Miracle-dz/UniFAR-FTUs huggingface dataset:
Efficient assessment of brain fog and fatigue: Development of the Fatigue and Altered Cognition Scale (FACs)

Debilitating symptoms of fatigue and accompanying “brain fog” are observed among patients with various chronic health conditions. Unfortunately, an efficient and psychometrically sound instrument to assess these co-occurring symptoms is unavailable. Here, we report the development and initial psychometric properties of the Fatigue and Altered Cognition Scale (the FACs), a measure of self-reported central fatigue and brain fog. Traumatic brain injury (TBI) was chosen to model and develop the FACs due to research team expertise and established links between TBI and the symptom complex. Potential items were generated by researchers and clinicians with experience treating these symptoms, drawing from relevant literature and review of patient responses to measures from past and current TBI studies. The 20 candidate items for the FACs—ten each to assess altered cognition (i.e., brain fog) and central fatigue–were formatted on an electronic visual analogue response scale (eVAS) via an online survey. Demographic information and history of TBI were obtained. A total of 519 participants consented and provided usable data (average age = 40.23 years; 73% female), 204 of whom self-reported a history of TBI (75% reported mild TBI). Internal consistency and reliability values were calculated. Confirmatory factor analysis (CFA) examined the presumed two-factor structure of the FACs and a one-factor solution for comparison. A measurement invariance test of the two latent constructs (altered cognition, fatigue) among participants with and without TBI was conducted. All items demonstrated normal distribution. Cronbach’s alpha coefficients indicated good internal consistency for both factors (α’s = .95). Omega reliability values were favorable (α’s = .95). CFA supported the presumed two-factor model and item loadings which outperformed the one-factor model. Measurement invariance found the two-factor structure was consistent between the two groups. Implications of these findings, study limitations, and potential use of the FACs in clinical research and practice are discussed.
Diagnostic value of thyroglobulin washout in fine-needle aspiration samples for diagnosis and follow-up of differentiated thyroid cancer

Our goal was to assess the effectiveness of fine-needle aspiration thyroglobulin (FNA-Tg) in detecting malignant lymph nodes (LNs) in patients with differentiated thyroid cancer (DTC). We also aimed to determine the factors that affect the accuracy of FNA-Tg. We conducted a retrospective cohort study using the laboratory, ultrasonographic, histopathological, FNA cytology (FNA-C), and FNA-Tg results of 176 DTC patients. We used receiver operating characteristic analysis to identify the cutoff value of FNA-Tg, and binary regression analysis to compare FNA-Tg with other diagnostic parameters. Spearman correlation was utilized to identify factors that influence FNA-Tg. Our study revealed that a cutoff value of 3.14 ng/mL for FNA-Tg had a sensitivity of 91.8% and a specificity of 96.6% in detecting malignant LNs in the entire group. In the subgroup with thyroid tissue, the optimal cutoff value for FNA-Tg was determined to be 15.5 ng/mL. Additionally, FNA-C had a sensitivity of 82.4% and a specificity of 99.4% for the entire group. The combined use of FNA-Tg and FNA-C yielded a sensitivity of 100% and a specificity of 96%, which was found to be more effective than using either test alone. Serum Tg positivity and serum thyroid-stimulating hormone were positively correlated with FNA-Tg levels in detecting malignant LNs. Our study demonstrated that FNA-Tg is a reliable method for detecting LN metastases in DTC patients, with a 3.14 ng/mL cutoff value. However, each center should take into account factors such as serum thyroid-stimulating hormone, serum Tg, and the presence of thyroid tissue when interpreting FNA-Tg results and determining the appropriate cutoff level.
Association between body composition and the risk of mortality in the obese population in the United States

