Miracle-dz/UniFAR-FTUs huggingface dataset:
Feasibility and Acceptability of a Digital Intervention to Support Shared Decision-making in Children’s and Young People’s Mental Health: Mixed Methods Pilot Randomized Controlled Trial

Background Interventions to involve parents in decisions regarding children’s and young people’s mental health are associated with positive outcomes. However, appropriately planning effectiveness studies is critical to ensure that meaningful evidence is collected. It is important to conduct pilot studies to evaluate the feasibility and acceptability of the intervention itself and the feasibility of the protocol to test effectiveness. Objective This paper reports the findings from a feasibility and acceptability study of Power Up for Parents, an intervention to promote shared decision-making (SDM) and support parents and caregivers making decisions regarding children’s and young people’s mental health. Methods A mixed method study design was adopted. In stage 1, health care professionals and parents provided feedback on acceptability, usefulness, and suggestions for further development. Stage 2 was a multicenter, 3-arm, individual, and cluster randomized controlled pilot feasibility trial with parents accessing services related to children’s and young people’s mental health. Outcome measures collected data on demographics, participation rates, SDM, satisfaction, and parents’ anxiety. Qualitative data were analyzed using thematic analysis. Google Analytics estimates were used to report engagement with the prototype. Outcomes from both stages were tested against a published set of criteria for proceeding to a randomized controlled trial. Results Despite evidence suggesting the acceptability of Power Up for Parents, the findings suggest that recruitment modifications are needed to enhance the feasibility of collecting follow-up data before scaling up to a fully powered randomized controlled trial. On the basis of the Go or No-Go criteria, only 50% (6/12) of the sites successfully recruited participants, and only 38% (16/42) of parents completed follow-up measures. Nonetheless, health care practitioners and parents generally accessed and used the intervention. Themes describing appearance and functionality, perceived need and general helpfulness, accessibility and appropriateness, and a wish list for improvement emerged, providing valuable information to inform future development and refinement of the intervention. Conclusions Owing to the high attrition observed in the trial, proceeding directly to a full randomized controlled trial may not be feasible with this recruitment strategy. Nonetheless, with some minor adjustments and upgrades to the intervention, this pilot study provides a platform for future evaluations of Power Up for Parents. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN) 39238984; http://www.isrctn. com/ISRCTN39238984. International Registered Report Identifier (IRRID) RR2-10.2196/14571
The effects of pH and chloride concentration on mercury sorption. II. By a soil

SUMMARY The pH of a soil was altered by incubation with either acid or lime, and the sorption of mercury was measured in the absence of chloride and at three chloride concentrations. In the absence of chloride there were only small effects of pH on sorption between pH 4 and 6; sorption decreased at higher pH. Addition of chloride decreased sorption at low pH but had little effect on sorption at high pH. Consequently, in the presence of chloride, sorption increased with increasing pH between pH 4 and 6 and then decreased. Many of the mercury sorption curves were sigmoid. This was explained by assuming that a small amount of complexing material was present in the solution after mixing with the soil. Calculation of the mercury species present in solution was made difficult by uncertainties about the postulated complexing material. Nevertheless, between pH 4 and pH 5.8, it was possible to explain the effects of pH and of chloride concentration on sorption as entirely due to changes in the HgOH+ concentration.
University of Southern Denmark Internet-Delivered Exposure-Based Therapy for Symptom Preoccupation in Atrial Fibrillation

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia in the adult population. AF is associated with a poor quality of life (QoL) and, in many patients, current medical treatments are inadequate in alleviating AF symptoms (eg, palpitations). Patients often present with symptom preoccupation in terms of symptom fear, avoidance, and control behaviors. Internet-delivered cognitive behavior therapy is effective for treating other somatic disorders but has never been evaluated in patients with AF. Objective: The aim of this study is to evaluate the efficacy and feasibility of AF-specific internet-delivered cognitive behavior therapy. Methods: We conducted an uncontrolled pilot study in which 19 patients with symptomatic paroxysmal AF underwent internet-delivered cognitive behavior therapy. Participants completed self-assessments at pretreatment, posttreatment, and at a 6-month follow-up along with handheld electrocardiogram measurements with symptom registration. The treatment lasted 10 weeks and included exposure to physical sensations, reduction in avoidance behavior, and behavioral activation. Results: We observed large within-group improvements in the primary outcome, AF-specific QoL (Cohen d=0.80; P<.001), and in symptom preoccupation (Cohen d=1.24; P<.001) at posttreatment; the results were maintained at the 6-month follow-up. Treatment satisfaction and adherence rates were also high. We observed an increased AF burden, measured by electrocardiogram, at the 6-month follow-up, but a significant decrease was observed in the overestimation of AF symptoms at posttreatment and 6-month follow-up. Exploratory mediation analysis showed that a reduction in symptom preoccupation mediated the effects of internet-delivered cognitive behavior therapy on AF-specific QoL. Conclusions: This study presents preliminary evidence for the potential efficacy and feasibility of a novel approach in treating patients with symptomatic AF with internet-delivered cognitive behavior therapy. Trial Registration: ClinicalTrials.gov NCT02694276; https://clinicaltrials.gov/ct2/show/NCT02694276 (JMIR Cardio 2021;5(1):e24524) doi: 10.2196/24524
Lumping and splitting: The need for precision medicine and “personomics” in endometrial cancer

