Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of Palliative Care in Evaluating and Relieving Symptoms in Patients with Advanced Cancer. Results from the DEMETRA Study

Background: Cancer patients experience multiple symptoms throughout the course of the disease. We aimed to provide a comprehensive analysis of the symptom burden in patients with advanced cancer at admission to specialist palliative care (PC) services and seven days later to estimate the immediate impact of PC intervention. Patient and methods: The analysis was based on an observational, prospective, multicenter study (named DEMETRA) conducted in Italy on new patients accessing network specialist PC centers during the period May 2017–November 2017. The prevalence and intensity of symptoms were assessed at baseline and after seven days using three tools including the Edmonton Symptom Assessment System (ESAS). Results: Five PC centers recruited 865 cancer patients. Thirty-three different symptoms were observed at the baseline, the most frequent being asthenia (84.9%) and poor well-being (71%). The intensity of the most frequent symptoms according to ESAS ranged from 5.5 for asthenia to 3.9 for nausea. The presence and intensity of physical symptoms increased with increasing levels of anxiety and depression. After seven days, prevalence of nausea and breathlessness as well as intensity of almost all symptoms significantly decreased. Conclusions: The study confirmed the considerable symptom burden of patients with advanced cancer. PC intervention has significantly reduced the severity of symptoms, despite the patients’ advanced disease and short survival.
Sex differences in presentation, management, and outcomes among patients hospitalized with acute pulmonary embolism

While the presence of gender disparities in cardiovascular disease have been described, there is a paucity of data regarding the impact of sex in acute pulmonary embolism (PE). We identified all patients admitted to a tertiary care hospital with acute PE between August 1, 2012 through July 1, 2018. We stratified the presenting characteristics, management, and outcomes between women and men. Of the 2031 patients admitted with acute PE, 1081 (53.2%) were women. Women were more likely to present with dyspnea (59.8% vs 52.0%, p < 0.001) and less likely to present with hemoptysis (1.9% vs 4.0%, p = 0.01). Women were older (63.8 ± 17.4 years vs 62.3 ± 15.0 years, p = 0.04), but had lower rates of myocardial infarction, liver disease, smoking history, and prior DVT. PE severity was similar between women and men (massive: 4.9% vs 3.6%; submassive: 43.9% vs 41.8%; p = 0.19), yet women were more likely to present with normal right ventricular size on a surface echocardiogram (63.2% vs 54.8%, p = 0.01). In unadjusted analyses, women were less likely to survive to discharge (92.4% vs 94.7%, p = 0.04), but after adjustment, there was no sex-based survival difference. There were no sex differences in the PE-related diagnostic studies performed, use of advanced therapies, or short-term outcomes, before and after adjustment (p > 0.05 for all). In this large PE cohort from a tertiary care institution, women had different comorbidity profiles and PE presentations compared with men. Despite these differences, there were no sex disparities in PE management or outcomes.
Black Soldier Fly Full-Fat Larvae Meal as an Alternative to Fish Meal and Fish Oil in Siberian Sturgeon Nutrition: The Effects on Physical Properties of the Feed, Animal Growth Performance, and Feed Acceptance and Utilization

