Miracle-dz/UniFAR-FTUs huggingface dataset:
Hypoxia-Inducible Factor Signaling in Macrophages Promotes Lymphangiogenesis in Leishmania major Infection

Vascular remodeling is a phenomenon seen in the cutaneous lesions formed during infection with Leishmania parasites. Within the lesion, Leishmania major infection leads to the infiltration of inflammatory cells, including macrophages, and is associated with hypoxic conditions and lymphangiogenesis in the local site. ABSTRACT Vascular remodeling is a phenomenon seen in the cutaneous lesions formed during infection with Leishmania parasites. Within the lesion, Leishmania major infection leads to the infiltration of inflammatory cells, including macrophages, and is associated with hypoxic conditions and lymphangiogenesis in the local site. This low-oxygen environment is concomitant with the expression of hypoxic inducible factors (HIFs), which initiate the expression of vascular endothelial growth factor-A (VEGF-A) in macrophages during the infection. Here, we found that macrophage hypoxia is elevated in the skin, and the HIF target Vegfa is preferentially expressed at the site of infection. Further, transcripts indicative of both HIF-1α and HIF-2α activation were increased at the site of infection. Given that HIF mediates VEGF-A and that VEGF-A/VEGFR-2 signaling induces lymphangiogenesis, we wanted to investigate the link between myeloid HIF activation and lymphangiogenesis during L. major infection. We show that myeloid aryl hydrocarbon receptor nuclear translocator (ARNT)/HIF/VEGF-A signaling promotes lymphangiogenesis (the generation of newly formed vessels within the local lymphatic network), which helps resolve the lesion by draining away inflammatory cells and fluid. Concomitant with impaired lymphangiogenesis, we find the deletion of myeloid ARNT/HIF signaling leads to an exacerbated inflammatory response associated with a heightened CD4+ Th1 immune response following L. major infection. Altogether, our data suggest that VEGF-A-mediated lymphangiogenesis occurs through myeloid ARNT/HIF activation following Leishmania major infection and this process is critical in limiting immunopathology.
Chronic bacterial pulmonary infections in advanced cystic fibrosis differently affect the level of sputum neutrophil elastase, IL‐8 and IL‐6

Advanced cystic fibrosis (CF) lung disease is commonly characterized by a chronic Pseudomonas aeruginosa infection and destructive inflammation caused by neutrophils. However, the lack of convincing evidence from most informative biomarkers of severe lung dysfunction (SLD‐CF) has hampered the formulation of a conclusive, targeted diagnosis of CF. The aim of this study was to determine whether SLD‐CF is related to the high concentration of sputum inflammatory mediators and the presence of biofilm‐forming bacterial strains. Forty‐one patients with advanced CF lung disease were studied. The severity of pulmonary dysfunction was defined by forced expiratory volume in 1 second (FEV1) < 40%. C‐reactive protein (CRP) and NLR (neutrophil–lymphocyte ratio) were examined as representative blood‐based markers of inflammation. Expectorated sputum was collected and analysed for cytokines and neutrophil‐derived defence proteins. Isolated sputum bacteria were identified and their biofilm‐forming capacity was determined. There was no association between FEV1% and total number of sputum bacteria. However, in the high biofilm‐forming group the median FEV1 was < 40%. Importantly, high density of sputum bacteria was associated with increased concentrations of neutrophil elastase and interleukin (IL)‐8 and low concentrations of IL‐6 and IL‐10. The low concentration of sputum IL‐6 is unique for CF and distinct from that observed in other chronic pulmonary inflammatory diseases. These findings strongly suggest that expectorated sputum is an informative source of pulmonary biomarkers representative for advanced CF and may replace more invasive bronchoalveolar lavage analysis to monitor the disease. We recommend to use of the following inflammatory biomarkers: blood CRP, NLR and sputum elastase, IL‐6, IL‐8 and IL‐10.
Optimal conditions for graft survival and reinnervation of denervated muscles after embryonic motoneuron transplantation into peripheral nerves undergoing Wallerian degeneration

