Miracle-dz/UniFAR-FTUs huggingface dataset:
Individual and Environmental Determinants of Provider Continuity Among Urban Older Adults With Heart Failure: A Retrospective Cohort Study

Objective: Continuity in patient–provider relationships is important to providing high-quality care for older adults with chronic conditions. We investigated individual and environmental determinants of provider continuity for office-based physician visits among urban older adults with heart failure. Method: We linked Medicare claims with data on neighborhood characteristics for a retrospective cohort of community-dwelling Medicare beneficiaries with heart failure in New York City (N = 50,475). Results: Mean continuity using the Bice–Boxerman index was 0.33 (SD = 0.22) (possible range of 0 [no continuity] to 1 [perfect continuity]). Multivariable regression indicated that provider continuity was higher among older, female, and dually eligible beneficiaries. Those with more chronic conditions had higher continuity, controlling for number of medical specialties seen. Continuity was lower for beneficiaries in neighborhoods with high median income and high primary care density. Conclusion: Individual and environmental predictors of provider continuity among urban older adults with heart failure could help to identify those at risk of care fragmentation.
Retrieval Potentiates New Learning: A Theoretical and Meta-Analytic Review

A growing body of research has shown that retrieval can enhance future learning of new materials. In the present report, we provide a comprehensive review of the literature on this finding, which we term test-potentiated new learning. Our primary objectives were to (a) produce an integrative review of the existing theoretical explanations, (b) summarize the extant empirical data with a meta-analysis, (c) evaluate the existing accounts with the meta-analytic results, and (d) highlight areas that deserve further investigations. Here, we identified four nonexclusive classes of theoretical accounts, including resource accounts, metacognitive accounts, context accounts, and integration accounts. Our quantitative review of the literature showed that testing reliably potentiates the future learning of new materials by increasing correct recall or by reducing erroneous intrusions, and several factors have a powerful impact on whether testing potentiates or impairs new learning. Results of a metaregression analysis provide considerable support for the integration account. Lastly, we discuss areas of under-investigation and possible directions for future research.
The PI3K/AKT pathway in obesity and type 2 diabetes

Obesity and type 2 diabetes mellitus are complicated metabolic diseases that affect multiple organs and are characterized by hyperglycaemia. Currently, stable and effective treatments for obesity and type 2 diabetes mellitus are not available. Therefore, the mechanisms leading to obesity and diabetes and more effective ways to treat obesity and diabetes should be identified. Based on accumulated evidences, the PI3K/AKT signalling pathway is required for normal metabolism due to its characteristics, and its imbalance leads to the development of obesity and type 2 diabetes mellitus. This review focuses on the role of PI3K/AKT signalling in the skeletal muscle, adipose tissue, liver, brain and pancreas, and discusses how this signalling pathway affects the development of the aforementioned diseases. We also summarize evidences for recently identified therapeutic targets of the PI3K/AKT pathway as treatments for obesity and type 2 diabetes mellitus. PI3K/AKT pathway damaged in various tissues of the body leads to obesity and type 2 diabetes as the result of insulin resistance, and in turn, insulin resistance exacerbates the PI3K/AKT pathway, forming a vicious circle.
Home Care Workers’ Experiences of Client Death and Disenfranchised Grief

While many types of health care workers experience patient death, home care workers do so under vastly different social and economic circumstances. When a client dies, home care workers often lose both a close relationship and a job. Though research suggests that health care workers’ grief may frequently be disenfranchised, there is no in-depth study of the mechanisms that disenfranchise home care workers’ grief specifically. To address this gap, our study used focus groups and peer interviews between home care workers in New York City. We describe four interrelated grief strategies they employ to navigate social and employer-based “grieving rules. ” Our findings suggest that home care workers’ grief is disenfranchised via employer and societal underestimations of their relationships with clients and their losses when clients die, particularly job loss. Building on our findings, we suggest alterations to agency practices and home care systems to improve support for workers.
Reconsidering the Differences Between Shame and Guilt

