Miracle-dz/UniFAR-FTUs huggingface dataset:
The road to achieving viral hepatitis elimination in Suriname: The progress, the challenges and the goals.

Background: Viral hepatitis is one of the leading causes of liver failure, cirrhosis, hepatocellular cancer and mortality worldwide and has long had limited treatment options. Estimates suggest that around 30% of the global population has at one point been infected with HBV, while 3.9% are chronically infected. 1.6 - 2.8% of the world population is estimated to be infected with HCV. With the introduction of the HBV birth-dose vaccines, HBV immunoglobulins and the more recent development of the HCV direct-acting antiviral medication, HBV and HCV infections have now become containable diseases. In 2016, all 194 member states of the World Health Organization endorsed the public-health goal to eradicate viral hepatitis by 2030. Yet, as of 2023, only a small group of countries are on course to achieving this goal. Suriname, a small, multi-ethnic country, located in the north of South America, has an intermediate prevalence of HBV and HCV of 3% and 1% respectively. Previously performed studies, however, show strong ethnic clustering in Suriname. Aim: With this manuscript we dissect the strategy we developed to tackle the hepatitis challenge in Suriname. We explain the importance of establishing more detailed insight into the geographical distribution of high-prevalence areas, as linked to the ethnic differences in the population. We present the screening and contact tracing approaches and end with our current insights on how to proceed toward further prevention and treatment options. Overall, we provide a blueprint towards eliminating viral hepatitis with simple and effective strategies usable in resource-limited countries with an intermediate to high prevalence of viral hepatitis.
Role of immigrant males and muzzle contacts in the uptake of a novel food by wild vervet monkeys

The entry into and uptake of information in social groups is critical for behavioral adaptation by long-lived species in rapidly changing environments. We exposed five groups of wild vervet monkeys to a novel food to investigate the innovation of processing and consuming it. We report that immigrant males innovated in two groups, and an infant innovated in one group. In two other groups, immigrant males imported the innovation from their previous groups. We compared uptake between groups with respect to the initial innovator to examine the extent to which dispersing males could introduce an innovation into groups. Uptake of the novel food was faster in groups where immigrant males ate first rather than the infants. Younger individuals were more likely overall, and faster, to subsequently acquire the novel food. We also investigated the role of muzzle contact behavior in information seeking around the novel food. Muzzle contacts decreased in frequency over repeated exposures to the novel food. Muzzle contacts were initiated the most by naïve individuals, high rankers, and juveniles; and were targeted most towards knowledgeable individuals and high rankers, and the least towards infants. We highlight the potential importance of dispersers in rapidly exploiting novel resources among populations.
Large Immature Intracranial Teratoma in an Infant: A Case Report

Intracranial immature teratomas are rare, highly malignant, and fast-growing with a poor prognosis. We report the case of an infant with a large immature teratoma in the intracranial compartment. A two-month-old child presented to the emergency room with drowsiness and seizures. CT and cranial MRI showed hydrocephalus with a large expansive process in the right cerebral hemisphere extending to the infratentorial compartment, compressing the cerebellum and brainstem. It was then decided to partially resect the lesion. Postoperatively, due to the aggressiveness of the residual tumor, the patient developed complications (status epilepticus, hyperthermia, and electrolyte disorders) and died. Histopathological and immunohistochemical studies confirmed an immature teratoma. Teratomas are a subtype of germ cell tumors. Immature teratomas contain a population of cells that retain embryonic characteristics and tissues with more primitive components derived from all or some of the three germ layers (ectoderm, mesoderm, and endoderm). The prognosis of immature teratomas is associated with the degree of tumor differentiation, and those composed of undifferentiated embryonic tissues have a poor prognosis. This case report illustrates the rare and severe occurrence of a bulky immature cerebral teratoma in an infant. Unfortunately, despite undergoing a planned partial resection, the infant ended up having complications and died. Therefore, due to the size of the lesion in an infant, these cases are always complex when deciding on a surgical approach.
Diagnostic accuracy of barium enema versus full‐thickness rectal biopsy in children with clinically suspected Hirschsprung's disease: A comparative cross‐sectional study

