Miracle-dz/UniFAR-FTUs huggingface dataset:
Procollagen III, N-terminal propeptide (PIIINP): establishment of reference intervals in Northern European adults and children using the MAGLUMI 800 chemiluminescence immunoassay

Abstract Procollagen III, N-terminal propeptide (PIIINP) is used as a biomarker for increased collagen III-synthesis. Reference intervals have not been established for the MAGLUMI 800 chemiluminescence immunoassay (CLIA) in Northern European adults or in children. The present study aimed to establish age-specific reference intervals in a Northern European population. PIIINP serum levels were analysed in healthy blood donors 19–67 years (n = 240) and children 2–18 years (n = 420). Furthermore, we investigated total imprecision and stability at room temperature and at −20 °C and performed a method comparison between MAGLUMI 800 CLIA (Snibe Diagnostics, Shenzhen, China) and ADVIA Centaur CP (Siemens Healthcare Diagnostics, Tarrytown, NY,USA). PIIINP was influenced by age but not sex. We established the following reference intervals: 2–10 years, 18–62 µg/L; 11–18 years, 15–75 µg/L; 19–39 years, 15–55 µg/L; 40–67 years, 14–31 µg/L. Total imprecision for PIIINP on MAGLUMI 800 was acceptable with coefficients of variation of 4.9% in the low range and 9.4% in the high range. PIIINP was stable for 24 h at room temperature after centrifugation and for at least 7 months at −20 °C. MAGLUMI 800 yielded significantly higher PIIINP levels than ADVIA Centaur CP. In conclusion, we established age-specific reference intervals for PIIINP using MAGLUMI 800 CLIA in a large Danish cohort. Our results may be useful for other laboratories wishing to establish PIIINP on the same platform and may provide improved guidance for medical doctors treating both children and adults with fibrotic disorders.
Double‐Gate MoS2 Field‐Effect Transistors with Full‐Range Tunable Threshold Voltage for Multifunctional Logic Circuits

Multifunctional reconfigurable devices, with higher information capacity, smaller size, and more functions, are urgently needed and draw most attention in frontiers in information technology. 2D semiconductors, ascribing to ultrathin body and easy electrostatic control, show great potential in developing reconfigurable functional units. This work proposes a novel double‐gate field‐effect transistor architecture with equal top and bottom gate (TG and BG) and realizes flexible optimization of the subthreshold swing (SS) and threshold voltage (VTH). While the TG and BG are used simultaneously, as a single gate to drive the transistor, ultralow average SS value of 65.5 mV dec−1 can be obtained in a large current range over 104, enabling the application in high gain inverter. While one gate is used to initialize the channel doping, full logic swing inverter circuit with high noise margin (over 90%) is demonstrated. Such device prototype is further extended for designing reconfigurable logic applications and can be dynamically switched and well maintained between binary and ternary logics. This study provides important concept and device prototype for future multifunctional logic applications.
Allopurinol and Cardiovascular Events: Time‐Related Biases in Observational Studies

Several observational studies reported that allopurinol, an effective treatment for gout, was associated with important reductions in cardiovascular (CV) events, with calls for large, randomized trials, although some results were conflicting. The present study was undertaken to assess the extent of time‐related biases in these observational studies.
The crystal structure of SnTox3 from the necrotrophic fungus Parastagonospora nodorum reveals a unique effector fold and provides insight into Snn3 recognition and pro-domain protease processing of fungal effectors.

Plant pathogens cause disease through secreted effector proteins, which act to promote infection. Typically, the sequences of effectors provide little functional information and further targeted experimentation is required. Here, we utilised a structure/function approach to study SnTox3, an effector from the necrotrophic fungal pathogen Parastagonospora nodorum, which causes cell death in wheat-lines carrying the sensitivity gene Snn3. We developed a workflow for the production of SnTox3 in a heterologous host that enabled crystal structure determination and functional studies. We show this approach can be successfully applied to study effectors from other pathogenic fungi. The β-barrel fold of SnTox3 is a novel fold among fungal effectors. Structure-guided mutagenesis enabled the identification of residues required for Snn3 recognition. SnTox3 is a pre-pro-protein, and the pro-domain of SnTox3 can be cleaved in vitro by the protease Kex2. Complementing this, an in-silico study uncovered the prevalence of a conserved motif (LxxR) in an expanded set of putative pro-domain-containing fungal effectors, some of which can be cleaved by Kex2 in vitro. Our in vitro and in-silico study suggests that Kex2-processed pro-domain (designated here as K2PP) effectors are common in fungi and this may have broad implications for the approaches used to study their functions.
Indication and surgical techniques of bypass choledochojejunostomy for intractable choledocholithiasis

