Miracle-dz/UniFAR-FTUs huggingface dataset:
Mosaic Turner Syndrome With Multiple Spontaneous Pregnancies: A Case Report

Turner syndrome (TS) is an abnormality of the X chromosome affecting females. This genetic defect causes infertility in most cases, but less commonly in patients with the mosaic form of Turner syndrome. In the rare event of a pregnancy, it usually leads to maternal and fetal complications, including miscarriage. In this study, we report a case of mosaic Turner syndrome (45,X/46,XX) in a 34-year-old female who presented to our outpatient clinic with a two-year history of secondary infertility following nine previous spontaneous pregnancies (SP). Her obstetric history showed two successful healthy pregnancies, seven first-trimester miscarriages, one intrauterine fetal demise (IUFD), and one infant death at six months of age. Cases of pregnancy in mosaic Turner syndrome patients are limited and have poor pregnancy outcomes; here, we aim for our case to contribute to the improvement of pregnancy outcomes in such patients.
Exploring the smoking cessation needs of individuals with diabetes using the Information-Motivation-Behavior Skills model

INTRODUCTION Smoking cessation is an important aspect of diabetes management. Despite the increased risk for diabetes complications when smoking, evidence suggests that people living with type 1 and type 2 diabetes are less likely to quit smoking when compared to those without diabetes. Guided by the Information-Motivation-Behavioral Skills model, this study aimed to identify the needs of individuals living with type 1 and type 2 diabetes to quit smoking. METHODS A qualitative descriptive design was adopted. Semi-structured telephone interviews were held between April and June 2021, with 20 former and current Maltese smokers living with type 1 or type 2 diabetes, recruited from the diabetic clinics within the two main acute public hospitals. The interview transcriptions were analyzed using applied thematic analysis. RESULTS Individuals with diabetes need more information on the effects of smoking on diabetes to encourage cessation. Preventing diabetic complications was reported as a motivator to quit smoking. However, having diabetes was identified as a challenge to quitting. Participants welcomed the provision of health professional support for quitting smoking, identifying the need to provide smoking cessation support within diabetic clinics. The provision of information on tobacco-associated diabetic complications, by using video messages featuring former smokers’ stories was also suggested. CONCLUSIONS To promote smoking cessation among individuals with diabetes, they need to be informed about how smoking affects their condition. Utilizing video messages featuring real-life stories of former smokers with diabetes who experienced tobacco-associated diabetic complications may be influential. Additionally, providing diabetes-specific intensive smoking cessation support is crucial to help them quit.
Roadside habitat: Boon or bane for pollinating insects?

Abstract Pollinators, which provide vital services to wild ecosystems and agricultural crops, are facing global declines and habitat loss. As undeveloped land becomes increasingly scarce, much focus has been directed recently to roadsides as potential target zones for providing floral resources to pollinators. Roadsides, however, are risky places for pollinators, with threats from vehicle collisions, toxic pollutants, mowing, herbicides, and more. Although these threats have been investigated, most studies have yet to quantify the costs and benefits of roadsides to pollinators and, therefore, do not address whether the costs outweigh the benefits for pollinator populations using roadside habitats. In this article, we address how, when, and under what conditions roadside habitats may benefit or harm pollinators, reviewing existing knowledge and recommending practical questions that managers and policymakers should consider when planning pollinator-focused roadside management.
Manipulating the diseased oral microbiome: the power of probiotics and prebiotics

