Miracle-dz/UniFAR-FTUs huggingface dataset:
Practical Guidelines and Considerations for the Use of Elastic Bands in Strength and Conditioning

ABSTRACT ELASTIC BANDS ARE A FORM OF VARIABLE RESISTANCE AND A STRENGTH TRAINING MODALITY COMMONLY SEEN WITHIN A STRENGTH AND CONDITIONING TRAINING ENVIRONMENT. THEY ARE CONSIDERED AN EFFECTIVE TRAINING TOOL DUE TO THE FACT THAT THE RESISTANCE ALIGNS WITH THE FORCE CAPABILITY OF THE MUSCULATURE THROUGHOUT THE RANGE OF MOTION OF MANY MOVEMENT TASKS. THIS ARTICLE WILL EXPLORE THE WAYS IN WHICH ELASTIC BANDS CAN BE USED TO CHALLENGE OR ACCOMMODATE A MOVEMENT'S RANGE OF MOTION TO PROVIDE A MORE SPECIFIC STRENGTH-TRAINING STIMULUS. FOR A VIDEO ABSTRACT OF THIS ARTICLE, SEE SUPPLEMENTAL DIGITAL CONTENT 1 (SEE VIDEO, HTTP://LINKS.LWW.COM/SCJ/A146).
Subdural empyema complicated after trepanation and drainage of chronic subdural hematoma

Abstract Rationale: Chronic subdural hematoma (CSDH) is one of the most common neurosurgical diseases. However, complicated subdural empyema rarely occurs after trepanation and drainage of chronic subdural hematoma. Patient concerns: A male patient (77 years old) was admitted to the hospital on the 2nd day of fever after an undergoing a “trepanation and drainage of chronic subdural hematoma” operation at a local hospital. After admission, the patient was treated with an emergency operation in which a subdural abscess was diagnosed and then administered antibiotics after the operation. Diagnosis: According to the clinical manifestations, intraoperative findings of imaging examination and the results of pus culture, the diagnosis was subdural empyema. Intervention: We surgically removed the subdural empyema. Postoperative antibiotics were administered according to the results of bacterial culture. Outcomes: At 3 months after the operation, the patient returned to the hospital for reexamination and was found to have achieved a good recovery and good self-care. Lessons: Subdural empyema after trepanation and drainage of chronic subdural hematoma is a very rare and severe disease. Early diagnosis and operative intervention as well as the intravenous administration of antibiotics can improve the prognosis of patients and enhance their quality of life.
Learning of skilled movements via imitation in ASD

Autism spectrum disorder (ASD) consists of altered performance of a range of skills, including social/communicative and motor skills. It is unclear whether this altered performance results from atypical acquisition or learning of the skills or from atypical “online” performance of the skills. Atypicalities of skilled actions that require both motor and cognitive resources, such as abnormal gesturing, are highly prevalent in ASD and are easier to study in a laboratory context than are social/communicative skills. Imitation has long been known to be impaired in ASD; because learning via imitation is a prime method by which humans acquire skills, we tested the hypothesis that children with ASD show alterations in learning novel gestures via imitation. Eighteen participants with ASD and IQ > 80, ages 8–12.9 years, and 19 typically developing peers performed a task in which they watched a video of a model performing a novel, meaningless arm/hand gesture and copied the gesture. Each gesture video/copy sequence was repeated 4–6 times. Eight gestures were analyzed. Examination of learning trajectories revealed that while children with ASD made nearly as much progress in learning from repetition 1 to repetition 4, the shape of the learning curves differed. Causal modeling demonstrated the shape of the learning curve influenced both the performance of overlearned gestures and autism severity, suggesting that it is in the index of learning mechanisms relevant both to motor skills and to autism core features. Autism Res 2020, 13: 777–784. © 2019 International Society for Autism Research, Wiley Periodicals, Inc.
When my four-year-old got cancer: a retrospective on resilience in a paediatric oncology ward