Abstract Background and Aims Hirschsprung's disease (HSD) remains a common cause of pediatric intestinal obstruction. Barium contrast enema (BE) is the primary imaging modality for the evaluation of clinically suspected cases. Here, we aimed to assess the diagnostic accuracy of BE in children with clinically suspected HSD when compared to a gold standard full‐thickness rectal biopsy (FTRB). Methods We recruited and consecutively enrolled children with clinically suspected HSD at two tertiary teaching hospitals. Participants underwent BE imaging and two radiologists interpreted the findings independently. Participants further underwent FTRB by pediatric surgeons as the confirmatory test. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristics (ROC) with the area under the curve (AUC) were calculated on Stata version 14.2, taking FTRB as the standard. Results We enrolled 55 cases, of which 49 completed the evaluation and were included in the final analysis. The median age was 9.4 months (interquartile range: 2–24], with a male‐to‐female ratio of 4.4:1. The sensitivity, specificity, PPV, and NPV of BE were 0.95 (95% confidence interval [CI] [0.81–0.99]), 0.73 (95% CI [0.39–0.94]), 0.92 (95% CI [0.82–0.97]), and 0.80 (95% CI [0.50–0.94]), respectively. On AUC, the diagnostic accuracy of BE compared to the confirmatory FTRB was 0.84 (95% CI [0.69–0.98]). The diagnostic accuracy was higher in neonates (ROC: 1.00) when compared to infants (ROC: 0.83) or those above 1 year of age (ROC: 0.798). HSD‐suggestive BE findings were associated with absence of ganglion cells on FTRB (χ 2 = 23.301, p < 0.001). Inverted rectosigmoid ratio and transition zone were more sensitive in detecting HSD of 0.92 (95% CI [0.74–0.98]) and 0.81 (95% CI [0.63–0.92]), respectively. Conclusion BE is sufficiently accurate in the diagnosis of children with HSD, suggesting BE would likely be used to inform surgical management in settings where confirmatory biopsy is lacking. However, clinical judgment is warranted in interpreting negative BE findings.
Internal Carotid Artery Dissection Presenting with Transient or Subclinical Horner Syndrome

Abstract Introduction The most frequently encountered symptoms in internal carotid artery dissection (ICAD) are head or neck pain and cerebral ischemia. Ocular symptoms or signs have been reported as the presenting feature in up to 50% of patients, with (painful) Horner syndrome being the most frequently associated. Horner syndrome is part of the classic triad that depicts the characteristic presentation of ICAD and that consists of pain in the ipsilateral neck, head and orbital regions, (partial) Horner syndrome, and cerebral or retinal ischemia. All patients presenting with painful Horner syndrome should therefore require prompt investigations to rule out carotid artery dissection. In patients with confirmed diagnosis, treatment should be started early to prevent permanent ocular or cerebral complications. Case Presentation Case 1: A 61-year-old woman presented with right temporal headache, an episode of transient visual loss and drooping of the right upper eyelid. Examination revealed anisocoria, which was more important in darkness. Reversal of anisocoria was observed after instilling drops of apraclonidine 0.5%. Neuroimaging demonstrated intrapetrous ICAD. Headaches, eyelid ptosis, and anisocoria all had resolved the next day. Apraclonidine pharmacologic testing a few weeks later was no longer dilating the previously smaller pupil. Case 2: A 48-year-old man presented with drooping of the right upper eyelid and right occipital headache and facial pain that all started one day after an intense yoga workout. Anisocoria was noticed upon examination, with topical cocaine 10% pharmacologic testing confirming a right Horner syndrome. Neuroimaging revealed ICAD. The patient reported resolution of his eyelid ptosis a few days later. Eyelid ptosis and anisocoria had indeed resolved at a follow-up examination a few weeks later. However, cocaine drop testing still produced anisocoria, compatible with subclinical Horner syndrome. Conclusion Transient or subclinical Horner syndrome can be the presenting feature in ICAD; in such cases, the characteristic eyelid ptosis and anisocoria may be short-lived and resolve in only a few days. If suspected by clinical history, pharmacologic testing may be helpful in identifying subclinical cases.
What am I Eating? The Use of Health and Environmental Messages in Predicting a Sustainable Diet

