Miracle-dz/UniFAR-FTUs huggingface dataset:
“Finding the Balance”: A Qualitative Study of the Experience of Nurses and Patients with Diabetes on an Insulin Pump in the Hospital

Purpose The purpose of this study was to explore experiences of hospitalized patients as they transition insulin pump self-management from home to hospital and the experience of nurses caring for them. Patients are often more knowledgeable about the pump than their nurses, which could lead to undiscovered challenges. Little is known about the hospital experience related to insulin pump therapy from nurses’ and patients’ perspectives. Methods A qualitative approach with interpretive descriptive design and purposive sampling was used. Eligible patients were ≥18 years of age, able to read and speak English, and admitted to non-ICU settings ≥20 hours. Eligible nurses cared for at least 1 patient using an insulin pump. Patients and nurses were interviewed separately. Interviews were audiotaped and transcribed verbatim. Data were analyzed using a constant comparative method. Coding was performed independently and jointly to reach consensus on emerging themes. Results Hospitalized patients and nurses had an array of perceptions highlighting challenges and adaption to “finding the balance” in managing diabetes when patients wore their insulin pumps. There were 4 interrelated themes representing a continuum of trust to lack of trust, control versus lack of control, effective communication to limited communication, and staff knowledge to lack of knowledge. Conclusions Results of this study provide valuable insights into the challenges for both patients and nurses. A standardized approach to caring for this population is necessary. These findings can inform the development of nursing education programs and policies aimed at improving their experiences.
Researches concerning in vitro cultures optimization of the vulnerable species Dianthus nardiformis Janka.

Our aim was to establish an optimized protocol for in vitro short-term conservation of the vulnerable species Dianthus nardiformis Janka belonging to Romanian Flora. For our purpose, different culture media compositions were tested: complex variants added with plant growth regulators and simplified media with low levels of macroand microelements. This species had a good in vitro reaction, the regeneration occurs through direct morphogenesis as in all Dianthus species. Generally, the use of variants of MS medium supplemented with cytokinin/ auxin at 10/1 ratio proved to induce high regeneration response starting from the first month of culture. In our study, MS media complex variants with diminished levels of plant growth hormones at the same ratio of cytokinins /auxins conducted to acceptable levels of regeneration. By the other hand on complex regeneration variants, the rooting process was absent or underwent at low levels. Using simplified media with reduced levels of macroand microelements, both rhizogenesis and shoots formation were induced. The in vitro response was characterized through the mean number of regenerated shoots/explants and the mean number of neoformed roots/initial inoculum. Despite of low microand macroelements levels (1/2 and 1⁄4 of MS salts), the modified MS basal medium composition proved to be beneficial for D. nardiformis, plants could be efficiently regenerated and rooted and regenerative aggregates can also be propagated as short-term cultures. The need of the supplementary transfer on particular rooting medium is also eliminated. Using simplified culture media, this species can be efficiently micropropagated and maintained as active tissue cultures, able to supply viable plants whenever it is necessary.
Effect of Urate-Lowering Therapy on Cardiovascular and Kidney Outcomes: A Systematic Review and Meta-Analysis.

