Miracle-dz/UniFAR-FTUs huggingface dataset:
Lived experience of people living with HIV in Blantyre, Malawi: an exploratory qualitative study

Background People living with the Human Immunodeficiency Virus (HIV) encounter a range of complex challenges that impact their physical, psychological, and social well-being. The combined effects of these challenges significantly impact their daily functioning. Despite the relatively high prevalence of HIV in Malawi, there is limited knowledge on how the challenges experienced by people living with HIV correlate with their societal participation and performance of activities. Objectives This study aimed to explore the lived experience of people living with HIV and how the challenges experienced impact societal participation and activity performance. Method A qualitative exploratory study design was used. Fourteen participants were purposefully selected for the study, with an equal number of males and females. The data was gathered through semi-structured interviews and manually analyzed using thematic analysis. Results It was found that participants faced discrimination, stigma, depression, anxiety, and worries. The study participants associated their taking of antiretroviral therapy with physical impairments such as dizziness, leg pain, yellow eyes, and fatigue. The physical impairments hampered participants' ability to walk, work, conduct business, perform household chores, and care for children. Conclusion This study identified the difficulties that people living with HIV faced in their communities and how these challenges impact societal participation and performance in activities. There is a need for a holistic approach to managing these challenges and making referrals to specialized professionals.
Procedural Volume and Outcomes with Atrial Fibrillation Ablation: A Report from the NCDR AFib Ablation Registry

Background: Hospital and physician procedure volumes have been associated with outcomes for several cardiac procedures however this has not been well defined for atrial fibrillation (AF) ablation in the contemporary practice. Objective: To determine the association between hospital and physician procedural volume and success for AF ablation and the risk of major adverse events (MAE). Methods: Procedures reported to the NCDR AFib Ablation Registry between July 2019 and June 2022 were included. Physician and hospital procedural volumes were annualized and stratified into quartiles (Q) to compare success and MAE. Three level hierarchical (patient, hospital and physician) generalized linear models were used to assess the adjusted relationship between procedural volume and the likelihood of procedural outcomes. Results: A total of 70,296 first time AF ablation at 186 hospitals across the United States were included. The mean age was 66.1 {+/-} 10.3 years, 36% were women, the mean CHA2DS2-VASc score was 2.7 {+/-} 1.6, and 57.4% of patients had paroxysmal AF. The median annual procedural volume for hospitals and physicians were 230 (IQR:144.7-307.2) and 66 (IQR: 44.7-97.5), respectively. Overall, acute procedural success was 98.5 % and the MAE rate was 1.0%. With Q4 (highest) hospital volume as a reference, the adjusted likelihood of procedural success was significantly lower for Q1 (OR: 0.44, CI: 0.29-0.68), Q2 (OR: 0.50, CI: 0.33-0.75) and Q3 (OR: 0.60, CI: 0.40-0.89). Similarly, for physician, procedural success was less among Q1 (OR: 0.38, CI: 0.28-0.51), Q2 (OR: 0.51, CI: 0.38-0.69) and Q3 (OR: 0.55, CI: 0.42-0.72). With MAE, compared with Q4, there was an inverse relationship between procedural volume for hospitals in Q1 (OR: 1.78, CI: 1.26-2.51) but not Q2 (OR: 1.06, CI: 0.77-1.46) or Q3 (OR: 1.19, CI: 0.89-1.58) and for physicians in Q1 (OR: 1.93, CI: 1.44-2.58) and Q2 (OR: 1.49, CI: 1.13-1.97) but not in Q3 (OR: 1.22, CI: 0.94-1.58). An adjusted MAE ? 1% was predicted by an annual volume of approximately 190 for hospitals and 60 for physicians. Conclusion: In this national cohort, hospital and physician AF ablation procedural volumes were directly related to acute procedural success and inversely related to rates of MAE.
Identification of disease-specific TCRs maintaining pathogenic T helper cell responses in postinfectious Lyme Arthritis

