Miracle-dz/UniFAR-FTUs huggingface dataset:
Determinants of intentions to prevent triatomine infestation based on the health belief model: An application in rural southern Ecuador

Introduction Control of triatomine infestation is a key strategy for the prevention of Chagas disease (CD). To promote this strategy, it is important to know which antecedents to behavioral change are the best to emphasize when promoting prevention. Objective The aim of this study was to determine predictors for intention to prevent home infestation based on the Health Belief Model (HBM), a commonly used health intervention planning theory. Materials & methods A cross-sectional study was conducted with 112 heads of household in six communities with endemic and high rates of triatomine infestation in Loja province, Ecuador. The data was collected by a questionnaire including perceived severity, susceptibility, benefits to action, barriers to action, and self-efficacy. These data were also used to predict actual infestation of homes. Results Community members reported strong intentions to prevent home infestation. HBM constructs predicted about 14% of the observed variance in intentions. Perceived susceptibility and severity did not predict behavioral intention well; perceived barriers to small-scale action that reduce likelihood of infestation and self-efficacy in participating in surveillance systems did. Self-efficacy and perception of barriers were equally powerful predictors. The HBM constructs, however, did not predict well actual infestation. Conclusion The findings supported the HBM as a way to predict intentions to prevent infestation of the home by triatomine bugs. The findings highlight that messages emphasizing self-efficacy in participating in surveillance systems and overcoming barriers to small-scale action that reduce likelihood of infestation, rather than a focus on risk, should be central messages when designing and implementing educational interventions for CD. The gap between behavioral intention and actual infestation reveals the need to assess home practices and their actual efficacy to fully enact and apply the HBM.
Uncoiling springs promote mechanical functionality of spider cribellate silk

ABSTRACT Composites, both natural and synthetic, achieve novel functionality by combining two or more constituent materials. For example, the earliest adhesive silk in spider webs – cribellate silk – is composed of stiff axial fibers and coiled fibers surrounded by hundreds of sticky cribellate nanofibrils. Yet, little is known of how fiber types interact to enable capture of insect prey with cribellate silk. To understand the roles of each constituent fiber during prey capture, we compared the tensile performance of native-state and manipulated threads produced by the cribellate spider Psechrus clavis, and the adhesion of native threads along a smooth surface and hairy bee thorax. We found that the coiled fiber increases the work to fracture of the entire cribellate thread by up to 20-fold. We also found that the axial fiber breaks multiple times during deformation, an unexpected observation that indicates: (i) the axial fiber continues to contribute work even after breakage, and (ii) the cribellate nanofibrils may perform a previously unidentified role as a binder material that distributes forces throughout the thread. Work of adhesion increased on surfaces with more surface structures (hairy bee thorax) corresponding to increased deformation of the coiled fiber. Together, our observations highlight how the synergistic interactions among the constituents of this natural composite adhesive enhance functionality. These highly extensible threads may serve to expose additional cribellate nanofibrils to form attachment points with prey substrata while also immobilizing prey as they sink into the web due to gravity. Summary: The coiled fibers of cribellate silk threads produced by Psechrus clavis spiders enhance prey capture in webs by increasing thread extensibility.
Three-dimensional vocal fold structural change due to implant insertion in medialization laryngoplasty

Glottal insufficiency due to vocal fold paralysis, paresis, or atrophy often leads to degraded voice quality. One of the primary surgical intervention procedures to treat glottal insufficiency is medialization laryngoplasty, in which an implant is inserted through a lateral window on the thyroid cartilage to medialize the vocal folds. While the goal of medialization is to modify the vocal fold structure to restore normal phonation, few studies have attempted to quantify such structural changes of the vocal folds. The goal of this study is to quantify the three-dimensional structural changes of the vocal folds due to implant insertion in medialization laryngoplasty, and evaluate its potential effect on voice production. Medialization laryngoplasty were performed in excised human larynges using implants of different stiffness. Magnetic resonance images of the larynges were obtained with and without implant insertion. The results showed that implant insertion significantly changed the original body-cover structure of the vocal folds, with the implant taking over the large space used to be occupied by the original body layer and the vocal fold being stretched into a thin layer wrapped around the implant. The medial-lateral dimension of the vocal fold was significantly reduced from about 4 mm to 1 mm, and the vocal fold was stretched in the coronal plane by about 70%. It is hypothesized that use of implants with stiffness comparable to that of the vocal folds is beneficial because the degree of medialization can be adjusted without much negative effects on phonation frequency, phonation threshold pressure, or vibration amplitude.
Moral Distress: Defined and Described by Neonatal and Pediatric Critical Care Nurses in a Quaternary Care Free-Standing Pediatric Hospital.

