Miracle-dz/UniFAR-FTUs huggingface dataset:
Neighbourhood walkability and dietary attributes: effect modification by area-level socio-economic status

Abstract Objective: Higher neighbourhood walkability would be expected to contribute to better health, but the relevant evidence is inconsistent. This may be because residents’ dietary attributes, which vary with socio-economic status (SES) and influence their health, can be related to walkability. We examined associations of walkability with dietary attributes and potential effect modification by area-level SES. Design: The exposure variable of this cross-sectional study was neighbourhood walkability, calculated using residential density, intersection density and destination density within 1-km street-network buffer around each participant’s residence. The outcome variables were dietary patterns (Western, prudent and mixed) and total dietary energy intake, derived from a FFQ. Main and interaction effects with area-level SES were estimated using two-level linear regression models. Setting: Participants were from all states and territories in Australia. Participants: The analytical sample included 3590 participants (54 % women, age range 34 to 86). Results: Walkability was not associated with dietary attributes in the whole sample. However, we found interaction effects of walkability and area-level SES on Western diet scores (P < 0·001) and total energy intake (P = 0·012). In low SES areas, higher walkability was associated with higher Western dietary patterns (P = 0·062) and higher total energy intake (P = 0·066). In high SES areas, higher walkability was associated with lower Western diet scores (P = 0·021) and lower total energy intake (P = 0·058). Conclusions: Higher walkability may not be necessarily conducive to better health in socio-economically disadvantaged areas. Public health initiatives to enhance neighbourhood walkability need to consider food environments and socio-economic contexts.
The efficacy of weight-based enoxaparin dosing for venous thromboembolism prophylaxis in trauma patients: A systematic review and meta-analysis

A review of the efficacy of different approaches to VTE prophylaxis in trauma patients. BACKGROUND Trauma patients are at high risk of developing venous thromboembolism (VTE), and standard dosing enoxaparin regimens may be inadequate for prophylaxis. This meta-analysis was performed to clarify the efficacy of alternative dosing regimens for VTE prophylaxis in this high-risk group. The objective of this systematic review was to review the evidence regarding weight-based dosing of enoxaparin for VTE prophylaxis in trauma patients. METHODS A systematic database search was undertaken for studies comparing standard versus weight-based dosing of enoxaparin for VTE prophylaxis in adult trauma patients, 18 years or older. The primary outcome was the achievement of anti–factor Xa (AFXa) levels within the prophylactic range. Secondary outcomes included subprophylactic AFXa levels, supraprophylactic AFXa levels, VTE incidence, and bleeding events. Meta-analysis was conducted using both fixed- and random-effects models, and presented as odds ratios, risk ratios (RRs), and risk differences (RDs) with 95% confidence intervals (CIs). RESULTS Four cohort studies were eligible for inclusion. Compared with standard dosing, weight-based enoxaparin prophylaxis dosing was associated with increased odds of prophylactic AFXa levels (odds ratio, 5.85; 95% CI, 3.02–11.30; p < 0.00001) and reduced risk of subprophylactic AFXa levels (RR, 3.97; 95% CI, 3.02–5.22; p < 0.00001). Standard dosing was associated with a reduced risk of supratherapeutic AFXa levels (RR, 0.23; 95% CI, 0.11–0.50; p = 0.0002), but this was not associated with a difference in risk of bleeding events (RD, −0.00; 95% CI, −0.02 to 0.01; p = 0.55). There was no statistical difference in incidence VTE between the two groups (RD, 0.01; 95% CI, −0.02 to 0.03; p = 0.64). CONCLUSION Compared with standard dosing, weight-based enoxaparin dosing regimens are associated with increased odds of prophylactic range AFXa levels. Further investigation is required to determine if this translates into improved VTE prophylaxis and reduced VTE incidence. LEVEL OF EVIDENCE Systematic Review and Meta-Analysis; Level III.
Resilient consumers accelerate the plant decomposition in a naturally acidified seagrass ecosystem