Although most researchers maintain that shame and guilt are distinct emotions, the debate on their differences is still open. We aim to show that some of the current distinctions between shame and guilt need to be redrawn, and their adaptive and social implications need to be revisited. We suggest the following distinguishing criteria: the kind of self-evaluation involved (inadequacy versus harmfulness); one’s focus on the perceived discrepancy between actual and ideal self versus one’s focus on the perceived responsibility for one’s fault; and consequently the different domains of self-esteem involved. Although these criteria have been in part suggested or alluded to in the relevant literature, we use and integrate them with each other in a novel way. This allows to better distinguish between shame and guilt, as well as to account for their possible coexistence or the shift from one emotion to the other.
Advances in the Biology of Seed and Vegetative Storage Proteins Based on Two-Dimensional Electrophoresis Coupled to Mass Spectrometry

Seed storage proteins play a fundamental role in plant reproduction and human nutrition. They accumulate during seed development as reserve material for germination and seedling growth and are a major source of dietary protein for human consumption. Storage proteins encompass multiple isoforms encoded by multi-gene families that undergo abundant glycosylations and phosphorylations. Two-dimensional electrophoresis (2-DE) is a proteomic tool especially suitable for the characterization of storage proteins because of their peculiar characteristics. In particular, storage proteins are soluble multimeric proteins highly represented in the seed proteome that contain polypeptides of molecular mass between 10 and 130 kDa. In addition, high-resolution profiles can be achieved by applying targeted 2-DE protocols. 2-DE coupled with mass spectrometry (MS) has traditionally been the methodology of choice in numerous studies on the biology of storage proteins in a wide diversity of plants. 2-DE-based reference maps have decisively contributed to the current state of our knowledge about storage proteins in multiple key aspects, including identification of isoforms and quantification of their relative abundance, identification of phosphorylated isoforms and assessment of their phosphorylation status, and dynamic changes of isoforms during seed development and germination both qualitatively and quantitatively. These advances have translated into relevant information about meaningful traits in seed breeding such as protein quality, longevity, gluten and allergen content, stress response and antifungal, antibacterial, and insect susceptibility. This review addresses progress on the biology of storage proteins and application areas in seed breeding using 2-DE-based maps.
Nutritional status in cerebral palsy: A Cross-sectional comparative survey of children in Kano, Nigeria

Background: Cerebral palsy (CP) is a common neurodevelopmental motor disorder resulting from early childhood brain insult. Nutrition in children is very important for growth and development. This is more so in those with chronic illnesses such as CP. This study was conducted with the aim of assessing the anthropometry and anthropometric indices of CP children. Materials and Methods: This comparative, cross-sectional study recruited 150 children with CP matched for age and sex, with 150 children without CP (as controls). The participants' socio-demographic and CP-related data were collected using a pre-tested questionnaire designed for the study. The weight and height of the subjects were measured. Nutritional status was determined using the World Health Organization Z-scores. Results: Overall prevalence of malnutrition in CP subjects was 86%. This was significantly higher than in controls, whose prevalence was 55.3% (χ2 = 34.027,P < 0.0001). The prevalence of stunting, wasting and underweight in CP subjects was 53.3%, 57.5% and 66.9%, respectively. These were also significantly higher than those of controls who had prevalence of stunting being 16.7%, wasting 8.5% and underweight 14.8%. Conclusion: This study found a high prevalence of malnutrition (especially under-nutrition) and therefore underscores the need for more emphases on nutritional assessment, counselling and management in CP patients.
Tendon Structure Quantified using Ultrasound Imaging Differs Based on Location and Training Type

