Miracle-dz/UniFAR-FTUs huggingface dataset:
Olfactory Dysfunction

Abstract Olfactory disorders may be observed together with cognitive impairment in patients with major depressive disorder (MDD). This study compared olfactory performances between patients with MDD and healthy controls and investigated the relationship between olfactory performance and subjective cognitive impairment in these patients. This study included 52 patients diagnosed with MDD and 46 healthy controls. The participants were evaluated in terms of their olfactory capacities (threshold, discrimination, and identification), subjective cognitive impairment, and depression. Although the olfactory threshold (OT) and olfactory discrimination scores were lower in patients with MDD compared with those in the control group, their olfactory identification scores did not differ significantly. OT was negatively correlated with subjective cognitive impairment and may serve as a determinant for subjective cognitive changes. Consequently, patients with MDD had lower olfactory performances compared with healthy controls. Finally, OT may be a component of subjective cognitive impairment in MDD.
Bio-clinical evaluation of collateral score in acute middle cerebral artery occlusion

Background/aim Acute ischemic stroke (AIS) is characterized as a neurological deficit owing to an acute focal damage to the brain by cerebral infarction. A collateral score is the most significant factor evaluating the prognosis of AIS, its relationship with demographic data, serum biochemical parameters, and clinical disability in this field. Materials and methods We conducted a single-center retrospective study with 100 patients with AIS within the first 6 h of ischemic stroke. Data for consecutive AIS patients were collected from February 2019 to May 2020. The collateral score was assessed by using developed scoring systems defined by Maas et al. The correlations between collateral score and demographic data, biochemical parameters, NIHSS scores (National Institutes of Health Stroke Scale), mRS (modified Rankin scale) scores were recorded. Results The research was performed in 100 patients (median age, 71.55 ± 11.46 years), and there was a statistically significant difference between elevated erythrocyte distribution width (RDW) and Maas collateral score (insular cortex) (p = 0.024) and lymphocyte/monocyte ratio (LMO) and Maas collateral (leptomeningeal) score (p = 0.025). Conclusion In patients with acute MCA M1 occlusion, our analysis found a significant association between elevated RDW, low LMO parameters, and collateral score. We assume that, in terms of simple and quick usability in acute stroke prognosis, these parameters are useful and functional as a new biomarker.
The Ambassador Project: Evaluating a Five-Year Nationwide Leadership Program to Bridge the gap Between Policy and District Nursing Practice

District nurses have a crucial position in healthcare provision and are expected to use leadership practices to ensure optimal quality patient care. To better equip them, a leadership program named the ambassador project was developed to support the development of a liaison role between policy and district nursing practice. This research aims to evaluate from different perspectives the impact of this nationwide, five-year leadership program for district nurses at the organizational, regional, and societal levels. A mixed-methods study was conducted using two focus groups based on peer-to-peer shadowing (n = 14), semistructured interviews (n = 13), and an online questionnaire (n = 45). The analysis shows that the impact of a nationwide leadership program for district nurses was perceived as predominantly positive, and nurses experienced an increase in courage, assertiveness, professional pride, and leadership skills. They obtained confidence in representing the group of district nurses at the organizational, regional, and societal levels when speaking with various key stakeholders from the healthcare system. They were able to bridge the gaps among daily practice, policymaking, and politics by using translations and shaping actions and information into terms suiting the needs of those involved.
Microscopic and transcriptomic analyses of Dalbergoid legume peanut reveal a divergent evolution leading to Nod Factor dependent epidermal crack-entry and terminal bacteroid differentiation.

