Miracle-dz/UniFAR-FTUs huggingface dataset:
Klinefelter syndrome and testosterone treatment: a national cohort study on thrombosis risk

Objectives Klinefelter syndrome (KS), 47,XXY, can be viewed as a disease model for investigating the risk of thrombosis in male hypogonadism and the subsequent risk related to testosterone treatment. We describe rates of thrombotic risk factors, thrombosis and thrombosis mortality in KS and the association with testosterone treatment. Methods National registry-based matched cohort study with follow-up from 1995 to 2016 set in Denmark. For the study, 1155 men with KS were each matched by year and month of birth to 100 men from the background population. First thrombotic events and thrombosis mortality was evaluated by event rates and hazard ratios (HRs) and by applying testosterone treatment as a time-dependent covariate. Results The KS cohort had higher incidence of venous thromboembolism relative to the comparison cohort (HR, 3.95; 95% CI, 2.83–5.52). Total thrombotic deaths were increased in KS (HR, 1.76; 95% CI, 1.18–2.62), and all-cause mortality was increased in KS following arterial thrombosis (HR 1.73; 95% CI 1.22–2.47). Only 48.7% of men with KS redeemed prescriptions for testosterone. Untreated men with KS were on average born 12 years before those treated, and the majority of untreated men with KS with available biochemistry were hypogonadal. Testosterone treatment in KS was associated with a non-significant decrease in venous thromboembolism and thrombotic deaths. Conclusion Thrombosis and thrombotic deaths are increased in KS. Only half of the men with KS ever received testosterone treatment, despite overt hypogonadism in the non-treated. Testosterone treatment in Klinefelter syndrome was insignificantly associated with lower incidence rates of venous thrombosis and thrombotic deaths.
Association of infant and young child feeding practices with cognitive development at 10-12 years: A birth cohort in rural western China.

We aimed to comprehensively examine the association of breastfeeding, types and initial timing of complementary foods with adolescent cognitive development in low- and middle-income countries. We conducted a prospective cohort study of 745 adolescents aged 10-12 who were born to women who participated in a randomized trial of prenatal micronutrient supplementation in rural western China. An infant feeding index was constructed based on current World Health Organization (WHO) recommendations. Full-scale intelligence quotient (FSIQ) was assessed and derived by the Fourth Edition of the Wechsler Intelligence Scale for Children. The duration of exclusive or any breastfeeding was not significantly associated with adolescent cognitive development. Participants who regularly consumed iron-rich or iron-fortified foods during 6-23 months of age had higher FSIQ than those who did not (adjusted mean differences [aMDs] 4.25; 95% confidence interval [CI] 1.99, 6.51). For cow's/goat's milk and high protein-based food, the highest FSIQ were found in participants who initially consumed at 10-12 months and 7-9 months, respectively. A strong dose-response relationship of the composite infant feeding index was also identified, with participants in the highest tertile of overall feeding quality having 3.03 (95% CI 1.37, 4.70) points higher FSIQ than those in the lowest tertile. These findings suggest that appropriate infant feeding practices (breastfeeding plus timely introduction of appropriate complementary foods) were associated with significantly improved early adolescent cognitive development scores in rural China. In addition, improvement in iron-rich or iron-fortified foods complementary feeding may produce better adolescent cognitive development outcomes.
Functional dissociations between subregions of the medial prefrontal cortex on the rodent touchscreen continuous performance test (rCPT) of attention.