Abstract The author presents an interpersonal experience between the author and her son during childhood cancer treatment and care, illustrating the complex relationship between childhood cancer and the term ‘resilience’. During treatment and care, nurses used the term ‘resilience’ in an apparent attempt to reassure her. However, the author found that the concept distanced her from her and her son’s experience, creating emotional distress for him. She discovered that the everyday use of resilience, devoid of its research connotations, has the potential to create barriers in understanding these experiences for the patient and the caregiver. For example, this everyday use did not account for the relationship that resilience has with growth. It is not just important in terms of diagnosing a tumour, it is also important for supporting the agency of a child and the cultivation of trustworthiness. A focus on growth supports the notion of an “active resilience,” a process informed by research literature to help medical staff and families develop the child patient’s capability for growing into resilience throughout the survivorship experience. By neglecting this relationship with growth, resilience was found to silence the agency and voice of the author’s child which added to the difficulty that she had in providing care. As more children survive cancer, a meaningful use of the term resilience can support their recovery from the adversities of treatment and a life of adverse outcomes. The ethnographic detail provides the context necessary for contributing to and unpacking the normative use of the term resilience in paediatric oncology.
Drivers of High-cost Medical Complexity in a Medicaid Population

Supplemental Digital Content is available in the text. Background: Efforts to improve outcomes for the 10% of patients using two thirds of health care expenditures increasingly include addressing social determinants. Empiric evidence is needed to identify the highest impact nonmedical drivers of medical complexity and cost. Objectives: This study examines whether complex, highest cost patients have different patterns of critical life adversity than those with better health and lower utilization. Research Design: Using a validated algorithm we constructed a complexity/cost risk patient profile. We developed and fielded a life experience survey (Supplemental Digital Content 1, http://links.lww.com/MLR/B920) to a representative sample, then examined how the prevalence of specific adversities varied between complex, high-cost individuals, and others. Subjects: Surveys were sent to 9176 adult Medicaid members in Portland, Oregon. Measures: Our primary variable was high medical complexity health cost risk; an alternative specification combined health cost risk and actual utilization/cost. Our survey instrument measured exposure to early and later-life adversities. Results: Compared with healthy individuals in our population, medically complex individuals had significantly higher rates of adversity. The greatest risk of medical complexity and cost was associated with substance use [odds ratio (OR), 4.1], homelessness (OR, 3.0), childhood maltreatment (OR, 2.8), and incarceration (OR 2.4). Those with the highest prior year acute care utilization and cost had the highest rates of these same factors: substance use (62.5%), homelessness (61.7%), childhood maltreatment (55.5%), and incarceration (52.1%). Conclusion: Clinical and policy strategies that mitigate high-impact social drivers of poor outcomes are likely critical for improving both health and costs for complex, high-needs patients.
Fast contour propagation for MR‐guided prostate radiotherapy using convolutional neural networks

Purpose To quickly and automatically propagate organ contours from pretreatment to fraction images in magnetic resonance (MR)‐guided prostate external‐beam radiotherapy. Methods Five prostate cancer patients underwent 20 fractions of image‐guided external‐beam radiotherapy on a 1.5 T MR‐Linac system. For each patient, a pretreatment T2‐weighted three‐dimensional (3D) MR imaging (MRI) scan was used to delineate the clinical target volume (CTV) contours. The same scan was repeated during each fraction, with the CTV contour being manually adapted if necessary. A convolutional neural network (CNN) was trained for combined image registration and contour propagation. The network estimated the propagated contour and a deformation field between the two input images. The training set consisted of a synthetically generated ground truth of randomly deformed images and prostate segmentations. We performed a leave‐one‐out cross‐validation on the five patients and propagated the prostate segmentations from the pretreatment to the fraction scans. Three variants of the CNN, aimed at investigating supervision based on optimizing segmentation overlap, optimizing the registration, and a combination of the two were compared to results of the open‐source deformable registration software package Elastix. Results The neural networks trained on segmentation overlap or the combined objective achieved significantly better Hausdorff distances between predicted and ground truth contours than Elastix, at the much faster registration speed of 0.5 s. The CNN variant trained to optimize both the prostate overlap and deformation field, and the variant trained to only maximize the prostate overlap, produced the best propagation results. Conclusions A CNN trained on maximizing prostate overlap and minimizing registration errors provides a fast and accurate method for deformable contour propagation for prostate MR‐guided radiotherapy.
Nighttime driving: visual, lighting and visibility challenges

Nighttime driving is dangerous and is one of the most challenging driving situations for most drivers. Fatality rates are higher at night than in the day when adjusted for distances travelled, particularly for crashes involving pedestrians and cyclists. Although there are multiple contributory factors, the low light levels at night are believed to be the major cause of collisions with pedestrians and cyclists at night, most likely due to their reduced visibility. Understanding the visibility problems involved in nighttime driving is thus critical, given the increased risk to road safety.
MicroRNA miR-7 regulates secretion of insulin-like peptides.