ABSTRACT Dental caries and periodontal disease are amongst the most prevalent global disorders. Their aetiology is rooted in microbial activity within the oral cavity, through the generation of detrimental metabolites and the instigation of potentially adverse host immune responses. Due to the increasing threat of antimicrobial resistance, alternative approaches to readdress the balance are necessary. Advances in sequencing technologies have established relationships between disease and oral dysbiosis, and commercial enterprises seek to identify probiotic and prebiotic formulations to tackle preventable oral disorders through colonisation with, or promotion of, beneficial microbes. It is the metabolic characteristics and immunomodulatory capabilities of resident species which underlie health status. Research emphasis on the metabolic environment of the oral cavity has elucidated relationships between commensal and pathogenic organisms, for example, the sequential metabolism of fermentable carbohydrates deemed central to acid production in cariogenicity. Therefore, a focus on the preservation of an ecological homeostasis in the oral environment may be the most appropriate approach to health conservation. In this review we discuss an ecological approach to the maintenance of a healthy oral environment and debate the potential use of probiotic and prebiotic supplementation, specifically targeted at sustaining oral niches to preserve the delicately balanced microbiome.
The 100 Top-Cited Articles on Medial Patellofemoral Ligament: A Bibliometric Analysis and Review

Background: The medial patellofemoral ligament (MPFL) has been investigated widely in the past 30 years, resulting in many research achievements in this field. Purpose: To perform a comprehensive bibliometric analysis to evaluate the 100 top-cited articles on the MPFL. Study Design: Cross-sectional study. Methods: We searched the Scopus database in December 2022 using the terms “medial patellofemoral ligament” OR “MPFL. ” The search was confined to English-language articles, including technical notes, systematic reviews on clinical outcomes and/or complications, clinical studies, studies regarding complications, and basic science articles (either cadaveric or biomechanical); we excluded letters, case reports, personal opinions, guidelines, editorials, and narrative or other types of reviews. Analysis of the 100 top-cited articles was performed according to total number of citations, average citations per year (ACY), study type, country of origin, journal of publication, affiliated institution, and most published authors. Results: The total number of citations was 16,358 (range of citations per article, 72-692). The majority of articles were published as clinical studies (54%), with cadaveric studies being the second most common (21%). Most studies originated in the United States (32%), with Japan (15%) and Germany (13%) following. The American Journal of Sports Medicine published the majority of the 100 top-cited articles (37/100; 6304 citations) as well as the 10 top-cited articles according to ACY (7/10; mean, 285.14 citations). The most prolific authors were Nomura (8 articles); Burks (6 articles); and Inoue, Sillanpää, and Dreyhaupt (5 articles each). Conclusion: By analyzing the characteristics of the 100 top-cited articles, this study demonstrated that the MPFL is a growing and popular area of research, with the focus varying through timeline trends. Questions regarding MPFL anatomy, isometry, and biomechanics might have been answered adequately, but research regarding optimal fixation technique under various circumstances is still ongoing.
Categorization dynamically alters representations in human visual cortex

Everyday visual search tasks require objects to be categorized according to behavioral goals. For example, when searching for an apple at the supermarket, one might first find the Granny Smith apples by separating all visible apples into the categories “green” and “non-green”. However, suddenly remembering that your family actually likes Fuji apples would necessitate reconfiguring the boundary to separate “red” from “red-yellow” objects. Despite this need for flexibility, prior research on categorization has largely focused on understanding neural changes related to overlearning a single category boundary that bifurcates an object space. At the same time, studies of feature-based attention have provided some insight into flexible selection of features, but have mainly focused on selection of a single, usually low-level, feature, which is rarely sufficient to capture the complexity of categorizing higher-dimensional object sets. Here we addressed these gaps by asking human participants to categorize novel shape stimuli according to different linear and non-linear boundaries, a task that requires dynamically reconfiguring selective attention to emphasize different sets of abstract features. Using fMRI and multivariate analyses of retinotopically-defined visual areas, we found that shape representations in visual cortex became more distinct across relevant category boundaries in a context-dependent manner, with the largest changes in discriminability observed for stimuli near the category boundary. Importantly, these attention-induced modulations were linked to categorization performance. Together, these findings demonstrate that adaptive attentional modulations can alter representations of abstract feature dimensions in visual cortex to optimize object separability based on currently relevant category boundaries.
Personalized pulmonary rehabilitation and occupational therapy based on cardiopulmonary exercise testing for patients with advanced chronic obstructive pulmonary disease

