Miracle-dz/UniFAR-FTUs huggingface dataset:
“Yes, My Uncle, I’ll Do Whatever You Say”: Experiences of Israeli Muslim Arab Children During Forensic Interviews Following Child Sexual Abuse

Children from Arab society in Israel have been overlooked in previous studies and efforts in the area of forensic interviews. The current study provides an in-depth thematic analysis of 30 forensic interviews with Israeli Muslim Arab children following child sexual abuse (CSA), all conducted by Arab forensic interviewers. In multicultural Israeli society, Muslim Arabs make up 18% of the population. In addition to the religious and cultural difference, this minority is involved in an ongoing conflict with the majority Jewish society in Israel and tends to have low trust of government authorities. This background necessarily affects the area of forensic interviews with children. The research explores the unique encounter between maltreated children from Israeli Muslim Arab society and forensic interviewers, highlighting its particular characteristics and challenges. Data analysis revealed a central theme of a clash of worlds. The forensic interviewers, although hailing from a similar background as the children, followed best practices developed in western societies. The children, on the other hand, faced enormous conflict in addressing CSA terminology and complying with the requirements of the forensic world in ways that are forbidden to the them in their own. Moreover, having been educated to accept the authority of adults unquestioningly, the children were torn between the difficulty of disclosing the abuse to someone outside the family, and the obligation to communicate candidly with the adult interviewer as required in the forensic context. The findings highlight the urgent need to reform the services these children receive and to dedicate future efforts to further assessment of cultural context and its impact on maltreated children, particularly in the forensic context.
Re: Poelstra R, et al. Patient’s satisfaction beyond hand function in Dupuytren’s disease: analysis of 1106 patients. J Hand Surg Eur. 2020, 45: 280–5.

We thank Mr Hems for his constructive letter. We completely agree with this perspective regarding the overemphasis of the Medical Research Council (MRC) muscle grading. Although the MRC is convenient in the clinical setting to communicate approximate muscle strength between medical staff, it becomes unreliable when comparing outcomes of different surgical techniques, and when formal quantitative measurements and statistical analysis are needed. We have encountered many hand surgeons and even journal editors who do not accept the utilization of quantitative analysis following nerve transfer surgery, who have the opinion that quantitative measurements following nerve transfers should not be the gold standard. That would be inconsistent with the view of most surgeons. With the current trend for outcomes reporting shifting towards measuring patient-reported outcomes, it could be argued that patient-reported outcomes are more likely to be aligned with accurately reported MRC than with quantitative measures of muscle strength, akin to how clinical strength is a more meaningful evaluation of an intervention than electrophysiologic recovery. I would like to highlight another issue in postoperative evaluation of muscle strength following nerve transfer for shoulder reconstruction. Most articles report their results using the MRC grading system, but do not account for synergistic muscle action in joint motion. For example, individual contributions to the biomechanics of the shoulder are inadequately studied in most publications, for which we recommend future studies to detail each component’s contribution to motion at the glenohumeral joint (deltoid, supraspinatus muscles) and the scapulothoracic joint (serratus anterior and trapezius). Surface electromyography in paediatric brachial plexus palsy patients to detect recovery of the target muscle following nerve transfer is routine in our practice. It is common for shoulder abduction to spontaneously recover deltoid function following spinal accessory nerve to suprascapular nerve transfer. Children are very adept in mastering supplemental muscle action from available unaffected muscles, to compensate for the weaker repaired muscle. Coincidently, in line with Mr Hems’ recommendation, we are currently using multi-channel surface electromyography to examine the supplemental functions of shoulder motion following nerve transfer. We greatly appreciate Mr Hems’ advice.
Cost-Effectiveness of Drug Treatment for Chinese Patients With Stage I Hypertension According to the 2017 Hypertension Clinical Practice Guidelines