Anthropogenic stressors are predicted to alter biodiversity and ecosystem functioning worldwide. However, scaling up from species to ecosystem responses poses a challenge, as species and functional groups can exhibit different capacities to adapt, acclimate, and compensate under changing environments. We used a naturally acidified seagrass ecosystem (the endemic Mediterranean Posidonia oceanica) as a model system to examine how ocean acidification (OA) modifies the community structure and functioning of plant detritivores, which play vital roles in the coastal nutrient cycling and food web dynamics. In seagrass beds associated with volcanic CO2 vents (Ischia, Italy), we quantified the effects of OA on seagrass decomposition by deploying litterbags in three distinct pH zones (i.e., ambient, low, extreme low pH), which differed in the mean and variability of seawater pH. We replicated the study in two discrete vents for 117 days (litterbags sampled on day 5, 10, 28, 55, and 117). Acidification reduced seagrass detritivore richness and diversity through the loss of less abundant, pH‐sensitive species but increased the abundance of the dominant detritivore (amphipod Gammarella fucicola). Such compensatory shifts in species abundance caused more than a threefold increase in the total detritivore abundance in lower pH zones. These community changes were associated with increased consumption (52%–112%) and decay of seagrass detritus (up to 67% faster decomposition rate for the slow‐decaying, refractory detrital pool) under acidification. Seagrass detritus deployed in acidified zones showed increased N content and decreased C:N ratio, indicating that altered microbial activities under OA may have affected the decay process. The findings suggest that OA could restructure consumer assemblages and modify plant decomposition in blue carbon ecosystems, which may have important implications for carbon sequestration, nutrient recycling, and trophic transfer. Our study highlights the importance of within‐community response variability and compensatory processes in modulating ecosystem functions under extreme global change scenarios.
Prevalence and Time Course of Thiamine Deficiency in Critically Ill Children: A Multicenter, Prospective Cohort Study in Turkey

OBJECTIVES: To determine the prevalence and time course of thiamine deficiency (TD) in PICU patients. DESIGN: Multicenter, prospective, cohort study between May 2019 and November 2019. SETTING: Three university-based tertiary care, mixed medical-surgical PICUs in Ankara, Turkey. PATIENTS: PICU patients 1 month to 18 years old. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We studied 476 patients and grouped them by TD status on days 1 and 3 of the PICU admission. There might be a risk of unintended bias since we excluded 386 patients because of the absence of consent, inadequate blood samples, loss of identifier information, and recent vitamin supplementation. On day 1, TD was present in 53 of 476 patients (11.1%) and median (minimum–maximum) thiamine levels were 65.5 ng/mL (5–431 ng/mL). On day 3, TD was present in 27 of 199 patients (13.6%) with repeated measurement. The median (minimum–maximum) thiamine levels were 63 ng/mL (13–357 ng/mL). The time course of TD from day 1 to day 3 in these 199 patients was as follows. In 21 of 199 patients (10.6%) with TD on day 1, 11 of 21 (52%) continued to have TD on day 3 and the other 10 of 21 patients (48%) improved to no longer having TD. In 178 of 199 patients (89.4%) without TD on day 1, 16 of 178 (9%) went on to develop TD by day 3, and the other 162 of 178 (91%) continued to have normal thiamine status. CONCLUSIONS: In the PICU population in three centers in Turkey, the prevalence of TD in the sample of patients was 11.1%. In those TD patients who had serial studies, we also identified that by day 3 some continued to be TD, and some patients improved to normal thiamine status. Of concern, however, is the population who develop TD over the course of PICU stay.
VGN: Value Decomposition With Graph Attention Networks for Multiagent Reinforcement Learning