Background: Antibiotic-Refractory Lyme Arthritis (ARLA) involves a complex interplay of T cell responses targeting Borrelia burgdorferi antigens succeeding towards autoantigens by epitope spreading. However, the precise molecular mechanisms driving the pathogenic T cell response in ARLA remain unclear. Our aim was to elucidate the molecular program of disease-specific Th cells. Methods: Using flow cytometry, high-throughput T cell receptor (TCR) sequencing and scRNA-seq of CD4+ Th cells isolated from the joints of European ARLA patients, we aimed at inferring antigen specificity through unbiased analysis of TCR repertoire patterns, identifying surrogate markers for disease-specific TCRs and connecting TCR specificity to transcriptional patterns. Results: PD-1hiHLA-DR+CD4+ effector T cells were clonally expanded within the inflamed joints and persisted throughout disease course. Among these cells, we identified a distinct TCR{beta} motive restricted to HLA-DRB1*11 or *13 alleles. These alleles, being underrepresented in North American ARLA patients, were unexpectedly prevalent in our European cohort. The identified TCR{beta} motive served as surrogate marker for a convergent TCR response specific to ARLA, distinguishing it from other rheumatic diseases. In the scRNA-seq dataset, the TCR{beta} motive particularly mapped to peripheral T helper (TPH) cells displaying signs of sustained proliferation, continuous TCR signaling, and expressing CXCL13 and IFN-{gamma}. Conclusion: By inferring disease-specific TCRs from synovial T cells we identified a convergent TCR response in the joints of ARLA patients that continuously fueled the expansion of TPH cells expressing a pathogenic cytokine effector program. The identified TCRs can be harnessed to identify the major antigen targets of the maladaptive immune response.
A framework for detecting causal effects of risk factors at an individual level based on principles of Mendelian randomization: Applications to modelling individualized effects of lipids on coronary artery disease

Mendelian Randomization (MR), a method that employs genetic variants as instruments for causal inference, has gained popularity in assessing the causal effects of risk factors. However, almost all MR studies primarily concentrate on the population's average causal effects. With the advent of precision medicine, the individualized treatment effect (ITE) is often of greater interest. For instance, certain risk factors may pose a higher risk to some individuals compared to others, and the benefits of a treatment may vary among individuals. This highlights the importance of considering individual differences in risk and treatment response. We propose a new framework that expands the concept of MR to investigate individualized causal effects. We presented several approaches for estimating Individualized Treatment Effects (ITEs) within this MR framework, primarily grounded on the principles of the "R-learner". To evaluate the existence of causal effect heterogeneity, we proposed two permutation testing methods. We employed Polygenic Risk Scores (PRS) as the instrument and demonstrated that the removal of potentially pleiotropic SNPs could enhance the accuracy of ITE estimates. The validity of our approach was substantiated through comprehensive simulations. We applied our framework to study the individualized causal effect of various lipid traits, including Low-Density Lipoprotein Cholesterol (LDL-C), High-Density Lipoprotein Cholesterol (HDL-C), Triglycerides (TG), and Total Cholesterol (TC), on the risk of Coronary Artery Disease (CAD) using data from the UK Biobank. Our findings indicate that an elevated level of LDL-C is causally linked to increased CAD risks, with the effect demonstrating significant heterogeneity. Similar results were observed for TC. We also revealed clinical factors contributing to the heterogeneity of ITE based on Shapley value analysis. Furthermore, we identified clinical factors contributing to the heterogeneity of ITEs through Shapley value analysis. This underscores the importance of individualized treatment plans in managing CAD risks.
Test-retest reliability and validity of the Importance of Olfaction Questionnaire in Denmark

While measures to detect psychophysical olfactory ability are a crucial part of clinicians’ assessment of potential olfactory loss, it gives no indication of how olfaction is experienced by the patient and these different aspects often deviate substantially. To ensure quality and reproducibility of subjectively reported olfactory experience and significance, the Importance of Olfaction Questionnaire (IO-Q) was introduced around a decade ago, and while initial validations have produced promising results, important aspects remain nearly unexamined. For example, the test-retest reliability has rarely been examined and the difference of online versus pen-and-paper administration remains unexplored. Here, we translated IO-Q to Danish and examined its validity, test-retest reliability and mode of administration. A cohort of 179 younger, Danish participants with a high level of English proficiency took the test twice with varying time in-between. The first test was taken digitally and in English, while the second was taken using pen-and-paper and in Danish. The distribution of scores and the relationship between the IO-Q and subscale scores were nearly identical between tests, indicating little to no influence of language/test modality in the sampled population. The internal consistency was comparable to previously published results. Likewise, an acceptable test-retest reliability was observed for the full IO-Q and slightly lower for subscales. No significant effect of time was found across several weeks. In conclusion, the IO-Q performed satisfactorily in all examinations and could therefore serve as a valuable clinical measure of subjective olfactory experience, and its Danish translation shows highly similar characteristics to the original, English version.
Evaluating host plant resistance and sowing date modification for the management of the stem borer, Coniesta ignefusalis hampson and the head miner Heliocheilus albipunctella de Joannis infesting pearl millet in the Nigerian Sudan savanna