Simple Summary Research for alternative protein sources that may replace fish meal and fish oil in fish diets is one of the ongoing tasks for aquaculture. Sturgeons role captive fish production increases due to the rapid decrease in its wild stocks during the 20th century. Insect meals are a novel group of feed materials rich in nutrients that are produced in an environmentally sustainable way. Therefore, the aim of the study was to assess the effects of black soldier fly larvae full-fat meal (BSFL) usage as fish meal and fish oil replacement in Siberian sturgeon diets. The experimentally obtained data showed the possibility of extruded feed production with up to 30% of BSFL and physical parameters suitable for fish feeding. Moreover, feed acceptance increase was observed in treatments containing than 10% and higher shares of BSFL. In the groups whose feed contained 5 to 30% of BSFL in the diet, the growth of experimental fish as well as their feed utilization parameters were improved; however, with no effects on feed digestibility. All presented data make BSFL a suitable nutrient source alternative to fish meal in Siberian sturgeon nutrition. Abstract This study provides data on the use of black soldier fly (Hermetia illucens) full-fat meal (BSFL) in Siberian sturgeon (Acipenser baerii) nutrition, examining pellet physical properties, growth performance, feed acceptance and utilization, apparent protein, and fat digestibility. The study consisted of: feed quality assessment; a growth performance; feed acceptance; digestibility trials. The effect of the use of BSFL as a replacement for fish meal (FM) and fish oil (FO) was investigated. The applied BSFL shares were 5%, 10%, 15%, 20%, 25%, and 30% of the diet, replacing up to 61.3% of FM and allowing us to reduce FO use by up to 95.4% in the case of 30% incorporation. The applied substitution affected feed quality, increasing the expansion rate, and decreasing feed density, sinking speed and water stability. However, body weight gain, specific growth rate, feed, and protein conversion ratios, were improved in groups fed BSFL. Moreover, feed acceptance was increased with treatments containing 10 to 30% BSFL. No effects on nutrients digestibility were observed. The results show that the use of BSFL as an FM and FO replacement may have positive effects on sturgeon growth performance, and BSFL can be developed as a promising alternative feed material.
Anti-Influenza Effect of Nanosilver in a Mouse Model

The present study assesses copper metabolism of the host organism as a target of antiviral strategy, basing on the “virocell” concept. Silver nanoparticles (AgNPs) were used as a specific active agent because they reduce the level of holo-ceruloplasmin, the main extracellular cuproenzyme. The mouse model of influenza virus A infection was used with two doses: 1 LD50 and 10 LD50. Three treatment regimens were used: Scheme 1—mice were pretreated 4 days before infection and then every day during infection development; Scheme 2—mice were pretreated four days before infection and on the day of virus infection; Scheme 3—virus infection and AgNP treatment started simultaneously, and mice were injected with AgNPs until the end of the experiment. The mice treated by Scheme 1 demonstrated significantly lower mortality, the protection index reached 60–70% at the end of the experiment, and mean lifespan was prolonged. In addition, the treatment of the animals with AgNPs resulted in normalization of the weight dynamics. Despite the amelioration of the infection, AgNP treatment did not influence influenza virus replication. The possibility of using nanosilver as an effective indirectly-acting antiviral drug is discussed.
AF-SSD: An Accurate and Fast Single Shot Detector for High Spatial Remote Sensing Imagery

There are a large number of studies on geospatial object detection. However, many existing methods only focus on either accuracy or speed. Methods with both fast speed and high accuracy are of great importance in some scenes, like search and rescue, and military information acquisition. In remote sensing images, there are some targets that are small and have few textures and low contrast compared with the background, which impose challenges on object detection. In this paper, we propose an accurate and fast single shot detector (AF-SSD) for high spatial remote sensing imagery to solve these problems. Firstly, we design a lightweight backbone to reduce the number of trainable parameters of the network. In this lightweight backbone, we also use some wide and deep convolutional blocks to extract more semantic information and keep the high detection precision. Secondly, a novel encoding–decoding module is employed to detect small targets accurately. With up-sampling and summation operations, the encoding–decoding module can add strong high-level semantic information to low-level features. Thirdly, we design a cascade structure with spatial and channel attention modules for targets with low contrast (named low-contrast targets) and few textures (named few-texture targets). The spatial attention module can extract long-range features for few-texture targets. By weighting each channel of a feature map, the channel attention module can guide the network to concentrate on easily identifiable features for low-contrast and few-texture targets. The experimental results on the NWPU VHR-10 dataset show that our proposed AF-SSD achieves superior detection performance: parameters 5.7 M, mAP 88.7%, and 0.035 s per image on average on an NVIDIA GTX-1080Ti GPU.
Characteristics of online medical care consultation for pregnant women during the COVID-19 outbreak: cross-sectional study

