Miracle-dz/UniFAR-FTUs huggingface dataset:
CCID_A_359010 535..540

Mycobacterium smegmatis is an acid-fast bacillus of rapidly growing mycobacteria (RGM) of nontuberculous mycobacteria (NTM). M. smegmatis was considered nonpathogenic to humans until 1986, when the first patient was linked to the infection. To date, fewer than 100 cases have been reported in the literature, mainly related to various surgical procedures. Herein, we report two immunocompetent patients who acquired M. smegmatis infection following cosmetic procedures. Due to the rarity of M. smegmatis infection in routine clinical practice, it is challenging for medical providers to diagnose and treat patients with M. smegmatis infection. M. smegmatis infection should be considered for patients with chronic skin and soft tissue infections at the injection site or surgical site following cosmetic procedures. Histological findings, pathogen identification by molecular testing or bacterial culture are required to make a definitive diagnosis. Medical providers should raise awareness of M. smegmatis infection for patients with chronic skin and soft tissue infections after cosmetic procedures. Stringent sterile procedures for surgical instruments, supplies, and environments should be enforced.
Fast track to renewables: Low emission electricity for south west Australia by 2030

Could renewable energy be implemented rapidly and on a large scale to supply the demand of stationary electrical grid systems? This thesis takes a step towards answering this question by simulating 100% renewable energy scenarios for the South-West Interconnected System (SWIS), which supplies electricity to most of the population and industry in the southwest of Western Australia (SWWA). The SWIS is remarkable in that it is both isolated from other grids and currently has little available hydro-power. Solar and wind energy were chosen as the energy sources to be simulated because they are commercially mature technologies, already have a presence in the SWIS, are widely available in many other parts of the world, yet they are geographically and temporally variable. To simulate the operation of rooftop solar PV and large scale solar and wind power plants, heuristic models were built to generate synthetic hourly values of solar and wind energy resources anywhere within the SWWA. An integrated simulation of the SWIS grid was built using simple models of population increase, energy efficiency, distributed battery storage and seasonal power to gas storage. The construction schedules required to build a 100% renewable system for the SWIS by the year 2030 were found to be achievable for scenarios with a mix of solar PV, solar thermal and wind. If solar PV, wind and battery storage capacity could maintain exponential growth, then the required growth rates are less than current global growth rates. Energy efficiency would need to improve at a greater rate, though still moderate, than the current global improvement rate. However, the more that energy efficiency is improved, the lower the total demand, and the easier the task becomes for the other technologies. The findings of this thesis have positive implications for world-wide rapid transformation to low emission electricity generation.
Multimodal Hypersensitivity Derived from Quantitative Sensory Testing Predicts Long-Term Pelvic Pain Outcome

Multimodal hypersensitivity (MMH)---greater sensitivity across multiple sensory modalities (e.g., light, sound, temperature, pressure)---is a mechanism hypothesized to be responsible for the development of chronic pain and pelvic pain. However, previous studies of MMH are restricted given their reliance on biased self-report questionnaires, limited use of multimodal quantitative sensory testing (QST), or limited follow-up. Therefore, we conducted multimodal QST on a cohort of 200 reproductive age women at elevated risk for developing or maintaining chronic pelvic pain conditions and pain-free controls. Pelvic pain self-report was examined over a four-year follow-up period. Multimodal QST was comprised of visual, auditory, bodily pressure, pelvic pressure, thermal, and bladder testing. A principal component analysis of QST measures resulted in three orthogonal factors that explained 43% of the variance: MMH, pressure stimulus-response, and bladder hypersensitivity. MMH and bladder hypersensitivity factors correlated with several self-report measures related to pain at baseline. Baseline self-report pain ratings were significant predictors of pelvic pain up to three years after assessment but decreased in their predictive ability of pelvic pain outcome over time. In contrast, MMH increased its predictive ability of pelvic pain outcome over time and was the only factor to predict outcome up to four years later. These results suggest that a "centralized" component of MMH is an important long-term risk factor for pelvic pain. Further research on the modifiability of MMH could provide options for future treatment avenues for chronic pain.
A matter of perspective: Distinct brain mechanisms for evaluating positive and negative social feedback about oneself and another person

