Miracle-dz/UniFAR-FTUs huggingface dataset:
An Exploratory Qualitative Study of Computer Screening to Support Decision-Making about Use of Palliative Care Registers in Primary Care: GP Think Aloud and Patient and Carer Interviews

Objectives: This study aimed to understand factors that influence general practitioner (GP) use of automated computer screening to identify patients for the palliative care register (PCR) and the experiences of palliative care and this emerging technology from patients’ and carers’ perspectives. Methods: A computer screening program electronically searches primary care records in routine clinical practice to identify patients with advanced illness who are not already on a PCR. Five GPs were asked to “think aloud” about adding patients identified by computer screening to the PCR. Key informant interviews with 6 patients on the PCR and 4 carers about their experiences of palliative care while on the PCR and their views of this technology. Data were analyzed thematically. Results and Conclusions: Using computer screening, 29% additional patients were added by GPs to the PCR. GP decision-making for the PCR was informed by clinical factors such as: if being treated with curative intent; having stable or unstable disease; end-stage disease, frailty; the likelihood of dying within the next 12 months; and psychosocial factors such as, age, personality, patient preference and social support. Six (60%) patients/carers did not know that they/their relative was on the PCR. From a patient/carer perspective, having a non-curative illness was not in and of itself sufficient reason for being on the PCR; other factors such as, unstable disease and avoiding pain and suffering were equally if not more, important. Patients and carers considered that computer screening should support but not replace, GP decision-making about the PCR. Computer screening merits ongoing development as a tool to aid clinical decision-making around entry to a PCR, but should not be used as a sole criterion. Care need, irrespective of diagnosis, disease trajectory or prognosis, should determine care.
Rest-activity daily rhythm and physical activity levels after hip and knee joint replacement: the role of actigraphy in orthopedic clinical practice

ABSTRACT Elective hip and knee joint replacement for osteoarthritis are cost-effective surgical procedures requiring specific rehabilitation programs. Actigraphy is widely used in both research and clinical practice to study activity patterns with great accuracy and validity but it has never been utilized in orthopedic patients. Therefore, the aim of this study was to objectively assess, through actigraphy, physical activity (PA) levels and rest-activity daily rhythm (RAR) in patients undergoing hip or knee joint replacement and hospitalized for ten days after surgery. Twenty subjects (11 males and 9 females; age: 62.68 ± 10.39 years old; BMI: 29.03 ± 3.92 kg/m2) wore the Actiwatch 2 actigraph (Philips Respironics, Portland, OR) to record both PA levels and RAR for 11 consecutive days and data on subjective scores of pain, by a visual analog scale (VAS), and functional and clinical scores were collected. The following time-points were considered for the statistical analysis: pre-surgery (PRE), the first (POST1), the fourth (POST4) and the tenth (POST10) day after surgery. RAR were processed with the population mean cosinor to describe the rhythm’s characteristics (acrophase, amplitude and MESOR) while data on actigraphy-based PA, VAS, and functional clinical scores were compared among PRE, POST1, POST4 and POST 10 with the RM-ANOVA or the non-parametric Friedman test. The day after surgery the subjects had a flattened RAR compared to the other conditions: lower values were detected in POST1 compared to both PRE, POST4 and POST10 for MESOR (p < .0001; η2 p = .71, large) and amplitude (p < .0001; η2 p = .63, large) while RAR’s acrophase (p < .0001; η2 p = .61, large) was delayed in PRE (16:45) compared to POST1 (12:42), POST4 (14:38), and POST10 (14:38). PA levels were significantly lower at POST 1 (76.7 ± 33.4) compared to PRE (192.3 ± 91.5; p < .0001 and ES: 1.68, large), POST4 (137.9 ± 45.9; p < .0001 and ES: 1.54, large), and POST10 (131.2 ± 54.3; p < .0001 and ES: 1.21, large) whereas VAS and functional clinical values significantly improved at POST10. Hip and knee joint replacement negatively influenced RAR and PA the first day after surgery but a progressive improvement in the circadian pattern of rest-activity cycle, PA levels, VAS and functional ability was recorded from POST4 to POST10. Actigraphy has the ability to collect real-life data without interfering with clinical practice and give clinicians a new measure of performance that is currently not available. This tool could allow to identify patients with disrupted circadian rhythm and reduced PA in the peri-operative period in orthopedic surgery, and timely intervene on these subjects with personalized rehabilitative intervention.
Size Analysis of Small Metal Nanoparticles Using Single Particle ICP Mass Spectrometry

