Miracle-dz/UniFAR-FTUs huggingface dataset:
Outcomes of Hospitalized Patients with Glucocorticoid-Induced Hyperglycemia—A Retrospective Analysis

Background: Glucocorticoid (GC)-induced hyperglycemia is a frequent side effect in hospitalized patients. Guidelines recommend treat-to-target treatment between 6–10 mmol/L (108–180 mg/dL) with insulin, but data on outcome is scarce. We investigated the 30-day outcome in hospitalized patients receiving GCs. Methods: All patient records of hospitalized patients between January 2014 and April 2018 were screened for GC administration and consecutive hyperglycemia. The primary combined endpoint consisted of death, cardiovascular events, and infections until 30 days after admission. Hypoglycemia was a secondary outcome. Results: Of the 2424 hospitalized patients (9.6% of all hospitalized patients) who received systemic GCs and met inclusion criteria, the overall incidence for GC-induced hyperglycemia was 812 (33.5%), and 89 (3.7%) had at least one documented hypoglycemia during their hospital stay. Compared to patients with normoglycemia, GC-induced hyperglycemia had an adjusted-odds ratio of 1.68 (95% CI 1.25–2.26) for the combined primary endpoint. Hypoglycemia even had an odds ratio of 1.95 (95% CI 1.2–3.17). Conclusions: Mortality, cardiovascular events, and rate of infections were markedly higher in patients with GC-induced hyperglycemia as compared to patients with normoglycemia. Importantly, hypoglycemia was associated with a doubled risk for adverse outcome. Future studies should evaluate whether optimized glucose control by minimizing the risk for hypoglycemia has a beneficial effect on clinical outcomes in patients with GC-induced hyperglycemia.
Expression of Transient Receptor Potential Ankyrin 1 and Transient Receptor Potential Vanilloid 1 in the Gut of the Peri-Weaning Pig Is Strongly Dependent on Age and Intestinal Site

Simple Summary Weaning is a critical event for the piglet, contributing to aberrant gut function and resulting in reduced barrier function and retarded protein digestion. The gut is able to “sense” nutrients and release gut hormones to regulate digestive processes. To that end, various gastrointestinal cell types possess transient receptor potential channels that are involved in regulating gastric motility and secretion. Herbal compounds, currently used in pig nutrition as antibiotic alternatives, are able to activate these channels and could potentially aid digestion. However, these channels have not been characterized in the gut of the pig and their ability to release gut hormones has never been explored. This study’s objective was to characterize TRPA1 and TRPV1 in the pig’s gut and explore their potential to modulate gastric function. A gene expression study was performed on tissues obtained from different locations in the guts of piglets of varying age. Moreover, the ability to secrete peptide hormones was investigated by characterizing them on enteroendocrine cells. Both channels were found to be expressed in the mucosa of the porcine gut, strongly dependent on age and location. Moreover, the endocrine nature of both channels was confirmed, indicating their possible role in gut hormone release and the regulation of gastric emptying. Abstract Transient receptor potential (TRP) channels contribute to sensory transduction in the body, agonized by a variety of stimuli, such as phytochemicals, and they are predominantly distributed in afferent neurons. Evidence indicates their expression in non-neuronal cells, demonstrating their ability to modulate gastrointestinal function. Targeting TRP channels could potentially be used to regulate gastrointestinal secretion and motility, yet their expression in the pig is unknown. This study investigated TRPA1 and TRPV1 expression in different gut locations of piglets of varying age. Colocalization with enteroendocrine cells was established by immunohistochemistry. Both channels were expressed in the gut mucosa. TRPV1 mRNA abundance increased gradually in the stomach and small intestine with age, most notably in the distal small intestine. In contrast, TRPA1 exhibited sustained expression across ages and locations, with the exception of higher expression in the pylorus at weaning. Immunohistochemistry confirmed the endocrine nature of both channels, showing the highest frequency of colocalization in enteroendocrine cells for TRPA1. Specific co-localization on GLP-1 immunoreactive cells indicated their possible role in GLP-1 release and the concomitant intestinal feedback mechanism. Our results indicate that TRPA1 and TRPV1 could play a role in gut enteroendocrine activity. Moreover, age and location in the gut significantly affected gene expression.
Experimental investigation of models for fluidized bed catalytic reactors