ABSTRACT Social rejection is a common experience in the life of young adults. Electroencephalographic (EEG) such as N1, P1 and P3 amplitude has been linked to experiencing social rejection; it remains unclear, whether these components are also influenced by the perspective, e.g., feedback directed to oneself or another person. We used EEG to investigate brain mechanisms associated with social feedback, directed either to oneself or another person. Female students (N = 57) engaged in a Chatroom Interact Task (CIT) during EEG. In this task participants received feedback as to whether themselves or someone else was accepted or rejected as a video chat partner. Mood was measured with the Positive Affect Negative Affect Schedule (PANAS). Participants showed more negative mood after rejection compared to acceptance. Spatiotemporal EEG cluster analysis revealed significant differences in P1, N1 and P3 ERP components associated with Acceptance vs. Rejection. The late positive potential (LPP) component was larger when processing self vs. other-related social feedback. Higher empathy, neuroticism, and lower age were associated with smaller LPP amplitude differences between Self and Other conditions. In this study we identified distinct brain dynamics associated with encoding social feedback and whether the feedback was targeted toward the self or to others.
Changes in Type 2 diabetes trends in Children and Adolescents during the COVID-19 Pandemic

Abstract PURPOSE To examine whether trends in new-onset pediatric type 2 diabetes (T2D) -- inclusive of patients requiring hospitalization and patients managed outpatient -- were impacted during the COVID-19 pandemic, and to compare patient characteristics prior to and during COVID-19. METHODS A retrospective single-center medical-record review was conducted in a hospital which cares for 90% of Alabama’s pediatric T2D patients. Patients with new-onset T2D referred from March 2017-March 2021 were included. Counts of patients presenting per month (“monthly rates”) were computed. Linear regression models were estimated for the full sample and stratified by Medicaid and non-Medicaid insurance status. Patient characteristics prior to versus during COVID-19 were compared. RESULTS 642 patients presented with new-onset T2D over this period. Monthly rates were 11.1 ± 3.8 prior to COVID-19,19.3 ± 7.8 during COVID-19 (p=0.004). Monthly rates for Medicaid patients differed prior to and during COVID-19 (7.9 ± 3.4 vs 15.3 ± 6.6, p = 0.003) but not for non-Medicaid patients (3.3 ± 1.7 vs 4.0 ± 2.4, p=0.33). Regression results showed significant increases in monthly rates during COVID-19 for the full sample (β=, p<0.05) and for Medicaid enrollees (β=, p<0.05) Hospitalization-rate, severity of obesity, and hemoglobin A1c remained similar prior to and during COVID-19, though the proportion of male patients increased from 36.8% to 46.1% (p=0.021). CONCLUSIONS A rise in new-onset T2D was observed among Alabama’s youth during the COVID-19 pandemic, a burden that disproportionately affected Medicaid enrollees and males. Future research should explore the pathways through which the pandemic impacted pediatric T2D.
C1q and mobility score in predicting sarcopenia in an Australian cohort of cancer surgery patients

Sarcopenia has been shown to have significant adverse health outcomes in a range of patient populations. Particularly, sarcopenic patients having cancer surgery are a unique group who demonstrate poorer post‐operative outcomes. Currently, the gold standard in diagnosing sarcopenia is through the use of computed tomography. However, the widespread use of imaging to diagnose patients with sarcopenia is neither cost‐effective nor practical. Identifying a serum biomarker or a simple mobility scoring system as an alternative diagnostic tool may aid in identifying more patients at risk of sarcopenia. C1q, a novel biomarker, has previously been shown to correlate with sarcopenia. Similarly, we sought to explore whether mobility scores may provide a useful surrogate marker for sarcopenia.
Health and demographic surveillance systems in low- and middle-income countries: history, state of the art and future prospects