An experiment was conducted in 1997 and repeated in 1998 cropping seasons in Maiduguri (northeastern Nigeria) to assess damage by the millet stem borer, Coniesta ignefusalis Hampson, and the millet head miner, Heliocheilus albipunctella de Joannis in 'Ex-borno', 'Wame', 'Zongori', 'Gargasori', 'Mboderi' and 'GB8735' millet cultivars. These cultivars were sown as sole crops on July 14, 21, 28 and August 5. The stem borer caused significantly higher damage (number of emergence holes and larval tunnels) to millet sown on 21 July in 1997 and to those sown on 14 July and 21 July in 1998 than to millet sown on the other dates. Cv. 'Gargasori', sown on 21 July in 1997, and 'Ex-borno', sown on 14 July in 1998, suffered significantly more damage from stem borer than the other combinations of cultivars and sowing dates. 'Ex-barno' millet, sown on 14 July, sustained significantly more damage from the head miner than the other cultivars sown on the other dates in 1997. Grain yield was significantly higher in 'Wame' in 1997 and in 'Gargasori' in 1998; yields were highest in 'Zongori' sown on 14 July in 1997 and in 'Ex-borno' sown on 28 July 1998.
Nursing Professional Commitment as a Mediator of the Relationship Between Work Environment and Missed Nursing Care Among Nurses: A Cross-Sectional Analysis

Introduction Nursing care plays a pivotal role in promoting patient well-being and optimizing health outcomes. The nursing profession is characterized by its commitment to delivering high-quality care to patients. Objective The purpose of the study was to explore the role of nursing professional commitment as a mediator between the work environment and missed nursing care. Methods A cross-sectional analysis study “STROBE guideline” used an online structured questionnaire to collect data. It was conducted on a sample of 813 nurses who worked at seven governmental hospitals in Egypt, in the hospital wards, operating rooms, intensive care unit (ICU) or outpatient clinics, during a 4-month period from April to August 2022. Researchers used Characteristics of nurses, Nursing Work Index-Revised, Nursing Professional Commitment Scale, and MISSCARE Questionnaire to collect the data. Structural equation modeling by AMOS was used for testing nursing professional commitment as a mediator between the work environment and missed nursing care. Nurses’ professional commitment was used as a mediator between work environment and missing nursing care. Results The working environment has a direct impact of −0.175, an indirect impact of −0.139, and a total impact of −0.314. Furthermore, professional commitment has a direct impact of −0.421. Additionally, when the working environment increases by 1, professional commitment increases by 0.33. Similarly, when the working environment increases by 1, missed care decreases by 0.175. Moreover, when professional commitment, as a mediating factor, increases by 1, missed care decreases by 0.421. Conclusion In conclusion, the findings of this study highlight the significant role of professional commitment as an intermediary factor between the working environment and missed nursing care. According to these results, it is necessary to formulate and implement intervention strategies to improve nurses’ professional commitment and working environment, which is the key to reducing their missed nursing care.
Phenotypic characteristics of F64L, I68L, I107V, and S77Y ATTRv genotypes from the Transthyretin Amyloidosis Outcomes Survey (THAOS)

