Miracle-dz/UniFAR-FTUs huggingface dataset:
Social Media as an Early Proxy for Social Distancing Indicated by the COVID-19 Reproduction Number: Observational Study

Background The magnitude and time course of the COVID-19 epidemic in the United States depends on early interventions to reduce the basic reproductive number to below 1. It is imperative, then, to develop methods to actively assess where quarantine measures such as social distancing may be deficient and suppress those potential resurgence nodes as early as possible. Objective We ask if social media is an early indicator of public social distancing measures in the United States by investigating its correlation with the time-varying reproduction number (Rt) as compared to social mobility estimates reported from Google and Apple Maps. Methods In this observational study, the estimated Rt was obtained for the period between March 5 and April 5, 2020, using the EpiEstim package. Social media activity was assessed using queries of “social distancing” or “#socialdistancing” on Google Trends, Instagram, and Twitter, with social mobility assessed using Apple and Google Maps data. Cross-correlations were performed between Rt and social media activity or mobility for the United States. We used Pearson correlations and the coefficient of determination (ρ) with significance set to P<. 05. Results Negative correlations were found between Google search interest for “social distancing” and Rt in the United States (P<.001), and between search interest and state-specific Rt for 9 states with the highest COVID-19 cases (P<.001); most states experienced a delay varying between 3-8 days before reaching significance. A negative correlation was seen at a 4-day delay from the start of the Instagram hashtag “#socialdistancing” and at 6 days for Twitter (P<.001). Significant correlations between Rt and social media manifest earlier in time compared to social mobility measures from Google and Apple Maps, with peaks at –6 and –4 days. Meanwhile, changes in social mobility correlated best with Rt at –2 days and +1 day for workplace and grocery/pharmacy, respectively. Conclusions Our study demonstrates the potential use of Google Trends, Instagram, and Twitter as epidemiological tools in the assessment of social distancing measures in the United States during the early course of the COVID-19 pandemic. Their correlation and earlier rise and peak in correlative strength with Rt when compared to social mobility may provide proactive insight into whether social distancing efforts are sufficiently enacted. Whether this proves valuable in the creation of more accurate assessments of the early epidemic course is uncertain due to limitations. These limitations include the use of a biased sample that is internet literate with internet access, which may covary with socioeconomic status, education, geography, and age, and the use of subtotal social media mentions of social distancing. Future studies should focus on investigating how social media reactions change during the course of the epidemic, as well as the conversion of social media behavior to actual physical behavior.
The Impacts of Antivirals on the Coronavirus Genome Structure and Subsequent Pathogenicity, Virus Fitness and Antiviral Design

With the global threat of SARS-CoV-2, much effort has been focused on treatment and disease control. However, how coronaviruses react to the treatments and whether the surviving viruses have altered their characteristics are also unanswered questions with medical importance. To this end, bovine coronavirus (BCoV), which is in the same genus as SARS-CoV-2, was used as a test model and the findings were as follows. With the treatment of antiviral remdesivir, the selected BCoV variant with an altered genome structure developed resistance, but its pathogenicity was not increased in comparison to that of wild type (wt) BCoV. Under the selection pressure of innate immunity, the genome structure was also altered; however, neither resistance developed nor pathogenicity increased for the selected BCoV variant. Furthermore, both selected BCoV variants showed a better efficiency in adapting to alternative host cells than wt BCoV. In addition, the previously unidentified feature that the spike protein was a common target for mutations under different antiviral treatments might pose a problem for vaccine development because spike protein is a common target for antibody and vaccine designs. The findings derived from this fundamental research may contribute to the disease control and treatments against coronaviruses, including SARS-CoV-2.
Is Vertical Transmission of SARS-CoV-2 Infection Possible in Preterm Triplet Pregnancy? A Case Series