BACKGROUND AND OBJECTIVES Several clinical practice guidelines noted the potential benefits of urate-lowering therapy on cardiovascular disease and CKD progression; however, the effect of this regimen remains uncertain. In this systematic review, we aimed to evaluate the efficacy of urate-lowering therapy on major adverse cardiovascular events, all-cause mortality, kidney failure events, BP, and GFR. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We systematically searched MEDLINE, Embase, and the Cochrane databases for trials published through July 2020. We included prospective, randomized, controlled trials assessing the effects of urate-lowering therapy for at least 6 months on cardiovascular or kidney outcomes. Relevant information was extracted into a spreadsheet by two authors independently. Treatment effects were summarized using random effects meta-analysis. RESULTS We identified 28 trials including a total of 6458 participants with 506 major adverse cardiovascular events and 266 kidney failure events. Overall urate-lowering therapy did not show benefits on major adverse cardiovascular events (risk ratio, 0.93; 95% confidence interval, 0.74 to 1.18) and all-cause mortality (risk ratio, 1.04; 95% confidence interval, 0.78 to 1.39) or kidney failure (risk ratio, 0.97; 95% confidence interval, 0.61 to 1.54). Nevertheless, urate-lowering therapy attenuated the decline in the slope of GFR (weighted mean difference, 1.18 ml/min per 1.73 m2 per year; 95% confidence interval, 0.44 to 1.91) and lowered the mean BP (systolic BP: weighted mean difference, -3.45 mm Hg; 95% confidence interval, -6.10 to -0.80; diastolic BP: weighted mean difference, -2.02 mm Hg; 95% confidence interval, -3.25 to -0.78). There was no significant difference (risk ratio, 1.01; 95% confidence interval, 0.94 to 1.08) in the risk of adverse events between the participants receiving urate-lowering therapy and the control group. CONCLUSIONS Urate-lowering therapy did not produce benefits on the clinical outcomes, including major adverse cardiovascular events, all-cause mortality, and kidney failure. Thus, there is insufficient evidence to support urate lowering in patients to improve kidney and cardiovascular outcomes.
Impact of dementia on informal care: a systematic review of family caregivers’ perceptions

Introduction Caregivers play a major role in providing all the support and care in daily activities for their relatives with dementia. To fully describe the influence of dementia caregiving on family caregivers’ life, we conducted a systematic review including caregivers’ perceptions about the positive and negative aspects of caring and the expressed factors. Materials and methods We conducted a systematic review including articles from January 1998 to July 2020. Qualitative studies reporting family caregivers’ perceptions about their experiences and the effects/impact of dementia caregiving were eligible. Two authors extracted the data independently, and the analysis focused on the positive and negative aspects of dementia caregiving in caregivers’ life. Results Eighty-one studies with 3347 participants were included in this review. The positive aspects of caregiving in caregivers’ life encompass personal accomplishment and strengthening relationships, which were enhanced by good medical counselling/formal care support and family/friends support. The negative aspects included emotional and social aspects experienced by caregivers. Other factors such as inappropriate medical/formal care support, illness progression and the costs of dementia contributed to negative appraisal. Discussion and implications The findings provide insights into the holistic experience of caring for a person with dementia revelling the major positive and negative aspects underlying the caregiver role. The evidence emphasises the need ‘to focus on positive aspects’ and targeted interventions aimed at reducing the negative impact of caregiving, which has serious consequences on caregivers’ quality of life. A multicomplex intervention for dementia informal caregiving should be developed, committing the society to promote mental health, address these community needs and improve the quality of life of the person with dementia and their family caregivers.
Erectile Dysfunction in Men With Psoriatic Arthritis: A Population-based Cohort Study

Objective To define the incidence of erectile dysfunction (ED) in a population-based cohort of men with psoriatic arthritis (PsA). Methods Data pertaining to demographics, ED, and potential confounding diagnosis were extracted from a comprehensive medical record system for a population-based cohort of men with PsA and an age-matched male comparator cohort. Cumulative incidence of ED adjusted for competing risk of death was compared between the 2 cohorts. Results There were 128 age-matched pairs of men with PsA and without PsA in the described cohorts. At baseline, there was a 7% prevalence of ED in men with PsA prior to diagnosis compared to a 3% prevalence of ED in the comparator cohort (P = 0.16). After PsA diagnosis/index date, diagnosis with PsA was associated with an increased risk of ED (age-adjusted HR 1.45, 95% CI 0.79–2.68), but this association did not reach statistical significance. This was based on 24 cases of ED in the men with PsA and 18 cases within the comparator cohort. No confounding factors or ED treatment strategies differed significantly between men with PsA and ED and comparators with ED. Conclusion Men with PsA may have an increased risk of ED, which was detected but likely underpowered in this study. Whether this difference is secondary to higher prevalence of traditional risk factors of ED in men with PsA compared to the general population will require further study.
Patch dynamics modeling framework from pathogens’ perspective: Unified and standardized approach for complicated epidemic systems

