Miracle-dz/UniFAR-FTUs huggingface dataset:
The Contribution of Alcohol Beverage Types to Consumption, Heavy Drinking, and Alcohol-Related Harms: A Comparison across Five Countries

Abstract Background This study examined the relative contribution of alcoholic beverage types to overall alcohol consumption and associations with heavy alcohol use and alcohol-related harms among adults. Methods Cross-sectional survey data were collected from adult samples in two cities involved in the Global Smart Drinking Goals (GSDG) initiative in each of five countries (Belgium, Brazil, China, South Africa, United States). Survey measures included past-30-day consumption of beer, wine, flavored alcoholic drinks, spirits, and homemade alcohol; past-30-day heavy drinking; 14 alcohol-related harms in the past 12 months; and demographic characteristics. Within in each country, we computed the proportion of total alcohol consumption for each beverage type. Regression analyses were conducted to estimate the relative associations between consumption of each alcoholic beverage type, heavy alcohol use, and alcohol-related harms, controlling for demographic characteristics. Results Beer accounted for at least half of total alcohol consumption in GSDG cities in Belgium, Brazil, the U.S., and South Africa, and 35% in China. Regression analyses indicated that greater beer consumption was associated with heavy drinking episodes and with alcohol-related harms in the cities in Belgium, Brazil, South Africa, and the U.S. Significant increases in heavy drinking and alcohol-related harms were also consistently observed for spirits consumption. Conclusions Beer accounts for the greatest proportion of total alcohol consumption in most of the GSDG cities and was consistently associated with more heavy drinking episodes and alcohol-related harms. Reducing beer consumption through evidence-based interventions may therefore have the greatest impact on hazardous drinking and alcohol-related harms.
Comparing Performance of Methods to Deal With Differential Attrition in Randomized Experimental Evaluations

Background: In randomized controlled trials, attrition rates often differ by treatment status, jeopardizing causal inference. Inverse probability weighting methods and estimation of treatment effect bounds have been used to adjust for this bias. Objectives: We compare the performance of various methods within two samples, both generated through lottery-based randomization: one with considerable differential attrition and an augmented dataset with less problematic attrition. Research Design: We assess the performance of various correction methods within the dataset with problematic attrition. In addition, we conduct simulation analyses. Results: Within the more problematic dataset, we find the correction methods often performed poorly. Simulation analyses indicate that deviations from the underlying assumptions for bounding approaches damage the performance of estimated bounds. Conclusions: We recommend the verification of the underlying assumptions in attrition correction methods whenever possible and, when verification is not possible, using these methods with caution.
Contextualising men’s role and participation in PMTCT programmes in Malawi and Zambia: A hegemonic masculinity perspective

ABSTRACT This study sought to explore and contextualise the man’s role in antenatal services, and the barriers and strategies for engaging men in prevention of mother-to-child HIV transmission (PMTCT). We conducted 143 interviews with pregnant and breastfeeding women, male partners, health workers and policy makers in Malawi and Zambia. We employed thematic and critical discourse analysis using the hegemonic masculinity perspective. We found that men’s roles in PMTCT reflected hegemonic masculinities. As breadwinners, men supported their partners with material and financial resources. As decision makers, men were involved in decision making on the health of their partners. As social protectors, men supported their partners in accessing and adhering to antenatal care, HIV treatment and care. Barriers and challenges to male involvement in antenatal care were often the result of conflict between the clinic operating hours and men’s working hours, the perception of antenatal care services as female spaces, and men’s fear of HIV testing. Proposed strategies to increase male engagement in PMTCT included sensitising men about HIV and pregnancy; engaging leaders and employers, providing services outside working hours, and providing incentives. We conclude that men’s role and participation in PMTCT services are an extension and adaptation of hegemonic masculinities.
Depression-related emotional problems mediate the relation between hopelessness and suicidal ideation severity.

