = 20). DNA was extracted from all samples, and HLA genotyping was performed for both class I (A, B, and C) and class II (DRB1, DQA1, and DQB1) using the PCR‐rSSO (polymerase chain reaction–reverse sequence‐specific oligonucleotide) molecular method. The frequency of HLA‐B*51 was significantly higher among patients in the fatal group than among those in the mild infection group (15% vs. 4.7%, p = 0.027). Additionally, the frequency of HLA‐B*35 was significantly higher in the mild infection group than in the fatal group (21.1% vs. 7.5%, p = 0.050 [a borderline p‐value]). In terms of HLA class II, DRB1*13 was significantly observed in the fatal group than in the mild infection group (17.5% vs. 11.3%, p = 0.049). However, the p‐value for all alleles became insignificant after a statistical correction for the p‐values (pc = 0.216, pc = 0.4, and pc = 0.49, respectively). Compared with all published data, this study highlights that the association between the HLA system and the COVID‐19 outcome might be ethnic‐dependent. Genetic variation between populations must be examined on a wider scale to assess infection prognosis and vaccine effectiveness.
Dietary Patterns of Insulinemia, Inflammation and Glycemia, and Pancreatic Cancer Risk: Findings from the Women's Health Initiative

Background: Pancreatic cancer risk is increasing in countries with high consumption of Western dietary patterns and rising obesity rates. We examined the hypothesis that specific dietary patterns reflecting hyperinsulinemia (empirical dietary index for hyperinsulinemia; EDIH), systemic inflammation (empirical dietary inflammatory pattern; EDIP), and postprandial glycemia [glycemic index (GI); glycemic load (GL)] are associated with pancreatic cancer risk, including the potential modifying role of type 2 diabetes (T2D) and body mass index (BMI). Methods: We calculated dietary scores from baseline (1993–1998) food frequency questionnaires among 129,241 women, 50–79 years-old in the Women's Health Initiative. We used multivariable-adjusted Cox regression to estimate HRs and 95% confidence intervals (95% CI) for pancreatic cancer risk. Results: During a median 19.9 years of follow-up, 850 pancreatic cancer cases were diagnosed. We observed no association between dietary scores and pancreatic cancer risk overall. However, risk was elevated among participants with longstanding T2D (present >3 years before pancreatic cancer diagnosis) for EDIH. For each 1 SD increment in dietary score, the HRs (95% CIs) were: EDIH, 1.33 (1.06–1.66); EDIP, 1.26 (0.98–1.63); GI, 1.26 (0.96–1.67); and GL, 1.23 (0.96–1.57); although interactions were not significant (all Pinteraction >0.05). Separately, we observed inverse associations between GI [0.86 (0.76–0.96), Pinteraction = 0.0068] and GL [0.83 (0.73–0.93), Pinteraction = 0.0075], with pancreatic cancer risk among normal-weight women. Conclusions: We observed no overall association between the dietary patterns evaluated and pancreatic cancer risk, although women with T2D appeared to have greater cancer risk. Impact: The elevated risk for hyperinsulinemic diets among women with longstanding T2D and the inverse association among normal-weight women warrant further examination.