Although value decomposition networks and the follow on value-based studies factorizes the joint reward function to individual reward functions for a kind of cooperative multiagent reinforcement problem, in which each agent has its local observation and shares a joint reward signal, most of the previous efforts, however, ignored the graphical information between agents. In this article, a new value decomposition with graph attention network (VGN) method is developed to solve the value functions by introducing the dynamical relationships between agents. It is pointed out that the decomposition factor of an agent in our approach can be influenced by the reward signals of all the related agents and two graphical neural network-based algorithms (VGN-Linear and VGN-Nonlinear) are designed to solve the value functions of each agent. It can be proved theoretically that the present methods satisfy the factorizable condition in the centralized training process. The performance of the present methods is evaluated on the StarCraft Multiagent Challenge (SMAC) benchmark. Experiment results show that our method outperforms the state-of-the-art value-based multiagent reinforcement algorithms, especially when the tasks are with very hard level and challenging for existing methods.
Dynamic Distribution of Gut Microbiota in Pigs at Different Growth Stages: Composition and Contribution

The ban on feed antibiotics by more and more countries, and the expected ban on ZnO in feed supplementation from 2022 in the EU, urge researchers and pig producers to search for new alternatives. One possible alternative is to use the so-called “next-generation probiotics (NGPs)” derived from gastrointestinal tract. ABSTRACT Fully understanding the dynamic distribution of the gut microbiota in pigs is essential, as gut microorganisms play a fundamental role in physiological processes, immunity, and the metabolism of nutrients by the host. Here, we first summarize the characteristics and the dynamic shifts in the gut microbial community of pigs at different ages based on the results of 63 peer-review publications. Then a meta-analysis based on the sequences from 16 studies with accession numbers in the GenBank database is conducted to verify the characteristics of the gut microbiota in healthy pigs. A dynamic shift is confirmed in the gut microbiota of pigs at different ages and growth phases. In general, Bacteroides, Escherichia, Clostridium, Lactobacillus, Fusobacterium, and Prevotella are dominant in piglets before weaning, then Prevotella and Aneriacter shift to be the predominant genera with Fusobacterium, Lactobacillus, and Miscellaneous as comparative minors in postweaned pigs. A number of 19 bacterial genera, including Bacteroides, Prevotella, and Lactobacillus can be found in more than 90% of pigs and three enterotypes can be identified in all pigs at different ages, suggesting there is a “core” microbiota in the gut of healthy pigs, which can be a potential target for nutrition or health regulation. The “core” members benefit the growth and gut health of the host. These findings help to define an “optimal” gut microbial profile for assessing, or improving, the performance and health status of pigs at different growth stages. IMPORTANCE The ban on feed antibiotics by more and more countries, and the expected ban on ZnO in feed supplementation from 2022 in the EU, urge researchers and pig producers to search for new alternatives. One possible alternative is to use the so-called “next-generation probiotics (NGPs)” derived from gastrointestinal tract. In this paper, we reveal that a total of 19 “core” bacterial genera including Bacteroides, Prevotella, and Lactobacillus etc., can be found in more than 90% of healthy pigs across different ages. These identified genera may probably be the potential candidates of NGPs or the potential target of microflora regulation. Adding substrates preferred by these target microbes will help to increase the abundance of specific symbiotic species and benefit the gut health of pigs. Further research targeting these “core” microbes and the dynamic distribution of microbiota, as well as the related function is of great importance in swine production.
First and final year physiotherapy students’ expectations of their future profession

ABSTRACT Background and Aim Students’ expectations of their future profession may have an impact on their professional development. This study aimed to describe first and final year physiotherapy students’ expectations of their future profession. Methods A total of 96 respondents participated; 45 students in their first semester 2006, and 51 students in their final semester 2014. Individual written reflections were analyzed separately for each semester, using qualitative manifest inductive content analysis. Results The analysis resulted in six categories from each semester. The categories from the first semester were: 1) Professional and person-centered; 2) Promote health in a holistic way; 3) Competence makes the patient and therapist feel confident; 4) Focus on education and behavioral change; 5) Confirmed as a role model; and 6) The impact of previous experiences and an unknown situation. The categories from the final semester were: 1) Interaction and learning; 2) Confidence by competence; 3) Value the work environment and knowledge exchange; 4) Personal goals and strategies; 5) Specialist or generalist work; and 6) Work with public health in a global world. Conclusions In the first semester, students described different work approaches, while students in the last semester described how approaches were to be used. Furthermore, students in their first semester referred more to previous experiences, while students in their final semester developed strategies to achieve their professional goals. These findings might contribute to guide students' in their continuous professional development based on their experiences and expectations.
CKD Biomarkers, Cognitive Impairment, and Incident Dementia in an Older Healthy Cohort

