Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevalence and determinants of sleep disorders in a community in rural southern India

Background. We assessed the prevalence of sleep disorders among people above 15 years of age from a rural area of Puducherry, south India. Methods. We did a community-based cross-sectional study among people residing in four service area villages of a rural primary health centre in Puducherry, India. Probability sampling techniques were used to select participants. The Pittsburgh Sleep Quality Index was administered to detect sleep disorders among the participants. The data were entered and analysed using EpiData entry 3.1 and Stata 12 software, respectively. Association between various individual factors and sleep disorders was assessed using generalized linear models adjusting for clustering at the household level and expressed as prevalence ratio with 95% confidence interval (CI). Results. The mean (SD) age of the 501 participants was 38.3 (15.4) years. Poor quality of sleep was present in 36.3% (95% CI 32.2%–40.6%). In multivariate generalized linear model, age >60 years (adjusted prevalence rate ratio [aPRR] 1.68; 95% CI 1.11–2.53), female sex (aPRR 1.57; 95% CI 1.18–2.08), living in a broken family (aPRR 1.47; 95% CI 1.06–2.02) and having a television in their sleeping room (aPRR 1.40; 95% CI 1.40–1.79) were independently associated with poor quality of sleep. Conclusions. A high prevalence suggests that sleep disorders are a problem in the rural community too. Capacity building among the existing health workforce to identify and treat sleep disorders and health education activities focusing on sleep hygiene among the general public are needed to tackle sleep disorders in the community.
Spatial Ability in Children with Mathematics Learning Disorder (MLD) and Its Impact on Executive Functions

ABSTRACT Mathematics Learning Disorder (MLD) has been found to be related to impairments in cognitive functions. Spatial ability (SA), which is made up of eight single but unified elements can be assumed to have a leading part in different areas of math skills. The first objective of this study was to explore differences in SA factors in 128 school children of third to sixth grade with and without MLD. The Flexibility of Closure, Closure Speed, Perceptual Speed, Visualization, Spatial Relation, Spatial Orientation, Spatial Temporal, and Wayfinding were measured through eight tasks. The second objective of the study was to explore the SA factors’ ability to predict the performance of MLD participants in three executive functions. The results revealed that participants with MLD had poorer performance in all the SA tasks and it took longer to finish the visualization, spatial relation, and spatial orientation tasks compared to children with typical development (TD). Regression analysis indicated that some of the SA factors could predict working memory and cognitive flexibility, but they were unable to predict response inhibition. Regarding these results, applying SA factors in cognitive rehabilitation programs of children with MLD seems necessary.
Do more stress and lower family economic status increase vulnerability to suicidal ideation? Evidence of a U-shaped relationship in a large cross-sectional sample of South Korean adolescents

It is widely held in socio-behavioral studies of suicide that higher levels of stress and lower levels of economic status amplify suicidal vulnerability when confronted with a proximal stressor, reflecting the traditionally prevalent understanding in health psychology and sociology that associates adverse life circumstances with undesirable mental health outcomes. However, upon reflection, there are strong theoretical reasons to doubt that having more stress or being in a more stressful environment always increases suicidal vulnerability given the occurrence of a crisis. Using large nationally representative public survey data on South Korean adolescents, I show that the association between recent psychosocial crisis and suicidal ideation often gets stronger with more favorable levels of perceived stress and improving levels of family economic status. Overall, the increase in the probability of suicidal ideation from recent exposure to a psychosocial crisis is consistently the smallest around medium levels of stress or family economic status and larger at low or high levels. A supplementary exercise suggests that the identified moderation effects operate mainly in virtue of individual-level stress or family economic status in the relative absence of contextual influences at the school level. The findings present preliminary evidence of the stress inoculation hypothesis with regard to suicidal ideation. Research on suicidal vulnerability could benefit from increased attentiveness to the mechanisms through which being in an adverse or unfavorable life situation could protect against the suicide-inducing effects of proximal stressors.
Long‐term results of low‐intensity chemotherapy with clofarabine or cladribine combined with low‐dose cytarabine alternating with decitabine in older patients with newly diagnosed acute myeloid leukemia

