Miracle-dz/UniFAR-FTUs huggingface dataset:
Validity of continuous glucose monitoring for categorizing glycemic responses to diet: implications for use in personalized nutrition

ABSTRACT Background Continuous glucose monitor (CGM) devices enable characterization of individuals’ glycemic variation. However, there are concerns about their reliability for categorizing glycemic responses to foods that would limit their potential application in personalized nutrition recommendations. Objectives We aimed to evaluate the concordance of 2 simultaneously worn CGM devices in measuring postprandial glycemic responses. Methods Within ZOE PREDICT (Personalised Responses to Dietary Composition Trial) 1, 394 participants wore 2 CGM devices simultaneously [n = 360 participants with 2 Abbott Freestyle Libre Pro (FSL) devices; n = 34 participants with both FSL and Dexcom G6] for ≤14 d while consuming standardized (n = 4457) and ad libitum (n = 5738) meals. We examined the CV and correlation of the incremental area under the glucose curve at 2 h (glucoseiAUC0–2 h). Within-subject meal ranking was assessed using Kendall τ rank correlation. Concordance between paired devices in time in range according to the American Diabetes Association cutoffs (TIRADA) and glucose variability (glucose CV) was also investigated. Results The CV of glucoseiAUC0–2 h for standardized meals was 3.7% (IQR: 1.7%–7.1%) for intrabrand device and 12.5% (IQR: 5.1%–24.8%) for interbrand device comparisons. Similar estimates were observed for ad libitum meals, with intrabrand and interbrand device CVs of glucoseiAUC0–2 h of 4.1% (IQR: 1.8%–7.1%) and 16.6% (IQR: 5.5%–30.7%), respectively. Kendall τ rank correlation showed glucoseiAUC0–2h-derived meal rankings were agreeable between paired CGM devices (intrabrand: 0.9; IQR: 0.8–0.9; interbrand: 0.7; IQR: 0.5–0.8). Paired CGMs also showed strong concordance for TIRADA with a intrabrand device CV of 4.8% (IQR: 1.9%–9.8%) and an interbrand device CV of 3.2% (IQR: 1.1%–6.2%). Conclusions Our data demonstrate strong concordance of CGM devices in monitoring glycemic responses and suggest their potential use in personalized nutrition. This trial was registered at clinicaltrials.gov as NCT03479866.
The Association Between Maternal Employment and Breastfeeding Duration With Household Income in Mexico

Background: Breastfeeding offers the best nutrition during the first months of life. Scholars have identified a dose-response association between breastfeeding duration and reduced risk for child morbidity and mortality. In upper-middle-income countries, including Mexico, maternal employment has been negatively associated with breastfeeding duration. Despite increasing numbers of women entering the workforce and disproportionately participating in the informal sector, where they are un-entitled to paid maternity leave, little is known about how these factors may affect breastfeeding practices. Research Aim: To determine whether household income moderated the association between maternal employment status (defined as unemployed, formal, and informal full- and part-time employed) and any breastfeeding for ≥ 6 months. Methods: We conducted a cross-sectional study using retrospective secondary data from the 2018–2019 Mexican Health and Nutrition Survey. The analytic sample included data about 2,156 children aged 6–36 months. We computed logistic regression models stratified by household income. Results: The association between maternal employment and breastfeeding duration varied by household income. Compared to unemployed women, among lower-income households, children were less likely to be breastfed for ≥ 6 months when the participants was part-time informally employed (AOR = 0.30, 95% CI [0.13, 0.69]). Among higher-income households, children were less likely to be breastfed for ≥ 6 months when the participants was full-time formally employed (AOR = 0.52, 95% CI [0.30, 0.88]). Conclusions: To increase breastfeeding duration, stakeholders need to continue strengthening and enforcing policies among formally employed women, and strategies are urgently needed to support women in the informal sector, particularly those in lower-income households.
Sinus Surgery and Balloon Sinuplasty: What Do Patients Want to Know?