Key Points Mild albuminuria was associated with worse baseline cognitive function, cognitive decline, and increased risk for incident dementia. Screening cognitive tests for older persons with a urine albumin-creatinine ratio ≥3 mg/mmol could identify those at elevated risk of cognitive decline and dementia. Visual Abstract Background CKD is a risk factor for cognitive impairment (CI), but reports of individual associations of eGFR and albuminuria with CI and incident dementia in healthier, older, longitudinal populations are lacking. Our goal was to estimate these associations in a large cohort of older healthy persons. Methods In a longitudinal cohort study of older persons without prior cardiovascular disease, we estimated the associations between baseline eGFR (in ml/min per 1.73 m2) and albuminuria, measured as urine albumin-creatinine ratio (UACR; in mg/mmol) and cognitive test scores, declines in cognitive test scores, and incident dementia using adjusted linear and linear mixed models. Cox proportional hazards regression models assessed the association between baseline kidney function and incident CI no dementia (CIND) or dementia at a median of 4.7 years. Results At baseline, among 18,131 participants, median age was 74 years, eGFR was 74 (IQR, 63–84) ml/min per 1.73 m2, UACR was 0.8 (IQR, 0.5–1.5) mg/mmol (7.1 [4.4–13.3] mg/g), and 56% were female. Baseline eGFR was not associated with performance on any cognitive tests in cross-sectional analysis, nor was incident CIND or dementia over a median follow-up of 4.7 years. However, baseline UACR ≥3 mg/mmol (≥26.6 mg/g) was significantly associated with lower baseline scores and larger declines on the Modified Mini-Mental State Exam, verbal memory and processing speed tests, and with incident CIND (hazard ratio [HR], 1.19; 95% CI, 1.07 to 1.33) and dementia (HR, 1.32; 95% CI, 1.06 to 1.66). Conclusion Mild albuminuria was associated with worse baseline cognitive function, cognitive decline, and increased risk for incident CIND and dementia. Screening global cognitive tests for older persons with UACR ≥3 mg/mmol could identify those at elevated risk of cognitive decline and dementia.
The antibody-drug conjugate loncastuximab tesirine for the treatment of diffuse large B-cell lymphoma

In this Blood Spotlight, Calabretta and colleagues describe the mechanism of action of loncastuximab tesirine, an anti-CD19 antibody-drug conjugate. They discuss data from the first phase 1 and 2 trials of the drug in patients with relapsed or refractory diffuse large B-cell lymphoma contributing to its recent approval by the US Food and Drug Administration.
Kidney Biopsy Features Most Predictive of Clinical Outcomes in the Spectrum of Minimal Change Disease and Focal Segmental Glomerulosclerosis

