Miracle-dz/UniFAR-FTUs huggingface dataset:
Patient Outcomes After Applied Behavior Analysis for Autism Spectrum Disorder

Abstract: Objectives: The purpose of this study was to examine patterns of service receipt and patient outcomes for children receiving applied behavior analysis (ABA) for autism spectrum disorder (ASD) in an integrated health care system in which commercially insured children were covered by a state autism mandate. Methods: This retrospective, observational study used a random sample of children with ASD (3–17 yrs) who were members of a large integrated health care system in Southern California and referred for ABA between January 2016 and November 2018. From the 4145 children referred, a random stratified sample of 334 was selected to extract data from clinical reports over 24 months of services. The primary outcome measures were time in ABA and child adaptive behavior. Results: Thirteen percent of the sample never received ABA after referral. Of those who were referred for ABA, 66% initiated ABA and remained in services for 12 months, whereas less than half (46%) remained in services for 24 months. Having a history of special education was associated with longer time spent in ABA, whereas having a single parent was associated with discontinuation of ABA. A minority of children received a full ABA dose (28%), but the lowest functioning children still experienced clinically significant adaptive behavior gains after 24 months of ABA (p = 0.02). Conclusion: In a health system implementation of ABA for children with ASD, there were high rates of ABA discontinuation and low ABA dosing. These challenges may diminish the potential benefits of ABA, even in a context in which there is mandated commercial insurance coverage.
Reference interval and the role of plasma oligomeric beta amyloid in screening of risk groups for cognitive dysfunction at health checkups

Alzheimer's disease (AD) has a prolonged preclinical stage characterized by cognitive dysfunction. Simple, reliable, and noninvasive biomarkers reflecting the pathogenesis of AD are needed for screening cognitive dysfunction in primary health care. The aims of this study were to determine (1) the potential utility of the Multimer Detection System‐Oligomeric Amyloid‐β (MDS‐OAβ) value in cognitive assessments and (2) the reference interval (RI) of plasma MDS‐OAβ values in the general population.
Drug tolerability: How much ambiguity can be tolerated? A systematic review of the assessment of tolerability in clinical studies

Drug tolerability refers to the degree to which drugs' overt adverse effects can be tolerated by patients. The tolerability profile is of comparative importance to its efficacy and safety, as it largely determines adherence to treatment and ultimately treatment success or failure. However, the term is frequently used imprecisely, and it is unclear if tolerability is limited to subjective patient‐reported symptoms or also covers certain objective signs and findings. The aim of this systematic review was to assess how clinical studies define, evaluate and present drug tolerability.
The Association Between Gaming Practices and Scholastic Performance Among Medical Students in India: Case-Control Study