BACKGROUND/INTRODUCTION Despite a growing population of chronically and acute critically ill neonatal and pediatric patients, there were few published articles related to moral distress as experienced by nurses caring for these patients. OBJECTIVES/AIMS The aim of this study was to define moral distress based on the perceptions and experiences of neonatal and pediatric critical care nurses. METHODS A qualitative descriptive study using focus group methodology was undertaken. All nurses with 2 or more years of experience from the 4 neonatal and pediatric intensive care units in a large 404-bed urban pediatric hospital located in the northeast were invited to attend 1 of 15 audio-recorded focus groups lasting 60 to 90 minutes. Once data were transcribed, conventional content analysis was used to develop the definition and categories of moral distress. RESULTS Nurse participants defined moral distress as "patient care situations where there is a mismatch or incongruity between expected behaviors of the nurse and his/her personal values/beliefs in the neonatal/pediatric critical care setting. " The 2 overarching categories that emerged from the data were patient-focused factors and nurse-focused factors. DISCUSSION/CONCLUSIONS Understanding how neonatal and pediatric critical care nurses define moral distress and what contributes to its development is foundational to developing targeted strategies for nursing support and education, with the goal of creating a culture of moral resiliency.
Cardiovascular Control During Exercise: the Connectivity of Skeletal Muscle Afferents to the Brain.

The exercise pressor reflex (EPR) is engaged upon activation of group III/IV skeletal muscle afferents and is one of the principal mediators of cardiovascular responses to exercise. This review explores the hypothesis that afferent signals from EPR communicate via GABAergic contacts within the brain stem to evoke parasympathetic withdrawal and sympathoexcitation to increase cardiac output, peripheral resistance, and blood pressure during exercise.
Safety and efficacy of outpatient follow-up for referred patients with undiagnosed fever

Abstract Fever is one of the most common symptoms seen in patients. The work-up and follow-up of fever in an outpatient-only setting is a reasonable option for stable patients referred for unexplained fever; however, the safety and efficacy of outpatient follow-up for those patients remain unclear. We conducted this study to evaluate the safety and efficacy of outpatient follow-up for referred patients with unexplained fever. This study was a retrospective cohort study. We included patients referred to the outpatient department of the diagnostic medicine of our university hospital for unexplained fever between October 2016 and September 2017. Exclusion criteria were recurrent fever or admission for fever evaluation prior to referral. Main outcomes of interest were the rate of admission without diagnosis, rate of remission of fever, and the total duration of fever in undiagnosed patients. Among 84 patients included in this study, 17 (20%) were diagnosed during outpatient follow-up, 6 (7%) were admitted due to worsened condition, 5 (6%) were lost to follow-up, and 56 (67%) were followed up as outpatients without a diagnosis. Among the 56 undiagnosed patients, fever resolved in 53 during outpatient follow-up with or without treatment (95%). The total duration of resolved fever in undiagnosed patients was within 8 weeks. Follow-up of patients referred for unexplained fever in an outpatient setting is safe and effective.
Syndecan‐4 Protects the Heart From the Profibrotic Effects of Thrombin‐Cleaved Osteopontin