Objective Limited knowledge exists regarding the information patients seek online about sinus procedures. The goals of our study were to identify the most searched online queries regarding functional endoscopic sinus surgery (FESS) and balloon sinuplasty and evaluate the sources to which patients are directed. Study Design Observational. Setting Online Google Database. Methods Google data were analyzed using the search engine optimization tool Ahrefs. People Also Ask (PAA) questions (extracted from Google searches) helped identify questions for analysis of search query volume. Search results were categorized into specific topics, and the source (eg, academic vs medical practice) of the information was identified. The JAMA benchmark criteria were used to determine the quality of the online resource. Results The most searched term (average monthly queries) on Google was “sinus surgery” (13,190), followed by “balloon sinuplasty” (9212). For FESS and balloon sinuplasty, most questions focused on treatment of sinusitis (71.64% vs 79.19%) and preoperative inquiries about sinus issues (11.50% vs 11.35%). Answers to PAA questions for FESS were obtained from academic sources at a higher frequency compared to balloon sinuplasty (26.7% vs 10.3%, P = .016) but a lower frequency from medical practice websites (15.2% vs 29.3%, P = .042). The mean (SD) JAMA scores for FESS and balloon sinuplasty sources were 1.59 (1.46) and 1.40 (1.46), respectively. Conclusion There is a high volume of online search queries regarding FESS and balloon sinuplasty. The quality of the sources could be improved by addressing authorship, attribution, disclosure, and currency. This information may help otolaryngologists better address patient queries.
Mediating Effect of Cognitive Function on the Relationship Between Geriatric Oral Health and Quality of Life Among Korean Seniors

Objectives Previous studies have found that the oral health of seniors can affect their physical nutrition and quality of life (QoL). Additionally, poor oral health can lead to the development of dementia, which is associated with decreased cognitive function. This study aimed to examine the impact of geriatric oral health (GOH) on the QoL of Korean seniors and the mediating effects of cognitive function. Methods We used data from the seventh Korean Longitudinal Study of Aging conducted in 2018. In total, 4049 seniors were included in our study. We analyzed the impact of GOH on QoL according to 5 mediating domains of cognitive function and control variables. To examine each path of mediating effects, bootstrapping with 5000 iterations was performed with 95% confidence intervals. Results Our findings revealed that good GOH had a positive effect on the QoL of seniors. Also, better GOH corresponded to a higher degree of cognitive function within all 5 domains: orientation, memory registration, attention/calculation, memory recall, and language and visuospatial ability. In addition, 3 domains of the 5 domains (attention/calculation, memory recall, and language and visuospatial ability) had significant mediating effects on the relationship between GOH and QoL. Conclusions This study suggests that adequate management of GOH is crucial for promoting a better QoL and a high degree of cognitive function among seniors. To prevent cognitive impairment, such as dementia, future studies should take a more targeted approach by examining data according to each cognitive domain and various socio-demographic factors.
Effect of hidradenitis suppurativa on obstetric and neonatal outcomes

Abstract Purpose Hidradenitis suppurativa (HS) is a debilitating chronic inflammatory skin disease with an often-unsatisfactory response to treatment. The objective was to evaluate the association between HS and pregnancy, delivery and neonatal outcomes. Methods The United States’ Healthcare Cost and Utilization Project-Nationwide Inpatient Sample database was used to conduct a retrospective cohort study among all women who delivered between 1999 and 2015. ICD-9 code 705.83 identified those with HS, with the remaining deliveries composing the comparison group. Multivariate logistic regression compared maternal and neonatal outcomes between these two groups, while adjusting for baseline maternal variables. Results The study included 13,792,544 deliveries, of which 1021 were associated with an HS diagnosis (7.4/100,000 deliveries). During the observation period, there was an upward trend in the prevalence of HS among pregnant women (<0.0001). Pregnant women with HS were more likely to be African-American, to belong to a lower income quartile, and to be insured by Medicaid. They were also more likely to smoke, to be morbidly obese, and to be hypertensive. Compared with women without HS, those with HS had a greater likelihood of developing preeclampsia (OR 1.36, 95% CI 1.08–1.71), delivering by cesarean section (OR 1.78, 95% CI 1.56–2.02), and having a baby with congenital anomalies (OR 2.00, 95% CI 1.10–3.62). Conclusions Although HS is a complex skin disorder, pregnancies complicated by HS had comparable outcomes to non-HS pregnancies, with the exception of a greater risk of preeclampsia, cesarean sections, and congenital anomalies. Health-care providers and women should be aware of these HS associated risks.
Transparent Anti-SARS-CoV-2 and Antibacterial Silver Oxide Coatings