Mathematical models are powerful tools to investigate, simulate, and evaluate potential interventions for infectious diseases dynamics. Much effort has focused on the Susceptible-Infected-Recovered (SIR)-type compartment models. These models consider host populations and measure change of each compartment. In this study, we propose an alternative patch dynamic modeling framework from pathogens’ perspective. Each patch, the basic module of this modeling framework, has four standard mechanisms of pathogen population size change: birth (replication), death, inflow, and outflow. This framework naturally distinguishes between-host transmission process (inflow and outflow) and within-host infection process (replication) during the entire transmission-infection cycle. We demonstrate that the SIR-type model is actually a special cross-sectional and discretized case of our patch dynamics model in pathogens’ viewpoint. In addition, this patch dynamics modeling framework is also an agent-based model from hosts’ perspective by incorporating individual host’s specific traits. We provide an operational standard to formulate this modular-designed patch dynamics model. Model parameterization is feasible with a wide range of sources, including genomics data, surveillance data, electronic health record, and from other emerging technologies such as multiomics. We then provide two proof-of-concept case studies to tackle some of the existing challenges of SIR-type models: sexually transmitted disease and healthcare acquired infections. This patch dynamics modeling framework not only provides theoretical explanations to known phenomena, but also generates novel insights of disease dynamics from a more holistic viewpoint. It is also able to simulate and handle more complicated scenarios across biological scales such as the current COVID-19 pandemic.
Development of an efficient regeneration protocol for three genotypes of Brassica juncea.

Two phytohormones, auxins (Naphthalene acetic acid and Indole acetic acid) and cytokinins (Benzylaminopurine and Kinetin) with concentrations were used to develop an efficient regeneration protocol for 3 genotypes of Brassica juncea (UCD-635, RL-18 and NIFA RAYE). The explants were cultured on MS-medium supplemented with BAP 1.0 mgL -1 /NAA 0.1 mgL -1 , BAP 2.0 mg L -1 /NAA 0.2 mg L -1 , BAP 3.0 mgL -1 /NAA 0.3 mg L -1 and Kinetin 1.0 mg L -1 /IAA 0.1 mg L -1 , Kinetin 2.0 mg L -1 /IAA 0.2 mg L -1 , Kinetin 3.0mg L -1 /IAA 0.3 mg L -1 . Maximum callus production (65.55) was observed on MS medium containing with BAP 2.0 mgL -1 /NAA 0.2 mg L - 1. Maximum shooting ( 22.31) was observed BAP 3.0 mg L -1 /NAA 0.3 mg L -1 and KIN 3.0 mg L -1 /IAA 0.3 mg L -1 . Regeneration efficiency was found maximum (7.13) with BAP 3.0 mg L -1 /NAA 0.3 mg L - 1. The three genotypes were found significantly different at p≤0.05 in shoots production and regeneration efficiency.
MRI-Based Assessment of the Pharyngeal Constrictor Muscle as a Predictor of Surgical Margin after Transoral Robotic Surgery in HPV-Positive Tonsillar Cancer

BACKGROUND AND PURPOSE: Transoral robotic surgery is an emerging strategy for treating human papillomavirus–positive cancers, but the role of MR imaging in predicting the surgical outcome has not been established. We aimed to identify preoperative MR imaging characteristics that predispose the outcome of transoral robotic surgery toward an insecure (positive or close) surgical margin in human papillomavirus–positive tonsillar squamous cell carcinoma. MATERIALS AND METHODS: Between December 2012 and May 2019, sixty-nine patients underwent transoral robotic surgery at our institution. Among these, 29 who were diagnosed with human papillomavirus–positive tonsillar squamous cell carcinoma, did not receive neoadjuvant treatment, underwent preoperative 3T MR imaging, and had postoperative pathologic reports and were included in this retrospective study. Two neuroradiologists evaluated the preoperative MR imaging scans to determine the tumor spread through the pharyngeal constrictor muscle using a 5-point scale: 1, normal constrictor; 2, bulging constrictor; 3, thinning constrictor; 4, obscured constrictor; and 5, tumor protrusion into the parapharyngeal fat. The risk of an insecure surgical margin (involved or <1 mm) according to the MR imaging scores was predicted using logistic regression with the Firth correction. RESULTS: The interobserver agreement for the MR imaging scores was excellent (κ = 0.955, P < .001). A score of ≥4 could predict an insecure margin with 87.5% sensitivity and 92.3% specificity (area under the curve = 0.899) and was the only significant factor associated with an insecure margin in the multivariable analysis (OR, 6.59; 95% CI, 3.11–22.28; P < .001). CONCLUSIONS: The pre-transoral robotic surgery MR imaging scoring system for the pharyngeal constrictor muscle is a promising predictor of the surgical margin in human papillomavirus–positive tonsillar squamous cell carcinoma.
Improving male involvement in antenatal care in low and middle-income countries to prevent mother to child transmission of HIV: A realist review

