Miracle-dz/UniFAR-FTUs huggingface dataset:
Myths and legends in workplace-based assessment; it’s all about perspective?

ABSTRACT Based on internationally published literature and the experience of the project team, we understood that already established beliefs and perceptions could influence the implementation of new workplace-based assessment (WBA) tools and processes. At the start of a project to design new WBA tools, we, therefore, attempted to understand the perspectives and perceptions of our GP training community and inform the communication strategy for the project. Online and paper surveys were disseminated to GP trainers, trainees and programme directors. Data were extracted from SurveyMonkey, added to paper-based data in an Excel spreadsheet and analysed using descriptive statistics. While it was generally acknowledged that trainers provide regular feedback to trainees, perceptions of the quality of feedback varied between the groups. The majority of participants agreed that WBA would be of value in learning but expressed concerns over increased workload. There were also some misconceptions about the purpose of WBA, with trainees stating they understood WBAs to be valid and reliable as a single-event sign-off tool. Differences in trainer, trainee and programme director perceptions of the use and usefulness of WBA may be attributed to many factors, not least of all (lack of) experience, perspective and position.
Commentary – Marijuana use during pregnancy and premature birth: A problem likely to worsen

This Commentary was provoked by three recent reports, concerning (1) the association between marijuana (cannabis) use during pregnancy and perinatal outcomes [1], (2) the increasing use of cannabis during pregnancy (see later), and (3) recent insights into the effects of cannabis on the developing brain [2]. Taken together, the data suggest that prenatal cannabis use has the potential to harm the developing brain and support the recent opinion of the Committee on Obstetric Practice of the American College of Obstetrics and Gynecology to discourage use of marijuana during pregnancy and lactation [3]. Notably, the opinion is consistent with the data to follow and with the well-established facts that tetrahydrocannabinol (THC), the principal psychoactive component of marijuana, crosses the placental barrier readily and during lactation can be identified in breast milk [2, 4, 5].
Recent trends in hepatitis A incidence in Brazil

Hepatitis A incidence has been decreasing in Brazil since child vaccination was implemented in 2014. This trend was interrupted by an outbreak among adult male in São Paulo in 2017. This study was outlined to estimate whether the increase of hepatitis A cases among adult men in Brazil was restricted to São Paulo. Cases reported to the national surveillance system from 14 large cities of all Brazilian regions were analyzed. Trends in time series from 2012 to 2018 were estimated by Prais‐Winsten regression. The outbreak in São Paulo extended to 2018. In Rio de Janeiro, the number of cases rose again, achieving the same levels reported before the vaccination era. Three of six cities from South and Southeast regions showed an upward trend in the number of cases among adult men (P < .005). The large cities in the other three Brazilian macroregions showed a decrease or stabilization of cases without an increase among male adults. The increase of hepatitis A virus (HAV) cases in Brazil has happened not only in São Paulo, but also in other cities of South and Southeast regions. The northernmost cities were not affected. A change in the epidemiological pattern of HAV infection is emerging in Southern Brazil.
Prior Day Negative Affect Influences Current Day Procrastination: A Lagged Daily Diary Analysis

ABSTRACT Background and objectives: Procrastination is a common problem among college students. Negative affect associated with stress and anxiety is linked to higher levels of procrastination. Although there is a relationship between procrastination and affect, little is known about the direction of this relationship. The current study explored whether changes in daily negative affect (NA) or positive affect (PA) preceded procrastination or whether procrastination preceded changes in affect. Method and design: The current study is a secondary data analysis of a larger study. After completing an initial survey assessing students’ emotional well-being, students were asked to participate in a follow-up daily diary survey. Participants in the daily diary (N = 53) completed a brief survey each weekday evening for two weeks that assessed daily affect and events. Multilevel regression tested whether NA and PA predicted next-day procrastination and vice versa. Results: Cross-lag panel analysis demonstrated that students reported more procrastination following days they experienced higher levels of NA. However, procrastination did not predict changes in NA. PA was not associated with prior day or next day procrastination experiences when controlling for NA. Conclusions: These findings demonstrate that negative emotions motivate procrastination behavior. Implications for helping students cope with and regulate NA are discussed.
Environmental exposures and child and maternal gut microbiota in rural Malawi

