Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of rural residence and low socioeconomic status on rate and timing of prenatal detection of major congenital heart disease in a jurisdiction of universal health coverage

Socioeconomic status (SES) and distance of residence from tertiary care may impact fetal detection of congenital heart disease (CHD), partly through reduced access to and quality of obstetric ultrasound screening. It is unknown whether SES and remoteness of residence (RoR) affect prenatal detection of CHD in jurisdictions with universal health coverage. We examined the impact of SES and RoR on the rate and timing of prenatal diagnosis of major CHD within the province of Alberta in Canada.
Lineage and role in integrative taxonomy of a heterotrophic orchid complex

Lineage‐based species definitions applying coalescent approaches to species delimitation have become increasingly popular. Yet, the application of these methods and the recognition of lineage‐only definitions have recently been questioned. Species delimitation criteria that explicitly consider both lineages and evidence for ecological role shifts provide an opportunity to incorporate ecologically meaningful data from multiple sources in studies of species boundaries. Here, such criteria were applied to a problematic group of mycoheterotrophic orchids, the Corallorhiza striata complex, analysing genomic, morphological, phenological, reproductive‐mode, niche, and fungal host data. A recently developed method for generating genomic polymorphism data–ISSRseq–demonstrates evidence for four distinct lineages, including a previously unidentified lineage in the Coast Ranges and Cascades of California and Oregon, USA. There is divergence in morphology, phenology, reproductive mode, and fungal associates among the four lineages. Integrative analyses, conducted in population assignment and redundancy analysis frameworks, provide evidence of distinct genomic lineages and a similar pattern of divergence in the extended data, albeit with weaker signal. However, none of the extended data sets fully satisfy the condition of a significant role shift, which requires evidence of fixed differences. The four lineages identified in the current study are recognized at the level of variety, short of comprising different species. This study represents the most comprehensive application of lineage + role to date and illustrates the advantages of such an approach.
Hippocampal miR-124 participates in the pathogenesis of depression via regulating the expression of BDNF in a Chronic Social Defeat Stress model of depression.

Objective As one of the most prevalent psychiatric disorders, the exact pathogenesis of depression remains elusive. Therefore, there is an urgent need to identify novel antidepressants for effective treatment. MicroRNA-124 (miR-124), the most abundant miRNA in brain tissue, plays a key effect on adult neurogenesis and neuronal differentiation. However, the mechanism of miR-124 in depression has not been clarified so far, the aim of this study is to provide broad insight into the mechanisms underlying depression. Methods In the study, we used the forced swim test (FST), the tail suspension test (TST), and a Chronic Social Defeat Stress (CSDS) mice model of depression. Quantitative real-time reverse transcription PCR (qRT-PCR), western blotting, immunofluorescence and virus-mediated gene transfer were used together. The level of plasma corticosterone in mice was analyzed by Enzyme Linked Immunosorbent Assay (ELISA). Results It was found that CSDS robustly increased the level of miR-124 in the hippocampus. Genetic knockdown of hippocampal miR-124 produced significant antidepressant-like effects in the CSDS model of depression. Furthermore, AAV-siR-124-EGFP treatment increased the level of plasma corticosterone in CSDS-induced mice. Moreover, it was found that the antidepressant-like effects induced by miR-124 inhibition required the hippocampal BDNF-TrkB system. Conclusion Hippocampal miR-124 participated in the pathogenesis of depression by regulating BDNF biosynthesis and was a feasible antidepressant target.
Caring for COVID‐19 patients through a pandemic in the intensive care setting: A narrative review