Objectives This study described the needs of pregnant women and the contents of online obstetric consultation in representative areas with various severity of the epidemic in China. Design This was a cross- sectional study. Setting Yue Yi Tong (YYT), a free online communication platform that allows pregnant women to consult professional obstetricians. Participants All the pregnant women who used the YYT platform. Intervention From 10 to 23 February, we collected data on online obstetric consultations and participants’ satisfaction through the YYT platform in the mild, moderate and severe epidemic areas which were defined according to the local confirmed cases. The primary outcomes were the reasons for online consultations by the severity of the epidemic. All the comparisons were performed using χ2 test. Statistical analysis was performed using SPSS V.24. Results A total of 2599 pregnant women participated in this study, of whom 448 (17.24%), 1332 (51.25%) and 819 (31.51%) were from the mild, moderate and severe epidemic areas, respectively. The distribution of the amount of online consultations was significantly different not only in different areas (p<0.001) but also in different trimesters (p<0.001). A total of 957 participants completed the satisfaction part of the survey. In this study, 77.95% of the participants used e-health for the first time, and 94.63% of the participants were completely or mostly satisfied with the online consultations. Conclusions The distribution of the amount of online consultations was significantly different not only in different areas but also in different trimesters. In any trimester, the amount of consultations on the second category (obstetric care-seeking behaviour) was the highest in the severe epidemic areas. The needs for online consultations were substantial. In order to prevent irreversible obstetric adverse events, an appropriate antenatal care contingency plan with e-health services is highly recommended during the Public Health Emergency of International Concern.
Salivary Stress/Immunological Markers in Crohn’s Disease and Ulcerative Colitis

There is continuous and growing interest in research into new alternatives to standard biomarkers to detect and follow-up disease, reducing physical and psychological stress in patients needing regular and invasive medical examinations for the evaluation of pathologies, including inflammatory bowel diseases (IBD). Saliva is one of the most promising body fluids in the research of new biomarkers, thanks to the large number of molecules it contains. Many molecules present in saliva are often directly correlated to their concentration in the blood but may be affected by the condition of the oral cavity. This means that a careful selection of a specific biomarker is required for each pathology, especially pathologies such as IBD, which may induce inflammation in the oral cavity. Here, we analyze the currently used and the proposed new salivary biomarkers (i.e., calprotectin, cytokines, IgA, cortisol, and oxidative stress markers) for the detection and follow-up of the main subtypes of IBD, known as ulcerative colitis and Crohn’s disease.
MicroRNA-Based Fingerprinting of Cervical Lesions and Cancer

The regulatory functions of microRNA (miRNA) are involved in all processes contributing to carcinogenesis and response to viral infections. Cervical cancer in most cases is caused by the persistence of high-risk human papillomavirus (HR-HPV) infection. While oncogenic human papillomaviruses induce aberrant expression of many cellular miRNAs, this dysregulation could be harnessed as a marker in early diagnosis of HR-HPV infection, cervical squamous intraepithelial lesions, and cancer. In recent years, growing data indicate that miRNAs show specific patterns at various stages of cervical pathology. The aim of this review is to systematize current reports on miRNA capacity that can be utilized in personalized diagnostics of cervical precancerous and cancerous lesions. The analysis of the resources available in online databases (National Center for Biotechnology Information—NCBI, PubMed, ScienceDirect, Scopus) was performed. To date, no standardized diagnostic algorithm using the miRNA pattern in cervical pathology has been defined. However, the high sensitivity and specificity of the reported assays gives hope for the development of non-invasive diagnostic tests that take into account the heterogeneity of tumor-related changes. Due to this variability resulting in difficult to predict clinical outcomes, precise molecular tools are needed to improve the diagnostic and therapeutic process.
Diabetic Macular Edema in Diabetological Practices Diabetisches Makulaödem in diabetologischen Schwerpunktpraxen

