Miracle-dz/UniFAR-FTUs huggingface dataset:
Acceptance of Telerheumatology by Rheumatologists and General Practitioners in Germany: Nationwide Cross-sectional Survey Study

Background The worldwide burden of musculoskeletal diseases is increasing. The number of newly registered rheumatologists has stagnated. Primary care, which takes up a key role in early detection of rheumatic disease, is working at full capacity. COVID-19 and its containment impede rheumatological treatment. Telemedicine in rheumatology (telerheumatology) could support rheumatologists and general practitioners. Objective The goal of this study was to investigate acceptance and preferences related to the use of telerheumatology care among German rheumatologists and general practitioners. Methods A nationwide, cross-sectional, self-completed, paper-based survey on telerheumatology care was conducted among outpatient rheumatologists and general practitioners during the pre-COVID-19 period. Results A total of 73.3% (349/476) of survey participants rated their knowledge of telemedicine as unsatisfactory, poor, or very poor. The majority of survey participants (358/480, 74.6%) answered that they do not currently use telemedicine, although 62.3% (291/467) would like to. Barriers to the implementation of telemedicine include the purchase of technology equipment (182/292, 62.3%), administration (181/292, 62.0%), and poor reimbursement (156/292, 53.4%). A total of 69.6% (117/168) of the surveyed physicians reckoned that telemedicine could be used in rheumatology. Surveyed physicians would prefer to use telemedicine to communicate directly with other physicians (370/455, 81.3%) than to communicate with patients (213/455, 46.8%). Among treatment phases, 64.4% (291/452) of participants would choose to use telemedicine during follow-up. Half of the participants would choose telecounseling as a specific approach to improve rheumatology care (91/170, 53.5%). Conclusions Before COVID-19 appeared, our results indicated generally low use but high acceptance of the implementation of telerheumatology among physicians. Participants indicated that the lack of a structural framework was a barrier to the effective implementation of telerheumatology. Training courses should be introduced to address the limited knowledge on the part of physicians in the use of telemedicine. More research into telerheumatology is required. This includes large-scale randomized controlled trials, economic analyses, and the exploration of user preferences.
Chromosome inheritance and meiotic stability in allopolyploid Brassica napus

Abstract Homoeologous recombination, aneuploidy, and other genetic changes are common in resynthesized allopolyploid Brassica napus. In contrast, the chromosomes of cultivars have long been considered to be meiotically stable. To gain a better understanding of the underlying mechanisms leading to stabilization in the allopolyploid, the behavior of chromosomes during meiosis can be compared by unambiguous chromosome identification between resynthesized and natural B. napus. Compared with natural B. napus, resynthesized lines show high rates of nonhomologous centromere association, homoeologous recombination leading to translocation, homoeologous chromosome replacement, and association and breakage of 45S rDNA loci. In both natural and resynthesized B. napus, we observed low rates of univalents, A–C bivalents, and early sister chromatid separations. Reciprocal homoeologous chromosome exchanges and double reductions were photographed for the first time in meiotic telophase I. Meiotic errors were non-uniformly distributed across the genome in resynthesized B. napus, and in particular homoeologs sharing synteny along their entire length exhibited multivalents at diakinesis and polysomic inheritance at telophase I. Natural B. napus appeared to resolve meiotic errors mainly by suppressing homoeologous pairing, resolving nonhomologous centromere associations and 45S rDNA associations before diakinesis, and reducing homoeologous cross-overs.
Association of Ablative Radiation Therapy With Survival Among Patients With Inoperable Pancreatic Cancer.