Motoneuron transplantation into peripheral nerves undergoing Wallerian degeneration may have applications in treating diseases causing muscle paralysis. We investigated whether functional reinnervation of denervated muscle could be achieved by early or delayed transplantation after denervation. Adult rats were assigned to six groups with increasing denervation periods (0, 1, 4, 8, 12, and 24 weeks) before inoculation with culture medium containing (transplantation group) or lacking (surgical control group) dissociated embryonic motoneurons into the peroneal nerve. Electrophysiological and tissue analyses were performed 3 months after transplantation. Reinnervation of denervated muscles significantly increased relative muscle weight in the transplantation group compared with the surgical control group for denervation periods of 1 week (0.042% ± 0.0031% vs. 0.032% ± 0.0020%, respectively; p = 0.009), 4 weeks (0.044% ± 0.0069% vs. 0.026% ± 0.0045%, respectively; p = 0.0023), and 8 weeks (0.044% ± 0.0029% vs. 0.026% ± 0.0008%, respectively; p = 0.0023). The ratios of reinnervated muscle contractile forces to naïve muscle in the 0, 1, 4, 8, and 12 weeks transplantation groups were 3.79%, 18.99%, 8.05%, 6.30%, and 5.80%, respectively, indicating that these forces were sufficient for walking. The optimal implantation time for transplantation of motoneurons into the peripheral nerve was 1 week after nerve transection. However, the neurons transplanted 24 weeks after denervation survived and regenerated axons. These results indicated that there is time for preparing cells for transplantation in regenerative medicine and suggested that our method may be useful for paralysed muscles that are not expected to recover with current treatment.
Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Language Recovery in Poststroke Survivors With Aphasia: An Updated Meta-analysis

The effects of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) on treating poststroke aphasia (PSA) remain inconclusive. We aimed to evaluate the efficacy and safety of LF-rTMS on language function poststroke and determine potential factors that may affect treatment effects. Electronic databases, including MEDLINE, EMBASE, and Cochrane Library were searched to identify relevant randomized controlled trials (RCTs) concerning the effects of LF-rTMS on language performance poststroke. We adopted fixed- and random-effects models to estimate intervention effects, which were represented by the Hedges’ g and 95% CIs. Subgroup analyses regarding several factors potentially influencing the effects of LF-rTMS on language recovery were also conducted. A total of 14 RCTs involving 374 participants were included in the meta-analysis. The pooled analysis showed the positive and significant effects of LF-rTMS on language function, both short-term (Hedges’ g = 0.65; P < .05) and long-term (Hedges’ g = 0.46; P < .05). Subgroup analyses demonstrated that LF-rTMS for 20 minutes per day over 10 days yielded the largest effect size (Hedges’ g = 1.02; P < .05) and that LF-rTMS significantly improved language performance in the chronic stage after stroke (Hedges’ g = 0.55; P < .05). Patients with different native languages might have diverse responses to LF-rTMS treatment efficacy. Additionally, there were significant improvements in language subtests, including naming, repetition, comprehension, and writing. Overall, this updated meta-analysis demonstrated that LF-rTMS has significant positive effects on PSA, with moderate treatment effects. It provides additional evidence to support LF-rTMS as a promising complementary therapy to promote language recovery in PSA.
Abdominal lymph node metastasis by lymphatic spread through the thoracic duct in patients with non‐small‐cell lung cancer

Abdominal lymph node metastasis (ALNM) is common in patients with metastatic non‐small‐cell lung cancer (NSCLC). However, its mechanism of spread remains to be elucidated. We investigated whether thoracic duct has the role as a pathway for ALNM in NSCLC using clinical data.
Understanding patient empowerment along the hearing health journey

Abstract Objective Related to the hearing health journey, this study aimed to: (i) explore how empowerment manifests itself from individuals’ first awareness of hearing loss through to hearing aid fitting and then to becoming an active hearing aid user, (ii) identify points when the different dimensions of empowerment are most relevant, and (iii) conceptualise empowerment. Design A semi-structured interview study was conducted, followed by a template analysis of the data. Study sample Adult hearing aid users from Sweden (n = 8) and Australia (n = 10) who had worn hearing aids for between 6 and 36 months. Results The themes that emerged from the transcripts were knowledge, skills and strategies, participation, self-efficacy, and control. Conclusions This study conceptualises empowerment along the hearing health journey as the process through which individuals with hearing-related challenges acquire and use knowledge, skills, and strategies, and increase self-efficacy, participation, and the feeling of control of their hearing health care, hearing solutions, and everyday lives. There are not specific points along the hearing health journey where any dimension is uniquely relevant, instead, each dimension is a dynamic component at all stages.
Home fall of elderly people: implications of stressors and representations in the COVID-19 context.

