Miracle-dz/UniFAR-FTUs huggingface dataset:
The utility of the Convergence Insufficiency Symptom Survey (CISS) post-concussion

ABSTRACT Background: The Convergence Insufficiency Symptom Survey (CISS) is being utilized as an assessment measure following concussion despite minimal research. This study explored the sensitivity and specificity of the CISS in identifying receded near point of convergence (NPC) post-concussion. Methods: Prospective study of 130 patients post-concussion aged 11–25, classified into normal NPC (n = 94) and CI (n = 36) groups (i.e., NPC >5 cm), completed the CISS, VOMS, and PCSS. Sensitivity and specificity identifying receded NPC were explored with published CISS cutoff score (>16). ROC with AUC analysis was conducted to determine an alternate CISS cutoff score to yield optimal sensitivity and specificity in patients with concussion. Results: Utilizing the published cutoff score, the CISS demonstrated adequate sensitivity (.78 [95% CI = .60-.89]) but poor specificity (.35 [95%CI = .26-.46]). ROC curve demonstrated that CISS score was significant (P = .01) in predicting a positive test result (i.e., NPC >5) with AUC of . 65 (95%CI .54-.76). An alternative cutoff score (CISS>23) maximized sensitivity (.70) and specificity (.53) for identifying receded NPC. Conclusions: Both the previously published CISS cutoff and our sample-based cutoff score yielded a high rate of false positives for receded NPC. CISS scores post-concussion may help the clinician understand difficulties with visual tasks but is not a suitable diagnostic tool in this patient population.
Say what? Patients have poor immediate memory of major risks of interscalene block disclosed during the informed consent discussion

Background Poor memory of disclosed risks can undermine informed consent and create medicolegal challenges. The extent to which patients remember the risks of peripheral nerve blockade following the informed consent discussion is unknown. This prospective cohort study evaluated patients’ immediate memory of risks related to interscalene block (ISB) that were disclosed during the preoperative informed consent discussion. Methods Using a standardized script, patients scheduled for arthroscopic shoulder surgery were informed of the risks of ISB by an anesthesiologist in the preoperative assessment clinic. Immediately thereafter, consenting participants were asked to identify the risks of ISB from a printed list of nine true risks (four major and five minor) and nine ‘distractor’ items, which were unrelated adverse events and not disclosed. The primary outcome was the proportion of participants who remembered all four true major risks including long-term nerve damage, seizure, life-threatening event, and damage to the covering of the lung. Results Among 125 participants, only 26 (21%) remembered all four major risks of ISB. The mean number of major risks remembered was 2±1 out of 4. Fifteen (12%) participants remembered all nine true risks. The mean number of true risks remembered was 6±2 out of 9. Multivariable analysis revealed that participants’ self-rated assessment of their memory was not associated with actual recall. Conclusion Patients have poor immediate memory of the major risks related to ISB disclosed during the informed consent discussion. Under the present study conditions, the validity of the informed consent process for patients undergoing ISB may be undermined.
Influence of mixing strategy on post weaning performances and agonistic behaviour of piglets

Mixing litters at weaning is a common practice to reduce weight heterogeneity within the pens. A 40 days long experiment has been undertaken to investigate the effects of grouping strategy after weaning on growth performance and social behaviour of piglets. At 28 days of age, 360 male and female piglets were weaned and placed in 24 pens according to their weight and origin. Twelve pens contained 15 piglets originated from 12.7 litters per pen (1 or 2 piglets per litter; MIX) whereas 12 other pens gathered 15 piglets from 4.0 litters (2 to 5 piglets per litter; FAM). The average body weight was 7.9 ± 1.4 kg and 7.9 ± 1.3 kg for MIX and FAM treatments, respectively. The initial within-pen standard deviation of body weight was of 0.5 ± 0.2 kg in MIX group and 1.1 ± 0.1 kg in FAM group. Piglets were housed in fully slatted pens (4.4 m 2 ) and received ad libitum a phase 1 diet up to 12 kg of body weight, then a phase 2 diet. FAM piglets had a higher feed intake (+5%, p<0.05) from day 1 to 20. Daily gain was thus higher during this period (+7%, p<0.05) and from day 21 to 40 (+6%, p<0.05). Accordingly, FAM piglets had a higher final body weight than MIX piglets (28.5 vs. 27.3 kg, p<0.001). In spite of the initial difference, within-pen weight heterogeneities were similar among treatments on days 20 and 40. Direct observations of agonistic behaviour were made on days 1, 2 and 6. The results showed a higher frequency of short fights for MIX piglets (p<0.01). Blood samples of 16 piglets per group were taken on days 1 and 8 to determine plasma concentrations of haptoglobin. This criterion was not influenced by the way that piglets were mixed. It can be concluded that pens should be constituted of piglets from a limited number of litters in order to reduce aggressions at weaning and improve post weaning performance.
Anatomy of Microscopic Structure of Ethaline Deep Eutectic Solvent Decoded Through Molecular Dynamics Simulations.