The countercurrent backmixing model of a fluidized bed reactor predicts axial concentration profiles quite different from those suggested by simple two-phase models. The models can also be distinguished in terms of the dependence of conversion on operating variables. An experimental study of ozone decomposition in a reactor of 22.9 cm diameter has provided extensive data for comparison with backmixing and two-phase models which incorporate bubble size variation. The measured profiles show a minimum concentration within the bed at gas velocities above a critical value, as predicted only by the backmixing model. The effect of operating variables on the shape of the profiles is also well accounted for by this model. The backmixing model is further supported by good agreement between predicted and measured reactant conversion. In particular, the variation of conversion with rate constant and gas velocity is fitted more accurately by the backmixing model than by two-phase models.
Retention, stability, iron bioavailability and sensory evaluation of extruded rice fortified with iron, folic acid and vitamin B12

Abstract Fortification of rice with micronutrients using extrusion technology is considered a sustainable strategy to prevent nutritional deficiencies in general population. The objective of the present study is to assess the retention, stability and iron bioavailability from indigenously developed triple fortified rice (iron, folic acid and vitamin B12) during rinsing and different cooking methods. Further, we also assessed the acceptability of fortified rice in adult human volunteers. The retention of iron during rinsing with excess water was ≥90%, whereas folic acid and vitamin B12 levels were reduced by ~25% during rinsing. Watertight cooking of rice (in electric cooker or on flame) had no additional effect on the nutrient levels as compared with rinsed rice, implying their stability during cooking. However, cooking with excess water followed by decanting led to loss of 45% iron and ≥70% folic acid and vitamin B12. The dialyzable iron and ferritin synthesis in Caco‐2 cells was significantly (P < .01) higher from fortified rice compared with unfortified rice. In addition, inclusion of ascorbic acid significantly (P < .01) increased the iron bioavailability from the fortified rice. Triangle tests in adult human subjects revealed that there are no significant sensory differences among fortified and unfortified rice. Further, fortified rice consumption appears to bridge the gaps in dietary iron intake deficits in children and women of reproductive age. These results suggest that the iron‐, folic acid‐ and vitamin B12‐fortified rice has higher retention and stability of fortified nutrients and is acceptable for consumption in adult human volunteers.
Increase in Kelch 13 Polymorphisms in Plasmodium falciparum, Southern Rwanda

Artemisinin resistance in Plasmodium falciparum is associated with nonsynonymous mutations in the Kelch 13 (K13) propeller domain. We found that 12.1% (8/66) of clinical P. falciparum isolates from Huye district, Rwanda, exhibited K13 mutations, including R561H, a validated resistance marker. K13 mutations appear to be increasing in this region.
Influences of psychosocial factors and home food availability on healthy meal preparation

Abstract The involvement of children in healthy meal preparation activities has emerged as a potential strategy to promote healthy eating behaviour among children. However, there is a lack of understanding of children's internal (psychosocial factors) and external factors (home food availability) that may support the practice of preparing healthy meals. This study aimed to determine children's psychosocial factors of healthy meal preparation within themselves and their external environment of home food availability as predictors for the practice of healthy meal preparation. Public schools (n = 8) from all three zones (Bangsar‐Pudu, Keramat and Sentul) in Kuala Lumpur, Malaysia, were selected through stratified random sampling. Two hundred children aged 9–11 and their parents participated. Children's psychosocial factors towards healthy meal preparation and their home food availability were assessed through children and parents, respectively, using validated questionnaires. Majority of the schoolchildren (86.5%) had poor practice of healthy meal preparation. Increased attitude (r = 0.344, P < 0.001) and self‐efficacy (r = 0.501, P < 0.001) of healthy meal preparation and the availability of fruits (r = 0.304, P < 0.001), vegetables (r = 0.243, P < 0.001) and healthful ready‐to‐eat foods (r = 0.227, P = 0.001) at home were positively correlated with the practice of preparing healthy meals. After adjusting for age, sex and monthly household income, increased self‐efficacy (P < 0.001), availability of fruits (P = 0.01) and lower availability of less healthful ready‐to‐eat food (P = 0.01) were associated with better healthy meal preparation practices. Outcomes revealed that positive self‐efficacy of healthy meal preparation, home food availability of fruits and less healthful alternatives were associated with the practice of healthy meal preparation and thus should be targeted in future health‐promotion strategy.
Milk Containing A2 β-Casein ONLY, as a Single Meal, Causes Fewer Symptoms of Lactose Intolerance than Milk Containing A1 and A2 β-Caseins in Subjects with Lactose Maldigestion and Intolerance: A Randomized, Double-Blind, Crossover Trial