Importance Surgical resection has been considered the only curative option for patients with pancreatic cancer. Nonoperative local treatment options that can provide a similar benefit are needed. Emerging radiation techniques that address organ motion have enabled curative radiation doses to be given in patients with inoperable disease. Objective To determine the association of hypofractionated ablative radiation therapy (A-RT) with survival for patients with locally advanced pancreatic cancer (LAPC) treated with a novel radiation planning and delivery technique. Design, Setting, and Participants This cohort study included 119 consecutive patients treated with A-RT between June 2016 and February 2019 and enrolled in a prospectively maintained database. Patients were treated with a standardized technique within a large academic cancer center regional network. All patients with localized, unresectable, or medically inoperable pancreatic cancer with tumors of any size and less than 5 cm luminal abutment with the primary tumor were eligible. Interventions Ablative RT (98 Gy biologically effective dose) was delivered using standard equipment. Respiratory gating, soft tissue image guidance, and selective adaptive planning were used to address organ motion and limit the dose to surrounding luminal organs. Main Outcomes and Measures The primary outcome was overall survival (OS). Secondary outcomes included incidence of local progression and progression-free survival. Results Between 2016 and 2019, 119 patients (59 men, median age 67 years) received A-RT, including 99 with T3/T4 and 53 with node-positive disease, with a median carbohydrate antigen 19-9 (CA19-9) level greater than 167 U/mL. Most (116 [97.5%]) received induction chemotherapy for a median of 4 months (0.5-18.4). Median OS from diagnosis and A-RT were 26.8 and 18.4 months, respectively. Respective 12- and 24-month OS from A-RT were 74% (95% CI, 66%-83%) and 38% (95% CI, 27%-52%). Twelve- and 24-month cumulative incidence of locoregional failure were 17.6% (95% CI, 10.4%-24.9%) and 32.8% (95% CI, 21.6%-44.1%), respectively. Postinduction CA19-9 decline was associated with improved locoregional control and survival. Grade 3 upper gastrointestinal bleeding occurred in 10 patients (8%) with no grade 4 to 5 events. Conclusions and Relevance This cohort study of patients with inoperable LAPC found that A-RT following multiagent induction therapy for LAPC was associated with durable locoregional tumor control and favorable survival. Prospective randomized trials in patients with LAPC are warranted.
Trans and Gender-Diverse peoples' experiences of crisis helpline services.

Crisis helplines are typically easily accessible and deliver interventions in a timely manner, regardless of geographical location. The efficacy and user experiences of these services are the subject of considerable interest within the field, but the experiences of trans and gender-diverse individuals remain unexplored despite high rates of mental ill health being documented in this population. A total of 134 trans and gender-diverse Australians were surveyed about their experiences of personal crises and of utilising crisis helplines. Within our sample, 84.2% (n = 113) of participants recognised at least one service - however, only 32.8% (n = 44) utilised a service to cope with a personal crisis. Participants cited poor recognition and understanding of the challenges specific to trans and gender-diverse individuals among helpline workers as a primary reason for avoiding these services, and articulated needs which were a poor fit for the one-off intervention model commonly employed by helpline services. In order for helpline services to be viable avenues of support for trans and gender-diverse individuals during a personal crisis, helpline workers must be sufficiently equipped to work with trans and gender-diverse callers and to facilitate their enrolment in 'traditional' mental health services.
FOLIAR RESPONSE REACTIONS INDUCED BY ATMOSPHERIC POLLUTANTS ON THE AESCULUS HIPPOCASTANUM L. AND TILIA TOMENTOSA L. SPECIES FROM IAŞI CITY AREA

1 Abstract: In this paper we present the foliar response reaction induced by atmospheric pollutants on the Aesculus hippocastanum L. and Tilia tomentosa L. species situated around Iasi citys air quality monitoring stations. Pollutants monitored by the five stations are represented by gaseous (sulfur dioxide, carbon dioxide, nitrogen dioxide, ozone) and solid pollutants (dust prone to sedimentation). Our investigations focused on morphological observations and tracked the dynamic of physiological and biochemical changes induced on leaves as compared with the unpolluted ones. We emphasized that the large amount of dry leaves is not always related to necrotic leaf surface. It was found that the amount of chlorophyll a and b and the intensity of photosynthesis arent always correlated, as already known from literature.
Factors Controlling the Removal of Organic Pollutants in Ozone Reactors

