Miracle-dz/UniFAR-FTUs huggingface dataset:
Prognostic and predictive factors in undifferentiated pleomorphic sarcoma: A long‐term study from a large tertiary care urban center

Undifferentiated pleomorphic sarcoma (UPS) is an aggressive type of soft tissue sarcoma (STS) with high rates of metastatic disease and local recurrence. We sought to identify risk factors for local recurrence, metastasis, and overall death, and assess their impact on overall survival (OS), local recurrence‐free survival (LRFS), and metastasis‐free survival (MFS).
Safety and efficacy of physician-modified thoracic endovascular aortic repair using a low-profile device for aortic arch lesions

Background We investigated the safety and efficacy of physician-modified thoracic endovascular aortic repair using a low-profile device for aortic arch lesions. Methods A total of 42 consecutive patients (mean age 67.2 ± 12.7 years; 32 men) with aortic arch lesions were treated by physician-modified thoracic endovascular aortic repair using a low-profile device (Zenith Alpha Thoracic Endovascular Graft) with four scallops or 13 fenestrations for the common carotid artery and 38 fenestrations or 30 branches for the left subclavian artery. The aortic repair indications were acute type B aortic dissection (n = 17, 40.5%), degenerative aneurysm (n = 14, 33.3%), chronic dissection aneurysmal degeneration (n = 4, 9.5%), and ulcer-like projection (n = 2, 4.8%). The mean iliac artery diameter was 7.6 ± 1.1 mm. Results There were no branches covered unintentionally or patients who died and suffered from severe spinal cord ischemia perioperatively. One patient (2.4%) experienced a postoperative minor stroke with full neurological recovery. The mean follow-up time was 18 ± 11 months, with 28 patients (66.7%) having at least 12 months. One access-related complication (2.4%) occurred. Two residual Ia (4.8%) and three residual IIIa (7.1%) endoleaks were treated by reintervention. There were no open repair conversions, ruptures, or other aortic complications. Conclusion Physician-modified thoracic endovascular aortic repair using the low-profile device may be a safe, feasible, and time-saving method for preserving the cervical artery and has high reproducibility and anatomical reconstruction. However, its durability requires long-term follow-up.
Impact of KRAS and NRAS mutations on outcomes in acute myeloid leukemia

Abstract The prognostic significance of RAS mutations in AML is poorly understood. In this ambispective cohort study of 239 newly-diagnosed AML patients at the University of Maryland, we assessed the median overall survival (mOS) and median event-free survival (mEFS) in RAS wild-type (WT) AML (n = 196), KRAS-mutated AML (n = 11), NRAS-mutated AML (n = 25), and KRAS/NRAS-mutated AML (n = 7). We used propensity score to adjust outcomes. NRAS-mutated AML had a similar response rate to first-line treatment and mOS compared to RAS-WT AML (57 vs. 54%, p = 0.8, 22.7 vs. 14.6 months, p = 0.7). The mOS of KRAS-mutated AML was shorter compared to RAS-WT AML (p = 0.049) and NRAS-mutated AML (p = 0.02). KRAS-mutated AML treated with anthracycline-based first-line regimens had a lower relative mortality compared to treatment with hypomethylating agents with venetoclax (HR <0.01, p = 0.04) and without venetoclax (HR <0.01, p = 0.04). This study demonstrates that KRAS but not NRAS mutations are associated with worse outcomes in AML. NOVELTY STATEMENT What is the new aspect of your work? The clinical significance of RAS mutations remains poorly defined and prior studies have yielded conflicting results. We used causal inferential methods, propensity score modeling, to determine the impact of KRAS and NRAS mutation on survival in newly diagnosed AML patients, independent of other risk factors. Moreover, we analyzed the outcomes of KRAS and NRAS-mutated AML patients receiving first-line therapy with hypomethylating agents and other non-anthracycline-based regimens. We provided a detailed description of RAS-mutated AML, including co-occurring mutations and cytogenetic abnormalities. What is the central finding of your work? KRAS mutations but not NRAS mutations in AML are directly linked to worse outcomes even after controlling for differences in AML type, co-occurring cytogenetic changes, treatment regimens, and comorbidities. KRAS-mutated AML has a higher relative mortality when treated with a hypomethylating agent-based first-line induction regimen compared to treatment with an anthracycline-based regimen. What is (or could be) the specific clinical relevance of your work? Our findings can help refine our genetic profiles of AML, improve prognostic models, and better stratify treatment regimens.
Advanced HIV disease: A review of diagnostic and prophylactic strategies

