Miracle-dz/UniFAR-FTUs huggingface dataset:
A Self-Administered Multicomponent Web-Based Mental Health Intervention for the Mexican Population During the COVID-19 Pandemic: Protocol for a Randomized Controlled Trial

Background The COVID-19 pandemic has become a public health emergency of international concern; it has not only threatened people's physical health but has also affected their mental health and psychological well-being. It is necessary to develop and offer strategies to reduce the psychological impact of the outbreak and promote adaptive coping. Objective This study protocol aims to describe a self-administered web-based intervention (Mental Health COVID-19) based on the principles of positive psychology supported by elements of cognitive behavioral therapy and behavioral activation therapy to reduce the symptoms of anxiety and depression and increase positive emotions and sleep quality during and after the COVID-19 outbreak through a telepsychology system. Methods A randomized controlled clinical superiority trial with two independent groups will be performed, with intrasubject measures at four evaluation periods: pretest, posttest, 3-month follow-up, and 6-month follow-up. Participants will be randomly assigned to one of two groups: self-administered intervention with assistance via chat or self-administered intervention without assistance via chat. The total required sample size will be 166 participants (83 per group). Results The clinical trial is ongoing. This protocol was approved by the Research Ethics Board of the Free School of Psychology-University of Behavioral Sciences (Escuela libre de Psicología-Universidad de Ciencias del Comportamiento). The aim is to publish the preliminary results in December 2020. A conservative approach will be adopted, and the size effect will be estimated using the Cohen d index with a significance level (α) of . 05 (95% reliability) and a conventional 80% power statistic. Conclusions The central mechanism of action will be to investigate the effectiveness of an intervention based on positive psychology through a web platform that can be delivered through computers and tablets, with content that has been rigorously contextualized to the Mexican culture to provide functional strategies to help the target users cope with the COVID-19 pandemic. Trial Registration ClinicalTrials.gov NCT04468893; https://clinicaltrials.gov/ct2/show/NCT04468893 International Registered Report Identifier (IRRID) DERR1-10.2196/23117
Population-Based Prevalence of Chlamydia trachomatis Infection and Antibodies in Four Districts with Varying Levels of Trachoma Endemicity in Amhara, Ethiopia

Abstract. The Trachoma Control Program in Amhara region, Ethiopia, scaled up the surgery, antibiotics, facial cleanliness, and environmental improvement (SAFE) strategy in all districts starting in 2007. Despite these efforts, many districts still require additional years of SAFE. In 2017, four districts were selected for the assessment of antibody responses against Chlamydia trachomatis antigens and C. trachomatis infection to better understand transmission. Districts with differing endemicity were chosen, whereby one had a previous trachomatous inflammation-follicular (TF) prevalence of ≥ 30% (Andabet), one had a prevalence between 10% and 29.9% (Dera), one had a prevalence between 5% and 10% (Woreta town), and one had a previous TF prevalence of < 5% (Alefa) and had not received antibiotic intervention for 2 years. Survey teams assessed trachoma clinical signs and took conjunctival swabs and dried blood spots (DBS) to measure infection and antibody responses. Trachomatous inflammation-follicular prevalence among children aged 1–9 years was 37.0% (95% CI: 31.1–43.3) for Andabet, 14.7% (95% CI: 10.0–20.5) for Dera, and < 5% for Woreta town and Alefa. Chlamydia trachomatis infection was only detected in Andabet (11.3%). Within these districts, 2,195 children provided DBS. The prevalence of antibody responses to the antigen Pgp3 was 36.9% (95% CI: 29.0–45.6%) for Andabet, 11.3% (95% CI: 5.9–20.6%) for Dera, and < 5% for Woreta town and Alefa. Seroconversion rate for Pgp3 in Andabet was 0.094 (95% CI: 0.069–0.128) events per year. In Andabet district, where SAFE implementation has occurred for 11 years, the antibody data support the finding of persistently high levels of trachoma transmission.
Neither Excessive Nitric Oxide Accumulation nor Acute Hyperglycemia Affects the N-Acetylaspartate Network in Wistar Rat Brain Cells