Abstract Background Gut microbiota composition is associated with child health, but the effect of the environment on microbiota composition is not well understood. Few studies have been conducted in low‐income settings where childhood malnutrition is common and possibly related to microbiota composition. Objectives To investigate whether gut microbiota composition in young children and their mothers is associated with different environmental exposures in rural Malawi. We hypothesized that more adverse environmental exposures would be associated with lower levels of microbiota maturity and diversity. Methods Faecal samples from up to 631 children and mothers participating in a nutrition intervention trial were collected at 1, 6, 12, 18, and 30 months (children) and at 1 month (mothers) after birth and analysed for microbiota composition with 16S rRNA sequencing. Bacterial OTU and genus abundances, measures of microbiota maturity and diversity, and UniFrac distances were compared between participants with different environmental exposures. The exposure variables included socio‐economic status, water source, sanitary facility, domestic animals, maternal characteristics, season, antibiotic use, and delivery mode. Results Measures of microbiota maturity and diversity in children were inversely associated with maternal education at 6, 18, and 30 months and did not otherwise differ consistently between participants with different environmental exposures. Phylogenetic distance was related to season of stool sample collection at all time points. At the level of individual OTUs and genera, season of stool sample collection, type of water source, and maternal education showed most associations with child gut microbiota, while HIV status was the most important predictor of relative OTU and genus abundances in mothers. Conclusion The results do not support the hypothesis that adverse environmental exposures are broadly associated with lower microbiota maturity and diversity but suggest that environmental exposures influence the abundance of several bacterial OTUs and genera and that low maternal education is associated with higher microbiota maturity and diversity.
A Comparison of Emergency Preparedness Policies by Long-Term Care Setting Type in Ohio: Assisted Living Settings Lag Behind Nursing Homes in Key Areas

Skilled nursing facilities (SNFs) have received regulatory attention in relation to their emergency preparedness. Yet, assisted living settings (ALs) have not experienced such interest due to their classification as a state-regulated, home- and community-based service. However, the growth in the number of ALs and increased resident acuity levels suggest that existing disaster preparedness policies, and therefore, plans, lag behind those of SNFs. We examined differences in emergency preparedness policies between Ohio’s SNFs and ALs. Data were drawn from the 2015 wave of the Ohio Biennial Survey of Long-Term Care Facilities. Across setting types, most aspects of preparedness were similar, such as written plans, specifications for evacuation, emergency drills, communication procedures, and preparations for expected hazards. Despite these similarities, we found SNFs were more prepared than large ALs in some key areas, most notably being more likely to have a backup generator and 7 days of pharmacy stocks and generator fuel.
The Emerging Role of Noncoding RNAs in Pediatric Inflammatory Bowel Disease

Abstract Prevalence of inflammatory bowel disease (IBD), a chronic inflammatory disorder of the gut, has been on the rise in recent years—not only in the adult population but also especially in pediatric patients. Despite the absence of curative treatments, current therapeutic options are able to achieve long-term remission in a significant proportion of cases. To this end, however, there is a need for biomarkers enabling accurate diagnosis, prognosis, and prediction of response to therapies to facilitate a more individualized approach to pediatric IBD patients. In recent years, evidence has continued to evolve concerning noncoding RNAs (ncRNAs) and their roles as integral factors in key immune-related cellular pathways. Specific deregulation patterns of ncRNAs have been linked to pathogenesis of various diseases, including pediatric IBD. In this article, we provide an overview of current knowledge on ncRNAs, their altered expression profiles in pediatric IBD patients, and how these are emerging as potentially valuable clinical biomarkers as we enter an era of personalized medicine.
Impact of calmodulin inhibition by fluphenazine on susceptibility, biofilm formation and pathogenicity of caspofungin-resistant Candida glabrata.