Significance Statement The classification of podocytopathies, including minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS), has historically been based on limited glomerular features. This study used supervised machine learning methods to identify the most important clinical and histopathologic predictors of disease progression, complete proteinuria remission, and treatment response in MCD/FSGS. The top predictors included conventional and novel glomerular and tubulointerstitial features. Biopsy reporting for podocytopathies should be standardized by including these prognostic morphologic features to inform risk stratification. Visual Abstract Background Heterogeneity in disease course and treatment response among patients with MCD/FSGS necessitates a granular evaluation of kidney tissue features. This study aimed to identify histologic and ultrastructural descriptors of structural changes most predictive of clinical outcomes in the Nephrotic Syndrome Study Network (NEPTUNE). Methods Forty-eight histologic (37 glomerular, 9 tubulointerstitial, 2 vascular) and 20 ultrastructural descriptors were quantified by applying the NEPTUNE Digital Pathology Scoring System to NEPTUNE kidney biopsies. Outcomes included time from biopsy to disease progression, first complete remission of proteinuria, and treatment response. Relative importance of pathology and clinical predictors was obtained from random forest models, and predictive discrimination was assessed. Results Among 224 participants (34% Black, 24% Hispanic), model performance was excellent, with predictive discrimination of 0.9 for disease progression, 0.85 for complete remission, and 0.81 for treatment response. The most predictive descriptors of outcomes included both conventional—e.g., global sclerosis or segmental sclerosis and interstitial fibrosis/tubular atrophy—and novel features, including adhesion, interstitial foam cells, deflation, periglomerular fibrosis, mononuclear white blood cells, endothelial cell abnormalities, microvillous transformation, and acute tubular injury. Conclusions The most predictive descriptors of clinical outcomes among MCD/FSGS patients reflected structural changes in multiple renal compartments. Reporting these descriptors should be standardized to guide prognostication of proteinuric glomerular diseases.
Response of plasma microRNAs to nusinersen treatment in patients with SMA

Spinal muscular atrophy (SMA) is a common genetic cause of infant mortality. Nusinersen treatment ameliorates the clinical outcome of SMA, however, some patients respond well, while others have limited response. We investigated microRNAs in blood samples from SMA patients and their response to nusinersen treatment evaluating the potential of circulating microRNAs as biomarkers for SMA.
Neomycin removal using the white rot fungus Trametes versicolor

Abstract The presence of antibiotic resistance genes in wastewater treatment plants (WWTPs), and in river and lake recipients show the need to develop new antibiotic removal strategies. The aminoglycoside antibiotic class is of special concern since the chemical structure of these compounds limits the choices of removal technologies. The experimental design included fungal mediated in vivo and in vitro experiments. The experiments were performed in Erlenmeyer flasks under non-sterile conditions. In the study, the role of the laccase redox mediator 4-hydroxy benzoic acid (HBA) in the removal of neomycin was investigated. The specific objective of the study was to conclude whether it is possible to use the white rot fungus (WRF) Trametes versicolor to biodegrade neomycin. It was shown that it is feasible to remove 34% neomycin in vitro (excluding living fungal cells) by laccase-HBA mediated extracellular biodegradation. In the in vivo experiments, polyurethane foam (PUF) was used as supporting material to immobilize fungal mycelia on. The presence of living fungal cells facilitated a removal of approximately 80% neomycin in the absence of HBA. Using liquid chromatography-high resolution-mass spectrometry, it was possible to tentatively identify oxidation products of neomycin hydrolysates. The results in this study open up the possibility to implement a pretreatment plant (PTP) aimed for neomycin removal.
Sex and limb comparisons of neuromuscular function in the morning versus the evening

The time‐of‐day influence on neuromuscular function is well‐documented, but important details remain elusive. It is currently unknown whether males and females differ in their diurnal variation for optimal neuromuscular performance. The purpose of this study is to identify the time‐of‐day influence on neuromuscular function between sexes and determine whether these responses differ for the upper versus lower limbs. A group of males (n = 12) and females (n = 15) completed neuromuscular performance testing in the morning (07:00–09:00) and evening (17:00–19:00) on separate days in a randomized order. Maximal force, the normalized rate of force development, EMG, normalized EMG rise, and submaximal force steadiness were compared between morning and evening hours. The main findings show that maximal force was greater in the evening for the knee extensors (d = 0.570, p < 0.01) but not the elbow flexors (d = 0.212, p = 0.281), whereas maximal muscle excitation was greater in the evening for the biceps brachii (d = 0.348, p < 0.01) but not the vastus lateralis (d = 0.075, p = 0.526) with no influence of sex. However, force steadiness during knee extension was superior in the evening versus the morning for males (d = 0.734, p = 0.025) and compared to evening values for females (g = 1.19, p = 0.032). Overall, these findings show that time‐of‐day affects the knee extensors more than the elbow flexors and that diurnal variability between sexes appears to be task‐dependent.