Abstract Using mobile OCT equipment and remote ophthalmological diagnosis of n = 1538 diabetics in 17 diabetes practices in Germany, we found diabetic macular edema in 10.1% of the patients and retinal bleedings or microaneurysms in 15.6%. In 1.62% of the diabetics examined, the size of the edema was > 0.4 mm², in 7% the retinal thickness was > 300 µm and thus in need of treatment. An intravitreal anti-VEGF injection was administered prior to the examination in only 10% of the patients with diabetic macular edema. By means of mobile tele-eye consultation and remote ophthalmological diagnosis using the cloud-based patient file certified as medical device IIa, patients with diabetic macular edema were identified and informed on site quickly and definitively. The data and images were made available to all attending physicians and ophthalmic surgeons. Zusammenfassung Mithilfe von mobilen OCT-Untersuchungsgeräten und augenärztlicher Fernbefundung von n = 1538 Diabetikern in 17 Diabetespraxen in Deutschland fanden wir bei 10,1% der Patienten ein diabetisches Makulaödem und bei 15,6% retinale Blutungen oder Mikroaneurysmen. Bei 1,62% der untersuchten Diabetiker war die Größe des Ödems > 0,4 mm², bei 7% war die Netzhautdicke > 300 µm und damit behandlungsbedürftig. Nur bei 10% der Patienten mit diabetischem Makulaödem erfolgte bis zur Untersuchung eine intravitreale Anti-VEGF-Injektion (VEGF: vascular endothelial growth factor). Mithilfe eines mobilen Teleaugenkonsils und augenärztlicher Fernbefundung durch Nutzung der als Medizinprodukt IIa zertifizierten, cloudbasierten Patientenakte konnten direkt vor Ort, schnell und definitiv Patienten mit diabetischem Makulaödem identifiziert und informiert werden. Die Daten und Bilder wurden allen behandelnden Ärzten und Ophthalmochirurgen zugänglich gemacht.
Awareness and use of nutrition information predict measured and self-rated diet quality of older adults in the USA

Abstract Objectives: To examine: (1) diet quality of older adults, using the Healthy Eating Index 2010 (HEI-2010) and self-rated diet quality, (2) characteristics associated with reported awareness and use of nutrition information and (3) factors associated with HEI score and self-rated diet quality. Design: Cross-sectional study. Based on Day 1 and/or Day 2 dietary recalls, the Per-Person method was used to estimate HEI-2010 component and total scores. T-tests and ANOVA were used to compare means. Logistic and linear regressions were used to test for associations with diet quality, controlling for potential confounders. Setting: National Health and Nutrition Examination Survey, 2009–2014. Participants: Three thousand and fifty-six adults, aged 60 years and older, who completed at least one 24-h recall and answered questions on awareness and use of nutrition information. Results: Mean HEI score for men was significantly lower than for women (56·4 ± 0·6 v. 60·2 ± 0·6, P < 0·0001). Compared with men, more women were aware of (44·8 % v. 33·7 %, P < 0·05) and used (13·7 % v. 5·9 %, P < 0·05) nutrition information. In multivariable analyses, awareness and use of nutrition information were significant predictors of both HEI and self-rated diet quality for both women and men. Groups with lower nutrition awareness included men, non-Whites, participants in nutrition assistance programmes and those with lower education and socio-economic status. Conclusions: Nutrition awareness and use of nutrition information are associated with diet quality in adults 60 years and older. Gaps in awareness of dietary guidelines in certain segments of the older adult population suggest that targeted education may improve diet quality for these groups.
Dynamic Content Reactivation Supports Naturalistic Autobiographical Recall in Humans

Humans can vividly recall and re-experience events from their past, and these are commonly referred to as episodic or autobiographical memories. fMRI experiments reliably associate autobiographical event recall with activity in a network of “default” or “core” brain regions. However, as prior studies have relied on covert (silent) recall procedures, current understanding may be hampered by methodological limitations that obscure dynamic effects supporting moment-to-moment content retrieval. Here, fMRI participants (N = 40) overtly (verbally) recalled memories for ∼2 min periods. The content of spoken descriptions was categorized using a variant of the Autobiographical Interview (AI) procedure (Levine et al., 2002) and temporally re-aligned with BOLD data so activity accompanying the recall of different details could be measured. Replicating prior work, sustained effects associated with autobiographical recall periods (which are insensitive to the moment-to-moment content of retrieval) fell primarily within canonical default network regions. Spoken descriptions were rich in episodic details, frequently focusing on physical entities, their ongoing activities, and their appearances. Critically, neural activity associated with recalling specific details (e.g., those related to people or places) was transient, broadly distributed, and grounded in category-selective cortex (e.g., regions related to social cognition or scene processing). Thus, although a single network may generally support the process of vivid event reconstruction, the structures required to provide detail-related information shift in a predictable manner that respects domain-level representations across the cortex. SIGNIFICANCE STATEMENT Humans can vividly recall memories of autobiographical episodes, a process thought to involve the reconstruction of numerous distinct event details. Yet how the brain represents a complex episode as it unfolds over time remains unclear and appears inconsistent across experimental traditions. One hurdle is the use of covert (silent) in-scanner recall to study autobiographical memory, which prevents experimenter knowledge of what information is being retrieved, and when, throughout the remembering process. In this experiment, participants overtly described autobiographical memories while undergoing fMRI. Activity associated with the recall and description of specific details was transient, broadly distributed, and grounded in category-selective cortex. Thus, it appears that as events unfold mentally, structures are dynamically reactivated to support vivid recollection.
Outcome of Targeted Therapy Recommendations for Metastatic and Recurrent Head and Neck Cancers

