Miracle-dz/UniFAR-FTUs huggingface dataset:
Delivery of a Mental Health Intervention for Chronic Pain Through an Artificial Intelligence–Enabled App (Wysa): Protocol for a Prospective Pilot Study

Background Patients with chronic pain often experience coexisting, long-term and debilitating mental health comorbidities such as depression and anxiety. Artificial intelligence–supported cognitive behavioral therapy (AI-CBT) interventions could offer cost-effective, accessible, and potentially effective resources to address this problem. However, there is not enough research conducted about the efficacy of AI-CBT interventions for chronic pain. Objective This prospective cohort study aims to examine the efficacy and use of an AI-CBT intervention for chronic pain (Wysa for Chronic Pain app, Wysa Inc) using a conversational agent (with no human intervention). To the best of our knowledge, this is the first such study for chronic pain using a fully-automated, free-text–based conversational agent. Methods Participants with self-reported chronic pain (n=500) will be recruited online on a rolling basis from April 2022 through posts on US-based internet communities within this prospective cohort. Informed consent is received from participants within the app, and the Wysa for Chronic Pain intervention is delivered remotely for 8 weeks. Outcome measures including a numeric pain rating scale and Patient-Reported Outcomes Measurement Information System–Pain Interference, Generalized Anxiety Disorder–7, and Patient Health Questionnaire–9 questionnaires administered to test the effectiveness of the intervention on reducing levels of pain interference, depression, and anxiety. The therapeutic alliance created with the conversational agent will be assessed through the Working Alliance Inventory–Short Revised instrument. Retention and use statistics will be observed for adherence and engagement. Results The study will open for recruitment in April 2022, and data collection is expected to be completed by August 2022. The results for the primary outcomes are expected to be published by late 2022. Conclusions Mental health conversational agents driven by artificial intelligence could be effective in helping patients with chronic pain learn to self-manage their pain and common comorbidities like depression and anxiety. The Wysa for Chronic Pain app is one such digital intervention that can potentially serve as a solution to the problems of affordability and scalability associated with interventions that include a human therapist. This prospective study examines the efficacy of the app as a treatment solution for chronic pain. It aims to inform future practices and digital mental health interventions for individuals with chronic pain. International Registered Report Identifier (IRRID) PRR1-10.2196/36910
Effectiveness and types of interventions to reduce mental illness-related stigma among Medical university students: A literature review (1997–2020)

There is a high prevalence of stigma among medical students towards mental illness, which can have far reaching negative consequences. It is essential to intervene and modify their preconceptions in order to fight against stigma. The objective of this study is to describe the types and effectiveness of interventions to reduce mental illness-related stigma among medical university students through a review of the literature published from 1997 to 2020. A systematic search was carried out in the following databases: PubMed, Web of Science (WOS) and Cochrane Library, following the PRISMA methodology. After the search, 87 manuscripts were found. 49 documents met the selection criteria, and 6 additional texts were included after a search for related studies. 44 studies were assessed, with a global participation of 20.196 MEDICINE students. In 97% of the cases, the methods of intervention for the reduction of stigma towards mental disorders (TM) were effective. 16 different types of interventions were found, with a limited number of methodologies. Teaching practices are the most effective in the long-term, together with a positive medical understanding, the search for help and the in vivo experiential contact, which are presented as strong strategies to combat stigmatizing attitudes.
A simple pipeline for cell cycle kinetic studies in the root apical meristem.

Root system architecture ultimately depends on precise signaling between different cells and tissues in the root apical meristem (RAM), and through its integration with environmental cues. This study describes a simple pipeline to simultaneously determine cellular parameters, nuclei geometry and cell cycle kinetics in the RAM. The method uses marker-free techniques for nucleus and cell boundaries detection, and 5-ethynyl-2'-deoxyuridine (EdU) staining for DNA replication quantification. Based on this approach, we characterized differences in cell volume, nucleus volume and nucleus shape across different domains of the Arabidopsis thaliana RAM. We found that DNA replication patterns were cell-layer and region dependent. G2 phase duration, which varied from 3.5 h in the pericycle to more than 4.5 h in the epidermis, was found associated with some nuclei geometry features. Endocycle duration was determined as the time required to achieve 100% EdU positive cells in the elongation zone and, as such, it was estimated to be in the range of 5 h for the epidermis and cortex. This experimental pipeline could be used to precisely map cell cycle duration in the RAM of mutants and in response to environmental stress in several plant species without the need for introgressing molecular cell cycle markers.
Do not forget the platelets: The independent impact of red blood cell to platelet ratio on mortality in massively transfused trauma patients

