Miracle-dz/UniFAR-FTUs huggingface dataset:
Depression and Quality of Life among the Chronic Kidney Disease Patients.

BACKGROUND Depression and other mental illness are very common among chronic kidney disease and also Quality of life has been found significantly impaired in chronic kidney disease. The objective of our study is to study Depression, Quality of life and its associations in chronic kidney disease. METHODS This was a descriptive cross-sectional study. We used convenient method of sampling for data collection. The World Health Organization Quality-of-Life 8-question scale was used for estimating quality of life and Beck Depression Inventory was used for the assessment of depression. Independent samples t-test was conducted to analysed bivariate relationship of sociodemographic factors with depression and Quality of life scores and multiple linear regression analysis was performed to determine predictors of Quality of life. RESULTS The 75.5% participants found to have depression. Depression was found statistically significant across socioeconomic status (p value 0.04) and other medical comorbidities (p value 0.04). Variables found to be significantly associated with total quality of life in multiple linear regression analysis were caste (p value 0.03), socioeconomic status (p value 0.009) and depression (p value 0.001). CONCLUSIONS Depression and reduced quality of life is very common among chronic kidney patients. Low socioeconomic status and comorbid medical conditions were associated with depression and caste, low socioeconomic status and depression were associated with low quality of life. Screening and management of depression should be included in the routine care and it could help improving the quality of life of patients with chronic kidney disease.
Gene expression responses to Zika virus infection in peripheral blood mononuclear cells from pregnant and non‐pregnant women

Congenital Zika syndrome is caused by mother‐to‐fetus transmission of the Zika virus (ZIKV). Peripheral blood mononuclear cells (PBMCs) are permissive to ZIKV infection and may carry ZIKV to the placenta. To identify pregnancy‐related differences in PBMC responses against ZIKV infection, we compared gene expression profiles of ZIKV‐infected and non‐infected PBMCs cultured from pregnant and non‐pregnant women. ZIKV‐infected pregnant conditions generally overexpressed M1‐shifted pro‐inflammatory responses and underexpressed M2‐shifted anti‐inflammatory responses. Additionally, transcripts involved in osteoclast differentiation and cardiac myopathies were upregulated following ZIKV infection. Our results suggest potential roles of pregnancy‐induced immune dysregulation in shaping neonatal pathology associated with ZIKV infection.
Adult cardiopulmonary bypass in Australian and New Zealand public hospitals: A survey of practice

A telephone survey of cardiac anaesthetists and perfusionists at the 29 public hospitals providing adult cardiac surgical services in Australia and New Zealand was carried out between December 2019 and January 2020. The aim was to investigate current practice with regard to selected contentious elements of anaesthetic and perfusion management during cardiopulmonary bypass; primarily relating to bypass circuit priming, blood conservation methods and point-of-care coagulation testing. There was a 100% response rate. The average number of adult public cardiopulmonary bypass cases per hospital was 508 (160–1400). For cardiopulmonary bypass cases, ten hospitals (34%) routinely used a cell saver and the remainder used a cell saver selectively. Residual blood remaining in the cardiopulmonary bypass circuit was processed using a cell saver routinely in four hospitals (14%) and selectively in 23 (79%). Acute normovolaemic haemodilution was rarely used. Retrograde autologous priming was used routinely in seven hospitals (24%) and selectively in 16 (55%). All hospitals had access to point-of-care coagulation testing. The majority of hospitals targeted an activated clotting time of 480 s (range 400–500 s) prior to commencing cardiopulmonary bypass. There was marked geographic variation in access to fibrinogen concentrate. The cardiopulmonary bypass circuit prime solution was primarily a balanced crystalloid in most hospitals; however, there was significant variation regarding the addition of human albumin, mannitol, sodium bicarbonate and other medications. Many of the interventions examined were used on a case-by-case basis. These findings support the need for further research to define more evidence-based practice of these interventions.
Sex-Related Differences in the Association of BMI and Pericardial Fat Volume With Coronary Atherosclerotic Markers in Young

