Miracle-dz/UniFAR-FTUs huggingface dataset:
Attitudes Toward Neonatal Intensive Care Treatment of Preterm Infants With a High Risk of Developing Long-term Disabilities

OBJECTIVES. To assess (1) the differences in attitudes toward disabilities of 3 groups of subjects involved in neonatal care decision-making: health care workers, mothers of term infants, and parents of preterm infants, and (2) the impact of subject characteristics on these attitudes including parental education level, religion, and severity of disability. METHODS. Five hundred seventy-eight subjects were interviewed, of whom 135 were health care workers, 155 were mothers of term infants, and 288 were parents of preterm infants. We assessed between-group differences of the (1) health state ranking permutations, (2) proportion of subjects willing to save the infant at all costs, (3) pivotal risks of each group to the 5 health states comprising varying combinations of mental, physical, and social disabilities, and (4) impact of personal characteristics on decision-making. RESULTS. Most health care workers ranked the most severe disability health state as worse than death, whereas most parents of preterm infants ranked death as the worst outcome. Significantly more parents of preterm infants chose to save the infant at all costs, compared with mothers of term infants and health care workers, and the pivotal risks of the parents of preterm infants group were highest for all health states. Religious worship was associated with increased probability of saving at all costs and pivotal risks. Increased severity of neonatal complications was associated with decreased probability of saving at all costs and pivotal risks in parents of preterm infants. CONCLUSIONS. Our findings suggest that parents of preterm infants as a group were most likely to save the infant at all costs and prepared to tolerate more severe disability health states. However, personal characteristics, in particular religious belief and severity of neonatal complications, have overriding influence on these attitudes. We suggest inclusion of experienced parents of preterm infants for more effective counseling of parents in making life-and-death decisions.
A Resource-Oriented Music Therapy Support Group Intervention for Adults Living with Fibromyalgia

Fibromyalgia syndrome is a generalized soft-tissue chronic pain syndrome characterized by tenderness upon palpation of 11 of 18 tender points and generalized pain on both sides of the body for at least 3 months. In Canada, 2-10% of the population has FMS, with diagnoses being higher in women than men. Music therapy research targeting FMS and chronic pain is minimal, while other health professions have seen music as a viable intervention tool (Oneiva-Zafra et al., 2010; Prasanna, 2009; Siedlecki, 2009; Chesky 1997). Therefore, the purpose of this research was to design the initial stages of a resource-oriented music therapy support group intervention for adults living with Fibromyalgia using Fraser and Galinsky’s (2010) intervention research method. Relevant medical, psychology, and music therapy literature pertaining to FMS and chronic pain was analyzed through open, axial and selective coding. Robb, Burns and Carpenter’s (2011) checklist of guidelines for reporting music-based interventions were used as a framework for describing the proposed interventions. The overarching aims of the intervention program are to foster awareness and develop self-management strategies for those living with FMS. Vocal and receptive music therapy techniques were incorporated into the intervention design to support said overarching aims by fostering the development and maintenance of participants’ own resources and strengths. It is hoped that this research will form the basis for the further development of music therapy resources and techniques specifically designed to benefit those living with FMS and/or chronic pain.
Cytokinin signalling regulates organ identity via the AHK4 receptor in Arabidopsis

ABSTRACT Mutual interactions of the phytohormones, cytokinins and auxin determine root or shoot identity during postembryonic de novo organogenesis in plants. However, our understanding of the role of hormonal metabolism and perception during early stages of cell fate reprogramming is still elusive. Here we show that auxin activates root formation, whereas cytokinins mediate early loss of the root identity, primordia disorganisation and initiation of shoot development. Exogenous and endogenous cytokinins influence the initiation of newly formed organs, as well as the pace of organ development. The process of de novo shoot apical meristem establishment is accompanied by accumulation of endogenous cytokinins, differential regulation of genes for individual cytokinin receptors, strong activation of AHK4-mediated signalling and induction of the shoot-specific homeodomain regulator WUSCHEL. The last is associated with upregulation of isopentenyladenine-type cytokinins, revealing higher shoot-forming potential when compared with trans-zeatin. Moreover, AHK4-controlled cytokinin signalling negatively regulates the root stem cell organiser WUSCHEL RELATED HOMEOBOX 5 in the root quiescent centre. We propose an important role for endogenous cytokinin biosynthesis and AHK4-mediated cytokinin signalling in the control of de novo-induced organ identity. Summary: Auxin-induced organ formation during plant postembryonic development is associated with upregulation of endogenous cytokinins that contribute to the exogenous cytokinin-regulated identity and development of newly formed organs via AHK4-mediated signalling.
Utility of Hepatic Transaminases to Recognize Abuse in Children