Achilles tendinopathy is ten-times more common amongst running athletes compared to age-matched peers. Load induced tendon remodeling and its progression in an at-risk population of developing symptomatic tendinopathy is not well understood. The purpose of this study was to prospectively characterize Achilles and patellar tendon structure in competitive collegiate distance runners over different competitive seasons using quantitative ultrasound imaging. Twenty-two collegiate cross country runners and eleven controls were examined for this study. Longitudinal and cross-sectional ultrasound images of bilateral Achilles and patellar tendons were obtained at the one week prior to start of formal collegiate cross country practices, one week after the conclusion of cross country season, and one week prior to outdoor track and field championships. Collagen organization, mean echogenicity, tendon thickness, and neovascularity were determined using well established image processing techniques. We found that Achilles and patellar tendons respond differently to high-volume running and transitions from one sport season to another, suggesting that tendon structure is sensitive to differences in tendon loading biomechanics. Our findings indicate that Achilles tendon structure in trained runners differ structurally to control tendons but is stable throughout training while patellar tendon structure changes in response to the transition in training volume between cross country and track seasons. These findings expand upon prior reports that some degree of tendon remodeling may act as a protective adaptation for sport specific loading. News and Noteworthy In this study we prospectively examined the Achilles and patellar tendon structure of distance runners to determine if continued training through multiple seasons elicits tendon remodeling or pathology. We found that Achilles and patellar tendons respond uniquely to the changing loads required during each season. Achilles tendon collagen alignment is mostly stable throughout the competitive cycle, but the patellar tendon undergoes structural changes following the transition from cross-country to track season.
Chest physiotherapy with early mobilization may improve extubation outcome in critically ill patients in the intensive care units

Extubation failure can lead to a longer intensive care unit (ICU) stay, higher mortality rate, and higher risk of requiring tracheostomy. Chest physiotherapy (CPT) can help patients in reducing the accumulation of airway secretion, preventing collapsed lung, improving lung compliance, and reducing comorbidities. Much research has investigated the correlation between CPT and respiratory system clearance. However, few studies have investigated the correlation between CPT and failed ventilator extubation. Therefore, this study aimed to investigate the use of CPT for reducing the rate of failed removal from mechanical ventilators.
Genome-wide meta-analysis of 158,000 individuals of European ancestry identifies three loci associated with chronic back pain

OBJECTIVES To conduct a genome-wide association study (GWAS) meta-analysis of chronic back pain (CBP). METHODS Adults of European ancestry were included from 16 cohorts in Europe and North America. CBP cases were defined as those reporting back pain present for >3–6 months; non-cases were included as comparisons (“controls”). Each cohort conducted genotyping using commercially available arrays followed by imputation. GWAS used logistic regression models with additive genetic effects, adjusting for age, sex, study-specific covariates, and population substructure. The threshold for genome-wide significance in the fixed-effect inverse-variance weighted meta-analysis was p<5×10−8. Suggestive (p<5×10−7) and genome-wide significant (p<5×10−8) variants were carried forward for replication or further investigation in an independent sample. RESULTS The discovery sample was comprised of 158,025 individuals, including 29,531 CBP cases. A genome-wide significant association was found for the intronic variant rs12310519 in SOX5 (OR 1.08, p=7.2×10−10). This was subsequently replicated in an independent sample of 283,752 subjects, including 50,915 cases (OR 1.06, p=5.3×10−11), and exceeded genome-wide significance in joint meta-analysis (0R=1.07, p=4.5×10−19). We found suggestive associations at three other loci in the discovery sample, two of which exceeded genome-wide significance in joint meta-analysis: an intergenic variant, rs7833174, located between CCDC26 and GSDMC (OR 1.05, p=4.4×10−13), and an intronic variant, rs4384683, in DCC (OR 0.97, p=2.4×10−10). DISCUSSION In this first reported meta-analysis of GWAS for CBP, we identified and replicated a genetic locus associated with CBP (SOX5). We also identified 2 other loci that reached genome-wide significance in a 2-stage joint meta-analysis (CCDC26/GSDMC and DCC).
Resting-state gamma-band power alterations in schizophrenia reveal E/I-balance abnormalities across illness-stages