Acute-feeding and multiple-day studies have demonstrated that milk containing A2 β-casein only causes fewer symptoms of lactose intolerance (LI) than milk containing both A1 and A2 β-caseins. We conducted a single-meal study to evaluate the gastrointestinal (GI) tolerance of milk containing different concentrations of A1 and A2 β-casein proteins. This was a randomized, double-blind, crossover trial in 25 LI subjects with maldigestion and an additional eight lactose maldigesters who did not meet the QLCSS criteria. Subjects received each of four types of milk (milk containing A2 β-casein protein only, Jersey milk, conventional milk, and lactose-free milk) after overnight fasting. Symptoms of GI intolerance and breath hydrogen concentrations were analyzed for 6 h after ingestion of each type of milk. In an analysis of the 25 LI subjects, total symptom score for abdominal pain was lower following consumption of milk containing A2 β-casein only, compared with conventional milk (p = 0.004). Post hoc analysis with lactose maldigesters revealed statistically significantly improved symptom scores (p = 0.04) and lower hydrogen production (p = 0.04) following consumption of milk containing A2 β-casein only compared with conventional milk. Consumption of milk containing A2 β-casein only is associated with fewer GI symptoms than consumption of conventional milk in lactose maldigesters.
Echocardiographic follow-up to right ventricular modifications in secondary pulmonary hypertension to diabetes in rats

ABSTRACT Clinical studies suggest that diabetes is a risk factor in the development of pulmonary arterial hypertension. The increase in blood pressure in the pulmonary area is characterized by the increase in the afterload and hypertrophy of the right ventricle. The objective of this study was to conduct a longitudinal follow-up of the morphological and functional changes in the right ventricle in a rat model with pulmonary arterial hypertension secondary to diabetes. Male Sprague Dawley rats were randomly divided into a control group (saline solution) and a diabetic group (60 mg/kg with streptozotocin). For 12 weeks, an echocardiography for longitudinal (in vivo) image analysis of the pulmonary pressure was performed at the same time as the evaluation of myocardial remodeling and right ventricular. After this period, the pulmonary pressure was measured by means of a pulmonary artery catheterization, and the presence of hypertrophy was determined by means of the Fulton index. The plasma concentration of brain natriuretic peptide was measured by means of the ELISA technique. It was found that the diabetic rats showed an increase in pressure in the pulmonary arteries, an increase in the Fulton index, and an increase in brain natriuretic peptide. The echocardiographic follow-up showed that the diabetic rats presented an increase in the pulmonary artery from the fourth week, while hypertrophy and right ventricular systolic dysfunction occurred until the twelfth week. In conclusion, pulmonary arterial hypertension induced by experimental diabetes generated hypertrophy and systolic dysfunction of the right ventricle.
The Critical Window of Opportunity: Lactation Initiation Following Cesarean Birth.