OBJECTIVE: Although experts recommend routine screening of hepatic transaminases (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) in cases of potential child physical abuse, this practice is highly variable. Our objective was to determine the sensitivity and specificity of routine transaminase testing in young children who underwent consultation for physical abuse. PATIENTS AND METHODS: This was a prospective, multicenter, observational study of all children younger than 60 months referred for subspecialty evaluation of possible physical abuse. The child abuse team at each center recommended screening transaminases routinely as standard of care for all cases with a reasonable concern for physical abuse. Sensitivity and specificity for transaminases and clinical examination findings to detect identified abdominal injuries were determined, and receiver operating characteristic analysis was undertaken. RESULTS: Of 1676 consultations, 1272 (76%) patients underwent transaminase testing, and 54 (3.2% [95% confidence interval: 2.4–4.2]) had identified abdominal injuries. Area under the curve for the highest level of either transaminase was 0.85. Using a threshold level of 80 IU/L for either AST or ALT yielded a sensitivity of 77% and a specificity of 82% (positive likelihood ratio: 4.3; negative likelihood ratio: 0.3). Of injuries with elevated transaminase levels, 14 (26%) were clinically occult, lacking abdominal bruising, tenderness, and distention. Several clinical findings used to predict abdominal injury had high specificity but low sensitivity. CONCLUSIONS: In the population of children with concern for physical abuse, abdominal injury is an important cause of morbidity and mortality, but it is not so common as to warrant universal imaging. Abdominal imaging should be considered for potentially abused children when either the AST or ALT level is >80 IU/L or with abdominal bruising, distention, or tenderness.
Assessment of arterio-ventricular coupling by tissue Doppler and wave intensity in type 2 diabetes:

Aim T o evaluate ventricular-arterial coupling in preclinical cardiovascular disease, we used a new wave intensity approach and tissue Doppler in patients with and without type 2 diabetes mellitus (DM). Methods Sixty-five type 2 diabetes patients and 57 control individuals with normal systolic left ventricular function and without overt coronary or peripheral artery disease were assessed by tissue Doppler for myocardial velocities and by a combined Doppler and echo-tracking system (Aloka SSD-5500, Tokyo) for local arterial stiffness (epsilon, pulse wave velocity) and the characteristic peaks W1 and W2 of pulse wave intensity. Results Diabetes patients had significantly higher systolic blood pressure and pressure derivates (p<0.002). Diastolic myocardial velocity (Ve) was decreased (p<0.001). Epsilon and pulse wave velocity (p<0.001) were higher and so was W1 (11785+7491 vs. 9191+4299, p<0.04) but not W2. In the pooled data, independent predictors for Ve were age, septal wall thickness, Vs and HbA1C (R2 0.426) and for W1 systolic blood pressure, Vs, W2 and duration of diabetes (R2 0.479).
Psychiatric comorbidity and medication use in autism: a community survey

AIMS AND METHOD Individuals with autism often have complex needs. In this paper, we attempt to establish the prevalence rates of other major psychiatric illnesses in learning disabled adults diagnosed with autism and analyse the use of medication in these individuals. A total of 571 clients with learning disability were screened for autistic spectrum disorder, identifying 164 individuals for study. Psychiatric and medical diagnoses were also reviewed. RESULTS Of the individuals with autism, 35% had another comorbid psychiatric disorder. An overall prevalence rate of 10% for hypothyroidism was also identified and 35% of people with autism and no other psychiatric diagnosis were on neuroleptics. CLINICAL IMPLICATIONS Planning of services for autism will have to take into account the high comorbidity of autism and other psychiatric conditions. Individuals with autism will also benefit from close monitoring of mental state and the development of hypothyroidism.
clueless, a conserved Drosophila gene required for mitochondrial subcellular localization, interacts genetically with parkin