Converging evidence in humans, monkeys, and rodents suggests a functional dissociation of cognitive function along the dorso-ventral axis of the prefrontal cortex (PFC). Previous studies of attention suggest that the anterior cingulate cortex (ACC) plays a role in target detection, whereas the prelimbic (PL) cortex is important for tests requiring the combined detection and discrimination of signals. We investigated the effect of discrete, quinolinic acid-induced lesions of subregions of the rat medial PFC (mPFC)-ACC, PL cortex, and infralimbic (IL) cortex-on attentional performance on the recently developed rodent touchscreen continuous performance test (rCPT). Rats were tested under a range of behavioral conditions involving stimulus duration (SD), flanker distraction, temporal predictability, and event rate. Rats with lesions of the PL cortex demonstrated the most persistent attentional impairment under conditions of reduced and variable SD and high event rate (lower discrimination sensitivity [d'] and hit rate), and flanker distraction (lower hit rate). Rats with lesions of the ACC exhibited a profound but transient attentional impairment (lower d' and hit rate) in the early stages of behavioral testing, which ameliorated with repeated testing. Rats with lesions of the IL cortex showed no impairments on response control measures. The PL cortex plays a greater role than the ACC in the detection and discrimination of a complex visual stimulus among multiple nontarget stimuli in the rCPT. The findings support evidence for a functional dissociation of attentional performance along the dorso-ventral axis of the mPFC. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
How Pharmacist Preceptors Foster Students’ Therapeutic Reasoning Using the One-Minute Preceptor Method

Objective. To compare whether preceptors trained in the One-Minute Preceptor (OMP) method versus preceptors not trained in the OMP method use OMP methods, and whether their students demonstrate more frequent expression of therapeutic reasoning processes during case presentations. Methods. A pilot quasi-experimental study was conducted. In 2015, four preceptors attended an OMP training session. The OMP preceptors and three preceptors not trained in OMP were asked to collect audio recordings of their students presenting patient cases. The audio recordings were coded for preceptors’ use of OMP methods and students’ expression of therapeutic reasoning processes. Results. In total, we collected 42 audio recordings from 27 students presenting a patient case to one of seven preceptors. Preceptors trained in OMP more frequently asked students to commit to a therapeutic assessment and plan, probed for their supporting reasoning, and reinforced what was done well. However, non-OMP preceptors’ students more frequently articulated assessments and treatment plans in their case presentations. The non-OMP students also more frequently initiated discussion about the reasoning behind their assessments and plans without prompting from their preceptor. Conclusion. Implementing OMP workshops for preceptors to elicit students’ therapeutic reasoning processes requires further consideration. Future research is needed on pragmatic and effective precepting methods.
Diagnosis and management of low-flow, low-gradient aortic stenosis.

PURPOSE OF REVIEW The severity of low-flow, low-gradient aortic stenosis cases continue to be misunderstood because of challenging diagnosis, and treatment remains complex. We discuss current diagnostic and treatment modalities for low-flow, low-gradient aortic stenosis. RECENT FINDINGS This article summarizes current guidelines and best practices for the management of low-flow, low-gradient aortic stenosis. SUMMARY Low-flow, low-gradient aortic stenosis is a difficult entity to diagnose and treat. Various diagnostic modalities are needed to accurately determine the severity of aortic stenosis and potential treatment benefit. True-severe classical and paradoxical low-flow, low-gradient aortic stenosis can be distinguished from pseudo-severe aortic stenosis by dobutamine stress echocardiography and/or multidetector computed tomography. Once the distinction is made, aortic valve replacement results in better outcomes compared with conservative management. Although both surgical and transcatheter aortic valve replacement result in adequate outcomes, the decision between the two treatment strategies is based on patient characteristics, valve morphology, and other risk factors.
Effectiveness of adding a workplace intervention to an inpatient multimodal occupational rehabilitation program: A randomized clinical trial

Objectives This study aimed to evaluate the effectiveness of a workplace intervention (WI) added to an inpatient multimodal occupational rehabilitation program (I-MORE) on sickness absence. Methods In this researcher-blinded randomized controlled trial with parallel groups, individuals on sick leave due to musculoskeletal, unspecified- or common mental health disorders were randomized to I-MORE (N=87) or I-MORE+WI (N=88). I-MORE lasted 2+1 weeks (with one week at home in between) and consisted of “acceptance and commitment therapy”, physical exercise, and work-related problem solving. The additional WI consisted of a preparatory part, a workplace meeting involving the sick-listed worker, the employer, and the primary rehabilitation therapist at the rehabilitation center, and follow-up work related to the meeting. The primary outcomes were number of sickness absence days and time until sustainable return to work (RTW) during 12 months of follow-up, measured by registry data. Results The median number of sickness absence days during the 12-month follow-up for I-MORE was 115 days [interquartile range (IQR) 53–183] versus 130 days (IQR 81–212) for I-MORE+WI. The difference between groups was not statistically significant (P=0.084). The hazard ratio for sustainable RTW was 0.74 (95% confidence interval 0.48–1.16; P=0.192) in favor of I-MORE. Conclusions This study provided no evidence in favor of I-MORE+WI compared to only I-MORE for long-term sickness absent individuals with musculoskeletal-, common mental- or unspecified disorders.
Adjunctive Yield of Wide-Area Transepithelial Sampling for Dysplasia Detection After Advanced Imaging and Random Biopsies in Barrett's Esophagus

