Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical characteristics of coronavirus disease 2019 (COVID-19) patients in Kuwait

Abstract Background: In early December 2019, the first clusters of Coronavirus Disease 2019 (COVID-19) were identified in Wuhan, China and attributed to a novel coronavirus, now known as Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV2). Kuwait reported its first cases of COVID-19 on February 24th 2020 and since then the number of cases has been increasing rapidly. Methods and Findings: This is a retrospective single-center study of consecutive 417 COVID-19 patients admitted to Jaber Al-Ahmad hospital between 24/2/2020 and 24/5/2020. The mean age of cohort was 45.35 years (S.D. 17.16) and 62.8% of cases were males. Patients were divided into four groups; Asymptomatic group, symptomatic group with mild form of the disease, ICU survivors and ICU death. In total, 39.3% of patients were asymptomatic, 41% were symptomatic with mild symptoms, 5.3% were admitted to ICU and recovered and 14.4% died. Mean age of ICU patients was 53.61 years (S.D. 13.43). Comorbidities were more prevalent in ICU death group when compared to other groups (p<0.05) including Diabetes (40%), Hypertension (46.7%), Asthma (20.3%) and cardiovascular disease (21.7%). Blood biochemistry analysis showed that ICU death group had a characteristic abnormal pattern of certain markers upon admission in the ICU. Including significantly high WBC and neutrophil counts (P<0.05) and prolonged Prothrombin Time (PT) and activated partial thromboplastin time (APTT) (P<0.05). D-dimer, C-reactive protein and Procalcitonin (PCT) showed significantly high levels in ICU admissions and in ICU death group in particular (P<0.05). Kidney injury complications were reported in 65% of ICU death group (P<0.05) which also showed significantly elevated urea levels (P<0.05). We also reported rapid deteriorating kidney function (eGFR) in ICU death cases during ICU stay until the outcome was reached. Conclusions: In this single-center study of 417 COVID19 patients in Kuwait. The disease showed varying degree of severity ranging from asymptomatic status to death. Our comprehensive laboratory analysis revealed distinct abnormal patterns of markers that are associated with poor prognosis. Our dynamic profiling of eGFR in COVID-19 ICU patients highlight potential role of renal markers in forecasting disease outcome and perhaps identify patients at risk of poor outcome.
Assessing the burden of COVID-19 in Canada

Background: The burden of COVID-19 in Canada is unequally distributed geographically, with the largest number of cases and fatalities recorded in Quebec and Ontario while other provinces experienced limited outbreaks. To date, however, no study has assessed how provincial epidemics have unfolded in a comparative perspective. This is essential to calibrate projections of the future course of the epidemic and plan health care resources for the second wave of infections. Methods: Using newly released individual-level data collected by the Public Health Agency of Canada, we assess COVID-19-related morbidity and mortality across age and gender groups at the provincial level through a combination of demographic and survival analyses. Results: Quebec has the highest absolute and per capita number of COVID-19 confirmed positive cases, hospitalizations and fatalities in all age groups. In each province, a higher number of women than men test positive for the disease, especially above age 80. Yet consistently across age groups, infected men are more likely to be hospitalized and enter intensive care than women do. These gender differences in hospitalisation rates account for the higher case fatality risk due to COVID-19 among men compared to women. Interpretation: Although health care capacity across provinces has been sufficient to treat severe cases, we find that the main factor accounting for gender differences in COVID-19-related mortality is the need for hospitalization and intensive care, especially above age 80. This suggests a selection effect of severe cases requiring to be treated in a hospital setting that needs to be further investigated.
Molecular insights into the powerful mucus-based adhesion of limpets (Patella vulgata L.)

