Miracle-dz/UniFAR-FTUs huggingface dataset:
Frailty assessment tools in the emergency department: A geriatric emergency department guidelines 2.0 scoping review

Abstract Objective Given the aging population and growing burden of frailty, we conducted this scoping review to describe the available literature regarding the use and impact of frailty assessment tools in the assessment and care of emergency department (ED) patients older than 60 years. Methods A search was made of the available literature using the Covidence system using various search terms. Inclusion criteria comprised peer‐reviewed literature focusing on frailty screening tools used for a geriatric population (60+ years of age) presenting to EDs. An additional search of PubMed, EBSCO, and CINAHL for articles published in the last 5 years was conducted toward the end of the review process (January 2023) to search specifically for literature describing interventions for frailty, yielding additional articles for review. Exclusion criteria comprised articles focusing on an age category other than geriatric and care environments outside the emergency care setting. Results A total of 135 articles were screened for inclusion and 48 duplicates were removed. Of the 87 remaining articles, 20 were deemed irrelevant, leaving 67 articles for full‐text review. Twenty‐eight were excluded for not meeting inclusion criteria, leaving 39 full‐text studies. Use of frailty screening tools were reported in the triage, care, and discharge decision‐making phases of the ED care trajectory, with varying reports of usefulness for clinical decision‐making. Conclusion The literature reports tools, scales, and instruments for identifying frailty in older patients at ED triage; multiple frailty scores or tools exist with varying levels of utilization. Interventions for frailty directed at the ED environment were scant. Further research is needed to determine the usefulness of frailty identification in the context of emergency care, the effects of care delivery interventions or educational initiatives for front‐line medical professionals on patient‐oriented outcomes, and to ensure these initiatives are acceptable for patients.
The ‘discontinuity hypothesis’ of depression in later life—clinical and research implications

Abstract The term depression is overused as an umbrella term for a variety of conditions, including depressed mood and various psychiatric disorders. According to psychiatric diagnostic criteria, depressive disorders impact nearly all aspects of human life and are a leading cause of disability worldwide. The widespread assumption that different types of depression lie on a continuum of severity has stimulated important research on subthreshold depression in later life. This view assumes that depressed mood is a precursor of a depressive disorder. The present narrative review argues why in later life depressed mood might either (i) lie on a continuum with depressive disorders among people vulnerable for a depressive disorder or (ii) be an ageing-related epiphenomenon of underlying physical illnesses in people who are resilient to depressive disorders (‘discontinuity hypothesis’). Three arguments are discussed. First, the course of depressed mood and depressive disorders differs across the life span. Second, screening instruments for depression have low predictive value for depressive disorders in later life. Third, a dose–response relationship has not been consistently found across different types of depression and detrimental health outcomes. Using the umbrella term depression may partly explain why pharmacological treatment is less effective with increasing age, and negative health-related outcomes might be overestimated. The discontinuity hypothesis may prevent pharmacological overtreatment of milder subtypes of depression and may stimulate comprehensive multidisciplinary assessment as well as the development of separate treatment algorithms for depressed mood and depressive disorders.
Gene expression signatures of stepwise progression of Hepatocellular Carcinoma

The molecular pathogenesis of Hepatocellular Carcinoma (HCC) is a complex process progressing from premalignant stages to cancer in a stepwise manner. Mostly, HCC is detected at advanced stages, leading to high mortality rates. Hence, characterising the molecular underpinnings of HCC from normal to cancer state through precancerous state may help in early detection and improve its prognosis and treatment. In this work, we analysed the transcriptomic profile of tumour and premalignant samples from HCC or chronic liver disease patients, who had undergone either total or partial hepatectomy. The normal samples from patients with metastatic cancer/polycystic liver disease/ cholangiocarcinoma were also included. A gene co-expression network approach was applied to identify hierarchical changes: modules, pathways, and genes related to different trajectories of HCC and patient survival. Our analysis shows that the progression from premalignant conditions to tumour is accompanied by differences in the downregulation of genes associated with HNF4A activity and the immune system and upregulation of cell cycle genes, bringing about variability in patient outcomes. However, an increase in immune and cell cycle activity is observed in premalignant samples. Interestingly, co-expression modules and genes from premalignant stages are associated with survival. THBD, a classical marker for dendritic cells, is a predictor of survival at the premalignant stage. Further, genes linked to microtubules, kinetochores, and centromere are altered in both premalignant and tumour conditions and are associated with survival. Our analysis revealed a three-way molecular axis of liver function, immune pathways, and cell cycle driving HCC pathogenesis.
Pathogen-driven nucleotide overload triggers mitochondria-centered cell death in phagocytes