There is limited data regarding the vertical transmission (VT) of severe acute respiratory syndrome-coronavirus-2 infection. We report the first case of VT in preterm triplet pregnancy, with all triplets positive for severe acute respiratory syndrome-coronavirus-2 at 20 hours and day 5 of life. This report reiterates the need for an expedited formulation of a simple, standardized, and reproducible international case definition and classification for VT.
Non-typhoidal Salmonella infections among children in a tertiary hospital in Ningbo, Zhejiang, China, 2012–2019

Background Non-typhoidal Salmonella (NTS), a common cause of diarrheal enterocolitis, may also cause severe invasive diseases. Limited information on NTS infections in children is available in China. Methods We performed a retrospective study of children admitted to the Ningbo Women and Children’s Hospital with culture-confirmed NTS infections between January 2012 and December 2019. Clinical and microbiological information were collected. We compared demographic, clinical and antibiotic resistance variables of invasive NTS (iNTS) infections and non-invasive NTS (non-iNTS) infections, and explored associations between hospitalizations for pediatric NTS infections and temperature and rainfall. Results A total of 166 pediatric hospitalizations due to NTS infection were identified during the 8-year study period. Most of the 166 children were <5 years old (93.4%). The primary serotype was Salmonella Typhimurium (62.6%). Of 166 children with NTS infections, 11 had invasive infection. Compared to 155 children with non-iNTS infections, we found that iNTS infections were more likely to occur in infants ≤6 months or children with an underlying medical condition of leukemia at admission, but iNTS infections less often presented with a symptom of diarrhea (P <0.05 in all cases). The resistance rates of non-iNTS isolates to ceftazidime, ceftriaxone, cefepime, and aztreonam were significantly higher than those of iNTS isolates (P <0.05 in all cases). In addition, compared with iNTS isolates, non-iNTS isolates were significantly associated with resistance to ≥4 CLSI (Clinical and Laboratory Standard Institute) classes (P = 0.041, OR: 0.089, 95% CI: 0.009–0.901) and ≥2 first-line treatment agents (P = 0.040, OR: 0.159, 95% CI: 0.028–0.916). On the other hand, we found that seasonal NTS hospitalizations were positively associated with average seasonal temperature (r = 0.961, P = 0.039) and average monthly rainfall (r = 0.921, P <0.001). Conclusion Non-iNTS accounts for the majority of infections in this study; infants ≤6 months and children with underlying medical conditions of leukemia are more likely to have invasive infection. The rates of antibiotic resistance in the iNTS isolates are generally lower than those in the non-iNTS isolates. On the other hand, high temperatures and heavy rainfall are positively associated with NTS hospitalizations among children in Ningbo.
TOLERABILITY AND PSYCHOLOGICAL EFFECTS OF A MULTIMODAL DAY-CARE REHABILITATION PROGRAMME FOR PERSONS WITH HUNTINGTON’S DISEASE

Objective To determine whether the psychological benefits of intense, inpatient, multimodal rehabilitation for persons with Huntington’s disease (HD), as found in earlier studies, also apply in a shorter, day-care setting. Design Prospective, non-randomized cohort study. Subjects Twenty patients attending a group-based 8-week (3 days/week) rehabilitation programme aimed at persons in early stages of HD. Methods An explorative cohort study on register data from a specialized rehabilitation centre, including descriptive data, number of cancellations, a self-reported evaluation, and measures of psychiatric symptoms, health-related quality of life, sense of coherence and physical function at baseline and at the end of rehabilitation. Results Patients’ attendance rate was almost 90%. Patients were satisfied, and displayed significantly reduced anxiety and depression and improved health-related quality of life after rehabilitation. Baseline measures of sense of coherence showed significant negative correlation with the number of cancelled days of rehabilitation. Physical function improved, but did not correlate significantly with psychological outcome measures. Conclusion These results indicate that an 8-week multimodal day-care rehabilitation programme can be tolerable, reduce psychiatric symptoms, and improve health-related quality of life for people with HD. A higher sense of coherence seems to promote attendance rates. Further larger studies, including the impact of cognition and disease progression on the treatment effect, are warranted. LAY ABSTRACT Huntington’s disease (HD) is characterized by a triad of clinical features; motor, cognitive, and psychiatric. Physical training seems to have positive effects on motor symptoms. Earlier studies have shown that intense, inpatient, multimodal rehabilitation may also reduce psychiatric symptoms. The present study aimed to explore whether the psychological benefits are retained in a shorter, day-care setting.This study included 20 patients attending a group-based rehabilitation programme. The results show that participants had an almost 90 % attendance rate and were satisfied with the programme. After rehabilitation, they displayed significantly reduced anxiety and depression and improved quality of life. Sense of coherence showed a significant negative correlation with the number of cancelled days of rehabilitation. These results indicate that a shorter multimodal day-care rehabilitation programme can be easier to tolerate than longer programmes, and still reduce psychiatric symptoms and improve quality of life for people with HD. A higher sense of coherence appears to promote the attendance rate.
Selective advantages to hemi-parasitic annuals, genus Melampyrum, of a seed-dispersal mutualism involving ants. I: Favorable nest sites