According to a model developed during this study, the efficiency of removing organic contaminants in ozone reactors is determined mainly by the reactivity and volatility of the contaminants. The chemical composition of the water, the mass transfer characteristics of the reactor, and certain operational conditions (flow rates of the gas and water, concentration of ozone in the applied gas stream, and detention time) were identified as the process parameters that control the performance of ozone reactors. Once the methodology has been developed to measure all key parameters, the model can be used to evaluate different operational alternatives for optimum performance of ozone reactors and to make performance and cost comparisons between ozonation and other processes, such as activated carbon adsorption and air stripping.
The cost-effectiveness of scaling-up rapid point-of-care testing for early infant diagnosis of HIV in southern Zambia

Introduction Early infant diagnosis (EID) and treatment can prevent much of the HIV-related morbidity and mortality experienced by children but is challenging to implement in sub-Saharan Africa. Point-of-care (PoC) testing would decentralize testing and increase access to rapid diagnosis. The objective of this study was to determine the cost-effectiveness of PoC testing in Southern Province, Zambia. Methods A decision tree model was developed to compare health outcomes and costs between the standard of care (SoC) and PoC testing using GeneXpert and m-PIMA platforms. The primary health outcome was antiretroviral treatment (ART) initiation within 60 days of sample collection. Additional outcomes included ART initiation by 12 months of age and death prior to ART initiation. Costs included both capital and recurrent costs. Health outcomes and costs were combined to create incremental cost effectiveness ratios (ICERs). Results The proportion of children initiating ART within 60 days increased from 27.8% with SoC to 79.8–82.8% with PoC testing depending on the algorithm and platform. The proportion of children initiating ART by 12 months of age increased from 50.9% with SoC to 84.0–86.5% with PoC testing. The proportion of HIV-infected children dying prior to ART initiation decreased from 18.1% with SoC to 3.8–4.6% with PoC testing. Total program costs were similar for the SoC and GeneXpert but higher for m-PIMA. ICERs for PoC testing were favorable, ranging from $23–1,609 for ART initiation within 60 days, $37–2,491 for ART initiation by 12 months of age, and $90–6,188 for deaths prior to ART initiation. Factors impacting the costs of PoC testing, including the lifespan of the testing instruments and integrated utilization of PoC platforms, had the biggest impact on the ICERs. Integrating utilization across programs decreased costs for the EID program, such that PoC testing was cost-saving in some situations. Conclusion PoC testing has the potential to improve linkage to care and ART initiation for HIV-infected infants and should be considered for implementation within EID programs to achieve equity in access to HIV services and reduce HIV-related pediatric morbidity and mortality.
Development and content validation of a measure to assess evidence-informed decision-making competence in public health nursing

There are professional expectations for public health nurses to develop competencies in evidence-informed decision-making (EIDM) due to its potential for improved client outcomes. Robust tools to assess EIDM competence can encourage increased EIDM engagement and uptake. This study aimed to develop and validate the content of a measure to assess EIDM competence among public health nurses. A four-stage process, based on measure development principles and the Standards for Educational and Psychological Testing, was used to develop and refine items for a new EIDM competence measure: a) content coverage assessment of existing measures; b) identification of existing measures for use and development of items; c) validity assessment based on content; d) validity assessment based on response process. An EIDM competence measurement tool consisting of EIDM knowledge, skills, attitudes/beliefs, and behaviour items was developed using conceptual literature and existing measures (Evidence-Based Practice Competency Tool and Evidence-Based Practice Beliefs Scale) to address limitations of existing EIDM tools identified from the content coverage assessment. Item content validity index ratings ranged from 0.64–1.00. Qualitative themes from validity assessment based on content and response process included word changes to improve clarity, reducing item redundancy, separating multi-component items, and ensuring items reflect nursing role expectations. Upon determining its reliability and validity, there is potential for the EIDM competence measure to be used in: public health nursing practice to identify competence gaps and strengths to facilitate professional development activities; in research to support development of strategies to build EIDM capacity; and for curriculum planning and development across nursing education programs.
Corneal ectasia with Stevens–Johnson syndrome