iii ACKNOWLEDGMENTS. v LIST OF TABLES.ix I. CHAPTER 1: INTRODUCTION AND LITERATURE REVIEW.1 Literature Review: Consequences and Potential Benefits of Eating Behaviors.2 Health Consequences of Industrial Diet; Health Benefits of Sustainable Diet.4 Environmental Consequences and Benefits of Eating Behaviors.12 Theory of Planned Behavior and Previous Research.15 Health Research.18 Environmental Research.21 Research Questions and Hypotheses.24 II. CHAPTER 2: METHODS.28 Pretest (Refer to Appendix A). 28 Survey Sample.30 Procedures (Refer to Appendices B and C). 31 Statistical Tests.36
First Complete Skull of a Late Pleistocene Steppe Bison (Bison priscus) in the Iberian Peninsula

Abstract. The Kiputz IX site has provided one of the best-preserved late Pleistocene bison populations in the southern Pyrenees and has yielded the first almost complete skull of a steppe bison (Bison priscus) in the Iberian Peninsula. This Bison priscus skull is compared on morphological and osteometric grounds with other specimens of steppe bison from Europe and North America. The skull from Kiputz IX falls within the range of the extinct subspecies Bison priscus mediator. Available data support the evidence of three chronological subspecies of Bison priscus (Bison priscus gigas, Bison priscus priscus, and Bison priscus mediator) during the Middle and late Pleistocene.
A spectral mixing algorithm for quantifying suspended sediment concentration in the Yellow River: a simulation based on a controlled laboratory experiment

ABSTRACT This study investigated the upper limit of suspended sediment concentration (SSC) with respect to the relationship between SSC and reflectance to develop an SSC remote-sensing model for the highly turbid Yellow River. An SSC quantification model was generated by using the spectral mixing index of sediments in water and sediment mixtures. In this study, laboratory experiments were made to measure the spectral curves of sediment-laden water with a high-resolution spectroradiometer. River-bed deposited sediments from two sites, one on the Yellow River at Huayuankou (HYK) and the other on the Wei River at Yangling (YL), and their sand, silt and clay particle groups were used for laboratory experiments to measure the spectral responses of sediment-laden water. The correlation analysis depicted stable correlation between SSC and reflectance at wavelengths ranging from 450 to 1000 nm, in which Spearman rank correlation coefficient (rs) for all sediments was above 0.7 while rs for the HYK natural sediment exceeded 0.9. Experimental results revealed the curves of the relationship between SSC and reflectance, up to 40 g l−1. A physical-based exponential model ( > 0.9) at each simulated Landsat band effectively interpreted the relationship between SSC and reflectance. The highest upper limit SSCs at 21 and 15 g l−1 in natural YL and HYK sediments, respectively, were observed in Landsat Band 4. A spectral mixing algorithm was used to build the model and estimate the SSC from reflectance at correlated wavelength bands. The spectral mixing algorithm can generate a uniform model that disregards the effects of sediment type by adopting the reflectance curve at the upper-limit SSC to represent the standard reflectance of sediment. This study is useful in understanding the spectral characteristic of high SSC in water and in applying remote-sensing techniques to monitor SSC in the Yellow River.
Differentiation and risk stratification of basal cell carcinoma with deep learning on histopathologic images and measuring nuclei and tumor microenvironment features

