Miracle-dz/UniFAR-FTUs huggingface dataset:
Knowledge and Power Relations in Older Patients’ Communication About Medications Across Transitions of Care

Communicating about medications across transitions of care is a challenging process for older patients. In this article, we examined communication processes between older patients, family members, and health professionals about managing medications across transitions of care, focusing on older patients’ experiences. A focused ethnographic design was employed across two metropolitan hospitals. Data collection methods included interviews, observations, and focus groups. Following thematic analysis, data were analyzed using Fairclough’s Critical Discourse Analysis and Medication Communication Model. Older patients’ medication knowledge and family members’ advocacy challenged unequal power relations between clinicians and patients and families. Doctors’ use of authoritative discourse impeded older patients’ participation in the medication communication. Older patients perceived that nurses’ involvement in medication communication was limited due to their task-related routines. To reduce the unequal power relations, health professionals should be more proactive in sharing information about medications with older patients across transitions of care.
Restrained eating behaviour, anorexia nervosa and food consumption between children and adolescents: a scoping review

Abstract Anorexia nervosa (AN) and restrained eating behaviour (REB) are characterised by reduced food intake to achieve body weight loss. This scope review aimed to describe the existing evidence on the association between AN, restrictive eating behaviour and food consumption. Studies with children and adolescents of both sexes of all races and ethnicities were included. Experimental and observational studies, systematic reviews, meta-analysis, case reports or series, conference abstracts, dissertations and theses were also included. The search was conducted in ten electronic databases and grey literature without language restriction on 14 November 2020. Twenty-four studies met the inclusion criteria. Most studies included girls and identified lower intake of energy content, fat and certain micronutrients. There was also a higher intake of caffeine, fibre, vegetables, legumes and fruits and a lower intake of low-quality snack, fast food, sweets and foods with high carbohydrate and fat contents. The need to improve the quality of the diet among study participants was also identified. Thus, it is recommended that the evaluation of food consumption be careful to develop effective prevention strategies for the development of AN/REB and minimise nutritional deficiencies in these individuals.
The efficacy of vitamin B6 as an adjunctive therapy to lithium in improving the symptoms of acute mania in patients with bipolar disorder, type 1; a double‐blind, randomized, placebo‐controlled, clinical trial

Vitamin B6 has been linked to a variety of probable roles, including anti‐inflammatory, homocysteine‐lowering, serotonin‐regulating, and dopamine‐lowering. In this study, we investigated the possible effect of vitamin B6 on bipolar disorder in manic episode with psychotic feature in a placebo‐controlled double‐blind clinical trial in a psychiatric hospital.
Functional Consequences of Poor Binaural Hearing in Development: Evidence From Children With Unilateral Hearing Loss and Children Receiving Bilateral Cochlear Implants

Poor binaural hearing in children was hypothesized to contribute to related cognitive and academic deficits. Children with unilateral hearing have normal hearing in one ear but no access to binaural cues. Their cognitive and academic deficits could be unique from children receiving bilateral cochlear implants (CIs) at young ages who have poor access to spectral cues and impaired binaural sensitivity. Both groups are at risk for vestibular/balance deficits which could further contribute to memory and learning challenges. Eighty-eight children (43 male:45 female, aged 9.89 ± 3.40 years), grouped by unilateral hearing loss (n = 20), bilateral CI (n = 32), and typically developing (n = 36), completed a battery of sensory, cognitive, and academic tests. Analyses revealed that children in both hearing loss groups had significantly poorer skills (accounting for age) on most tests than their normal hearing peers. Children with unilateral hearing loss had more asymmetric speech perception than children with bilateral CIs (p < .0001) but balance and language deficits (p = .0004, p < .0001, respectively) were similar in the two hearing loss groups (p > .05). Visuospatial memory deficits occurred in both hearing loss groups (p = .02) but more consistently across tests in children with unilateral hearing loss. Verbal memory was not significantly different than normal (p > .05). Principal component analyses revealed deficits in a main cluster of visuospatial memory, oral language, mathematics, and reading measures (explaining 46.8% data variability). The remaining components revealed clusters of self-reported hearing, balance and vestibular function, and speech perception deficits. The findings indicate significant developmental impacts of poor binaural hearing in children.
Long noncoding RNA HAGLR sponges miR‐338‐3p to promote 5‐Fu resistance in gastric cancer through targeting the LDHA‐glycolysis pathway

