Miracle-dz/UniFAR-FTUs huggingface dataset:
Protocol of a mixed-method randomised controlled pilot study evaluating a wilderness programme for adolescent and young adult cancer survivors: the WAYA study

Introduction The majority of childhood, adolescent and young adult (AYA) cancer survivors suffer from long-term and late effects such as fatigue, psychological distress or comorbid diseases. Effective health promotion strategies are needed to support the health of this vulnerable group. This protocol provides a methodological description of a study that aims to examine the feasibility and safety of performing a randomised clinical trial (RCT) on a wilderness programme that is developed to support the health of AYA cancer survivors. Methods and analysis The pilot RCT study has a mixed-method design, including quantitative and qualitative evaluations. Participants are AYAs, aged 16–39 years, that have been diagnosed with cancer during childhood, adolescence or young adulthood. A total of 40 participants will be randomly assigned to a wilderness programme (n=20) or a holiday programme (n=20). Both arms include participation in an 8-day summer programme, followed by a 4-day programme 3 months later. Primary outcomes are feasibility and safety parameters such as time to recruitment, willingness to be randomised, programme adherence and adverse effects. Secondary outcomes include self-reported health such as self-esteem, quality of life, self-efficacy and lived experiences. Descriptive statistics will be used to analyse outcomes and explore indications of differences between the programmes. Interviews are analysed by directed content analysis and hermeneutic phenomenology. A convergent parallel mixed-method analysis design will be applied to integrate quantitative and qualitative data. Results of this feasibility study will inform the preparation for a larger RCT with AYA cancer survivors. Ethics and dissemination The study protocol is approved by the Swedish Ethical Review Authority (reference: 2020-00239). This study will be performed between January 2021 and December 2023. Results will be published in international peer-reviewed journals, presented at conferences and disseminated to participants, cancer societies, healthcare professionals and outdoor instructors. Trial registration number NCT04761042.
Treatment of valvular heart disease in young patients—“early evidence” versus “latest fashion”

Is the performance of locally manufactured mechanical valve prostheses relevant for modern cardiac surgery, in which mechanical valve replacement has become a rarity? This question comes to mind reading the article in this issue of the Journal demonstrating equal outcomes of the TTK Chitra tilting disk mechanical heart valve prostheses in comparison to the SJM bi‐leaflet blockbuster. The evidence documenting efficacy of mechanical valve replacement stems from the early ages of cardiac surgery, but often demonstrates superior outcomes in terms of survival and hemodynamics. Yet, the latest fashion in the Western world consists biological choices in combination with new transcatheter techniques (valve in valve options) or the Ozaki or Ross procedures. As long‐term results are often missing and documented advantages for mechanical valves stems from early evidence, the local emphasis of mechanical valve replacement may possibly result in superior individual prognoses compared to following the Western world's latest fashions. Individual patient information and decision making moves into focus.
Clonal hematopoiesis is associated with increased risk of severe neurotoxicity in axicabtagene ciloleucel therapy of large B-cell lymphoma.

To explore the role of clonal hematopoiesis (CH) on chimeric antigen receptor (CAR) T therapy outcomes, we performed targeted deep-sequencing on buffy coats collected during the 21 days before lymphodepleting chemotherapy from 114 large B-cell lymphoma patients treated with anti-CD19 CAR T cells. We detected CH in 42 (36.8%) pre-treatment samples, most frequently in PPM1D (19/114) and TP53 (13/114) genes. Grade {greater than or equal to}3 immune-effector cell-associated neurotoxicity syndrome (ICANS) incidence was higher in CH-positive patients than CH-negative patients (45.2% vs. 25.0%, p=0.038). Higher toxicities with CH were primarily associated with DNMT3A, TET2 and ASXL1 genes (DTA mutations). Grade {greater than or equal to}3 ICANS (58.9% vs. 25%, p=0.02) and {greater than or equal to}3 cytokine release syndrome (17.7% vs. 4.2%, p=0.08) incidences were higher in DTA-positive than CH-negative patients. The estimated 24-month cumulative incidence of therapy-related myeloid neoplasms after CAR T therapy was higher in CH-positive than CH-negative patients (19% [95%CI: 5.5-38.7] vs. 4.2% [95%CI: 0.3-18.4], p=0.028).
Iodine status during child development and hearing ability: a systematic review