Background Recent studies have presented the concept of the obesity paradox, suggesting that individuals with obesity have a lower risk of death than those without obesity. This paradox may arise because body mass index (BMI) alone is insufficient to understand body composition accurately. This study investigated the relationship between fat and muscle mass and the risk of mortality in individuals with overweight/obesity. Methods We used data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2006 and 2011 to 2018, which were linked to mortality information obtained from the National Death Index. Multiple Cox regression analyses were performed to estimate mortality risk. Subgroup analysis was conducted using propensity score-matched (PSM) data for age, sex, and race/ethnicity. Results This study included 16,555 participants who were overweight/obese (BMI≥25 kg/m2). An increase in appendicular skeletal muscle mass index was associated with a lower mortality risk (hazard ratio [HR]: 0.856; 95% confidence interval [CI]: 0.802–0.915). This finding was consistent with the subgroup analysis of the PSM data. Contrastingly, a high fat mass index was associated with an increased risk of mortality. Sarcopenic overweight/obesity was significantly associated with high mortality compared to obesity without sarcopenia (HR: 1.612, 95%CI: 1.328–1.957). This elevated risk was significant in both age- and sex-based subgroups. This finding was consistent with the subgroup analysis using PSM data. Conclusion In contrast to the obesity paradox, a simple increase in BMI does not protect against mortality. Instead, low body fat and high muscle mass reduce mortality risk.
Assessment of maternal knowledge of solar exposure and vitamin D in the neonatal period

ABSTRACT Objective: To assess mothers’ knowledge on sun exposure related to serum vitamin D levels in the neonatal period. Methods: Observational, analytical and cross-sectional study, carried out from August 2020 to May 2021 through a questionnaire directed to mothers of newborns, in a maternity hospital in Southern Brazil. Results: From 141 interviewees, 132 (93.6%) believe it is important to expose the neonate to sun, 101 (71.6%) think this exposure can increase vitamin D levels, 86 (61%) received such information from a doctor, 108 (76.6%) believe there are no risks of sun exposure, 88 (62.4%) claim it isn´t necessary to use any kind of protection, 96 (68.1%) said that only exposure to the sun was necessary to maintain adequate levels of vitamin D during the neonatal period. Only two mothers (1.4%) claim that you should not exposure the neonate to the sun, and only one (0.7%) stated that sun expose can cause skin problems. Conclusions: Most mothers lack satisfactory knowledge about sun exposure related to serum vitamin D levels in the neonatal period. The need to inform and clarify the population about sun exposure during this period is remarkable, in addition to disseminating the proper way to maintain serum levels of vitamin D.
Prevalence and association of early onset severe hyperbilirubinemia in newborn in the East China region: Retrospective medical record analyses

Research on the prevalence and association of hyperbilirubinemia is controversial because of different cultures, demographics, and clinical conditions. The etiology of hyperbilirubinemia is affected by the environment and other factors in the newborn. The World Health Organization recommended a 1-day hospital stay after uncomplicated delivery, jaundice assessment before discharge, and screening on 3rd and 7th days after birth for hyperbilirubinemia. However, the implementation of these recommendations is difficult in China. The objective of this study was to evaluate the prevalence and association of early onset severe hyperbilirubinemia in newborns in East China. Retrospective medical record analyses for 250 cesarean sections or vaginal deliveries, ≥2 kg body weight, and negative for Hepatitis B surface antigen by birth newborns were performed. A biochemical analyzer, quantitative assay, and quantitative polymerase chain reaction were used to evaluate total serum bilirubin, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and gene variant phenotyping, respectively. A total in 33 (13%) newborns were reported with early onset severe hyperbilirubinemia (according to the American Academy of Pediatrics, total serum bilirubin ≥ 342 μmol/L within 6 hours of birth). All newborns with severe hyperbilirubinemia were hospitalized and underwent phototherapy. The mothers of all newborns had a gestational age ≥ 35 weeks. Hospitalization included artificial feeding, and breastfeeding was rare (P < .0001). ABO incompatibility (“O” blood type for mother and either “A” or “AB” or “B” blood type for newborn, P = .0411), G6PD deficiency (G6PD/6-phosphogluconate dehydrogenase ≤ 1.0 in quantitative assay, P = .0422), Rh incompatibility (the mother’s blood type was Rh negative and newborn blood type was Rh positive, P = .0416), fewer genotype rs4149056 frequencies (P = .0452), higher genotype rs2306283 frequencies (P = .0461), and higher genotype rs1805173 frequencies (P = .0471) were independent parameter for early onset severe hyperbilirubinemia of newborns. The prevalence of early onset severe hyperbilirubinemia in Chinese newborns is 13% in the East China region. Blood incompatibility, G6PD deficiency, fewer genotype rs4149056 frequencies, higher genotype rs2306283 frequencies, and higher genotype rs1805173 frequencies were independent predictors of early onset severe hyperbilirubinemia among newborns in the East China region (Level of Evidence: IV; Technical Efficacy: Stage 5).
The Effect of Group Prenatal Care on the Empowerment of Pregnant Adolescents