Limpets (Patella vulgata L.) are renowned for their powerful attachments to rocks on wave-swept seashores. Unlike adult barnacles and mussels, limpets do not adhere permanently; instead, they repeatedly transition between long-term adhesion and locomotive adhesion depending on the tide. Recent studies on the adhesive secretions (bio-adhesives) of marine invertebrates have expanded our knowledge on the composition and function of temporary and permanent bio-adhesives. In comparison, our understanding of the limpets' transitory adhesion remains limited. In this study, we demonstrate that suction is not the primary attachment mechanism in P. vulgata; rather, they secrete specialized pedal mucus for glue-like adhesion. Through combined transcriptomics and proteomics, we identified 171 protein sequences from the pedal mucus. Several of these proteins contain conserved domains found in temporary bio-adhesives from sea stars, sea urchins, marine flatworms and sea anemones. Many of these proteins share homology with fibrous gel-forming glycoproteins, including fibrillin, hemolectin and SCO-spondin. Moreover, proteins with potential protein- and glycan-degrading domains could have an immune defence role or assist degrading adhesive mucus to facilitate the transition from stationary to locomotive states. We also discovered glycosylation patterns unique to the pedal mucus, indicating that specific sugars may be involved in transitory adhesion. Our findings elucidate the mechanisms underlying P. vulgata adhesion and provide opportunities for future studies on bio-adhesives that form strong attachments and resist degradation until necessary for locomotion.
Approach and Management of Hypertension After Kidney Transplantation

Hypertension is one of the most common cardiovascular co-morbidities after successful kidney transplantation. It commonly occurs in patients with other metabolic diseases, such as diabetes mellitus, hyperlipidemia, and obesity. The pathogenesis of post-transplant hypertension is complex and is a result of the interplay between immunological and non-immunological factors. Post-transplant hypertension can be divided into immediate, early, and late post-transplant periods. This classification can help clinicians determine the etiology and provide the appropriate management for these complex patients. Volume overload from intravenous fluid administration is common during the immediate post-transplant period and commonly contributes to hypertension seen early after transplantation. Immunosuppressive medications and donor kidneys are associated with post-transplant hypertension occurring at any time point after transplantation. Transplant renal artery stenosis (TRAS) and obstructive sleep apnea (OSA) are recognized but common and treatable causes of resistant hypertension post-transplantation. During late post-transplant period, chronic renal allograft dysfunction becomes an additional cause of hypertension. As these patients develop more substantial chronic kidney disease affecting their allografts, fibroblast growth factor 23 (FGF23) increases and is associated with increased cardiovascular and all-cause mortality in kidney transplant recipients. The exact relationship between increased FGF23 and post-transplant hypertension remains poorly understood. Blood pressure (BP) targets and management involve both non-pharmacologic and pharmacologic treatment and should be individualized. Until strong evidence in the kidney transplant population exists, a BP of <130/80 mmHg is a reasonable target. Similar to complete renal denervation in non-transplant patients, bilateral native nephrectomy is another treatment option for resistant post-transplant hypertension. Native renal denervation offers promising outcomes for controlling resistant hypertension with no significant procedure-related complications. This review addresses the epidemiology, pathogenesis, and specific etiologies of post-transplant hypertension including TRAS, calcineurin inhibitor effects, OSA, and failed native kidney. The cardiovascular and survival outcomes related to post-transplant hypertension and the utility of 24-h blood pressure monitoring will be briefly discussed. Antihypertensive medications and their mechanism of actions relevant to kidney transplantation will be highlighted. A summary of guidelines from different professional societies for BP targets and antihypertensive medications as well as non-pharmacological interventions, including bilateral native nephrectomy and native renal denervation, will be reviewed.
Understanding Environmental Changes in Temperate Coastal Seas: Linking Models of Benthic Fauna to Carbon and Nutrient Fluxes