We assessed sex-related differences in the association of pericardial fat volume (PFV) and obesity measured by body mass index (BMI) with coronary atherosclerotic markers (coronary artery calcium score [CAC], coronary luminal stenosis severity, and coronary plaque) in young patients. Patients (n = 174; age <50 years) with suspected coronary artery disease who underwent 64-slice multidetector computed tomography angiography were enrolled. Females tended to have a younger age and increased BMI, normal coronary arteries (free from luminal stenosis), and increased percentage of absent coronary plaque compared with males. There was a significant independent association between PFV with coronary luminal stenosis and between PFV and BMI with coronary noncalcified plaque presence after adjustment for conventional cardiac risk factors. On the other hand, males showed a more increment in PFV, CAC, percentage of calcified plaque, and percentage of significant coronary luminal stenosis compared with females. There was a significant independent association of PFV with CAC, significant coronary stenosis, and calcified plaque presence, while no association was observed between BMI with coronary markers in young males. In conclusion, PFV, but not BMI, showed a significant independent association with advanced coronary atherosclerosis in young male patients.
Testing consensus implementations using communication closure

Large scale production distributed systems are difficult to design and test. Correctness must be ensured when processes run asynchronously, at arbitrary rates relative to each other, and in the presence of failures, e.g., process crashes or message losses. These conditions create a huge space of executions that is difficult to explore in a principled way. Current testing techniques focus on systematic or randomized exploration of all executions of an implementation while treating the implemented algorithms as black boxes. On the other hand, proofs of correctness of many of the underlying algorithms often exploit semantic properties that reduce reasoning about correctness to a subset of behaviors. For example, the communication-closure property, used in many proofs of distributed consensus algorithms, shows that every asynchronous execution of the algorithm is equivalent to a lossy synchronous execution, thus reducing the burden of proof to only that subset. In a lossy synchronous execution, processes execute in lock-step rounds, and messages are either received in the same round or lost forever—such executions form a small subset of all asynchronous ones. We formulate the communication-closure hypothesis, which states that bugs in implementations of distributed consensus algorithms will already manifest in lossy synchronous executions and present a testing algorithm based on this hypothesis. We prioritize the search space based on a bound on the number of failures in the execution and the rate at which these failures are recovered. We show that a random testing algorithm based on sampling lossy synchronous executions can empirically find a number of bugs—including previously unknown ones—in production distributed systems such as Zookeeper, Cassandra, and Ratis, and also produce more understandable bug traces.
Incremental Risk of Developing Severe COVID-19 Among Mexican Patients With Diabetes Attributed to Social and Health Care Access Disadvantages

OBJECTIVE Diabetes is an important risk factor for severe coronavirus disease 2019 (COVID-19), but little is known about the marginal effect of additional risk factors for severe COVID-19 among individuals with diabetes. We tested the hypothesis that sociodemographic, access to health care, and presentation to care characteristics among individuals with diabetes in Mexico confer an additional risk of hospitalization with COVID-19. RESEARCH DESIGN AND METHODS We conducted a cross-sectional study using public data from the General Directorate of Epidemiology of the Mexican Ministry of Health. We included individuals with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 between 1 March and 31 July 2020. The primary outcome was the predicted probability of hospitalization, inclusive of 8.5% of patients who required intensive care unit admission. RESULTS Among 373,963 adults with COVID-19, 16.1% (95% CI 16.0–16.3) self-reported diabetes. The predicted probability of hospitalization was 38.4% (37.6–39.2) for patients with diabetes only and 42.9% (42.2–43.7) for patients with diabetes and one or more comorbidities (obesity, hypertension, cardiovascular disease, and chronic kidney disease). High municipality-level of social deprivation and low state-level health care resources were associated with a 9.5% (6.3–12.7) and 17.5% (14.5–20.4) increased probability of hospitalization among patients with diabetes, respectively. In age-, sex-, and comorbidity-adjusted models, living in a context of high social vulnerability and low health care resources was associated with the highest predicted probability of hospitalization. CONCLUSIONS Social vulnerability contributes considerably to the probability of hospitalization among individuals with COVID-19 and diabetes with associated comorbidities. These findings can inform mitigation strategies for populations at the highest risk of severe COVID-19.
A High Percentage of People With Human Immunodeficiency Virus (HIV) on Antiretroviral Therapy Experience Detectable Low-Level Plasma HIV-1 RNA Following Coronavirus Disease 2019 (COVID-19)