BACKGROUND In recent decades, Candida glabrata has emerged as a frequent cause of life-threatening fungal infection. In C. glabrata, echinocandin resistance is associated with mutations in FKS1/FKS2 (β-1,3-glucan synthase). The calmodulin/calcineurin pathway is implicated in response to antifungal stress and calcineurin gene disruption specifically reverses Fks2-mediated resistance of clinical isolates. OBJECTIVES We evaluated the impact of calmodulin inhibition by fluphenazine in two caspofungin-resistant C. glabrata isolates. METHODS C. glabrata isolates were identified by ITS1/ITS4 (where ITS stands for internal transcribed spacer) sequencing and the echinocandin target FKS1/FKS2 genes were sequenced. Susceptibility testing of caspofungin in the presence of fluphenazine was performed by a modified CLSI microbroth dilution method. The effect of the fluphenazine/caspofungin combination on heat stress (37°C or 40°C), oxidative stress (0.2 and 0.4 mM menadione) and biofilm formation (polyurethane catheter) was analysed. A Galleria mellonella model using blastospores (1 × 109 cfu/mL) was developed to evaluate the impact of this combination on larval survival. RESULTS F659del was found in the FKS2 gene of both resistant strains. In these clinical isolates, fluphenazine increased susceptibility to caspofungin and reduced their thermotolerance. Furthermore, the fluphenazine/caspofungin combination significantly impaired biofilm formation in an in vitro polyurethane catheter model. All these features participated in the increasing survival of infected G. mellonella after combination treatment in comparison with caspofungin alone. CONCLUSIONS In a repurposing strategy, our findings confirm that calmodulin could provide a relevant target in life-threatening fungal infectious diseases.
Cognitive functioning in children with cerebral palsy

Children with cerebral palsy (CP) have an increased risk of cognitive impairments. This narrative review of the literature discusses assessment of cognition in children with CP, presents the most salient characteristics of cognitive functioning pertaining to each subtype, and discusses the relationships between brain injury, functioning, and intervention from a developmental perspective. A search for original studies of cognitive functioning in children with different subtypes of CP was performed. The search resulted in 81 unique hits. There were few studies with a representative sample of children with CP where all participants were individually assessed. Cognitive functioning in children with the most severe motor impairments were often assumed and not assessed. Furthermore, there was a confounding of IQ below 70 and intellectual disability, possibly leading to an overestimation of the prevalence of intellectual disability. Longitudinal neuropsychological studies, including also very young children and those with the most severe speech and motor impairments, as well as intervention studies, are called for.
Importance of model size in quantum mechanical studies of DNA intercalation

The convergence of DFT‐computed interaction energies with increasing binding site model size was assessed. The data show that while accurate intercalator interaction energies can be derived from binding site models featuring only the flanking nucleotides for uncharged intercalators that bind parallel to the DNA base pairs, errors remain significant even when including distant nucleotides for intercalators that are charged, exhibit groove‐binding tails that engage in noncovalent interactions with distant nucleotides, or that bind perpendicular to the DNA base pairs. Consequently, binding site models that include at least three adjacent nucleotides are required to consistently predict converged binding energies. The computationally inexpensive HF‐3c method is shown to provide reliable interaction energies and can be routinely applied to such large models.
Acute psychosocial stress during retrieval impairs pattern separation processes on an episodic memory task

Abstract Numerous studies have shown that the presence of psychosocial stress impairs the ability to retrieve episodic memories, which raise questions about the specific cognitive processes that underlie this impairment. Here, we tested the hypothesis that stress targets retrieval processes needed to reliability discriminate previously learned from new information within episodic memory, pattern separation processing by measuring the effects of retrieval-induced stress on a modified version of the Mnemonic Similarity Task. In a two-part between-subjects design, all participants studied a series of object images in an initial testing session. In a second session, held 24 h later, half of the participants completed a stress induction task (stress group) and half performed a similarly structured but non-stressful task (control group) and all were then given a recognition memory test for the previously studied images which included new images similar to those studied (lures), and images that were completely novel (foils). Both groups performed equally well in terms of overall recognition memory, but the stress group was significantly impaired in discriminating new and similar (lure) items from studied items. This pattern of results suggests that stress specifically targets pattern separation processing when retrieving information from episodic memory. We discuss the implications of this effect, specifically how stress at retrieval reduces the ability to discriminate new from learned information.
How Firm Are the Foundations of Mind-Set Theory? The Claims Appear Stronger Than the Evidence