Background Childhood Human Immunodeficiency Virus (HIV) infection occurs almost exclusively via mother to child transmission (MTCT) during pregnancy, birth, or through breastfeeding. Recent studies have shown that male involvement (MI) in antenatal care (ANC) and HIV testing, including couples voluntary counselling and testing (CVCT), increases the likelihood that women will adhere to prevention advice and comply with HIV treatment if required during their pregnancy; hence reducing the rates of MTCT of HIV. This realist review investigates how, why, when, and for whom MI in ANC works best to provide contextual advice on how MI in ANC can be best used for prevention of mother to child transmission (PMTCT) of HIV. Methods A realist review of existing evidence was conducted. Realist review seeks to explain how and why an intervention works, or does not work, in a given context. This was completed through the five stages of realist synthesis; Eliciting the program theory, search strategy, study selection criteria, data extraction, and data analysis and synthesis. Findings are presented as context-mechanism-outcome (CMO) configurations outlining the mechanisms that work in given contexts to give an outcome. Results Three CMO configurations were developed. These describe that 1) Couples in monogamous relationships have higher levels of trust, commitment and security leading to increased uptake of PMTCT programs together; 2) ANC spaces that make ‘male friendly’ adaptions promote normalisation of MI in PMTCT and are more welcoming, leading to increased willingness of male partners to participate in ANC; and 3) couples and communities with higher health literacy encourage increased informed decision making, ownership, and responsibility and thus increased participation in PMTCT of HIV. Conclusions The CMOs developed in this review give contextual advice on how one might improve ANC services to increase MI and help reduce MTCT of HIV. We propose that MI in ANC works best where couples are monogamous and trusting, where ANC spaces actively promote being a ‘male friendly space’ and where there are high levels of community education programs around MTCT.
Structural equation modeling to detect correlates of childhood vaccination: A moderated mediation analysis

Objectives This study used a health belief theory derived framework and structural equation model to examine moderators, mediators, and direct and indirect predictors of childhood vaccination. Methods A secondary analysis was conducted using data collected from a cross-sectional survey of a random sample of 1599 parents living in urban and rural areas of Mysore district, India. Applying two-stage probability proportionate-to-size sampling, adolescent girls attending 7th through 10th grades in 23 schools were selected to take home a questionnaire to be answered by their parents to primarily assess HPV vaccine intentions. Parents were also asked whether their children had received one dose of Bacillus Calmette–Guérin; three doses of Diphtheria, Pertussis, Tetanus; three doses of oral Polio vaccine; and one dose of Measles vaccine. In addition, parents were asked about their attitudes towards childhood vaccination. Results Out of the 1599 parents, 52.2% reported that their children had received all the routine vaccines (fully vaccinated); 42.7% reported their children had missed at least one routine vaccine, and 5.2% reported that their children had missed all routine vaccinations. Perceptions about the benefits/facilitators to childhood vaccination significantly predicted the full vaccination rate (standardized regression coefficient (β) = 0.29) directly and mediated the effect of parental education (β = 0.11) and employment (β = -0.06) on the rate of full vaccination. Parental education was significantly associated indirectly with higher rates of full vaccination (β = 0.11). Parental employment was significantly associated indirectly with decreasing rates of full vaccination (β = -0.05). Area of residence moderated the role of religion (β = 0.24) and the ‘number of children’ in a family (β = 0.33) on parental perceptions about barriers to childhood vaccination. The model to data fit was acceptable (Root Mean Square Error of Approximation = 0.02, 95% CI 0.018 to 0.023; Comparative Fit Index = 0.92; Tucker–Lewis Index = 0.91). Conclusions Full vaccination rate was relatively low among children in Mysore, especially among parents who were unsure about the benefits of routine vaccination and those with low educational levels. Interventions increasing awareness of the benefits of childhood vaccination that target rural parents with lower levels of education may help increase the rate of full childhood vaccination in India.
Computational characterisation of Toxoplasma gondii FabG (3-oxoacyl-[acyl-carrier-protein] reductase): a combined virtual screening and all-atom molecular dynamics simulation study