Atomistic molecular dynamics simulations have been performed to investigate the microscopic structure of ethaline deep eutectic solvent (DES), a mixture of choline chloride ([Ch][Cl]) and ethylene glycol (EG) in molar ratio of 1:2, respectively. As much as the structure of a DES is derived by the composition of the species present in it, the arrangement of hydrogen bond donor species also plays a crucial role in laying down the microscopic structure of DESs. By virtue of its inherent chemical structure, EG renders both intra- and inter-molecular hydrogen bonds. Therefore, the molecular level structural landscape of DESs containing EG as hydrogen bond donor is reckoned to be a bit complex. In the present study, we aim to understand the structural morphology of ethaline using optimum force-field parameters for EG recently proposed by our group. After initial assessment of the refined force-field parameters for ethaline DES, we have presented an in-depth analysis of the arrangement and ordering of its components at molecular level. Simulated X-ray scattering structure function and its partial components reveal the presence of short as well as long range interactions in ethaline. The role of hydrogen bonding interactions between all the three species [Ch]^{+}, [Cl]^{-} and EG were predominantly observed through radial and radial-angular distribution functions and substantiated by spatial distribution functions. The observation of competitive nature of [Ch]^{+} and EG to form hydrogen bond with the anion is one of the major outcomes of the present study. Also, weaker intra- and inter-molecular hydrogen bonding interactions between EG molecules were seen along with their simultaneous involvement with the ammonium group of choline cation.
Prevalence of hypertension and cardiovascular risk factors among long‐term AIDS survivors: A report from the field

HIV infection is associated with increased risk and progression of cardiovascular disease (CVD), yet little is known about the prevalence of CVD risk factors among long‐term AIDS survivors in resource‐limited settings. Using routinely collected data, we conducted a retrospective study to describe the prevalence of CVD risk factors among a cohort of HIV‐infected patients followed for over 10 years in Port‐au Prince, Haiti. This cohort includes 910 adults who initiated antiretroviral therapy (ART) between 2003 and 2004 and remained in care between 2014 and 2016 when routine screening for CVD risk factors was implemented at a large clinic in Haiti. A total of 397 remained in care ≥10 years and received screening. At ART initiation, 59% were female, median age was 38 years (IQR 33‐44), and median CD4 count was 117 cells/mm3 (IQR 34‐201). Median follow‐up time from ART initiation was 12.1 years (IQR 11.7‐12.7). At screening, median CD4 count was 574 cells/mm3 (IQR 378‐771), and 84% (282 of 336 screened) had HIV‐1 RNA < 1000 copies/mL. Seventy‐four percent of patients had at least 1 risk factor including 58% (224/385) with hypertension, 8% (24/297) diabetes, 43% (119/275) hypercholesterolemia, 8% (20/248) active smoking, and 10% (25/245) obesity. Factors associated with hypertension were age (adjusted OR 1.06, P < .001) and weight at screening (adjusted OR 1.02, P = .019). Long‐term AIDS survivors have a high prevalence of CVD risk factors, primarily hypertension. Integration of cardiovascular screening and management into routine HIV care is needed to maximize health outcomes among aging HIV patients in resource‐limited settings.
Estimating Age-Based Developmental Trajectories Using Latent Change Score Models Based on Measurement Occasion