Abstract Since the declaration of the novel SARS‐CoV‐2 virus pandemic, health systems/ health‐care‐workers globally have been overwhelmed by a vast number of COVID‐19 related hospitalizations and intensive care unit (ICU) admissions. During the early stages of the pandemic, the lack of formalized evidence‐based guidelines in all aspects of patient management was a significant challenge. Coupled with a lack of effective pharmacotherapies resulted in unsatisfactory outcomes in ICU patients. The anticipated increment in ICU surge capacity was staggering, with almost every ICU worldwide being advised to increase their capacity to allow adequate care provision in response to multiple waves of the pandemic. This increase in surge capacity required advanced planning and reassessments at every stage, taking advantage of experienced gained in combination with emerging evidence. In University Hospital Southampton General Intensive Care Unit (GICU), despite the initial lack of national and international guidance, we enhanced our ICU capacity and developed local guidance on all aspects of care to address the rapid demand from the increasing COVID‐19 admissions. The main element of this success was a multidisciplinary team approach intertwined with equipment and infrastructural reorganization. This narrative review provides an insight into the approach adopted by our center to manage patients with COVID‐19 critical illness, exploring the initial planning process, including contingency preparations to accommodate (360% capacity increment) and adaptation of our management pathways as more evidence emerged throughout the pandemic to provide the most appropriate levels of care to our patients. We hope our experience will benefit other intensive care units worldwide. This article is categorized under: Infectious Diseases > Genetics/Genomics/Epigenetics
The current management of scaphoid fractures in the emergency department across an Australian metropolitan public health service: A retrospective cohort study

Background: Scaphoid fractures are commonly present to emergency departments (EDs), challenging medical practitioners to achieve accurate diagnosis and management. This is because of the prevalence of radiographically occult scaphoid fractures and complications associated with missed diagnoses. Clinical Guidelines are limited for treatment of suspected scaphoid fractures, and heterogeneity in the literature further complicates management. This study aimed to explore the differences in management between practitioners in the ED and determine if immobilizing clinically suspected scaphoid fractures is supported by current evidence. This study also aimed to establish if there are predictors to assist in the diagnosis of a scaphoid fracture in the ED. Methods: A retrospective cohort study analyzed clinical data from patient’s charts who attended the ED for a scaphoid fracture in 2019. Using retrospective patient chart audits and a Data Extraction Form, the clinical data regarding the assessment, treatment, diagnosis, and follow-up outcomes were collected. Descriptive analysis and multivariable logistic regression were performed to assess current management and find out predictors of a scaphoid fracture. Results: There was significance between practitioners performing physical assessments and providing treatment (P < .001). Physiotherapists performed assessment and education combined treatment more frequently than nurse practitioners and doctors. Thirty-four cases (11.7%) were negative for fracture in ED and positive in follow-up at the orthopedic clinic. There was an estimated loss of income of $327,433.60 (Australian dollar) for 221 patients who missed work due to overtreatment with immobilization. The strongest predictors for a confirmed scaphoid fracture were of male gender (odds ratio, 3.2; 95% confidence interval, 2.1–5.0; P < .001) and a positive x-ray in ED (odds ratio, 36.6; 95% confidence interval, 17.4–77.0; P < .001). Conclusion: Management of scaphoid fractures across the Gold Coast Hospital Health Service ED followed commonly accepted practices involving x-ray and immobilization; however, this conservative approach to management is associated with increased health costs and low rates of conversion to a confirmed scaphoid fracture. Male gender was the only significant predictor associated with a scaphoid fracture.
Smartphone ophthalmoscopy versus slit-lamp biomicroscopy for optic nerve head evaluation: A digital apparatus into medical education

Objective Th aim of this study is to explore the diagnostic accuracy of smartphone-based D-EYE ophthalmoscopy in the diagnosis of optic nerve head (ONH) abnormalities and screening for glaucoma. Methods This is a prospective clinical-based validation study performed on 90 patients recruited from a tertiary teaching hospital. Patients underwent dilated fundus examination by slit-lamp and smartphone-based D-EYE fundoscopy operated by two experienced ophthalmologists. Results The diagnostic accuracy of smartphone-based D-EYE ophthalmoscopy of normal vertical cup-to-disc ratio (VCDR) was acceptable (sensitivity 85.8%–96.4%; specificity 51.4%–96.4%). The D-EYE would often underestimate VCDR values as mean VCDR was significantly lower among overall and glaucoma cohorts (all p-value <0.001) for D-EYE in comparison with slit-lamp. In terms of ONH abnormalities, the D-EYE adequately demonstrated high sensitivity in the identification of only margins-related abnormalities (sensitivity 92.5%–96.6%). Overall, the diagnostic accuracy and agreement between expert ophthalmologists using the D-EYE and the reference slit-lamp examination were significantly poor. Conclusion We demonstrated that the D-EYE is a highly specific tool for VCDR within the normal range but not in patients with glaucoma. Despite being an easy and portable tool to measure VCDR, it is limited in terms of diagnosing ONH and blood vessel abnormalities.
Spread of antimicrobial resistance genes via pig manure from organic and conventional farms in the presence or absence of antibiotic use