Objectives This study aimed to evaluate the effect of group prenatal care (GPNC) on the empowerment of pregnant adolescents. Methods In this trial, 294 pregnant adolescents (aged 15–19 years) were randomly assigned into the GPNC (n = 147) and individual prenatal care (IPNC; n = 147) groups, where they received 5 sessions of GPNC (90–120 min) and IPNC, respectively, between the 16th and 40th weeks of pregnancy. The empowerment of participants in the two groups was measured using the Empowerment Scale for Pregnant Women. Data were analysed using various tests. Results The mean total score of pregnant women’s empowerment in both groups after the intervention was 86.46 ± 4.95 and 81.89 ± 4.75, respectively (β = 6.11, 95% confidence interval: 4.89, 7.33; P <0.0001). Conclusion GPNC can improve pregnant adolescent empowerment. The current study’s results can provide a foundation for implementing the GPNC model in Iran.
Connective tissue disease‐associated pulmonary hypertension: A comprehensive review

Abstract Connective tissue diseases (CTDs) can be associated with various forms of pulmonary hypertension, including pulmonary arterial hypertension (PAH), pulmonary veno‐occlusive disease, pulmonary venous hypertension, interstitial lung disease‐associated pulmonary hypertension, chronic thromboembolic pulmonary hypertension, and sometimes a combination of several processes. The prevalence of PAH varies among the different CTDs, with systemic sclerosis (SSc) having the highest at 8%–12%. The most recent European Society of Cardiology/European Respiratory Society guidelines recommend routine annual screening for PAH in SSc and CTDs with SSc features. As CTDs can be associated with a myriad of presentations of pulmonary hypertension, a thorough evaluation to include a right heart catheterization to clearly delineate the hemodynamic profile is essential in developing an appropriate treatment plan. Treatment strategies will depend on the predominant phenotype of pulmonary vasculopathy. In general, management approach to CTD‐PAH mirrors that of idiopathic PAH. Despite this, outcomes of CTD‐PAH are inferior to those of idiopathic PAH, with those of SSc‐PAH being particularly poor. Reasons for this may include extrapulmonary manifestations of CTDs, including renal disease and gastrointestinal involvement, concurrent interstitial lung disease, and differences in the innate response of the right ventricle to increased pulmonary vascular resistance. Early referral for lung transplant evaluation of patients with CTD‐PAH, particularly SSc‐PAH, is recommended. It is hoped that in the near future, additional therapies may be added to the armamentarium of effective treatments for CTD‐PAH. Ultimately, a better understanding of the pathogenesis of CTD‐PAH will be required to develop targeted therapies for this morbid condition.
Meta-analysis of stereotactic hematoma removal and craniotomy hematoma removal in the treatment of hypertensive intracerebral hemorrhage in the elderly