Directed dispersal to nest sites that are favorable in several possible regards may he an important factor in the maintenance and, by inference, the evolution of myrmecochory in Melampyrum. Results of a field study in oak-pine woodlands of the Keweenaw Peninsula of northern Michigan, USA support such a hypothesis. Diaspores were set out at grid points on the forest floor and monitored for ant removal. Nest sites (n = 47), which were otherwise undetectable, were located and marked by tracing diaspore-carrying ants to their destination. Additional diaspores were placed at each nest site and then observed until all (n=20) were taken into the nest
Investigating the Matching Relationship between Physical Exercise and Stereotypic Behavior in Children with Autism.

PURPOSE Physical exercise has been shown to be effective in reducing stereotypic behaviors in children with autism spectrum disorder (ASD). One possible mechanism concerns the matching hypothesis between exercise and behavior. The present study sought to examine this matching exercise-behavior relationship. METHODS Participants (N = 21, 17 males and 4 females, Mage = 11.07 ± 1.44 yr, Mheight = 1.46 ± 0.99 m, and Mweight = 40.60 ± 8.25 kg), with observable forms of hand-flapping and body-rocking stereotypic behaviors, underwent three separate days of conditions, one for the control condition, one for the 10-min ball-tapping exercise condition, and one for the 10-min jogging condition, in randomized order. The frequency of each type of stereotypic behavior was video-recorded from 15 min before to 60 min after the exercise. RESULTS Results revealed that only hand-flapping stereotypic behaviors were significantly reduced in the ball-tapping exercise condition (p <.017), while only body-rocking stereotypic behaviors were significantly reduced in the jogging exercise condition (p <.017). However, the behavioral benefit diminished at 45 min after the respective exercise. CONCLUSION Physical exercise should be topographically-matched with stereotypic behavior in order to produce desirable behavioral benefits in children with ASD.
Histological and immunohistopathological differentiation between guttate psoriasis and pityriasis rosea

had slightly higher LDL-c levels. It is reported in previous studies that Pmax and Smin values correlated with LDL-c levels. Visceral adipose tissue plays a role as an endocrine organ by secreting adipokines and cytokines, including adiponectin, leptin, resistin, visfatin, retinol-binding protein 4 and omentin. These bioactive substances play roles in metabolic syndrome, insulin resistance, coronary artery disease, and carotid atherosclerosis, and obesity. Therefore, visceral adipose tissue is more closely related to cardiovascular disease than total body fat. The strength of our study is that we matched patients for BMI and tobacco use. Also, we excluded patients with contributing factors for cardiovascular disease including obesity, metabolic, or endocrine disorders, and excessive alcohol consumption. Our data may suggest that rosacea itself is not associated with increased risk of visceral fat area or dyslipidemia.
Video Assisted Laryngoscope Facilitates Intubation Skill Learning in the Emergency Department.