We examined alterations in E/I-balance in schizophrenia (ScZ) through measurements of resting-state gamma-band activity in participants meeting clinical high-risk (CHR) criteria (n = 88), 21 first episode (FEP) patients and 34 chronic ScZ-patients. Furthermore, MRS-data were obtained in CHR-participants and matched controls. Magnetoencephalographic (MEG) resting-state activity was examined at source level and MEG-data were correlated with neuropsychological scores and clinical symptoms. CHR-participants were characterized by increased 64–90 Hz power. In contrast, FEP- and ScZ-patients showed aberrant spectral power at both low- and high gamma-band frequencies. MRS-data showed a shift in E/I-balance toward increased excitation in CHR-participants, which correlated with increased occipital gamma-band power. Finally, neuropsychological deficits and clinical symptoms in FEP and ScZ-patients were correlated with reduced gamma band-activity, while elevated psychotic symptoms in the CHR group showed the opposite relationship. The current study suggests that resting-state gamma-band power and altered Glx/GABA ratio indicate changes in E/I-balance parameters across illness stages in ScZ.
Journalists' Experiences with Using Nurses as Sources in Health News Stories.

: Purpose: In a 2018 replication of a 1997 study, the Woodhull Study on Nursing and the Media, nurses were identified as sources in only 2% of health news stories in the same print publications investigated in the earlier study, showing no improvement in 20 years. We sought to interview health journalists across a spectrum of media to better understand their perceptions of the barriers and facilitators to using nurses as sources in news stories. METHODS This qualitative study employed a snowball sampling technique to obtain a sample of 10 health journalists. One-to-one semistructured telephone interviews using open-ended questions were conducted and recorded, and thematic analysis was performed on the transcripts. RESULTS Analysis of the transcripts revealed an overarching theme of biases about women, nurses, and positions of authority in health care among journalists, newsrooms, and public relations staff in health care organizations and universities that impeded journalists' use of diverse sources in health reporting. Subthemes were that 1) when used as sources, nurses can enrich a story; 2) health journalists don't understand the range of nurses' roles, work, and education; 3) health journalists don't know how to find nurses to interview for news stories and have little time to do so; 4) communications staff of health care organizations and universities aren't offering nurses as sources; 5) editorial biases, policies, and processes can get in the way of journalists using nurses as sources; and 6) nurses and the nursing profession aren't strategic about engaging journalists. CONCLUSIONS Because nurses as sources can enhance the quality of health news, health journalists should become more aware of their biases and strive to include more nurses, as well as more women and people of color overall, in their stories. Nurses and nursing organizations can do more to reach out to journalists and public relations staff to raise awareness of nurses' expertise.
Apolipoprotein E Fragmentation within Lewy Bodies of the Human Parkinson’s Disease Brain

Although harboring the Apolipoprotein E4 (APOE4) allele is a well-known risk factor in Alzheimer’s disease (AD), whether a similar risk holds true for Parkinson’s disease (PD) is currently not known. To investigate whether apoE pathology is present in PD, an immunohistochemical study was undertaken with fixed, human PD brain sections from the substantia nigra utilizing a recently characterized antibody that detects an amino-terminal fragment of apoE. This antibody, termed the apoE cleavage fragment p17 (nApoECFp17) antibody specifically detects an amino-terminal 17 kDa fragment of apoE without reacting with full-length forms of the protein. Application of this antibody revealed the presence of this fragment in Lewy bodies in all cases examined. Colocalization of nApoECFp17 with an antibody to alpha-synuclein (α-Syn), which served as a general marker for Lewy bodies, indicated the presence of this apoE fragment in 87.5% of all identified Lewy bodies. In addition, localization of nApoECFp17 was also evident within oligodendrocytes, the nucleus of melatonin-containing neurons, and blood vessels. Conversely, little staining was observed in the substantia nigra from Pick’s disease or in the frontal cortex of dementia with Lewy bodies (DLB) cases, suggesting a specificity for nApoECFp17 immunoreactivity in PD. Collectively, these data have identified widespread evidence for apoE fragmentation in the human PD brain and documented for the first time the presence of apoE within Lewy bodies, the major pathological marker for this neurodegenerative disease.
Barriers to using clozapine in treatment-resistant schizophrenia: systematic review