In this nationwide analysis of massively transfused trauma patients, unbalanced PLT transfusion was more prevalent than unbalanced FFP. The impact of unbalanced PLT transfusion on 24-hour mortality was independent from and potentially more pronounced than unbalanced FFP. BACKGROUND Balanced blood component administration during massive transfusion is standard of care. Most literature focuses on the impact of red blood cell (RBC)/fresh frozen plasma (FFP) ratio, while the value of balanced RBC:platelet (PLT) administration is less established. The aim of this study was to evaluate and quantify the independent impact of RBC:PLT on 24-hour mortality in trauma patients receiving massive transfusion. METHODS Using the 2013 to 2018 American College of Surgeons Trauma Quality Improvement Program database, adult patients who received massive transfusion (≥10 U of RBC/24 hours) and ≥1 U of RBC, FFP, and PLT within 4 hours of arrival were retrospectively included. To mitigate survival bias, only patients with consistent RBC:PLT and RBC:FFP ratios between 4 and 24 hours were analyzed. Balanced FFP or PLT transfusions were defined as having RBC:PLT and RBC:FFP of ≤2, respectively. Multivariable logistic regression was used to compare the independent relationship between RBC:FFP, RBC:PLT, balanced transfusion, and 24-hour mortality. RESULTS A total of 9,215 massive transfusion patients were included. The number of patients who received transfusion with RBC:PLT >2 (1,942 [21.1%]) was significantly higher than those with RBC:FFP >2 (1,160 [12.6%]) (p < 0.001). Compared with an RBC:PLT ratio of 1:1, a gradual and consistent risk increase was observed for 24-hour mortality as the RBC:PLT ratio increased (p < 0.001). Patients with both FFP and PLT balanced transfusion had the lowest adjusted risk for 24-hour mortality. Mortality increased as resuscitation became more unbalanced, with higher odds of death for unbalanced PLT (odds ratio, 2.48 [2.18–2.83]) than unbalanced FFP (odds ratio, 1.66 [1.37–1.98]), while patients who received both FFP and PLT unbalanced transfusion had the highest risk of 24-hour mortality (odds ratio, 3.41 [2.74–4.24]). CONCLUSION Trauma patients receiving massive transfusion significantly more often have unbalanced PLT rather than unbalanced FFP transfusion. The impact of unbalanced PLT transfusion on 24-hour mortality is independent and potentially more pronounced than unbalanced FFP transfusion, warranting serious system-level efforts for improvement. LEVEL OF EVIDENCE Therapeutic/Care Management; Level IV.
Self-Reported Use of HIV Preexposure Prophylaxis Is Highly Accurate Among Sexual Health Clinic Patients in New York City

Compared with an objective biomarker of drug-level measurements, self-report provides an accurate indicator for assessing preexposure prophylaxis use among New York City sexually transmitted infection clinic patients. Abstract In New York City, 91% of sexually transmitted infection clinic patients reported preexposure prophylaxis (PrEP) use that matched the detection of PrEP in their serum. Self-report had 80% sensitivity and 96% specificity (κ = 0.79) compared with measured PrEP. Our findings suggest that self-report may be a valid indicator of PrEP uptake.
Determination of fluoroquinolones in chicken muscle by molecularly imprinted graphitic carbon nitride-based solid-phase extraction and ultra-performance liquid chromatography

Abstract A graphitic carbon nitride was synthesised and nalidixic acid (NA) based molecularly imprinted microspheres (MIMs) were polymerised on its surface to create a composite material. After characterisation and evaluation of its absorption ability, the composite was used to prepare a solid-phase extraction (SPE) cartridge for purification of fluoroquinolones in chicken muscle, analysed by ultra-performance liquid chromatography. The cartridge showed high absorption capacities (378–559 μg) and high recoveries (92.1–99.4%) for eight fluoroquinolones, and could be reused at least 20 times. The limits of detection for the 8 drugs were 0.2–0.8 ng g−1, and recoveries from standard fortified blank chicken muscle samples were 71.9–96.8%. This is the first study reporting the use of molecularly imprinted graphitic carbon nitride composite to determine the residue of veterinary drug in foods of animal origin.
The role of miRNAs as a big master regulator of signaling pathways involved in lymphoblastic leukemia