INTRODUCTION: Little is known about the additive yield of wide-area transepithelial sampling with computer-assisted three-dimensional analysis (WATS-3D) after a thorough examination with advanced imaging. The aim was to evaluate the adjunctive yield of WATS-3D after advanced imaging. METHODS: This is an observational cohort study from January 2017 to December 2018 for consecutive patients who underwent an examination that consists of high-definition white light endoscopy (HDWLE), narrow-band imaging (NBI), volumetric laser endomicroscopy (VLE), and Seattle protocol (SP) biopsies (collectively termed HDWLE-NBI-VLE-SP examination). Raised lesions were removed by endoscopic resection. Areas suspicious for dysplasia on NBI and VLE were biopsied. This was followed by random biopsies and WATS-3D brush biopsies. RESULTS: One hundred thirty-eight cases were included in this study. Thirty-five cases (25% of the total) were identified as some degree of dysplasia on the HDWLE-NBI-VLE-SP examination. Adjunctive use of WATS-3D yielded an additional 12 new cases of dysplasia (9 with crypt dysplasia and 3 with low-grade dysplasia [LGD]), for added yield of 34.3% (=12/35, 95% confidence interval 14.6%–62.2%). When restricting the analysis to LGD and higher, 21 dysplastic cases (15% of the total cases) were identified by HDWLE-NBI-VLE-SP, while WATS-3D found 4 additional new cases (3 with LGD and 1 with high-grade dysplasia) for an added yield of 19% (=4/21, 95% confidence interval 0.6%–45.7%). DISCUSSION: The addition of WATS-3D to an already thorough examination with HDWLE-NBI-VLE-SP may increase the yield of dysplasia detection.
Systematic genome editing of the genes on zebrafish Chromosome 1 by CRISPR/Cas9

Genome editing by the well-established CRISPR/Cas9 technology has greatly facilitated our understanding of many biological processes. However, a complete whole-genome knockout for any species or model organism has rarely been achieved. Here, we performed a systematic knockout of all the genes (1333) on Chromosome 1 in zebrafish, successfully mutated 1029 genes, and generated 1039 germline-transmissible alleles corresponding to 636 genes. Meanwhile, by high-throughput bioinformatics analysis, we found that sequence features play pivotal roles in effective gRNA targeting at specific genes of interest, while the success rate of gene targeting positively correlates with GC content of the target sites. Moreover, we found that nearly one-fourth of all mutants are related to human diseases, and several representative CRISPR/Cas9-generated mutants are described here. Furthermore, we tried to identify the underlying mechanisms leading to distinct phenotypes between genetic mutants and antisense morpholino-mediated knockdown embryos. Altogether, this work has generated the first chromosome-wide collection of zebrafish genetic mutants by the CRISPR/Cas9 technology, which will serve as a valuable resource for the community, and our bioinformatics analysis also provides some useful guidance to design gene-specific gRNAs for successful gene editing.
Maternal MUAC and fetal outcome in an Indian tertiary care hospital: A prospective observational study