The insulin/IGF pathway is essential for linking nutritional status to growth and metabolism. MicroRNAs (miRNAs) are short RNAs that are players in the regulation of this process. The miRNA miR-7 shows highly conserved expression in insulin-producing cells across the animal kingdom. However, its conserved functions in regulation of insulin-like peptides (ILPs) remain unknown. Using Drosophila as a model, we demonstrate that miR-7 limits ILP availability by inhibiting its production and secretion. Increasing miR-7 alters body growth and metabolism in an ILP-dependent manner, elevating circulating sugars and total body triglycerides, while decreasing animal growth. These effects are not due to direct targeting of ILP mRNA, but instead arise through alternate targets that affect the function of ILP-producing cells. The Drosophila F-actin capping protein alpha, CPA, is a direct target of miR-7, and knockdown of CPA in IPCs phenocopies the effects of miR-7 on ILP secretion. This regulation of CPA is conserved in mammals, with the mouse ortholog Capza1 also targeted by miR-7 in β-islet cells. Taken together, these results support a role for miR-7 regulation of an actin capping protein in insulin regulation, and highlight a conserved mechanism of action for an evolutionarily ancient microRNA.
Physical Activity, Sedentary Behavior, and White Matter Microstructure in Children with Overweight or Obesity

Supplemental digital content is available in the text. ABSTRACT Purpose This study aimed to investigate the associations of objectively measured and self-reported physical activity (PA) and sedentary behavior with white matter microstructure in children with overweight or obesity. Methods In a sample of 103 participants (age, 10.02 ± 1.15 yr; 42 girls) from the ActiveBrains project, we assessed PA and sedentary behavior using accelerometers (GT3X+; ActiGraph, Pensacola, FL), and the Youth Activity Profile-Spain questionnaire. Objectively measured PA and sedentary behavior were classified into different intensities following the hip- and wrist-based cutoff points for the Euclidean Norm Minus One metric by Hildebrand et al., wrist-based cutoff points for counts metric by Chandler et al., and hip-based cutoff points for counts metric for Romanzini et al. and Evenson et al. Magnetic resonance imaging of white matter microstructure, fractional anisotropy (FA), and mean diffusivity (MD) were derived from diffusion tensor imaging. Linear regression models were used to examine the associations of objectively measured and self-reported PA and sedentary behavior with global and tract-specific FA and MD. Results Self-reported total PA was positively associated with global FA (β = 0.236, P = 0.038), whereas watching television was negatively associated with global FA (β = −0.270, P = 0.014). In regard to the objective measures, using single regression models, light PA (β = 0.273, P = 0.016), moderate-to-vigorous PA (β = 0.257, P = 0.035), and total PA (β = 0.294, P = 0.013) were positively associated with global FA only when Hildebrand–Euclidean Norm Minus One hip cut points were used for analyses. Lastly, no association was found between PA and sedentary behavior and FA and MD within individual tracts. Conclusions Our results suggest that PA and watching television are related to white matter microstructure in children with overweight or obesity. However, longitudinal large-scale studies are needed to confirm and expand these findings.
Changes in Quality of Care after Hospital Mergers and Acquisitions.