SUMMARY Parkinson’s disease has been linked to altered mitochondrial function. Mutations in parkin (park), the Drosophila ortholog of a human gene that is responsible for many familial cases of Parkinson’s disease, shorten life span, abolish fertility and disrupt mitochondrial structure. However, the role played by Park in mitochondrial function remains unclear. Here, we describe a novel Drosophila gene, clueless (clu), which encodes a highly conserved tetratricopeptide repeat protein that is related closely to the CluA protein of Dictyostelium, Clu1 of Saccharomyces cerevisiae and to similar proteins in diverse metazoan eukaryotes from Arabidopsis to humans. Like its orthologs, loss of Drosophila clu causes mitochondria to cluster within cells. We find that strong clu mutations resemble park mutations in their effects on mitochondrial function and that the two genes interact genetically. Conversely, mitochondria in park homozygotes become highly clustered. We propose that Clu functions in a novel pathway that positions mitochondria within the cell based on their physiological state. Disruption of the Clu pathway may enhance oxidative damage, alter gene expression, cause mitochondria to cluster at microtubule plus ends, and lead eventually to mitochondrial failure.
Integrin β3 Leu33Pro Homozygosity and Risk of Cancer

BACKGROUND: Increased tumor cell expression of integrins containing the beta3 subunit is associated with increased progression to invasive tumors, whereas inhibition of beta3 integrin expression and/or function may reduce tumor growth and metastasis. The Leu33Pro polymorphism of the beta3 subunit modulates the function of alpha(IIb)beta3 integrin. We examined whether this polymorphism influences cancer risk. METHODS: Using participants (n = 9242) from the Copenhagen City Heart Study with 24 years of follow-up and endpoints from the Danish Cancer Registry, we assessed the risk of all cancers and of 27 cancer types in individuals who carry the Leu33Pro polymorphism (heterozygotes and homozygotes) relative to those without the polymorphism (non-carriers). Relative risks (RRs) of cancer and 95% confidence intervals (CIs) were calculated by Cox proportional hazards regression analysis. Differences in cumulative cancer incidence (per 10 000 person-years) were tested using log-rank statistics. Statistical tests were two-sided. RESULTS: Among the participants, 70.0% were non-carriers, 27.3% were heterozygotes, and 2.7% were homozygotes. We detected 1296 participants with a first cancer. Cumulative incidences in non-carriers, heterozygotes, and homozygotes were 81, 83, and 112, respectively (homozygotes versus non-carriers, P =.02). The age-adjusted RR of all cancers in homozygotes relative to non-carriers was 1.4 (95% CI = 1.1 to 1.9). Incidences in non-carriers, heterozygotes, and homozygotes were 3, 4, and 16 for ovarian cancer; 19, 24, and 36 for breast cancer; and 2, 3, and 7 for melanoma (homozygotes versus non-carriers; P =.002, P =.06, and P =.03, respectively). The age-adjusted RR in homozygotes relative to non-carriers was 4.7 (95% CI = 1.6 to 14) for ovarian cancer, 1.9 (95% CI = 1.0 to 3.7) for breast cancer, and 3.5 (95% CI = 1.1 to 12) for melanoma. Adjustment for other cancer risk factors did not alter these results. Heterozygotes did not differ from non-carriers with respect to cancer risk. CONCLUSION: Individuals homozygous for the Leu33Pro polymorphism of the beta3 integrin subunit have an increased cancer risk.
Emergence of a new strain of porcine circovirus in pigs in Canada

PORCINE circovirus (PCV) was first isolated in 1974. In the late 1990s, it was associated with an emerging disease in pigs described as postweaning multisystemic wasting syndrome (PMWS). Due to genetic differences between the PMWS-associated PCV and the first isolated strain, the non-pathogenic
Identification and antimicrobial susceptibility of Staphylococcus aureus isolated from milk samples of dairy cows and nasal swabs of farm workers in selected dairy farms around Addis Ababa, Ethiopia