Take-home summary: Personalized pulmonary rehabilitation including occupational therapy improves the prognosis of patients with advanced COPD. Purpose: We previously reported that patients with chronic obstructive pulmonary disease (COPD) exhibit three exercise-induced life-threatening conditions: hypoxemia, sympathetic overactivity, and respiratory acidosis. We aimed to verify whether mortality in patients with advanced COPD could be reduced by a personalized pulmonary rehabilitation (PPR) program in hospital, which determines individual safe ranges and includes occupational therapy (PPR-OT), to prevent desaturation and sympathetic nerve activation during daily activities. Patients and methods: The novel PPR-OT program was evaluated in a retrospective study of patients with COPD (Global Initiative for Chronic Obstructive Lung Disease [GOLD] Grade D) who underwent cardiopulmonary exercise testing (CPET) between April 1990 and December 1999. They received regular treatment without the proposed therapy (control group: n = 61; male-to-female ratio [M:F] = 57:4; mean age: 68.5 ± 6.7 years) or with the proposed therapy (PPR-OT group: n = 46; M:F = 44:2; mean age: 68.7 ± 7.1 years). A prospective observational study included patients with COPD receiving home oxygen therapy (HOT) between April 1995 and March 2007 to compare the survival rates of the control group (n = 47; M:F ratio = 34:13; mean age: 71.3 ± 10.0 years) and the PPR-OT group (n = 85; M:F = 78:7; mean age: 70.7 ± 6.1 years) who completed the proposed therapy. Survival after CPET or HOT was analyzed using Cox proportional-hazards regression and Kaplan–Meier analyses. Results: In both studies, the program significantly improved all-cause mortality (retrospective study: risk ratio = 0.389 [range: 0.172–0.800]; P = 0.0094; log-rank test, P = 0.0094; observational study: risk ratio = 0.515 [range: 0.296–0.933]; P = 0.0291; log-rank test, P = 0.0232]. At 5 years and 7 years, all-cause mortality was extremely low in patients in the PPR-OT group receiving HOT (18.8% and 28.2%, respectively), compared to that in the control group (34.0% and 44.7%, respectively). Survival of patients with life-threatening pathophysiological conditions also greatly improved. Conclusion: The PPR-OT program improved the survival of patients with advanced COPD probably because it modified life-threatening conditions.
Comparing the Waterlow and Jackson/Cubbin pressure injury risk scales in intensive care units: A multi‐centre study

Abstract To compare the predictive properties of the Jackson/Cubbin scale and Waterlow scales in intensive care unit patients. A multi‐centre study. This study was conducted between April 2021 and February 2023 in 72 intensive care units of 38 tertiary hospitals in Gansu Province, China. All adults admitted to the intensive care unit for 24 hours or more without pressure injury on admission were screened using the Waterlow scale and Jackson/Cubbin scales in intensive care. Additionally, the negative predictive value, positive predictive value, sensitivity, specificity and receiver operating characteristic curve with area under the curve of the Waterlow scale and Cubbin/Jackson scales were determined. The participant population for this study included 6203 patients. Predictive properties for the Jackson/Cubbin scales and Waterlow scales, respectively, were as follows: Cut‐off scores, 28 versus 22; AUC, 0.859 versus 0.64; sensitivity, 92.4% versus 51.9%; specificity, 67.26% versus 71.46%; positive predictive value, 35% versus 23%; negative predictive value, 99.9% versus 99.1%. Both Waterlow scales and Jackson/Cubbin scales could predict pressure injury risk for patients in the intensive care unit. However, the Jackson/Cubbin scale demonstrated superior predictive properties than the Waterlow scale.
Perceptual reorganisation from prior knowledge emerges late in childhood