Gastric cancer (GC) is one of the most common human malignancies due to its invasiveness and metastasis. 5‐Fu is a widely applied chemotherapeutic agent against GC. Although 5‐Fu therapy has achieved improvements in GC treatment, a large fraction of patients developed drug resistance which significantly limited its clinical applications. Recent studies revealed the pivotal roles of long noncoding RNAs (lncRNAs) in tumorigenesis and progressions of various tumors, including GC. However, the biological roles and molecular mechanisms of lncRNA HAGLR in GC remain unclear. Here, we report HAGLR was upregulated in both GC tissues and cell lines. In addition, HAGLR was associated with a poorly survival rate of GC patients. Blocking HAGLR inhibited GC cells proliferation and sensitized GC cells to 5‐Fu. Bioinformatical analysis and luciferase assay demonstrated that HAGLR sponged microRNA (miR)‐338‐3p, which functions as a tumor suppressor in GC to downregulate its expressions. Moreover, from the established 5‐Fu resistant GC cell line (HGC27 5‐Fu R), we detected significantly elevated HAGLR, downregulated miR‐338‐3p, and glucose metabolism compared with parental HGC27 cells. We identified lactate dehydrogenase‐A (LDHA), a glucose metabolism key enzyme, was the direct target of miR‐338‐3p in GC cells. Rescue experiments demonstrated that restoration of miR‐338‐3p in HAGLR‐overexpressing HGC27 5‐Fu R cells successfully overrode the HAGLR‐promoted 5‐Fu resistance through targeting LDHA. Taken together, this study revealed essential roles and molecular mechanisms for the HAGLR‐mediated 5‐Fu resistance in GC, contributing to the development of new noncoding RNA‐based therapeutic strategies against chemoresistant GC.
Airborne Fumigants and Residual Chemicals in Shipping Containers Arriving in New Zealand

Abstract Background Airborne fumigants and other hazardous chemicals inside unopened shipping containers may pose a risk to workers handling containers. Methods Grab air samples from 490 sealed containers arriving in New Zealand were analysed for fumigants and other hazardous chemicals. We also collected grab air samples of 46 containers immediately upon opening and measured the total concentration of volatile organic compounds in real-time during ventilation. Additive Mixture Values (AMV) were calculated using the New Zealand Workplace Exposure standard (WES) and ACGIH Threshold Limit Values (TLV) of the 8-h, time-weighted average (TWA) exposure limit. Regression analyses assessed associations with container characteristics. Results Fumigants were detectable in 11.4% of sealed containers, with ethylene oxide detected most frequently (4.7%), followed by methyl bromide (3.5%). Other chemicals, mainly formaldehyde, were detected more frequently (84.7%). Fumigants and other chemicals exceeded the WES/TLV in 6.7%/7.8%, and 7.8%/20.0% of all containers, respectively. Correspondingly, they more frequently exceeded ‘1’ for the AMV-TLV compared to the AMV-WES (25.7% versus 7.8%). In samples taken upon opening of doors, fumigants were detected in both fumigated and non-fumigated containers, but detection frequencies and exceedances of the WES, TLV, and AMVs were generally higher in fumigated containers. Detection frequencies for other chemicals were similar in fumigated and non-fumigated containers, and only formaldehyde exceeded both the WES and TLV in both container groups. Volatile compounds in container air reduced rapidly during ventilation. Some cargo types (tyres; personal hygiene, beauty and medical products; stone and ceramics; metal and glass; and pet food) and countries of origin (China) were associated with elevated airborne chemical and fumigant concentrations. Conclusion Airborne chemicals in sealed containers frequently exceed exposure limits, both in fumigated and non-fumigated containers, and may contribute to short-term peak exposures of workers unloading or inspecting containers.
Frontal Alpha Asymmetry in Posttraumatic Stress Disorder: Group Differences Among Individuals With and Without PTSD During an Inhibitory Control Task