Supplemental Digital Content is available in the text. Systolic/diastolic blood pressure of 130 to 139/80 to 89 mm Hg has been defined as stage I hypertension by the 2017 Hypertension Clinical Practice Guidelines. Drug treatment is recommended for stage I hypertensive patients aged ≥65 years without cardiovascular disease in the 2017 Hypertension Clinical Practice Guidelines but not in the 2018 Chinese guidelines. However, the cost-effectiveness of drug treatment among this subgroup of Chinese patients is unclear. This study developed a microsimulation model to compare costs and effectiveness of drug treatment and nondrug treatment for the subgroup of stage I hypertensive patients over a lifetime horizon from a government affordability perspective. Event rates of mortality and cardiovascular complications were estimated from 3 cohorts in the Chinese population. Costs and health utilities were obtained from the national statistics report and published literature. The model predicted that drug treatment generated quality-adjusted life-years of 13.52 and associated with expected costs of $6825 in comparison with 13.81 and $7328 produced by nondrug treatment over a lifetime horizon among stage I hypertensive patients aged ≥65 years without cardiovascular disease. At a willingness-to-pay threshold of $8836/quality-adjusted life-year (the GDP per capita in 2017), drug treatment only had a 1.8% probability of being cost-effective compared with nondrug treatment after 10 000 probabilistic simulations. Sensitivity analysis of treatment costs, benefits expected from treatment, health utilities, and discount rates did not change the results. Our results suggested that drug treatment was not cost-effective compared with nondrug treatment for stage I hypertensive patients aged ≥65 years without cardiovascular disease in China.
Geographical variation in case fatality rate and doubling time during the COVID-19 pandemic

Abstract Case fatality rate (CFR) and doubling time are important characteristics of any epidemic. For coronavirus disease 2019 (COVID-19), wide variations in the CFR and doubling time have been noted among various countries. Early in the epidemic, CFR calculations involving all patients as denominator do not account for the hospitalised patients who are ill and will die in the future. Hence, we calculated cumulative CFR (cCFR) using only patients whose final clinical outcomes were known at a certain time point. We also estimated the daily average doubling time. Calculating CFR using this method leads to temporal stability in the fatality rates, the cCFR stabilises at different values for different countries. The possible reasons for this are an improved outcome rate by the end of the epidemic and a wider testing strategy. The United States, France, Turkey and China had high cCFR at the start due to low outcome rate. By 22 April, Germany, China and South Korea had a low cCFR. China and South Korea controlled the epidemic and achieved high doubling times. The doubling time in Russia did not cross 10 days during the study period.
Natural killer cell mobilization and egress following acute exercise in men with prostate cancer

What is the central question of this study? What are the characteristics of the NK cell response following acute moderate‐intensity aerobic exercise in prostate cancer survivors and is there a relationship between stress hormones and NK cell mobilization? What is the main finding and its importance? NK cell numbers and proportions changed similarly between prostate cancer survivors and controls following acute exercise. Consecutive training sessions can likely be used without adverse effects on the immune system during prostate cancer treatment.
The potential benefit of a second C-reactive protein measurement in patients with gram-negative bacteraemia presenting to the emergency medicine department

Abstract Background Low C-reactive protein in acute bacterial infections could convey the erroneous impression of a mild infection. We focussed on gram-negative bacteraemia, a phenomenon frequently seen at the emergency room. Methods Of 2200 patients with gram-negative bacteraemia, 460 patients with first C-reactive protein <30 mg/L and 460 patients with C-reactive protein >187 mg/L were reviewed. Following exclusions, we finally investigated 229 and 289 patients with low and high C-reactive protein concentrations, respectively. Results The cohort was divided into low and high C-reactive protein groups. Median first C-reactive protein was 13.6 and 219.9 mg/L, respectively (interquartile range 6.4–21.6 and 195–270.1). Compared to patients with first high C-reactive protein, patients with first low C-reactive protein concentrations had a significant five-fold higher C-reactive protein level with their second test. Conclusions Patients with gram-negative bacteraemia can present with C-reactive protein within the range of apparently healthy individuals. A second C-reactive protein might help to avoid an erroneous decision regarding the severity of the infection.
The evolution of minimally invasive tissue sampling in postmortem examination: a narrative review