BACKGROUND The hospital industry has consolidated substantially during the past two decades and at an accelerated pace since 2010. Multiple studies have shown that hospital mergers have led to higher prices for commercially insured patients, but research about effects on quality of care is limited. METHODS Using Medicare claims and Hospital Compare data from 2007 through 2016 on performance on four measures of quality of care (a composite of clinical-process measures, a composite of patient-experience measures, mortality, and the rate of readmission after discharge) and data on hospital mergers and acquisitions occurring from 2009 through 2013, we conducted difference-in-differences analyses comparing changes in the performance of acquired hospitals from the time before acquisition to the time after acquisition with concurrent changes for control hospitals that did not have a change in ownership. RESULTS The study sample included 246 acquired hospitals and 1986 control hospitals. Being acquired was associated with a modest differential decline in performance on the patient-experience measure (adjusted differential change, -0.17 SD; 95% confidence interval [CI], -0.26 to -0.07; P = 0.002; the change was analogous to a fall from the 50th to the 41st percentile) and no significant differential change in 30-day readmission rates (-0.10 percentage points; 95% CI, -0.53 to 0.34; P = 0.72) or in 30-day mortality (-0.03 percentage points; 95% CI, -0.20 to 0.14; P = 0.72). Acquired hospitals had a significant differential improvement in performance on the clinical-process measure (0.22 SD; 95% CI, 0.05 to 0.38; P = 0.03), but this could not be attributed conclusively to a change in ownership because differential improvement occurred before acquisition. CONCLUSIONS Hospital acquisition by another hospital or hospital system was associated with modestly worse patient experiences and no significant changes in readmission or mortality rates. Effects on process measures of quality were inconclusive. (Funded by the Agency for Healthcare Research and Quality.).
Hippocampal long‐term synaptic depression and memory deficits induced in early amyloidopathy are prevented by enhancing G‐protein‐gated inwardly rectifying potassium channel activity

Hippocampal synaptic plasticity disruption by amyloid‐β (Aβ) peptides + thought to be responsible for learning and memory impairments in Alzheimer's disease (AD) early stage. Failures in neuronal excitability maintenance seems to be an underlying mechanism. G‐protein‐gated inwardly rectifying potassium (GirK) channels control neural excitability by hyperpolarization in response to many G‐protein‐coupled receptors activation. Here, in early in vitro and in vivo amyloidosis mouse models, we study whether GirK channels take part of the hippocampal synaptic plasticity impairments generated by Aβ1–42. In vitro electrophysiological recordings from slices showed that Aβ1–42 alters synaptic plasticity by switching high‐frequency stimulation (HFS) induced long‐term potentiation (LTP) to long‐term depression (LTD), which led to in vivo hippocampal‐dependent memory deficits. Remarkably, selective pharmacological activation of GirK channels with ML297 rescued both HFS‐induced LTP and habituation memory from Aβ1–42 action. Moreover, when GirK channels were specifically blocked by Tertiapin‐Q, their activation with ML297 failed to rescue LTP from the HFS‐dependent LTD induced by Aβ1–42. On the other hand, the molecular analysis of the recorded slices by western blot showed that the expression of GIRK1/2 subunits, which form the prototypical GirK channel in the hippocampus, was not significantly regulated by Aβ1–42. However, immunohistochemical examination of our in vivo amyloidosis model showed Aβ1–42 to down‐regulate hippocampal GIRK1 subunit expression. Together, our results describe an Aβ‐mediated deleterious synaptic mechanism that modifies the induction threshold for hippocampal LTP/LTD and underlies memory alterations observed in amyloidosis models. In this scenario, GirK activation assures memory formation by preventing the transformation of HFS‐induced LTP into LTD.
Enhanced Carrier Screening for Spinal Muscular Atrophy: Detection of Silent (SMN1: 2 + 0) Carriers Utilizing a Novel TaqMan Genotyping Method.

BACKGROUND Individuals whose copies of the survival motor neuron 1 (SMN1) gene exist on the same chromosome are considered silent carriers for spinal muscular atrophy (SMA). Conventional screening for SMA only determines SMN1 copy number without any information regarding how those copies are arranged. A single nucleotide variant (SNV) rs143838139 is highly linked with the silent carrier genotype, so testing for this SNV can more accurately assess risk to a patient of having an affected child. METHODS Using a custom-designed SNV-specific Taqman genotyping assay, we determined and validated a model for silent-carrier detection in the laboratory. RESULTS An initial cohort of 21 pilot specimens demonstrated results that were 100% concordant with a reference laboratory method; this cohort was utilized to define the reportable range. An additional 177 specimens were utilized for a broader evaluation of clinical validity and reproducibility. Allelic-discrimination analysis demonstrated tight clustering of genotype groupings and excellent reproducibility, with a coefficient of variation for all genotypes ranging from 1% to 4%. CONCLUSION The custom-developed Taqman SNV genotyping assay we tested provides a rapid, accurate, and cost-effective method for routine SMA silent-carrier screening and considerably improves detection rates of residual risk for SMA carriers.
Outcomes of anatomical versus non-anatomical resection for hepatocellular carcinoma according to circulating tumour-cell status