OBJECTIVE Cross-sectional research with adult samples suggests that hopelessness may indirectly affect suicidal ideation (SI) through overall depressive symptom severity. However, particular depressive symptom constellations, rather than overall symptoms, may underlie the association between hopelessness and SI. Yet, the cross-sectional nature of these studies precludes examination of the temporal associations among these constructs. METHODS Using path analysis, the present study examined whether depression-related emotional problems mediate the relation between hopelessness and SI in a clinical sample of 110 adolescents over a 6-month period. The specificity of depression-related emotional problems as a mediator was also evaluated. RESULTS After accounting for covariates, results supported the specificity of 3-month depression-related emotional problems as a mediator of the association between baseline levels of hopelessness and 6-month SI. CONCLUSION Results suggest that treatment targeted specifically at hopelessness may help reduce depression-related emotional problems and lower SI, and ultimately, adolescent suicide risk.
Plasma Metabolic Phenotypes of HPV-Associated versus Smoking-Associated Head and Neck Cancer and Patient Survival

Background: Metabolic differences between human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) and smoking-associated HNSCC may partially explain differences in prognosis. The former relies on mitochondrial oxidative phosphorylation (OXPHOS) while the latter relies on glycolysis. These differences have not been studied in blood. Methods: We extracted metabolites using untargeted liquid chromatography high-resolution mass spectrometry from pretreatment plasma in a cohort of 55 HPV-associated and 82 smoking-associated HNSCC subjects. Metabolic pathway enrichment analysis of differentially expressed metabolites produced pathway-based signatures. Significant pathways (P < 0.05) were reduced via principal component analysis and assessed with overall survival via Cox models. We classified each subject as glycolytic or OXPHOS phenotype and assessed it with survival. Results: Of 2,410 analyzed metabolites, 191 were differentially expressed. Relative to smoking-associated HNSCC, bile acid biosynthesis (P < 0.0001) and octadecatrienoic acid beta-oxidation (P = 0.01), were upregulated in HPV-associated HNSCC, while galactose metabolism (P = 0.001) and vitamin B6 metabolism (P = 0.01) were downregulated; the first two suggest an OXPHOS phenotype while the latter two suggest glycolytic. First principal components of bile acid biosynthesis [HR = 0.52 per SD; 95% confidence interval (CI), 0.38–0.72; P < 0.001] and octadecatrienoic acid beta-oxidation (HR = 0.54 per SD; 95% CI, 0.38–0.78; P < 0.001) were significantly associated with overall survival independent of HPV and smoking. The glycolytic versus OXPHOS phenotype was also independently associated with survival (HR = 3.17; 95% CI, 1.07–9.35; P = 0.04). Conclusions: Plasma metabolites related to glycolysis and mitochondrial OXPHOS may be biomarkers of HNSCC patient prognosis independent of HPV or smoking. Future investigations should determine whether they predict treatment efficacy. Impact: Blood metabolomics may be a useful marker to aid HNSCC patient prognosis.
Self-Ensembling Co-Training Framework for Semi-Supervised COVID-19 CT Segmentation

The coronavirus disease 2019 (COVID-19) has become a severe worldwide health emergency and is spreading at a rapid rate. Segmentation of COVID lesions from computed tomography (CT) scans is of great importance for supervising disease progression and further clinical treatment. As labeling COVID-19 CT scans is labor-intensive and time-consuming, it is essential to develop a segmentation method based on limited labeled data to conduct this task. In this paper, we propose a self-ensembled co-training framework, which is trained by limited labeled data and large-scale unlabeled data, to automatically extract COVID lesions from CT scans. Specifically, to enrich the diversity of unsupervised information, we build a co-training framework consisting of two collaborative models, in which the two models teach each other during training by using their respective predicted pseudo-labels of unlabeled data. Moreover, to alleviate the adverse impacts of noisy pseudo-labels for each model, we propose a self-ensembling strategy to perform consistency regularization for the up-to-date predictions of unlabeled data, in which the predictions of unlabeled data are gradually ensembled via moving average at the end of every training epoch. We evaluate our framework on a COVID-19 dataset containing 103 CT scans. Experimental results show that our proposed method achieves better performance in the case of only 4 labeled CT scans compared to the state-of-the-art semi-supervised segmentation networks.
Pretreatment Tissue TCR Repertoire Evenness Is Associated with Complete Pathologic Response in Patients with NSCLC Receiving Neoadjuvant Chemoimmunotherapy

