Miracle-dz/UniFAR-FTUs huggingface dataset:
Early life exposures and the occurrence and timing of heart disease among the older adult Puerto Rican population

Few studies have examined the effects of early life conditions on the timing of the onset of heart disease. We use the remarkable example of a representative sample of the population of older Puerto Ricans aged 60– 74 who lived in the countryside during childhood (n = 1,438) to examine the effects of seasonal exposures to poor nutrition and infectious diseases during late gestation on the timing of the onset and the probability of ever experiencing adult heart disease. Cox and log logistic hazard models controlling for childhood conditions (self-reported childhood health status and socioeconomic status [SES], rheumatic fever, and knee height) and adult risk factors (adult SES, obesity, smoking, texercise, and self-reported diabetes) showed that the risk of onset of heart disease was 65% higher among those born during high-exposure periods compared with unexposed individuals. However, there were no significant differences in median time of onset for those ever experiencing heart disease. As a comparison, we found that there were no significant seasonality effects for those who lived in urban areas during childhood. We conclude that early exposures in utero have important ramifications for adult heart disease among the older Puerto Rican population. We show, however, that while exposure is associated with the probability of ever experiencing adult heart disease, it is not associated with the timing of onset among those who do experience it.
Confidence with and Barriers to Serious Illness Communication: A National Survey of Hospitalists.

OBJECTIVE To describe the concerns, confidence, and barriers of practicing hospitalists around serious illness communication. BACKGROUND Hospitalist physicians are optimally positioned to provide primary palliative care, yet their experiences in serious illness communication are not well described. METHODS Web-based survey, conducted in May 2016. The survey link was distributed via email to 4000 members of the Society of Hospital Medicine. The 39-item survey assessed frequency of concerns about serious illness communication, confidence for common tasks, and barriers using Likert-type scales. It was developed by the authors based on prior work, a focus group, and feedback from pilot respondents. RESULTS We received 332 completed surveys. On most or every shift, many participants reported having concerns about a patient's or family's understanding of prognosis (53%) or the patient's code status (63%). Most participants were either confident or very confident in discussing goals of care (93%) and prognosis (87%). Fewer were confident or very confident in responding to patients or families who had not accepted the seriousness of an illness (59%) or in managing conflict (50%). Other frequently cited barriers were lack of time, lack of prior discussions in the outpatient setting, unrealistic prognostic expectations from other physicians, limited institutional support, and difficulty finding records of previous discussions. DISCUSSION Our results suggest opportunities to improve hospitalists' ability to lead serious illness communication by increasing the time hospitalists have for discussions, improving documentation systems and communication between inpatient and outpatient clinicians, and targeted training on challenging communication scenarios.
Assessment of presentation patterns, clinical severity, and sensorial mechanism of tip‐toe behavior in severe ASD subjects with intellectual disability: A cohort observational study

We assessed presentation patterns and characteristics of tip‐toe behavior (TTB), more commonly known as toe walking, in a cohort of severe autism spectrum disorder (ASD) subjects with intellectual disability in two studies. The first study included 69 consecutive ASD subjects (57 males, mean age = 14 years—3.7 SD) under observation at our institute. A therapist assessed the presence of TTB during standing, walking, and running through direct observation and an interview with the subjects main caregiver. The prevalence of TTB was 32%. We found three clinical presentation patterns of TTB: (1) present when standing, walking and running (45.5%), (2) present when walking and running (18.4%), or (3) present only when running (36.4%). TTB subjects were more frequently nonverbal than those without TTB (72.7% vs. 44.6%‐P = 0.03). On the other hand, no significant difference in ASD severity according to the ADOS scale was found between TTB and non‐TTB subjects. In the second study, carried out in a subgroup of 14 ASD subjects (7 TTB and 7 non‐TTB), we evidenced that a soft floor surface (foam mats) made a substantial difference in reducing the TTB phenomenon. TTB is frequently present in ASD individuals and may occur in three mutually exclusive modalities, which ultimately defines what is commonly known as toe walking. The presence of TTB seems correlated to the severity of language delay. Foot contact on soft surfaces reduces TTB both during static and/or dynamic tasks. Further evaluation is needed to clarify the potential pathophysiological implications of this phenomenon. Autism Res 2017, 10: 1547–1557. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
Long non-coding RNA nuclear paraspeckle assembly transcript 1 inhibits the apoptosis of retina Müller cells after diabetic retinopathy through regulating miR-497/brain-derived neurotrophic factor axis