The N-acetylaspartate network begins in neurons with N-acetylaspartate production catalyzed by aspartate N-acetyltransferase from acetyl-CoA and aspartate. Clinical studies reported a significant depletion in N-acetylaspartate brain level in type 1 diabetic patients. The main goal of this study was to establish the impact of either hyperglycemia or oxidative stress on the N-acetylaspartate network. For the in vitro part of the study, embryonic rat primary neurons were treated by using a nitric oxide generator for 24 h followed by 6 days of post-treatment culture, while the neural stem cells were cultured in media with 25–75 mM glucose. For the in vivo part, male adult Wistar rats were injected with streptozotocin (65 mg/kg body weight, ip) to induce hyperglycemia (diabetes model) and euthanized 2 or 8 weeks later. Finally, the biochemical profile, NAT8L protein/Nat8l mRNA levels and enzymatic activity were analyzed. Ongoing oxidative stress processes significantly affected energy metabolism and cholinergic neurotransmission. However, the applied factors did not affect the N-acetylaspartate network. This study shows that reduced N-acetylaspartate level in type 1 diabetes is not related to oxidative stress and that does not trigger N-acetylaspartate network fragility. To reveal why N-acetylaspartate is reduced in this pathology, other processes should be considered.
Respiratory Pathogen Detection in Pediatric Patients Intubated for Presumed Infection

Objectives Respiratory syncytial virus (RSV) in pediatric patients has been associated with low risk of concomitant bacterial infection. However, in children with severe disease, it occurs in 22% to 50% of patients. As viral testing becomes routine, bacterial codetections are increasingly identified in patients with non-RSV viruses. We hypothesized, among patients intubated for respiratory failure secondary to suspected infection, there are similar rates of codetection between RSV and non-RSV viral detections. Methods This retrospective chart review, conducted over a 5-year period, included all patients younger than 2 years who required intubation secondary to respiratory failure from an infectious etiology in a single pediatric emergency department. Patients intubated for noninfectious causes were excluded. Results We reviewed 274 patients, of which 181 had positive viral testing. Of these, 48% were RSV-positive and 52% were positive for viruses other than RSV. Codetection of bacteria was found in 76% (n = 65; 95% confidence interval [CI], 66%, 84%) of RSV-positive patients and 66% (n = 63, 95% CI: 57%, 76%) of patients positive with non-RSV viruses. Among patients with negative viral testing, 33% had bacterial growth on lower respiratory culture. Male sex was the only patient-related factor associated with increased odds of codetection (odds ratio [OR], 2.2; 95% CI, 1.08–4.38). The odds of codetection between RSV-positive patients and non-RSV viruses were not significantly different (OR, 1.3; 95% CI, 0.62–2.71). Conclusions Bacterial codetection is common and not associated with anticipated patient-related factors or with a specific virus. These results suggest consideration of empiric antibiotics in infants with respiratory illness requiring intubation.
Thiopurines and non-melanoma skin cancer: partners in crime in inflammatory bowel diseases.

INTRODUCTION Several studies have shown that inflammatory bowel diseases (IBD) patients treated with thiopurines have an increased risk of developing skin cancer. SOURCES OF DATA This review is based on recent published literature regarding the use of thiopurines in IBD and skin malignancies. AREAS OF AGREEMENT Exposure to thiopurines is significantly associated with nonmelanoma skin cancer, but not with melanoma. Primary and secondary prevention including sun-protective measures and regular dermatologic screening are recommended in IBD patients, particularly in those exposed to thiopurines. AREAS OF CONTROVERSY Both when and how immunosuppressive therapy should be resumed in patients with a prior history of skin cancer still remain debatable topics. GROWING POINTS The benefit-risk balance between thiopurine therapy and risk of skin cancer should be evaluated in the drug decision process. AREAS TIMELY FOR DEVELOPING RESEARCH The approval of new effective strategies requires the re-evaluation of the positioning of thiopurines within the therapeutic algorithm based on an increasingly individualized approach.
Seroprevalence of Toxoplasma gondii infection among women of childbearing age in an endemic region of Romania, 2016–2018