Purpose: Characterization of the T-cell receptor (TCR) repertoire may be a promising source for predictive biomarkers of pathologic response to immunotherapy in locally advanced non–small cell lung cancer (NSCLC). Experimental Design: In this study, next-generation TCR sequencing was performed in peripheral blood and tissue samples of 40 patients with NSCLC, before and after neoadjuvant chemoimmunotherapy (NADIM clinical trial, NCT03081689), considering their complete pathologic response (CPR) or non-CPR. Beyond TCR metrics, tissue clones were ranked by their frequency and spatiotemporal evolution of top 1% clones was determined. Results: We have found a positive association between an uneven TCR repertoire in tissue samples at diagnosis and CPR at surgery. Moreover, TCR most frequently ranked clones (top 1%) present in diagnostic biopsies occupied greater frequency in the total clonal space of CPR patients, achieving an AUC ROC to identify CPR patients of 0.967 (95% confidence interval, 0.897–1.000; P = 0.001), and improving the results of PD-L1 tumor proportion score (TPS; AUC = 0.767; P = 0.026) or tumor mutational burden (TMB; AUC = 0.550; P = 0.687). Furthermore, tumors with high pretreatment top 1% clonal space showed similar immune cell populations but a higher immune reactive gene expression profile. Finally, the selective expansion of pretreatment tissue top 1% clones in peripheral blood of CPR patients suggests also a peripheral immunosurveillance, which could explain the high survival rate of these patients. Conclusions: We have identified two parameters derived from TCR repertoire analysis that could outperform PD-L1 TPS and TMB as predictive biomarkers of CPR after neoadjuvant chemoimmunotherapy, and unraveled possible mechanisms of CPR involving enhanced tumor immunogenicity and peripheral immunosurveillance.
Immune Checkpoint Inhibitor-induced myocarditis with myositis/myasthenia gravis overlap syndrome: a systematic review of cases.

BACKGROUND The development of immune checkpoint inhibitors (ICI) represents a paradigm shift in the treatment of cancers. Despite showing remarkable efficacy, these agents can be associated with life-threatening immune-related adverse events. In recent years, several cases of myocarditis with myositis and/or myasthenia gravis overlap syndrome (IM3OS) have been reported. However, given the rarity, the clinical features and outcomes of these cases remain poorly understood. We, therefore, attempted to systematically review and summarize all cases of IM3OS reported in the literature. METHODS Studies reporting IM3OS were identified in Embase and MEDLINE. Only case reports and case series published in journals or presented at conferences were included. We conducted a systematic review according to the PRISMA Harms guidelines. RESULTS A total of 60 cases were eligible. The patients' median age was 71 years, and the majority (67%) were males; melanoma was the most common indication for ICI (38%). The most-reported symptom was fatigue (80%) and muscle weakness (78%). The median number of doses to the development of IM3OS was one. The average creatine kinase level was 9645 IU/L. Cardiac arrhythmias occurred in 67% of patients, and 18% had depressed ejection fraction. Initial treatment consisted of immunosuppression with high-dose steroids and supportive therapies. 60% of the patients died in hospital due to acute complications. CONCLUSION IM3OS can be associated with significant mortality and morbidity. Prospective studies are needed to understand the optimal approach to diagnose and manage these patients and to develop biomarkers to predict the occurrence and severity of this rare but serious condition.
Effect of different preoperative fasting time on safety and postoperative complications of painless gastrointestinal endoscopy for polyps in patients.

OBJECTIVE To determine the effect of different preoperative fasting time on safety and postoperative complications of painless gastrointestinal endoscopy for polyps in patients. METHODS Enrolled patients were assigned to an observation group and a control group by the random number table method (each n=68). Before operation, each patient in the observation group was fasted from solids for 6 h and from liquids for 2 h, while each one in the control group was fasted from solids for 8-12 h and from liquids for 4 h according to the conventional method. The levels of blood glucose, insulin, potassium and sodium in patients before and after operation were determined, and their hunger and thirst were recorded before anesthesia. Additionally, the incidences and degrees of vomiting and nausea among the patients after anesthesia and operation were recorded. RESULTS Before operation, the observation group showed higher levels of blood glucose, insulin, serum potassium and serum sodium than the control group (all P<0.001), while after operation, the observation group showed lower levels of blood glucose and insulin and higher levels of serum potassium and serum sodium than the control group (all P<0.001). In addition, the degrees and incidences of hunger and thirst in patients of the observation group were significantly lower than those in the control group before operation (P<0.01), and the degrees and incidences of nausea and vomiting in the observation group were also notably lower than those in the control group before and after operation (both P<0.05). CONCLUSION For patients undergoing painless gastrointestinal endoscopy for polyps, shortening their fasting time from solids and liquids before operation can stabilize their blood glucose, insulin and electrolyte levels before and after operation, relieve their thirst and hunger before operation, and reduce the incidences of postoperative nausea and vomiting.
Subinhibitory concentrations of nalidixic acid alter bacterial physiology and induce anthropogenic resistance in a commensal strain of Escherichia coli in vitro