For size analysis of small nanoparticles (i.e., nanoparticles smaller than 10 nm) using spICP-MS, two approaches were employed to improve the signal-to-noise ratio of ion signals emanating from small nanoparticles. The first one was enhancement of the instrumental sensitivity using a desolvating system. The second approach was separation of the ion signals from background signals through a deconvolution method. A combination of these approaches enabled us to measure 5 nm gold nanoparticles, and the calculated size detection limit was 3.8 nm.
Changes in social, psychological and physical well-being in the last 5 years of life of older people with cancer: a longitudinal study

Abstract Background older people with cancer are at risk of complex and fluctuating health problems, but little is known about the extent to which their well-being changes in the last years of life. Objective to examine changes in physical, psychological and social well-being in the last 5 years of life of older people with cancer. Design prospective cohort study. Setting Belgium, the Netherlands. Participants people with a new primary diagnosis of breast, prostate, lung or gastrointestinal cancer, aged ≥70 years, life expectancy >6 months, were recruited from nine hospitals. We analysed data of deceased patients. Methods data were collected from participants around diagnosis, and after 6 months, 1, 3 and 5 years through structured questionnaires administered through interviews or as self-report. Outcomes were physical, emotional, social, role functioning (EORTC QLQ-C30), depressive symptoms (GDS-15), emotional and social loneliness (Loneliness Scale). We conducted linear mixed model analyses. Results analysing 225 assessments from 107 deceased participants (assessments took place between 1,813 and 5 days before death), mean age at baseline 77 years (standard deviation: 5.2), we found statistically significant deterioration in physical functioning (b = 0,016 [95%confidence interval 0.009–0.023]), depressive symptoms (b = −0,001 [−0.002 to 0.000]) and role functioning (b = 0.014 [0.004–0.024]). Changes over time in emotional and social functioning and in social and emotional loneliness were smaller and statistically non-significant. Conclusions care towards the end of life for older people with cancer needs to put their social and psychological well-being at the centre, alongside physical needs. Future research should focus on understanding inter-individual variation in trajectories.
Bicycling and Tricycling Road Race Performance in International Para-Cycling Events Between 2011 and 2019

Abstract This study described bicycling (C classes) and tricycling (T classes) performance in the International Cycling Federation road race events between 2011 and 2019. A total of 3243 race results from 33 events were analyzed. Race velocity was calculated for each result. Bicycling and tricycling data were separately modeled using a linear mixed-effects model. Bicycling velocity was statistically different between all adjacent men’s classes (Cohen d = 0.14–0.73) and between the women’s C1 and C2 (d = 1.15) and C3 and C4 (d = 0.48) classes. The absence of statistical differences between some women’s bicycling classes may be due to a limited number of observations in these classifications. As expected, velocity was statistically different between men’s (d = 1.64) and women’s (d = 1.38) T1 and T2 classes. Road race performance was hierarchical within the disciplines of bicycling and tricycling, although not all adjacent women’s bicycling classes were statistically different. The existence of a performance hierarchy does not necessarily validate the classification system. The integration of information regarding athlete impairment type and severity, with performance data, would provide greater insight into the validity of the classification system and should be prioritized as an area of future research.
Increased seminal root number associated with domestication improves nitrogen and phosphorus acquisition in maize seedlings