ABSTRACT Health and Demographic Surveillance Systems (HDSS) have been developed in several low- and middle-income countries (LMICs) in Africa and Asia. This paper reviews their history, state of the art and future potential and highlights substantial areas of contribution by the late Professor Peter Byass. Historically, HDSS appeared in the second half of the twentieth century, responding to a dearth of accurate population data in poorly resourced settings to contextualise the study of interventions to improve health and well-being. The progress of the development of this network is described starting with Pholela, and progressing through Gwembe, Balabgarh, Niakhar, Matlab, Navrongo, Agincourt, Farafenni, and Butajira, and the emergence of the INDEPTH Network in the early 1990’s The paper describes the HDSS methodology, data, strengths, and limitations. The strengths are particularly their temporal coverage, detail, dense linkage, and the fact that they exist in chronically under-documented populations in LMICs where HDSS sites operate. The main limitations are generalisability to a national population and a potential Hawthorne effect, whereby the project itself may have changed characteristics of the population. The future will include advances in HDSS data harmonisation, accessibility, and protection. Key applications of the data are to validate and assess bias in other datasets. A strong collaboration between a national HDSS network and the national statistics office is modelled in South Africa and Sierra Leone, and it is possible that other low- to middle-income countries will see the benefit and take this approach.
Outcomes of second allogeneic stem cell transplantation and anti‐relapse strategies in patients with relapsed/refractory acute myeloid leukemia: A unicentric retrospective analysis

Second allogeneic stem cell transplantation (allo‐SCT2) represents a rescue option for selected patients (pts) with relapsed/refractory (r/r) acute myeloid leukemia (AML). Still, relapse rates post‐allo‐SCT2 remain high and effective anti‐relapse strategies and predictive biomarkers remain to be defined. We here analyzed a cohort of 41 AML patients (pts) undergoing allo‐SCT2 in our center. Allo‐SCT2 induced a third hematologic complete remission (CR) in 37 pts, at costs of a 36% non‐relapse mortality rate. Furthermore, 19 pts eventually relapsed post allo‐SCT2. Addressing relapse after allo‐SCT2, 14 pts (74%) underwent cell‐based anti‐relapse strategies, including third allogeneic transplantation (allo‐SCT3; 3/14), donor lymphocyte infusions (DLIs) combined with either 5‐azacytidin and venetoclax (4/14) or chemotherapeutic agents (7/14). Notably, six of seven pts (86%) who received either allo‐SCT3 or a combination therapy of DLIs, 5‐azacytidine and venetoclax achieved CR despite poor cytogenetics post‐allo‐SCT2 (e.g., TP53). Finally, 11 of 41 pts were alive at the last follow‐up (seven CR2, three CR3, one partial remission) resulting in estimated 2‐ and 5‐year overall survival of 35% and 25%, respectively.
Synthetic peptides bioinspired in temporin‐PTa with antibacterial and antibiofilm activity

Several antimicrobial peptides (AMPs) have been reported in amphibian toxins, as temporin‐PTa from Hylarana picturata. The amino acid distribution within a helical structure of AMPs favors the design of new bioactive peptides. Therefore, this work reports the rational design of two new synthetic peptides denominated Hp‐MAP1 and Hp‐MAP2 derived from temporin‐PTa. These peptides present an amphipathic helix with positive charges of +4 and +5, hydrophobic moment () of 0.66 and 0.72 and hydrophobicity () of 0.49 and 0.41, respectively. Hp‐MAP1 and Hp‐MAP2 displayed in vitro activity against Gram‐negative and Gram‐positive bacteria from 2.8 to 92 µM, without presenting hemolytic effects. Molecular dynamics simulation suggested that the parent and designed temporin‐like peptides lack structural stability in an aqueous solution. By contrast, α‐helical structures were predicted in hydrophobic and anionic environments. Additionally, the peptides were simulated on mimetic membranes composed of anionic and neutral phospholipids 1,2‐dipalmitoylsn‐glycerol‐3‐phosphatidylglycerol (DPPG‐anionic), 1,2‐dipalmitoyl‐sn‐lyco‐3 phosphatidylethanolamine (DPPE‐neutral). When in contact with DPPG/DPPE (90:10) and DPPG/DPPE (50:50) temporin‐PTa, Hp‐MAP1 and Hp‐MAP2 established interactions guided by hydrogen and saline bounds. Therefore, the findings described here reveal that the optimization of the amphipathic α‐helical cationic peptides Hp‐MAP1 and Hp‐MAP2 enabled the generation of new synthetic antimicrobial agents to combat pathogenic microorganisms.
A prospective multi-centre study assessing the safety and effectiveness following the implementation of an accelerated chest pain pathway using point-of-care troponin for use in New Zealand rural hospital and primary care settings