Background: The role of long non-coding RNA in diabetic retinopathy, a serious complication of diabetes mellitus, has attracted increasing attention in recent years. The purpose of this study was to explore whether long non-coding RNA nuclear paraspeckle assembly transcript 1 was involved in the context of diabetic retinopathy and its underlying mechanisms. Results: Our results revealed that nuclear paraspeckle assembly transcript 1 was significantly downregulated in the retina of diabetes mellitus rats. Meanwhile, miR-497 was significantly increased in diabetes mellitus rats’ retina and high glucose–treated Müller cells, but brain-derived neurotrophic factor was increased. We also found that high glucose–induced apoptosis of Müller cells was accompanied by the significant downregulation of nuclear paraspeckle assembly transcript 1 in vitro. Further study demonstrated that high glucose–promoted Müller cells apoptosis through downregulating nuclear paraspeckle assembly transcript 1 and downregulated nuclear paraspeckle assembly transcript 1 mediated this effect via negative regulating miR-497. Moreover, brain-derived neurotrophic factor was negatively regulated by miR-497 and associated with the apoptosis of Müller cells under high glucose. Conclusion: Our results suggested that under diabetic conditions, downregulated nuclear paraspeckle assembly transcript 1 decreased the expression of brain-derived neurotrophic factor through elevating miR-497, thereby promoting Müller cells apoptosis and aggravating diabetic retinopathy.
More Is Meaningful: The Magnitude Effect in Intertemporal Choice Depends on Self-Control

Impulsivity is a variable behavioral trait that depends on numerous factors. For example, increasing the absolute magnitude of available choice options promotes farsighted decisions. We argue that this magnitude effect arises in part from differential exertion of self-control as the perceived importance of the choice increases. First, we demonstrated that frontal executive-control areas were more engaged for more difficult decisions and that this effect was enhanced for high-magnitude rewards. Second, we showed that increased hunger, which is associated with lower self-control, reduced the magnitude effect. Third, we tested an intervention designed to increase self-control and showed that it reduced the magnitude effect. Taken together, our findings challenge existing theories about the magnitude effect and suggest that visceral and cognitive factors affecting choice may do so by influencing self-control.
Maryland's Medical Orders for Life-Sustaining Treatment Form Use: Reports of a Statewide Survey.

BACKGROUND Advance directives (ADs) and Physicians Orders for Life-Sustaining Treatment (POLST) orders perform different but complementary functions in documenting a patient's treatment preferences and translating them into actionable orders that change in keeping with the patient's evolving clinical picture. Maryland's Medical Orders for Life-Sustaining Treatment (MOLST) form developed through a stakeholder-driven process that deviates from other POLST forms. While a patient or surrogate can decline discussing MOLST orders with a clinician, clinicians must write MOLST orders for certain patients (e.g., those admitted to a nursing home (NH), assisted living facility (ALF), hospice, home health (HH) agency, or dialysis center, discharged from a hospital to any of these facilities, or transferred between hospitals). OBJECTIVE To gather data on Maryland MOLST form use to evaluate performance and inform future research and practice. DESIGN Chart reviews (CRs). SETTING/SUBJECTS MOLST forms and patient data collected from Maryland hospitals (adult nonpsych, nontrauma, nonobstetric patients), NHs, ALFs, hospices, HH agencies, and dialysis centers. MEASUREMENTS Facility demographic tool and CR tools. RESULTS A total of 1959 CRs were received from 137 facilities, including 2064 MOLST forms. Most patients required to have MOLST orders had them (84%); fewer had ADs (47%). Few patients or surrogates declined discussing MOLST orders (1%). Few MOLST orders were written based on medical ineffectiveness criteria defined in Maryland law (<1%). MOLST form completion error rates ranged from 1% to 3%. Non-white patients were about twice as likely to have a MOLST "Attempt CPR" order (62%) as white patients (32%). CONCLUSIONS MOLST error rates are relatively low and consistent with other research. Areas for improvement include selecting one order option where required, avoiding contradictions between Page 1 and 2 orders, offering MOLST Page 2 options if relevant, and documenting in the medical record a summary of the discussion informing MOLST orders.
Mean platelet volume is associated with lower risk of overall and non-vascular mortality in a general population