Abstract Studies to date demonstrated the relatedness of mid‐upper arm circumference (MUAC) measurement of pregnant women to their anthropometry/weight. Hence, the objective was to determine whether maternal MUAC at different gestational age predicted birthweight, and if so, to identify which cut‐offs provided the best prediction of low birthweight (LBW) in pregnant women cohort. A total of 928 pregnant women, free of any obstetrical and medical complications known to affect fetal growth, were followed from 20 to 24 weeks' gestation till delivery. Weight, height, and MUAC were determined for the pregnant women, and gestational age along with newborns anthropometry was collected. The mean birthweight was 2.6 ± 0.460 kg. Maternal age, height, weight, MUAC (three time points), gestational age at delivery, and post‐natal weight showed positive correlation with birthweight, crown heel length, and head circumference of the neonates. The cut‐off limit with the best sensitivity–specificity (54.0 and 59.8, respectively) for MUAC was 23 cm, whereas maternal weight of 55 kg had sensitivity and specificity of 62.5 and 59.9 for predicting LBW. Maternal weight of 55 kg and MUAC value of 23 cm had almost similar sensitivity and specificity for predicting LBW. MUAC (≤23 cm) can be considered as a potential indicator of LBW where weighing of pregnant women is not feasible or when presentation for antenatal care is late, especially where pre‐pregnancy weights are not available.
The genetic workup for structural congenital heart disease

Congenital heart disease (CHD) is the most prevalent birth defect and is the result of multiple etiologies including genetic and environmental causes. This article reviews the genetic workup for structural CHD in the clinical setting, beginning with CHD epidemiology and etiology and then moving to genetic testing, clinical evaluation, and genetic counseling. An algorithm is presented as a guide to genetic test selection, and available tests are explained with their respective advantages and limitations. Finally, future advances are discussed. As this review focuses on structural heart disease, isolated cardiomyopathies, inherited primary arrhythmia syndromes and aortopathies are not discussed.
Significant reduction of vancomycin resistant E. faecium in the Norwegian broiler population coincided with measures taken by the broiler industry to reduce antimicrobial resistant bacteria

Vancomycin resistant enterococci (VRE) belong to the most common causes of nosocomial infections worldwide. It has been reported that use of the glycopeptide growth promoter avoparcin selected for a significant livestock-reservoir of VRE in many European countries, including Norway. However, although avoparcin was banned as a feed-additive in 1995, VRE have for unknown reasons consistently been reported in samples from Norwegian broilers. When avoparcin was banned, broiler-feed was supplemented with the polyether ionophore narasin in order to control the diseases coccidiosis and the frequent sequela necrotic enteritis. A potential link between transferrable vancomycin resistance and reduced susceptibility to narasin was recently reported. The use of narasin as a feed additive was abolished by the Norwegian broiler industry in 2016 and since then, broilers have been reared without in-feed antibacterial supplements. In this study, we demonstrate that all VRE isolates from Norwegian broilers collected in 2006–2014 displayed reduced susceptibility to narasin. Surveillance data collected two years after the narasin abolishment show a significant reduction in VRE, below the detection limit of the surveillance method, and a concurrent marked reduction in Enterococcus faecium with reduced susceptibility to narasin. The significant decline of E. faecium with reduced susceptibility to these antimicrobial compounds also coincided with an increased focus on cleaning and disinfection between broiler flocks. Furthermore, data from a controlled in vivo experiment using Ross 308 broilers indicate that the proportion of E. faecium with reduced susceptibility to narasin was heavily reduced in broilers fed a narasin-free diet compared to a diet supplemented with narasin. Our results are consistent with that the abolishment of this feed additive, possibly in combination with the increased focus on cleaning and disinfection, has had a substantial impact on the occurrence of VRE in the Norwegian broiler population.
Microcephaly infant mortality in Brazil before zika outbreak.

Introduction We present temporal and spatial variation of deaths from microcephaly in children under 1 year of age is analyzed at regional, state, and municipal level in the pre-Zika period in Brazil. Materials and Methods Data on births and deaths of infants with microcephaly was obtained from DATASUS from 1996 to 2013. Infant mortality rate from microcephaly (IMR-M) was estimated at Region, Federative Unit (UF), and Municipality level. Secular trend (ST) and risk of death variation were estimated using a Poisson regression model. Satscan software was used to obtain a statistic spatial scan for the Poisson model. Results IMR-M shows a non-significant negative ST in the Southeast, South and Central West Regions of Brazil. A greater IMR-M risk of death variation is found in the North and Northeast Regions. Most UFs in the Southeast, South and Central West Regions showed a negative ST, in contrast to what occurs in the UFs of the North and Northeast Regions showed a positive ST. Six high risk significant clusters were found: 3 in the North-Northeast and 3 in the South-SouthWest-Center-West. Conclusions The North and Northeast Regions showed positive ST for IRM-M and higher death risk, which was not observed in the other regions. Cluster distribution for higher IMR-M and risk resembles the distribution of the microcephaly and Zika cases in the outbreak period.
A child-focused version of the Attention Network Task designed to investigate interactions between the attention networks, including the endogenous orienting network