https://ejgo.org Endometrial cancer is the most common gynecologic malignancy in developed countries [1,2]. Following standard surgical treatment, patients with low grade and “low risk“ [1] tumor confined to the uterus have a very good prognosis, with a 5-year cancer related survival over 95% [3,4]. While the overall oncologic outcomes of women with endometrial cancer are favorable, still a significant rate of recurrences occurs in patients with apparently uterineconfined disease [5].
Improving Bioavailaibity of Hydrophobic Prodrugs through Supramolecular Nanocarriers based on Recombinant Proteins for Osteosarcoma Treatment.

Supramolecular nanodrug assembly originated from supramolecular chemistry is becoming a powerful strategy for medication. The potential of engineered proteins as building blocks for nanoformulation is rarely investigated. Here, we developed a new generation of recombinant protein-based nanodrug carrier, which is very efficient for loading and delivering hydrophobic prodrug aldoxorubicin. Significantly enhanced anti-tumor effects in osteosarcoma (OS) models were observed. Half-life of the nanodrug reached almost two days and the corresponding bioavailability had 17-fold increase. This is significantly superior to other counterpart, empowering long-acting OS treatment scenarios. Importantly, off-target side effects of the prodrug including cardiotoxicity and lung-metastasis were greatly mitigated with our medication. Thus, our assembly strategy potently enables customized designs of advanced nanodelivery systems employing broader biomaterial building blocks for cancer therapy.
Cation Exchange and Mineral Reactions Observed in MX 80 Buffer Samples of the Prototype Repository In Situ Experiment in Äspö, Sweden

Bentonites are candidate materials for high-level radioactive waste (HLRW) repositories and, therefore, are investigated with respect to long-term stability. In order to identify possible bentonite alteration processes, long-term in situ tests are conducted in rock laboratories. The prototype repository in situ experiment (PR) is one of the best examples of this kind of test due to the size of the installation as well as the duration. In the present study, chemical and mineralogical alteration processes of the bentonite MX 80 after an 8 y heating period were investigated. The water content of all samples increased following inflowing Na-Ca-Cl-type granitic groundwater causing cation exchange in the bentonite buffer materials. Exchangeable magnesium was desorbed in the buffer and MgO concentration increased at the bentonite-Cu canister interface; the Mg sink could not be detected, however. CaO also accumulated at this interface mainly as Ca carbonate and Ca sulfate. Cu corrosion products were identified at the bentonite-canister interface by chemical analysis, scanning electron microscopy equipped with energy dispersive X-ray spectroscopy (SEM-EDX), and differential thermal analysis. Up to 0.5 mm into the bentonites Cu could be detected by SEM-EDX. No cristobalite dissolution was observed in contrast to other in situ tests in which iron heaters were used. The corrosion products and the lubricant which was added during manufacturing of the bentonite blocks were mixed with the bentonite at the bentonite-canister interface. A quantitative measure of that mixture was the decrease in the cation exchange capacity (CEC). The CEC also reduced in all other samples, however, compared to the CECs of the reference samples, particularly in the warmer deposition hole 5 compared to the colder deposition hole 6. Overall, the PR in situ experiment proved that cation exchange reactions occurred in full-scale bentonite buffer experiments in all bentonite blocks but structural degradation of smectite could not be identified.
A spectroscopic method based on the anthocyanin copigmentation interaction and applied to the quantitative study of molecular complexes