Transparent antimicrobial coatings can maintain the aesthetic appeal of surfaces and the functionality of a touch-screen while adding the benefit of reducing disease transmission. We fabricated an antimicrobial coating of silver oxide particles in a silicate matrix on glass. The matrix was grown by a modified Stöber sol–gel process with vapor-phase water and ammonia. A coating on glass with 2.4 mg of Ag2O per mm2 caused a reduction of 99.3% of SARS-CoV-2 and >99.5% of Pseudomonas aeruginosa, Staphylococcus aureus, and methicillin-resistant Staphylococcus aureus compared to the uncoated glass after 1 h. We envisage that screen protectors with transparent antimicrobial coatings will find particular application to communal touch-screens, such as in supermarkets and other check-out or check-in facilities where a number of individuals utilize the same touch-screen in a short interval.
Regional variability and genotypic and pharmacodynamic effects on PrP concentration in the CNS

Prion protein (PrP) concentration controls the kinetics of prion replication and is a genetically and pharmacologically validated therapeutic target for prion disease. In order to evaluate PrP concentration as a pharmacodynamic biomarker and assess its contribution to known prion disease risk factors, we developed and validated a plate-based immunoassay reactive for PrP across 6 species of interest and applicable to brain and cerebrospinal fluid (CSF). PrP concentration varied dramatically across different brain regions in mice, cynomolgus macaques, and humans. PrP expression did not appear to contribute to the known risk factors of age, sex, or common PRNP genetic variants. CSF PrP was lowered in the presence of rare pathogenic PRNP variants, with heterozygous carriers of P102L displaying 55%, and D178N just 31%, of the CSF PrP concentration of mutation-negative controls. In rodents, pharmacologic reduction of brain Prnp RNA was reflected in brain parenchyma PrP and, in turn in CSF PrP, validating CSF as a sampling compartment for the effect of PrP-lowering therapy. Our findings support the use of CSF PrP as a pharmacodynamic biomarker for PrP-lowering drugs and suggest that relative reduction from individual baseline CSF PrP concentration may be an appropriate marker for target engagement.
Electroacupuncture relieves neuropathic pain by inhibiting degradation of the ecto‐nucleotidase PAP in the dorsal root ganglions of CCI mice

Although electroacupuncture is widely used in chronic pain management, it is quite controversial due to its unclear mechanism. We hypothesised that EA alleviates pain by inhibiting degradation of the ecto‐nucleotidase prostatic acid phosphatase (PAP) and facilitating ATP dephosphorylation in dorsal root ganglions (DRGs).
Outcomes of Initial Management Strategies in Patients With Autoimmune Lymphocytic Hypophysitis: A Systematic Review and Meta-analysis.

CONTEXT Lymphocytic hypophysitis (LyHy) is characterized by inflammation of the pituitary and or neuroinfundibulum and is uncommon. Treatment options include observation, high-dose glucocorticoids (HD-GCs) or surgery. Optimal first-line management strategy, however, remains unknown. OBJECTIVE This work aimed to assess response to first-line treatment options (observation, HD-GCs, or surgery) of clinically relevant outcomes (symptomatic, hormonal, and radiographic improvement) among patients with LyHy. METHODS A systematic review was conducted in 6 databases through 2020. Meta-analysis was conducted when feasible using a random-effects model. RESULTS We included 33 studies reporting on 591 patients (423 women, 72%) with LyHy. Improvement/resolution of anterior pituitary dysfunction was highest when HD-GCs was first-line treatment. Surgery was associated with the greatest proportion of patients who had regression on imaging. Subgroup analysis comparing HD-GCs to observation showed the odds of anterior pituitary hormone recovery (OR 3.41; 95% CI, 1.68-6.94) or radiographic regression (OR 3.13; 95% CI, 1.54-6.36) were higher with HD-GCs, but so was the need for additional forms of treatment (OR 4.37; 95% CI, 1.70-11.22). No statistically significant difference was seen in recovery of diabetes insipidus (OR 0.9; 95% CI, 0.26-3.10). Certainty in these estimates was very low. CONCLUSION Observation and use of HD-GCs both are successful first-line management strategies in LyHy. Although use of HD-GCs was associated with increased recovery of anterior pituitary hormone deficit, it also was associated with greater likelihood of additional treatment after withdrawal. Optimal dosing and duration of HD-GCs remains unknown.
Preliminary evaluation and implications of the SPECAL method as an intervention for informal dementia care partners