Summary Larger mean platelet volume (MPV) has been associated with adverse health outcomes in high-risk populations or patients with cardiovascular disease (CVD). We tested the association of MPV with mortality in a prospective cohort study including 17,402 subjects randomly recruited from an adult general population within the Moli-sani study (2005–2010). Two distinct subgroups (with or without CVD at baseline) were subsequently analysed. Hazard ratios (HR) were calculated using multivariable Cox-proportional hazard models. Over a median follow up of eight years (137,547 person-years), 925 all-cause deaths occurred (330 vascular, 351 cancer and 244 other deaths). In a multivariable model, the highest MPV quintile (mean MPV=10.0 fL), as compared to the lowest one, was associated with reduced risk of overall mortality (HR=0.79; 95 % confidence interval 0.64–0.98), cancer death (HR=0.70; 0.49–1.00) and death from other non- vascular/non cancer causes (HR=0.55; 0.36–0.84) but not with vascular mortality. The inverse association with overall death appeared even stronger in the subgroup without CVD at baseline (HR=0.64; 0.50–0.81). In contrast, within 920 subjects reporting a previous CVD event, larger MPV was associated with higher risk of total mortality (HR=1.69; 1.05–2.72; p for interaction=0.048) and with a trend of risk for other cause-specific deaths. In conclusion, larger MPV is associated with lower risk of overall and non-vascular death in subjects apparently free from CVD, but appears to be a predictive marker of death in patients with CVD history. The latter is a likely effect modifier of the association between MPV and death.
Cognitive impairment in adult ADHD--perspective matters!

OBJECTIVE The assessment of cognitive functions of adults with attention deficit hyperactivity disorder (ADHD) comprises self-ratings of cognitive functioning (subjective assessment) as well as psychometric testing (objective neuropsychological assessment). The aim of the present study was to explore the utility of these assessment strategies in predicting neuropsychological impairments of adults with ADHD as determined by both approaches. METHOD Fifty-five adults with ADHD and 66 healthy participants were assessed with regard to cognitive functioning in several domains by employing subjective and objective measurement tools. Significance and effect sizes for differences between groups as well as the proportion of patients with impairments were analyzed. Furthermore, logistic regression analyses were carried out in order to explore the validity of subjective and objective cognitive measures in predicting cognitive impairments. RESULTS Both subjective and objective assessment tools revealed significant cognitive dysfunctions in adults with ADHD. The majority of patients displayed considerable impairments in all cognitive domains assessed. A comparison of effect sizes, however, showed larger dysfunctions in the subjective assessment than in the objective assessment. Furthermore, logistic regression models indicated that subjective cognitive complaints could not be predicted by objective measures of cognition and vice versa. CONCLUSIONS Subjective and objective assessment tools were found to be sensitive in revealing cognitive dysfunctions of adults with ADHD. Because of the weak association between subjective and objective measurements, it was concluded that subjective and objective measurements are both important for clinical practice but may provide distinct types of information and capture different aspects of functioning.
Association Between Alcohol Intoxication and Alcohol-Related Problems: An Event-Level Analysis