Aims and method To systematically review the literature on barriers to the use of clozapine and identify any interventions for optimizing clozapine use in treatment-resistant schizophrenia. Journal databases were searched from 1972 to March 2018. The following search terms were used: treatment-resistant schizophrenia, clozapine, barriers, use, prescription rates, implementation, clozaril and prescribing practices. Following a review of the literature, 15 papers were included in the review. Results The major barriers that were identified included mandatory blood testing, fear of serious side-effects and lack of adherence by the patients, difficulty in identifying suitable patients, service fragmentation, and inadequate training in or exposure to using clozapine. Clinical implications In view of consistent evidence across the studies on inadequate knowledge and skills as a significant barrier, we suggest that a certification requiring competence in initiating and managing side-effects of clozapine becomes a mandatory requirement in training programmes. Declarations of interest None.
Mood Self-Assessment in Children From the Age of 7

The evaluation of emotions is one of the main challenges facing theorists and applied psychology researchers. In children, in order to focus on subjective feelings, psychologists mainly use non-verbal scales that measure both the intensity and valence of the emotions felt. The use of these scales poses a main research questions: What is the children’s knowledge of the emotion presented? In order to properly assess the emotional state of a child, it is first necessary to measure the child’s understanding of the major characteristics of emotion. Secondly, it is important to assess the child’s ability to designate the primary emotion associated with a particular situation, and assess how these emotional situations alters their own assessment of their emotional state. This research aims to know if children from the age of seven to eleven can be emotionally induced and if this induction varies in the lifespan.
NMDA-receptor antibodies alter cortical microcircuit dynamics

Significance Recently, autoantibodies against NMDA receptors (NMDARs) were identified as a major cause of autoimmune encephalitis. They cause abnormalities in brain function often associated with significant changes in patients’ brain dynamics. Here we use computational modeling to identify how NMDAR dysfunction causes abnormalities in brain dynamics using patient EEGs and local field potential recordings in a mouse model of NMDAR-Ab encephalitis. NMDAR autoantibodies cause a specific shift in excitatory coupling within cortical circuits that places the circuits closer to pathological transitions between dynamic brain states. Because of the proximity to these phase transitions, otherwise benign fluctuations in neuronal coupling cause abnormal EEG responses in the presence of the antibodies. Our modeling results thus explain fluctuating abnormalities in brain dynamics observed in patients. NMDA-receptor antibodies (NMDAR-Abs) cause an autoimmune encephalitis with a diverse range of EEG abnormalities. NMDAR-Abs are believed to disrupt receptor function, but how blocking this excitatory synaptic receptor can lead to paroxysmal EEG abnormalities—or even seizures—is poorly understood. Here we show that NMDAR-Abs change intrinsic cortical connections and neuronal population dynamics to alter the spectral composition of spontaneous EEG activity and predispose brain dynamics to paroxysmal abnormalities. Based on local field potential recordings in a mouse model, we first validate a dynamic causal model of NMDAR-Ab effects on cortical microcircuitry. Using this model, we then identify the key synaptic parameters that best explain EEG paroxysms in pediatric patients with NMDAR-Ab encephalitis. Finally, we use the mouse model to show that NMDAR-Ab–related changes render microcircuitry critically susceptible to overt EEG paroxysms when these key parameters are changed, even though the same parameter fluctuations are tolerated in the in silico model of the control condition. These findings offer mechanistic insights into circuit-level dysfunction induced by NMDAR-Ab.