Toxoplasmosis is an important worldwide zoonosis caused by the protozoan parasite Toxoplasma gondii. This parasitic infection is often asymptomatic in immunocompetent people. However, if the infection occurs in pregnant women, it can have serious consequences for the foetus. In this study, we evaluated the seroprevalence of T. gondii in women of childbearing age in Arad County, Western Romania. Serum samples from 2626 women were analysed using a Siemens ADVIA Centaur XP Immunoassay System. Toxoplasma gondii IgG antibodies were demonstrated in 1081 women (41%) and prevalence tended to increase with age, from 32% in women aged 15–19 years to 62% in women aged 40–45 years. There was a higher prevalence in rural areas (46%) than in urban areas (36%). This study provides new data on T. gondii seroprevalence in women of childbearing age from Western Romania.
Clinical characteristics of 1 006 Chinese patients with lupus erythematosus: results from the Lupus Erythe-matosus Multicenter Case-control Study in Chinese populations (LEMCSC)

Objective To explore clinical characteristics of Chinese patients with lupus erythematosus (LE). Methods Data were obtained from the Lupus Erythematosus Multicenter Case-control Study in Chinese populations(LEMCSC). A unified standard was used to recruit patients and collect clinical information. The EpiData 3.1 and SPSS 18 softwares were utilized to input and analyze data respectively. Results One thousand and six patients (87.6% female) with lupus erythematosus (LE) were included in this analysis, of whom, 887 (89.9% female) had systemic LE(SLE), and 119 (70.6% female) had isolated cutaneous LE (CLE). The most common involved system in SLE patients was skin (72.7%), followed by joints (69.2%), hematological system (60.8%), kidney (48.5%), serosa (18.2%), and nervous system (5.7%). The appearance of LE-specific skin manifestations was associated with an increased risk of arthritis (odds ratio [OR]=1.612, 95% confidence interval [CI]: 1.181-2.200), but with a decreased risk of nephritis (OR = 0.218, 95% CI: 0.157 - 0.303) and serositis (OR = 0.311, 95% CI: 0.218 - 0.443). The presence of acute CLE (ACLE) lesions was a risk factor for systemic involvement (OR = 4.931, 95% CI: 3.232 - 7.524), while that of chronic CLE (CCLE) lesions was a protective factor for systemic involvement (OR = 0.355, 95% CI: 0.234 - 0.541). The appearance of LE-nonspecific skin manifestations was closely correlated with the involvement of internal organs in patients with LE. Conclusion This study revealed main characteristics of LE patients in China and the relationship between LE-related skin lesions and internal organ involvement. Key words: Lupus erythematosus, systemic; Lupus erythematosus, cutaneous; Disease attributes; Multicenter study; Cross-sectional studies
Comparative Safety of Sleeve Gastrectomy and Gastric Bypass

Supplemental Digital Content is available in the text Objective: To compare the safety of sleeve gastrectomy and gastric bypass in a large cohort of commercially insured bariatric surgery patients from the IBM MarketScan claims database, while accounting for measurable and unmeasurable sources of selection bias in who is chosen for each operation. Summary of Background Data: Sleeve gastrectomy has rapidly become the most common bariatric operation performed in the United States, but its longer-term safety is poorly described, and the risk of worsening gastroesophageal reflux requiring revision may be higher than previously thought. Prior studies comparing sleeve gastrectomy to gastric bypass are limited by low sample size (in randomized trials) and selection bias (in observational studies). Methods: Instrumental variables analysis of commercially insured patients in the IBM MarketScan claims database from 2011 to 2018. We studied patients undergoing bariatric surgery from 2012 to 2016. We identified re-interventions and complications at 30 days and 2 years from surgery using Comprehensive Procedural Terminology and International Classification of Disease (ICD)-9/10 codes. To overcome unmeasured confounding, we use the prior year's sleeve gastrectomy utilization within each state as an instrumental variable—exploiting variation in the timing of payers’ decisions to cover sleeve gastrectomy as a natural experiment. Results: Among 38,153 patients who underwent bariatric surgery between 2012 and 2016, the share of sleeve gastrectomy rose from 52.6% (2012) to 75% (2016). At 2 years from surgery, patients undergoing sleeve gastrectomy had fewer re-interventions (sleeve 9.9%, bypass 15.6%, P < 0.001) and complications (sleeve 6.6%, bypass 9.6%, P = 0.001), and lower overall healthcare spending ($47,891 vs $55,213, P = 0.003), than patients undergoing gastric bypass. However, at the 2-year mark, revisions were slightly more common in sleeve gastrectomy than in gastric bypass (sleeve 0.6%, bypass 0.4%, P = 0.009). Conclusions and Relevance: In a large cohort of commercially insured patients, sleeve gastrectomy had a superior safety profile to gastric bypass up to 2 years from surgery, even when accounting for selection bias. However, the higher risk of revisions in sleeve gastrectomy merits further exploration.
Mechanical Characterisation of Single-Walled Carbon Nanotube Heterojunctions: Numerical Simulation Study