When monitored by visible absorption spectrometry, anthocyanin copigmentation appears to be of wide application in the field of quantitative investigation of molecular complexes in general. This is made possible by the strong hyperchromic effect in the visible range involving the influence of the copigment in slightly acidic aqueous solutions. For instance, when we add to a solution containing both malvin (the pigment) and chlorogenic acid (the copigment) a third species able to interact, in a non-covalent way, with the copigment, the effect produced by the presence of the new complex (chlorogenic acid–third species), on the copigmentation reaction itself, is significant. Two types of chlorogenic acid molecular associations have been investigated. The first one corresponds to the inclusion of chlorogenic acid into α- and β-cyclodextrins, both macrocycles being inert with respect to malvin. Concerning the study of inclusion complexes, our method remains valid when the guest molecule is not a copigment, provided that malvin is replaced by an anthocyanic pigment capable of entering the macrocycle cavity. Callistephin and chrysanthemin, two very abundant naturally occurring anthocyanins, fit this requirement. Inclusion of the latter pigments into β-cyclodextrin is characterized by a much better inclusion of their colourless forms than of their coloured flavylium cations, leading to what may be called an ‘anti-copigment’ effect. The second type of chlorogenic acid molecular association, investigated with our method, corresponds to the stacking of chlorogenic acid, the copigment, with the third species, which is now also a copigment. The two interacting copigments are chlorogenic acid and caffeine. The chlorogenic acid–caffeine stability constant was measured as 36 (±9) dm3 mol–1 at 25 °C, a value in good agreement with that reported in the literature.
Anomalous mechanics of Zn2+-modified fibrin networks

Significance Fibrin forms a three-dimensional network in blood clots during hemostasis that must be strong enough to stop bleeding yet flexible enough to withstand pressure variations of arterial flow. During clotting, activated platelets release Zn2+ whose effect on the structure and mechanics of fibrin gels is poorly understood. We show that Zn2+ unexpectedly reduces fibrin gel stiffness even though it induces bundling that coarsens the network. This results from weak interactions between the fibrils that make up the bundle, leading to a loose coupling that results in a softer network. These results provide important insight into the impact of Zn2+ on the behavior of blood clots and represent a different class of network that becomes weaker even with increasing bundle thickness. Fibrin is the main component of blood clots. The mechanical properties of fibrin are therefore of critical importance in successful hemostasis. One of the divalent cations released by platelets during hemostasis is Zn2+; however, its effect on the network structure of fibrin gels and on the resultant mechanical properties remains poorly understood. Here, by combining mechanical measurements with three-dimensional confocal microscopy imaging, we show that Zn2+ can tune the fibrin network structure and alter its mechanical properties. In the presence of Zn2+, fibrin protofibrils form large bundles that cause a coarsening of the fibrin network due to an increase in fiber diameter and reduction of the total fiber length. We further show that the protofibrils in these bundles are loosely coupled to one another, which results in a decrease of the elastic modulus with increasing Zn2+ concentrations. We explore the elastic properties of these networks at both low and high stress: At low stress, the elasticity originates from pulling the thermal slack out of the network, and this is consistent with the thermal bending of the fibers. By contrast, at high stress, the elasticity exhibits a common master curve consistent with the stretching of individual protofibrils. These results show that the mechanics of a fibrin network are closely correlated with its microscopic structure and inform our understanding of the structure and physical mechanisms leading to defective or excessive clot stiffness.
SpoT-Mediated NapA Upregulation Promotes Oxidative Stress-Induced Helicobacter pylori Biofilm Formation and Confers Multidrug Resistance

Recently, the incidence of drug-resistant Helicobacter pylori infection has increased. Biofilm formation confers multidrug resistance on bacteria. ABSTRACT Recently, the incidence of drug-resistant Helicobacter pylori infection has increased. Biofilm formation confers multidrug resistance on bacteria. Moreover, it has been found that the formation of biofilms on the surfaces of gastric mucosae is an important reason for the difficulty of eradication of H. pylori. The mechanisms underlying H. pylori biofilm formation in vivo have not been elucidated. Reactive oxygen species (ROS) released by the host immune cells in response to H. pylori infection cannot effectively clear the pathogen. Moreover, the extracellular matrix of the biofilm protects the bacteria against ROS-mediated toxicity. This study hypothesized that ROS can promote H. pylori biofilm formation, and treatment with low concentrations of hydrogen peroxide (H2O2) promoted this process in vitro. Comparative transcriptome analysis of planktonic and biofilm-forming cells revealed that the expression of SpoT, a (p)ppGpp (guanosine 3′-diphosphate 5′-triphosphate and guanosine 3′,5′-bispyrophosphate) synthetase/hydrolase, is upregulated in H2O2-induced biofilms and that knockout of spoT inhibited H. pylori biofilm formation. Additionally, this study used weighted gene coexpression network analysis to examine the key target molecules involved in SpoT regulation. The analysis revealed that neutrophil-activating protein (NapA; HP0243) promoted H2O2-induced biofilm formation and conferred multidrug resistance. Furthermore, vitamin C exhibited anti-H. pylori biofilm activity and downregulated the expression of napA in vitro. These findings provide novel insights into the clearance of H. pylori biofilms.
The relationship between neuropsychological dispersion, processing speed and memory after electrical injury