Transthyretin amyloidosis (ATTR amyloidosis) is a progressive, multi-systemic disease with wild-type (ATTRwt) and hereditary (ATTRv) forms. Over 130 variants associated with ATTRv amyloidosis have been identified, although little is known about the majority of these genotypes. This analysis examined phenotypic characteristics of symptomatic patients with ATTRv amyloidosis enrolled in the Transthyretin Amyloidosis Outcomes Survey (THAOS) with four less frequently reported pathogenic genotypes: F64L (c.250T>C, p.F84L), I68L (c.262A>T, p.I88L), I107V (c.379A>G; p.I127V), and S77Y (c.290C>A; p.S97Y). THAOS is the largest ongoing, global, longitudinal observational study of patients with ATTR amyloidosis, including both ATTRwt and ATTRv amyloidosis. This analysis describes the baseline demographic and clinical characteristics of untreated symptomatic patients with the F64L, I68L, I107V, or S77Y genotypes at enrollment in THAOS (data cutoff date: January 4, 2022). There were 141 symptomatic patients with F64L (n = 46), I68L (n = 45), I107V (n = 21), or S77Y (n = 29) variants at the data cutoff. Most patients were male and median age at enrollment was in the sixth decade for S77Y patients and the seventh decade for the others. A predominantly neurologic phenotype was associated with F64L, I107V, and S77Y genotypes, whereas patients with the I68L genotype presented with more pronounced cardiac involvement. However, a mixed phenotype was also reported in a considerable proportion of patients in each variant subgroup. This analysis from THAOS represents the largest study of ATTRv symptomatic patients with the F64L, I68L, I107V, and S77Y genotypes. These data add to the limited knowledge on the clinical profile of patients with specific ATTRv variants and emphasize the importance of comprehensive assessment of all patients. Trial registration ClinicalTrials.gov: NCT00628745.
Risk of adverse reactions associated with inhaled corticosteroids for chronic obstructive pulmonary disease: A meta-analysis

Background: In the majority of current therapeutic regimens for chronic obstructive pulmonary disease (COPD), bronchodilators are coupled with inhaled corticosteroids (ICS) to lower the inflammatory response and improve symptoms. This study aims to evaluate the safety of ICS in the treatment of COPD. Methods: Randomized controlled trials related to ICS for COPD that were eligible up to 1 June 2023 were searched in PubMed, EMBASE, and Cochrane. We searched and screened eligible studies for the occurrence of total adverse events, cardiovascular events, upper respiratory tract infections (URTI), pneumonia, oral Candida infections, and musculoskeletal disorders, and finally analyzed them by Review Manager 5.4. 1. Results: The results showed that ICS increased the incidence of adverse reactions in COPD patients (RR = 1.06, 95% CI: 1.03–1.10, P = .0004); ICS treatment did not increase the risk of cardiovascular events in COPD patients (RR = 0.95, 95% CI: 0.88–1.02, P = .14); ICS increased the incidence of URTI in COPD patients (RR = 1.29, 95% CI: 1.02–1.62, P = .03); ICS increased the incidence of pneumonia in patients with COPD (RR = 2.09, 95% CI: 1.63–2.69, P < .00001); ICS treatment significantly increased the incidence of oral Candida in patients with COPD (RR = 2.96, 95% CI: 1.99–4.41, P < .00001); ICS increased the incidence of musculoskeletal disorders in patients with COPD (RR = 2.87, 95% CI: 1.51–5.45, P = .001). Conclusion: ICS does not increase the risk of cardiovascular events in patients with COPD, but it does increase the risk of URTI, pneumonia, oral Candida infections, and musculoskeletal disorders in patients with COPD.
Perceptions of organizational value and unethical/deviant behaviors among lecturers in Archeology and Religion and Cultural Studies: An intervention study

Background: Understanding an organization’s ethical standards assists employees in abiding by stipulated rules and regulations and reduces the prevalent rate of inappropriate behaviors. Unfortunately, some workers do not know and as a result, they become dysfunctional, affecting their professional identities. Given this, scholars have called for psychoeducational strategies that coach workers to improve their perceptions. With this in mind, we investigated the impact of psychoeducational coaching on workplace ethical perceptions and deviant behaviors among lecturers in Archeology and Religion and Cultural Studies. Methods: A group randomized control design was adopted, and a sample of lecturers was assigned to intervention and control groups using a simple allocation sequence method. Three dependent measures were used to assess the participants’ irrational beliefs, work values, and deviant behaviors before the intervention, after, and 2 months later as a follow-up test. Data collected were cued into SPSS version 28. A multivariate analysis was performed to test postulated hypotheses at . 05 probability level. Results: The results showed that rational-emotive behavior occupational coaching has a significant impact on reducing unethical work values and work-deviant behaviors among lecturers in Archeology and Religion and Cultural Studies. The finding of this study justified the effectiveness of rational-emotive behavior therapy (REBT) approaches in treating irrational beliefs that occasioned work-deviant behaviors among the employees. Conclusion: It is concluded in this study that rational-emotive behavior occupational coaching is beneficial and effective in decreasing unethical work values and work-deviant behaviors among lecturers in Archeology and Religion and Cultural Studies. Therefore, REBT practitioners should liaise with lecturers in Archeology and Religion and Cultural Studies to advance the practice of REBT in workplaces.
Preliminary Study of White Matter Abnormalities and Associations With the Metabotropic Glutamate Receptor 5 to Distinguish Bipolar and Major Depressive Disorders