Abstract Objective: The degenerative nature of Alzheimer’s disease and related dementias (ADRD) means that people diagnosed with ADRD often rely on friends and family to provide care as their cognitive and physical abilities decline. Caring for a person with dementia is complicated, in part because ADRD changes a person’s ability to communicate and create memories. Practitioners have increasingly identified communication-centered interventions as one way to address care partner needs while also improving well-being for the person with dementia. In this study, we evaluated one program, the SPECAL® method. Method: Using mixed-methods research, we assessed the effectiveness of a seven-week SPECAL course at facilitating positive outcomes for informal care partners. Participants completed pre- and post-program surveys (n = 17) as well as post-program interviews (n = 20). Results: Results showed several positive changes from pre- to post-program. Participants also reported several key themes in their experiences and implementation of SPECAL, including many beneficial and some challenging outcomes. Conclusion: Results from this study underscore the importance of communication as an intervention target for dementia care partners, identifying opportunities and challenges in working to help care partners communicate with people with ADRD in ways that sustain their relationship and foster mutual well-being.
Referring patients with stable moderate-to-advanced chronic kidney disease back to primary care: a feasibility study

Background Care for patients with chronic kidney disease (CKD) necessitates tailored pathways between primary and secondary care. It is unknown if back referring patients with CKD is safe and effective. Aim To study the feasibility of discharging patients with stable moderate-to-advanced CKD from secondary to primary care, and to evaluate quality of care (QoC) and patients’ and GPs‘ experiences. Design & setting A monocentre prospective mixed-method study in the Netherlands. Method Patients were included who met pre-determined back-referral (BR) criteria. Patients were discharged with personalised information guides and transfer letters. GPs had the option of consulting a nephrologist by telenephrology. Renal outcomes, QoC, and experiences were collected after 1 year. Results Eighteen patients were included. The mean age was 73 years; the mean estimated glomerular filtration rate (eGFR) was 33.2 ml/min/1.73 m2 at baseline. After 1 year, four patients had received either no or incomplete monitoring, and one patients’ blood pressure was too high. The remaining 13 had stable eGFR, proteinuria, and metabolic parameters. Patients were satisfied with information provision and treatment by GPs but expected more frequent monitoring. In one-third of cases, monitoring frequency was decreased by GPs for several reasons. GPs believed they had sufficient knowledge to treat patients with CKD, but indicated they needed support besides a transfer letter. Conclusion BR seems safe and feasible for patients with stable moderate-to-advanced CKD who meet specific criteria. Patients have good renal outcomes after 1 year and are satisfied with treatment. GP QoC can be improved, particularly completeness and monitoring frequency.
Exploring characteristics of specialization as moderators of the link between specialization and patient experience of care

Supplemental digital content is available in the text. Background Hospitals are increasingly pursuing specialization as a strategy to operate efficiently while delivering high-quality care. To date, however, evidence is lacking on whether hospital specialization has a consistent effect on patients’ experience of care or whether different specialization characteristics influence how specialization works. Purpose This study investigates whether specialization characteristics, that is, the within-specialty concentration and the within-specialty urgency score, moderate the link between hospital specialization and patient experience of care. Methodology We use patient-reported and administrative data from German hospitals between 2014 and 2017, with orthopedic and trauma care as the research setting. Our sample consists of 157,458 patient observations nested within 483 hospitals. We apply random-intercept multilevel modeling. Results Our results indicate that the effect of specialization on patient experience of care (a) decreases as the within-specialty concentration increases and (b) increases as the within-specialty urgency score increases. Conclusion This study provides novel insights into the specialization characteristics that make hospital specialization in orthopedic and trauma care particularly effective at improving patient experiences. Practice Implications Although specialization is gaining popularity as a strategy for pooling scarce resources and facilitating high-quality health care, hospital managers and policymakers should consider that certain characteristics of specialization can influence the way that specialization works and how effective it is in improving patient experiences. Within the scope of orthopedic and trauma care, our study suggests that a low concentration of diagnoses within a service area and a high average level of medical urgency make specialization particularly effective at improving patient experiences.
Itaconate and fumarate derivatives inhibit priming and activation of the canonical NLRP3 inflammasome in macrophages