ABSTRACT Background Because of low acceptance rates and limited capacity, complete diagnostic autopsies (CDAs) are seldom conducted in low- and middle-income countries (LMICs). There have been growing investments in less-invasive postmortem examination methodologies, including needle-based autopsy, known as minimally invasive autopsy or minimally invasive tissue sampling (MITS). MITS has been shown to be a feasible and informative alternative to CDA for cause of death investigation and mortality surveillance purposes. Objective The aim of this narrative review is to describe historical use and evolution of needle-based postmortem procedures as a tool to ascertain the cause of death, especially in LMICs. Methods Key word searches were conducted in PubMed and EBSCO in 2018 and 2019. Abstracts were reviewed against inclusion and exclusion criteria. Full publications were reviewed for those abstracts meeting inclusion criteria and a start set was established. A snowball search methodology was used and references for all publications meeting inclusion criteria were manually reviewed until saturation was reached. Results A total of 1,177 publications were initially screened. Following an iterative review of references, 79 publications were included in this review. Twenty-nine studies, published between 1955 and 2019, included MITS as part of postmortem examination. Of the publications included, 76% (60/79) have publication dates after 2010. More than 60% of all publications included addressed MITS in LMICs, and a total of nine publications compared MITS with CDA. Conclusions Although there is evidence of less-invasive postmortem sampling starting in the 1800s, more structured needle-based postmortem examination publications started to appear in the mid-twentieth century. Early studies were mostly conducted in high-income countries but starting in 2010 the number of publications began to increase, and a growing number of studies were conducted in LMICs. Initial studies in LMICs were disease-specific but since 2015 have evolved to include more expansive postmortem examination.
Genetics of Chronic Traumatic Encephalopathy

Abstract Although chronic traumatic encephalopathy (CTE) garners substantial attention in the media and there have been marked scientific advances in the last few years, much remains unclear about the role of genetic risk in CTE. Two athletes with comparable contact-sport exposure may have varying amounts of CTE neuropathology, suggesting that other factors, including genetics, may contribute to CTE risk and severity. In this review, we explore reasons why genetics may be important for CTE, concepts in genetic study design for CTE (including choosing controls, endophenotypes, gene by environment interaction, and epigenetics), implicated genes in CTE (including APOE, MAPT, and TMEM106B), and whether predictive genetic testing for CTE should be considered.
CPAP titration failure is not equivalent to long-term CPAP treatment failure in patients with obesity hypoventilation syndrome: a case series.

STUDY OBJECTIVES Medium and long-term trials comparing CPAP with noninvasive ventilation in patients with obesity hypoventilation syndrome (OHS) have shown no differences in outcomes. However, it remains unclear whether CPAP therapy should be prescribed if significant hypoxemia persists during CPAP titration, despite optimization of upper airway obstructive events or if maximum CPAP pressure is reached. We aimed to examine the effects of 6 weeks of home CPAP therapy on gas exchange in patients with OHS who failed CPAP titration due to persistent hypoxemia. METHODS This case series is a substudy of a randomized-controlled trial evaluating efficacy of three different PAP modalities in OHS. Patients randomized to CPAP who failed titration and were prescribed CPAP are included. CPAP failure was defined as spending more than 20% of total sleep time with oxygen saturation below 90% despite adequate resolution of apneas and hypopneas. Follow-up data included in-laboratory PSG on prescribed CPAP after 6 weeks of home CPAP therapy. RESULTS Three out of seven participants (43%) randomized to CPAP failed CPAP titration. All were morbidly obese, had severe OSA (AHI >90/h) and severe sleep hypoxemia (percentage of total sleep time with oxygen saturation <90% [T90] = 60-89%). Hypoxemia (T90: 43-67%, T80: 0-31% and T70: 0-11%) and hypercapnia (transcutaneous pCO₂ levels >50mmHg) persisted during CPAP titration PSG. The final PSG after 6 weeks of adherent home CPAP therapy showed effective control of OSA. Hypoventilation and hypoxemia severity decreased significantly in all three participants. CONCLUSIONS Our data suggests that CPAP titration failure does not equal CPAP treatment failure. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov, Title: AVAPS-AE Efficacy Study, URL: https://clinicaltrials.gov/ct2/show/NCT01368614, Identifier: NCT01368614.
Neurocognitive outcomes in adults following cerebral hypoxia: A systematic literature review.