Background Gaming is a billion-dollar industry that is expanding at a compound annual growth rate of 9% to 14.3%, with the biggest market in Southeast Asian countries. The availability of low-cost smartphones and the ease at which the internet can be accessed have made gaming popular among youth, who enjoy it as a leisure activity. According to the World Health Organization, excessive indulgence in gaming can lead to gaming disorder. Medical students indulging in excessive gaming can succumb to gaming disorder, which can affect their scholastic performance. Objective This study aimed to assess the association between gaming practices and scholastic performance among medical students. Methods This study used a case-control design, where 448 medical undergraduate students (first year to prefinal) were preliminarily surveyed using universal sampling on their gaming practices in the last 6 months. Out of this sample, the 91 participants who admitted to gaming in the past 6 months were recruited as cases, while participants who never engaged in gaming in the last 6 months were recruited as controls. Both the cases and controls were matched for age and gender in a 1:1 ratio. The internal assessment scores (based on 2 midterms completed in the last 6 months) of cases and controls were compared. The Snedecor F test was used to determine the association between the number of hours spent gaming and internal assessment scores (%), while the Student t test was used to determine significant differences between the internal assessment scores of cases and controls. Odds ratios were calculated to identify the risk of poor scholastic performance among cases compared to the controls. The prevalence of gaming disorder among cases was assessed using the Gaming Addiction Scale (GAS). Results The frequency of gaming (in hours) was not associated with mean internal assessment scores (P=.13). Male cases reported significantly lower internal assessment scores compared to male controls (P=.005 vs P=.01), whereas no significant differences were observed between the internal assessment scores of female cases and controls (P=.89 vs P=.59). A negative correlation was observed between GAS scores and internal assessment scores (r=–0.02). The prevalence of gaming disorder using the GAS was observed to be 6.3% (28/448) in the study population and 31% (28/91) among cases. The risk of low scores (<50%) among gamers was observed to be 1.9 (95% CI 1.04-3.44, P=.03) times higher in the first midterm and 1.80 (95% CI 0.97-3.36, P=.06) times higher in the second midterm compared to nongamers. Conclusions The findings suggest that excessive gaming adversely affects the scholastic performance of male participants more than female participants. Awareness about gaming disorder needs to be created among students, parents, and teachers. Treatment services should be made available to medical students with gaming disorders.
Diagnostic performance of US-based FNAB criteria of the 2020 Chinese guideline for malignant thyroid nodules: comparison with the 2017 American College of Radiology guideline, the 2015 American Thyroid Association guideline, and the 2016 Korean Thyroid Association guideline.

Background To investigate the diagnostic performance of the ultrasonography-based fine-needle aspiration biopsy criteria of the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) for malignant nodules compared to 3 other guidelines. Methods This study included 2,309 thyroid nodules in 1,697 patients with histopathological and cytopathological diagnoses of benign and malignant nodules from January 2018 to August 2020. The clinical and ultrasonographic features of the nodules were retrospectively reviewed and classified according to the Chinese guideline (C-TIRADS), the American College of Radiology guideline (ACR-TIRADS), the American Thyroid Association guideline (ATA guideline), and the Korean Thyroid Association guideline (K-TIRADS). The diagnostic performance of the guidelines and their unnecessary fine-needle aspiration biopsy rates were calculated using randomized, blinded trials. Results Of the 2,309 nodules, 1,418 (61.4%) were benign and 891 (38.6%) were malignant, with 884 (99.21%) papillary carcinomas. The accuracy of C-TIRADS was 84.71%, followed by the guidelines of ACR-TIRADS (82.11%), K-TIRADS (81.64%), and the ATA guideline (78.56%). Furthermore, the area under the receiver operating characteristic curve (AUC) was the highest for the C-TIRADS (0.905). Similar results were revealed for both the diagnostic performance and AUC of nodules smaller and larger than 10 mm. The ACR-TIRADS showed the lowest unnecessary biopsy rate (17.54%), followed by the C-TIRADS (22.61%), ATA guideline (27.90%), and the K-TIRADS (28.67%). Conclusions The C-TIRADS demonstrated high diagnostic performance and a relatively low unnecessary biopsy rate in detecting thyroid cancer compared to the 3 other guidelines. However, further understanding of the ultrasonography-based fine-needle aspiration biopsy criteria of the C-TIRADS should be gained in the future.
The relation between working memory, number sense, and mathematics throughout primary education in children with and without mathematical difficulties

ABSTRACT Number sense and working memory contribute to mathematical development throughout primary school. However, it is still unclear how the contributions of each of these predictors may change across development and whether the cognitive contribution is the same for children with and without mathematical difficulties. The aim of the two studies in this paper was to shed light on these topics. In a cross-sectional design, a typically developing group of children (study 1; N = 459, Grades 1–4) and a group with mathematical difficulties (study 2; N = 61, Grades 4–6) completed a battery of number sense and working memory tests, as well as a measure of arithmetic competence. Results of study 1 indicated that number sense was important in first grade, while working memory gained importance in second grade, before predictive value of both predictors waned. Number sense and working memory supported mathematics development independently from one another from Grade 1. Analysis of task demands showed that typically developing children rely on comprehension and visualization of quantity-to-number associations in early development. Later in development, pupils rely on comparing larger numerals and working memory until automatization. Children with mathematical difficulties were less able to employ number sense during mathematical operations, and thus might remain dependent on their working memory resources during arithmetic tasks. This suggests that children with mathematical difficulties need aid to employ working memory for mathematics from an early age to be able to automatize mathematical abilities later in development.
Clinical Features of Acute Chikungunya Virus Infection in Children and Adults during an Outbreak in the Maldives