Mind-set refers to people’s beliefs about whether attributes are malleable (growth mind-set) or unchangeable ( fixed mind-set). Proponents of mind-set theory have made bold claims about mind-set’s importance. For example, one’s mind-set is described as having profound effects on one’s motivation and achievements, creating different psychological worlds for people, and forming the core of people’s meaning systems. We examined the evidentiary strength of six key premises of mind-set theory in 438 participants; we reasoned that strongly worded claims should be supported by equally strong evidence. However, no support was found for most premises. All associations (rs) were significantly weaker than . 20. Other achievement-motivation constructs, such as self-efficacy and need for achievement, have been found to correlate much more strongly with presumed associates of mind-set. The strongest association with mind-set (r = −.12) was opposite from the predicted direction. The results suggest that the foundations of mind-set theory are not firm and that bold claims about mind-set appear to be overstated.
Short-term outcomes with the REDAPT monolithic, tapered, fluted, grit-blasted, forged titanium revision femoral stem.

AIMS Although good clinical outcomes have been reported for monolithic tapered, fluted, titanium stems (TFTS), early results showed high rates of subsidence. Advances in stem design may mitigate these concerns. This study reports on the use of a current monolithic TFTS for a variety of indications. METHODS A multi-institutional retrospective study of all consecutive total hip arthroplasty (THA) and revision total hip arthroplasty (rTHA) patients who received the monolithic TFTS was conducted. Surgery was performed by eight fellowship-trained arthroplasty surgeons at four institutions. A total of 157 hips in 153 patients at a mean follow-up of 11.6 months (SD7.8) were included. Mean patient age at the time of surgery was 67.4 years (SD 13.3) and mean body mass index (BMI) was 28.9 kg/m2 (SD 6.5). Outcomes included intraoperative complications, one-year all-cause re-revisions, and subsidence at postoperative time intervals (two weeks, six weeks, six months, nine months, and one year). RESULTS There were eight intraoperative complications (4.9%), six of which were intraoperative fractures; none occurred during stem insertion. Six hips (3.7%) underwent re-revision within one year; only one procedure involved removal of the prosthesis due to infection. Mean total subsidence at latest follow-up was 1.64 mm (SD 2.47). Overall, 17 of 144 stems (11.8%) on which measurements could be performed had >5 mm of subsidence, and 3/144 (2.1%) had >10 mm of subsidence within one year. A univariate regression analysis found that additional subsidence after three months was minimal. A multivariate regression analysis found that subsidence was not significantly associated with periprosthetic fracture as an indication for surgery, the presence of an extended trochanteric osteotomy (ETO), Paprosky classification of femoral bone loss, stem length, or type of procedure performed (i.e. full revision vs conversion/primary). CONCLUSION Advances in implant design, improved trials, a range of stem lengths and diameters, and high offset options mitigate concerns of early subsidence and dislocation with monolithic TFTS, making them a valuable option for femoral revision. Cite this article: Bone Joint J 2020;102-B(2):191-197.
Fluorescence staining vs. routine KOH smear for rapid diagnosis of oral candidiasis- A diagnostic test.