2. Timbrook TT. Antimicrobial stewardship and implementation of rapid multiplex respiratory diagnostics: is there method in the madness? Clin Infect Dis 2020; 71:1690–2. 3. Jain S, Self WH, Wunderink RG, et al; CDC EPIC Study Team. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med 2015; 373:415–27. 4. Musher DM, Montoya R, Wanahita A. Diagnostic value of microscopic examination of Gram-stained sputum and sputum cultures in patients with bacteremic pneumococcal pneumonia. Clin Infect Dis 2004; 39:165–9. 5. Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. an official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med 2019; 200:e45–67. 6. Hanson KE, Azar MM, Banerjee R, et al. Molecular testing for acute respiratory tract infections: clinical and diagnostic recommendations from the IDSA’s Diagnostics Committee. Clin Infect Dis 2020; 71:2744–51. 7. Zacharioudakis IM, Zervou FN, Dubrovskaya Y, Inglima K, See B, Aguero-Rosenfeld ME. Evaluation of multiplex PCR panel for the microbiologic diagnosis of pneumonia in hospitalized patients: a retrospective analysis from an academic medical center. Int J Infect Dis 2020. doi:10.1016/j.ijid. 2021.01. 004 8. Barlam TF, Cosgrove SE, Abbo LM, et al. Implementing an antibiotic stewardship program: guidelines by the infectious diseases society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis 2016; 62:e51–77.
Long-Term Impact of Diabetes Mellitus on Initially Conservatively Managed Patients With Severe Aortic Stenosis.

BACKGROUND Although diabetes mellitus (DM) is a common comorbidity of aortic stenosis (AS), clinical evidence about the long-term effect of DM on patients with AS is insufficient.Methods and Results:Data were acquired from CURRENT AS, a large Japanese multicenter registry that enrolled 3,815 patients with severe AS. Patients without initial valve replacement were defined as the conservative group; among them, 621 (23.4%) had DM, whereas 1997 did not. The DM group was further divided into 2 groups according to insulin treatment (insulin-treated DM, n=130; non-insulin treated DM, n=491). The primary outcome was a composite of aortic valve (AV)-related death and heart failure (HF) hospitalization. Secondary outcomes were AV-related death, HF hospitalization, all-cause death, cardiovascular death, sudden death, and surgical or transcatheter AV replacement during follow up. As a result, DM was associated with higher risk for the primary outcome (52.8% vs. 42.9%, P<0.001), with a statistically significant adjusted hazard ratio (HR 1.33, 95% confidence interval: 1.14-1.56, P<0.001). All secondary outcomes were not significantly different between DM and non-DM patients after adjusting for confounding factors, except for HF hospitalization. Insulin use was not associated with higher incidence of primary or secondary outcome. CONCLUSIONS In initially conservatively managed patients with AS, DM was independently associated with higher risk for a composite of AV-related death or HF hospitalization; however, insulin use was not associated with poor outcomes.
Ultrasonographic Monitoring in 38 Dogs with Clinically Suspected Acute Pancreatitis

Abdominal ultrasound examinations (AUEs) are commonly used in the diagnostic evaluation of canine acute pancreatitis (AP). The purpose of this retrospective study was to evaluate and monitor the ultrasonographic changes observed in dogs with clinically suspected AP on consecutive AUEs. The study population was constituted by 38 client-owned dogs hospitalized for no less than 48 h from January 2016 to December 2019. Dogs included in this study were suspected of AP based on the clinical examination and abnormal rapid specific canine pancreatic lipase test performed at admission. Dogs were submitted to two AUEs, the first on the first day of hospitalization, and the second between 40–52 h after the first one. Twelve dogs had both AUEs suggestive of AP. Fourteen dogs received an ultrasonographic diagnosis of AP exclusively on the second AUE. Twelve dogs remained negative on both the first and the second AUE. In 26 out of 38 patients the second AUE was suggestive of AP. If a patient is suspected of AP, it is advisable to carry out ultrasonographic monitoring at least within the first 52 h after admission, since ultrasonographic signs of AP may only become observable later after hospitalization.
Improving Glucose Homeostasis after Parathyroidectomy for Normocalcemic Primary Hyperparathyroidism with Co-Existing Prediabetes