Root nodule symbiosis (RNS) is the pillar behind sustainable agriculture and plays a pivotal role in the environmental nitrogen cycle. Most of the genetic, molecular, and cell-biological knowledge on RNS come from model legumes that exhibit a root-hair mode of bacterial infection in contrast to the Dalbergoid legumes exhibiting crack-entry of rhizobia. As a step towards understanding this important group of legumes, we have combined microscopic analysis and temporal transcriptome to obtain a dynamic view of plant gene expression during Arachis hypogaea (peanut) nodule development. We generated a comprehensive transcriptome data by mapping the reads to A. hypogaea, and two diploid progenitor genomes. Additionally, we performed BLAST searches to identify nodule-induced yet-to-be annotated peanut genes. Comparison between peanut, Medicago truncatula, Lotus japonicus, and Glycine max showed upregulation of 61 peanut orthologs among 111 tested known RNS-related genes, indicating conservation in mechanisms of nodule development among members of the Papilionoid family. Unlike model legumes, recruitment of class 1 phytoglobin derived symbiotic hemoglobin (SymH) in peanut indicates diversification of oxygen scavenging mechanisms in the Papilionoid family. Finally, absence of cysteine-rich motif-1 containing-NCRs, but the recruitment of defensin like NCRs suggest a diverse molecular mechanism of terminal bacteroid differentiation. In summary, our work describes genetic conservation and diversification in legume-rhizobial symbiosis in the Papilionoid family, as well as among members of the Dalbergoid legumes.
Does Chronic Kidney Disease Affect the Surgical Outcome and Prognosis of Patients with Gastric Cancer? A Meta-Analysis

Abstract Purpose: The purpose of this meta-analysis was to evaluate the impact of chronic kidney disease on short-term complications and long-term survival in patients with gastric cancer. Methods: The PubMed, Embase, and Cochrane Library databases were searched from inception to May 18, 2021. The search strategy focused on two keywords: chronic kidney disease and gastric cancer. Pooled odds ratios, mean differences, and hazard ratios were analyzed. RevMan 5.3 was used for data analysis in this meta-analysis. Results: A total of seven studies including 3,346 patients were included in this meta-analysis. The chronic kidney disease group had a higher proportion of males and older patients, lower albumin levels, higher comorbidity rates, and higher N staging. The chronic kidney disease group had higher rates of overall postoperative complications (OR = 2.05, 95% CI = 1.38 to 3.05, P = 0.0004), more severe postoperative complications (OR = 2.06, 95% CI = 1.59 to 2.66, P < 0.00001), and higher rates of cardiovascular-related complications, anastomotic leakage, pneumonia, wound infections, pancreatic-related diseases and short-term death. Furthermore, the chronic kidney disease group had poorer overall survival than the nonchronic kidney disease group (HR = 2.89, 95% CI = 2.20 to 3.80, P < 0.00001). Conclusion: Preexisting chronic kidney disease was associated with higher complications and poorer overall survival following gastrectomy in patients with gastric cancer.
Metabolic engineering of Saccharomyces cerevisiae for hydroxytyrosol overproduction directly from glucose

Hydroxytyrosol (HT) is one of the most powerful dietary antioxidants with numerous applications in different areas, including cosmetics, nutraceuticals and food. In the present work, heterologous hydroxylase complex HpaBC from Escherichia coli was integrated into the Saccharomyces cerevisiae genome in multiple copies. HT productivity was increased by redirecting the metabolic flux towards tyrosol synthesis to avoid exogenous tyrosol or tyrosine supplementation. After evaluating the potential of our selected strain as an HT producer from glucose, we adjusted the medium composition for HT production. The combination of the selected modifications in our engineered strain, combined with culture conditions optimization, resulted in a titre of approximately 375 mg l−1 of HT obtained from shake‐flask fermentation using a minimal synthetic‐defined medium with 160 g l−1 glucose as the sole carbon source. To the best of our knowledge, this is the highest HT concentration produced by an engineered S. cerevisiae strain.
Updated Competency Model for Professional Rehabilitation Nursing: Practice Applications

Abstract Background The Competency Model for Professional Rehabilitation Nursing is a lens through which nurses can view their practice; the four domains provide a template that guides that practice. Purpose The aim of this study was to describe a task force’s review procedures and share the updated model. Appraisal Process A rehabilitation nursing task force appraised the model over the course of 1 year. Revision Outcomes The original four domains remain, with wording changes for content and clarity throughout. Notable changes include (1) new competency for Domain 1 that focuses on the understanding of the worldview of individuals who are culturally different and (2) case stories for each domain related to nurses’ proficiency (beginner, intermediate, and expert). Clinical Relevance This updated model can be used to explicate the rehabilitation nurses’ role on intra/interprofessional teams, as well as provide a framework for education and staff orientation/performance evaluation. Conclusion This competency model reflects the current practice and advances of the specialty practice of rehabilitation nursing.
Improvement in executive function for older adults through smartphone apps: a randomized clinical trial comparing language learning and brain training