Background: A large number of clinical studies suggested that surgery might be a better choice than conservative treatment for treating hypertensive intracerebral hemorrhage in the middle-aged and elderly. Stereotactic puncture can reduce the mass effect caused by hematoma, reduce the intervention of body homeostasis, reduce brain tissue damage, and improve the prognosis of patients with cerebral hemorrhage. This meta-analysis aims to evaluate the efficacy of stereotactic puncture and craniotomy in elderly patients with hypertensive intracerebral hemorrhage. Methods: A search strategy was designed to search in databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials, CNKI, Wanfang database and relevant references. Literature on the efficacy and safety of different surgical methods for hypertensive cerebral hemorrhage in the middle-aged and elderly were retrieved. The search time was until August 17, 2022. Keywords included “hypertensive intracerebral hemorrhage,” “stereotactic hematoma removal,” “craniotomy. ” After the literature search, 2 researchers independently conducted literature screening, quality evaluation of included trials and data extraction. RevMan5.4 software was used to perform a Meta-analysis on the operation time, hospital stay, postoperative Glasgow Coma Scale (GCS) score, postoperative daily activity ability, postoperative complications and neurological prognosis scores included in the included studies. Results: A total of 1988 samples were included in 9 studies. 1022 patients underwent stereotactic hematoma removal, and 968 patients underwent craniotomy hematoma removal. The orientation group had more advantages in the length of hospital stay, postoperative disability, pulmonary infection, intracranial infection and digestive tract ulcer, and the difference was statistically significant (P < .05). In addition, the length of stay (I²= 83%) of the included articles had good homogeneity (I²< 50%), and there was no significant difference between the 2 groups in operation time, postoperative GCS score, postoperative daily activity ability, and neurological prognosis score (P > .05). Conclusion: The meta-analysis indicate that compared to craniotomy for hematoma removal, stereotactic hematoma removal can reduce the postoperative disability rate, intracranial infection rate, lung infection rate, and digestive tract ulcer rate in middle-aged and elderly patients with hypertensive intracerebral hemorrhage.
Eastern Gray Squirrel Ecology and Interactions with Western Gray Squirrels

Eastern Gray Squirrel Ecology and Interactions with Western Gray Squirrels Aaron N. Johnston Chair of Supervisory Committee: Associate Director and Professor Stephen D. West School of Environmental and Forest Sciences Populations of State-threatened western gray squirrels (Sciurus griseus) have declined in areas invaded by introduced eastern gray squirrels (S. carolinensis) in the Western United States, but little is known about competitive interactions between these species. The western gray squirrel is an ecologically important member of oak woodlands, and intensive efforts to recover this species are underway in Washington. We tracked eastern and western gray squirrels with radio-telemetry for over four years to investigate resource use and interactions between species on Joint Base Lewis-McChord near Tacoma, WA. Following a pre-treatment monitoring period of 1-2 years, we experimentally removed eastern gray squirrels from two sites and monitored both species at two control sites for up to 2.5 years to measure competitive effects on western gray squirrels based on measures of spatial-partitioning, body mass, fecundity, and survival rates. We also described dietary overlap between species based on foraging observations and examination of fungal spores in fecal pellets collected from squirrels during the study. Dietary overlap for most food resources was high between eastern and western gray squirrels but they did not share space and had little overlap in their use of habitat types. Western gray squirrels were found primarily in coniferous uplands with little cover of understory vegetation, whereas eastern gray squirrels were in riparian areas with deciduous trees and dense cover of understory vegetation. Following removal treatments, few western gray squirrels used areas formerly occupied by eastern gray squirrels, and we found no increases in body mass, fecundity, or survival for western gray squirrels. Although interspecies avoidance or competitive interactions may occur in habitats suitable for both species, such habitats were rare on our study area. Coexistence of eastern and western gray squirrels appears possible where distinctly different upland and riparian habitats occur in an area.
Adenomyosis in women undergoing hysterectomy for abnormal uterine bleeding associated with uterine leiomyomas