Background Understanding distinct neurobiological mechanisms underlying bipolar disorder (BD) and major depressive disorder (MDD) is crucial for accurate diagnosis and the discovery of novel and more effective targeted treatments. Previous diffusion-weighted MRI studies have suggested some common frontotemporal corticolimbic system white matter (WM) abnormalities across the disorders. However, critical to the development of more precise diagnosis and treatment is identifying distinguishing abnormalities. Promising candidates include more prominent frontotemporal WM abnormalities observed in BD in the uncinate fasciculus (UF) that have been associated with frontal-amygdala functional dysconnectivity, and with suicide that is especially high in BD. Prior work also showed differentiation in metabotropic glutamate receptor 5 (mGlu5) abnormalities in BD versus MDD, which could be a mechanism affected in the frontotemporal system. However, associations between WM and mGlu5 have not been examined previously as a differentiator of BD. Using a multimodal neuroimaging approach, we examined WM integrity alterations in the disorders and their associations with mGluR5 levels. Methods Individuals with BD (N = 21), MDD (N = 10), and HC (N = 25) participated in structural and diffusion-weighted MRI scanning, and imaging with [18F]FPEB PET for quantification of mGlu5 availability. Whole-brain analyses were used to assess corticolimbic WM matter fractional anisotropy (FA) across BD and MDD relative to HC; abnormalities were tested for associations with mGlu5 availability. Results FA corticolimbic reductions were observed in both disorders and altered UF WM integrity was observed only in BD. In BD, lower UF FA was associated with lower amygdala mGlu5 availability (p < .05). Conclusions These novel preliminary findings suggest important associations between lower UF FA and lower amygdala mGlu5 levels that could represent a disorder-specific neural mechanism in which mGluR5 is associated with the frontotemporal dysconnectivity of the disorder.
Effect of short-term cardiac function changes after cardiac resynchronization therapy on long-term prognosis in heart failure patients with and without diabetes

Background: The relationship between short-term cardiac function changes and long-term outcomes in heart failure (HF) patients undergoing cardiac resynchronization therapy (CRT) remains uncertain, especially when stratified by diabetes status. Objectives: This study aims to assess the association between short-term cardiac function changes and outcomes such as all-cause mortality and HF hospitalization in patients undergoing CRT, stratified by diabetes status. Design: This is a cohort longitudinal retrospective study. Methods: A total of 666 HF patients, treated with CRT between March 2007 and March 2019, were included in this study. Among them, 166 patients (24.9%) were diagnosed with diabetes. Cardiac function was assessed at baseline and again at 6 months, incorporating evaluations of left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left atrial diameter (LAD), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and QRS duration. The QRS duration represents the time required for a stimulus to spread through the ventricles (ventricular depolarization). The primary endpoints of the study were all-cause mortality and HF-related hospitalization. Results: During a median follow-up of 2.51 years, 172 (25.8%) patients died and 197 (29.6%) were hospitalized for HF. Changes in LVEF, LVEDD, and LAD within 6 months had similar effects on adverse outcomes in both diabetic and nondiabetic patients. However, the presence of diabetes significantly modified the association between changes in NT-proBNP and QRS duration and adverse outcomes. Short-term changes in NT-proBNP and QRS duration were positively associated with all-cause mortality and HF hospitalization in patients without diabetes. However, the relationship between short-term changes in NT-proBNP and QRS duration and adverse outcomes was non-linear in diabetic patients. Conclusion: Improvement of cardiac function after CRT implantation can reduce long-term risk of all-cause mortality and HF hospitalization in HF patients. However, the presence of diabetes may affect the association between short-term changes in NT-proBNP and QRS duration and adverse outcomes.