The human gut houses a complex group of bacterial genera, including both opportunistic pathogens and commensal micro‐organisms. These are regularly exposed to antibiotics, and their subinhibitory concentrations play a pivotal role in shaping the microbial responses. This study was aimed to investigate the effects exerted by sub‐MICs of nalidixic acid (NA) on the growth rate, bacterial motility, biofilm formation and expression of outer membrane proteins (OMPs) in a commensal strain of E. coli. The NA‐sensitive strain was sequentially passaged under sub‐MICs of NA. E‐test was used to determine the MIC values of NA. Results indicated significant changes in the growth profile of commensal E. coli upon exposure to NA at sub‐MICs. Differential expression of OMPs was observed in cells treated with sub‐MICs of NA. Bacterial motility was reduced under 1/2 MIC of NA. Interestingly, successive passaging under 1/2 MIC of NA led to the emergence of resistant E. coli with an increased MIC value of 64 µg ml−1 in just 24 days. The NA‐resistant variant was confirmed by comparing its 16S rRNA sequence to that of the sensitive commensal strain. Mutations in the Quinolone Resistance‐Determining Regions (QRDRs) of chromosomal gyrA, and Topoisomerase IV‐encoding parC genes were detected in NA‐resistant E. coli. Our results demonstrate how antibiotics play an important role as signalling molecules or elicitors in driving the pathogenicity of commensal bacteria in vitro.
Looking for Wugs in all the Right Places: Children's Use of Prepositions in Word Learning

To help infer the meanings of novel words, children frequently capitalize on their current linguistic knowledge to constrain the hypothesis space. Children's syntactic knowledge of function words has been shown to be especially useful in helping to infer the meanings of novel words, with most previous research focusing on how children use preceding determiners and pronouns/auxiliary to infer whether a novel word refers to an entity or an action, respectively. In the current visual world experiment, we examined whether 28- to 32-month-olds could exploit their lexical semantic knowledge of an additional class of function words-prepositions-to learn novel nouns. During the experiment, children were tested on their ability to use the prepositions in, on, under, and next to to identify novel creatures displayed on a screen (e.g., The wug is on the table), as well as their ability to later identify the creature without accompanying prepositions (e.g., Look at the wug). Children overall demonstrated understanding of all the prepositions but next to and were able to use their knowledge of prepositions to learn the associations between novel words and their intended referents, as shown by greater-than chance looks to the target referent when no prepositional phrase was provided.
Synergistic effect of combined treatment with baicalin and emodin on DSS‐induced colitis in mouse

The treatment of combination drugs in complex diseases has been spotlighted. Ulcerative colitis (UC) is a chronic inflammatory disease that has made progress in combination therapy. Baicalin, a flavone from Scutellaria baicalensis Georgi. (Lamiaceae), and emodin, an anthraquinone derivative from Rhei Radix et Rhizoma. (Polygonaceae), both have been reported to possess antiinflammatory activities. Our study investigated whether combined treatment with baicalin and emodin had a synergistic effect in inhibiting colitis inflammation. The results showed that baicalin combined with emodin at a lower dose had the same effect as the two drugs alone significantly alleviated the symptoms of dextran sulfate sodium (DSS)‐induced colitis mice, involving the prevention of the loss of body weight and colon shortening, the decrease in the disease activity index (DAI), and intestinal damages. The combined treatment decreased the expression of CD14/TLR4/NF‐κB pathway proteins and increased the expression of PPAR‐γ protein in the colon of colitis mice. Further study in vitro has shown that baicalin decreased the expression of CD14, whereas emodin increased the expression of PPAR‐γ, both of which inhibited the activity of NF‐κB and exerted antiinflammatory effects. Furthermore, compared to the treatment using the two drugs individually, baicalin combined with emodin had more significant effects on the expression of CD14 and PPAR‐γ. Therefore, emodin combined with baicalin had a synergistic effect on DSS‐induced colitis.
Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: A systematic review and meta‐analysis