Background Up-to-date technology has been increasingly useful for learning resuscitation skills in the emergency and resuscitation settings. It improves the learning curve of the learners and helps them to avoid making mistakes on real patients. This study aimed to evaluate the educational efficiency for tracheal intubation by comparing Macintosh (direct) laryngoscope (DL) and video laryngoscope (VL) learning in novices. Methods This prospective randomized controlled study was conducted in an emergency department between 2013 and 2014. Fifth- and sixth-year medical students were enrolled and assigned to normal airway and difficult airway groups, respectively. They were then further randomized into using a VL or DL for tracheal intubation learning. Participants had three practices before proceeding to the post-course assessment. Our primary outcome was post-course assessment performance, which included intubation success rate, total intubation time and best glottic view. The secondary outcome was the sum of total intubation learning times during the three practices. Results We recruited 177 undergraduate students. Of these, 97 were assigned to the normal airway group (49 VL and 48 DL) and 80 were placed in the difficult airway group (40 each for VL and DL). VL significantly quickened the intubation learning time in both the normal airway and difficult airway groups (140 s vs. 158 s, 141 s vs. 221.5 s; both p < 0.05). The learning curve was much improved with VL when compared using time-to-event analysis (p < 0.001). VL also improved the glottic view performance during post-course assessments. Conclusions VL improves the learning curve in acquiring intubation skills compared with traditional DL. It shortens the time undergraduate students take to develop such skills and increased their first attempt success rates.
Enteral Bioactive Factor Supplementation in Preterm Infants: A Systematic Review

Feeding preterm infants with mother’s own milk is associated with a reduction in postnatal complications and an improved neurocognitive outcome. Therefore, the bioactive factor composition of human milk has been used as a tool for the development of nutritional supplements with a potential prophylactic or therapeutic effect. The aim of this systematic review was to provide an overview on bioactive factors which have been studied as supplement to enteral nutrition in randomized controlled trials, and to provide an overview of ongoing trials. MEDLINE, EMBASE, CENTRAL, and clinical trial registers were searched. Studies on the antimicrobial protein lactoferrin were excluded as these were summarized very recently in three separate systematic reviews. Studies on vitamins D, K and iron were also excluded as they are already incorporated in most international guidelines. We identified 17 different bioactive factors, which were investigated in 26 studies. Despite the encouraging potential effects of several bioactive factors, more high-quality studies with a sufficient number of preterm infants are required before a certain factor may be implemented into clinical practice. Three large trials (n > 500) that investigate the effects of either enteral insulin or vitamin A are currently ongoing and could provide more definite answers on these specific supplements.
Birthweight and its association with retinal vessel equivalents – Results from the population‐based German Gutenberg Health Study

Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Preventive Cardiology and Preventive Medicine/Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Center for Cardiology – Cardiology I,UniversityMedicalCenter of the Johannes Gutenberg University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner site Rhine-Main, Mainz, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
Brain immune cells undergo cGAS-STING-dependent apoptosis during herpes simplex virus type 1 infection.

Protection of the brain from viral infections involves the type I interferon (IFN-I) system, defects in which renders humans susceptible to herpes simplex encephalitis (HSE). However, excessive cerebral IFN-I levels leads to pathologies, suggesting the need for tight regulation of responses. Based on data from mouse models, human HSE cases, and primary cell culture systems, we here show that microglia and other immune cells undergo apoptosis in the HSV-1-infected brain through a mechanism dependent on the cyclic GMP-AMP synthase (cGAS) - stimulator of interferon genes (STING) pathway, but independent of IFN-I. HSV-1 infection of microglia induced cGAS-dependent apoptosis at high viral doses, while lower viral doses led to IFN-I responses. Importantly, inhibition of caspase activity prevented microglial cell death and augmented IFN-I responses. Accordingly, HSV-1-infected organotypic brain slices, or mice treated with caspase inhibitor, exhibited lower viral load and improved outcome of infection. Collectively, we identify an activation-induced apoptosis program in brain immune cells which down-modulates local immune responses.
KidneyCare Guided Immuno-Optimization in Renal Allografts: The KIRA Protocol