Coastal seas are highly productive systems, providing an array of ecosystem services to humankind, such as processing of nutrient effluents from land and climate regulation. However, coastal ecosystems are threatened by human-induced pressures such as climate change and eutrophication. In the coastal zone, the fluxes and transformations of nutrients and carbon sustaining coastal ecosystem functions and services are strongly regulated by benthic biological and chemical processes. Thus, to understand and quantify how coastal ecosystems respond to environmental change, mechanistic modeling of benthic biogeochemical processes is required. Here, we discuss the present model capabilities to quantitatively describe how benthic fauna drives nutrient and carbon processing in the coastal zone. There are a multitude of modeling approaches of different complexity, but a thorough mechanistic description of benthic-pelagic processes is still hampered by a fundamental lack of scientific understanding of the diverse interactions between the physical, chemical and biological processes that drive biogeochemical fluxes in the coastal zone. Especially shallow systems with long water residence times are sensitive to the activities of benthic organisms. Hence, including and improving the description of benthic biomass and metabolism in sediment diagenetic as well as ecosystem models for such systems is essential to increase our understanding of their response to environmental changes and the role of coastal sediments in nutrient and carbon cycling. Major challenges and research priorities are (1) to couple the dynamics of zoobenthic biomass and metabolism to sediment reactive-transport in models, (2) to test and validate model formulations against real-world data to better incorporate the context-dependency of processes in heterogeneous coastal areas in models and (3) to capture the role of stochastic events.
A Mobile App Adopting an Identity Focus to Promote Physical Activity (MoveDaily): Iterative Design Study

BACKGROUND Web-based and mobile interventions to influence physical activity behavior have had limited effects on sustained behavior change. One reason may be that the interventions aim to change largely habitual behavior. Following an identity-oriented approach could be a successful strategy to behavior change because people are committed to behave in line with their self-perception of identity. OBJECTIVE In this paper, we take a closer look at the role of motivation in long-term adherence to lifestyle interventions. The paper outlines a method for web-based or mobile intervention development that allows exploration of integrating behavior change theory into the design process. We will describe the development of a mobile app that allows people to be self-determined and to value and self-regulate physical activity by adopting an identity-oriented approach. METHODS This paper describes a Research through Design (RtD) process in which design activities are carried out as part of the knowledge-generating process. Two RtD phases were completed, followed by a conceptual design phase. In the first RtD phase, 8 participants used diary cards to study initial attitudes toward starting with small changes in physical activity. In the second RtD phase, 26 participants used a web-based app to study changes in physical activity. We used an adapted version of the Self-Report Habit Index (SRHI) to evaluate individuals' perceptions of a particular behavior with respect to the three facets of a habit. The conceptual design phase consolidated the results from first two RtD phases into a design of a mobile app that combines an identity approach with gamification principles. The conceptual design was evaluated in a user-experience study with 4 participants. RESULTS In the first RtD phase, we found that interacting daily with diary cards and reflecting on physical activity patterns is a promising strategy but works better through a digital medium. In the second RtD phase, SHRI ratings from all participants generally increased each week. In the conceptual design phase, we found that the concept of the mobile app was positively evaluated by participants. However, participants mentioned that terms such as "identity" do not resonate with them and that scenarios could be simpler. CONCLUSIONS This paper provides deeper insights into designing for electronic health (eHealth) interventions and services and suggests a new way that motivation can be shaped by the design of an intervention and adherence to physical activity. To the best of our knowledge, this was the first iterative design study in which the effects of adopting an identity approach to both motivation and physical activity were included and observed. Initial promising results were found for using a web-based intervention where habits and identification with the personal importance of a behavior were repetitively triggered.
New perspectives on the definition, diagnosis, and treatment of true arterial hypertension