Abstract Aims Most rural hospitals and general practices in New Zealand (NZ) are reliant on point-of-care troponin. A rural accelerated chest pain pathway (RACPP), combining an electrocardiogram (ECG), a structured risk score (Emergency Department Assessment of Chest Pain Score), and serial point-of-care troponin, was designed for use in rural hospital and primary care settings across NZ. The aim of this study was to evaluate the safety and effectiveness of the RACPP. Methods and results A prospective multi-centre evaluation following implementation of the RACPP was undertaken from 1 July 2018 to 31 December 2020 in rural hospitals, rural and urban general practices, and urgent care clinics. The primary outcome measure was the presence of 30-day major adverse cardiac events (MACEs) in low-risk patients. The secondary outcome was the percentage of patients classified as low-risk that avoided transfer or were eligible for early discharge. There were 1205 patients enrolled in the study. 132 patients were excluded. Of the 1073 patients included in the primary analysis, 474 (44.0%) patients were identified as low-risk. There were no [95% confidence interval (CI): 0–0.3%] MACE within 30 days of the presentation among low-risk patients. Most of these patients (91.8%) were discharged without admission to hospital. Almost all patients who presented to general practice (99%) and urgent care clinics (97.6%) were discharged to home directly. Conclusion The RACPP is safe and effective at excluding MACEs in NZ rural hospital and primary care settings, where it can identify a group of low-risk patients who can be safely discharged home without transfer to hospital.
Clinical utility of a regional precision medicine molecular tumor board and challenges to implementation

Purpose Molecular tumor boards provide precision treatment recommendations based on cancer genomic profile. However, practical barriers limit their benefits. We studied the clinical utility of the precision medicine molecular tumor board (PMMTB) and described challenges with PMMTB implementation. Methods An observational cohort study included patients reviewed by the PMMTB between September 2015 to December 2017. Patients who had consented to the registry study were included. The primary endpoint of this study was time on treatment (ToT) ratio. Clinical utility was established if the primary endpoint had least 15% of patients achieving a ToT ratio of ≥1.3. Results Overall, 278 patients were presented to the PMMTB and 113 cases were included in the final analysis. The PMMTB identified at least one nonstandard of care (SOC) clinically actionable mutation for 69.0% (78/113) of cases. In patients who received non-SOC treatment, 43.8% (7/16) achieved a ToT ratio of 1.3 or more (p < 0.001). Fifty-nine patients did not receive non-SOC recommendations. Reasons for not pursuing treatment included 35.6% having response to current treatment, 20.3% died prior to starting or considering PMMTB recommendations, 13.6% pursued other treatment options based on clinician discretion, another 10.2% pursued other treatment options because clinical trials recommended were not geographically accessible, 8.5% had rapid decline of performance status, 6.8% lacked of financial support for treatment, and 5.1% were excluded from clinical trials due to abnormal laboratory values. Conclusion The regional PMMTB non-SOC recommendations benefitted a majority of patients and additional processes were implemented to assist with non-SOC treatment accessibility.
PD‐L1 expressed from tumor cells promotes tumor growth and invasion in lung cancer via modulating TGF‐β1/SMAD4 expression

Programmed death ligand‐1 (PD‐L1) has a known association with the prognosis of human cancers because of its ability to alter tumor immune surveillance via its interaction with PD‐1. We questioned whether expression of PD‐L1 in tumor cells could directly promote tumor growth and invasiveness in non–small cell lung cancer (NSCLC).
Investigating the Impulse Buying of Young Online Shoppers

In Indonesia, shopping online is a trend involving young shoppers. This study is aimed to examine the impact of discount, hedonic consumption, positive emotion, and visual merchandising towards online impulse buying. Discount and visual merchandising are considered as input or stimulus for the customers whereas hedonic consumption and positive emotion are to represent process or organism. In total there were seen hypotheses to be tested. An online instrument was attached on an ecommerce website where participants who were repeater buyers self-selected filling in the instrument. In total there were 322 participants completed it. This study found that discount, hedonic consumption, and positive emotion had a direct positive and significant impact on impulse buying. This study offers an alternative model showing similar findings.
Long‐Term Outcomes and Clinical Predictors of Mortality Following Occurrence of Stent Thrombosis