Despite development in endoscopic treatment and minimally invasive surgery for choledocholithiasis, there remains a small number of patients who require bypass Roux-en-Y choledochojejunostomy (RYCJ) because of the intractable occurrence of common bile duct (CBD) stones. We herein present the detailed procedures of open RYCJ customized for intractable choledocholithiasis. The first method is a side-to-end choledochojejunostomy with intraluminal closure of the distal CBD. This method was applied to a 79-year-old female patient who underwent endoscopic retrograde cholangiopancreatography (ERCP) more than 10 times in the past 14 years (Case No. 1). The distal CBD was explored through choledochotomy and then the distal CBD lumen was occluded with internal running sutures. A large-sized choledochojejunostomy was performed. The patient recovered uneventfully and has been doing well for the past 2 years. The second method is an end-to-end choledochojejunostomy with segmental CBD resection. It was applied to a 75-year-old male patient who underwent ERCP 9 times in the past 10 years (Case No. 2). The CBD was resected segmentally and a large-sized choledochojejunostomy was performed. The patient also recovered uneventfully and has been doing well for the past 2 years. In conclusion, the primary indication of bypass RYCJ is intractable choledocholithiasis which requires numerous sessions of endoscopic stone removal over a long period. Open RYCJ is the preferred procedure to date. If the papilla is patulous, the distal CBD should be occluded or resected to prevent reflux ascending cholangitis. We recommend to resect the intrapancreatic distal CBD if it is markedly dilated like choledochal cyst.
An augmented food strategy leads to complete energy compensation during a 15‐day military training expedition in the cold

Soldiers on military expeditions usually fail to compensate for the increase in energy expenditure, with potential deleterious consequences. We therefore analyzed the characteristics of energy compensation in 12 male soldiers, during a 15‐day expedition in the cold, while alleviating some of the contextual limitations of food intake (~20‐MJ daily bags of easy‐to‐use, highly palatable and familiar foods with multiple and long breaks allowed during the day). Body and fat mass losses were low and moderate, respectively (−1.13 ± 1.42% and −19.5 ± 15.6%, respectively, p < .021). Mean energy intake (EI) was high (~16.3 MJ) and increased at each third of the expedition (15.3 ± 2.1, 16.1 ± 2.1, and 17.6 ± 2.0 for D1–5, D6–10 and D11–15, respectively, p < .012). This resulted in reaching a neutral energy balance as soon as the D6 to 10 period and reaching normal energy availability during D11 to 15. Participants only increased their EI during the mid‐day (10:00–14:00) period (p = .002) whereas hunger and thirst only increased in the morning, with higher scores during D11–15 than D1–5 (p < .009). Last, the reward value of sweet foods was also higher during D11–15 than during D1–5 (p = .026). The changes in body mass were positively associated with EI (r = 0.598, p = .040) and carbohydrate intake (r = 0.622, p = .031). This study indicates that complete energy compensation can be reached in challenging field conditions when food intake is facilitated, offering some guidelines to limit energy deficit during operational missions.
A systematic review of self-determination interventions for children and youth with disabilities