Abstract Iodine, through the thyroid hormones, is required for the development of the auditory cortex and cochlea (the sensory organ for hearing). Deafness is a well-documented feature of endemic cretinism resulting from severe iodine deficiency. However, the range of effects of suboptimal iodine intake during auditory development on the hearing ability of children is less clear. We therefore aimed to systematically review the evidence for the association between iodine exposure (i.e. intake/status/supplementation) during development (i.e. pregnancy and/or childhood) and hearing outcomes in children. We searched PubMed and Embase and identified 330 studies, of which thirteen were included in this review. Only three of the thirteen studies were of low risk of bias or of good quality, this therefore limited our ability to draw firm conclusions. Nine of the studies (69 %) were in children (one RCT, two non-RCT interventions and six cross-sectional studies) and four (31 %) were in pregnant women (one RCT, one cohort study and two case reports). The RCT of iodine supplementation in mildly iodine-deficient pregnant women found no effect on offspring hearing thresholds. However, hearing was a secondary outcome of the trial and not all women were from an iodine-deficient area. Iodine supplementation of severely iodine-deficient children (in both non-RCT interventions) resulted in improved hearing thresholds. Five of six cross-sectional studies (83 %) found that higher iodine status in children was associated with better hearing. The current evidence base for the association between iodine status and hearing outcomes is limited and further good-quality research on this topic is needed.
Seropositivity for Coxiella burnetii in suspected patients with dengue in São Paulo state, Brazil

Q fever and brucellosis are zoonoses that cause fever and other systemic clinical signs in humans; their occurrences are neglected and the differential diagnosis for some diseases is disregarded. This study aimed to investigate the seropositivity for Coxiella burnetii and Brucella spp. antibodies in patients suspected of dengue from 38 municipalities in the state of São Paulo, Brazil. The samples (n = 604) were obtained by convenience from the Adolfo Lutz Institute serum bank. Sera were subjected to an indirect immunofluorescence assay (IFA) using in-house and commercial diagnostic protocols to evaluate C. burnetii positivity. For Brucella spp. , sera were subjected to rapid plate serum agglutination with buffered acidified antigen (AAT), slow tube serum agglutination (SAL), and 2-mercaptoethanol (2-ME) techniques. Associations and statistical inferences of the results were performed by logistic regression according to the clinical and demographic variables collected from the patients. Statistical analyses were performed using Statistical Analysis Software (SAS) and associations were considered when p value was <0.05. In all, 129 patients showed positive results for Q fever, indicating a seropositivity of 21.4% (95% CI 18.15–24.85). Patients with 14–20 days of symptoms had 2.12 (95% CI 1.34–3.35) times more chances of being seropositive for Q fever than patients with 7–13 days, and patients with 21–27 days of fever had 2.62 (95% CI 1.27–5.41) times more chances of being seropositive for Q fever than patients with 7–13 days. For the other variables analyzed, there were no significant associations between the groups. No positivity for brucellosis was observed. This is the most comprehensive study of people seropositive for Q fever in São Paulo state and provides additional data for the medical community in Brazil. It is suggested that Q fever may be an important differential diagnosis of febrile illnesses in the region, demanding the government’s attention and investment in health.
Published population pharmacokinetic models of valproic acid in adult patients: a systematic review and external validation in a Chinese sample of inpatients with bipolar disorder