Corneal ectasia and Stevens–Johnson syndrome (SJS) are uncommon ocular conditions, both of which can be managed with scleral contact lenses to improve visual acuity, provide constant corneal lubrication, and decrease photophobia. Very few reports of co-existing keratoconus and SJS have been published. Rathi et al. described three cases (14–25-year-old males) with drug-induced SJS who developed keratoconus between two and seven years after the onset of SJS. They demonstrated a significant improvement in visual acuity and decrease in photophobia and ocular symptoms with full-time scleral lens wear. Saaed et al. described nine cases of keratoconus that developed on average 10 years after the onset of SJS and were successfully managed with scleral lenses. This clinical communication highlights the use of scleral lenses in the management of co-existing keratoconus and SJS.
Modeling the Response of Cassava to Fertilizers: A Site-Specific Nutrient Management Approach for Greater Tuberous Root Yield

Conventional fertilizer-management strategy results in decreased fertilizer-use efficiency and unbalanced nitrogen (N)–phosphorus (P)–potassium (K) applications. The quantitative evaluation of fertility of tropical soils (QUEFTS) model was used for determining region-specific balanced NPK uptake requirements and recommendations for a target yield of cassava. Minimum and maximum internal efficiencies of N, P, and K were estimated as 35 and 80 for N, 250 and 750 for P, and 32 and 102 for K (kg tuberous root per kg nutrient removed). Linear increases in tuberous root yield with N, P, and K uptakes of 17.6, 2.2, and 15.6 kg N, P, and K per 1000 kg tuberous root yield were observed. Relationships between soil supply and soil chemical properties and between fertilizer nutrient recovery efficiencies with their rates of application were developed for major cassava-production regions. Good agreement between measured and predicted yields was observed while calibrating the model, which shows that the model can be used for making site-specific NPK recommendations for cassava in major cassava production regions of India.
Secondary chordal resection with septal myectomy for treatment of symptomatic obstructive hypertrophic cardiomyopathy.

OBJECTIVES Left ventricular outflow tract obstruction causes symptoms of heart failure in most patients with hypertrophic cardiomyopathy. Resection of the secondary mitral valve (MV) chordae has recently been shown to move the MV apparatus posteriorly, thereby eradicating the outflow gradient. The aim of this study was to evaluate whether secondary chordal resection concomitant to septal myectomy improves outcomes. METHODS Between 2005 and 2020, a total of 165 patients underwent septal myectomy without MV repair or replacement in our Medical Center. Secondary MV chordal resection was performed in 60 patients, and their outcomes were compared with those of the remaining 105 patients who did not undergo chordal resection (controls). Mean age was 61 ± 13 and 58 ± 16 years, respectively (P = 0.205). RESULTS There were no in-hospital deaths throughout the entire cohort. Of those patients who underwent secondary chordal resection, New York Heart Association functional class decreased from 3 (interquartile range 2-3) preoperatively to 1 (interquartile range 1-2) postoperatively (P < 0.001), and resting outflow gradient decreased from 91 ± 39 mmHg to 13 ± 8 mmHg (86% change, P < 0.001). Compared with controls, patients who underwent secondary chordal resection had a significant lower resting outflow gradient at follow-up (14 ± 7 mmHg vs 21 ± 15 mmHg, P = 0.002). The rate of moderate or more than moderate mitral regurgitation at 5 years was 2% in the secondary chordal resection group and 5% in the controls (hazard ratio 1.05, confidence interval 0.11-10.32; P = 0.965). CONCLUSIONS In this observational study, we report that secondary chordal resection concomitant to septal myectomy for left ventricular outflow tract obstruction is safe, relieves heart failure symptoms and reduces left ventricular outflow tract gradient in appropriately selected patients.
Occupational and non-occupational risk factors for neck and lower back pain among computer workers: a cross-sectional study