Despite expanded access to antiretroviral therapy (ART) and the rollout of the World Health Organization's (WHO) ‘test‐and‐treat’ strategy, the proportion of people with HIV (PWH) presenting with advanced HIV disease (AHD) remains unchanged at approximately 30%. Fifty percent of persons with AHD report prior engagement to care. ART failure and insufficient retention in HIV care are major causes of AHD. People living with AHD are at high risk for opportunistic infections and death. In 2017, the WHO published guidelines for the management of AHD that included a comprehensive package of care for screening and prophylaxis of major opportunistic infections (OIs). In the interim, ART regimens have evolved: integrase inhibitors are first‐line therapy globally, and the diagnostic landscape is evolving. The objective of this review is to highlight novel point‐of‐care (POC) diagnostics and treatment strategies that can facilitate OI screening and prophylaxis for persons with AHD.
Barriers to and Facilitators of a Blended Cognitive Behavioral Therapy Program for Depression and Anxiety Based on Experiences of University Students: Qualitative Interview Study

Background Blended cognitive behavioral therapy (bCBT) programs have been proposed to increase the acceptance and adoption of digital therapeutics (DTx) such as digital health apps. These programs allow for more personalized care by combining regular face-to-face therapy sessions with DTx. However, facilitators of and barriers to the use of DTx in bCBT programs have rarely been examined among students, who are particularly at risk for developing symptoms of depression and anxiety disorders. Objective This study aimed to evaluate the facilitators of and barriers to the use of a bCBT program with the elona therapy app among university students with mild to moderate depression or anxiety symptoms. Methods Semistructured interviews were conducted via videoconference between January 2022 and April 2022 with 102 students (mean age 23.93, SD 3.63 years; 89/102, 87.2% female) from universities in North Rhine-Westphalia, Germany, after they had completed weekly individual cognitive behavioral therapy sessions (25 minutes each) via videoconference for 6 weeks and regularly used the depression (n=67, 65.7%) or anxiety (n=35, 34.3%) module of the app. The interviews were coded based on grounded theory. Results Many participants highlighted the intuitive handling of the app and indicated that they perceived it as a supportive tool between face-to-face sessions. Participants listed other benefits, such as increased self-reflection and disorder-specific knowledge as well as the transfer of the content of therapy sessions into their daily lives. Some stated that they would have benefited from more personalized and interactive tasks. In general, participants mentioned the time requirement, increased use of the smartphone, and the feeling of being left alone with potentially arising emotions while working on tasks for the next therapy session as possible barriers to the use of the app. Data security was not considered a major concern. Conclusions Students mostly had positive attitudes toward elona therapy as part of the bCBT program. Our study shows that DTx complementing face-to-face therapy sessions can be perceived as a helpful tool for university students with mild to moderate anxiety or depression symptoms in their daily lives. Future research could elaborate on whether bCBT programs might also be suitable for students with more severe symptoms of mental disorders. In addition, the methods by which such bCBT programs could be incorporated into the university context to reach students in need of psychological support should be explored.
Maternal Perceptions of Evidence-Based Early Childhood Sleep Health Promotion Recommendations: An Explanatory Sequential Study