The elastic properties of single-walled carbon nanotube heterojunctions were investigated using conventional tensile, bending and torsion tests. A three-dimensional finite element model was built in order to describe the elastic behaviour of cone heterojunctions (armchair–armchair and zigzag–zigzag). This comprehensive systematic study, to evaluate the tensile, bending and torsional rigidities of heterojunctions, enabled the formulation analytical methods for easy assessment of the elastic properties of heterojunctions using a wide range of their geometrical parameters.
Mobile Phone Apps in Australia for Improving Pregnancy Outcomes: Systematic Search on App Stores

Background Women are increasingly turning to mobile health platforms to receive health information and support in pregnancy, yet the content of these platforms vary. Although there is great potential to influence health behaviors, little research has assessed the quality of these platforms or their ability to change behavior. In recent years, validated tools to assess app quality have become available. Objective To identify and assess the quality and ongoing popularity of the top 10 freely available pregnancy apps in Australia using validated tools. Methods A systematic search on app stores to identify apps was performed. A Google Play search used subject terms pregnancy, parenting, and childbirth; the iTunes search used alternative categories medical and health and fitness. The top 250 apps from each store were cross-referenced, and the top 100 found in both Google Play and iTunes were screened for eligibility. Apps that provided health information or advice for pregnancy were included. Excluded apps focused on nonhealth information (eg, baby names). The top 10 pregnancy apps were assessed using the Mobile App Rating Scale (MARS). A comparative analysis was conducted at 2 time points over 2 years to assess the ongoing popularity of the apps. The MARS score was compared to the download and star rating data collected from iTunes and Google Play in 2017 and 2019. Health behaviors including breastfeeding, healthy pregnancy weight, and maternal awareness of fetal movements were reviewed for apparent impact on the user’s knowledge, attitudes, and behavior change intentions using the MARS perceived impact section and the Coventry, Aberdeen, and London—Refined (CALO-RE) taxonomy. Results A total of 2052 free apps were screened for eligibility, 1397 were excluded, and 655 were reviewed and scored. The top 10 apps were selected using download numbers and star ratings. All 10 apps were suboptimal in quality, practicality, and functionality. It was not possible to identify a primary purpose for all apps, and there was overlap in purpose for many. The mean overall MARS app quality score across all 10 apps was 3.01 (range 1.97-4.40) in 2017 and 3.40 (range 2.27-4.44) in 2019. A minority of apps scored well for perceived impact on health behavior using the MARS tool. Using the CALO-RE 40 item taxonomy, the number of behavior change techniques used was low. The mean number of behavior change techniques for breastfeeding was 5 (range 2-11), for pregnancy weight was 4 (range 2-12), and for maternal awareness of fetal movements was 5 (range 2-8). Conclusions This review provides valuable information to clinicians and consumers about the quality of apps currently available for pregnancy in Australia. Consideration is needed regarding the regulation of information and the potential opportunity to incorporate behavior change techniques to improve maternal and fetal outcomes.
The Effect of Using Eye Masks and Earplugs on Intensive Care Patients Quality of Sleep and Vital Signs