MicroRNAs (miRNAs) belong to small noncoding RNAs, which have long attracted researchers' attention because of their potency in acting either as oncogenes or tumor‐suppressors in cancers. acute lymphocytic leukemia (ALL) and chronic lymphocytic leukemia (CLL) are two known types of leukemia with high mortality rates in adults and children. On a molecular basis, various signaling pathways are active in both types, making researchers consider the potential role of miRNAs in activating or suppressing these pathways to further hinder cancer development. In this review, we summarized the potential miRNAs, especially circulating ones, involved in essential signaling pathways in the ALL and CLL patients which serve as biomarkers and valuable targets in the treatment fields.
Emergency department visits due to new psychoactive substances and other illicit drugs in Taiwan: preliminary results of the Taiwan Emergency Department Drug Abuse Surveillance (TEDAS) project

Abstract Introduction The use of new psychoactive substances (NPSs) has markedly increased worldwide; thus, it is important to monitor NPS-related effects. The Taiwan Emergency Department Drug Abuse Surveillance (TEDAS) project aims to assess the patterns of recreational drug use in patients presenting to emergency departments (EDs) across the country. Here, we report the preliminary results of this project. Methods This observational study included the collection and analysis of urine samples and assessment of the clinical presentation of patients from 79 EDs across Taiwan. Clinical features were recorded through a questionnaire filled by attending doctors or nurses who collected urine samples for clinical diagnosis. Urine samples were analyzed for 110 drugs and metabolites using electrospray ionization liquid chromatography-tandem mass spectrometry (LC-MS/MS). Results Between February and November 2019, a total of 2649 patients were enrolled for urine drug analysis. A total of 675 cases older than 12 years (males, n = 480) had NPS or other illicit drugs detected in their urine samples. Overall, 1271 counts of drugs, among which 717 (56.4%) were NPS. At least one NPS was detected in 340 patients (50.4%), and 292 cases were positive for multiple drugs. The most frequently detected drug was methamphetamine/amphetamine, followed by synthetic cathinones, ketamine and its two analogs, and opioids. The most common drug combination was cathinones plus ketamine and/or its analogs (n = 56). Younger patients (OR = 3.3, p≤.0001) and women (OR = 1.5, p = .01) were more likely to have NPS detected in their urine samples. NPS-positive cases frequently experienced chest pain (OR = 2.6, p = .03), tachycardia (OR = 2.6, p = .0002), and suicide attempt/non-suicidal self-harm (OR = 1.8, p = .004), whereas depressed consciousness (OR = 0.5, p = .001) was less frequent among NPS-positive cases than among other illicit drug-positive cases. Conclusions The TEDAS project provides a nationwide epidemiological profile of recreational drug use in Taiwan. More than half of the recreational drugs were NPSs, which were comprehensively detected using LC-MS/MS.
Least Square SVM Regression Method Based on Sliding Time Window and Its Simulation

This paper introduced a least square SVM (LS SVM) regression method based on sliding time window. In this method, a sliding time window is built and data in the sliding time window are employed to construct the dynamic model of a system. The model of the system is refreshed on-line with the rolling of the time window. Different weights are assigned to the data in sliding time window in order to richly exploit the data information. The method was employed to construct soft sensor model, which is applied to the estimation of the frozen point of light diesel oil. The effective result indicates that the proposed method is a powerful method for the modeling.
Computerized adaptive testing of symptom severity: a registry-based study of 924 patients with trapeziometacarpal arthritis

We aimed to develop a computerized adaptive testing (CAT) version of the 11 item Patient Evaluation Measure (PEM), using an item response theory model. This model transformed the ordinal scores into ratio-interval scores. We obtained PEM responses from 924 patients with trapeziometacarpal osteoarthritis to build a CAT model and tested its performance on a simulated cohort of 1000 PEM response sets. The CAT achieved high precision (median standard error or measurement 0.26) and reduced the number of questions needed for accurate scoring from 11 to median two. The CAT scores and item-response-theory-based 15-item PEM scores were similar, and a Bland–Altman analysis demonstrated a mean score difference of 0.2 between the CAT and the full-length PEM scores on a scale from 0 to 100. We conclude that the CAT substantially reduced the burden of the PEM while also harnessing the validity of item response theory scoring.
Community-level characteristics of COVID-19 vaccine hesitancy in England: A nationwide cross-sectional study