Background Uterine leiomyomas and adenomyosis are both common and often associated with abnormal uterine bleeding (AUB), including the symptom of heavy menstrual bleeding (HMB). Understanding the prevalence of adenomyosis in women with uterine leiomyomas could inform clinicians and patients in a way that may improve therapeutic approaches. Objective To explore the prevalence of adenomyosis in a group of women who underwent hysterectomy for AUB-L, to determine the prevalence of submucous leiomyomas, and to examine the utility of preoperative ultrasound to detect the presence of adenomyosis. Methods The Kaiser Permanente Hysterectomy Database (KPHD) was searched for women aged 18–52 undergoing hysterectomy for leiomyoma-associated chronic AUB (AUB-L) in 2018 and 2019. A target sample of 400 comprised those with at least 3 years in the Health System. Radiologists evaluated preoperative pelvic ultrasound images to determine leiomyoma size and level 2 FIGO type (submucous or other), and the linked electronic medical record abstracted for clinical features, including histopathological evidence of adenomyosis. Results Of the 370 subjects that met the study criteria, adenomyosis was identified via histopathology in 170 (45.9%). There was no difference in the adenomyosis prevalence with (47.1%) and without (43.0%) at least one submucous leiomyoma. Subgroup analysis of ultrasound images by an expert radiologist for the presence of adenomyosis demonstrated a positive predictive value of 54.0% and a negative predictive value of 43.4%. Conclusions Adenomyosis was present in almost half of this AUB-L cohort undergoing hysterectomy and was equally prevalent in those with and without submucous leiomyomas as determined by sonographic evaluation. The imaging findings are in accord with prior investigators and demonstrate that 2-D ultrasound is insensitive to the presence of adenomyosis when the uterus is affected by leiomyomas. Further research is necessary to determine the impact of various adenomyosis phenotypes on the presence and severity of the symptom of HMB.
Neurobiology of Aging

Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) have been linked to age-related neurodegeneration and Alzheimer’s disease (AD), but their role in normal aging is poorly understood. We used linear mixed models to determine if baseline or rate of yearly change in cerebrospinal fluid (CSF) levels of MMP-2; MMP-3; MMP-10; TIMP-123 (composite of TIMP-1, TIMP-2, and TIMP-3); or TIMP-4 predicted changes in bilateral entorhinal cortex thickness, hippocampal volume, or lateral ventricle volume in cognitively unimpaired individuals. We also assessed effects on the CSF AD biomarkers amyloid-β 42 and phosphorylated tau 181 . Low baseline levels of MMP-3 predicted larger ventricle volumes and more entorhinal cortex thinning. Increased CSF MMP-2 levels over time predicted more entorhinal thinning, hippocampal atrophy, and ventricular expansion, while increased TIMP-123 over time predicted ventricular expansion. No MMP/TIMPs predicted changes in CSF AD biomarkers. Notably, we show for the first time that longitudinal increases in MMP-2 and TIMP-123 levels may predict age-associated brain atrophy. In conclusion, MMPs and TIMPs may play a role in brain atrophy in cognitively unimpaired aging. © 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
From Knowledge Representation to Knowledge Organization and Back

Knowledge Representation (KR) and facet-analytical Knowledge Organization (KO) have been the two most prominent methodologies of data and knowledge modelling in the Artificial Intelligence community and the Information Science community, respectively. KR boasts of a robust and scalable ecosystem of technologies to support knowledge modelling while, often, underemphasizing the quality of its models (and model-based data). KO, on the other hand, is less technology-driven but has developed a robust framework of guiding principles (canons) for ensuring modelling (and model-based data) quality. This paper elucidates both the KR and facet-analytical KO methodologies in detail and provides a functional mapping between them. Out of the mapping, the paper proposes an integrated KO-enriched KR methodology with all the standard components of a KR methodology plus the guiding canons of modelling quality provided by KO. The practical benefits of the methodological integration has been exemplified through a prominent case study of KR-based image annotation exercise.
Strong convergence of a class of adaptive numerical methods for SDEs with jumps

We develop adaptive time-stepping strategies for It\^o-type stochastic differential equations (SDEs) with jump perturbations. Our approach builds on adaptive strategies for SDEs. Adaptive methods can ensure strong convergence of nonlinear SDEs with drift and diffusion coefficients that violate global Lipschitz bounds by adjusting the stepsize dynamically on each trajectory to prevent spurious growth that can lead to loss of convergence if it occurs with sufficiently high probability. In this article we demonstrate the use of a jump-adapted mesh that incorporates jump times into the adaptive time-stepping strategy. We prove that any adaptive scheme satisfying a particular mean-square consistency bound for a nonlinear SDE in the non-jump case may be extended to a strongly convergent scheme in the Poisson jump case where jump and diffusion perturbations are mutually independent and the jump coefficient satisfies a global Lipschitz condition.