Heavy-drinking students experience a myriad of alcohol-related negative consequences. Use of event-level data permits predictions to be made regarding (a) the likelihood of alcohol-related consequences occurring after specific drinking events, and (b) moderators of the association between intoxication and consequences. College students (N = 183, 64% female) completed 4 consecutive 7-day drinking diaries and turned them in weekly. The diaries yielded prospective event-level data on daily drinks, time spent drinking, and negative consequences related to each drinking event. Alcohol intoxication on a given day was significantly associated with increased levels of risk, although this association was moderated by average level of intoxication. Furthermore, self-control was associated with increased likelihood of negative consequences at all levels of intoxication, and self-regulation and impulsivity moderated the event-level association between daily intoxication and likelihood of negative consequences. Results suggest that self-regulation subsumes impulsivity and self-control.
Managing portfolio risk in strategic technology management: evidence from a panel data-set of the world's largest R&D performers

ABSTRACT In this article, we analyze the impact of firms’ technology bases on their financial performance. By taking a strategic perspective of technology, we argue that it is not sufficient to analyze only the size or novelty/quality of the technology base as technology bases can best be understood as portfolios of individual technologies. In such a framework, risk consideration should be taken into account. More specifically, we argue that increasing technological breadth can serve as a hedge against the inherent uncertainties of developing and commercializing technology, in particular when the technology base is very large or novel. We also propose that technology has higher impacts on financial performance for firms with broader technology portfolios. A similar argument proposes that technological breadth can offset the increased risks of addressing foreign markets. We test our hypotheses using an international panel data-set of large R&D-performing firms. Our results suggest that broad technology portfolios can indeed serve as a hedge against technological and commercialization risks.
Perivascular adipose tissue as a regulator of vascular disease pathogenesis: identifying novel therapeutic targets

Adipose tissue (AT) is an active endocrine organ with the ability to dynamically secrete a wide range of adipocytokines. Importantly, its secretory profile is altered in various cardiovascular disease states. AT surrounding vessels, or perivascular AT (PVAT), is recognized in particular as an important local regulator of vascular function and dysfunction. Specifically, PVAT has the ability to sense vascular paracrine signals and respond by secreting a variety of vasoactive adipocytokines. Due to the crucial role of PVAT in regulating many aspects of vascular biology, it may constitute a novel therapeutic target for the prevention and treatment of vascular disease pathogenesis. Signalling pathways in PVAT, such as those using adiponectin, H2S, glucagon‐like peptide 1 or pro‐inflammatory cytokines, are among the potential novel pharmacological therapeutic targets of PVAT.
Unmyelinated axon loss with postnatal hypertonia after fetal hypoxia

White matter (WM) injury due to myelination defects is believed to be responsible for the motor deficits seen in cerebral palsy. We tested the hypothesis that the predominant injury is to functional electrical connectivity in unmyelinated WM fibers by conducting a longitudinal study of central WM tracts in newborn rabbit kits with hypertonia in our model of cerebral palsy.
The effect of dietary supplementation with rumen‐protected methionine alone or in combination with rumen‐protected choline and betaine on sheep milk and antioxidant capacity

This study investigated the effects of dietary inclusion of rumen-protected methionine alone or in combination with rumen-protected choline and betaine on: (i) milk yield, chemical composition and fatty acids (FA) profile and (ii) blood plasma glutathione transferase (GST) activity of periparturient ewes. Furthermore, the oxidative stress indicators for measuring total antioxidant and free radical scavenging activity [ferric reducing ability of plasma (FRAP) and 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) assays] were also determined in plasma and milk of ewes. Thus, 45 ewes were divided into three equal groups. Each animal of the control group fed daily with a basal diet. The same diet was offered also in each animal of the other two groups. However, the concentrate fed to M group was supplemented with 2.5 g/kg rumen-protected methionine, while the concentrate fed to MCB group with 5 g/kg of a commercial product which contained a combination of methionine, choline and betaine, all three in rumen-protected form. The results showed that the M diet, compared with the control, increased significantly the ewe's milk fat and the total solids content. Likewise, a tendency for higher milk fat and total solids content in ewes fed the MCB diet was also observed. Both M and MCB diets had not noticeable impact on ewes milk FA profile. Significantly higher FRAP values in the blood plasma of ewes fed the MCB and in the milk of ewes fed with the M diet compared with the control were found. Additionally, significantly higher GST activity in the blood plasma of ewes fed the M diet, compared with the control, was observed. Moreover, a significant increase (by 20%) and a tendency for increase (by 16.72%) in the growth rate of lambs nursing ewes fed with M and MCB diets, respectively, compared to controls, were found.
Initial forces experienced by the anterior and posterior teeth during dental-anchored or skeletal-anchored en masse retraction in vitro.