ABSTRACT Background This study reviewed all published valproic acid (VPA) population pharmacokinetic (PPK) models in adult patients and assessed them using external validation methods to determine predictive performance. Methods Thirteen published PPK models (labeled with letters A to M) not restricted to children were identified in PubMed, Embase, and Web of Science databases. They were evaluated in a sample totaling 411 serum concentrations from 146 adult inpatients diagnosed with bipolar disorder in a Chinese hospital. Serum concentrations of VPA were analyzed by validated ultra-performance liquid chromatography-tandem mass spectrometry. Performance was assessed by four tests (prediction-based diagnostics, visual predictive checks, normalized prediction distribution error, and Bayesian forecasting). Results Models K and L, developed in large samples of Chinese and Thai patients, showed good performance in our Chinese dataset. Models H and J demonstrated good performance in 2 and 3 of the 4 tests, respectively. Another seven models exhibited intermediate performance. The models with the worst performance, F and M, could not be improved by Bayesian forecasting. Conclusion In our validation study, the most important factors contributing to good performance were absence of children, Asian ethnicity, one-compartment models, and inclusion of body weight and VPA dose in previously published models.
Nature and nurture. Genetic and environmental factors on the relationship between back pain and sleep quality

Chronic low back pain (LBP), neck pain (NP), and sleep quality (SQ) are genetically influenced. All three conditions frequently co‐occur and shared genetic aetiology on a pairwise base has been reported. However, to our knowledge, no study has yet investigated if these three conditions are influenced by the same genetic and environmental factors and the extent and pattern of genetic overlap between them, hence the current research.
The discovery and optimisation of solid state materials for the energy and the electronics sectors using MBE based methodologies

Compositional gradient thin film materials prepared by simultaneously combining the atomic constituents through the use of Knudsen cells, cracking sources, e-beam sources or plasma atom sources provide a powerful route to materials discovery and optimisation. A kinetically favourable route to solid state crystalline materials is provided, often through the synthesis of the metastable nano-crystalline or amorphous phases. A consequence is that complex materials can be produced at lower crystalisation temperatures, and that high quality, dense thin films are produced. The addition of “wedge” shutters allows excellent control of composition space over areas suitable for screening on micro-fabricated MEMS arrays. A wide range of elements can be incorporated in the materials which are of high purity as a result of the UHV environment for synthesis. The method is also suitable for producing combinatorial ranges of supported nano-particles in the size range (1-10nm) where strong size dependent catalytic activity is observed. These important advantages are exemplified here in the synthesis of a range of platinum particle sizes on carbon which have been subsequently screened for oxygen reduction activity in an environment appropriate to mimicking the cathode of a low temperature PEM fuel cell. A second example is provided in the comparitive direct and indirect synthesis of CIGS materials, and their primary screening for potential thin film photovoltaic applications
Thermosynechococcus switches the direction of phototaxis by a c-di-GMP-dependent process with high spatial resolution

Many cyanobacteria, which use light as an energy source via photosynthesis, show directional movement towards or away from a light source. However, the molecular and cell biological mechanisms for switching the direction of movement remain unclear. Here, we visualized type IV pilus-dependent cell movement in the rod-shaped thermophilic cyanobacterium Thermosynechococcus vulcanus using optical microscopy at physiological temperature and light conditions. Positive and negative phototaxis were controlled on a short time scale of 1 min. The cells smoothly moved over solid surfaces towards green light, but the direction was switched to backward movement when we applied additional blue light illumination. The switching was mediated by three photoreceptors, SesA, SesB, and SesC, which have cyanobacteriochrome photosensory domains and synthesis/degradation activity of the bacterial second messenger cyclic dimeric GMP (c-di-GMP). Our results suggest that the decision-making process for directional switching in phototaxis involves light-dependent changes in the cellular concentration of c-di-GMP. Direct visualization of type IV pilus filaments revealed that rod-shaped cells can move perpendicular to the light vector, indicating that the polarity can be controlled not only by pole-to-pole regulation but also within-a-pole regulation. This study provides insights into previously undescribed rapid bacterial polarity regulation via second messenger signalling with high spatial resolution.
Dental age estimation of Malaysian children: a comparison of two-dimensional versus three-dimensional imaging analyses of the developing root apices