The treatment of older patients with newly diagnosed acute myeloid leukemia (AML) using intensive chemotherapy is associated with treatment intolerance and poor survival. We evaluated two new lower‐intensity regimens with clofarabine (n = 119) or cladribine (n = 129) combined with low‐dose cytarabine (LDAC) alternating with decitabine. We reviewed response rates by subgroup and long term outcomes of 248 patients with newly diagnosed non core‐binding‐factor AML treated on two clinical trials investigating double nucleoside‐analogue therapy (DNT) alternating with HMA from October, 2008 to April, 2018. Of 248 patients with a median age of 69 years (range, 49–85 years), 102 patients (41%) were ≥ 70 years, and 108 (44%) had adverse karyotype. Overall, 164 patients (66%) responded: 147 (59%) complete remission (CR) and 17 (7%) CR with incomplete count recovery (CRi). With a median follow up of 60 months, median relapse‐free and overall survival (OS) were 10.8 and 12.5 months, respectively. The 2‐year OS was 29%. Among patients with normal karyotype, the CR/CRi rate was 79% and the median OS 19.9 months. High response rates and OS were observed in patients with mutations in NPM1, FLT3, IDH2, and RUNX1. The 4‐ and 8‐week mortality rates were 2% and 11%, respectively. The backbone of clofarabine or cladribine and LDAC alternating with decitabine was effective and safe for the treatment of older patients with newly diagnosed AML. Incorporating targeted therapies could extend the efficacy of this approach and provide more curative therapeutic options in this AML population.
Overcoming Culture Restriction for SARS-CoV-2 in Human Cells Facilitates the Screening of Compounds Inhibiting Viral Replication

Efforts to mitigate the coronavirus disease 2019 (COVID-19) pandemic include the screening of existing antiviral molecules that could be repurposed to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Although SARS-CoV-2 replicates and propagates efficiently in African green monkey kidney (Vero) cells, antivirals such as nucleos(t)ide analogs (nuc’s) often show decreased activity in these cells due to inefficient metabolization. ABSTRACT Efforts to mitigate the coronavirus disease 2019 (COVID-19) pandemic include the screening of existing antiviral molecules that could be repurposed to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Although SARS-CoV-2 replicates and propagates efficiently in African green monkey kidney (Vero) cells, antivirals such as nucleos(t)ide analogs (NUCs) often show decreased activity in these cells due to inefficient metabolization. SARS-CoV-2 exhibits low viability in human cells in culture. Here, serial passages of a SARS-CoV-2 isolate (original-SARS2) in the human hepatoma cell clone Huh7.5 led to the selection of a variant (adapted-SARS2) with significantly improved infectivity in human liver (Huh7 and Huh7.5) and lung cancer (unmodified Calu-1 and A549) cells. The adapted virus exhibited mutations in the spike protein, including a 9-amino-acid deletion and 3 amino acid changes (E484D, P812R, and Q954H). E484D also emerged in Vero E6-cultured viruses that became viable in A549 cells. Original and adapted viruses were susceptible to scavenger receptor class B type 1 (SR-B1) receptor blocking, and adapted-SARS2 exhibited significantly less dependence on ACE2. Both variants were similarly neutralized by COVID-19 convalescent-phase plasma, but adapted-SARS2 exhibited increased susceptibility to exogenous type I interferon. Remdesivir inhibited original- and adapted-SARS2 similarly, demonstrating the utility of the system for the screening of NUCs. Among the tested NUCs, only remdesivir, molnupiravir, and, to a limited extent, galidesivir showed antiviral effects across human cell lines, whereas sofosbuvir, ribavirin, and favipiravir had no apparent activity. Analogously to the emergence of spike mutations in vivo, the spike protein is under intense adaptive selection pressure in cell culture. Our results indicate that the emergence of spike mutations will most likely not affect the activity of remdesivir.
HIV TB coinfection - perspectives from India