Background Pressure overload of the heart occurs in patients with hypertension or valvular stenosis and induces cardiac fibrosis because of excessive production of extracellular matrix by activated cardiac fibroblasts. This initially provides essential mechanical support to the heart, but eventually compromises function. Osteopontin is associated with fibrosis; however, the underlying signaling mechanisms are not well understood. Herein, we examine the effect of thrombin‐cleaved osteopontin on fibrosis in the heart and explore the role of syndecan‐4 in regulating cleavage of osteopontin. Methods and Results Osteopontin was upregulated and cleaved by thrombin in the pressure‐overloaded heart of mice subjected to aortic banding. Cleaved osteopontin was higher in plasma from patients with aortic stenosis receiving crystalloid compared with blood cardioplegia, likely because of less heparin‐induced inhibition of thrombin. Cleaved osteopontin and the specific osteopontin peptide sequence RGDSLAYGLR that is exposed after thrombin cleavage both induced collagen production in cardiac fibroblasts. Like osteopontin, the heparan sulfate proteoglycan syndecan‐4 was upregulated after aortic banding. Consistent with a heparan sulfate binding domain in the osteopontin cleavage site, syndecan‐4 was found to bind to osteopontin in left ventricles and cardiac fibroblasts and protected osteopontin from cleavage by thrombin. Shedding of the extracellular part of syndecan‐4 was more prominent at later remodeling phases, at which time levels of cleaved osteopontin were increased. Conclusions Thrombin‐cleaved osteopontin induces collagen production by cardiac fibroblasts. Syndecan‐4 protects osteopontin from cleavage by thrombin, but this protection is lost when syndecan‐4 is shed in later phases of remodeling, contributing to progression of cardiac fibrosis.
Implant Disease Risk Assessment IDRA - a tool for preventing peri-implant disease.

OBJECTIVE This treatment concept paper introduces a risk assessment tool, the Implant Disease Risk Assessment, (IDRA) which estimates the risk for a patient to develop peri-implantitis. The functional risk assessment diagram was constructed incorporating eight parameters, each with documented evidence for an association with peri-implantitis. The eight vectors of the diagram include (1) assessment of a history of periodontitis (2) percentage of sites with bleeding on probing (BOP) (3) number of teeth/implants with probing depths (PD) ≥ 5 mm (4) the ratio of bone loss (evaluated from a radiograph) divided by the patient's age (5) periodontitis susceptibility as described by the staging and grading categories from the 2017 World Workshop on the Classification of Periodontal Diseases (Tonetti, Greenwell, & Kornman, 2018) (6) the frequency/compliance with supportive periodontal therapy (7) the distance in mm from the restorative margin of the implant-supported prosthesis to the marginal bone crest and (8) prosthesis-related factors including cleanability and fit of the implant-supported prosthesis. The combination of these factors in a risk assessment tool, IDRA, may be useful in identifying individuals at risk for development of peri-implantitis.
Birth Weight and Cardiorespiratory Fitness Among Young Men Born at Term: The Role of Genetic and Environmental Factors

Background Preterm delivery and low birth weight are prospectively associated with low cardiorespiratory fitness (CRF). However, whether birth weight, within the at‐term range, is associated with later CRF is largely unknown. Thus, the aim of the current study was to examine this issue and whether such association, if any, is explained by shared and/or nonshared familial factors. Methods and Results We conducted a prospective cohort study, including 286 761 young male adults and a subset of 52 544 siblings born at‐term. Objectively measured data were retrieved from total population registers. CRF was tested at conscription and defined as the maximal load obtained on a cycle ergometer. We used linear and nonlinear and fixed‐effects regression analyses to explore associations between birth weight and CRF. Higher birth weight, within the at‐term range, was strongly associated with increasing CRF in a linear fashion. Each SD increase in birth weight was associated with an increase of 7.9 (95% CI, 7.8–8.1) and 6.6 (95% CI; 5.9–7.3) Wmax in the total and sibling cohorts, respectively. The association did not vary with young adulthood body mass index. Conclusions Birth weight is strongly associated with increasing CRF in young adulthood among men born at‐term, across all categories of body mass index. This association appears to be mainly driven by factors that are not shared between siblings. Hence, CRF may to some extent be determined already in utero. Prevention of low birth weight, also within the at‐term‐range, can be a feasible mean of increasing adult CRF and health.
Characterization of the dynamic behavior of neural activity in Alzheimer’s disease: exploring the non-stationarity and recurrence structure of EEG resting-state activity