ABSTRACT Introduction Office blood pressure measurements (OBPM), still used today for diagnosis and management of hypertension, fail to reveal clinically important features of the mostly predictable blood pressure (BP) 24 h pattern, and lead to >45% of individuals being misclassified. Current hypertension guidelines do not provide recommendation on when-to-treat, despite multiple prospective clinical trials documenting improved normalization of 24 h BP pattern and significant reduction in cardiovascular disease (CVD) events when hypertension medications are ingested at bedtime rather than upon waking. Areas covered In this review, the authors discuss current evidence on the: (i) most relevant attributes of the 24 h BP pattern deterministic of CVD risk; (ii) asleep systolic BP (SBP) mean as the most significant therapeutic target for CVD risk reduction; (iii) ingestion-time differences in pharmacodynamics of BP-lowering medications as reported with high consistency in multiple clinical trials; and (iv) enhanced prevention of CVD events achieved by bedtime hypertension chronotherapy. Expert opinion Several prospective trials consistently document asleep SBP mean and sleep-time relative SBP decline (dipping) constitute highly significant CVD risk factors, independent of OBPM. Bedtime, compared to customary upon-waking, hypertension chronotherapy reduces risk of major CVD events. Collectively, these findings call for new definition of true hypertension and, accordingly, its proper diagnosis and management.
Two cases of marked red cell anisopoikilocytosis and haemolysis with alectinib, an anaplastic lymphoma kinase inhibitor

We report two patients with marked red cell morphological changes and haemolysis soon after commencing alectinib, a second-generation anaplastic lymphoma kinase (ALK) inhibitor, used to treat ALK-mutant metastatic non-small cell lung carcinoma. The first patient was a 66-year-old man with brain only metastasis. He had a background of b thalassaemia trait, with a baseline haemoglobin (Hb) concentration of 115 g/l and mean corpuscular volume (MCV) of 62 fl. After 1 month of therapy his Hb had decreased to 80 g/l. Haemolytic markers were abnormal, including unconjugated bilirubin 31 lmol/l, lactate dehydrogenase (LDH) 758 units/l, haptoglobin 0.04 g/l and reticulocyte count 140 9 10/l. A direct anti-globulin test (DAT) was negative. His blood film (left) showed marked fragmentation and marked anisopoikilocytosis, with irregularly contracted cells, acanthocytes, microspherocytes and polychromasia. There was background microcytosis and basophilic stippling, consistent with known b thalassaemia trait. Follow-up at 2 weeks demonstrated persistent morphological changes, but improvements in haemolytic parameters. Alectinib was permanently ceased, with the plan for use of an alternative ALK inhibitor on disease progression. The second patient was a 77-year-old woman with nodal, pulmonary and pleural disease. At 3 months after initiation of alectinib her Hb had decreased from a baseline of 115 to 93 g/l, with evidence of haemolysis including an unconjugated bilirubin peaking at 93 lmol/l, LDH 322 units/l, haptoglobin 0.97 g/l, reticulocyte count 100 9 10/l, and a negative DAT. The film (right) showed marked spheroacanthocytosis. In contrast to the first case, there was minimal red cell fragmentation. At 2 weeks after alectinib cessation, the patient’s unconjugated bilirubin had normalised to 12 lmol/l, and her Hb was stable at 90 g/l. She was re-challenged with a reduced dose of alectinib at 450 mg twice daily (from 600 mg twice daily), with the outcome pending. This report highlights the need for both clinicians and morphologists to be vigilant for unrecognised off-target effects of novel agents, and also the importance of clinicopathological correlation.
Factors associated with motor dexterity on the grooved pegboard test in a Lebanese sample

Abstract The Grooved Pegboard Test (GPT) is a cognitive test used to assess patients’ manual dexterity, rapid visual-motor coordination and psychomotor speed. Studies have shown that performance on the GPT is associated to cognitive functions and examinee’s demographics; however, none of which involved Arab populations. The present study aims to explore motor dexterity as measured by the GPT and its relationship to intellectual abilities, age, gender and education in a sample of Lebanese individuals. We reviewed the charts of 330 patients who were administered the GPT as part of larger cognitive batteries in an outpatient diagnostic center in Beirut, Lebanon between September 2013 and September 2016. Results from this sample suggest that a higher Full Scale IQ, and an older age contribute to a better performance on the GPT, whereas gender and grade level are not significant predictors of performance. Results also show a significant difference between the performance of patients diagnosed with a Developmental Coordination Disorder and patients with no neurodevelopmental diagnosis.
Utility of Transnasal Humidified Rapid Insufflation Ventilatory Exchange for Microlaryngeal Surgery