Abstract Purpose Developing self-determination skills is an important component of youth’s maturation. However, many youths with disabilities lack opportunities to engage in activities that can promote these skills. The purpose of this study was to conduct a systematic review of self-determination interventions for children and youth with disabilities. Methods A systematic review was performed on seven international databases that identified 28 studies meeting our inclusion criteria. Results Among the 28 studies, 5184 youth with disabilities (aged 9–29, mean age 16.8 years) were represented across three countries. The interventions varied in duration, length, number of sessions, and delivery format, which included curriculum-based, workshops, experiential or residential learning, peer coaching and mentoring, self-directed individual learning, computer games, and multi-component designs. 19/28 studies reported a significant improvement in self-determination. Of these 13/18 studies showed improvements as measured by Arc’s self-determination scale, while 8/13 studies reported a significant improvement as measured by AIR self-determination scale. Other significant differences were reported in vocational skills self-efficacy and self-determination inventory. Conclusions Our findings highlight that there are several types of interventions that have the potential to improve self-determination for youth with disabilities. Further research is needed to understand what program components could help youth to obtain optimal outcomes. Implications for Rehabilitation Several types of interventions (school-based, community, online) have potential to influence self-determination for youth with disabilities. Clinicians and educators should consider having multiple components including workshops, one-to-one and group-based learning, mentoring and coaching for optimal program outcomes. Interventions that are targeted to enhance self-determination for youth with disabilities should be theoretically informed and use a validated measure to assess their effectiveness.
Voxel-based quantitative susceptibility mapping revealed increased cerebral iron over the whole brain in chronic migraine

Background The previous documents demonstrated that iron deposition was identified in brain deep nuclei and periaqueductal gray matter region in chronic migraine (CM), and less is known about the cerebral iron deposition in CM. The aim of this study is to investigate the cerebral iron deposition in CM using an advanced voxel-based quantitative susceptibility mapping. Methods A multi-echo gradient echo MR sequence was obtained from 14 CM patients and 28 normal controls (NC), and quantitative susceptibility mapping images were reconstructed and voxel-based analysis was performed over the whole cerebrum. The susceptibility value of all the positive brain regions was extracted and correlation was calculated between the susceptibility value and the clinical variables. Results The brain regions with increased susceptibility value in CM patients located in right precuneus, insula, supramarginal gyrus, dorsolateral superior frontal gyrus, postcentral gyrus, cuneus and left postcentral gyrus compared with NC. The correlation analysis demonstrated that a positive correlation was identified between susceptibility value of all the positive brain regions and VAS score. Conclusion The current study demonstrated increased cerebral iron deposition presented in chronic patients, which suggested that increased cerebral iron deposition might play a role in the migraine chronicization.
Bacterial protease activity as a biomarker to assess the risk of non‐healing in chronic wounds: Results from a multicentre randomised controlled clinical trial

Millions worldwide suffer from chronic wounds challenging clinicians and burdening healthcare systems. Bacteria impede wound healing; however, the diagnosis of excessive bacterial burden or infection is elusive. Clinical signs and symptoms of infection are inaccurate and unreliable. This trial evaluated a novel, point‐of‐care, lateral flow diagnostic designed to detect virulence factors released by the most common bacteria found in chronic wounds. A multicentre prospective cohort clinical trial examined the efficacy of a diagnostic test in detecting bacterial proteases taken from swab samples of chronic venous, arterial, pressure and mixed aetiology chronic wounds. Two hundred and sixty six wounds were included in the analysis of the study. The wounds were tested at the start of the study after which investigators were permitted to use whatever dressings they desired for the next 12 weeks. Healing status at 12 weeks was assessed. The presence of elevated bacterial protease activity decreased the probability of wound healing at 12 weeks. In contrast, a greater proportion of wounds were healed at 12 weeks if they had little or no bacterial protease activity at study start. In addition, the presence of elevated bacterial protease activity increased the time it takes for a wound to heal and increased the risk that a wound would not heal, when compared to the absence of bacterial protease activity. The results of this clinical trial indicate that bacterial protease activity, as detected by this novel diagnostic test, is a valid clinical marker for chronicity in wounds. The diagnostic test offers a tool for clinicians to detect clinically significant bacteria in real time and manage bacteria load before the clinical signs and symptoms of infection are evident.
Health-related integration interventions for migrants by civil society organizations: an integrative review