The current study examined frontal alpha asymmetry (FAA) as a marker of approach- and avoidance-related prefrontal activity in participants with and without trauma exposure and posttraumatic stress disorder (PTSD). We investigated FAA in an inhibitory control paradigm (threatening vs nonthreatening cues) under 2 levels of cognitive demand (baseline: images constant within a block of trials; vs filtering: images varied randomly within a block) in 3 groups of participants: individuals with PTSD (n = 16), exposed to trauma but without PTSD (n = 14), and a control group without PTSD or trauma exposure (n = 15). Under low demand (baseline), both PTSD and trauma-exposed participants exhibited significantly greater relative left than right frontal brain activity (approach) to threatening than to nonthreatening images. Under high demand (filtering), no FAA differences were found between threatening and nonthreatening images, but PTSD participants revealed more relative left than right FAA, whereas trauma-exposed participants showed reduced left relative right FAA. In all conditions, healthy controls exhibited reduced left relative to right FAA and no differences between threatening and nonthreatening images. Study findings suggest dysfunctional prefrontal mechanisms of emotion regulation in PTSD, but adaptive prefrontal regulation in trauma-exposed individuals without PTSD.
Incidence and prognosis of COVID‐19 in patients with psoriasis on apremilast: a multicentre retrospective cohort study

Exacerbated systemic signs/symptoms, including respiratory distress, with SARS-CoV-2 infection (COVID-19) has been linked to a disruption in the balance of pro- and anti-inflammatory cytokines. [1] The effect of immunomodulatory therapies on the clinical course of COVID-19 remains under investigation. Limited studies report no increase in incidence of infection or risk of developing severe COVID-19 symptoms in patients with psoriasis treated with biologic agents. [2-5] Apremilast is an oral phosphodiesterase-4 inhibitor approved for the treatment of chronic plaque psoriasis, psoriatic arthritis, and Behcet's disease. Contrary to patients' concerns about the use of immunomodulatory agents during the COVID-19 pandemic, data from 3 Canadian dermatology practices showed that patients did not discontinue apremilast due to such concerns. [6] The risk of contracting SARS-CoV-2 in patients receiving apremilast treatment, however, remains unknown. Accordingly, we aimed to quantify the proportion of patients with psoriasis who contracted COVID-19 during treatment with apremilast.
PQN-59 and GTBP-1 contribute to stress granule formation but are not essential for their assembly in C. elegans embryos

ABSTRACT When exposed to stressful conditions, eukaryotic cells respond by inducing the formation of cytoplasmic ribonucleoprotein complexes called stress granules. Here, we use C. elegans to study two proteins that are important for stress granule assembly in human cells – PQN-59, the human UBAP2L ortholog, and GTBP-1, the human G3BP1 and G3BP2 ortholog. Both proteins assemble into stress granules in the embryo and in the germline when C. elegans is exposed to stressful conditions. Neither of the two proteins is essential for the assembly of stress-induced granules, as shown by the single and combined depletions by RNAi, and neither pqn-59 nor gtbp-1 mutant embryos show higher sensitivity to stress than control embryos. We find that pqn-59 mutants display reduced progeny and a high percentage of embryonic lethality, phenotypes that are not dependent on stress exposure and that are not shared with gtbp-1 mutants. Our data indicate that, in contrast to human cells, PQN-59 and GTBP-1 are not required for stress granule formation but that PQN-59 is important for C. elegans development.
The androgen receptor depends on ligand‐binding domain dimerization for transcriptional activation

Whereas dimerization of the DNA‐binding domain of the androgen receptor (AR) plays an evident role in recognizing bipartite response elements, the contribution of the dimerization of the ligand‐binding domain (LBD) to the correct functioning of the AR remains unclear. Here, we describe a mouse model with disrupted dimerization of the AR LBD (ARLmon/Y). The disruptive effect of the mutation is demonstrated by the feminized phenotype, absence of male accessory sex glands, and strongly affected spermatogenesis, despite high circulating levels of testosterone. Testosterone replacement studies in orchidectomized mice demonstrate that androgen‐regulated transcriptomes in ARLmon/Y mice are completely lost. The mutated AR still translocates to the nucleus and binds chromatin, but does not bind to specific AR binding sites. In vitro studies reveal that the mutation in the LBD dimer interface also affects other AR functions such as DNA binding, ligand binding, and co‐regulator binding. In conclusion, LBD dimerization is crucial for the development of AR‐dependent tissues through its role in transcriptional regulation in vivo. Our findings identify AR LBD dimerization as a possible target for AR inhibition.
Serological response to mRNA and inactivated COVID-19 vaccine in healthcare workers in Hong Kong: decline in antibodies 12 weeks after two doses.