The general management for chronic kidney disease (CKD) includes treating reversible causes, including obesity, which may be both a driver and comorbidity for CKD. Bariatric surgery has been shown to reduce the likelihood of CKD progression and improve kidney function in observational studies. We performed a systematic review and meta‐analysis of patients with at least stage 3 CKD and obesity receiving bariatric surgery. We searched Embase, MEDLINE, CENTRAL and identified eligible studies reporting on kidney function outcomes in included patients before and after bariatric surgery with comparison to a medical intervention control if available. Risk of bias was assessed with the Newcastle‐Ottawa Risk of Bias score. Nineteen studies were included for synthesis. Bariatric surgery showed improved eGFR with a mean difference (MD) of 11.64 (95%CI: 5.84 to 17.45, I2 = 66%) ml/min/1.73m2 and reduced SCr with MD of −0.24 (95%CI −0.21 to −0.39, I2 = 0%) mg/dl after bariatric surgery. There was no significant difference in the relative risk (RR) of having CKD stage 3 after bariatric surgery, with a RR of −1.13 (95%CI: −0.83 to −2.07, I2 = 13%), but there was reduced likelihood of having uACR >30 mg/g or above with a RR of −3.03 (95%CI: −1.44 to −6.40, I2 = 91%). Bariatric surgery may be associated with improved kidney function with the reduction of BMI and may be a safe treatment option for patients with CKD. Future studies with more robust reporting are required to determine the feasibility of bariatric surgery for the treatment of CKD.
Neurotensin secretion after Roux‐en‐Y gastric bypass, sleeve gastrectomy, and truncal vagotomy with pyloroplasty

Neurotensin (NT) is released from enteroendocrine cells and lowers food intake in rodents. We evaluated postprandial NT secretion in humans after surgeries associated with accelerated small intestinal nutrient delivery, and after Roux‐en‐Y gastric bypass (RYGB) when glucagon‐like peptide‐1 (GLP‐1) signalling and dipeptidyl peptidase 4 (DPP‐4) were inhibited, and during pharmacological treatments influencing entero‐pancreatic functions.
Patients with idiopathic pulmonary fibrosis have poor clinical outcomes with COVID-19 disease: a propensity matched multicentre research network analysis

Introduction Outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with pre-existing idiopathic pulmonary fibrosis (IPF) remain understudied, and it is unknown if IPF is an independent predictor of worse disease course. Herein, we report the clinical outcomes in a large cohort of 251 patients with COVID-19 in the setting of known IPF. Outcomes were compared with a propensity matched cohort of patients with COVID-19 without IPF. Methods Analysis of a federated multicentre research network TriNetX was performed including patients more than 16 years of age diagnosed with SARS-CoV-2 infection. Outcomes in patients diagnosed as positive for SARS-CoV-2 infection with concurrent IPF were compared with a propensity matched cohort of patients without IPF. Results A total of 311 060 patients with SARS-CoV-2 infection on the research network were identified, 251 patients (0.08%) carried a diagnosis of IPF. Mean age of patients with IPF was 68.30±12.20 years, with male predominance (n=143, 56.97%). Comorbidities including chronic lower respiratory diseases, diabetes mellitus, ischaemic heart disease and chronic kidney disease were more common in patients with IPF when compared with the non-IPF cohort. After propensity matching, higher rates of composite primary outcome (death or mechanical ventilation) at 30 and 60 days, as well as need for hospitalisation, critical care, and acute kidney injury were observed in the IPF cohort. Conclusion Poor outcomes of COVID-19 disease were observed in patients with IPF after robust matching of confounders. Our data confirm that patients with IPF constitute a high-risk cohort for poor outcomes related to COVID-19 disease.