OBJECTIVES To describe personal conditions and home structure that predisposes the elderly to the risk of falling, in the perspective of Neuman's stressors; to describe the content, structure and origin of social representations about falling at home by elderly people; and conjecture the implications of this empirical evidence on the daily lives of the elderly in the context of the pandemic caused by COVID-19. METHOD Mixed method with concomitant triangulation (January-July/2017), qualitative design (structural and procedural approaches to the Social Representations Theory) and quantitative (sectional) approaching elderly people ≥65 years. RESULTS Environmental factors were identified for falling at home, fear of activities of daily living and loss of visual acuity. Feelings and behaviors mentioned in the possible central nucleus justified the modulation of behaviors. Analysis categories: 1) Representation of the (in)adaptability of the home environment; 2) Representation and overcoming limitations arising from weaknesses. CONCLUSION It was possible to produce conjectures based on empirical evidence in the current situation in the pandemic's dynamics.
Sleep duration and physical performance during a 6‐week military training course

Sleep is vital in influencing effective training adaptations in the military. This study aimed to assess the relationship between sleep and changes in physical performance over 6 weeks of military training. A total of 22 officer‐trainees (age: 24 ± 5 years) from the New Zealand Defence Force were used for this prospective cohort study. Participants wore wrist‐actigraphs to monitor sleep, completed subjective wellbeing questionnaires weekly, and were tested for: 2.4‐km run time‐trial, maximum press‐up and curl‐ups before and after 6 weeks of training. Average sleep duration was calculated over 36 nights (6:10 ± 0:28 hr:min), and sleep duration at the mid‐point (6:15 hr:min) was used to stratify the trainees into two quantile groups (UNDERS: 5:51 ± 0:29 hr:min, n = 11) and (OVERS: 6:27 ± 0:09 hr:min, n = 11). There were no significant group × time interactions for 2.4‐km run, press‐ups or curl‐ups (p > .05); however, small effects were observed in favour of OVERS for 2.4‐km run (59.8 versus 44.9 s; d = 0.26) and press‐ups (4.7 versus 3.2 reps; d = 0.45). Subjective wellbeing scores resulted in a significant group × time interaction (p < .05), with large effect sizes in favour of the OVERS group for Fatigue in Week 1 (d = 0.90) and Week 3 (d = 0.87), and Soreness in Week 3 (d = 1.09) and Week 4 (d = 0.95). Sleeping more than 6:15 hr:min per night over 6 weeks was associated with small benefits to aspects of physical performance, and moderate to large benefits on subjective wellbeing measures when compared with sleeping < 6:15 hr:min.
Biomechanical Comparison of Assistance Strategies Using a Bilateral Robotic Knee Exoskeleton

Despite there being studies that have investigated the effects of human augmentation using a knee exoskeleton, comparing different assistance schemes on a single knee exoskeleton has not been studied. Using a light-weight, low-profile bilateral knee exoskeleton system, this study examined and compared the biomechanical effects of three common assistance strategies (biological torque, impedance, and proportional myoelectric controllers) exhibiting different levels of flexibility for the user to control the assistance. Nine subjects walked on a 15% gradient incline surface at 1.1 m/s in the three powered conditions and with the exoskeleton unpowered. All the assistance strategies significantly reduced the metabolic cost of the users compared to the unpowered condition by 3.0% on average across strategies (p < 0.05), led by the significant reduction in the biological knee kinetic effort and knee extensor muscle activation (p < 0.05). Between assistance strategies, the metabolic cost and biomechanics displayed no statistically significant differences. The metabolic and biomechanical results indicate that powered extension assistance during early stance can improve performance compared to the unpowered condition. However, the user's ability to control the assistance may not be significant for human augmentation when walking on an inclined surface with a knee exoskeleton.
Using Simulation to Teach Transitions of Care for Hospitalized Patients