Simple Summary In this retrospective study, we aimed to provide molecular-driven therapy recommendations for patients with recurrent/metastatic head and neck cancers based on the respective individual molecular profile. For 31 of 50 patients (62.0% of all patients), a targeted therapy approach could be recommended. Therapy recommendations were significantly more often issued for men than for women. Eventually, 14 patients (28%) received the recommended targeted therapy. Six patients (12%) achieved stable disease and four patients (8%) experienced progressive disease. The median time to treatment failure was 2.8 months. Our analysis showed that although precision medicine approaches are implementable and feasible for the management of recurrent/metastatic head and neck cancers in daily clinical routine, there are major limitations and challenges that have to be overcome. Abstract Recurrent/metastatic (R/M) head and neck cancers bear a poor prognosis. In this analysis, we examined the efficacy and the outcome of targeted therapy recommendations based on the patients’ molecular tumor portrait after failure of all standard therapy options. In this single-center, real-world retrospective analysis of our platform for precision medicine, we analyzed the molecular profile of 50 patients diagnosed with R/M head and neck cancer. Tumor samples of the patients were examined using next-generation sequencing panels of mutation hotspots, microsatellite instability (MSI) testing, and immunohistochemistry (IHC). In 31 cases (62.0% of all patients), a molecular-driven targeted therapy approach was recommended. Eventually, 14 patients (28%) received the suggested targeted therapy. Six of fourteen patients (43%) achieved stable disease conditions and four patients (29%) experienced a progressive disease. The median time to treatment failure was 2.8 months. Therapy recommendations were significantly more often issued for men (p = 0.037) than for women. This analysis demonstrated that precision medicine provided the basis for molecular-driven therapy recommendations in over half of the patients with advanced therapy refractory head and neck cancers, with significantly more therapy recommendations for men. Our analysis showed that although precision medicine approaches are implementable and feasible for the management of recurrent/metastatic head and neck cancers in daily clinical routine, there are major limitations and challenges that have to be overcome.
Screening of Sensitive Items on Gross Motor Development in Toddlers Aged 24~36 Months and Analysis of the Factors Influencing the Passing Rate

Background: To save assessment time and improve the efficiency, it is necessary to find sensitive indicators from the test items of gross motor development in the C-LAP system for children aged 24~36 months and analyze the influencing factors of the passing rate of these indicators. Methods: This retrospective study was conducted among 1354 toddlers (3058 person-times) aged 24 to 36 months in Beijing, Shanghai, Guangdong between January 2013 and December 2019. A linear regression model and Cox regression model were performed to screen sensitive indicators and explore their influencing factors, respectively. Results: “Walk backwards”, “Stand from supine position” and “Hop with one foot at least twice” are the three sensitive indicators for evaluating the development of gross motor function in 24~36 month old children. The child’s physiological age at first measurement and region are the two common independent factors influencing the passing rate of the three items, while paternal age and education may influence one or two of them. Conclusions: “Walk backwards”, “Stand from supine position” and “Hop with one foot at least twice” are sensitive indicators for the effective evaluation of the development of gross motor function in 24~36 month old children, and their passing rates are influenced by some demographic variables.