Introduction: Cesarean birth is reported to be risk factor for the delayed onset of maternal lactation. The purpose of this study was to describe the timing of lactation initiation, subsequent feeding/milk expression patterns, and daily milk volumes among women who had a cesarean birth of an infant with a known congenital anomaly during the 3-day postpartum hospital stay. Materials and Methods: Retrospective descriptive cohort study. The electronic medical records of dyads, between 2014 and 2017 at the study setting, were abstracted for demographic and clinical data. Milk expression and milk volume data were abstracted from maternal lactation logs. Data were analyzed using descriptive statistics. Results: Among the cohort (n = 468 dyads), the mean time from infant delivery by cesarean to lactation initiation was 257.5 minutes. The cohort was divided into three groups by the timing of lactation initiation: EARLY (≤60 minutes; n = 112), MID (>60 minutes to ≤360 minutes; n = 309), and LATE (>360 minutes; n = 47). Statistically significant differences are seen between groups for the daily means: number of feeds/pumps and maternal milk volumes (irrespective of the presence of lactation risk factors). Discussion: This is the first study to explore the relationship of lactation initiation among women postcesarean birth whose infants have a known congenital anomaly. The time between the infant's birth and the first feed/milk expression, and the patterns of feeding/milk expression during the postpartum hospital stay, are key drivers for maternal milk supply.
UV Resonance Raman Studies of Bacteria

Abstract Rapid and reliable methods for the detection and identification of microorganisms are very important. Fortunately, many effective means for bacterial identification have been developed. On the other hand, only a few of these are rapid, accurate, and cost effective. In most instances, if general examinations of bacteria must be performed, presently used techniques are very slow and may not be helpful unless extremely tedious procedures are followed. Traditional methods, which are based upon visual microscopic examination, biochemical reactions, and physiological functions of bacteria, are inherently slow, time consuming, and tedious. Even today, important decisions related to the presence of pathogens have to be made before the results of microbiological tests are available. This situation is changing rapidly, however.
Clinical Outcomes, Costs, and Cost-effectiveness of Strategies for Adults Experiencing Sheltered Homelessness During the COVID-19 Pandemic

Key Points Question What are the projected clinical outcomes and costs associated with strategies for reducing severe acute respiratory syndrome coronavirus 2 infections among people experiencing sheltered homelessness? Findings In this decision analytic model, daily symptom screening with polymerase chain reaction (PCR) testing of individuals who had positive symptom screening paired with nonhospital care site management of people with mild to moderate coronavirus disease 2019 (COVID-19) was associated with a substantial decrease in infections and lowered costs over 4 months compared with no intervention across a wide range of epidemic scenarios. In a surging epidemic, adding periodic universal PCR testing to symptom screening and nonhospital care site management was associated with improved clinical outcomes at modestly increased costs. Meaning In this study, daily symptom screening with PCR testing of individuals who had positive symptom screening and use of alternative care sites for COVID-19 management among individuals experiencing sheltered homelessness were associated with substantially reduced new cases and costs compared with other strategies.
Possible roads to improve hemophagocytic lymphohistiocytosis outcome.

We read with interest the article by Bergsten et al on the outcomes of patients with hemophagocytic lymphohistiocytosis (HLH) enrolled in the HLH-2004 protocol and treated with allogeneic hematopoietic stem cell transplantation (HSCT). 1 The investigators analyzed 187 children treated with the HLH-2004 protocol who received HSCT between 2004 and 2012. The 5-year projected overall survival and event-free survival after HSCT for the entire cohort were 66% (95% confidence interval [CI], 59-72) and 60% (95% CI, 52-67), respectively. Median time from diagnosis to transplant was 148 days, and approximately two thirds of patients were transplanted within 6 months from the start of therapy. Notably, a time to transplant . 6 months was not associated with a worse outcome, as reported in the study published by the Italian Association for Pediatric Hematology and Oncology group. 2 Remarkably, most of the events occurred in the first year after HSCT. Achievement of complete remission at the time of transplant was associated with an improved outcome, although this advantage was not statistically evident when a ferritin threshold of 2000 ng/mL, instead of 500 ng/mL, was used to define response. 3 There was no difference in outcome when patients were stratified according to the type of conditioning regimen used, although there was a trend toward an improved outcome for patients receiving treosulfan-based conditioning, as also suggested by previous studies. 2,4 The investigators concluded that “ post-HSCT survival in FHL remains suboptimal ” and that “ we are optimistic that
An exploratory study of risk factors for pressure injury in patients undergoing spine surgery