The NLRP3 inflammasome is a multiprotein complex that regulates caspase‐1 activation and subsequent interleukin (IL)‐1β and IL‐18 release from innate immune cells in response to infection or injury. Derivatives of the metabolites itaconate and fumarate, dimethyl itaconate (DMI), 4‐octyl itaconate (4OI) and dimethyl fumarate (DMF) limit both expression and release of IL‐1β following NLRP3 inflammasome activation. However, the direct effects of these metabolite derivatives on NLRP3 inflammasome responses require further investigation. Using murine bone marrow‐derived macrophages, mixed glia and organotypic hippocampal slice cultures (OHSCs), we demonstrate that DMI, 4OI and DMF pretreatments inhibit pro‐inflammatory cytokine production in response to lipopolysaccharide (LPS), as well as inhibit subsequent NLRP3 inflammasome activation induced by nigericin. DMI, 4OI, DMF and monomethyl fumarate (MMF), another fumarate derivative, also directly inhibited biochemical markers of NLRP3 activation in LPS‐primed macrophages, mixed glia, OHSCs and human macrophages in response to nigericin and imiquimod, including ASC speck formation, caspase‐1 activation, gasdermin D cleavage and IL‐1β release. DMF, an approved treatment of multiple sclerosis, as well as DMI, 4OI and MMF, inhibited NLRP3 activation in macrophages in response to lysophosphatidylcholine, which is used to induce demyelination, suggesting a possible mechanism for DMF in multiple sclerosis through NLRP3 inhibition. The derivatives also reduced pro‐IL‐1α cleavage in response to the calcium ionophore ionomycin. Together, these findings reveal the immunometabolic regulation of both the priming and activation steps of NLRP3 activation in macrophages. Furthermore, we highlight itaconate and fumarate derivatives as potential therapeutic options in NLRP3‐ and IL‐1α‐driven diseases, including in the brain.
Comprehensive characterization of the alternative splicing landscape in ovarian cancer reveals novel events associated with tumor-immune microenvironment

Abstract Background: Ovarian cancer (OV) is a serious threat to women’s health. Immunotherapy is a new approach. Alternative splicing (AS) of messenger RNA (mRNA) and its regulation are highly relevant for understanding every cancer hallmark and may offer a broadened target space. Methods: We downloaded the clinical information and mRNA expression profiles of 587 tumor tissues from The Cancer Genome Atlas (TCGA) database. We constructed a risk score model to predict the prognosis of OV patients. The association between AS-based clusters and tumor-immune microenvironment features was further explored. The ESTIMATE algorithm was also carried out on each OV sample depending on the risk score groups. A total of three immune checkpoint genes that have a significant correlation with risk scores were screened. Results: The AS-events were a reliable and stable independent risk predictor in the OV cohort. Patients in the high-risk score group had a poor prognosis (P<0.001). Mast cells activated, NK cells resting, and Neutrophils positively correlated with the risk score. The number of Macrophages M1 was also more numerous in the low-risk score group (P<0.05). Checkpoint genes CD274, CTLA-4, and PDCD1LG2, showed a negative correlation with the risk score of AS in OV. Conclusions: The proposed AS signature is a promising biomarker for estimating overall survival (OS) in OV. The AS-events signature combined with tumor-immune microenvironment enabled a deeper understanding of the immune status of OV patients, and also provided new insights for exploring novel prognostic predictors and precise therapy methods.