OBJECTIVE A diagnostic test was designed to evaluate the accuracy and applicability of fluorescence staining with fluorescein-labelled chitinase vs. routine 10% KOH smear for rapid diagnosis of oral candidiasis. METHODS In total, 124 subjects with suspected oral candidiasis symptoms/signs were sequentially enrolled in this study. The diagnostic efficacy indexes (sensitivity, specificity, Youden index, predictive value, likelihood ratio, diagnostic odds ratio, diagnostic accuracy and area under the curve (AUC)) were compared between 10% KOH smear and fluorescence staining. RESULTS The sensitivity (85.48% vs. 64.52%) and specificity (91.94% vs. 72.58%) of fluorescence staining were higher than those of KOH smear. The AUC of fluorescence staining (0.887) was remarkably higher than that of 10% KOH smear (0.685), demonstrating that the diagnostic efficacy of fluorescence staining is significantly higher than that of KOH smear (p=0.0005). Furthermore, fluorescence staining showed higher sensitivity than that of KOH smear (84.75% vs. 62.71%) in diagnosis of erythaematous type oral candidiasis, which is the most common type and the type most challenging to differentially diagnose. CONCLUSION The advantages of fluorescence staining with fluorescein-labelled chitinase in rapid diagnosis of oral candidiasis and its ease of operation suggest its potential use in clinical practice.
Identification of potential genomic regions for egg weight by a haplotype-based genome-wide association study using Bayesian methods

ABSTRACT 1. Theoretically, haplotype blocks might be a more suitable alternative to SNP genotypes as they are usually better at capturing multi-allelic QTL effects, compared to individual SNP genotypes in genome-wide association studies. The objectives of this study were to identify genomic regions related to egg weight traits by Bayesian methods (BayesA, BayesB, and BayesN) that fit fixed-length haplotypes using GenSel software. 2. Genotypes at 294,705 SNPs, that were common on a 600K Affymetrix chip, were phased for an egg-laying hen population of 1,063 birds. Recorded traits included first egg weight (FEW) and average egg weight at 28, 36, 56, 66, 72 and 80 weeks of age. 2. Fitting 1Mb haplotypes from BayesB resulted in the highest proportion of genetic variance explained for the egg weight traits. Based on the trait, the genetic variance explained by each marker ranged from 27% to 76%. 3. Different haplotype windows associated with egg weight traits only explained a small percentage of the genetic variance. 4. The top one 1-Mb window on GGA1 explained approximately 4.05% of total genetic variance for the FEW. Candidate genes, including PRKAR2B, HMGA2, LEMD3, GRIP1, EHBP1, MAP3K7, and MYH were identified for egg weight traits. 5. Several genomic regions, potentially associated with egg weight traits, were identified, some of which overlapped with known genes and previously reported QTL regions for egg production traits.
Cardiovascular Mortality following Liver Transplantation: Predictors and Temporal Trends over 30 years.

AIMS There has been significant evolution in operative and post-transplant therapies following liver transplantation (LT). We sought to study their impact on cardiovascular mortality, particularly in the longer-term. METHODS AND RESULTS A retrospective cohort study was conducted of all adult LTs in Australia and New Zealand across three 11-year eras from 1985 to assess prevalence, modes and predictors of early (≤30-day) and late (>30-day) cardiovascular mortality. A total of 4,265 patients were followed-up for 37,409 person-years. Overall, 1,328 patients died, and cardiovascular mortality accounted for 228 (17.2%) deaths. Both early and late cardiovascular mortality fell significantly across the eras (p < 0.001). However, cardiovascular aetiologies were consistently the leading cause of early mortality and accounted for ∼40% of early deaths in the contemporary era. Cardiovascular deaths occurred significantly later than non-cardiac aetiologies (8.8 vs 5.2 years, p < 0.001). On multivariable Cox-regression, coronary artery disease (HR 4.6,95%CI 1.2-21.6, p = 0.04) and era of transplantation (HR 0.44; 95%CI 0.28-0.70, p = 0.01) were predictors of early cardiovascular mortality while advancing age (HR 1.05, 95%CI 1.02-1.10, p = 0.005) was an independent predictors of late cardiovascular mortality. Most common modes of cardiovascular death were cardiac arrest, cerebrovascular events and myocardial infarction. CONCLUSION Despite reductions in cardiovascular mortality post-LT over 30-years, they still account for a substantial proportion of early and late deaths. The late occurrence of cardiovascular deaths highlights the importance of longitudinal follow-up to study the efficacy of targeted risk-reduction strategies in this unique patient population.