Abstract Background Nuclear pleomorphism and tumor microenvironment (TME) play a critical role in cancer development and progression. Identifying most predictive nuclei and TME features of basal cell carcinoma (BCC) may provide insights into which characteristics pathologists can use to distinguish and stratify this entity. Objectives To develop an automated workflow based on nuclei and TME features from basaloid cell tumor regions to differentiate BCC from trichoepithelioma (TE) and stratify BCC into high‐risk (HR) and low‐risk (LR) subtypes, and to identify the nuclear and TME characteristics profile of different basaloid cell tumors. Methods The deep learning systems were trained on 161 H&E ‐stained sections which contained 51 sections of HR‐BCC, 50 sections of LR‐BCC and 60 sections of TE from one institution (D1), and externally and independently validated on D2 (46 sections) and D3 (76 sections), from 2015 to 2022. 60%, 20% and 20% of D1 data were randomly splitted for training, validation and testing, respectively. The framework comprised four stages: tumor regions identification by multi‐head self‐attention (MSA) U‐Net, nuclei segmentation by HoVer‐Net, quantitative feature by handcrafted extraction, and differentiation and risk stratification classifier construction. Pixel accuracy, precision, recall, dice score, intersection over union (IoU) and area under the curve (AUC) were used to evaluate the performance of tumor segmentation model and classifiers. Results MSA‐U‐Net model detected tumor regions with 0.910 precision, 0.869 recall, 0.889 dice score and 0.800 IoU. The differentiation classifier achieved 0.977 ± 0.0159, 0.955 ± 0.0181, 0.885 ± 0.0237 AUC in D1, D2 and D3, respectively. The most discriminative features between BCC and TE contained Homogeneity, Elongation, T‐T_meanEdgeLength, T‐T_Nsubgraph, S‐T_HarmonicCentrality, S‐S_Degrees. The risk stratification model can well predict HR‐BCC and LR‐BCC with 0.920 ± 0.0579, 0.839 ± 0.0176, 0.825 ± 0.0153 AUC in D1, D2 and D3, respectively. The most discriminative features between HR‐BCC and LR‐BCC comprised IntensityMin, Solidity, T‐T_minEdgeLength, T‐T_Coreness, T‐T_Degrees, T‐T_Betweenness, S‐T_Degrees. Conclusions This framework hold potential for future use as a second opinion helping inform diagnosis of BCC, and identify nuclei and TME features related with malignancy and tumor risk stratification.
Testing the incremental effectiveness of pay-for-performance to improve implementation of a motivational interviewing brief intervention for substance use disorders in HIV settings: Results of a cluster-randomized type 3 hybrid trial

Background: Substance use disorders (SUDs) have a serious adverse impact on people living with HIV. Previously, using a 39-site dual-randomized type 2 hybrid trial design, findings from the Substance Abuse Treatment to HIV Care Project supported the Implementation and Sustainment Facilitation (ISF) strategy to improve implementation and effectiveness of a motivational interviewing brief intervention (MIBI) for SUD within HIV service settings across the United States (US). Building on this trial, this cluster-randomized type 3 hybrid trial aimed to test the incremental effectiveness of a pay-for-performance (P4P), a form of the “alter incentive/allowance structures” strategy. Methods: Twenty-six HIV service organizations, their staff participants (N=87), and their client participants (N=341) were cluster-randomized to one of two implementation conditions. The control condition included staff-focused training, feedback, and consultation (TFC) and team-focused implementation and sustainment (ISF). The experimental condition included TFC+ISF as well as P4P (TFC+ISF+P4P). P4P used financial incentives to reward MIBI implementation (US$10 per MIBI delivered) and MIBI implementation at or above a pre-defined level of quality (US$10 per demonstration). In addition to these outcomes, past 4-week changes/reductions in client participant’s days of primary substance use and anxiety symptoms were examined. Results: The addition of P4P had a large and significant effect on the number of MIBIs implemented (d=1.30, p<.05) and reduction in anxiety (d=−1.54), but there was no impact on days of substance use. P4P had large effects on MIBI quality (d=1.24) and MIBI implementation effectiveness (d=1.28), but these were not significant (p<.10). Conclusions: P4P is a form of the “alter incentive/allowance structures” strategy Its function is to reward the implementation of a clinical innovation. Rewarding implementation is consistent with the theory of implementation effectiveness, which suggests implementation climate (i.e., the extent to which implementation is expected, supported, and rewarded) is a key antecedent of implementation effectiveness (i.e., the consistency and quality of implementation). We found that P4P had a significant, positive impact on MIBI implementation in HIV service settings, but client-level outcomes were mixed. Future research should examine the cost-effectiveness of this strategy, as well as to examine the effectiveness of P4P to improve the implementation of other evidence-based innovations. Trial registration: ClinicalTrials.gov: NCT04687917. Registered 12/18/2020.
Effects of decompressive craniectomy combined with edaravone on postoperative neurological functions and hemodynamics of patients with severe traumatic brain injury