Antibiotic‐resistant bacteria affect human and animal health. Hence, their environmental spread represents a potential hazard for mankind. Livestock farming is suspected to be a key factor for spreading antibiotic resistance; consumers expect organic farming to imply less environmental health risk. This study aimed to assess the role of manure from organic and conventional farms for spreading antimicrobial resistance (AMR) genes.
Daily fluctuations in social status, self‐esteem, and clinically relevant emotions: Testing hierometer theory and social rank theory at a within‐person level

Abstract Introduction Grounded in hierometer theory and social rank theory, this research examined how within‐person fluctuations in social status relate to within‐person fluctuations in self‐esteem and several clinically relevant emotions. Both hierometer theory and social rank theory postulate that particular psychological mechanisms help individuals to navigate social hierarchies adaptively. However, hierometer theory emphasizes self‐esteem, whereas social rank theory emphasizes emotions—specifically, depression, anxiety, and shame. Methods We conducted a 10‐day diary study and analyzed the data using multilevel modeling. Participants (N = 345) completed daily measures of their social status, self‐esteem, depression, anxiety, shame, and guilt. Results On days when their status was higher, participants reported higher self‐esteem and lower depression, anxiety, and shame. On days when their self‐esteem was higher, participants reported lower depression, anxiety, and shame. These patterns persisted after controlling for baseline individual differences. Furthermore, multilevel mediation analyses indicated that daily self‐esteem mediated the links between daily status, and, individually, daily depression, anxiety, and shame, but not guilt. Conclusions Supporting hierometer theory and social rank theory, self‐esteem, and the clinically relevant emotions (except for guilt) appear to serve a status‐tracking function. Self‐esteem plays a more primary role, accounting for the link between status and depression, anxiety, and shame.
Use of a synthetic biodegradable temporising matrix after necrotising fasciitis infection of the thigh

Biodegradable temporising matrix (BTM NovoSorb; PolyNovo, Melbourne, Australia) is a novel synthetic polyurethane dermal substitute. Licensed in Europe in 2020, it was developed primarily for reconstruction of infected wounds. We present a case of a healthy man in his 60s with necrotising fasciitis of his left thigh. His medical history was significant for recurrent left thigh liposarcoma that was treated years earlier with surgical excision and adjuvant radiotherapy. The affected area was within the previously irradiated tissue, debrided down to fascia and dressed with a vacuum-assisted closure to help regenerate the wound bed. Reconstruction options were limited by having a circumferential thigh defect that was infected. Following the use of NovoSorb BTM, the area was dressed with Acticoat Flex 7 antimicrobial barrier dressing for 5 weeks. Patient mobilisation was permitted. The material integrated very well and formed a soft, pliable healthy dermal layer that was autografted with split thickness skin grafts. This resulted in durable cover of the thigh with good aesthetic contour and minimal contracture.
Differences in wild-type– and R338L-tenase complex formation are at the root of R338L-factor IX assay discrepancies

Key Points • There was a threefold range in reported R338L-FIX activity in a field study of 15 different 1-stage (OSA) or chromogenic FIX:C assays (CSA). • OSA discrepancies were linked to activating reagent/phospholipids, whereas FX influenced the relative potency of R338L-FIX in CSA.
Latent class analysis to characterize neonatal risk for neurodevelopmental differences