ABSTRACT Objectives The purpose of this explanatory sequential design study was to better understand caregivers’ perceptions about and interest in evidence-based early childhood sleep health promotion recommendations. Method A purposeful sample of mothers of 20 1–5-year-old children (10 children exhibiting optimal sleep and 10 children exhibiting insufficient/fragmented sleep) attending a preschool serving a low socio-economic (SES) status metropolitan community were invited to participate in qualitative interviews. Data were coded according to a grounded theory approach and themes were identified within the optimal and suboptimal sleeper groups. Results Mothers reported different approaches to managing electronics by optimal/suboptimal sleeper group, with mothers of optimal sleepers limiting access to electronics more than mothers in the suboptimal sleep group. Other themes of sleep health practices did not differ meaningfully between groups. Conclusions Maternal perspectives about early childhood sleep health were similar across optimal and suboptimal sleepers on most elements of child sleep health. Managing child sleep was contextually influenced and these results highlight the complexities of how families living in lower SES environments perceive common sleep recommendations. Thus, sleep health education efforts should be tailored to the needs and values of specific families and communities.
Vibrio cholerae O37: one of the exceptions that prove the rule

Between 1965 and 1968, outbreaks of cholera in Sudan and former Czechoslovakia provoked considerable public health concern. These still represent important historical events that need to be linked to the growing genomic evidence describing the aetiological agent of cholera, Vibrio cholerae . Whilst O1 serogroup V. cholerae are canonically associated with epidemic and pandemic cholera, these events were caused by a clone of toxigenic V. cholerae O37 that may be more globally distributed than just to Europe and North Africa. Understanding the biology of these non-O1 strains of V. cholerae is key to understanding how diseases like cholera continue to be globally important. In this article, we consolidate epidemiological, molecular and genomic descriptions of the bacteria responsible for these outbreaks. We attempt to resolve discrepancies in order to summarize the history and provenance of as many commonly used serogroup O37 strains as possible. Finally, we highlight the potential for whole-genome sequencing of V. cholerae O37 isolates from strain collections to shed light on the open questions that we identify.
Tissue‐like environments shape functional interactions of HIV‐1 with immature dendritic cells

Immature dendritic cells (iDCs) migrate in microenvironments with distinct cell and extracellular matrix densities in vivo and contribute to HIV‐1 dissemination and mounting of antiviral immune responses. Here, we find that, compared to standard 2D suspension cultures, 3D collagen as tissue‐like environment alters iDC properties and their response to HIV‐1 infection. iDCs adopt an elongated morphology with increased deformability in 3D collagen at unaltered activation, differentiation, cytokine secretion, or responsiveness to LPS. While 3D collagen reduces HIV‐1 particle uptake by iDCs, fusion efficiency is increased to elevate productive infection rates due to elevated cell surface exposure of the HIV‐1‐binding receptor DC‐SIGN. In contrast, 3D collagen reduces HIV transfer to CD4 T cells from iDCs. iDC adaptations to 3D collagen include increased pro‐inflammatory cytokine production and reduced antiviral gene expression in response to HIV‐1 infection. Adhesion to a 2D collagen matrix is sufficient to increase iDC deformability, DC‐SIGN exposure, and permissivity to HIV‐1 infection. Thus, mechano‐physical cues of 2D and 3D tissue‐like collagen environments regulate iDC function and shape divergent roles during HIV‐1 infection.
Microenvironmental mechanoactivation through Yap/Taz suppresses chondrogenic gene expression