ABSTRACT Introduction: HIV and tuberculosis (TB) are two of the most challenging infections faced by humanity and place immense burden on health care systems worldwide. Both HIV and TB impact one another’s progression. Areas covered: HIV is the most important risk factor for progression of latent TB to active disease. TB is the most common cause of death among People Living with HIV (PLHIV). Timely detection of TB among PLHIV and screening for HIV among TB patients, early initiation of ART and ATT among coinfected persons, provision of CPT and TB Preventive therapy along with control of air-borne infection are some of the key activities to reduce morbidity and mortality among coinfected persons. Despite many challenges, the collaboration between two programs has yielded good results and globally more than 7.3 million lives of PLHIV have been saved globally through scale-up of collaborative TB/HIV activities since 2005. The review looked into key features of both programs that are the collaboration strategies and challenges that still need to be addressed. Expert opinion: The overarching principle for effective implementation of collaborative activities is integration of the TB and HIV national programs right from policy making to service delivery and monitoring.
Association Between Age at Diabetes Onset and Subsequent Risk of Dementia.

Importance Trends in type 2 diabetes show an increase in prevalence along with younger age of onset. While vascular complications of early-onset type 2 diabetes are known, the associations with dementia remains unclear. Objective To determine whether younger age at diabetes onset is more strongly associated with incidence of dementia. Design, Setting, and Participants Population-based study in the UK, the Whitehall II prospective cohort study, established in 1985-1988, with clinical examinations in 1991-1993, 1997-1999, 2002-2004, 2007-2009, 2012-2013, and 2015-2016, and linkage to electronic health records until March 2019. The date of final follow-up was March 31, 2019. Exposures Type 2 diabetes, defined as a fasting blood glucose level greater than or equal to 126 mg/dL at clinical examination, physician-diagnosed type 2 diabetes, use of diabetes medication, or hospital record of diabetes between 1985 and 2019. Main Outcomes and Measures Incident dementia ascertained through linkage to electronic health records. Results Among 10 095 participants (67.3% men; aged 35-55 years in 1985-1988), a total of 1710 cases of diabetes and 639 cases of dementia were recorded over a median follow-up of 31.7 years. Dementia rates per 1000 person-years were 8.9 in participants without diabetes at age 70 years, and rates were 10.0 per 1000 person-years for participants with diabetes onset up to 5 years earlier, 13.0 for 6 to 10 years earlier, and 18.3 for more than 10 years earlier. In multivariable-adjusted analyses, compared with participants without diabetes at age 70, the hazard ratio (HR) of dementia in participants with diabetes onset more than 10 years earlier was 2.12 (95% CI, 1.50-3.00), 1.49 (95% CI, 0.95-2.32) for diabetes onset 6 to 10 years earlier, and 1.11 (95% CI, 0.70-1.76) for diabetes onset 5 years earlier or less; linear trend test (P < .001) indicated a graded association between age at onset of type 2 diabetes and dementia. At age 70, every 5-year younger age at onset of type 2 diabetes was significantly associated with an HR of dementia of 1.24 (95% CI, 1.06-1.46) in analyses adjusted for sociodemographic factors, health behaviors, and health-related measures. Conclusions and Relevance In this longitudinal cohort study with a median follow-up of 31.7 years, younger age at onset of diabetes was significantly associated with higher risk of subsequent dementia.
Comparison of ultrasound-accelerated versus conventional catheter-directed thrombolysis for deep vein thrombosis: A systematic review and meta-analysis