BACKGROUND Hypoxic ischemic brain injury (HIBI) occurs as a result of complete or partial disruption of cerebral oxygen supply. The physical and cognitive sequelae of adults following hypoxia varies widely. OBJECTIVE To systematically review studies exploring the neuropsychological outcomes following hypoxic brain insult in adults. METHODS Data was sourced using six databases (CINAHL, Cochrane, Embase, Medline, PsycInfo and Web of Science). Initial MESH terms identified 2,962 articles. After a three-stage independent review process, 18 articles, 9 case studies and 9 group studies were available for data synthesis from 1990-2012. Case study data was converted to standardised scores and compared to available test norms. Cohen's d was calculated to permit group data interpretation. RESULTS Intellectual decrement was observed in some studies although difficult to delineate given the lack of use of measures of premorbid ability. Cognitive sequelae varied albeit with predominant disturbance in verbal memory, learning ability and executive function observed across studies. Wechsler Memory Scale Revised (WMS-R) visual memory was comparable to normative data. Impaired Rey Osterrieth Complex Figure (ROCFT) performance was found among group studies. Across visuo-constructional and attention domains, performance varied, although no significant difference relative to reported means was observed. CONCLUSIONS Future studies should consider the use of standardised assessment protocols, which include measures of premorbid functioning and performance validity.
Profiling HPV-16–specific T cell responses reveals broad antigen reactivities in oropharyngeal cancer patients

Proteome-wide profiling of HPV-specific T cell immunity in oropharyngeal cancer (OPC) patients reveals broad and multiple antigen-specific reactivities directed to HPV-encoded proteins E1, E2, E4, E5 E6, E7, and L1. These observations provide novel insights for future development of cellular immunotherapies for HPV-associated OPC patients.
Clinical Outcomes of TAVI or SAVR in Men and Women with Aortic Stenosis at Intermediate Operative Risk: a post hoc analysis of the randomized SURTAVI trial.

AIMS In patients with aortic stenosis randomized to transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR), sex-specific differences in complication rates are unclear in intermediate-risk patients. METHODS AND RESULTS 1,660 intermediate-risk patients underwent TAVI with a supra-annular, self-expanding bioprosthesis or SAVR. The population was stratified by sex and treatment modality (female TAVI=366, male TAVI=498, female SAVR=358, male SAVR=438). The primary endpoint was a composite of all-cause mortality or disabling stroke at two years. Compared to males, females had a smaller body surface area, a higher Society of Thoracic Surgeons score (4.7±1.6% vs. 4.3±1.6%, p<0.01) and more frailty. Men required more concomitant revascularization (23% vs. 16%). All-cause mortality or disabling stroke at two years was similar between TAVI and SAVR for females (10.2% vs. 10.5%, p=0.90) and males (14.5% vs. 14.4%, p=0.99); the difference between females and males was 10.2% vs. 14.5%, for TAVI (p=0.08) and 10.5% vs. 14.4%, SAVR (p=0.13). Functional status improvement was more pronounced after TAVI for females than males. CONCLUSIONS Aortic valve replacement, either by surgical or transcatheter approach, appears similarly effective and safe for males and females at intermediate surgical risk. Functional status appears to improve most in females after TAVI.
The Experiences of Bereaved Parents After the Loss of a Child to Cancer: A Qualitative Metasynthesis

This study aims to synthesize qualitative evidence about the bereavement experience of parents following the death of a child due to cancer. A qualitative metasynthesis was conducted from searching five databases. The search identified 650 articles that were independently assessed by two reviewers. Thirty-one articles were selected for full-text reading and assessed for eligibility; a total of 14 articles were included in the final sample and submitted to quality appraisal. The software NVivo® was used to organize the data and support the thematic analysis procedures. Two analytical themes were constructed: (1) losing a child and facing a rupture in identity and sense of life and (2) surviving grief and reengaging in life. The grief process was dynamic, continuous, and begun before the death of the child. Fathers and mothers reacted differently to the loss and experience of grief. The loss of a child definitively changed the parents’ life and caused identity crisis and loss of life’s purpose. During the process of survival, parents constructed new meanings that helped them cope with grief; they used strategies that allowed them to recover their sense of purpose in life. Synthesizing the experience of bereaved parents is essential to improve the support families of children with advanced cancer receive to better cope with their suffering and loss, before and after the child’s death.
Association between naturally occurring lithium in drinking water and suicide rates: systematic review and meta-analysis of ecological studies