Chondrocyte phenotype is preserved when cells are round and the actin cytoskeleton is cortical. Conversely, these cells rapidly dedifferentiate in vitro with increased mechanoactive Rho signaling, which increases cell size and causes large actin stress fiber to form. While the effects of Rho on chondrocyte phenotype are well established, the molecular mechanism is not yet fully elucidated. Yap, a transcriptional coregulator, is regulated by Rho in a mechanotransductive manner and can suppress chondrogenesis in vivo. Here, we sought to elucidate the relationship between mechanoactive Rho and Yap on chondrogenic gene expression. We first show that decreasing mechanoactive state through Rho inhibition results in a broad increase in chondrogenic gene expression. Next, we show that Yap and its coregulator Taz are negative regulators of chondrogenic gene expression, and removal of these factors promotes chondrogenesis even in environments that promote cell spreading. Finally, we establish that Yap/Taz is essential for translating Rho-mediated signals to negatively regulate chondrogenic gene expression, and that its removal negates the effects of increased Rho signaling. Together, these data indicate that Rho is a mechanoregulator of chondrogenic differentiation, and that its impact on chondrogenic expression is exerted principally through mechanically induced translocation and activity of Yap and Taz.
Multimodel Imaging Evidence of Traction Component in Lamellar Macular Hole with Epiretinal Proliferation

Introduction: The aim of this study was to investigate the association of epiretinal traction in idiopathic lamellar macular hole (LMH) with or without lamellar hole-associated epiretinal proliferation (LHEP). Methods: A retrospective consecutive case series included 108 eyes diagnosed with LMH in a single tertiary referral center. Epiretinal traction was determined by the presence of epiretinal membrane (ERM), attached posterior hyaloid, or vascular traction with multimodal imaging studies and intraoperative findings in those received surgical interventions. Results: The 53 LMHs with LHEP had similar age, refraction, initial, and final visual acuity to the 55 LMHs without LHEP. Both groups exhibited high incidences of vascular traction (with and without LHEP: 92% and 84%, p = 0.36, respectively) and ERM and/or attached posterior hyaloid (both 100%, p = 1.00). The vision improved 10.5 and 14 ETDRS letters (p = 0.60) in the 30 eyes with and 19 eyes without LHEP that underwent vitrectomy. Vascular tractions released postoperatively in 88% and 100% of LMHs with and without LHEP, respectively (p = 0.27). The LMH, ERM foveoschisis, and mixed subtypes exhibited epiretinal traction in 100% of cases in all subtypes (p = 1.00). Conclusion: Our findings indicated that epiretinal traction, evaluated by multimodal imaging, is the norm rather than the exception in LMHs showing LHEP. The presence of tractional forces should be taken into consideration when treatment was planned in LMHs.
Pseudo-Haptic Heaviness Influenced by the Range of the C/D Ratio and the Position of the C/D Ratio Within a Given Range

Pseudo-haptic heaviness refers to the illusory sensation of heaviness caused by a dissociation in amplitudes between object movements on a screen and users' motor actions. The amplitude ratio of object movements to the user's actions, the so-called C/D ratio, is a powerful determinant of pseudo-haptic heaviness. According to previous studies, perceptual judgments for a given stimulus value are influenced by the position of the value within a given stimulus range, while no studies have shown the same to be true for pseudo-haptic heaviness. The present study examined whether pseudo-haptic heaviness determined by the C/D ratio was influenced by the range of C/D ratios, and also, by the position of the C/D ratio within a given range. Participants were asked to drag and lift a square on the screen up to a target line and then rate its heaviness; the range of C/D ratios was controlled as a between-participants factor. We observed a phenomenon whereby both the range and position of the C/D ratio influenced the rated heaviness. This phenomenon was clearly established over 8 experimental trials. We conclude that both the C/D ratio range and the position of the C/D ratio within a given range are determinants for pseudo-haptic heaviness.
Ultimate and Primary Biodegradation of a Range of Nonpolymeric and Polymeric Surfactants in Seawater