Background Recent in vitro and clinical studies have shown that ultrasound-accelerated catheter-directed thrombolysis (USACDT) can accelerate thrombolysis. Therefore, in this meta-analysis, we aimed to compare the efficacy and safety of USACDT with conventional catheter-directed thrombolysis in patients with deep vein thrombosis. Methods A systematic search of the following electronic databases was performed from their dates of inception to 20 June 2020: MEDLINE, Scopus, Google Scholar, CINAHL, Cochrane Library, and EMBASE. All randomized controlled trials that directly compared the complications and efficacy of USACDT and conventional catheter-directed thrombolysis in patients with deep vein thrombosis were identified. The statistical analysis was performed using comprehensive meta-analysis software. Results Finally, 18 studies with a total of 597 participants were included in our meta-analysis according to the eligibility criteria. Pooled proportion of USACDT success in patients with deep vein thrombosis was 87.8% (18 studies; 95% CI: 83.1–91.3). Success rate was significantly higher in USACDT treatment than in conventional catheter-directed thrombolysis treatment (seven studies; OR: 2.96; 95% CI: 1.69–5.16; P < 0.01)). Although the mean infusion time was higher in catheter-directed thrombolysis treatment compared to USACDT treatment, this difference was not statistically significant (three studies; MD: –1.46; 95% CI: –3.25–0.32; P = 0.10). Moreover, pooled rate of complications was lower in USACDT than catheter-directed thrombolysis which was not statistically significant (seven studies; OR: 0.49; 95% CI: 0.13–1.76; P = 0.27). Conclusion This meta-analysis revealed that USACDT significantly increased the success rate of thrombolysis compared to conventional catheter-directed thrombolysis. Furthermore, USACDT was associated with lower rate of complication and infusion time. Taken together, these findings confirm the superiority of this novel intervention over conventional catheter-directed thrombolysis in treatment of patients with deep vein thrombosis.
Anti-Toxoplasma IgG assays: What performances for what purpose? A systematic review

Chronic infection with Toxoplasma gondii is attested by the detection of specific anti-Toxoplasma IgG. A wide panel of serologic methods is currently marketed, and the most suitable method should be chosen according to the laboratory resources and the screened population. This systematic review of evaluation studies aimed at establishing an overview of the performances, i.e. sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of marketed anti-Toxoplasma IgG assays, and discussing their technical characteristics to guide further choice for routine diagnostic use. According to PRISMA guidelines, the search performed in PubMed and Web of Science databases recovered 826 studies, of which 17 were ultimately included. Twenty commercial anti-Toxoplasma IgG assays were evaluated, in comparison with an accepted reference method. Most of them were enzyme-immunoassays (EIAs, n = 12), followed by agglutination tests (n = 4), immunochromatographic tests (n = 3), and a Western-Blot assay (WB, n = 1). The mean sensitivity of IgG assays ranged from 89.7% to 100% for standard titers and from 13.4% to 99.2% for low IgG titers. A few studies pointed out the ability of some methods, especially WB to detect IgG early after primary infection. The specificity of IgG assays was generally high, ranging from 91.3% to 100%; and higher than 99% for most EIA assays. The PPV was not a discriminant indicator among methods, whereas significant disparities (87.5%–100%) were reported among NPVs, a key-parameter assessing the ability to definitively rule out a Toxoplasma infection in patients at-risk for opportunistic infections.
Grain chalkiness traits is affected by the synthesis and dynamic accumulation of the storage protein in rice.

BACKGROUOND Grain chalkiness lowers the market value of the rice. To alleviate grain chalkiness is the most challenging issue in many rice-producing areas of the world. Nitrogen (N) metabolism has received increasing attention due to its relation with grain chalkiness, but little information is available on the mechanism of N-induced grain chalk. RESULTS A highly chalky rice variety OM052 was used to explore the protein synthesis and its accumulation in the grain exposed to N topdressing (N+) at the panicle initiation stage and a control (N-). Results showed that chalky kernels were stimulated by the N+ treatment and more prone to occur on the top and primary rachis. The grain protein content were increased due to the increased average and maximum rates of protein accumulation during the grain filling, which was related to the enhanced activities of glutamine synthetase, glutamate synthase, glutamic oxalo-acetic transaminase and glutamate pyruvate transaminase under the N+ treatment. The activities of these enzymes at 15 days after flowering (DAF) were notably positively correlated with grain chalky traits and protein content. CONCLUSION N topdressing regulates the synthesis and accumulation of the protein by affecting the key enzymes, especially at 15 DAF, which is attributed to grain chalkiness in rice. This article is protected by copyright. All rights reserved.
Effectiveness and Harms of High-Flow Nasal Oxygen for Acute Respiratory Failure: An Evidence Report for a Clinical Guideline From the American College of Physicians