Abstract Background and Aims Domesticated maize (Zea mays ssp. mays) generally forms between two and six seminal roots, while its wild ancestor, Mexican annual teosinte (Zea mays ssp. parviglumis), typically lacks seminal roots. Maize also produces larger seeds than teosinte, and it generally has higher growth rates as a seedling. Maize was originally domesticated in the tropical soils of southern Mexico, but it was later brought to the Mexican highlands before spreading to other parts of the continent, where it experienced different soil resource constraints. The aims of this study were to understand the impacts of increased seminal root number on seedling nitrogen and phosphorus acquisition and to model how differences in maize and teosinte phenotypes might have contributed to increased seminal root number in domesticated maize. Methods Seedling root system architectural models of a teosinte accession and a maize landrace were constructed by parameterizing the functional–structural plant model OpenSimRoot using plants grown in mesocosms. Seedling growth was simulated in a low-phosphorus environment, multiple low-nitrogen environments, and at variable planting densities. Models were also constructed to combine individual components of the maize and teosinte phenotypes. Key Results Seminal roots contributed ~35 % of the nitrogen and phosphorus acquired by maize landrace seedlings in the first 25 d after planting. Increased seminal root number improved plant nitrogen acquisition under low-nitrogen environments with varying precipitation patterns, fertilization rates, soil textures and planting densities. Models suggested that the optimal number of seminal roots for nutrient acquisition in teosinte is constrained by its limited seed carbohydrate reserves. Conclusions Seminal roots can improve the acquisition of both nitrogen and phosphorus in maize seedlings, and the increase in seed size associated with maize domestication may have facilitated increased seminal root number.
Modular Synthesis of Chiral β-Diketiminato-TypeLigands Containing 2-Oxazoline Moiety via Palladium-CatalyzedAmination

A family of new chiral β-diketiminato-type ligands containingoxazoline moiety has been synthesized in moderate to high yields(typically 30-95%) via a Pd-catalyzed aminationreaction of chiral oxazolines with primary amines and amides. Notably,( S)- TERT-butylsulfinamidewas successfully incorporated into the ligand framework as a couplingpartner in amination. Due to the readily available pool of chiralbuilding blocks, this represents a facile and modular approach forsynthesizing libraries of novel chiral β-diketiminato-typeligands, with potential applications in asymmetric catalysis.
U.S. Genetic counselors’ perceptions of inpatient genetic counseling: A valuable model for medically complex patients

Some genetic counselors (GCs) provide care in the inpatient setting. However, there is little literature on inpatient genetic counseling. The purpose of our study was to describe GC’s experiences with the provision of genetic counseling services within inpatient care settings. Participants were recruited from respondents to a quantitative survey study on inpatient genetic counseling, which recruited GCs via the National Society of Genetic Counselors forum. GCs seeing at least five inpatients per year were invited to participate in semi‐structured interviews. The interview guide explored how and why their inpatient genetic counseling service started, workflow, and the perceived impact of the service. Interviews were transcribed, inductive analysis was used to develop a codebook, and thematic analysis was used to identify themes. Twenty‐one inpatient genetic counselors participated in the study. Many participants worked primarily in outpatient roles with some inpatient duties (61.9%), while the rest worked primarily in inpatient roles (38.1%). Most participants have provided inpatient care for <2 years (66.7%). Many participants were involved in inpatient care across multiple specialties (66.7%), most frequently, pediatrics, neonatology, and neurology. Three themes were identified: (a) The convenience of inpatient genetic counseling leads to increased access to appropriate genetics care for medically complex patients and their inpatient healthcare providers, (b) the inpatient genetic counseling process and workflow is not standard and has multiple moving parts, and (c) genetic counselors are fulfilled by the diverse and unique opportunities of the inpatient care setting despite the emotional intensity of this environment. Participants described their inpatient care as valuable because it increases access to genetics services and adds genetics expertise to multidisciplinary inpatient teams. Overall, participants perceive inpatient genetic counseling as a way to bring genetics care directly to patients at a critical time point in their care, which benefits medically complex patients and their multidisciplinary inpatient team.
Rewiring of Lactate–Interleukin-1β Autoregulatory Loop with Clock-Bmal1: a Feed-Forward Circuit in Glioma