To the Editor—We previously reported serological findings of 302 healthcare workers (HCWs) who completed two doses of mRNA (BNT162b2/ Comirnaty; Fosun-BioNTech Pharma) and inactivated COVID-19 vaccine (CoronaVac; Sinovac Life Sciences, Beijing, China). 1 Both vaccines were found to be immunogenic in the majority of HCWs. The BNT162b2 resulted in a 11-fold higher level of anti-spike IgG (Abbott SARS-CoV-2 IgG II Quant assay, mean=11572.6 AU/mL vs 1005.2 AU/mL; P<0.001) and a higher surrogate neutralising antibody (sNAb) [GenScript cPass SARS-CoV-2 Surrogate Virus Neutralization Test Kit] positive rate (100% vs 94.4%; P<0.001). We report week 12 serological data of our cohort. Among 197 CoronaVac and 100 BNT162b2 recipients, baseline characteristics of the two Hong Kong Med J 2021;27:380–3 https://doi.org/10.12809/hkmj219744
Computational tibial bone remodeling over a population after total knee arthroplasty: A comparative study

Abstract Periprosthetic bone loss is an important factor in tibial implant failure mechanisms in total knee arthroplasty (TKA). The purpose of this study was to validate computational postoperative bone response using longitudinal clinical DEXA densities. Computational remodeling outcome over a population was obtained by incorporating the strain‐adaptive remodeling theory in finite element (FE) simulations of 26 different tibiae. Physiological loading conditions were applied, and bone mineral density (BMD) in three different regions of interest (ROIs) was considered over a postoperative time of 15 years. BMD outcome was compared directly to previously reported clinical BMD data of a comparable TKA cohort. Similar trends between computational and clinical bone remodeling over time were observed in the two proximal ROIs, with most rapid bone loss taking place in the initial months after TKA and BMD starting to level in the following years. The extent of absolute proximal BMD change was underestimated in the FE population compared with the clinical subject group, which might be the result of significantly higher initial clinical baseline BMD values. Large differences in remodeling response were found in the distal ROI, in which resorption was measured clinically, but a large BMD increase was predicted by the FE models. Multiple computational limitations, related to the FE mesh, loading conditions, and strain‐adaptive algorithm, likely contributed to the extensive local bone formation. Further research incorporating subject‐specific comparisons using follow‐up CT scans and more extensive physiological knee loading is recommended to optimize bone remodeling more distal to the tibial baseplate.
Factor structure and clinical applicability of new semantic tasks in Alzheimer’s disease and aphasia

Abstract Semantic tasks are frequently used when examining language functions in patients with acquired disorders such as Alzheimer’s disease (AD) and aphasia. Little is known about the possible covariation between different types of tasks or their factor structure in healthy adults. Additionally, few studies have examined semantic task performances in different patient groups. The aims of this data-driven study were to examine the factor structure in a wide range of semantic tasks in healthy older adults, the possible differences in factor variables between healthy controls, patients with AD and patients with stroke aphasia, as well as the clinical applicability of tasks in differentiating the two patient groups from controls. Participants included 59 healthy older adults, 13 patients with AD and 14 patients with aphasia. The results indicated a four-factor solution for the semantic task variables: (1) the Semantic association factor, (2) the Time factor, (3) the Verbal factor and (4) the Synonym factor. The Verbal factor was the only distinguishing factor between the two patient groups. Three factors reliably discriminated between the controls and the AD patients, and the Verbal factor reliably discriminated between the controls and the aphasia patients. In addition, a few single task variables showed outstanding discrimination for both patient groups. This study supports the notions of semantic tasks tapping into more than one cognitive subcomponent and a more general semantic impairment in AD than in aphasia. In clinical assessment, choosing appropriate semantic tasks is crucial in order to reliably detect the characteristics of the impairment.
The history of magnetic resonance imaging and its reflections in Acta Radiologica