Background Stent thrombosis (ST) remains a significant medical issue. In particular, longer‐term mortality and clinical predictors after ST occurrence have yet to be elucidated. Methods and Results This was a multicenter, retrospective, observational study. A total of 187 definite ST cases from January 2008 to December 2017 were enrolled, and the long‐term clinical outcomes were investigated. The primary outcome measure was the cumulative mortality after ST occurrence. In addition, independent predictors of mortality were assessed. Among the stent types causing ST, bare‐metal stent, first‐generation drug‐eluting stent, second‐generation drug‐eluting stent, and third‐generation drug‐eluting stent comprised 31.0%, 19.3%, 36.9%, and 6.4% of cases, respectively. Median duration from stent implantation to ST was 680.5 (interquartile range, 33.8–2450.5) days. Cumulative mortality was 14.6%, 17.4%, 21.2%, 24.4%, and 33.8% at 1, 2, 3, 5 and 10 years, respectively. The cumulative mortality did not significantly differ by type of stent, and mortality of late ST was higher than that of early ST and very late ST; however, it did not reach statistical significance after the multivariate analysis. Independent predictors of mortality were hemodialysis (hazard ratio [HR], 7.80; 95% CI, 3.07–19.81; P<0.001), culprit lesions in the left main trunk (HR, 8.14; 95% CI, 1.71–38.75; P=0.008), culprit lesions in the left coronary artery (HR, 2.77; 95% CI, 1.10–6.96; P=0.030), and peak creatine kinase (HR, 1.017; 95% CI, 1.011–1.022; P<0.001). Conclusions The 10‐year cumulative mortality after ST reached 33.8%. Close follow‐up is thus mandatory for patients with ST, especially with hemodialysis, culprit lesions in the left main trunk and left coronary artery, and high peak creatine kinase.
Metabolic syndrome and periodontitis among adults: The 2018 Indonesia National Health Survey

Abstract Aim This study aimed to examine the association between metabolic syndrome (MetS), its components, and periodontitis among Indonesian adults. Materials and Methods Cross‐sectional data from the 2018 Indonesia National Health Survey (Riskesdas) was analysed. The sample included dentate individuals aged 35 years or older for whom complete information was available on components of MetS and periodontitis, including bleeding on probing (BOP) (N = 13,356), pocket depth (PD) (N = 13,273), and clinical attachment loss (CAL) (N = 13,000). Rate ratios (RRs) and 95% confidence intervals (CIs) were estimated with negative binomial regression models. Results The prevalence of MetS was 41.0%. The prevalence of individuals having at least one tooth with BOP, one tooth with PD ≥4 mm, or one sextant with CAL ≥4 mm was 74.9%, 40.7%, and 40.6%, respectively. No associations were observed between MetS and BOP, PD, or CAL, but hyperglycaemia was constantly positively associated with BOP (RR = 1.06; 95% CI 1.01–1.11), PD (RR = 1.13; 95% CI 1.03–1.23), and CAL (RR = 1.15; 95% CI 1.08–1.23). Conclusions Our findings support the potential influence of hyperglycaemia on periodontitis. Incorporating oral disease prevention strategies into the management of systemic diseases could be beneficial for reducing the burden of these diseases in Indonesia.
Biopharmaceutics considerations for direct oral anticoagulants

Abstract Vitamin K antagonists (VKA) and direct oral anticoagulants (DOACs) have been clinically used in the treatment of coagulation disorders. There are four DOACs approved since 2010 (dabigatran etexilate, rivaroxaban, apixaban, and edoxaban), and they were designed to overcome the practical limitations of VKA. This review summarized biopharmaceutics considerations about DOACs, which are critically discussed, applying risk analyses to subside the further classification of these drugs according to the Biopharmaceutics Classification System (BCS). These discussions included data compiled about physicochemical properties, equilibrium solubility, permeability, and drug dissolution of DOACs. From the biopharmaceutics characteristics is possible to identify critical variables related to the absorption process, which can help in the design of new formulations. The data were compared with the criteria recommended by regulatory agencies for the biopharmaceutics classification according to the BCS. From that, these data may be used to discuss the approval of generic medicines by the BCS-based biowaiver, and the clinical risks arising from novel formulations with DOACs. However, although there are indications of biopharmaceutics classifications for DOACs, conclusive information to classify these compounds according to the BCS is lacking, requiring more experimental studies to achieve this aim. Conclusive information is essential for a safe decision about the biowaiver, as well as to guide the development of new formulations containing the DOACs.