A desynchronized circadian rhythm in tumors is coincident with aberrant inflammation and dysregulated metabolism. As their interrelationship in cancer etiology is largely unknown, we investigated the link among the three in glioma. ABSTRACT A desynchronized circadian rhythm in tumors is coincident with aberrant inflammation and dysregulated metabolism. As their interrelationship in cancer etiology is largely unknown, we investigated the link among the three in glioma. The tumor metabolite lactate-mediated increase in the proinflammatory cytokine interleukin-1β (IL-1β) was concomitant with elevated levels of the core circadian regulators Clock and Bmal1. Small interfering RNA (siRNA)-mediated knockdown of Bmal1 and Clock decreased (i) lactate dehydrogenase A (LDHA) and IL-1β levels and (ii) the release of lactate and proinflammatory cytokines. Lactate-mediated deacetylation of Bmal1 and its interaction with Clock regulate IL-1β levels and vice versa. Site-directed mutagenesis and luciferase reporter assays indicated the functionality of E-box sites on LDHA and IL-1β promoters. Sequential chromatin immunoprecipitation (ChIP–re-ChIP) revealed that lactate–IL-1β cross talk positively affects the corecruitment of Clock-Bmal1 to these E-box sites. Clock-Bmal1 enrichment was accompanied by decreased H3K9me3 and increased H3K9ac and RNA polymerase II (Pol II) occupancy. The lactate–IL-1β–Clock (LIC) loop positively regulated the expression of genes associated with the cell cycle, DNA damage, and cytoskeletal organization involved in glioma progression. TCGA (The Cancer Genome Atlas) data analysis suggested the presence of lactate–IL-1β cross talk in other cancers. The responsiveness of stomach and cervical cancer cells to lactate inhibition followed the same trend as that exhibited by glioma cells. In addition, components of the LIC loop were found to be correlated with (i) patient survival, (ii) clinically actionable genes, and (iii) anticancer drug sensitivity. Our findings provide evidence for potential cancer-specific axis wiring of IL-1β and LDHA through Clock-Bmal1, the outcome of which is to fuel an IL-1β–lactate autocrine loop that drives proinflammatory and oncogenic signals.
Cortical connectivity in the face of congenital structural changes—A case of homozygous LAMC3 mutation

The homozygous LAMC3 gene mutation is associated with severe bilateral smoothening and thickening of the lateral occipital cortex . Despite this and further significant changes in gray matter structure, a patient harboring this mutation exhibited a range of remarkably intact perceptual abilities . One possible explanation of this perceptual sparing could be that the white matter structural integrity and functional connectivity in relevant pathways remained intact. To test this idea, we used diffusion tensor and functional magnetic resonance imaging to investigate functional connectivity in resting‐state networks in major structural pathways involved in object perception and visual attention and corresponding microstructural integrity in a patient with homozygous LAMC3 mutation and sex, age, education, and socioeconomically matched healthy control group. White matter microstructural integrity results indicated widespread disruptions in both intra‐ and interhemispheric structural connections except inferior longitudinal fasciculus. With a few exceptions, the functional connectivity between the patient's adjacent gray matter regions of major white matter tracts of interest was conserved. In addition, functional localizers for face, object, and place areas showed similar results with a representative control, providing an explanation for the patient's intact face, place, and object recognition abilities. To generalize this finding, we also compared functional connectivity between early visual areas and face, place, and object category‐selective areas, and we found that the functional connectivity of the patient was not different from the control group. Overall, our results provided complementary information about the effects of LAMC3 gene mutation on the human brain including intact temporo‐occipital structural and functional connectivity that are compatible with preserved perceptual abilities.
Patients’ judgments of the importance of treatment-induced reductions in symptoms of depression: The role of specific symptoms, magnitudes of change, and post-treatment levels

Abstract Objective: An implicit assumption in the use of depressive severity measures to assess change during treatment, such as the Hamilton Rating Scale for Depression (HRSD), is that reductions from pre- to post-treatment that are equal to each other are of equal value. However, stakeholders' valuations of changes might depart substantially from this assumption. Method: Vignettes were constructed that reflected the six possible 1, 2, and 3-point reductions on five cognitive and four somatic symptoms derived from the HRSD. Former or currently depressed patients provided judgments of the importance of the symptom reductions. Mean importance ratings were modeled using symptom category and the pre/post-treatment combination. Differences were explored using the Tukey method. Results: Results indicated that mean ratings, from most to least important, were: Anxiety, Suicide, Depressed Mood, Work, and Guilt (the cognitive symptoms) followed by Somatic, Sleep, Appetite & Weight, and Retardation (the somatic symptoms). Participants valued reductions that resulted in posttreatment scores of zero more than expected, given the magnitude of the reductions. Conclusions: The value of reductions in symptoms captured by the HRSD, as judged by patients, appears to differ as a function of symptom category and the post-treatment score. Similar patterns might characterize other measures of depression severity.
XEN45 Gelstent Implantation in the Treatment of Glaucoma Secondary to Fuchs Uveitis Syndrome