Staphylococcus aureus is a dangerous pathogen that evolved refined immuno-evasive strategies to antagonize host immune responses. This involves the biogenesis of death-effector deoxyribonucleosides, which kill infectious foci-penetrating macrophages. However, the exact mechanisms whereby staphylococcal death-effector deoxyribonucleosides and coupled imbalances of intracellular deoxyribonucleotide species provoke immune cell death remain elusive. Here, we report that S. aureus systematically promotes an overload of deoxyribonucleotides to trigger mitochondrial rupture in macrophages, a fatal event that induces assembly of the caspase-9-processing apoptosome and subsequent activation of the intrinsic pathway of apoptosis. Remarkably, genetic disruption of this cascade not only helps macrophages coping with death-effector deoxyribonucleoside-mediated cytotoxicity but also enhances their infiltration into abscesses thereby ameliorating pathogen control and infectious disease outcomes in laboratory animals. Combined with the discovery of protective alleles in human CASP9, these data highlight the role of mitochondria-centered apoptosis during S. aureus infection and suggest that gene polymorphisms may shape human susceptibility toward a predominant pathogen.
How does subjective social status at school at the age of 15 affect the risk of depressive symptoms at the ages of 18, 21, and 28? A longitudinal study

Background Young people’s mental health is declining. Depression is a public disease which is increasing internationally, and in Denmark an increase is seen especially among young people. Objective social status is known to be associated with mental health and depression, but little is known about the association between adolescent subjective social status at school and depressive symptoms during young adulthood. The aim was to investigate the association between 15-year-old’s subjective social status at school and the development of depressive symptoms at age 18, 21 and 28. Methods The study is a longitudinal study using questionnaire data from The West Jutland Cohort Study Denmark. The study population consisted of adolescents who at baseline, at age 15 (2004), had answered questions about their subjective social status in school using the MacArthur scale-youth version. Answers were categorised into low, medium, and high subjective social status. Outcome data about depressive symptoms was collected at age 18 (2007), age 21 (2010) and age 28 (2017) using the CES-DC and CES-D scales, dichotomised into few or many depressive symptoms. The associations between subjective social status at school at age 15 and depressive symptoms at ages 18, 21 and 28 were analysed using multiple logistic regression. Results Statistically significant associations were found between low subjective social status at school at age 15 and the odds of many depressive symptoms at all three age points in young adulthood. When adjusting for co-variates the odds ratio for many depressive symptoms at age 18 was OR 3.34 [1.84;6.08], at age 21 OR 3.31 [1.75;6.26] and at age 28 OR 2.12 [1.13;3.97]. Conclusions The subjective social status of 15-year-olds is associated with depressive symptoms at ages 18, 21 and 28, respectively. It seems that subjective social status at age 15 is of greatest importance for the occurrence of depressive symptoms in the short run, and that the impact attenuates over time.
Height and number of shoots on the survival and development of micropropagated bamboo plantlets during pre-acclimatization