Supplemental digital content is available in the text. ABSTRACT BACKGROUND: Intensive care unit (ICU) patients with severe health problems experience a high rate of sleep deprivation that harms their psychological and physiological health. Environmental factors are considered to be the greatest cause of sleep deprivation in the ICU, and noise and light are leading among these factors. This study aimed to investigate the effect of eye masks and earplugs on the sleep quality and vital signs of conscious ICU patients. METHODS: This study used a quasi-experimental, in similar groups, pretest-posttest design with a control group. The Richards-Campbell Sleep Questionnaire (RCSQ) was used to collect data, and vital signs were recorded every 2 hours. On day 1, standard care was provided to the experimental group (n = 32), and they were provided with eye masks and earplugs on day 2. The control group (n = 32) was provided with standard care on both days. Chi-square, t, and McNemar and McNemar-Bowker tests were used to analyze the data. Multiple regression analysis was used for predictive analysis. RESULTS: The RCSQ mean (SD) pretest and posttest scores were 50.21 (16.02) and 68.50 (17.57), respectively, for the experimental group and 55.34 (16.62) and 49.03 (15.53), respectively, for the control group. In the experimental group, the posttest RCSQ score was significantly higher than the pretest RCSQ score (P < .01). No differences in vital signs were observed in the control group. All the vital signs were found to be similar in the experimental group, except for the mean daily pulse rate. CONCLUSION: The use of earplugs and eye masks may help reduce sleep deprivation. Eye masks and earplugs can be used by nurses to improve the sleep quality of patients in ICUs.
Mechanisms of melanocyte death in vitiligo

Vitiligo is an autoimmune depigment disease results from extensive melanocytes destruction. The destruction of melanocyte is thought to be of multifactorial causation. Genome‐wide associated studies have identified single‐nucleotide polymorphisms in a panel of susceptible loci as risk factors in melanocyte death. But vitiligo onset can't be solely attributed to a susceptive genetic background. Oxidative stress triggered by elevated levels of reactive oxygen species accounts for melanocytic molecular and organelle dysfunction, a minority of melanocyte demise, and melanocyte‐specific antigens exposure. Of note, the self‐responsive immune function directly contributes to the bulk of melanocyte deaths in vitiligo. The aberrantly heightened innate immunity, type‐1‐skewed T helper, and incompetent regulatory T cells tip the balance toward autoreaction and CD8+ cytotoxic T lymphocytes finally execute the killing of melanocytes, possibly alarmed by resident memory T cells. In addition to the well‐established apoptosis and necrosis, we discuss several death modalities like oxeiptosis, ferroptosis, and necroptosis that are probably employed in melanocyte destruction. This review focuses on the various mechanisms of melanocytic death in vitiligo pathogenesis to demonstrate a panorama of that. We hope to provide new insights into vitiligo pathogenesis and treatment strategies by the review.
Impact of online mental health screening tools on help-seeking, care receipt, and suicidal ideation and suicidal intent: Evidence from internet search behavior in a large U.S. cohort.

INTRODUCTION Most people with psychiatric illnesses do not receive treatment for almost a decade after disorder onset. Online mental health screens reflect one mechanism designed to shorten this lag in help-seeking, yet there has been limited research on the effectiveness of screening tools in naturalistic settings. MATERIAL AND METHODS We examined a cohort of persons directed to a mental health screening tool via the Bing search engine (n = 126,060). We evaluated the impact of tool content on later searches for mental health self-references, self-diagnosis, care seeking, psychoactive medications, suicidal ideation, and suicidal intent. Website characteristics were evaluated by pairs of independent raters to ascertain screen type and content. These included the presence/absence of a suggestive diagnosis, a message on interpretability, as well as referrals to digital treatments, in-person treatments, and crisis services. RESULTS Using machine learning models, the results suggested that screen content predicted later searches with mental health self-references (AUC = 0·73), mental health self-diagnosis (AUC = 0·69), mental health care seeking (AUC = 0·61), psychoactive medications (AUC = 0·55), suicidal ideation (AUC = 0·58), and suicidal intent (AUC = 0·60). Cox-proportional hazards models suggested individuals utilizing tools with in-person care referral were significantly more likely to subsequently search for methods to actively end their life (HR = 1·727, p = 0·007). DISCUSSION Online screens may influence help-seeking behavior, suicidal ideation, and suicidal intent. Websites with referrals to in-person treatments could put persons at greater risk of active suicidal intent. Further evaluation using large-scale randomized controlled trials is needed.