Perception in the mature human visual system relies heavily on prior knowledge. Here we show for the first time that prior-knowledge-induced reshaping of visual perception emerges gradually, and late in childhood. To isolate the effects of prior knowledge on vision, we presented 4-to-12-year-olds and adults with two-tone images, which are degraded photos that are hard to recognise on first viewing. In adults, seeing the original photo causes a perceptual reorganisation leading to sudden, mandatory recognition of the two-tone version - a well-documented process relying on top-down signalling from higher-order brain areas to early visual cortex. We find that children younger than 7 to 9 years, however, do not experience this knowledge-guided shift, despite viewing the original photo immediately before each two-tone. To assess potential computations underlying this development we compared human performance to three state-of-the-art neural networks with varying architectures. We found that the best-performing architecture behaved much like 4- to 5-year-old humans, who display a feature-based rather than holistic processing strategy akin to neural networks. Our results reveal a striking age-related shift in the reconciliation of prior knowledge with sensory input, which may underpin the development of many perceptual abilities.
Improvement of the interleukin 2 and tumour necrosis factor α release by blood leukocytes as well as of plasma cortisol and antioxidant levels after acupuncture treatment in women suffering anxiety

In the context of psychoneuroimmunology, which studies the complex interactions between the nervous system and the immune system, anxiety-causing situations affect the immune function leading to its impairment, whereas acupuncture provides the possibility of improving it via its action on the nervous system. Therefore, the aim of the present work was to study, in anxious adult women, the effect of an acupuncture treatment specifically designed to relieve their symptoms, on several parameters known to be altered in disturbed emotional situations. These include the release by blood leukocytes of the cytokines interleukin-2 (IL-2) and tumour necrosis factor-alfa (TNF-α), as well as the plasma cortisol levels and total antioxidant capacity. The results show regulation by acupuncture of all the studied parameters, as early as 72 hours after one single acupuncture session. Thus, the levels of IL-2, which were decreased in women with anxiety, increase following acupuncture, and the levels of TNF-α and cortisol, which were increased in these patients, decrease after the session. Therefore, acupuncture could exert its therapeutic action on anxiety by modulation of a number of parameters including those examined in the present work.
Risk of death due to COVID-19 among current and former smokers in the Netherlands: a population-based quasi-cohort study

Abstract Background Research on smoking as a risk factor for death due to COVID-19 remains inconclusive, with different studies demonstrating either an increased or decreased risk of COVID-19 death among smokers. To investigate this controversy, this study uses data from the Netherlands to assess the relationship between smoking and death due to COVID-19. Methods In this population-based quasi-cohort study, we linked pseudonymized individual data on smoking status from the 2016 and 2020 ‘Health Monitor Adults and Elderly’ in the Netherlands (n = 914 494) to data from the cause-of-death registry (n = 2962). Death due to COVID-19 in 2020 or 2021 was taken as the main outcome. Poisson regression modelling was used to calculate relative risks (RRs) and 95% CIs of death due to COVID-19 for current and former smokers compared with never smokers while adjusting for relevant confounders (age, sex, educational level, body mass index and perceived health). Results Former smokers had a higher risk of death due to COVID-19 compared with never smokers across unadjusted (RR, 2.22; 95% CI, 2.04–2.42), age–sex-adjusted (RR, 1.38; 95% CI, 1.22–1.55) and fully adjusted (RR, 1.30; 95% CI, 1.16–1.45) models. Current smokers had a slightly higher risk of death due to COVID-19 compared with never smokers after adjusting for age and sex (RR, 1.21; 95% CI, 1.00–1.48) and after full adjustment (RR, 1.08; 95% CI, 0.90–1.29), although the results were statistically non-significant. Conclusions People with a history of smoking appear to have a higher risk of death due to COVID-19. Further research is needed to investigate which underlying mechanisms may explain this.
Change in motivational bias during treatment predicts outcome in anorexia nervosa.