ABSTRACT A new variation of the Attention Network Task (ANT) was designed to measure the functioning of and interactions between the alerting, exogenous and endogenous visual spatial orienting, and executive control systems in young school children. Previous research has produced mixed results regarding typical functioning of the attention networks in six-year-olds; no ANT has measured the functioning of the endogenous network. This Staged ANT tested the Alerting, Exogenous, and Endogenous orienting networks in separate conditions. Two hundred and forty-seven children (average age 6 years, 103 girls) completed the task. There was no clear benefit of the alerting cue until the spatial orienting cues were introduced into the task, suggesting task complexity was needed before alerting benefits were observed. The validity effect of the exogenous cue was very strong: in contrast, the validity effect of the endogenous cue was very weak. The flanker effect was very strong. A benefit of the alerting cue was shown during both the exogenous and endogenous conditions, while a cost of the alerting cue was shown during the invalid exogenous trials. Neither the alerting nor validity effects interacted with the flanker effect. These results suggest that the alerting cue primes the exogenous and endogenous systems for the upcoming cues. Once the complexity of the task increases with the addition of the flankers, the alerting effect attenuates. The alerting and the two orienting networks interact together but the executive attention network acts independently, in children aged 6 years.
Sources of Directional Spatial Biases in Hemi-Image Drawing

We examined the performance of right- and left-handed brain-intact adult readers of English or Farsi on a hemi-image generation task in which participants were to imagine and then draw halves of objects using either their dominant or nondominant hand. Which half of the object was drawn was examined in relation to biomechanical, cerebral laterality, and cultural predictors. Findings showed a differential side bias as a function of reading/writing direction and hand used to draw. Specifically, when the dominant hand was used to draw (Experiment 1), English left-handers produced more left hemi-images while Farsi right-handers produced more right hemi-images. Body specificity associated with hand used, however, drove spatial preference when enlisting the nondominant hand (Experiment 2) with English right-handers now showing a significant left hemi-image bias and English left-handers showing a right hemi-image bias. Farsi right-handers using their nondominant hand did not show a significant bias in either direction. Taken together, the findings suggest a joint influence of handedness and reading/writing direction, aligned with an embodiment account of directional spatial biases.
Rating the Valence of Media Content about Electronic Cigarettes Using Crowdsourcing: Testing Rater Instructions and Estimating the Optimal Number of Raters

ABSTRACT Electronic cigarettes (e-cigarettes) are a controversial public health topic due to their increasing popularity among youth and the uncertainty about their risks and benefits. Researchers have started to assess the valence of media content about e-cigarette use, mostly using expert coding. The current study aims to offer a methodological framework and guideline when using crowdsourcing to rate the valence of e-cigarette media content. Specifically, we present (1) an experiment to determine rating instructions that would result in reliable valence ratings and (2) an analysis to identify the optimal number of raters needed to replicate these ratings. Specifically, we compared ratings produced by crowdsourced raters instructed to rate from several different perspectives (e.g., objective vs. subjective) and determined the instructions that led to reliable ratings. We then used bootstrapping methods and a set of criteria to identify the minimum number of raters needed to replicate these ratings. Results suggested that when rating e-cigarette valence, instructing raters to rate from their own subjective perspective produced reliable results, and nine raters were deemed the optimal number of raters. We expect these findings to inform future content analyses of e-cigarette valence. The study procedures can be applied to crowdsourced content analyses of other health-related media content to determine appropriate rating instructions and the number of raters.