Abstract Aim This study compared the effectiveness of the three-dimensional (3D) cone beam computed tomography (CBCT) method of age estimation developed by Asif et al. with two-dimensional Cameriere’s method. Subjects and methods CBCT images belonging to 129 Malaysian Chinese and Malay ethnic groups aged 7–14 years were investigated and analysed. Results The results indicated a strong correlation between chronological age and the predictor variables for both Cameriere’s (r = 0.984) and Asif’s (r = 0.988) methods of age estimation. Fisher Z test analysis indicated no statistically significant difference in the correlation values between the two methods. Mean absolute error (MAE) value of 0.613 was observed for Cameriere’s and 0.290 was observed for Asif’s method. Conclusions The results indicated that the methods of age estimation from both Asif et al. and Cameriere et al. are applicable on Malaysian children. However, Asif et al.’s 3D CBCT method of age estimation resulted in greater accuracy and reliability in estimating chronological age.
Clinically Localized Prostate Cancer: AUA/ASTRO Guideline, Part I: Introduction, Risk Assessment, Staging, and Risk-Based Management

Purpose: The summary presented herein represents Part I of the three-part series dedicated to Clinically Localized Prostate Cancer: AUA/ASTRO Guideline, discussing risk assessment, staging, and risk-based management in patients diagnosed with clinically localized prostate cancer. Please refer to Parts II and III for discussion of principles of active surveillance, surgery and follow-up (Part II), and principles of radiation and future directions (Part III). Materials and Methods: The systematic review utilized to inform this guideline was conducted by an independent methodological consultant. A research librarian conducted searches in Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. The methodology team supplemented searches of electronic databases with the studies included in the prior AUA review and by reviewing reference lists of relevant articles. Results: The Clinically Localized Prostate Cancer Panel created evidence- and consensus-based guideline statements to aid clinicians in the management of patients with clinically localized prostate cancer. Statements regarding risk assessment, staging, and risk-based management are detailed herein. Conclusions: This guideline aims to inform clinicians treating patients with clinically localized prostate cancer. Continued research and publication of high-quality evidence from future trials will be essential to further improve care for these men.
The role of maladaptive emotion regulation in the bidirectional relation between sleep and depression in college students during the COVID-19 pandemic

ABSTRACT Background: Emotion regulation deficits are an outcome and risk factor for both insomnia and depression, suggesting that maladaptive emotion regulation might in part explain the bi-directional links between sleep and depression. The current study tests this hypothesis during the COVID-19 pandemic in emerging adult undergraduate students, a high-risk population for both depression and sleep disturbance. Methods: A sample of 154 undergraduate students completed a series of online questionnaires bi-weekly on sleep, depression, and emotion regulation strategies across eight weeks during the early days of the COVID-19 pandemic (April 2nd to June 27th, 2020). Results: Sleep disturbance and depression prospectively predicted one another across eight weeks, and both directions were mediated by maladaptive emotion regulation. However, sleep and depression failed to predict change in one another controlling for baseline measures, directly or via emotion regulation. Conclusions: The results suggest that maladaptive emotion regulation is a potential mechanism through which sleep disturbance and depression help maintain high levels of one another in college students during the COVID-19 pandemic. Therefore, emotion regulation deficits are potentially an important target for interventions to interrupt the sleep disturbance-depression cycle.
Interprofessional collaboration in palliative dementia care through the eyes of informal caregivers

A qualitative study was conducted to examine the experiences of informal caregivers of persons with dementia pertaining interprofessional collaboration with and among healthcare professionals in home care (HC), nursing homes and during home to nursing home transitions in palliative care. Semi-structured interviews were performed with bereaved informal caregivers. Data were analysed using a critical realist approach. The two main themes that emerged were: (1) Informal caregivers’ roles in interprofessional collaboration with healthcare professionals and (2) Informal caregivers’ perception of interprofessional collaboration among healthcare professionals. Informal caregivers’ roles were identified in three collaboration processes: information exchange, care process and shared decision-making. Interprofessional collaboration among healthcare professionals was more perceptible on the collaboration outcome level (e.g. being up to date with the health status of the person with dementia; acting proactive, being adequate and consistent in the care process; and giving a warm welcome) than on the collaboration processes level (e.g. communicating and being involved in team processes). Our study revealed that intrinsic and extrinsic factors and interprofessional collaboration among healthcare professionals affected informal caregivers’ collaborative roles. In summary, our study showed that informal caregivers have important roles as team members in the continuity and quality of palliative care for persons with dementia.
Evaluation of Stop the Bleed Training Among High School Personnel: A Qualitative Study