Abstract Accelerated longitudinal designs (ALDs) are designs in which participants from different cohorts provide repeated measures covering a fraction of the time range of the study. ALDs allow researchers to study developmental processes spanning long periods within a relatively shorter time framework. The common trajectory is studied by aggregating the information provided by the different cohorts. Latent change score (LCS) models provide a powerful analytical framework to analyze data from ALDs. With developmental data, LCS models can be specified using measurement occasion as the time metric. This provides a number of benefits, but has an important limitation: It makes it not possible to characterize the longitudinal changes as a function of a developmental process such as age or biological maturation. To overcome this limitation, we propose an extension of an occasion-based LCS model that includes age differences at the first measurement occasion. We conducted a Monte Carlo study and compared the results of including different transformations of the age variable. Our results indicate that some of the proposed transformations resulted in accurate expectations for the studied process across all the ages in the study, and excellent model fit. We discuss these results and provide the R code for our analysis.
Prevalence and factors associated with fatigue in the Lausanne middle-aged population: a population-based, cross-sectional survey

Objective To assess the prevalence and factors associated with fatigue in the general population. Design Population-based, cross-sectional survey performed between May 2014 and April 2017. Setting General population of the city of Lausanne, Switzerland. Participants 2848 participants (53.2% women, age range 45–86 years). Primary outcome measure Prevalence of fatigue the previous week, defined as a score of ≥4 using the Fatigue Severity Scale. Results The prevalence of fatigue was 21.9% (95% CI 20.4% to 23.4%) in the total sample. On bivariate analysis, participants with fatigue were younger, had a higher body mass index, a lower handgrip strength and lower ferritin levels. Participants with fatigue were more frequently women, had a lower educational level, presented more frequently with clinical insomnia, diabetes, anaemia, depression and low thyroid stimulating hormone (TSH) values, had a higher consumption of antihistamines, antidepressants and hypnotics, and rated more frequently their health as bad or very bad. Multivariable analysis showed that obesity (OR 1.40 (95% CI 1.03 to 1.91)), insomnia categories (p value for trend <0.001), depression (OR 3.26 (95% CI 2.38 to 4.46)), anaemia (OR 1.70 (95% CI 1.00 to 2.89)) and low self-rated health status (p value for trend <0.001) were positively associated with fatigue, while older age (p value for trend 0.002) was negatively associated with fatigue. Conversely, no association was found for diabetes, TSH levels, antihistamines or hypnotics. Conclusion In a population-based sample aged 45–86, fatigue was present in one out of five subjects. Regarding clinical factors, sleep disturbances such as insomnia and sleep apnoea should be assessed first, followed by depression. Regarding biological factors, anaemia should be ruled out, while screening for hypothyroidism is not recommended as a first step. Sleep complaints and fatigue in older subjects are not due to ageing and should prompt identification of the underlying cause.
Inaccuracy of buccal bone thickness estimation on cone-beam CT due to implant blooming: an ex-vivo study.

AIM The aim of this article was to evaluate the accuracy of buccal bone thickness measurements around implants on CBCT. MATERIAL AND METHODS Forty-four Osseospeed EV implants (3.6 in Ø) were placed guided and flapless in five fresh frozen human cadaver heads. The buccal peri-implant bone was measured clinically via guided bone sounding. Post-op CBCTs were taken with two different CBCT scanners (NewTom® , Accuitomo® ) on which the buccal bone was measured. Consequently, after implant removal, a new CBCT was made without implant artefacts (image reference standard) on which the real buccal bone thickness was scored. RESULTS Due to an average blooming (artificial increase of implant diameter) percentage of 12%-15%, the buccal peri-implant bone thickness was underestimated by 0.3 mm on both CBCT devices. Immediately adjacent to the implant blooming area, a doubtful zone of about 0.45 mm was observed in which the buccal bone was not always visible. Buccal bone that was thick enough to fall outside this doubtful zone could always be visualized. CONCLUSION The findings in this study may help the clinician in the decision-making process whether or not to intervene surgically in areas with ambiguous CBCT results.
Synthesis of 3D Ordered Macro/Microporous Yolk-Shelled Nanoreactor with Spatially Separated Functionalities for Cascade Reaction.