ABSTRACT. The chikungunya virus is an arthritogenic arbovirus that has re-emerged in many tropical and subtropical regions, causing explosive outbreaks. This re-emergence is due to a genomic polymorphism that has increased the vector susceptibility of the virus. The majority of those infected with chikungunya virus exhibit symptoms of fever, rash, and debilitating polyarthralgia or arthritis. Symptoms can persist for weeks, and patients can relapse months later. Fatalities are rare, but individuals of extreme age can develop severe infection. Here, we describe the 2019 outbreak, the second-largest since the virus re-emerged in the Maldives after the 2004 Indian Ocean epidemic, in which a total of 1,470 cases were reported to the Health Ministry. Sixty-seven patients presenting at the main referral tertiary care hospital in the Maldives capital with acute undifferentiated illness were recruited following a negative dengue serology. A novel point-of-care antigen kit was used to screen suspected cases, 50 of which were subsequently confirmed using real-time reverse transcription–polymerase chain reaction. We describe the genotype and polymorphism of Maldives chikungunya virus using phylogenetic analysis. All isolates were consistent with the East Central South African genotype of the Indian Ocean lineage, with a specific E1-K211E mutation. In addition, we explored the clinical and laboratory manifestations of acute chikungunya in children and adults, of which severe infection was found in some children, whereas arthritis primarily occurred in adults. Arthritides in adults occurred irrespective of underlying comorbidities and were associated with the degree of viremia.
Risk, Cooperation and the Economic Origins of Social Trust: an Empirical Investigation * (job Market Paper)

Extensive research has documented the importance of social trust for economic development, yet the origins of trust remain largely unexplored. This paper examines the historical relationship between risk, cooperation and the emergence of social trust. I hypothesize that norms of trust developed in preindustrial times as a result of experiences of collective action and mutual insurance triggered by the need for subsistence farmers to cope with climatic risk. These norms persisted over time, even after climate had become largely unimportant for economic activity. I test this hypothesis in the context of Europe combining high-resolution climate data for the period 1500-2000 with contemporary survey data at the sub-national level. I find that regions characterized by higher year-to-year variability in precipitation and temperature display higher levels of trust. Consistent with a theory of insurance through geographic differentiation, I also find that trust is higher in regions with more spatially heterogeneous precipitation. Furthermore, variation in social trust is driven by weather patterns during the growing season and by historical rather than recent variability. These results are robust to the inclusion of country fixed-effects, a variety of geographical controls, and regional measures of early political and economic development.
The participation of singlet oxygen in a photocitotoxicity of extract from amazon plant to cancer cells

We have been searching for new photosensitizers (PS) for photodynamic therapy (PDT) of cancer based on extracts from Amazonian plants since 2009. In this paper, we demonstrate that, under certain conditions, the extract from fruits of the Amazonian palm Euterpe oleraceae (popular name Açaí) can serve as a PS for PDT treatment of murine breast cancer cells (4T1 cell line). We have been first to show directly that the photodynamic effect of plant PS is due to singlet oxygen.
Rule learning in adolescents at clinical high risk for psychosis shows altered patterns of activation