Staphylococcus aureus is a major problem of public health which causes a number of human and animal diseases. In order to isolate and identify S. aureus from milk of dairy cows and nasal swabs of farm workers of different farm settings, a cross sectional study was conducted on a total of 260 lactating dairy cows milk and 68 nasal swabs of farm workers in selected dairy farms around Addis Ababa, Ethiopia. The collected nasal swabs and milk (California Mastitis Test Screened) were cultured on sheep blood agar.Presumptive Staphylococci colonies were sub-cultured on mannitol salt agar andconfirmed by BiOLOG Identification system. Antimicrobial susceptibility pattern of S. aureus isolates was done by Kirby-Bauer disk diffusion method using twelve antimicrobials. The prevalence of S. aureus was found to be 51 (15.5%) out of the total samples examined. In addition, the prevalence of S. aureus was 42 (16.2%) from milk of 260 lactating dairy cows and 9 (13.2%) from nasal swabs of 68 farm workers. The prevalence of S. aureus ranges from 8 (8.9%) to 13 (36.1%) in selected dairy farms where poorly managed farms showed high prevalence. S. aureus was more likely to occur in cows that were poorly managed and treated frequently with antimicrobials. Antimicrobial susceptibility test revealed the resistance of S. aureus to the tested antimicrobials. Thus,out of a total of 51 isolates, high resistance rate was observed primarily to penicillin G 47 (92.2%) followed by tetracycline 34 (66.7%), amoxicillin-clavulinic acid 19 (37.3%), oxacillin 17 (33.3%), cephalothin 14 (27.5%) and low level of resistance to chloroamphenicol 12 (23.5%), erythromycin 12 (23.5%), sulphamethoxazole-trimethoprim 11 (21.6%), gentamicin 10 (19.6%), clindamycin 9 (17.6%), vancomycin 2 (3.9%) and rifampicin 1 (2%). There was no statistically significant difference (p>0.05) between type of samples in determining resistance pattern to each antimicrobial except for pencillin G and tetracycline. Multidrug resistance was also observed in 23 (45.1%) of the total isolates and most of them were from milk samples, 20 (47.6%) with no statistically significant difference (P>0.05) between dairy farm workers and dairy cows. S. aureus becamealmost resistant to β-lactams and tetracycline. Hence, antimicrobial susceptibility should be conducted before treating dairy cows. Consequently, reduction in transfer of resistant S. aureus strains between humans and animals could possibly be made. Key words: Staphylococcus aureus, dairy cow milk, farm workers, antimicrobial susceptibility test, Ethiopia.
Mastering Diagnostic Skills: Enhancing Proficiency in Otitis Media, a Model for Diagnostic Skills Training

OBJECTIVE: We developed a program for training in the diagnosis of otitis media that included images illustrating various otoscopic findings, mnemonic guides to recollection, and discrimination sessions that included feedback and assessments of diagnostic skills. METHODS: We prepared a computerized, interactive curriculum, Enhancing Proficiency in Otitis Media (ePROM), that was centered around assemblages of clinically diverse, still and video images of tympanic membranes (TMs). To assess curriculum effectiveness, we constructed a test, the Diagnostic Ear Assessment Resource, that consisted of 50 video TM images. We administered the test to 84 residents in pediatrics or family practice who had not been exposed to ePROM and, varying the order in which the images were presented, to another group of 102 residents in the same programs both before and after exposure to ePROM. RESULTS:o Mean proportions of correct diagnoses in the Diagnostic Ear Assessment Resource were larger among residents who had been exposed to ePROM than among residents at comparable levels of training who had not been exposed (67% vs 62%; P = .007). Among residents exposed to ePROM, mean proportions of correct diagnoses were larger after exposure than before (67% vs 55%; P < .001). CONCLUSION: A structured, computerized curriculum to supplement standard clinical training can enhance residents' abilities to interpret still and video images of TMs and may improve their skills in diagnosing otitis media.
Efficacy of Inhaled Corticosteroids in Infants and Preschoolers With Recurrent Wheezing and Asthma: A Systematic Review With Meta-analysis