Constructing three-dimensional (3D) hierarchical materials with spatial compartmentalization of multiple catalytic functionalities effectively facilitates the chemical processes intensification, especially for bulky-molecule-involved cascade reaction. Herein, a facile and novel core-shell colloidal crystal templating strategy was developed to synthesize highly ordered arrays of integrated yolk-shelled nanoreactor consisting of monolithically interconnected ZIF-8 shell and sulfonated polystyrene yolks decorated with rhodium nanoparticles. The obtained nanoreactor achieves efficient catalytic one-pot cascade Knoevenagel condensation-hydrogenation reactions for larger molecules, by taking advantage of the superior mass diffusion properties of hierarchical macro/microporous metal-organic framework (MOF) skeleton, robust monolith nature as well as the spatially separated functionalities. This work offers an important strategy for preparing MOF-based (MOF-based) composites with a hierarchical framework, accelerating various applications of MOF, such as electrochemical applications, photothermal conversion, and heterogeneous catalysis.
Linking openness to cognitive ability in older adulthood: The role of activity diversity

Abstract Relatively few studies have examined the reasons older individuals participate in activities that may benefit cognition with aging. Personality traits, particularly, openness to experience, are likely to influence how activities are selected. Openness to experience has also reliably shown to relate to cognitive and intellectual capacities. The current study tested whether diversity in activity helped to explain the overlap between openness to experience and cognitive functioning in an older adult sample (n = 476, mean age: 72.5 years). Results suggest that openness is a better predictor of activity diversity than of time spent engaged in activities or time spent in cognitively challenging activities. Further, activity diversity explained significant variance in the relationship between openness and cognitive ability for most constructs examined. This relationship did not vary with age, but differed as a function of education level, such that participating in a more diverse array of activities was most beneficial for those with less formal education. These results suggest that engagement with a diverse behavioral repertoire in late life may compensate for lack of early life resources.
Linking depressive symptoms and cognitive functioning: The mediating role of leisure activity.

OBJECTIVES Greater depressive symptoms are associated with cognitive decline in older adulthood, but it is not clear what underlying factors drive this association. One behavioral pathway through which depressive symptoms may negatively influence cognitive functioning is through activity engagement. Prior research has independently linked greater depressive symptoms to both lower leisure and physical activity and independently linked both lower leisure and physical activity to lower cognition. Therefore, depressive symptoms may negatively influence cognition by reducing engagement in beneficial leisure and/or physical activities that help to maintain cognition. METHODS The current study examined associations between depressive symptoms, leisure activity, physical activity, and global cognitive functioning using longitudinal data from the Washington Heights-Inwood Columbia Aging Project (n = 5,458 older adults). A multilevel structural equation model estimated the between-person and within-person effects of depressive symptoms on global cognition through leisure and physical activity. RESULTS Leisure activity, but not physical activity, mediated the association between depressive symptoms and global cognition between- and within-persons. When individuals reported high depressive symptoms, they also reported fewer leisure activities, which was associated with lower global cognition. CONCLUSION These findings highlight behavioral pathways through which depressive symptoms may negatively influence cognitive functioning. Findings support the view that perhaps depressive symptoms act as a risk factor for cognitive impairment by reducing leisure activity engagement. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
The Common Attributes of Successful Care Manager Programs for High-Need, High-Cost Persons

Supplemental Digital Content is Available in the Text. Many programs use care managers to improve care coordination for high-need, high-cost patient populations. However, little is known about how programs integrate care managers into care delivery or the attributes shared by successful programs. We used a case study approach to examine the common attributes of 10 programs for high-need, high-cost individuals utilizing a longitudinal care manager that had achieved success in reducing cost, improving quality, or increasing patient satisfaction. Through interviews with program leaders and document review, we identified 10 common attributes of successful care manager programs, offering insights for providers aiming to better serve the high-need, high-cost population.
The Use of Dehydrated Human Amniotic/Chorionic Membrane Skin Substitute in the Treatment of Pediatric Facial Burn.