We have previously described increased fasting plasma glucose levels in patients with normocalcemic primary hyperparathyroidism (NPHPT) and co-existing prediabetes, compared to prediabetes per se. This study evaluated the effect of parathyroidectomy (PTx) (Group A), versus conservative follow-up (Group B), in a small cohort of patients with co-existing NPHPT and prediabetes. Sixteen patients were categorized in each group. Glycemic parameters (levels of fasting glucose (fGlu), glycosylated hemoglobin (HbA1c), and fasting insulin (fIns)), the homeostasis model assessment for estimating insulin secretion (HOMA-B) and resistance (HOMA-IR), and a 75-g oral glucose tolerance test were evaluated at baseline and after 32 weeks for both groups. Measurements at baseline were not significantly different between Groups A and B, respectively: fGlu (119.4 ± 2.8 vs. 118.2 ± 1.8 mg/dL, p = 0.451), HbA1c (5.84 ± 0.3 %vs. 5.86 ± 0.4%, p = 0.411), HOMA-IR (3.1 ± 1.2 vs. 2.9 ± 0.2, p = 0.213), HOMA-B (112.9 ± 31.8 vs. 116.9 ± 21.0%, p = 0.312), fIns (11.0 ± 2.3 vs. 12.8 ± 1.4 μIU/mL, p = 0.731), and 2-h post-load glucose concentrations (163.2 ± 3.2 vs. 167.2 ± 3.2 mg/dL, p = 0.371). fGlu levels demonstrated a positive correlation with PTH concentrations for both groups (Group A, rho = 0.374, p = 0.005, and Group B, rho = 0.359, p = 0.008). At the end of follow-up, Group A demonstrated significant improvements after PTx compared to the baseline: fGlu ((119.4 ± 2.8 vs. 111.2 ± 1.9 mg/dL, p = 0.021) (−8.2 ± 0.6 mg/dL)), and 2-h post-load glucose concentrations ((163.2 ± 3.2 vs. 144.4 ± 3.2 mg/dL, p = 0.041), (−18.8 ± 0.3 mg/dL)). For Group B, results demonstrated non-significant differences: fGlu ((118.2 ± 1.8 vs. 117.6 ± 2.3 mg/dL, p = 0.031), (−0.6 ± 0.2 mg/dL)), and 2-h post-load glucose concentrations ((167.2 ± 2.7 vs. 176.2 ± 3.2 mg/dL, p = 0.781), (+9.0 ± 0.8 mg/dL)). We conclude that PTx for individuals with NPHPT and prediabetes may improve their glucose homeostasis when compared with conservative follow-up, after 8 months of follow-up.
The Role of Work Engagement in Relationship between Transformational Leadership and Job Performance in Banking Sector of Lahore (Pakistan)

This study investigates an underlying mechanism that clarifies the connection between transformational leadership and job performance. Specifically, it explores the mediating role of work engagement in a relationship between transformational leadership and job performance. Banking sector of Lahore (Pakistan) has been considered as target population. Different bank's branches were selected randomly for conducting the research. Overall 200 questionnaires were distributed. 170 questionnaires were used for analysis. The results of Correlation analysis show positive relationship between transformational leadership, work engagement and job performance. Moreover work engagement partially mediates the link between transformational leadership and job performance. Due to a shortage of budget, the sample of the paper is kept low, and only a few banks were taken into account, and the numbers of the questionnaire were limited. The target population of the study is only banking sector and all other sectors like textile sector, the education sector, and telecommunication sector remain to be unexplored. This study provides information for banking sector of Lahore (Pakistan) managers about why and under what circumstances employees perform the ways they do in the view of discussed variables.
Structure and regulation of the BsYetJ calcium channel in lipid nanodiscs