Background Understanding and facilitating the seamless and safe transitions of patients across high-acuity hospital settings are important for students to grasp in order to meet patient and family care needs. Problem Clinical placements do not always give students the opportunity to care for patients in various hospital settings or apply complex knowledge and skills learned in their didactic courses. Furthermore, the global pandemic has limited student clinical experiences in health care settings, underscoring the need for simulated clinical learning opportunities. Approach A multiscenario simulation using a high-fidelity human patient simulation manikin was incorporated into a senior-level capstone course. Simulated hospital settings included the (1) emergency department, (2) critical care unit, and (3) progressive care unit. Outcome Student evaluations revealed positive perceptions of learning, enhanced proficiency of clinical skills, and increased confidence regarding transitions of care. Faculty held agreeable opinions of the simulation's ease of facilitation and effectiveness as a teaching tool. Conclusion Application of complex knowledge and skills, understanding the use of bundles of care, and an appreciation for transitions of care hospitalized patients were successfully achieved.
Disparities in Awareness of Hepatitis C Virus Among US Adults: An Analysis of the 2019 Health Information National Trends Survey

A national survey demonstrated high hepatitis C virus awareness among US adults. However, among adults younger than 55 years, Asian and Hispanic adults were less aware of hepatitis C virus, indicating opportunity for Internet-based educational interventions. Background The U.S. Preventive Services Task Force updated hepatitis C virus (HCV) screening 2020 guidelines to target adults aged 18 to 79 years: a major shift from the prior focus on high-risk populations (“baby boomers” aged ≥55 years as of 2019). To inform efforts to maximize HCV screening coverage, our objective was to identify demographic groups reporting a lack of HCV awareness, particularly by race/ethnicity and age, and sources of health information. Methods We used nationally representative data of adults (≥18 years) included in the 2019 Health Information National Trends Survey (n = 5438). Awareness of HCV was defined using the following question: “Have you ever heard of the hepatitis C virus (also known as Hep C or HCV)? ” We estimated frequencies by demographic groups and computed risk differences (RDs) with 95% confidence intervals (CIs) to compare lack of HCV awareness by age (<55 and ≥55 years) and race/ethnicity. Results Overall, 17% of adults never heard of HCV. Younger adults (<55 years; 21%) were more likely to have never heard of HCV compared with older adults (≥55 years; 12%; χ2P < 0.001). This observation was consistent across most demographic characteristics including, racial/ethnic categories, and residing in the Southern United States. More than one-third of adults with low English fluency had a lack of HCV awareness in both age groups (χ2P = 0.537). Non-Hispanic (NH) Asian (RD, 25%; 95% CI, 6.9%–43.3%) and Hispanic (RD, 10%; 95% CI, 0.01%–19.6%) adults younger than 55 years were significantly more likely to have never heard of HCV compared with their NH White counterparts after adjustment for sex, educational level, household income, English fluency, and having a regular provider. Adults younger than 55 years with a lack of HCV awareness commonly obtained their health information from the Internet across most sociodemographic characteristics. Conclusions Hispanic and NH Asian young adults should be targeted for public health messaging regarding HCV screening, potentially through social media campaigns.
PHOSPHORUS FRACTIONS AND AVAILABILITY IN A HAPLIC PLINTHOSOL UNDER NO-TILLAGE SYSTEM IN THE BRAZILIAN CERRADO

Soil use and fertilizer management as well as cropping systems influence phosphorus (P) availability in the soil. This study evaluated P fractions and availability in a chronosequence of anthropic influence in a Haplic Plinthosol, in sites under no-till for different time periods: seven (NT7), eleven (NT11), and sixteen (NT16) years. Labile P concentrations in the soil accounted for 10%, 8%, and 9% of the total P for treatments NT7, NT11, and NT16, respectively. The labile P values ranged between 99 and 122 mg dm-3andindicatied no time in no-tillage influence on labile P under in the studied Plinthosol. However, moderately labile P contents increased with time: NT7 < NT11 < NT16 (237, 341, and 375 mg dm-3, respectively). This increased followed the elevation in iron oxide contents, indicating a relationship between mineralogy and P accumulation. Regardless of no-tillage period, P contents extracted by Mehlich-1 were lower, underestimating the available P content, when compared with the extraction using a P selective resin. The stocks of labile P were sufficient to maintain high crop yields, according to the recommendations for the Cerrado region. Even if labile P contents are reduced, when adopting no-till system, the contents and stocks of P in the soil after several years were high enough to provide for adequate crop yields.
Validation of semi‐automated anatomically labeled SEEG contacts in a brain atlas for mapping connectivity in focal epilepsy

Stereotactic electroencephalography (SEEG) has been widely used to explore the epileptic network and localize the epileptic zone in patients with medically intractable epilepsy. Accurate anatomical labeling of SEEG electrode contacts is critically important for correctly interpreting epileptic activity. We present a method for automatically assigning anatomical labels to SEEG electrode contacts using a 3D‐segmented cortex and coregistered postoperative CT images.
Project ECHO COVID-19: Vulnerable Populations and Telehealth Early in the Pandemic

Introduction/Objectives Project ECHO COVID-19 was launched nationwide on March 4, 2020 to disseminate guidance about COVID-19 in a timely and scalable manner to meet the urgent needs of primary care settings, the first line of defense in a pandemic. Methods Data from post-session surveys were analyzed to assess participant satisfaction, knowledge gaps, change in knowledge, and anticipated changes in practice as a result of Project ECHO COVID-19. A content analysis was conducted of the 243 questions and concerns posted by over 2000 participants in the Question and Answer function of Zoom during the first 8 sessions (March 4-April 29, 2020). Results Of 5243 registrants, 49% attended at least one session. Respondents agreed or strongly agreed that didactic sessions (97%) and case presentations (96%) met their learning needs; 93% reported gaining new knowledge, and 88% would implement that knowledge. Only 32% and 53% of respondents anticipated changing workflows and adapting to telehealth, respectively, despite the need for both as the pandemic continued. The content analysis identified 3 categories: clinical operations (eg, testing, triage, telehealth, billing); patient care (diagnosis and treatment of COVID-19, management of high-risk vulnerable populations); and epidemiology (viral spread, implications for public health). Conclusions Care of vulnerable populations and clinical operations should be addressed when planning education and clinical interventions for public health crises. Adapting the Project ECHO model to be more scalable was an effective means of creating a community of practice among health professionals when evidence-based guidance was not available to manage the implications of a pandemic.
A globally ubiquitous symbiont can drive experimental host evolution

Organisms harbour myriad microbes which can be parasitic or protective against harm. The costs and benefits resulting from these symbiotic relationships can be context‐dependent, but the evolutionary consequences to hosts of these transitions remain unclear. Here, we mapped the Leucobacter genus across 13,715 microbiome samples (163 studies) to reveal a global distribution as a free‐living microbe or a symbiont of animals and plants. We showed that across geographically distant locations (South Africa, France, Cape Verde), Leucobacter isolates vary substantially in their virulence to an associated animal host, Caenorhabditis nematodes. We further found that multiple Leucobacter sequence variants co‐occur in wild Caenorhabditis spp. which combined with natural variation in virulence provides real‐world potential for Leucobacter community composition to influence host fitness. We examined this by competing C. elegans genotypes that differed in susceptibility to different Leucobacter species in an evolution experiment. One Leucobacter species was found to be host‐protective against another, virulent parasitic species. We tested the impact of host genetic background and Leucobacter community composition on patterns of host‐based defence evolution. We found host genotypes conferring defence against the parasitic species were maintained during infection. However, when hosts were protected during coinfection, host‐based defences were nearly lost from the population. Overall, our results provide insight into the role of community context in shaping host evolution during symbioses.