The first reports in Acta Radiologica on magnetic resonance imaging (MRI) were published in 1984, four years after the first commercial MR scanners became available. For the first two years, all MR papers originated from the USA. Nordic contributions started in 1986, and until 2020, authors from 44 different countries have published MR papers in Acta Radiologica. Papers on MRI have constituted, on average, 30%–40% of all published original articles in Acta Radiologica, with a high of 49% in 2019. The MR papers published since 1984 document tremendous progress in several areas such as magnet and coil design, motion compensation techniques, faster image acquisitions, new image contrast, contrast-enhanced MRI, functional MRI, and image analysis. In this historical review, all of these aspects of MRI are discussed and related to Acta Radiologica papers.
Treatment Outcome in Bilateral Cleft lip and Palate Patients Evaluated With the Huddart-Bodenham Scoring System and the Bilateral Cleft lip and Palate Yardstick: A Systematic Review

Objectives To assess treatment outcome (transversal and sagittal dental arch relationships) and its determinants in complete bilateral cleft lip and palate (BCLP) evaluated with the modified Huddart-Bodenham scoring system and the BCLP Yardstick. Materials and methods Multiple electronic databases were searched without time limitation. Randomized clinical trials, cohort and case control studies using BCLP Yardstick and/or modified Huddart-Bodenham system to judge treatment outcome of patients with BCLP were included. The Risk of Bias in Nonrandomized Studies of Interventions tool and Grading of Recommendations, Assessment, Development, and Evaluation was used. Results Of the 528 studies identified by the electronic search, only eight retrospective studies met the inclusion criteria and were included. A total of 12 cleft centers were represented. All treatment protocols differed and background information was underreported. The results for the BCLP yardstick showed that all except the centers in New Zealand had a mean score lower than 3, indicating good treatment results. However, these studies had a moderate to high risk of bias. The modified Huddart-Bodenham scores were negative in all studies. No further meta-analysis was done due to heterogeneity and high risk of bias. The quality of evidence was graded as very low. Conclusion Results for the dental arch relationship of studies in complete BCLP and possible determinants were not synthesized due to very low quality of evidence. Clinical research for patients with BCLP should focus on sound methodological designs to enable evidence-based decision making to improve treatment for patients with BCLP and thereby hopefully their quality of life.
Low testosterone levels and high estradiol to testosterone ratio are associated with hyperinflammatory state and mortality in hospitalized men with COVID-19.

OBJECTIVE Evidence supports a sex disparity in clinical outcomes of COVID-19 patients, with men exhibiting higher mortality rates compared to women. We aimed to test the correlation between serum levels of sex hormones [total testosterone, estradiol (E2), estradiol to testosterone (E2/T) ratio, progesterone), prolactin and 25-hydroxyvitamin D [25(OH)D] and markers of inflammation, coagulation and sepsis at admission in hospitalized men with COVID-19. PATIENTS AND METHODS We conducted an exploratory retrospective study including symptomatic men with confirmed SARS-CoV-2 infection who were consecutively admitted to our Institution between April 1 and May 31, 2020. RESULTS Patients were divided into survivors (n=20) and non-survivors (n=39). As compared to survivors, non-survivors showed significantly higher median neutrophil-to-lymphocyte ratio (NLR) values, D-dimer and procalcitonin (PCT) levels, along with significantly lower median 25(OH)D levels and total testosterone levels. Non-survivors exhibited significantly higher median values of E2/T ratio (a marker of aromatase activity). Spearman's correlation analysis revealed that total testosterone levels were significantly and inversely correlated with NLR, high-sensitivity C-reactive protein (hsCRP), interleukin-6, D-dimer and PCT. Conversely, E2/T ratio values were significantly and positively correlated with the aforementioned markers and with white blood cell (WBC) count. In a multivariate analysis performed by a logistic regression model after adjusting for major confounders (age, body mass index, hypertension and cardiovascular disease, diabetes mellitus and malignancy), total testosterone levels were significantly and inversely associated with risk of COVID-19-related in-hospital mortality. CONCLUSIONS Low total testosterone levels and elevated E2/T ratio values at admission are associated with hyperinflammatory state in hospitalized men with COVID-19. Low total testosterone levels at admission represent an independent risk factor for in-hospital mortality in such patients. Therefore, total testosterone and E2/T ratio may serve as prognostic markers of disease severity in this population.