Microlaryngeal surgery typically requires oxygenation and ventilation via either an endotracheal tube (ETT), jet ventilation (JV), or intermittent apnea with an ETT. Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) delivered by high flow nasal cannula has been reported as an alternative technique. This method of apneic oxygenation and ventilation allows for stable, unobstructed visualization of immobile laryngeal structures. We aim to describe the technique and characterize intraoperative parameters related to its safety.
Nanoparticles induced embryo–fetal toxicity

Applications of nanomaterials cause a general concern on their toxicity when they intentionally (such as in medicine) or unintentionally (environment exposure) enter into the human body. As a special subpopulation, pregnant women are more susceptible to nanoparticle (NP)-induced toxicity. More importantly, prenatal exposures may affect the entire life of the fetus. Through blood circulation, NPs may cross placental barriers and enter into fetus. A cascade of events, such as damage in placental barriers, generation of oxidative stress, inflammation, and altered gene expression, may induce delayed or abnormal fetal development. The physicochemical properties of NPs, exposure time, and other factors directly affect nanotoxicity in pregnant populations. Even though results from animal studies cannot directly extrapolate to humans, compelling evidence has already shown that, for pregnant women, caution must be taken when dealing with nanomedicines or NP pollutants.
Association of Arthritis and Antihypertensive Medication Use Among Individuals With Hypertension

Background The aim of this study was to assess whether arthritis is associated with lower antihypertensive medication (AHM) use among those with hypertension and whether this relationship differs by age or cardiovascular (CV) comorbidity. Methods The data were from the 2017 Behavioral Risk Factor Surveillance System. We employed survey weights to account for the complex sampling design and nonresponse bias. We used generalized linear models to estimate unadjusted and adjusted prevalence ratios (PRs) and 95% confidence intervals comparing AHM use among those with severe or mild arthritis to those without arthritis, stratified by age, sex, and CV comorbidity. Results Among 173,098 adults with hypertension, 26.0% had severe arthritis and 22.3% had mild arthritis. Compared with those without arthritis, individuals with mild or severe arthritis were older, predominantly female, with lower income and more comorbidities. After adjustment for sex, race, inability to afford medications, and CV comorbidity, the prevalence ratios for AHM use were stronger for younger versus older age groups. Associations did not differ significantly by sex or CV comorbidity. Associations were similar for mild and severe arthritis, compared with no arthritis. Conclusions Among individuals with hypertension, those with arthritis had significantly higher prevalences of AHM use compared with those without arthritis. Higher prevalences of AHM use were seen with older age categories, although a stronger association of arthritis and AHM use was found in younger age groups. Future studies on hypertension management in arthritis should examine these relationships more closely.
Effectiveness of a life story intervention for adults with intellectual disability and depressive and trauma‐related complaints

Abstract Introduction People with intellectual disability have a higher chance of developing mental disorders than the general population. Yet, few evidence‐based interventions exist. This article evaluates My Lifestory, a narrative intervention tailored to people with intellectual disability and depressive or trauma‐related complaints. Method A quasi‐experimental research design was adopted with an experimental condition (My Lifestory) and a matched control condition (care as usual). Measurements took place before the intervention, at the end of the intervention and at follow‐up two months later. Measurements focused on psychiatric complaints, well‐being, life satisfaction, mastery, and purpose in life. Results Participants in the intervention condition improved more in psychiatric complaints, well‐being, life satisfaction, and purpose in life, but not in mastery, than participants in the control condition. Effect sizes were large in the intervention condition and small in the control condition. Discussion Despite some limitations, this study adds to the evidence base of this narrative intervention.