Background The prevalence of mental health conditions and national suicide rates are increasing in many countries. Lithium is widely and effectively used in pharmacological doses for the treatment and prevention of manic/depressive episodes, stabilising mood and reducing the risk of suicide. Since the 1990s, several ecological studies have tested the hypothesis that trace doses of naturally occurring lithium in drinking water may have a protective effect against suicide in the general population. Aims To synthesise the global evidence on the association between lithium levels in drinking water and suicide mortality rates. Method The MEDLINE, Embase, Web of Science and PsycINFO databases were searched to identify eligible ecological studies published between 1 January 1946 and 10 September 2018. Standardised regression coefficients for total (i.e. both genders combined), male and female suicide mortality rates were extracted and pooled using random-effects meta-analysis. The study was registered with PROSPERO (CRD42016041375). Results The literature search identified 415 articles; of these, 15 ecological studies were included in the synthesis. The random-effects meta-analysis showed a consistent protective (or inverse) association between lithium levels/concentration in publicly available drinking water and total (pooled β = −0.27, 95% CI −0.47 to −0.08; P = 0.006, I2 = 83.3%), male (pooled β = −0.26, 95% CI −0.56 to 0.03; P = 0.08, I2 = 91.9%) and female (pooled β = −0.13, 95% CI −0.24 to −0.02; P = 0.03, I2 = 28.5%) suicide mortality rates. A similar protective association was observed in the six studies included in the narrative synthesis, and subgroup meta-analyses based on the higher/lower suicide mortality rates and lithium levels/concentration. Conclusions This synthesis of ecological studies, which are subject to the ecological fallacy/bias, supports the hypothesis that there is a protective (or inverse) association between lithium intakes from public drinking water and suicide mortality at the population level. Naturally occurring lithium in drinking water may have the potential to reduce the risk of suicide and may possibly help in mood stabilisation, particularly in populations with relatively high suicide rates and geographical areas with a greater range of lithium concentration in the drinking water. All the available evidence suggests that randomised community trials of lithium supplementation of the water supply might be a means of testing the hypothesis, particularly in communities (or settings) with demonstrated high prevalence of mental health conditions, violent criminal behaviour, chronic substance misuse and risk of suicide.
Targeting polyamine biosynthesis to stimulate beta cell regeneration in zebrafish

ABSTRACT Type 1 diabetes (T1D) is a disease characterized by destruction of the insulin-producing beta cells. Currently, there remains a critical gap in our understanding of how to reverse or prevent beta cell loss in individuals with T1D. Previous studies in mice discovered that pharmacologically inhibiting polyamine biosynthesis using difluoromethylornithine (DFMO) resulted in preserved beta cell function and mass. Similarly, treatment of non-obese diabetic mice with the tyrosine kinase inhibitor Imatinib mesylate reversed diabetes. The promising findings from these animal studies resulted in the initiation of two separate clinical trials that would repurpose either DFMO (NCT02384889) or Imatinib (NCT01781975) and determine effects on diabetes outcomes; however, whether these drugs directly stimulated beta cell growth remained unknown. To address this, we used the zebrafish model system to determine pharmacological impact on beta cell regeneration. After induction of beta cell death, zebrafish embryos were treated with either DFMO or Imatinib. Neither drug altered whole-body growth or exocrine pancreas length. Embryos treated with Imatinib showed no effect on beta cell regeneration; however, excitingly, DFMO enhanced beta cell regeneration. These data suggest that pharmacological inhibition of polyamine biosynthesis may be a promising therapeutic option to stimulate beta cell regeneration in the setting of diabetes.