Surfactants are chemicals commonly used in a wide range of domestic and industrial products. In the present study, ultimate biodegradation of 18 surfactants representing different classes (including several polymeric alcohol ethoxylates [AEs]) was determined in seawater at 20 °C by a Closed Bottle test method. After 28 days of incubation, 12 surfactants reached 60% biodegradation and were considered to be readily biodegradable in seawater. The results for the six additional surfactants indicated that the 60% pass level may be reached by extended incubation time, or that reduced biodegradation could be associated with toxicity of the chemicals. All these six surfactants were biodegraded >20% after 28 days, indicative of primary biodegradation in seawater. Polymeric ethoxylates with high numbers of ethylene oxide (EO) groups (40–50 EO groups) were more slowly biodegraded than polyethoxylates with 4 to 23 EO groups. Biodegradation experiments of the AE C12 EO9 (3 to 18 EO groups) in a carousel system at 20 °C with natural seawater and a surfactant concentration of 500 µg/L showed rapid primary biodegradation by targeted analyses of the AE, with >99% primary biodegradation after 2 days of incubation. The surfactant depletion coincided with temporary formation of polyethylene glycols, suggesting that central fission is an important degradation step in seawater. A primary biodegradation experiment in the carousel system with C12 EO9 was conducted in the presence of suspended particulate materials (SPMs; marine phytoplankton and clay particles), showing that the presence of SPMs did not hamper the primary biodegradation of the surfactant. Separation of fractions in 20‐µm steel filters indicated some particle association of the surfactant. Environ Toxicol Chem 2023;42:1472–1484. © 2023 SETAC
Health-related quality of life in Hong Kong physicians up to 20 years post-graduation: A cross-sectional survey

Background Problems with health-related quality of life can affect physicians’ ability to work effectively. This study compared the health-related quality of life of Hong Kong physicians to the general population and explored the factors associated with mental and physical health-related quality of life. Methods This cross-sectional study was conducted from January to April 2016. Medical graduates from the University of Hong Kong participated in a survey containing the Short Form-12 Item Health survey version 2, Patient Health Questionnaire-9, Copenhagen Burnout Inventory, and items on lifestyle behaviors, career satisfaction, and socio-demographics. Results 496 responses were received. The mean physical component summary score was 53.2 (SD = 7.6), similar to the general population. The mean mental component summary score was 43.6 (SD = 11.8), significantly worse than the general population (P<0.01). Compared to the general population, all Short-Form 12 Health Survey version 2 domains were worse in doctors, aside from bodily pain and general health. Regular exercise was positively associated with physical component summary scores (Coeff 2.024; P = 0.047); but having children and higher personal burnout scores were negatively associated with it (Coeff -1.890; P = 0.036; and Coeff -0.045; P = 0.027, respectively). Poorer mental component summary scores correlated with worse personal (Coeff -0.284; P< 0.001), work-related (Coeff -0.135; P = 0.040), and patient-related burnout (Coeff -0.060; P = 0.041), and higher Patient Health Questionnaire-9 scores (Coeff -9.170; P<0.001). There were significant differences in mental health (P = 0.042) and mental component summary scores (P = 0.012) across age groups, but not with gender. Conclusion Hong Kong physicians are less impacted by physical health than mental health. Compared to the general population, doctors’ mental health has a more significant impact on their lives. Interventions aimed to improve burnout and depression rates in physicians may improve physicians’ mental health-related quality of life.
Viewing distance and character size in the use of smartphones across the lifespan

The use of smartphones has seen an extraordinary growth in recent years, thus the understanding of visual habits associated with the use of such devices across the lifespan is becoming important. In the present study we measured viewing distance and character size in a group of non-presbyopes (n = 157) and a group of presbyopes (n = 60) while participants read a simple text message on their smartphone. Results showed that non-presbyopes use shorter viewing distances as compared to presbyopes, a behavior causing a significantly higher accommodative demand. Presbyopes also use larger character sizes and this behavior is more evident whenever difficulties in near vision emerge in the Near Activity Visual Questionnaire (NAVQ, Italian version). Nevertheless, the two groups did not differ in the measurement of angular size subtended by the smallest detail of the letters. Overall, our data reveal that non-presbyopes and presbyopes have different visual habits when using a smartphone. These differences should be considered when determining the best near correction.