ABSTRACT Purpose: Migrants are a vulnerable group concerning health and integration. Civil society organizations are deemed important for the integration and health of migrants and have been encouraged to help. This study explored health and acculturation, as expressed in research into health-related integration interventions for migrant groups provided by civil society organizations. Methods: Databases, journal websites and reference lists were searched in an integrative review. Thirteen articles were found and analysed using concepts of health strategies/perspectives and of acculturation with regard to general and health culture. Results: Studies were divided between two primary spectrums: 1) assimilation-integration and 2) integration-separation spectrum. Spectrum 1 interventions tend to promote assimilation into the present host culture and into a Western view of health. They are mostly driven by representatives of the host culture. Spectrum 2 interventions are characterized by a greater openness concerning the home-culture understandings of health, alongside an appreciation of the home culture in general. They are mostly migrant-driven. Conclusions: The different acculturating approaches in migrant and native-driven civil society organizations call for an awareness of their guiding health and acculturation assumptions and their applied perspectives and strategies. This awareness is considered crucial in order to achieve desired health and acculturation outcomes.
Comparison of skeletal muscle index-based formula and body surface area-based formula for calculating standard liver volume

Backgrounds/Aims Formula-derived standard liver volume (SLV) has been clinically used for living donor liver transplantation and hepatic resection. The majority of currently available SLV formulae are based on body surface are (BSA). However, they often show a wide range of error. Skeletal muscle index measured at the third lumbar vertebra level (L3SMI) appears to reflect lean body mass. The objective of this study was to compare the accuracy of L3SMI-based formula and BSA-based formula for calculating SLV. Methods The study cohort was 500 hundred living liver donors who underwent surgery between January 2010 and December 2013. Computed tomography images were used for liver volumetry and skeletal muscle area measurement. Results The study cohort included 250 male and 250 female donors. Their age, BSA, L3SMI, and body mass index were 26.8±8.7 years, 1.68±0.16 m2, 45.6±9.0 cm2/m2, and 21.7±2.5 kg/m2, respectively. The BSA-based SLV formula was “SLV (ml)=−362.3+901.5×BSA (m2) (r=0.71, r2=0.50, p<0.001)”. The L3SMI-based SLV formula was “SLV (ml)=471.9+14.9×L3SMI (cm2/m2) (r=0.65, r2=0.42, p<0.001)”. Correlation coefficients were similar in subgroup analyses with 250 male donors and 250 female donors. There was a crude correlation between L3SMI and body mass index (r=0.51, r2=0.27, p<0.001). Conclusions The results of this study suggest that SLV calculation with L3SMI-based formula does not appear to be superior to the currently available BSA-based formulae.
Driving Pressure and Normalized Energy Transmission Calculations in Mechanically Ventilated Children Without Lung Disease and Pediatric Acute Respiratory Distress Syndrome*

OBJECTIVES: To compare the new tools to evaluate the energy dissipated to the lung parenchyma in mechanically ventilated children with and without lung injury. We compared their discrimination capability between both groups when indexed by ideal body weight and driving pressure. DESIGN: Post hoc analysis of individual patient data from two previously published studies describing pulmonary mechanics. SETTING: Two academic hospitals in Latin-America. PATIENTS: Mechanically ventilated patients younger than 15 years old were included. We analyzed two groups, 30 children under general anesthesia (ANESTH group) and 38 children with pediatric acute respiratory distress syndrome. INTERVENTIONS: Respiratory mechanics were measured after intubation in all patients. MEASUREMENTS AND MAIN RESULTS: Mechanical power and derived variables of the equation of motion (dynamic power, driving power, and mechanical energy) were computed and then indexed by ideal body weight. Driving pressure was higher in pediatric acute respiratory distress syndrome group compared with ANESTH group. Receiver operator curve analysis showed that driving pressure had the best discrimination capability compared with all derived variables of the equation of motion indexed by ideal body weight. The same results were observed when the subgroup of patients weighs less than 15 kg. There was no difference in unindexed mechanical power between groups. CONCLUSIONS: Driving pressure is the variable that better discriminates pediatric acute respiratory distress syndrome from nonpediatric acute respiratory distress syndrome in children than the calculations derived from the equation of motion, even when indexed by ideal body weight. Unindexed mechanical power was useless to differentiate against both groups. Future studies should determine the threshold for variables of the energy dissipated by the lungs and their association with clinical outcomes.
Developing Adaptive Serious Games for Children With Specific Learning Difficulties: A Two-phase Usability and Technology Acceptance Study