Immunosuppressant agents are essential in every transplant recipient’s care yet walking the fine line of over- or under-immunosuppression is a constant struggle for both patients and transplant providers alike. Optimization and personalization of immunosuppression has been limited by the need for non-invasive graft surveillance methods that are specific enough to identify organ injury in real time. With this in mind, we propose a pilot study protocol utilizing both donor derived cell free DNA (dd-cfDNA, gene expression profiling (GEP), and machine learning (iBox), called KidneyCare, to assess the feasibility and safety in reducing immunosuppressant exposure without increasing the risk of clinical rejection, graft injury, or allograft loss. Patients randomized to the immunominimization arm will be enrolled in one of two protocols designed to eliminate one immunosuppressant and optimize the dose of the Calcineurin Inhibitors (CNIs) using the KidneyCare platform. All patients will be maintained on dual therapy of either steroids and a low dose CNI, or mycophenolate mofetil (MMF) and low dose CNI. Their outcomes will be compared to patients who have their immunosuppressants managed using standard clinical assessment and treatment protocols to determine the impact of immuno-optimization on graft function, complications, and patient reported outcomes.
Effectiveness of a novel digital application to promote fundamental movement skills in 3- to 6-year-old children: A randomized controlled trial

ABSTRACT Objective Fundamental movement skills (FMS) are the foundational building blocks for lifetime participation in physical activity (PA). Programmes to promote FMS development have been primarily delivered in childcare settings. No studies have evaluated the effectiveness of an interactive digital application, designed to be co-used by parent and child, to increase FMS proficiency in preschool-aged children. Therefore, the purpose of this study was to evaluate the effectiveness of the Moovosity™ programme, a novel digital application to increase FMS proficiency in 3- to 6-year-old children. Methods: A randomized controlled trial (RCT) was conducted involving 34 parent-child dyads randomly assigned to either the 8-week intervention (n = 17) or wait-list control (n = 17) condition. FMS proficiency, PA, and parental support for PA was assessed at baseline and 8-weeks. Intervention participants were given free access to the app over a period of 8 weeks. Wait-listed controls were given access after the 8-week period. Group differences for pre to post changes in outcomes were tested for significance using general linear mixed models. Results: There was a significant group by time interaction for object control skills (F1,32 = 10.81, P = 0.003). Intervention children exhibited significant improvements in object control skills, while children in the wait-list control group exhibited a modest decline. Intervention children also exhibited improvements in locomotor skills, while wait-listed controls exhibited minimal change; however, the group by time interaction fell outside the 0.05 level of significance (F1,32 = 3.15, P = 0.09). There were no significant intervention effects observed for child PA (F1,32 = 0.03, P = 0.86) and parental support for PA (F1,32 = 0.84, P = 0.37). Conclusions: An 8-week exposure to a digital application to promote motor competence within a family environment was effective in improving FMS proficiency in preschool-aged children. The results warrant further investigation in larger trials.
Ultrafast ultrasound coupled with cervical magnetic stimulation for non‐invasive and non‐volitional assessment of diaphragm contractility

Twitch transdiaphragmatic pressure elicited by cervical magnetic stimulation of the phrenic nerves is a fully non‐volitional method for assessing diaphragm contractility in humans, yet it requires invasive procedures such as oesophageal and gastric catheter balloons. Ultrafast ultrasound enables a very high frame rate allowing the capture of transient events, such as muscle contraction elicited by nerve stimulation (twitch). Whether indices derived from ultrafast ultrasound can be used as an alternative to the invasive measurement of twitch transdiaphragmatic pressure is unknown. Our findings demonstrate that maximal diaphragm tissue velocity assessed using ultrafast ultrasound following cervical magnetic stimulation is reliable, sensitive to change in cervical magnetic stimulation intensity, and correlates to twitch transdiaphragmatic pressure. This approach provides a novel fully non‐invasive and non‐volitional tool for the assessment of diaphragm contractility in humans.