Objectives: To assess the effects of decompressive craniectomy combined with edaravone on the postoperative neurological functions and hemodynamics of patients with severe traumatic brain injury (STBI). Methods: The subjects included totally 186 STBI patients admitted during January 2018 and January 2021. The random number table method was adopted to set an operation group (n=82) and a combined medication group (n=104) for the subjects. The changes of the clinical indicators were observed. Results: Compared with the operation group, the combined medication group had higher Neurobehavioral Cognitive Status Examination score, Barthel index score, total response rate and heart rate (p<0.05). Besides, by contrast to those of the operation group, the mean arterial pressure, myocardial zymogram indicators, postoperative neurological function indicators and total incidence rate of complications of the combined medication group were reduced (p<0.05). In comparison with the operation group, the combined medication group exhibited raised ipsilateral contralateral blood velocities (p<0.05). Furthermore, the combined medication group had a better postoperative 1-year prognosis than the operation group (p<0.05). Conclusion: Edaravone in combination with decompressive craniectomy benefits the postoperative improvement of neurological functions of STBI patients, effectively stabilizes the hemodynamics, induces few complications and improves the prognosis.
Gut-brain axis interplay via STAT3 pathway: Implications of Helicobacter pylori derived secretome on inflammation and Alzheimer’s disease

ABSTRACT Helicobacter pylori is a pathogenic bacterium that causes gastritis and gastric carcinoma. Besides gastric complications its potential link with gut-brain axis disruption and neurological disorders has also been reported. The current study investigated the plausible role and its associated molecular mechanism underlying H. pylori mediated gut-brain axis disruption and neuroinflammation leading to neurological modalities like Alzheimer’s disease (AD). We have chosen the antimicrobial resistant and susceptible H. pylori strains on the basis of broth dilution method. We have observed the increased inflammatory response exerted by H. pylori strains in the gastric as well as in the neuronal compartment after treatment with Helicobacter pylori derived condition media (HPCM). Further, elevated expression of STAT1, STAT3, and AD-associated proteins- APP and APOE4 was monitored in HPCM-treated neuronal and neuron-astrocyte co-cultured cells. Excessive ROS generation has been found in these cells. The HPCM treatment to LN229 causes astrogliosis, evidenced by increased glial fibrillary acidic protein. Our results indicate the association of STAT3 as an important regulator in the H. pylori-mediated pathogenesis in neuronal cells. Notably, the inhibition of STAT3 by its specific inhibitor, BP-1-102, reduced the expression of pSTAT3 and AD markers in neuronal compartment induced by HPCM. Thus, our study demonstrates that H. pylori infection exacerbates inflammation in AGS cells and modulates the activity of STAT3 regulatory molecules. H. pylori secretome could affect neurological compartments by promoting STAT3 activation and inducing the expression of AD-associated signature markers. Further, pSTAT-3 inhibition mitigates the H. pylori associated neuroinflammation and amyloid pathology.
Grazing with Goats Changed the Woodland Plant- Species Composition During Summer

Woodland grazing is a common practice in the Southeast; however, information is limited on its effects on the woodland plant-species composition. The study objective was to determine the effect of summer grazing on woodland plant-species composition. Before- and after-grazing observations were taken at the ground, mid, and high levels in three plots (1-acre each) along the pre-established transects. Kiko wethers (29, 6-8 months old, 26.8±0.67 kg body weight) were allowed to graze the plots after before-grazing observations were taken. After-grazing observations were taken immediately after the goats were moved out from the plots. Grazing showed a significant effect on the plant species diversity at the ground- and mid-level (p<0.0001). The evenness indices after grazing for the ground- and mid-level vegetation were decreased by 26% and 24%, respectively. The results suggest that goats’ grazing can have a significant short-term impact on the woodland-plant community below 1.5 m height.