Significance The endoplasmic reticulum (ER) serves as the major intracellular calcium store. The release of calcium from this store regulates a variety of cellular functions, hence playing a key role in regulating apoptosis. The transmembrane BAX inhibitor-1 motif-containing 6 (TMBIM6) is an evolutionarily conserved multifunctional ER membrane protein that mediates calcium homeostasis to protect against apoptosis and ER stress. We study a bacterial homolog of TMBIM6 and report several previously unidentified conformational substates involved in the calcium transport process. Our findings stimulate a model of calcium-release channel showing that membrane protein functioning requires the interconversion between distinct conformations in preexisting conformational equilibria. BsYetJ is a bacterial homolog of transmembrane BAX inhibitor-1 motif-containing 6 (TMBIM6) membrane protein that plays a key role in the control of calcium homeostasis. However, the BsYetJ (or TMBIM6) structure embedded in a lipid bilayer is uncharacterized, let alone the molecular mechanism of the calcium transport activity. Herein, we report structures of BsYetJ in lipid nanodiscs identified by double electron–electron resonance spectroscopy. Our results reveal that BsYetJ in lipid nanodiscs is structurally different from those crystallized in detergents. We show that BsYetJ conformation is pH-sensitive in apo state (lacking calcium), whereas in a calcium-containing solution it is stuck in an intermediate, inert to pH changes. Only when the transmembrane calcium gradient is established can the calcium-release activity of holo-BsYetJ occur and be mediated by pH-dependent conformational changes, suggesting a dual gating mechanism. Conformational substates involved in the process and a key residue D171 relevant to the gating of calcium are identified. Our study suggests that BsYetJ/TMBIM6 is a pH-dependent, voltage-gated calcium channel.
COVIDOSE: A Phase II Clinical Trial of Low‐Dose Tocilizumab in the Treatment of Noncritical COVID‐19 Pneumonia

Interleukin‐6 (IL‐6)–mediated hyperinflammation may contribute to the mortality of coronavirus disease 2019 (COVID‐19). The IL‐6 receptor–blocking monoclonal antibody tocilizumab has been repurposed for COVID‐19, but prospective trials and dose‐finding studies in COVID‐19 have not yet fully reported. We conducted a single‐arm phase II trial of low‐dose tocilizumab in nonintubated hospitalized adult patients with COVID‐19, radiographic pulmonary infiltrate, fever, and C‐reactive protein (CRP) ≥ 40 mg/L. We hypothesized that doses significantly lower than the emerging standards of 400 mg or 8 mg/kg would resolve clinical and laboratory indicators of hyperinflammation. A dose range from 40 to 200 mg was evaluated, with allowance for one repeat dose at 24 to 48 hours. The primary objective was to assess the relationship of dose to fever resolution and CRP response. Thirty‐two patients received low‐dose tocilizumab, with the majority experiencing fever resolution (75%) and CRP decline consistent with IL‐6 pathway abrogation (86%) in the 24–48 hours following drug administration. There was no evidence of a relationship between dose and fever resolution or CRP decline over the dose range of 40–200 mg. Within the 28‐day follow‐up, 5 (16%) patients died. For patients who recovered, median time to clinical recovery was 3 days (interquartile range, 2–5). Clinically presumed and/or cultured bacterial superinfections were reported in 5 (16%) patients. Low‐dose tocilizumab was associated with rapid improvement in clinical and laboratory measures of hyperinflammation in hospitalized patients with COVID‐19. Results of this trial provide rationale for a randomized, controlled trial of low‐dose tocilizumab in COVID‐19.
Can We Ditch Feature Engineering? End-to-End Deep Learning for Affect Recognition from Physiological Sensor Data

To further extend the applicability of wearable sensors in various domains such as mobile health systems and the automotive industry, new methods for accurately extracting subtle physiological information from these wearable sensors are required. However, the extraction of valuable information from physiological signals is still challenging—smartphones can count steps and compute heart rate, but they cannot recognize emotions and related affective states. This study analyzes the possibility of using end-to-end multimodal deep learning (DL) methods for affect recognition. Ten end-to-end DL architectures are compared on four different datasets with diverse raw physiological signals used for affect recognition, including emotional and stress states. The DL architectures specialized for time-series classification were enhanced to simultaneously facilitate learning from multiple sensors, each having their own sampling frequency. To enable fair comparison among the different DL architectures, Bayesian optimization was used for hyperparameter tuning. The experimental results showed that the performance of the models depends on the intensity of the physiological response induced by the affective stimuli, i.e., the DL models recognize stress induced by the Trier Social Stress Test more successfully than they recognize emotional changes induced by watching affective content, e.g., funny videos. Additionally, the results showed that the CNN-based architectures might be more suitable than LSTM-based architectures for affect recognition from physiological sensors.