Background Neonatal risk factors, such as preterm birth and low birth weight, have been robustly linked to neurodevelopmental deficits, yet it is still unclear why some infants born preterm and/or low birth weight experience neurodevelopmental difficulties while others do not. The current study investigated this heterogeneity in neurodevelopmental abilities by examining additional neonatal morbidities as risk factors, utilizing latent class analysis to classify neonates into groups based on similar neonatal risk factors, and including neonates from the full spectrum of gestational age. Methods Neonates who received neonatal care at an academic public hospital during an almost 10‐year period (n = 19,951) were included in the latent class analysis, and 21 neonatal indicators of health were used. Neonatal class, sex, and the interaction between neonatal class and sex were used to examine differences in neurodevelopment at 18 months of age in a typically developing population. Results The best fitting model included five infant classes: healthy, hypoxic, critically ill, minorly ill, and complicated delivery. Scores on the parent‐rated neurodevelopmental measure differed by class such that infants in the critically ill, minorly ill, and complicated delivery classes had lower scores. There was no main effect of sex on the neurodevelopmental measure scores, but the interaction between sex and neonatal class was significant for three out of five neurodevelopmental domains. Conclusions The current study extends the understanding of risk factors in neurodevelopment by including several neonatal medical conditions that are often overlooked and by using a person‐centered, as opposed to variable‐centered, approach. Future work should continue to examine risk factors, such as maternal health during pregnancy and medical interventions for newborns, in relation to neonatal risks and neurodevelopment by using a person‐centered approach.
Antipsychotics in the California Foster Care System: A 10-Year Analysis.

Background: In response to concerns regarding psychotropic medication prescribing, California's foster care system implemented oversight strategies to improve prescribing and monitoring practice, particularly for antipsychotics. The impact of these policies has not been evaluated. Objectives: To examine foster youth psychotropic use data in California and their relationship to national and state policy initiatives. Methods: This study analyzed 2011-2020 data curated by the California Child Welfare Indicators Project. The platform matches Medicaid medication and laboratory claims with individual-level foster youth data to report rates of dispensed psychotropic medications, authorization status, and metabolic screening. Results: In 2011, there were 78,231 California youth in foster care, of which 10,435 (13.3%) received psychotropics and 5570 (7.1%) antipsychotics. In 2020, of 68,386 foster children, 7172 (12.2%) received psychotropics and 2068 (3.0%) antipsychotics. Proper authorizations for psychotropics were obtained for 5581 (77.8%) foster youth in 2020. Of those receiving antipsychotics, 904 (43.7%) underwent metabolic screening. The greatest declines in antipsychotic use occurred between 2013 (6.7%) and 2018 (3.1%). Overall 2011 to 2020 declines were similar for males (8.5% → 3.6%, 58% reduction, p < 0.001) and females (5.5% → 2.4%, 57% reduction, p < 0.001). Regarding age and race, greater declines occurred for children <10 years (2.33% → 0.84%, 64% reduction, p < 0.001) and Latino youth (5.4% → 2.2%, 59% reduction, p < 0.001). Conclusions: Temporal patterns in antipsychotic use suggest an impact of policies and guidelines. While 12.2% of foster youth continue to receive psychotropics, there were reductions in racial/ethnic disparities and declines in antipsychotic use. Lack of adherence to authorization and metabolic screening requirements continue to be concerning.
Functional changes in hemostasis during asexual and sexual parasitemia in a controlled human malaria infection