Objective. Mild cognitive impairment (MCI) and dementia due to Alzheimer’s disease (AD) have been shown to induce perturbations to normal neuronal behavior and disrupt neuronal networks. Recent work suggests that the dynamic properties of resting-state neuronal activity could be affected by MCI and AD-induced neurodegeneration. The aim of the study was to characterize these properties from different perspectives: (i) using the Kullback–Leibler divergence (KLD), a measure of non-stationarity derived from the continuous wavelet transform; and (ii) using the entropy of the recurrence point density () and the median of the recurrence point density (), two novel metrics based on recurrence quantification analysis. Approach. KLD, and were computed for 49 patients with dementia due to AD, 66 patients with MCI due to AD and 43 cognitively healthy controls from 60 s electroencephalographic (EEG) recordings with a 10 s sliding window with no overlap. Afterwards, we tested whether the measures reflected alterations to normal neuronal activity induced by MCI and AD. Main results. Our results showed that frequency-dependent alterations to normal dynamic behavior can be found in patients with MCI and AD, both in non-stationarity and recurrence structure. Patients with MCI showed signs of patterns of abnormal state recurrence in the theta (4–8 Hz) and beta (13–30 Hz) frequency bands that became more marked in AD. Moreover, abnormal non-stationarity patterns were found in MCI patients, but not in patients with AD in delta (1–4 Hz), alpha (8–13 Hz), and gamma (30–70 Hz). Significance. The alterations in normal levels of non-stationarity in patients with MCI suggest an initial increase in cortical activity during the development of AD. This increase could possibly be due to an impairment in neuronal inhibition that is not present during later stages. MCI and AD induce alterations to the recurrence structure of cortical activity, suggesting that normal state switching during rest may be affected by these pathologies.
Characterization of thromboelastography of patients with different pathological types of nephrotic syndrome

Abstract To investigate the changes in blood coagulability as measured by thromboelastography (TEG) in patients with nephrotic syndrome of different etiologies as well as in patients with venous thromboembolic events (VTE). From January 2013 to October 2017, patients who were diagnosed as idiopathic membranous nephropathy (IMN), minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) were enrolled into this retrospective study in which their clinical characteristics, including TEG variables, were investigated. According to the presence or absence of VTE, the patients with IMN were divided into 2 groups of VTE and non-VTE. The risk factors of VTE were analyzed with logistic regression. Significant differences in TEG parameters were found among the 3 groups of patients with R and K values lower, while the α-angle, maximum amplitude (MA) and confidence interval (CI) values higher, in the IMN group than those in the MCD and FSGS groups (P < .01). Multiple linear regression analysis indicated that the histologic subtype was an independent relevant factor of K time, angle, MA, and CI values. Multivariate logistic regression analysis revealed that serum albumin and CI value were independent risk factors of VTE (P < .05). The results showed that IMN patients may have higher whole blood coagulability than MCD and FSGS patients. The hypercoagulability in IMN patients may be attributed to platelet hyperactivity and the accelerated fibrin-platelet interaction. Hypoproteinemia and increased CI value were independent risk factors of VTE in IMN.
Direct Visualization of the Femoral Cortical Button in Anterior Cruciate Ligament Reconstruction Helps Ensure Proper Positioning.

This study sought to postoperatively compare femoral cortical button (FCB) placement in anterior cruciate ligament (ACL) reconstruction performed using an adjustable loop cortical femoral fixation button under direct arthroscopic visualization vs indirect methods. The authors conducted a retrospective review of postoperative knee radiographs from 76 patients who had undergone ACL reconstruction with an adjustable loop cortical femoral fixation button. Operative reports were reviewed to determine the technique used for graft placement. Two sports fellowship-trained surgeons reviewed the collected radiographs, and the position of the FCB in each patient was subsequently graded. Of the 76 patients reviewed, 42 cases were performed using direct visualization, whereas 34 cases used indirect methods. This analysis showed that FCBs placed with direct visualization were more likely to have optimal position directly on the femoral cortex compared with indirect methods (chi-square test, P=.046). The grading scores demonstrated moderate strength of interobserver reliability (kappa coefficient=0.62). Direct arthroscopic visualization while placing an FCB during ACL reconstruction with an adjustable loop cortical fixation button can help ensure optimal button placement. [Orthopedics. 2020;43(X):xx-xx. ].
A PRISMA-compliant meta-analysis