Abstract Background and aims: Hepatic resection is the first-line treatment for hepatocellular carcinoma (HCC). Whether to perform anatomical (AR) or non-anatomical resection (NAR) remains controversial. This retrospective study compares the outcomes according to the number and type of circulating tumour cells (CTCs). Methods: The cohort included 136 patients with HCC treated with R0 resection between 2014 and 2017. CanPatrol CTC-enrichment technique was used to enrich and classify CTCs according to epithelial-to-mesenchymal transition phenotype. Results: 91.91% of total patients were CTC-positive, with 91.23% in the AR group and 92.41% in the NAR group. Tumour-free survival (TFS) did not differ significantly between the two groups. However, TFS was significantly higher in patients with low CTCs count and mesenchymal- and epithelial/mesenchymal-negative phenotypes. As for the incidence and types of recurrence, high pre-resection CTC count and mesenchymal- and epithelial/mesenchymal-positivity were significantly associated with extrahepatic and multi-intrahepatic recurrence. Higher morbidities for hepatic failure and ascites were observed in patients treated by AR. Conclusion: AR may be more beneficial than NAR only in patients with low CTC count and mesenchymal- and epithelial/mesenchymal-negative phenotypes. For patients with a high CTC count, the balance between operative risk and prognostic benefit is more important than the resection method performed. Key messages Anatomic resection may improve the survival of HCC patients, but only those with low CTC count and negative M- and E/M-CTC phenotypes. CTC analysis before surgery can be used to better guide the choice of resection method for HCC.
A posterior approach for lateral posterior basal bisegmentectomy of the lower lobes

下葉肺底区で背側の区域の切除は，肺動脈・気管支が葉間の肺門から深部にあり難度が高いとされる．当科ではこれらの区域切除に造影MDCTから再構成した3次元血管樹シミュレーションを用い，後方から気管支・肺動脈にアプローチすることで，術式を簡易化し得たので報告する．
Best Practice for Delivering Small-Volume Intermittent Intravenous Infusions

This study investigated the delivery of small-volume intermittent intravenous (IV) infusions. Laboratory protocol evaluated potential medication loss among 6 administration methods using 50- and 100-mL solutions. Significant variations existed in calculated medication loss depending on administration method and volume. Up to 35% of medication may not be administered due to residual volume, with the greatest percentage associated with 50-mL solutions. Results suggest that intermittent IV infusions should only be delivered as a secondary infusion through a primary infusion administration set with a continuous infusion or an infusion that can flush the administration set at the completion of the secondary infusion.
Role of cutaneous and proprioceptive inputs in sensorimotor integration and plasticity occurring in the facial primary motor cortex

Previous studies investigating the effects of somatosensory afferent inputs on cortical excitability and neural plasticity often used transcranial magnetic stimulation (TMS) of hand motor cortex (M1) as a model, but in this model it is difficult to separate out the relative contribution of cutaneous and muscle afferent input to each effect. In the face, cutaneous and muscle afferents are segregated in the trigeminal and facial nerves, respectively. We studied their relative contribution to corticobulbar excitability and neural plasticity in the depressor anguli oris M1. Stimulation of trigeminal afferents induced short‐latency (SAI) but not long‐latency (LAI) afferent inhibition of face M1, while facial nerve stimulation evoked LAI but not SAI. Plasticity induction was observed only after a paired associative stimulation protocol using the facial nerve. Physiological differences in effects of cutaneous and muscle afferent inputs on face M1 excitability suggest they play separate functional roles in behaviour.