OBJECTIVE. To compare the efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing or asthma. METHODS. Randomized, prospective, controlled trials published January 1996 to March 2008 with a minimum of 4 weeks of inhaled corticosteroids versus placebo were retrieved through Medline, Embase, and Central databases. The primary outcome was wheezing/asthma exacerbations; secondary outcomes were withdrawal caused by wheezing/asthma exacerbations, changes in symptoms score, pulmonary function (peak expiratory flow and forced expiratory volume in 1 second), or albuterol use. RESULTS. Of eighty-nine studies identified, 29 (N = 3592 subjects) met the criteria for inclusion. Patients who received inhaled corticosteroids had significantly less wheezing/asthma exacerbations than those on placebo (18.0% vs 32.1%); posthoc subgroup analysis suggests that this effect was higher in those with a diagnosis of asthma than wheeze but was independent of age (infants versus preschoolers), atopic condition, type of inhaled corticosteroid (budesonide metered-dose inhaler versus fluticasone metered-dose inhaler), mode of delivery (metered-dose inhaler versus nebulizer), and study quality (Jadad score: <4 vs ≥4) and duration (<12 vs ≥12 weeks). In addition, children treated with inhaled corticosteroids had significantly fewer withdrawals caused by wheezing/asthma exacerbations, less albuterol use, and more clinical and functional improvement than those on placebo. CONCLUSIONS. Infants and preschoolers with recurrent wheezing or asthma had less wheezing/asthma exacerbations and improve their symptoms and lung function during treatment with inhaled corticosteroids.
Fundamental design tradeoffs in cognitive radio systems

Under the current system of spectrum allocation, rigid partitioning has resulted in vastly underutilized spectrum bands, even in urban locales. Cognitive radios have been proposed as a way to reuse this underutilized spectrum in an opportunistic manner. To achieve this reuse while guaranteeing non-interference with the primary user, cognitive radios must detect very weak primary signals. However, uncertainties in the noise+interference impose a limit on how low of a primary signal can be robustly detected. In this paper, we show that the presence/absence of possible interference from other opportunistic spectrum users represents a major component of the uncertainty limiting the ability of a cognitive radio network to reclaim a band for its use. Coordination among nearby cognitive radios is required to control this uncertainty. While this coordination can take a form similar to a traditional MAC protocol for data communication, its role is different in that it aims to reduce the uncertainty about interference rather than just reducing the interference itself. We show how the degree of coordination required can vary based on the coherence times and bandwidths involved, as well as the complexity of the detectors themselves. The simplest sensing strategies end up needing the most coordination, while more complex strategies involving adaptive coherent processing and interference prediction can be individually more robust and thereby reduce the need for coordination across different networks. We also show the existence of a coordination radius wall which limits secondary user densities that can be supported irrespective of coordination involved. Furthermore, local cooperation among cognitive radios for collective decision making can reduce the fading margins we need to budget for. This cooperation benefits from increased secondary user densities and hence induces a minima in the power-coordination tradeoff.
Child Abuse Training and Knowledge: A National Survey of Emergency Medicine, Family Medicine, and Pediatric Residents and Program Directors

OBJECTIVE. The objective of this study was to determine the level of knowledge, comfort, and training related to the medical management of child abuse among pediatrics, emergency medicine, and family medicine residents. METHODS. Surveys were administered to program directors and third-year residents at 67 residency programs. The resident survey included a 24-item quiz to assess knowledge regarding the medical management of physical and sexual child abuse. Sites were solicited from members of a network of child abuse physicians practicing at institutions with residency programs. RESULTS. Analyzable surveys were received from 53 program directors and 462 residents. Compared with emergency medicine and family medicine programs, pediatric programs were significantly larger and more likely to have a medical provider specializing in child abuse pediatrics, have faculty primarily responsible for child abuse training, use a written curriculum for child abuse training, and offer an elective rotation in child abuse. Exposure to child abuse training and abused patients was highest for pediatric residents and lowest for family medicine residents. Comfort with managing child abuse cases was lowest among family medicine residents. On the knowledge quiz, pediatric residents significantly outperformed emergency medicine and family medicine residents. Residents with high knowledge scores were significantly more likely to come from larger programs and programs that had a center, provider, or interdisciplinary team that specialized in child abuse pediatrics; had a physician on faculty responsible for child abuse training; used a written curriculum for child abuse training; and had a required rotation in child abuse pediatrics. CONCLUSIONS. By analyzing the relationship between program characteristics and residents' child abuse knowledge, we found that pediatric programs provide far more training and resources for child abuse education than emergency medicine and family medicine programs. As leaders, pediatricians must establish the importance of this topic in the pediatric education of residents of all specialties.