BACKGROUND Facial burns have lasting physical and psychological effects on pediatric patients. Proper management to minimize morbidities challenges reconstructive surgeons. New technologies allowed the development of skin substitutes such as amniotic and chorionic membranes, yet the use of these skin dressings and their impact on burn outcomes have not been sufficiently studied to guide practices. The objective of this study is to report on the outcomes of dehydrated amniotic membrane as a biologic skin dressing in pediatric facial burn injury compared to cadaveric allografts. METHODS Retrospective review of data collected from our institutional burn registry from 2012 to 2016. The study population included patients younger than 16 years with facial burns. Patients between 2012 and 2014 received cadaveric allografts, whereas during 2015 to 2016 patients received dehydrated human amniotic/chorionic membrane as standard treatment. Demographic characteristics and outcome measures were compared between the 2 groups. RESULTS Included 30 patients with a mean age of 3.7 years and with an average total body surface area burn of 6.8% (2%-27%). Mean injury severity scores did not significantly differ between both groups, 1.8 in amniotic group versus 2.3 in cadaveric skin group (P > 0.05). There were 4 complications (3 hypertrophic scars and 1 wound infection) in the cadaveric allografts group versus no complications in the amniotic membrane group (P < 0.05). CONCLUSION Dehydrated amniotic/chorionic membrane wound dressings are a safe alternative to cadaveric allografts in treating pediatric partial thickness facial burns.
Formulation and evaluation of thymoquinone niosomes: application of developed and validated RP-HPLC method in delivery system

Abstract A rapid, accurate, and sensitive reverse phase high-performance liquid chromatographic (RP-HPLC) method was developed and validated for the estimation of Thymoquinone (TMQ) in API as well as in noisome. The chromatograms were developed with the mobile phase – water: 2-propanol: methanol (50:45:5 v/v/v) as a solvent system at 254 nm. The method was validated as per ICH guidelines for different parameters and the recovery of TMQ was calculated in developed niosomes. Further, TMQ loaded niosomes (TMQNIOS) were prepared and evaluated for different parameters. The optimized TMQNIOS (F3) was further evaluated for surface morphology, in vitro drug release, permeation study, and confocal laser scanning microscopic (CLSM) study. The method showed linearity range between 6.25 and 100 µg/ml with low detection limit and quantitation limit with a value of 2.08 and 6.25 µg/ml. The developed formulations showed the vesicle size and encapsulation efficiency in the range of 157.32 ± 3.15 to 211.44 ± 5.23 nm and 59.32 ± 4.87 to 83.21 ± 3.55%, respectively. The drug release result showed the significant higher release from TMQNIOS in compared to TMQDIS, and the release kinetics data showed Higuchi's equation with highest regression coefficient values. The permeation study and the confocal laser microscopy study further confirmed the enhancement in permeation of TMQ in the intestinal mucosa.
Predictors of exercise capacity in chronic venous disease patients

Objectives The aim of this study was to determine predictors of exercise capacity and explore the relationship between exercise capacity, lower extremity performance level, pain, fatigue, physical activity, sleep quality, and quality of life in patients with chronic venous disease. Methods A total of 170 chronic venous disease patients who were referred to the Cardiovascular Surgery department were included. Assessment tools included the six-minute walk test for exercise capacity, repeated sit-to-stand test for lower limb performance level, Visual Analog Scale for pain, Fatigue Severity Scale for fatigue, Pittsburgh Sleep Quality Index for sleep quality, International Physical Activity Questionnaire for physical activity, and Venous Insufficiency Epidemiological and Economic Study’s Quality of Life questionnaire for quality of life. Results Exercise capacity was weakly and negatively correlated with body mass index (r = –0.391, p < 0.001), pain level (r = –0.268, p < 0.001), age (r = –0.355, p < 0.001), and fatigue severity (r = –0.141, p < 0.05). There was a weak positive correlation in walking distance with quality of life (r = –0.129, p < 0.05) and education level (r = 0.166, p < 0.05), whereas moderate positive correlation was observed between walking distance and lower limb performance level (r = 0.518, p < 0.001). Lower limb performance level was a significant predictor of exercise capacity, accounting for 50% of the variance. Conclusions Exercise capacity is an important determinant of morbidity. Therefore, there is a need to improve lower extremity performance and functional mobility in patients suffering from chronic venous disease.