BACKGROUND Use of high-flow nasal oxygen (HFNO) for treatment of adults with acute respiratory failure (ARF) has increased. PURPOSE To assess HFNO versus noninvasive ventilation (NIV) or conventional oxygen therapy (COT) for ARF in hospitalized adults. DATA SOURCES English-language searches of MEDLINE, Embase, CINAHL, and Cochrane Library from January 2000 to July 2020; systematic review reference lists. STUDY SELECTION 29 randomized controlled trials evaluated HFNO versus NIV (k = 11) or COT (k = 21). DATA EXTRACTION Data extraction by a single investigator was verified by a second, 2 investigators assessed risk of bias, and evidence certainty was determined by consensus. DATA SYNTHESIS Results are reported separately for HFNO versus NIV, for HFNO versus COT, and by initial or postextubation management. Compared with NIV, HFNO may reduce all-cause mortality, intubation, and hospital-acquired pneumonia and improve patient comfort in initial ARF management (low-certainty evidence) but not in postextubation management. Compared with COT, HFNO may reduce reintubation and improve patient comfort in postextubation ARF management (low-certainty evidence). LIMITATIONS Trials varied in populations enrolled, ARF causes, and treatment protocols. Trial design, sample size, duration of treatment and follow-up, and results reporting were often insufficient to adequately assess many outcomes. Protocols, clinician and health system training, cost, and resource use were poorly characterized. CONCLUSION Compared with NIV, HFNO as initial ARF management may improve several clinical outcomes. Compared with COT, HFNO as postextubation management may reduce reintubations and improve patient comfort; HFNO resulted in fewer harms than NIV or COT. Broad applicability, including required clinician and health system experience and resource use, is not well known. PRIMARY FUNDING SOURCE American College of Physicians. (PROSPERO: CRD42019146691).
Multigenerational exposure to warming and fishing causes recruitment collapse, but size diversity and periodic cooling can aid recovery

Significance The synergistic impacts of rapid climatic warming and fisheries harvest are threatening the sustainability of wild fisheries. Their collective impact on fish recruitment—a key process underpinning stock abundance—remains poorly understood. We experimentally exposed fish populations to realistic warming and fishing-selection regimes over multiple generations and found that warmed populations experienced a severe decline in recruitment rate. This warming-induced decline was exacerbated by size-selective fishery harvest. Once warming and size-selective fishing were relaxed, recruitment rates rapidly recovered. Our results suggest that synergistic impacts of fishing and warming can have delayed effects on stock resilience and that preserving fish body size diversity will help to increase their resilience to global warming. Global warming and fisheries harvest are significantly impacting wild fish stocks, yet their interactive influence on population resilience to stress remains unclear. We explored these interactive effects on early-life development and survival by experimentally manipulating the thermal and harvest regimes in 18 zebrafish (Danio rerio) populations over six consecutive generations. Warming advanced development rates across generations, but after three generations, it caused a sudden and large (30–50%) decline in recruitment. This warming impact was most severe in populations where size-selective harvesting reduced the average size of spawners. We then explored whether our observed recruitment decline could be explained by changes in egg size, early egg and larval survival, population sex ratio, and developmental costs. We found that it was most likely driven by temperature-induced shifts in embryonic development rate and fishing-induced male-biased sex ratios. Importantly, once harvest and warming were relaxed, recruitment rates rapidly recovered. Our study suggests that the effects of warming and fishing could have strong impacts on wild stock recruitment, but this may take several generations to manifest. However, resilience of wild populations may be higher if fishing preserves sufficient body size diversity, and windows of suitable temperature periodically occur.