BACKGROUND: Uncontrolled hemorrhage is the primary preventable cause of death following trauma. Stop the Bleed training exists to promote identification and basic treatment of life-threatening bleeding in the prehospital or community setting. Limited qualitative research is available on participant evaluation of hemorrhage control training for laypersons. OBJECTIVE: To evaluate the experience and satisfaction with Stop the Bleed training among lay community members in an urban public school setting. METHODS: Three group interviews were conducted with public high school personnel (faculty and staff) who received Stop the Bleed training. Personnel were asked to evaluate the training and provide suggestions for improvement. Responses were digitally recorded and transcribed verbatim. Content analysis for common themes was performed using NVivo. RESULTS: A total of eight participants were interviewed. Participants expressed satisfaction with hands-on training and dissatisfaction with crowded and rushed training conditions. Major themes included: (1) skill acquisition, retention, and decay, (2) training format and setting, and (3) use of simulation. CONCLUSIONS: Current Stop the Bleed training is considered satisfactory among public school educators. Suggestions for improvement include annual retraining programs and simulation-enhanced training opportunities.
Prediction of emergency cerclage outcomes in women with cervical insufficiency: The role of inflammatory, angiogenic, and extracellular matrix-related proteins in amniotic fluid

Objective We aimed to determine whether various novel inflammatory, angiogenic, and extracellular matrix-related mediators in amniotic fluid (AF) can independently predict emergency cerclage outcomes in women with acute cervical insufficiency (CI). Methods This was a retrospective cohort study conducted among 50 singleton pregnant women (18–25 weeks) who underwent emergency cerclage for CI and were subjected to amniocentesis. The AF samples were assayed for endoglin, endostatin, haptoglobin, insulin-like growth factor-binding protein (IGFBP)-3, -4, kallistatin, lumican, macrophage colony-stimulating factor (M-CSF), pentraxin 3, p-selectin, receptor for advanced glycation end products (RAGE), resistin, transforming growth factor beta-induced (TGFBI), and vitamin D-binding protein (VDBP) levels. Interleukin (IL)-6 levels in the AF were also measured for comparison with potential biomarkers assessed in this study. The primary endpoint was spontaneous preterm delivery (SPTD) at <34 weeks following emergency cerclage. Results The AF levels of pentraxin 3, RAGE, and resistin were significantly higher in women who had SPTD at <34 weeks after cerclage placement (pentraxin-3: P = 0.003; RAGE: P = 0.041; and resistin; P = 0.002). In multivariate analysis, elevated AF levels of pentraxin 3 (P = 0.007) and resistin (P = 0.006), but not those of RAGE (P = 0.069), were independently associated with the occurrence of SPTD at <34 weeks after cerclage, following adjustment for baseline clinical variables (e.g., cervical dilation). The area under the curve (AUC) values of AF pentraxin 3, RAGE, and resistin for the prediction of SPTD at <34 weeks were 0.749, 0.669, and 0.770, respectively, which were similar to those of AF IL-6. However, in univariate analyses, no differences in the AF levels of endoglin, endostatin, haptoglobin, IGFBP-3, IGFBP-4, kallistatin, lumican, p-selectin, TGFBI, and VDBP were found to be associated with SPTD at <34 weeks after cerclage placement. Conclusions In women with acute CI, the AF levels of pentraxin 3, RAGE, and resistin could be useful novel biomarkers for predicting SPTD following emergency cerclage. However, the clinical utility of these new biomarkers should be validated in larger multicenter studies.