ABSTRACT Purpose Evaluation of treatment efficacy of XEN45 gelstent for glaucoma secondary to Fuchs uveitis syndrome (FUS). Methods This retrospective case series evaluated patients with glaucoma secondary to FUS, who underwent XEN45 implantation. Complete success was defined as IOP lowering of ≥ 20% and cutoff IOP at 18 mmHg. Success was qualified if additional glaucoma medication was necessary. Additional glaucoma surgery except for needling and open bleb revision was regarded as failure. Results Twelve eyes of 12 patients were included. Qualified and complete success rates were 50% after one year (n = 10). Qualified success was achieved in 66.6% of patients with 33.3% of patients achieving complete success after two years (n = 6). Conclusions XEN45 implantation had some success in the treatment of glaucoma secondary to FUS, but needling was frequently necessary to improve outcome.
Ecological risk assessment of the effects of neonicotinoid insecticides on northern bobwhites (Colinus virginianus) in the South Texas Plains Ecoregion

Neonicotinoid insecticides are among the latest class of insecticides that can have harmful effects on birds. Approximately 30 000 kg of neonicotinoid insecticides are applied annually to 429 100 ha of row‐crop fields within the South Texas Plains Ecoregion, Texas, USA. Various studies have demonstrated that treated seeds can be highly toxic to northern bobwhites, with the consumption of only 20 corn seeds causing a fatality. Similarly, other studies have indicated that neonicotinoid insecticides can reduce arthropod populations—a substantial prey base for northern bobwhites, especially during the breeding season—by approximately 60%. Our objective was to conduct an ecological risk assessment of neonicotinoid insecticides' impact on northern bobwhite (Colinus virginianus) populations in the South Texas Plains Ecoregion. We estimated that juvenile and adult northern bobwhites could intake from 7.32 to 27.0 mg/kg/day and from 10.0 to 37.5 mg/kg/day of neonicotinoid insecticides, respectively, which can cause adverse effects on growth, reproductive output, and long‐term survival. Our study determined that the application of 30 000 kg of neonicotinoid insecticides annually in the South Texas Plains Ecoregion harms the region's northern bobwhite that are exposed to neonicotinoids. Integr Environ Assess Manag 2022;18:488‐499. © 2021 SETAC
Chemical constituents of two Cameroonian medicinal plants: Sida rhombifolia L. and Sida acuta Burm. f. (Malvaceae) and their antiplasmodial activity

Abstract An extensive phytochemical investigation of the EtOH/H2O (7:3) extracts of Sida rhombifolia L. and Sida acuta Burm. f. , yielded a previously undescribed ceramide named rhombifoliamide (1) and a xylitol dimer (2), naturally isolated here for the first time, as well as the thirteen known compounds viz, oleanolic acid (3), β-amyrin glucoside (4), ursolic acid (5), β-sitosterol glucoside (6), tiliroside (7), 1,6-dihydroxyxanthone (8), a mixture of stigmasterol (9) and β-sitosterol (10), cryptolepine (11), 20-Hydroxyecdysone (12), (E)-suberenol (13), thamnosmonin (14) and xanthyletin (15). Their structures were elucidated by the analyses of their spectroscopic and spectrometric data (1 D and 2 D NMR, and HRESI-MS) and by comparison with the previously reported data. The crude extracts, fractions, and some isolated compounds were tested against chloroquine-sensitive (3D7) and chloroquine-resistant (Dd2) Plasmodium falciparum strains. All the tested samples demonstrated moderate and/or significant activities against 3D7 (IC50 values: 0.18―20.11 µg/mL) and Dd2 (IC50 values: 0.74―63.09 µg/mL).