ABSTRACT During the in vitro multiplication of bamboo plantlets, it is common the formation of shoots aggregates. Once individualized, these can yield a greater number of plantlets than if planted in clusters. This study aimed to evaluate the effect of the relationship between height and number of initial shoots in micropropagated bamboo plantlets on the survival and development of plants, during the pre-acclimatization stage. Guadua aff. chaparensis shoots, after successive subcultures of in vitro multiplication, were classified into three height classes (2.5-5.0 cm; 5.1-10.0 cm; 10.1-15.0 cm) and number of aggregate shoots (one shoot per plantlet/single-stem plantlet, two and three shoots per plantlet) and pre-acclimatized in a commercial substrate composition plus washed sand. The plantlets were evaluated for survival, height, number of new shoots and roots, shoot and root fresh and dry mass. In plantlets from micropropagation, the plant height does not influence the survival rates, being acclimatized preferably at heights between 5.0 cm and 15.0 cm, with survival rates of up to 97 %. Plantlets with height starting at 5.1 cm and composed of 2 or 3 initial shoots show a greater vigor and ex vitro growth, a fact evidenced by the higher values obtained in relation to height and emission of new shoots and roots, as well as a greater fresh and dry biomass accumulation.
A new genus and three new species of Paranthrenini from tropical Africa (Lepidoptera: Sesiidae)

Abstract In this study, a new genus of African Paranthrenini, Fortikona Bartsch & Sáfián, gen. n. and three new species, Fortikona rhynchiformis Sáfián & Bartsch, sp. n. from Liberia, Fortikona aethiopica Bartsch & Sáfián, sp. n. from Guinea and Fortikona dalaba Sáfián & Bartsch, sp. n. from Ethiopia, are described and depicted. The type species Fortikona xanthosoma (Hampson, 1910), comb. n. , as well as Fortikona callipleura (Meyrick, 1932), comb. n. and Fortikona porphyractis (Meyrick, 1937), comb. n. , are transferred from the genus Paranthrene Hübner, [1819]; Fortikona xanthopyga (Hampson, 1919), comb. n. and Fortikona lampadura (Meyrick, 1935), comb. n. are transferred from the genus Sura Walker, 1856. A redescription of the type species, Fortikona xanthosoma comb. n. , is provided. The life histories and hostplants of the included species are unknown. Zusammenfassung In dieser Arbeit wird eine neue Gattung afrikanischer Paranthrenini, Fortikona Bartsch & Sáfián, gen. n. , und drei neue Arten, Fortikona rhynchiformis Sáfián & Bartsch, sp. n. aus Liberia, Fortikona aethiopica Bartsch & Sáfián, sp. n. aus Guinea und Fortikona dalaba Sáfián & Bartsch, sp. n. aus Äthiopien, beschrieben und abgebildet. Die Typusart, Fortikona xanthosoma (Hampson, 1910), comb. n. , sowie Fortikona callipleura (Meyrick, 1932), comb. n. und Fortikona porphyractis (Meyrick, 1937), comb. n. werden aus der Gattung Paranthrene Hübner, [1819] transferiert; Fortikona xanthopyga (Hampson, 1919), comb. n. und Fortikona lampadura (Meyrick, 1935), comb. n. werden aus der Gattung Sura Walker, 1856 transferiert. Eine Wiederbeschreibung der Typusart, Fortikona xanthosoma comb. n. , wird vorgelegt. Die Lebensweisen und Wirtspflanzen der zugehörigen Arten sind unbekannt.
Does Health & Her app use improve menopausal symptoms? A longitudinal cohort study

Objectives The Health & Her app provides menopausal women with a means of monitoring their symptoms, symptom triggers and menstrual periods, and enables them to engage in a variety of digital activities designed to promote well-being. This study aimed to examine whether sustained weekly engagement with the app is associated with improvements in menopausal symptoms. Design A pre–post longitudinal cohort study. Setting Analysed data collected from Health & Her app users. Participants 1900 women who provided symptom data via the app across a 2-month period. Primary and secondary outcome measures Symptom changes from baseline to 2 months was the outcome measure. A linear mixed effects model explored whether levels of weekly app engagement influenced symptom changes. Secondary analyses explored whether app-usage factors such as total number of days spent logging symptoms, reporting triggers, reporting menstrual periods and using in-app activities were independently predictive of symptom changes from baseline. Covariates included hormone replacement therapy use, hormonal contraceptive use, present comorbidities, age and dietary supplement use. Results Findings demonstrated that greater engagement with the Health & Her app for 2 months was associated with greater reductions in symptoms over time. Daily use of in-app activities and logging symptoms and menstrual periods were each independently associated with symptom reductions. Conclusions This study demonstrated that greater weekly engagement with the app was associated with greater reductions in symptoms. It is recommended that women be made aware of menopause-specific apps, such as that provided by Health & Her, to support them to manage their symptoms.
Cognitive trajectory in the first year after first-ever ischaemic stroke in young adults: the ODYSSEY study