One year after the start of the COVID-19 vaccination programme in England, more than 43 million people older than 12 years old had received at least a first dose. Nevertheless, geographical differences persist, and vaccine hesitancy is still a major public health concern; understanding its determinants is crucial to managing the COVID-19 pandemic and preparing for future ones. In this cross-sectional population-based study we used cumulative data on the first dose of vaccine received by 01-01-2022 at Middle Super Output Area level in England. We used Bayesian hierarchical spatial models and investigated if the geographical differences in vaccination uptake can be explained by a range of community-level characteristics covering socio-demographics, political view, COVID-19 health risk awareness and targeting of high risk groups and accessibility. Deprivation is the covariate most strongly associated with vaccine uptake (Odds Ratio 0.55, 95%CI 0.54–0.57; most versus least deprived areas). The most ethnically diverse areas have a 38% (95%CI 36–40%) lower odds of vaccine uptake compared with those least diverse. Areas with the highest proportion of population between 12 and 24 years old had lower odds of vaccination (0.87, 95%CI 0.85–0.89). Finally increase in vaccine accessibility is associated with higher COVID-19 uptake (OR 1.07, 95%CI 1.03–1.12). Our results suggest that one year after the start of the vaccination programme, there is still evidence of inequalities in uptake, affecting particularly minorities and marginalised groups. Strategies including prioritising active outreach across communities and removing practical barriers and factors that make vaccines less accessible are needed to level up the differences.
Clinicopathologic Factors Associated With Reversion to Normal Cognition in Patients With Mild Cognitive Impairment

Background and Objectives To identify clinicopathologic factors contributing to mild cognitive impairment (MCI) reversion to normal cognition. Methods We analyzed 3 longitudinal cohorts in this study: the Mayo Clinic Study of Aging (MCSA), the Religious Orders Study and Memory and Aging Project (ROSMAP), and the National Alzheimer's Coordinating Center (NACC). Demographic characteristics and clinical outcomes were compared between patients with MCI with or without an experience of reversion to normal cognition (referred to as reverters and nonreverters, respectively). We also compared longitudinal changes in cortical thickness, glucose metabolism, and amyloid and tau load in a subcohort of reverters and nonreverters in MCSA with MRI or PET imaging information from multiple visits. Results We identified 164 (56.4%) individuals in MCSA, 508 (66.8%) individuals in ROSMAP, and 280 (34.1%) individuals in NACC who experienced MCI reversion to normal cognition. Cox proportional hazards regression models showed that MCI reverters had an increased chance of being cognitively normal at the last visit in MCSA (HR 3.31, 95% CI 2.14–5.12), ROSMAP (HR 3.72, 95% CI 2.50–5.56), and NACC (HR 9.29, 95% CI 6.45–13.40) and a reduced risk of progression to dementia (HR 0.12, 95% CI 0.05–0.29 in MCSA; HR 0.41, 95% CI 0.32–0.53 in ROSMAP; and HR 0.29, 95% CI 0.21–0.40 in NACC). Compared with MCI nonreverters, reverters had better-preserved cortical thickness (β = 0.082, p <0.001) and glucose metabolism (β = 0.119, p = 0.001) and lower levels of amyloid, albeit statistically nonsignificant (β = −0.172, p = 0.090). However, no difference in tau load was found between reverters and nonreverters (β = 0.073, p = 0.24). Discussion MCI reversion to normal cognition is likely attributed to better-preserved cortical structure and glucose metabolism.
EUS-guided radiofrequency and ethanol ablation for pancreatic neuroendocrine tumors: A systematic review and meta-analysis