ABSTRACT Introduction: Previous studies of neuropsychological performance in electrical injury (EI) patients have produced evidence of deficits in various cognitive domains, but studies have yet to investigate relationships among performance in cognitive domains post-EI. This study examined whether dispersion among neuropsychological test scores was associated with injury parameters and neuropsychological performance in EI patients. Additionally, we examined whether dispersion, processing speed and/or executive abilities explain variance in episodic verbal and visual memory performance among EI patients. Method: Data from 52 post-acute EI patients undergoing outpatient evaluation with objectively-verified valid neuropsychological test performance were examined. Tests included measures of verbal and visual memory, processing speed, and executive functioning. Dispersion was calculated from executive functioning and processing speed scores. Results: Dispersion was not related to mean performance or injury characteristics, but was significantly negatively correlated with performance on a test of processing speed, suggesting that increased dispersion is associated with reduced cognitive efficiency post-EI. Delayed visual memory was related to both dispersion scores and processing speed. Stepwise regression equations predicting delayed memory determined that processing speed most significantly predicted delayed visual memory, even after controlling for immediate visual memory. No significant relationships emerged between verbal memory and non-memory neuropsychological scores. Conclusions: This is the first study to examine neuropsychological dispersion and relationships among domains of cognitive functioning in EI. Current results suggested that neuropsychological dispersion is not a marker of general functioning or severity of injury in EI patients, but may represent more specific processing speed abilities. Processing speed predicts delayed visual memory performance in EI patients, which should be considered in interpreting test scores during evaluations.
Laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma: A propensity case-matched analysis of the long-term survival

Backgrounds/Aims Despite the widespread popularity of laparoscopic surgery, laparoscopic liver resection (LLR) remains in evolution. This study aimed to compare the long-term outcomes for patients undergoing laparoscopic versus open hepatectomy for hepatocellular carcinoma (HCC) ≤7 cm. Methods Patients diagnosed with HCC treated by hepatectomy from October 2000 to May 2019 were included. Excluding tumors larger than 7 cm, 1:2 propensity score matching was performed between laparoscopic and open hepatectomies. The perioperative outcomes, 5-year overall survival (OS) and disease-free survival (DFS) of the two groups were compared. Results Forty-five patients who underwent LLR were matched to 90 open hepatectomy (OH) during the same period. LLR group had shorter median hospital stay (5 days vs. 9 days, p=0.00) but required longer operative time (326.0 minutes vs. 272.5 minutes, p=0.018) than the OH group. The 5-year overall survival was better in the LLR group (84.9% vs. 61.1%; p=0.036), though there was no significant difference in the 5-year disease free survival (20.0% vs. 22.2%, p=0.613). The rate of R0 resection was comparable between the 2 groups with a slightly better margin distance in the LLR (5 mm vs. 3 mm, p=0.043). Conclusions Laparoscopic liver resection is safe and feasible for cirrhotic patients with HCC size up to 7 cm. It has better short-term outcomes and comparable perioperative blood loss and complication rates. The resection margin is not jeopardized and the 5-year overall and disease-free survivals are comparable with the open group.
Predictors of Patient-Centered Communication among U.S. Adults: Analysis of the 2017-2018 Health Information National Trends Survey (HINTS)

An essential component of patient-centered care is the communication between patients and their providers, which can affect patients’ health outcomes A cancer care model, developed by Epstein and Street, includes a multi-dimensional patient-centered communication (PCC) framework with six functions: foster healing relationships, exchange information, respond to emotions, manage uncertainty, make decisions, and enable patient self-management. Seven domains that describe the functions were included on the Health Information National Trends Survey (HINTS) to assess PCC. We examined the association between sociodemographic and health-related factors and PCC as well as how U.S. adults, by different age groups, ranked different domains of PCC. Nationally representative data (n = 5,738) from 2017 to 2018 HINTS were merged to examine predictors of PCC among U.S. adults. Weighted statistics describe the study sample and prevalence for ratings of PCC domains. A multivariate linear regression model was computed to assess associations among predictors and PCC. Participants rated their communication with doctors in the last year with an overall mean of 80 out of 100. Older age, those reporting excellent health, and those with higher confidence in taking care of one’s health predicted better PCC. Individuals who reported being non-Hispanic Asian and having lower household income were associated with poorer communication. Participants’ lowest rating of PCC concentrated on providers dealing with their emotional needs. Findings suggest that many patients do not feel that their providers adequately manage, communicate, nor respond to their emotional needs. Future efforts should enhance interpersonal exchanges among sub-populations who report poorer communication with providers during clinical visits.