ABSTRACT Bilingualism has been linked to improved executive function and delayed onset of dementia, but it is unknown whether similar benefits can be obtained later in life through deliberate intervention. Given the logistical hurdles of second language acquisition in a randomized trial for older adults, few interventional studies have been done thus far. However, recently developed smartphone apps offer a convenient means to acquire skills in a second language and can be compared with brain training apps specifically designed to improve executive function. In a randomized clinical trial, 76 adults aged 65–75 were assigned to either 16 weeks of Spanish learning using the app Duolingo 30 minutes a day, an equivalent amount of brain training using the app BrainHQ, or a waitlist control condition. Executive function was assessed before and after the intervention with preregistered (NCT03638882) tests previously linked to better performance in bilinguals. For two of the primary measures: incongruent Stroop color naming and 2-back accuracy, Duolingo provided equivalent benefits as BrainHQ compared to a control group. On reaction time for N-back and Simon tests, the BrainHQ group alone experienced strong gains over the other two groups. Duolingo was rated as more enjoyable. These results suggest that app-based language learning may provide some similar benefits as brain training in improving executive function in seniors but has less impact on processing speed. However, future advancements in app design may optimize not only the acquisition of the target language but also the side benefits of the language learning experience.
Creation of a Novel Hands-on Model to Teach Breast Tanner Staging to Pediatric Learners

Introduction Pubertal Tanner staging is a standard part of the pediatric physical examination and provides valuable insight into a child's growth and development. In practice, pediatric care practitioners have varying levels of confidence and expertise with Tanner staging. Currently, breast Tanner staging is taught via illustrated images or limited hands-on practice on real patients during pediatric residency training. Methods We used synthetic materials to develop a lifelike, 3-dimensional, hands-on educational tool aimed at teaching medical students and pediatric resident physicians how to identify and distinguish among the 5 breast Tanner stages. This tool was evaluated by a group of experienced pediatric endocrinologists. Results Thirty pediatric endocrinologists with an average of 16.7 years of clinical experience evaluated the model, and all participants believed the model was a valuable teaching tool for medical students and pediatric resident physicians. Tanner stages 1, 2, 3, 4, and 5 were correctly identified by 100%, 93%, 90%, 100%, and 73% of participants, respectively. Conclusions We show that the use of a synthetic, 3-dimensional, lifelike breast model to teach breast Tanner staging may be valuable within the context of pediatric medical education. Further refinement of the model as well as curriculum development and evaluation is necessary before broadly disseminating this model as an educational tool.
Three-Dimensional Printing Assisted Preoperative Surgical Planning for Cerebral Arteriovenous Malformation

Objective The aim of this study to investigate the benefits of patient-based 3-dimensional (3D) cerebral arteriovenous malformation (AVM) models for preoperative surgical planning and education. Methods Fifteen patients were operated on for AVMs between 2015 and 2019 with patient-based 3D models. Ten patients’ preoperative cranial angiogram screenings were evaluated preoperatively or perioperatively via patient-based 3D models. Two patients needed emergent surgical intervention; their models were solely designed based on their AVMs and used during the operation. However, the other patients who underwent elective surgery had the modeling starting from the skull base. These models were used both preoperatively and perioperatively. The benefits of patients arising from treatment with these models were evaluated via patient files and radiological data. Results Fifteen patients (10 males and five females) between 16 and 66 years underwent surgery. The mean age of the patients was 40.0±14.72. The most frequent symptom patients observed were headaches. Four patients had intracranial bleeding; the symptom of admission was a loss of consciousness. Two patients (13.3%) belonged to Spetzler-Martin (SM) grade I, four (26.7%) belonged to SM grade II, eight (53.3%) belonged to SM grade III, and one (6.7%) belonged to SM grade IV. The mean operation duration was 3.44±0.47 hours. Three patients (20%) developed transient neurologic deficits postoperatively, whereas three other patients died (20%). Conclusion Several technological innovations have emerged in recent years to reduce undesired outcomes and support the surgical team. For example, 3D models have been employed in various surgical procedures in the last decade. The routine usage of patient-based 3D models will not only support better surgical planning and practice, but it will also be useful in educating assistants and explaining the situation to the patient as well.
Exploration of Machine Learning and Statistical Techniques in Development of a Low-Cost Screening Method Featuring the Global Diet Quality Score for Detecting Prediabetes in Rural India

ABSTRACT Background The prevalence of type 2 diabetes has increased substantially in India over the past 3 decades. Undiagnosed diabetes presents a public health challenge, especially in rural areas, where access to laboratory testing for diagnosis may not be readily available. Objectives The present work explores the use of several machine learning and statistical methods in the development of a predictive tool to screen for prediabetes using survey data from an FFQ to compute the Global Diet Quality Score (GDQS). Methods The outcome variable prediabetes status (yes/no) used throughout this study was determined based upon a fasting blood glucose measurement ≥100 mg/dL. The algorithms utilized included the generalized linear model (GLM), random forest, least absolute shrinkage and selection operator (LASSO), elastic net (EN), and generalized linear mixed model (GLMM) with family unit as a (cluster) random (intercept) effect to account for intrafamily correlation. Model performance was assessed on held-out test data, and comparisons made with respect to area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Results The GLMM, GLM, LASSO, and random forest modeling techniques each performed quite well (AUCs >0.70) and included the GDQS food groups and age, among other predictors. The fully adjusted GLMM, which included a random intercept for family unit, achieved slightly superior results (AUC of 0.72) in classifying the prediabetes outcome in these cluster-correlated data. Conclusions The models presented in the current work show promise in identifying individuals at risk of developing diabetes, although further studies are necessary to assess other potentially impactful predictors, as well as the consistency and generalizability of model performance. In addition, future studies to examine the utility of the GDQS in screening for other noncommunicable diseases are recommended.
Virtual and augmented reality: New tools for visualizing, analyzing, and communicating complex morphology

Virtual and augmented reality (VR/AR) are new technologies with the power to revolutionize the study of morphology. Modern imaging approaches such as computed tomography, laser scanning, and photogrammetry have opened up a new digital world, enabling researchers to share and analyze morphological data electronically and in great detail. Because this digital data exists on a computer screen, however, it can remain difficult to understand and unintuitive to interact with. VR/AR technologies bridge the analog‐to‐digital divide by presenting 3D data to users in a very similar way to how they would interact with actual anatomy, while also providing a more immersive experience and greater possibilities for exploration. This manuscript describes VR/AR hardware, software, and techniques, and is designed to give practicing morphologists and educators a primer on using these technologies in their research, pedagogy, and communication to a wide variety of audiences. We also include a series of case studies from the presentations and workshop given at the 2019 International Congress of Vertebrate Morphology, and suggest best practices for the use of VR/AR in comparative morphology.
Exploring Hidden Issues in the Use of Antipsychotic Polypharmacy in the Treatment of Schizophrenia

The mainstay of schizophrenia treatment is pharmacological therapy using various antipsychotics including first- and second-generation antipsychotics which have different pharmacokinetic and pharmacodynamic property leading to differential presentation of adverse events (AEs) and treatment effects such as negative symptoms, cognitive symptoms and cormorbid symptoms. Major treatment guidelines suggest the use of antipsychotic monotherapy (APM) as a gold standard in the treatment of schizophrenia. However, the effects of APM is inadequate and less potent to achieve symptom remission as well as functional recovery in real practice which has been consistently reported in numerous controlled clinical trials, large practical trials, independent small studies and systematic reviews till today. Therefore antipsychotic polypharmacy (APP) regardless of the class of antipsychotics has been also commonly utilized for many reasons in real world practice. However, APP has also crucial pitfalls including increase of total psychotics including antipsychotics, high-doses of antipsychotics used, poor compliance, drug-drug interaction and risks for developing AEs, all of which are paradoxically related to poor clinical outcomes, whereas APP has also substantial advantages in reduction of re-hospitalization, severe psychopathology and targeted control of concurrent symptoms. Given currently limited therapeutic options, it is also important to properly utilize APP in order to maximize its clinical utility and minimize its risk for better treatment outcomes for patients with schizophrenia, based on risk/benefit with full understanding of pharmacological and clinical issues on APP. The present paper intends to address intriguing and important issues in the use of APP in real world practice.
Six Days of Low Carbohydrate, Not Energy Availability, Alters the Iron and Immune Response to Exercise in Elite Athletes

ABSTRACT Purpose To quantify the effects of a short-term (6-d) low carbohydrate (CHO) high fat (LCHF), and low energy availability (LEA) diet on immune, inflammatory, and iron-regulatory responses to exercise in endurance athletes. Methods Twenty-eight elite male race walkers completed two 6-d diet/training phases. During phase 1 (Baseline), all athletes consumed a high CHO/energy availability (CON) diet (65% CHO and ~40 kcal·kg−1 fat-free mass (FFM)·d−1). In phase 2 (Adaptation), athletes were allocated to either a CON (n = 10), LCHF (n = 8; <50 g·d−1 CHO and ~40 kcal·kg−1·FFM−1·d−1), or LEA diet (n = 10; 60% CHO and 15 kcal·kg−1·FFM−1·d−1). At the end of each phase, athletes completed a 25-km race walk protocol at ~75% V˙O2max. On each occasion, venous blood was collected before and after exercise for interleukin-6, hepcidin, cortisol, and glucose concentrations, as well as white blood cell counts. Results The LCHF athletes displayed a greater IL-6 (P = 0.019) and hepcidin (P = 0.011) response to exercise after Adaptation, compared with Baseline. Similarly, postexercise increases in total white blood cell counts (P = 0.026) and cortisol levels (P < 0.001) were larger compared with Baseline after LCHF Adaptation. Decreases in blood glucose concentrations were evident postexercise during Adaptation in LCHF (P = 0.049), whereas no change occurred in CON or LEA (P > 0.05). No differences between CON and LEA were evident for any of the measured biological markers (all P > 0.05). Conclusions Short-term adherence to a LCHF diet elicited small yet unfavorable iron, immune, and stress responses to exercise. In contrast, no substantial alterations to athlete health were observed when athletes restricted energy availability compared with athletes with adequate energy availability. Therefore, short-term restriction of CHO, rather than energy, may have greater negative impacts on athlete health.
Eating and Physical Activity Patterns in Day and Night Shift EMS Clinicians

Abstract Objective: EMS clinicians work in shifts to provide 24-hour care. Shift work is linked with metabolic disease and over 70% of EMS clinicians report having overweight or obesity. Inability to store food in their vehicles combined with limited overnight dining establishments, and unpredictable job demands leads to reliance on convenience and fast foods. The objective of this study was to describe the eating and physical activity patterns among EMS clinicians on days on and off shift. Methods: EMS clinicians throughout the United States participated in a study involving four 24-hour monitoring periods. Participants wore activity monitors to measure physical activity level and remote food photography was used to collect dietary data on two work days and two days off. Repeated measures analysis of variance was conducted to compare energy and macronutrient intake and activity levels in day and night workers on and off shift. Results: We analyzed data from 39 EMS clinicians (29.7 + 8.5yrs old). Controlling for sex, those working night shifts consumed more kilocalories (p=.037) and total fat (p=.043) compared to day shift workers. Night shift workers had fewer steps (p = 0.045), more sedentary time (p = 0.053), and less moderate activity (p = 0.037) during a shift compared to day workers. Conclusion: Among EMS clinicians, night shift is associated with greater energy intake, and decreased physical activity during shifts. This may contribute to positive energy balance and weight gain overtime, increasing risk for metabolic disease.