Background Limited data exists on cognitive recovery in young stroke patients. We aimed to investigate the longitudinal course of cognitive performance during the first year after stroke at young age and identify predictors for cognitive recovery. Methods We conducted a multicentre prospective cohort study between 2013 and 2021, enrolling patients aged 18–49 years with first-ever ischaemic stroke. Cognitive assessments were performed within 6 months and after 1 year following the index event, covering seven cognitive domains. Composite Z-scores using normative data determined cognitive impairment (Z-score<−1.5). A Reliable Change Index (RCI) assessed cognitive recovery (RCI>1.96) or decline (RCI<−1.96). Results 393 patients (median age 44.3 years, IQR 38.4–47.2) completed cognitive assessments with a median time interval of 403 days (IQR 364–474) between assessments. Based on RCI, a similar proportion of patients showed improvement and decline in each cognitive domain, while the majority exhibited no cognitive change. Among cognitively impaired patients at baseline, improvements were observed in processing speed (23.1%), visuoconstruction (40.1%) and executive functioning (20.0%). Younger age was associated with better cognitive recovery in visuoconstruction, and larger lesion volume was related to cognitive recovery in processing speed. No other predictors for cognitive recovery were identified. Conclusions Cognitive impairment remains prevalent in young stroke even 1 year after the event. Most patients showed no cognitive change, however, recovery may have occurred in the early weeks after stroke, which was not assessed in our study. Among initially cognitively impaired patients, cognitive recovery is observed in processing speed, visuoconstruction and executive functioning. It is still not possible to predict cognitive recovery in individual patients.
Prevalence and influencing factors of sleep disorders in patients with CRS: a protocol for systematic review and meta-analysis

Background Chronic rhinosinusitis (CRS) is a common chronic disease that seriously affects patients’ quality of life and imposes a heavy physical and mental burden on patients. There is growing evidence that sleep disorders are strongly associated with patients with CRS. However, there is no systematic evidence to clarify the prevalence and influencing factors of sleep disorders in patients with CRS with nasal polyps (NP) (CRSwNP) and CRS without NP (CRSsNP). For this reason, this study will systematically analyse the prevalence of sleep disorders in patients with CRSwNP and CRSsNP and explore the related influencing factors. Methods and analysis We will electronically search PubMed, Web of Science, Embase, Cochrane, Ovid, Scopus, the China National Knowledge Infrastructure, the Wanfang database, the China Biomedical Literature Database and the China Scientific Journals Database from the establishment of the database to September 2023 to collect the prevalence of sleep disorders in patients with CRSwNP or CRSsNP and related studies on factors affecting sleep disorders. Two researchers will independently conduct literature screening and data extraction and evaluate the quality of the included studies using the Newcastle-Ottawa Quality Scale and Agency for Healthcare Research and Quality scales. The extracted data will be meta-analysed using Review Manager 5.3 and Stata 14.0 software, and the quality of the evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation. Publication bias will be assessed using the funnel plots, Egger’s test and Begg’s test. Ethics and dissemination This review will not require ethical approval, as we will only use research data from the published documents. Our final findings will be published in a peer-reviewed, open-access journal for dissemination. PROSPERO registration number CRD42023446833.
What factors facilitate partnerships between higher education and local mental health services for students? A case study collective