Background Perioperative patients are potentially at risk for pressure injuries due to anesthetic agents and surgical positioning. Pressure injury increases discomfort and pain in patients and causes complications, which lead to an increase in mortality and hospitalization duration. Most previous studies did not focus on specific types of surgery or surgical positioning. We tried to identify the incidence of perioperative pressure injury during spinal surgery and perioperative risk factors that contribute to pressure injury. Methods We retrospectively analyzed electronic medical records of 663 patients who underwent spinal surgery between March 2016 and May 2018. The primary outcome was occurrence of pressure injury. Potential risk factors of pressure injury were selected based on previous studies and expert opinion, and divided into two sub-categories: preoperative and intraoperative risk factors. We compared the clinical characteristics of patients in the pressure injury and non-injury groups. Perioperative risk factors for pressure injury were analyzed by logistic regression. Results Among 663 patients, the incidence of all stages of pressure injury was 5.9%. The face and inguinal regions were the most injured sites (both 28.6%). The pressure injury group showed a 13% longer hospitalization period. Preoperative plasma concentration of protein was associated with 0.5-fold lower pressure injury (OR: 0.50; 95% CI: 0.27 to 0.95; P = 0.034). Conclusions The incidence of pressure injury was similar to that previously reported and occurred in the direct weight-bearing areas, which led to longer hospitalization. We found that a lower preoperative serum protein level is significantly associated with intraoperative pressure injury occurrence during spinal surgery.
Profile of reticulated platelets in the early, subacute and late phases after transient ischemic attack or ischemic stroke

Abstract Information regarding the profile of reticulated platelets (RP) in ischemic cerebrovascular disease (CVD) patients is limited. Data from two prospective, observational, case-control studies were combined to compare the %RP using whole blood flow cytometry in patients ≤ 4 weeks of TIA/stroke onset (baseline, N = 210), and 14 ±7 days (14d, N = 182) and ≥ 90 days (90d, N = 145) after starting or changing antiplatelet therapy with healthy controls (N = 34). There were no differences in median %RP between the overall CVD patient population at baseline or 14d vs. controls (P ≥ 0.2). However, the median %RP was significantly higher in CVD patients overall at 90d (P = .036), and in the subgroup of patients with “lacunar” TIA/ischemic stroke at baseline (P = .04) and at 90d (P = .01), but not at 14d (P = .06) vs. controls. There were no significant differences in the median %RP between other TIA/stroke subgroups and controls (P ≥ 0.05). Elevated circulating reticulated platelets, as a marker of increased platelet production/turnover, may occur following an ischemic event in a well-phenotyped TIA/ischemic stroke population overall, but may precede symptom onset at least in the subgroup with small vessel occlusion. These data improve our understanding of the profile of reticulated platelets in CVD patients.
Canadian emergency medicine and critical care physician perspectives on pandemic triage in COVID-19.

INTRODUCTION Local and regional policies to guide the allocation of scarce critical care resources have been developed, but the views of prospective users are not understood. We sought to investigate the perspectives of Canadian acute care physicians toward triaging scarce critical care resources in the COVID-19 pandemic. METHODS We rapidly deployed a brief survey to Canadian emergency and critical care physicians in April 2020 to investigate current attitudes toward triaging scarce critical care resources and identify subsequent areas for improvement. Descriptive and between-group analyses along with thematic coding were used. RESULTS The survey was completed by 261 acute care physicians. Feelings of anxiety related to the pandemic were common (65 percent), as well as fears of psychological distress if required to triage scarce resources (77 percent). Only 49 percent of respondents felt confident in making resource allocation decisions. Both critical care and emergency physicians favored multidisciplinary teams over single physicians to allocate scarce critical care resources. Critical care physicians were supportive of decision making by teams not involved in patient care (3.4/5 versus 2.9/5 p = 0.04), whereas emergency physicians preferred to maintain their involvement in such decisions (3.4/5 versus 4.0/5 p = 0.007). Free text responses identified five themes for subsequent action including the need for further guidance on existing triage policies, ethical support in decision making, medicolegal protection, additional tools for therapeutic communications, and healthcare provider psychological support. CONCLUSION There is an urgent need for collaboration between policymakers and frontline physicians to develop critical care resource triage policies that wholly consider the diversity of provider perspectives across practice environments.