Decreased platelet count is an early phenomenon in asexual Plasmodium falciparum parasitemia, but its association with acute or long-term functional changes in platelets and coagulation is unknown. Moreover, the impact of gametocytemia on platelets and coagulation remains unclear. We investigated the changes in platelet number and function during early asexual parasitemia, gametocytemia and convalescence in 16 individuals participating in a controlled human malaria infection study, and studied its relationship with changes in total and active von Willebrand factor levels (VWF) and the coagulation system. Platelet activation and reactivity were determined by flow cytometry, and the coagulation system was assessed using different representative assays including antigen assays, activity assays and global functional assays. Platelet count was decreased during asexual blood stage infection but normalized during gametocytemia. Platelet P-selectin expression was slightly increased during asexual parasitemia, gametocytemia and at day 64. In contrast, platelet reactivity to different agonists remained unchanged, except a marked decrease in reactivity to low dose collagen-related peptide-XL. Thrombin generation and antigen assays did not show a clear activation of the coagulation during asexual parasitemia, whereas total and active VWF levels were markedly increased. During gametocytemia and on day 64, the endogenous thrombin potential, thrombin peak and velocity index were increased and prothrombin conversion and plasma prothrombin levels were decreased. We conclude that the decreased platelet count during asexual parasitemia is associated with increased active VWF levels (i.e. endothelial activation), but not platelet hyperreactivity or hypercoagulability, and that the increased platelet clearance in asexual parasitemia could cause spontaneous VWF-platelet complexes formation.
Feasibility of virtual reality and treadmill training in traumatic brain injury: a randomized controlled pilot trial

ABSTRACT Objective To evaluate the safety and efficacy of treadmill training with virtual reality compared to treadmill training alone and standard of care balance and mobility treatment in chronic traumatic brain injury (TBI). Participants and Design Thirty-one individuals with chronic TBI with self-reported and objective balance deficits participated in a 4-week 12 session intervention of treadmill training with virtual reality, treadmill training alone, or standard of care overground therapy. Outcome Measures Primary measures included recruitment and enrollment rates, retention, tolerance to intervention, completeness of outcome measures, and adverse events. Secondary measures included the Community Balance and Mobility Scale, 10 Meter Walk Test, 6 Minute Walk Test, and Timed Up and Go. Results No serious adverse events were reported. All participants completed all training sessions and assessments at all time points. Recruitment, enrollment, and retention rates were high. All groups showed a trend toward improvement in all balance and mobility measures following treatment. Conclusion Virtual reality and treadmill training are safe and feasibile for individuals with TBI. Participants show improvements on balance and mobility measures following a 4-week intervention. Future research is needed to evaluate the efficacy of this intervention compared to other modes of balance and mobility training.
PROJECT-BASED LEARNING AND SOLAR ENERGY UTILIZATION USING LOCALLY DESIGNED SOLAR CONCENTRATOR: ENCOURAGING SUSTAINABLE DEVELOPMENT PRACTICES AMONG NIGERIAN SCIENCE STUDENTS

Emerging trends in education reforms have continued to call for quality education that will foster the ability of learners to meet the challenges of the 21st century and encourage their participation in sustainable development issues. The wealth drawn from quality education form the basis to finding solutions to issues of national economy beginning from needs of rural people. The current economic recession in Nigeria radically challenges the system of education to shift from factory model of education to a more proactive system of education through PBL. Twenty secondary school students from Anambra State, Nigeria participated in the study. The study was an experiment that involved the participants in designing a solar concentrator using locally available materials. The students used the designed solar concentrator to generate high temperatures at the focal region of the concentrator where the absorber was positioned. The incoming solar radiation was measured periodically for four days using pyranometer between 8.00 to 18.00 hours. The temperatures of the concentrator surface, the focal region (the absorber), the control, the ambient, the air within the aperture of the concentrator and outside the concentrator were monitored using mercury-in-glass thermometers. Results revealed that the rise in temperature of the absorber was much higher than that of the control, concentrator surface and ambient temperatures. The behavior of the system was similar for all the days, with the maximum temperatures obtained at the absorber between 12.30 hours and 14.30 hours (70 oC to 96 oC). The temperature of the collector varied between 43˚C and 45˚C while the ambient temperature varied slightly from about 30 o C to 32 o C. The results clearly showed that the designed solar concentrator was an effective solar cooker/solar furnace and could function better than most kerosene stoves which exude smoke and pollute the air. Collaborative working in groups also enhanced the acquisition of soft and generic skills. Article DOI: https://dx.doi. org/10.20319/pijtel.2017. 11.2850 This work is licensed under the Creative Commons Attribution-Non-commercial 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/4.0/ or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA.