Miracle-dz/UniFAR-FTUs huggingface dataset:
Development and Validation of Urological and Appearance Domains of the Post-Affirming Surgery Form and Function Individual Reporting Measure (AFFIRM) for Transwomen following Genital Surgery

Purpose: As feminizing gender-affirming surgery becomes increasingly accessible, functional outcomes are increasingly relevant. We aimed to develop and validate the first patient-reported outcome questionnaire focusing on postoperative symptomatology and quality of life. Material and Methods: Questions were developed from interviews with postoperative transwomen followed by face validation from a multispecialty clinician group. The measure was co-administered with established relevant questionnaires for concurrent validity testing. Participants were asked to complete the questionnaire at baseline and at a 2-week retest interval. Results: The AFFIRM questionnaire is a 33-item patient-reported outcome measure comprising Appearance, Urological and Gynecologic domains, each scored to create a composite AFFIRM score. A total of 102 women participated, with 60% completing the test-retest. The overall Cronbach’s α for AFFIRM was 0.79, and domain α for AFFIRM-A, AFFIRM-U and AFFIRM–G was 0.85, 0.87 and 0.42, respectively. Test-retest demonstrated score reliability (z values −1.862 to −0.005, p >0.05) with intraclass coefficients demonstrating moderate to good absolute correlation (0.54 to 0.88). The AFFIRM-A and AFFIRM-U correlated well with the Genital Appearance Satisfaction Measure and Urinary Distress Inventory-6, respectively (ρ 0.556 and 0.618, p <0.001); 89% of participants confirmed congruence between their external genitalia and gender identity, 87.8% reported clitoral sensation and 75.6% expressed satisfaction with vaginal caliber. Reported symptoms included a misdirected urinary stream (68.9%), nocturia (51.3%), urinary frequency (29.7%) and vaginal pain (46.7%). Conclusions: Transwomen have diverse symptoms not captured by unstructured questions or cisgender questionnaires. The AFFIRM questionnaire is the first tool available to reliably evaluate outcomes following feminizing gender-affirming surgery.
COVID-19, the Built Environment, and Health

Background: Since the dawn of cities, the built environment has both affected infectious disease transmission and evolved in response to infectious diseases. COVID-19 illustrates both dynamics. The pandemic presented an opportunity to implement health promotion and disease prevention strategies in numerous elements of the built environment. Objectives: This commentary aims to identify features of the built environment that affect the risk of COVID-19 as well as to identify elements of the pandemic response with implications for the built environment (and, therefore, for long-term public health). Discussion: Built environment risk factors for COVID-19 transmission include crowding, poverty, and racism (as they manifest in housing and neighborhood features), poor indoor air circulation, and ambient air pollution. Potential long-term implications of COVID-19 for the built environment include changes in building design, increased teleworking, reconfigured streets, changing modes of travel, provision of parks and greenspace, and population shifts out of urban centers. Although it is too early to predict with confidence which of these responses may persist, identifying and monitoring them can help health professionals, architects, urban planners, and decision makers, as well as members of the public, optimize healthy built environments during and after recovery from the pandemic. https://doi.org/10.1289/EHP8888
Increased activity of procoagulant factors in patients with small cell lung cancer

Small cell lung cancer (SCLC) patients have augmented risk of developing venous thromboembolism, but the mechanisms triggering this burden on the coagulation system remain to be understood. Recently, cell-derived microparticles carrying procoagulant phospholipids (PPL) and tissue factor (TF) in their membrane have attracted attention as possible contributors to the thrombogenic processes in cancers. The aims of this study were to assess the coagulation activity of platelet-poor plasma from 38 SCLC patients and to provide a detailed procoagulant profiling of small and large extracellular vesicles (EVs) isolated from these patients at the time of diagnosis, during and after treatment compared to 20 healthy controls. Hypercoagulability testing was performed by thrombin generation (TG), procoagulant phospholipid (PPL), TF activity, Protein C, FVIII activity and cell-free deoxyribonucleic acid (cfDNA), a surrogate measure for neutrophil extracellular traps (NETs). Our results revealed a coagulation activity that is significantly increased in the plasma of SCLC patients when compared to age-related healthy controls, but no substantial changes in coagulation activity during treatment and at follow-up. Although EVs in the patients revealed an increased PPL and TF activity compared with the controls, the TG profiles of EVs added to a standard plasma were similar for patients and controls. Finally, we found no differences in the coagulation profile of patients who developed VTE to those who did not, i.e. the tests could not predict VTE. In conclusion, we found that SCLC patients display an overall increased coagulation activity at time of diagnosis and during the disease, which may contribute to their higher risk of VTE.
Impact of KCNJ11 rs5219, UCP2 rs659366, and MTHFR rs1801133 Polymorphisms on Type 2 Diabetes: A Cross-Sectional Study

OBJECTIVE Type 2 diabetes (T2D) is a multifactorial disease. Its occurrence and prognosis are affected by many genes, including KCNJ11, UCP2, and MTHFR. The objective of this study was to investigate the distribution of various variants of these genes and evaluate their contribution to the outcome of T2D. METHODS 80 females with T2D and class I-II obesity in the age of 40-65 years old underwent a genetic study, a biochemical blood test, and indirect calorimetry. RESULTS Carriers of C/T and T/T genotypes of the MTHFR gene had higher levels of cholesterol and triglycerides and lower levels of vitamin B6 and folate. The T/T genotype of the UCP2 gene was associated with higher levels of glycated hemoglobin, pre- and postprandial glycemia and lipid oxidation rate, lower carbohydrate oxidation, and lower serum vitamin C levels. CONCLUSIONS Genotyping UCP2 and probably KCNJ11 may help to select the optimal antidiabetic therapy and improve disease prognosis, whereas the MTHFR gene may determine the need to monitor group B vitamin status and the risk of dyslipidemia.
Modifications of intravitreal injections in response to the COVID-19 pandemic.

The Coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruption to the normal operation of the healthcare system. On a worldwide scale, hospitals suspended non-urgent surgeries and outpatient visits to downsized clinical loadings to redistribute manpower to counteract the pandemic's impact. So far, there is no evidence-based guideline defining a clear line between urgent and non-urgent indications of intravitreal injections (IVI). Herein, we aimed to summarize IVI algorithm modifications and discuss the patient prioritization according to medical needs in the hostile environment in the COVID crisis. Assessing current literature, we found that neovascular age-related macular degeneration is considered the utmost priority among conditions that require IVI. Other conditions assigned with a high priority include monocular or quasi-monocular patients (only one eye > 20/40), neovascular glaucoma, and new patients with significant vision loss. Although patients with central retinal vein occlusion and proliferative diabetic retinopathy are not advised to delay treatments, we found no consistent evidence that correlated with a worse outcome. Diabetic macular edema and branched retinal vein occlusion patients undertaking treatment delay should be regularly followed up every 2-3 months. Serving as the principle of management behind the algorithm modifications, the reduction of both patient visit and IVI therapy counts should be reckoned together with the risk of permanent visual loss and COVID infection.
Effect of Implant Surface Modification on Bone Mineral Density and Survival Rate in the Maxilla After a Short Period Using Cone Beam Computed Tomography

Supplemental Digital Content is available in the text Abstract This study was aimed to objectively measure the changes in bone density amount obtained through cone-beam computed tomography around dental implants after a short period of time in the maxilla. Thirty-two SLActive Straumann implants were inserted into 12 healthy patients. Changes in bone density were measured at the surgery time (Bone mineral density (BMD)0) and 60 days after investment (Bone mineral density (BMD)60). Statistically, significant differences were observed between traumatic and sinus zones at the time of surgery and after 60 days respectively (P ≤ 0.05). For each group, a significant decrease in density was observed with the following variables (male, age of 18–40 years, sinus zone, and implant diameter of 4.1 mm). The survival rate was 83.8% after 60 days. Implant surface modification has no significant effect on bone mineral density after a short period of time in the sinus zone. Early loading of the prosthesis can be performed in the traumatic zone only.
Temperature effects on RNA polymerase initiation kinetics reveal which open complex initiates and that bubble collapse is stepwise

Significance To transcribe DNA sequences into RNA, RNA polymerase (RNAP) first binds to promoter DNA. The promoter sequence dictates both binding strength and rate of remodeling the DNA duplex by RNAP to open 13 base pairs in the start site region. This open “bubble” allows complementary nucleotides to pair with template-strand bases and be incorporated into RNA. All sequence-specific, RNAP-promoter contacts must break for RNAP to escape and elongate the RNA, but how this occurs is not well understood. Here, we report rate constants for each initiation step at the λPR promoter at different temperatures. We analyze these data to obtain insights into which open complex initiates and when RNAP-promoter contacts are disrupted, allowing bubble collapse, duplex formation, and promoter escape. Transcription initiation is highly regulated by promoter sequence, transcription factors, and ligands. All known transcription inhibitors, an important class of antibiotics, act in initiation. To understand regulation and inhibition, the biophysical mechanisms of formation and stabilization of the “open” promoter complex (OC), of synthesis of a short RNA–DNA hybrid upon nucleotide addition, and of escape of RNA polymerase (RNAP) from the promoter must be understood. We previously found that RNAP forms three different OC with λPR promoter DNA. The 37 °C RNAP-λPR OC (RPO) is very stable. At lower temperatures, RPO is less stable and in equilibrium with an intermediate OC (I3). Here, we report step-by-step rapid quench-flow kinetic data for initiation and growth of the RNA–DNA hybrid at 25 and 37 °C that yield rate constants for each step of productive nucleotide addition. Analyzed together, with previously published data at 19 °C, our results reveal that I3 and not RPO is the productive initiation complex at all temperatures. From the strong variations of rate constants and activation energies and entropies for individual steps of hybrid extension, we deduce that contacts of RNAP with the bubble strands are disrupted stepwise as the hybrid grows and translocates. Stepwise disruption of RNAP-strand contacts is accompanied by stepwise bubble collapse, base stacking, and duplex formation, as the hybrid extends to a 9-mer prior to disruption of upstream DNA–RNAP contacts and escape of RNAP from the promoter.
Acinetobacter defence mechanisms against biological aggressors and their use as alternative therapeutic applications

Abstract Several Acinetobacter strains are important nosocomial pathogens, with Acinetobacter baumannii being the species of greatest worldwide concern due to its multi-drug resistance and the recent appearance of hyper-virulent strains in the clinical setting. Colonisation of this environment is associated with a multitude of bacterial factors, and the molecular features that promote environmental persistence in abiotic surfaces, including intrinsic desiccation resistance, biofilm formation and motility, have been previously addressed. On the contrary, mechanisms enabling Acinetobacter spp. survival when faced against other biological competitors are starting to be characterised. Among them, secretion systems (SS) of different types, such as the T5bSS (Contact-dependent inhibition systems) and the T6SS, confer adaptive advantages against bacterial aggressors. Regarding mechanisms of defence against bacteriophages, such as toxin-antitoxin, restriction-modification, Crispr-Cas and CBASS, among others, have been identified but remain poorly characterised. In view of this, we aimed to summarise the present knowledge on defence mechanisms that enable niche establishment in members of the Acinetobacter genus. Different proposals are also described for the use of some components of these systems as molecular tools to treat Acinetobacter infections.
RNA 5-methylcytosine modification and its emerging role as an epitranscriptomic mark

ABSTRACT 5-methylcytosine (m5C) is identified as an abundant and conserved modification in various RNAs, including tRNAs, mRNAs, rRNAs, and other non-coding RNAs. The application of high-throughput sequencing and mass spectrometry allowed for the detection of m5C at a single-nucleotide resolution and at a global abundance separately; this contributes to a better understanding of m5C modification and its biological functions. m5C modification plays critical roles in diverse aspects of RNA processing, including tRNA stability, rRNA assembly, and mRNA translation. Notably, altered m5C modifications and mutated RNA m5C methyltransferases are associated with diverse pathological processes, such as nervous system disorders and cancers. This review may provide new sights of molecular mechanism and functional importance of m5C modification.
Ceiling effects indicate a possible threshold structure for working alliance.

This review investigated whether ceiling effects on client-reported working alliance measures represent measurement artifacts or valid information related to the formation of the working alliance. Using data from two previously published meta-analyses, a total of 92 estimates of ceiling effects were calculated based on 37 studies with 6,439 participants. Analyses examined the size of ceiling effects, relation with demographic variables, type of alliance measure, and ceiling effect stability across sessions. Moderate to large ceiling effects appeared across score distributions of multiple measures of client-rated alliance, across time administered, and across different sample characteristics such as gender, age, and ethnicity. When examined with the Session Rating Scale (SRS), analyses indicated ceiling effects had a moderate correlation with session number. When SRS ceiling effects were examined in a single study with a large sample of complete cases (N = 2,990) across seven sessions, large initial ceiling effects continued to increase slightly in size across sessions. Higher ceiling effects were also observed with the Working Alliance Inventory. Given the prevalence and relative stability of ceiling effects on score distributions, working alliance scores do not exhibit the characteristics of a normally distributed continuous variable. While the working alliance has typically been defined in terms of theoretical content such as tasks, goals, and bond, study findings suggest another key element may be a threshold structure where clients shift to an experience of the therapeutic relationship as established. Discussion focuses on directions for alliance research and clinical practice as well as study limitations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Global waves synchronize the brain’s functional systems with fluctuating arousal

Traveling waves spatiotemporally organize brain-wide activity in synchrony with ongoing arousal fluctuations. We propose and empirically support a parsimonious account of intrinsic, brain-wide spatiotemporal organization arising from traveling waves linked to arousal. We hypothesize that these waves are the predominant physiological process reflected in spontaneous functional magnetic resonance imaging (fMRI) signal fluctuations. The correlation structure (“functional connectivity”) of these fluctuations recapitulates the large-scale functional organization of the brain. However, a unifying physiological account of this structure has so far been lacking. Here, using fMRI in humans, we show that ongoing arousal fluctuations are associated with global waves of activity that slowly propagate in parallel throughout the neocortex, thalamus, striatum, and cerebellum. We show that these waves can parsimoniously account for many features of spontaneous fMRI signal fluctuations, including topographically organized functional connectivity. Last, we demonstrate similar, cortex-wide propagation of neural activity measured with electrocorticography in macaques. These findings suggest that traveling waves spatiotemporally pattern brain-wide excitability in relation to arousal.
Index-based dietary patterns and stomach cancer in a Chinese population

Supplemental Digital Content is available in the text. Objectives Dietary factors are of importance in the development of stomach cancer. This study aims to examine index-based dietary patterns associated with stomach cancer in a Chinese population. Methods Using data from a population-based case-control study conducted in Jiangsu Province, China, we included a total of 8432 participants (1900 stomach cancer cases and 6532 controls). Dietary data collected by food frequency questionnaire was evaluated by modified Chinese Healthy Eating Index-2016 (mCHEI-2016) and the US Healthy Eating Index-2015 (HEI-2015). Multiple logistic regression analyses were applied to examine the association of mCHEI-2016 and HEI-2015 with stomach cancer while adjusting for potential confounders. The possible interactions between mCHEI-2016 or HEI-2015 and established risk factors were explored. Results Among nonproxy interviews, after adjusting for potential confounding factors, a higher score of sodium, reflecting lower intake per day, was inversely associated with stomach cancer [odds ratio (OR), 0.95; 95% CI, 0.91–0.99 for mCHEI-2016; OR, 0.97; 95% CI, 0.94–0.99 for HEI-2015]. No clear associations with stomach cancer were identified for total scores of HEI-2015 (OR, 0.98; 95% CI, 0.87–1.10 with a 10-point increase, P trend = 0.98) and mCHEI-2016 (OR, 1.05; 95% CI, 0.94–1.17 with a 10-point increase, P trend = 0.22). However, the relation between stomach cancer and the mCHEI-2016 was modified by BMI, with a possible inverse association in normal-weight subjects. Conclusions Our findings highlight that reduced intake of dietary sodium would prevent the development of stomach cancer. The data indicate a heterogeneity between normal weight and overweight’s dietary factors in relation to stomach cancer.
Human Neutrophils Lose Their Surface FcyRIII and Acquire Annexin V Binding Sites During Apoptosis In Vitro

We have previously reported that neutrophilic granulocytes rapidly release part of their FcyRlll from the plasma membrane upon in vitro activation, probably by proteolytic cleav-age. In plasma and other body fluids, released or soluble FcyRlll has been found in considerable amounts. In the present study, neutrophils were kept in maintenance culture for 18 to 24 hours. Forty percent of the neutrophils completely lost FcyRIII, and the remainder of the cells showed a 60% decrease in FcyRlll expression on their surface. Released FcyRlll was detected in the culture supernatant. Neverthe- less, more than 90% of the cells was viable as judged by hydrolysis of fluorescein diacetate. The presence of inter- feron y, granulocyte colony-stimulating factor, or granulo-cyte-macrophage colony-stimulating factor, but not interleu-kin-3 (IL-3). IL-6, or IL-8, in the culture medium increased the number of cells that still expressed FcyRIII. We found that OLYMORPHONUCLEAR neutrophils play an important role in the inflammation process. As a first-line defense, neutrophils leave the circulation upon stimulation and enter the inflamed site to subsequently kill the invading micro-organisms. For this purpose, neutrophils express receptors on their plasma membranes for IgG antibodies and complement fragments present on opsonized micro-organ-isms. The receptors for the Fc region of IgG (FcyR) present on neutrophils are the transmembrane FcyRIIa and the PI-linked FcyRIIIb. In addition, neutrophils can be induced by certain cytokines to express the high-affinity FcyRI.
– Extending An Organisational Value Framework

The primary contribution is the establishment of a value framework within which future IA research can position itself, refining extant measures and thereby enabling greater cohesion in future studies. The secondary contribution, impacting beyond the field of GM, is the development of this framework including: the identification and discussion of value itself; the significance of organizational sub-levels; the extension of the definitions of isolating mechanisms and competition to explicate value capture; the importance of temporal analysis; and the inclusion of value assessment.
Strategies for Increasing Attendance for Identified Student Populations via Online Engagement Methods During the COVID-19 Pandemic

This Capstone literature review discusses a school counselor’s role in increasing attendance in schools. The review discusses the common risk factors of absenteeism and the new risk factors that arose after the onset of the COVID-19 pandemic. The onset of the COVID-19 pandemic changed the strategies that school professionals should use to increase engagement in learning, increase school attendance, and check on the well-being of identified student populations. The review brings light to several strategies that may help counselors increase school attendance with online education during the COVID-19 pandemic. Strategies include: incorporation of gameplay into lessons, keeping consistency with the lesson formats when possible, encouraging autonomy, and incorporating hands-on lessons into homework.