EUS-guided radiofrequency ablation (RFA) and ethanol ablation (EA) for pancreatic neuroendocrine tumors (PNETs) have recently been reported with good outcomes. We performed a systematic review and meta-analysis to evaluate the comparative effectiveness and safety of EUS-RFA and EUS-EA in the treatment of PNETs. A comprehensive search of multiple databases (through October 2020) was performed to identify studies that reported outcomes of EUS-RFA and EUS-EA of PNETs. Outcomes assessed included clinical success, technical success, and adverse events (AEs). A total of 181 (100 EUS-RFA, 81 EUS-EA) patients (60.7 ± 9.2 years) with 204 (113 EUS-RFA, 91 EUS-EA) PNETs (mean size 15.1 ± 4.7 mm) were included from 20 studies. There was no significant difference in the rates of technical success (94.4% [95% confidence interval (CI): 88.5–97.3, I2 = 0] vs. 96.7% [95% CI: 90.8–98.8, I2 = 0]; P = 0.42), clinical success (85.2% (95% CI: 75.9–91.4, I2 = 0) vs. 82.2% [95% CI: 68.2–90.8, I2 = 10.1]; P = 0.65), and AEs (14.1% [95% CI: 7.1–26.3, I2 = 0] vs. 11.5% [95% CI: 4.7–25.4, I2 = 63.5]; P = 0.7) between EUS-RFA and EUS-EA, respectively. The most common AE was pancreatitis with the rate of 7.8% and 7.6% (P = 0.95) for EUS-RFA and EUS-EA, respectively. On meta-regression, the location of PNETs in head/neck of pancreas (P = 0.03) was a positive predictor of clinical success for EUS-RFA. EUS-RFA and EUS-EA have similar effectiveness and safety for PNETs ablation. Head/neck location of PNETs was a positive predictor for clinical success after EUS-RFA.
Evaluation of End Tidal Carbon Dioxide Values in Intubated Patients with COVID-19

Background: The aim of this study is to establish the value of PETCO2 in COVID-19 patients intubated in emergency department, and its effects on mortality. Objectives: Between May 15, 2020 and January 15, 2021, The patients aged ≥18 years and diagnosed COVID-19, scheduled for urgent intubation in the emergency department were included. Method: Single-center, prospective and observational study. Age, gender, vital signs, laboratory findings are recorded. Immediately after intubation as measured by the capnography, the initial PETCO2_1 and at post-ventilation 15 min, PETCO2_2 and first, second arterial blood gas analysis are recorded. Results: The mean age of the 48 patients was 74 years. The PETCO2_1 and PETCO2_2 measurements were statistically significantly different between the patients who survived and those who died (p=0.014, p=0.015). The patients with a high first PETCO2_1 value and a decrease to the normal level survived, but those with a low PETCO2_1 value that could not increase to a normal value died (p=0.038, p=0.031). Increased levels of SpO2, PETCO2_1, PETCO2_2 and PaCO2_2 decreased the risk of mortality, while an increased level of PaO2_2 increased the risk of mortality. Conclusion: Capnography is non-invasive and provides continuous measurement. Assessment of changes in PETCO2 value would contribute to patient survival. (www.actabiomedica.it)
Complications and safety analysis of diagnostic bronchoscopy in COPD: a systematic review and meta-analysis

ABSTRACT Background Chronic obstructive pulmonary disease (COPD) often coexists with many diseases that require bronchoscopy. We conducted this systematic review and meta-analysis to assess the safety and complication rate of diagnostic bronchoscopy in patients with COPD. Methods We retrieved clinical trials that reporting the complications of conducting diagnostic bronchoscopy on patients with COPD through electronic databases. Analyses of the overall major complication rate of bronchoscopy and potential risk factors in patients with COPD were conducted. Results 18 trials/arms were evaluated. The overall major complication rate of bronchoscopy was 4.3% (95% CI, 2.2%-8.2%; 18 trials/arms, n = 2000). The major complication rate of the patients with an exacerbation of COPD was higher than that of the stable patients (7.8% vs. 4.5%, Q-value = 11.29, df (Q) = 1, p < 0.01); using of sedative medicine was also related with higher major complication rate (Q-value = 6.303, df (Q) = 2, p = 0.043). Patients with severe COPD who were GOLD stages III and IV (Q = 13.40, df = 1, p < 0.01; R2 = 0.66) or had a high BMI (Q = 30.83, df = 1, p < 0.01; R2 = 0.91) more easily encountered complications during bronchoscopy. Conclusions The major complication rate of diagnostic bronchoscopy in patients with COPD was acceptable and low Exacerbations of COPD and using sedative medicine were related with higher major complication rate. Expert opinion COPD is a major risk factor for lung cancer and infection, so the patients with COPD often required bronchoscopy. Although our results showed diagnostic bronchoscopy might not be more fatal for patients with COPD, further studies are needed to explore the potential risk factors for major complications of bronchoscopy in patients with COPD.