Abstract Toxoplasma gondii is an opportunistic obligate parasite, ubiquitous around the globe with seropositivity rates that range from 10% to 90% and infection by the parasite of pregnant women causes pre-natal death of the foetus in most cases and severe neurodegenerative syndromes in some. No vaccine is currently available, and since drug-resistance is common among T. gondii strains, discovering lead compounds for drug design using diverse tactics is necessary. In this study, the sole constituent isoform of an enzymatic 3-oxoacyl-[acyl-carrier-protein] reduction step in an apicoplast-located fatty acid biosynthesis pathway was chosen as a possible drug target. FASII is prokaryotic therefore, targeting it would pose fewer side-effects to human hosts. After a homology 3D modelling of TgFabG, a high-throughput virtual screening of 9867 compounds, the elimination of ligands was carried out by a flexible ligand molecular docking and 200 ns molecular dynamics simulations, with additional DCCM and PC plot analyses. Molecular Dynamics and related post-MD analyses of the top 3 TgFabG binders selected for optimal free binding energies, showed that L2 maintained strong H-bonds with TgFabG and facilitated structural reorientation expected of FabGs, namely an expansion of the Rossmann Fold and a flexible lid capping. The most flexible TgFabG sites were the α7 helix (the flexible lid region) and the β4-α4 and β5-α6 loops. For TgFabG-L2, the movements of these regions toward the active site enabled greater ligand stability. Thus, L2 ("Skimmine"; PubChem ID: 320361), was ultimately selected as the optimal candidate for the discovery of lead compounds for rational drug design. Communicated by Ramaswamy H. Sarma
A Correlation-Driven Mapping For Deep Learning application in detecting artifacts within the EEG

Objective. When developing approaches for automatic preprocessing of electroencephalogram (EEG) signals in non-isolated demanding environment such as intensive care unit (ICU) or even outdoor environment, one of the major concerns is varying nature of characteristics of different artifacts in time, frequency and spatial domains, which in turn causes a simple approach to be not enough for reliable artifact removal. Considering this, current study aims to use correlation-driven mapping to improve artifact detection performance. Approach. A framework is proposed here for mapping signals from multichannel space (regardless of the number of EEG channels) into two-dimensional RGB space, in which the correlation of all EEG channels is simultaneously taken into account, and a deep convolutional neural network (CNN) model can then learn specific patterns in generated 2D representation related to specific artifact. Main results. The method with a classification accuracy of 92.30% (AUC = 0.96) in a leave-three-subjects-out cross-validation procedure was evaluated using data including 2310 EEG sequences contaminated by artifacts and 2285 artifact-free EEG sequences collected with BrainStatus self-adhesive electrode and wireless amplifier from 15 intensive care patients. For further assessment, several scenarios were also tested including performance variation of proposed method under different segment lengths, different numbers of isoline and different numbers of channel. The results showed outperformance of CNN fed by correlation coefficients data over both spectrogram-based CNN and EEGNet on the same dataset. Significance. This study showed the feasibility of utilizing correlation image of EEG channels coupled with deep learning as a promising tool for dimensionality reduction, channels fusion and capturing various artifacts patterns in temporal-spatial domains. A simplified version of proposed approach was also shown to be feasible in real-time application with latency of 0.0181 s for making real-time decision.