OBJECTIVE To investigate initial forces acting on teeth around the arch during en masse retraction using an in vitro Orthodontic SIMulator (OSIM). MATERIALS AND METHODS The OSIM was used to represent the full maxillary arch in a case wherein both first premolars had been extracted. Dental and skeletal anchorage to a posted archwire and skeletal anchorage to a 10-mm power arm were all simulated. A 0.019 × 0.025-inch stainless steel archwire was used in all cases, and 15-mm light nickel-titanium springs were activated to approximately 150 g on both sides of the arch. A sample size of n = 40 springs were tested for each of the three groups. Multivariate analysis of variance (α = 0.05) was used to determine differences between treatment groups. RESULTS In the anterior segment, it was found that skeletal anchorage with power arms generated the largest retraction force (P < .001). The largest vertical forces on the unit were generated using skeletal anchorage, followed by skeletal anchorage with power arms, and finally dental anchorage. Power arms were found to generate larger intrusive forces on the lateral incisors and extrusive forces on the canines than on other groups. For the posterior anchorage unit, dental anchorage generated the largest protraction and palatal forces. Negligible forces were measured for both skeletal anchorage groups. Vertical forces on the posterior unit were minimal in all cases (<0.1 N). CONCLUSIONS All retraction methods produced sufficient forces to retract the anterior teeth during en masse retraction. Skeletal anchorage reduced forces on the posterior teeth but introduced greater vertical forces on the anterior teeth.
Noninvasive 3‐dimensional imaging of liver regeneration in a mouse model of hereditary tyrosinemia type 1 using the sodium iodide symporter gene

Cell transplantation is a potential treatment for the many liver disorders that are currently only curable by organ transplantation. However, one of the major limitations of hepatocyte (HC) transplantation is an inability to monitor cells longitudinally after injection. We hypothesized that the thyroidal sodium iodide symporter (NIS) gene could be used to visualize transplanted HCs in a rodent model of inherited liver disease: hereditary tyrosinemia type 1. Wild‐type C57Bl/6J mouse HCs were transduced ex vivo with a lentiviral vector containing the mouse Slc5a5 (NIS) gene controlled by the thyroxine‐binding globulin promoter. NIS‐transduced cells could robustly concentrate radiolabeled iodine in vitro, with lentiviral transduction efficiencies greater than 80% achieved in the presence of dexamethasone. Next, NIS‐transduced HCs were transplanted into congenic fumarylacetoacetate hydrolase knockout mice, and this resulted in the prevention of liver failure. NIS‐transduced HCs were readily imaged in vivo by single‐photon emission computed tomography, and this demonstrated for the first time noninvasive 3‐dimensional imaging of regenerating tissue in individual animals over time. We also tested the efficacy of primary HC spheroids engrafted in the liver. With the NIS reporter, robust spheroid engraftment and survival could be detected longitudinally after direct parenchymal injection, and this thereby demonstrated a novel strategy for HC transplantation. This work is the first to demonstrate the efficacy of NIS imaging in the field of HC transplantation. We anticipate that NIS labeling will allow noninvasive and longitudinal identification of HCs and stem cells in future studies related to liver regeneration in small and large preclinical animal models. Liver Transpl 21:442–453, 2015. © 2015 AASLD.