Background: There are differences among the outcomes regarding cognitive impairment in heart failure (HF) because the evidence is fragmented and sample size is small. Therefore we aimed to systematically review and analyze the available evidence about the association between HF and dementia. Methods: In the present study, we searched for articles published until August 2019 in the following databases: PubMed, Web of Science, EMBASE, Medline and Google Scholar. The pooled multivariate odds ratio (OR) or relative risk (RR) and 95% confidence intervals (CI) were obtained by the use of STATA 12.0 software. Results: The meta-analysis showed a positive association between HF and risk of all-cause dementia (OR/RR=1.28, 95% CI 1.15 to 1.43, I=70.0%, P<0.001). Additionally, the study showed no significant association between HF and risk of Alzheimer’s disease (AD) (OR/RR=1.38, 95% CI 0.90 to 2.13, I=74.8%, P=0.008). Conclusion: In conclusion, HF was associated with an increased risk of developing dementia. In addition, large scale prospective studies are essential to explore the associations between HF and risk of AD. Abbreviations: AD = Alzheimer’s disease, CI = confidence intervals, HF = heart failure, OR = odds ratio, PRISMA = Preferred Reporting Items for Systematic reviews and Meta-Analysis, RR = relative risk.
Hidden fluid mechanics: Learning velocity and pressure fields from flow visualizations

Machine-learning fluid flow Quantifying fluid flow is relevant to disciplines ranging from geophysics to medicine. Flow can be experimentally visualized using, for example, smoke or contrast agents, but extracting velocity and pressure fields from this information is tricky. Raissi et al. developed a machine-learning approach to tackle this problem. Their method exploits the knowledge of Navier-Stokes equations, which govern the dynamics of fluid flow in many scientifically relevant situations. The authors illustrate their approach using examples such as blood flow in an aneurysm. Science, this issue p. 1026 A machine learning approach exploiting the knowledge of Navier-Stokes equations can extract detailed fluid flow information. For centuries, flow visualization has been the art of making fluid motion visible in physical and biological systems. Although such flow patterns can be, in principle, described by the Navier-Stokes equations, extracting the velocity and pressure fields directly from the images is challenging. We addressed this problem by developing hidden fluid mechanics (HFM), a physics-informed deep-learning framework capable of encoding the Navier-Stokes equations into the neural networks while being agnostic to the geometry or the initial and boundary conditions. We demonstrate HFM for several physical and biomedical problems by extracting quantitative information for which direct measurements may not be possible. HFM is robust to low resolution and substantial noise in the observation data, which is important for potential applications.
Association between speech perception in noise and electrophysiological measures: an exploratory study of possible techniques to evaluate cochlear synaptopathy in humans

Abstract Objective: The primary aim of this study was to investigate whether scores for a speech-in-noise test were associated with the results of two electrophysiological techniques mainly targeting low spontaneous rate, high-threshold auditory fibres. Design: Cross-sectional study. Participants were evaluated with the hearing-in-noise test (HINT), along with the Auditory Brainstem Response (ABR) with and without ipsilateral noise. The wave V/I amplitude ratio for the ABR without ipsilateral noise and ABR wave V latency shift in the presence of ipsilateral noise were obtained. Study sample: Twenty adults aged between 20 and 34 years (10 females) who did not report occupational exposure to noise were selected. All participants presented with normal hearing thresholds (0.250–8 kHz) and the presence of distortion product otoacoustic emissions, bilaterally. Results: A significant association between the wave V/I amplitude ratio for the left ear and the HINT scores for the left ear was found. Conclusions: Based on the results of this study, in normal-hearing listeners, the wave V/I ratio is associated with speech-in-noise performance, specifically in the left ear. This non-invasive procedure has the potential to be used in clinical populations who present with speech-in-noise difficulties despite having normal audiograms.