OBJECTIVE Reward and punishment sensitivity are known to be altered in anorexia nervosa (AN). Most research has examined these constructs separately although motivated behavior is influenced by considering both the potential for reward and risk of punishment. The present study sought to compare the relative balance of reward and punishment sensitivity in AN versus healthy controls (HCs) and examine whether motivational bias is associated with AN symptoms and treatment outcomes. METHODS Adolescents and adults with AN (n = 262) in a partial hospitalization program completed the Eating Disorders Examination Questionnaire (EDE-Q), Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scales, and Sensitivity to Punishment/Sensitivity to Reward Questionnaire (SPSRQ) at admission and discharge. HCs (HC; n = 90) completed the BIS/BAS and SPSRQ. Motivational Bias Scores were calculated to reflect the dominance of reward versus punishment sensitivity. RESULTS Individuals with AN demonstrated significantly greater bias toward punishment sensitivity than HC. In AN, a bias toward punishment was associated with higher EDE-Q Global score at admission. Change in motivational bias during treatment predicted EDE-Q Global scores, but not BMI, at discharge, with greater increases in reward sensitivity or greater decreases in punishment sensitivity during treatment predicting lower eating pathology. Similar findings were observed using the BIS/BAS and SPSRQ. DISCUSSION Change in motivational bias during treatment is associated with improved outcomes in AN. However, it appears that much of the change in motivational bias can be attributed to changes in punishment sensitivity, rather than reward sensitivity. Future research should examine the mechanisms underlying punishment sensitivity decreases during treatment. PUBLIC SIGNIFICANCE Sensitivity to reward and punishment may be important treatment targets for individuals with anorexia nervosa (AN). To date, most research has considered reward and punishment sensitivity separately, rather than examining their relationship to each other. We found that the balance of reward and punishment sensitivity (i.e., motivational bias) differs between healthy controls and those with AN and that this bias is associated with eating disorder symptoms and treatment outcome.
Peer-reviewed publications in orthopaedic surgery from lower income countries: A comparative analysis

Introduction: Musculoskeletal (MSK) disease is a substantial global burden, especially in lower income countries. However, limited research has been published on MSK health by scholars from these countries. We aimed to study the distribution of authorships, including trends in peer-reviewed orthopaedic publications based on each author’s affiliated institution’s country income status. Methods: Based on a bibliometric search, 119 orthopaedic-related journals were identified using the Journal Citation Reports database. Details of all scientific articles published in these journals between 2012 and 2021 were used to study trends and association between each of the author’s affiliated institution’s country income status, using the World Bank Classification. Results: Of the 133,718 unique articles, 87.6% had at least one author affiliation from a high-income country (HIC), 7.0% from an upper-middle income country (UMIC), 5.2% from a lower-middle income country (LMIC), and 0.2% from a low-income country (LIC). Overall, these articles were cited 1,825,365 times, with 92.5% of citations from HIC-affiliated authors and < 0.1% from LIC-affiliated authors. Over the 10-year study period, HIC-affiliated articles demonstrated the largest increase in the number of publications (9107–14,619), compared to UMIC-affiliated (495–1214), LMIC-affiliated (406–874), and LIC-affiliated articles (4–28). Conclusions: There are large and persistent disparities in orthopaedic research publications based on the country income status of the author’s affiliated institution, especially in the higher impact orthopaedic journals. Efforts should be made to increase opportunities for scholars from LICs and LMICs to publish their research in high-impact orthopaedic journals.
The contribution of trees and palms to a balanced diet in three rural villages of the Fatick Province, Senegal

Abstract Improving the quality of people’s diets represents a major challenge for developing countries, particularly in Sahelian African countries. Foods from trees, shrubs, and palms are present in many meals and may improve dietary quality, especially for rural communities but, as their contributions have rarely been quantified, investigating the link between the intake of tree foods and the nutritional composition of diet is important. This study assesses the contribution of tree and palm foods to dietary intake in three rural communities in Senegal, using three household food consumption surveys to quantify the dietary intake of meals. The consumption of tree and palm foods in meals was frequent, mentioned by 93–99% of the families depending on the time of year. Products of 11 tree and palm species were used in meals, with Adansonia digitata (baobab) leaves the most frequently mentioned. The energy contribution of tree and palm foods was low, but their contribution of certain micronutrients was high, with 56% of the daily household food consumption of vitamin A, 45% of vitamin C, 17% of vitamin B6 and 21% of iron (Fe). Products from 18 tree and palm species were consumed as snacks or beverages between meals, and consumption was frequent in February and June, but rare in October. We discuss the possibilities of improving nutrition in rural communities from an increased use of trees and palms.