Background Higher education institutions face challenges in providing effective mental health services for diverse student needs. In the UK, discrepancies between healthcare and education service provision create barriers for students and require stronger alignment through partnerships. Objectives This study aimed to identify risks, barriers and enablers to developing service partnerships between universities and the National Health Service (NHS) in England. It investigated existing partnerships and strategies that facilitate effective collaborative working. Design and setting A case study approach was employed, including coproduction and stakeholder involvement with staff and service users, to gather information from eight English universities developing regional student mental health hubs. This research received appropriate ethical approval. Participants In total, 27 professional staff from counselling, mental health, disability and well-being services participated and represented their respective services. Outcome measures Descriptive information was collected from service websites, handbooks, reports and 11 focus groups using a standardised data collection template. Inter-rater reliability was used to determine the agreement between coders and finalise focus group themes. EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Standards for Reporting Qualitative Research were adopted. Results Using inductive thematic analysis, five themes were identified for developing partnerships: building blocks, facing barriers, achieving positive outcomes, shaping student services and developing coordinated care. Fleiss’ kappa showed strong agreement between raters regarding the partnership factors (k=0.84 (95% CI 0.81 to 0.87), p<0.0005). Effective communication, shared understanding and trust were essential. Barriers included restrictions to information sharing and incompatible data infrastructures between services. Conclusions Stronger partnerships between universities and NHS are needed to meet increasing student mental health demands. Addressing barriers and implementing strategies to develop partnerships can enhance student services. Preregistration https://osf.io/u54qk/
Individual and community-level risk factors for maternal morbidity and mortality among Native American women in the USA: protocol for systematic review

Introduction Incidents of maternal morbidity and mortality (MMM) continue to rise in the USA. Significant racial and ethnic health inequities exist, with Native American (NA) women being three to four times more likely to die than white, non-Hispanic women, and three to five times more likely to experience an incident of severe maternal morbidity. Few studies have identified individual and community-level risk factors of MMM experienced by NA women. Therefore, this systematic review will identify said risk factors of MMM experienced by NA women in the USA. Methods and analysis This systematic review will be conducted according to the Cochrane Handbook for Systematic Reviews, and the findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). The search strategy will include searches from electronic databases: PUBMED, EMBASE, CINAHL and SCOPUS, from 1 January 2012 to 10 October 2022. The search strategy will include terms related to the search concepts: ‘maternal’, ‘Native American’ and ‘MMM’. Bibliographies of selected articles, previously published reviews and high-yield journals will also be searched. All included papers will be evaluated for quality and bias using NIH Quality Assessment Tools for Observational Studies. A description of the study findings will be presented in a tabular format organised by outcome of interest along with study characteristics. Ethics and dissemination There are no formal ethics approvals needed for this protocol. The findings of this systematic review will be shared with academic, governmental, community-based, institutes and NA (tribal) entities via a published peer-reviewed article, informational brief, poster and oral presentations. PROSPERO registration number CRD42022363405.
Diciclo: Flexible User-level Services for Efficient Multitenant Isolation

Containers are a mainstream virtualization technique for running stateful workloads over persistent storage. In highly-utilized multitenant hosts, resource contention at the system kernel leads to inefficient container I/O handling. Although there are interesting techniques to address this issue, they incur high implementation complexity and execution overhead. As a cost-effective alternative, we introduce the Diciclo architecture with our assumptions, goals and principles. For each tenant, Diciclo isolates the control and data I/O path at user level and runs dedicated storage systems. Diciclo includes the libservice unified user-level abstraction of system services and the node structure design pattern for the application and server side. We prototyped a toolkit of user-level components that comprise the library to invoke the standard I/O calls, the I/O communication mechanism, and the I/O services. Based on Diciclo, we built Danaus, a filesystem client that integrates a union filesystem with a Ceph distributed filesystem client and configurable shared cache. Across different host configurations, workloads and systems, Danaus achieves improved performance stability because it handles I/O with reserved per-tenant resources and avoids intensive kernel locking. Based on having built and evaluated Danaus, we share valuable lessons about resource contention, file management, service separation and performance stability in multitenant systems.