Objectives. The aim of this study was to identify major determinants for neck and lower back pain (LBP) among office workers of different ages. Methods. Computer workers (N = 2000) responded to a questionnaire on demographics, musculoskeletal disorders (MSDs), lifestyle characteristics, ergonomics of computer work and psychosocial and physical job characteristics. Results. Over 48% of respondents complained of MSDs last year, in particular neck pain and LBP. The results of logistic regression analysis revealed that prolonged computer time (odds ratio [OR] 1.92) and increased job demands (OR 1.06) were likely to increase the risk of neck pain, while social support (OR 0.96) and the use of seat-plate height adjustment (OR 0.64) would help to reduce the risk. Risk factors for LBP included smoking more than 14 cigarettes a day (OR 2.21), long hours spent working with a computer (OR 1.94), increased physical exertion at work (OR 1.29), increased work demands (OR 1.03) and older age (OR 1.03). Conclusions. The most effective way to eliminate MSD hazards in the workplace is to develop health programmes aimed at advocating healthy lifestyle behaviours and raising workers’ awareness of workstation ergonomics and work organization, especially for women and older workers.
Metabolites with Cytotoxic Activity from the Formosan Soft Coral Cladiella Australis

The metabolites, (24S)-3β-acetoxyergost-5-en-21-oic acid (2), 5′-O-acetylthymidine (3), 3′-O-acetylthymidine (4), and p-vinylbenzyl alcohol (5), along with a known steroid (1) were isolated from the EtOAc extract of the Formosan soft coral Caldiella australis. The structures of new metabolites were determined on the basis of spectroscopic (including 1D and 2D NMR) analyses and by comparison of their NMR spectral data with those of related compounds. Except for 3, all compounds exhibited cytotoxic activity of various degrees of potency against a limited panel of human liver and breast cancer cell lines.
Dietary Blueberry and Soluble Fiber Supplementation Reduces Risk of Gestational Diabetes in Women with Obesity in a Randomized Controlled Trial.

BACKGROUND Gestational diabetes mellitus (GDM) is a growing public health concern and maternal obesity and poor dietary intakes could be implicated. Dietary polyphenols and fiber mitigate the risk of diabetes and its complications, but little is known about their efficacy in preventing GDM. OBJECTIVES We examined the effects of whole blueberry and soluble fiber supplementation on primary outcomes of cardiometabolic profiles in women at high risk of developing GDM. METHODS Women (n = 34; mean ± SD age: 27 ± 5 y; BMI: 35.5 ± 4.0 kg/m2; previous history of GDM ∼56%; Hispanic ∼79%) were recruited in early pregnancy (<20 weeks of gestation) and randomly assigned to 1 of the following 2 groups for 18 wk: intervention (280 g whole blueberries and 12 g soluble fiber per day) and standard prenatal care (control). Both groups received nutrition education and maintained 24-h food recalls throughout the study. Data on anthropometrics, blood pressure, and blood samples for biochemical analyses were collected at baseline (<20 weeks), midpoint (24-28 weeks), and end (32-36 weeks) of gestation. Diagnosis of GDM was based on a 2-step glucose challenge test (GCT). Data were analyzed using a mixed-model ANOVA. RESULTS Maternal weight gain was significantly lower in the dietary intervention than in the control group at the end of the trial (mean ± SD: 6.8 ± 3.2 kg compared with 12.0 ± 4.1 kg, P = 0.001). C-reactive protein was also lower in the intervention than in the control group (baseline: 6.1 ± 4.0 compared with 6.8 ± 7.2 mg/L; midpoint: 6.1 ± 3.7 compared with 7.5 ± 7.3 mg/L; end: 5.5 ± 2.2 compared with 9.5 ± 6.6 mg/L, respectively, P = 0.002). Blood glucose based on GCT was lower in the intervention than in the control (100 ± 33 mg/dL compared with 131 ± 40 mg/dL, P < 0.05). Conventional lipids (total, LDL, and HDL cholesterol and triglycerides) did not differ between groups over time. No differences were noted in infant birth weight. CONCLUSIONS Whole blueberry and soluble fiber supplementation may prevent excess gestational weight gain and improve glycemic control and inflammation in women with obesity.This trial was registered at clinicaltrials.gov as NCT03467503.