Background Specific learning difficulties (SpLD) include several disorders such as dyslexia, dyscalculia, and dysgraphia, and the children with these SpLD receive special education. However, the studies and the educational material so far focus mainly on one specific disorder. Objective This study’s primary goal is to develop comprehensive training material for different types of SpLD, with five serious games addressing different aspects of the SpLD. The second focus is measuring the impact of adaptive difficulty level adjustment in the children’s and their educators’ usability and technology acceptance perception. Receiving feedback from the children and their educators, and refining the games according to their suggestions have also been essential in this two-phase study. Methods A total of 10 SpLD educators and 23 children with different types of SpLD tested the prototypes of the five serious games (ie, Word game, Memory game, Category game, Space game, and Math game), gave detailed feedback, answered the System Usability Scale and Technology Acceptance Model (TAM) questionnaires, and applied think-aloud protocols during game play. Results The games’ standard and adaptive versions were analyzed in terms of average playtime and the number of false answers. Detailed analyses of the interviews, with word clouds and player performances, were also provided. The TAM questionnaires’ average and mean values and box plots of each data acquisition session for the children and the educators were also reported via System Usability Scale and TAM questionnaires. The TAM results of the educators had an average of 8.41 (SD 0.87) out of 10 in the first interview and an average of 8.71 (SD 0.64) out of 10 in the second interview. The children had an average of 9.07 (SD 0.56) out of 10 in the first interview. Conclusions Both the educators and the children with SpLD enjoyed playing the games, gave positive feedback, and suggested new ways for improvement. The results showed that these games provide thorough training material for different types of SpLD with personalized and tailored difficulty systems. The final version of the proposed games will become a part of the special education centers’ supplementary curriculum and training materials, making new enhancements and improvements possible in the future.
Impact of dietary intake of sodium and potassium on short-term blood pressure variability

Supplemental Digital Content is available in the text Background: Dietary Approaches to Stop Hypertension (DASH)-Sodium trial showed that dietary sodium and potassium affect blood pressure (BP). We aimed to investigate whether dietary sodium and potassium affect short-term BP variability (BPV) in addition to BP. Methods: A total of 343 participants from the DASH-Sodium trial (age 48.4 ± 9.7, 42.5% men) and 323 individuals from the Jackson Heart Study (JHS) (age 56.7 ± 11.2, 30.7% men) with satisfactory ambulatory BP monitoring records and 24-h urine collection were included. Average real variability (ARV) was calculated as a measure of short-term BPV. Results: By estimating dietary intake from urinary excretion, we observed that higher urinary sodium-to-potassium ratio was significantly associated with higher diastolic ARV in both studies. Among the DASH-Sodium trial, potassium-rich DASH diet alone had insignificant effect on both systolic (−0.1 ± 1.7 mmHg, P = 0.343) or diastolic ARV (−0.2 ± 1.5 mmHg, P = 0.164), whereas combined DASH diet and low sodium intake significantly reduced both systolic (8.5 ± 1.6 vs. 8.9 ± 1.7 mmHg, P = 0.032) and diastolic ARV (7.5 ± 1.5 vs. 7.8 ± 1.6 mmHg, P = 0.025) as compared with control diet and high sodium intake. As the reduction of systolic ARV was majorly derived from the change of mean SBP, diastolic ARV was significantly determined by urinary sodium-to-potassium ratio (β coefficient ± standard error: 0.012 ± 0.004; P = 0.006) after adjusting for age, sex, smoking, mean DBP, BMI, and race. Conclusion: Dietary sodium and potassium can jointly modulate short-term BPV in addition to BP. Combined DASH diet and low sodium intake may reduce systolic and diastolic ARV via different mechanisms.