Abstract Background The ability to flexibly apply rules to novel situations is a critical aspect of adaptive human behavior. While executive function deficits are known to appear early in the course of psychosis, it is unclear which specific facets are affected. Identifying whether rule learning is impacted at the early stages of psychosis is necessary for truly understanding the etiology of psychosis and may be critical for designing novel treatments. Therefore, we examined rule learning in healthy adolescents and those meeting criteria for clinical high risk (CHR) for psychosis. Methods 24 control and 22 CHR adolescents underwent rapid, high-resolution fMRI while performing a paradigm which required them to apply novel or practiced task rules. Results Previous work has suggested that practiced rules rely on rostrolateral prefrontal cortex (RLPFC) during rule encoding and dorsolateral prefrontal cortex (DLPFC) during task performance, while novel rules show the opposite pattern. We failed to replicate this finding, with greater activity for novel rules during performance. Comparing the HC and CHR group, there were no statistically significant effects, but an effect size analysis found that the CHR group showed less activation during encoding and greater activation during performance. This suggests the CHR group may use less efficient reactive control to retrieve task rules at the time of task performance, rather than proactively during rule encoding. Conclusions These findings suggest that flexibility may be altered in the clinical high risk state, however, more data is needed to determine whether these deficits predict disease progression.
Fast drying of cut tobacco in drop tube reactor and its effect on petroleum ether tobacco extracts

ABSTRACT Entrained flow drying is an important fast drying tool in tobacco industry. This study used a drop tube reactor (DTR) as an entrained flow dryer to investigate drying process of flue-cured cut tobacco. Lab-scale cold and hot DTRs were set up to obtain drying kinetics for three types of cut tobacco using different drying gases and temperatures. The effective diffusion coefficients of cut tobacco in DTRs were compared with those in a general cylinder dryer. Moreover, the effects of different drying gases and temperatures on petroleum ether extract content were investigated. The results showed that the effective diffusion coefficients of cut tobacco in the DTRs were between 2.296 × 10−8 and 8–6.244 × 10−8 m2/s, which are two orders of magnitude higher than those in the cylinder dryer. Compared to hot air as a drying medium, superheated steam improved the effective diffusion coefficient of cut tobacco. The petroleum ether tobacco extract had a higher retention ratio when the superheated steam was used in the DTRs. An increase in the drying temperature resulted in a lower retention of the petroleum ether tobacco extract.
Financial Inclusion

The past two decades have seen a rapid increase in interest in financial inclusion, both from policymakers and researchers. This paper surveys the main findings from the literature, documenting the trends over time and gaps that have arisen across regions, income levels, and gender, among others. It points out that structural, as well as policy-related, factors, such as encouraging banking competition or channeling government payments through bank accounts, play an important role, and describes the potential macro and microeconomic benefits that can be derived from greater financial inclusion. It argues that policy should aim to identify and reduce frictions holding back financial inclusion, rather than targeting specific levels of inclusion. Finally, it suggests areas for future research.
Comparison between buttress plate and anteroposterior screw internal fixation for posterior pilon fracture: a retrospective study

Background: Posterior pilon fracture (PPF) is a serious ankle injury caused by combined vertical and rotational trauma. Surgical treatment includes buttress plate (BP), anteroposterior screw (APS) and posteroanterior screw (PAS) fixation. This study aimed to compare the therapeutic effects after PPF internal fixation with BPs and APSs. Methods: From January 2015 to June 2018, 37 patients with PPFs underwent surgical treatment in our institution. The patients were divided into the BP (11 patients) and APS (26 patients) groups according to the internal fixation method. Bone healing time and postoperative complications were recorded. At the last follow-up, American Orthopedic Foot and Ankle Society (AOFAS) scores, visual analog scale (VAS) scores and Burwell-Charnley scores were used to evaluate ankle joint function, ankle joint pain, and fracture reduction on imaging, respectively. Results: No significant difference in bone healing time was found between the two groups (P > 0.05). Local necrosis of the posterolateral incision and chronic ankle pain occurred in 1 case each in the BP group. Chronic ankle joint pain occurred in 4 cases in the APS group. Two cases of soft tissue irritation were caused by screws that were too long. Local numbness of the posterolateral incision occurred in 1 case. At the last follow-up, no significant difference in VAS scores between the two groups at rest (P = 0.477), but a significant difference during exercise was noted (P = 0.033). AOFAS scores were better in the BP group than those in the APS group (P = 0.002). According to the Burwell-Charnley scoring system, 11 cases were anatomically reduced in the BP group. In the APS group, anatomical reduction was achieved in 19 cases and fair in 7 cases. Conclusion: Compared with APSs, BPs resulted in better reduction, ankle joint functional recovery and complication rates. BPs are recommended for internal fixation of PPFs.
Circulating miR-660-5p is associated with no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention

Background: The no-reflow phenomenon (NRP) is an important factor affecting the prognosis of patients with acute myocardial infarction undergoing primary percutaneous coronary intervention (PPCI). This study aims to investigate the association of circulating miR-660-5p with NRP in patients with ST segment elevation myocardial infarction (STEMI) undergoing PPCI.Methods: Consecutive patients diagnosed with anterior STEMI within 12 h of pain onset were included in the study; in these patients, coronary angiography confirmed that the infarct-related artery was the left anterior descending (LAD) artery. Angiographic NRP was defined as a final TIMI flow of 2 or a final TIMI flow of 3 with a myocardial blush grade (MBG) < 2. High miR-660-5p was defined as a value in the third tertile. The relationship of circulating miR-660-5p with NRP was assessed using Spearman correlation analysis and multiple linear regression analysis.Results: Fifty-two eligible patients were finally included in this study (mean age: 56±12.4 years, >65 years: 53.8%, male: 76.9%, and mean BMI: 26.3±3.5). The incidence of NRP was 38.5%. Circulating miR-660-5p was significantly related to the mean platelet volume (MPV). Patients were divided into tertiles by miR-660-5p levels (Q1: ≤ 7.18, Q2: 7.18-11.31, Q3: > 11.31). Patients in the high microRNA-660-5p group had almost a 6-fold higher risk of NRP than those in the low microRNA-660-5p group [(odds ratio (OR)=5.68, 95% confidence interval (CI) 1.40-23.07, p=0.015). When analysed by tertiles, consistent trends of an increasing relative odds of NRP were reported (OR1 for Q2 VS. Q1: 1.25, 95% CI: 0.27-5.73, p=0.77; OR2 for Q3 VS. Q1: 5.96, 95% CI: 1.33-26.66, p=0.02), even after multivariable adjustment. Receiver operating characteristic curve analysis demonstrated that the microRNA-660-5p level of 10.17 was the best cut-off level to predict the incidence of the no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention with an area under the curve (AUC) of 0.768 (95% CI: 0.636-0.890). Conclusion: Circulating miR-660-5p was significantly associated with NRP, and it may be a useful biomarker to predict the incidence of NRP in patients with STEMI undergoing PPCI.
Inventive Methods Used to Study and Control Thermal Necrosis: A Review

Orthopedic surgeries use screw and plate fixations. Bone drilling is performed for smooth and minimum damage to bone surface during screw insertion. Bone drilling creates a hole with circular cross-section. This process involves cutting and material removal with a helical drill tool. Heat is generated at the drilling site due to cutting, shearing of bone material by drill tool and friction between drill tool and bone surface. Previous research studies found that if temperature at drilling site reaches 47°C and remains the same for one minute, irreversible cell damage i.e. thermal necrosis can occur. Thermal necrosis causes ring sequestrum around the pin; this leads to a vicious cycle involving secondary infection, discharge and pin loosening. This postoperative complication can only be rectified by removal of pin and sequestrum, curettage of the tract and pin replacement and so thermal necrosis- the root cause must be avoided and attended very seriously. To avoid thermal necrosis, postoperative complications and delay in patient rehabilitation, researchers are studying bone drilling in detail. In this review paper, a discussion is made on different innovative methods that are turning points in the study of thermal necrosis and the latest technologically improved equipment devised by researchers. These inventive methods have used experimental set ups, software-based simulations and training programs. The author also conducted experiments on female goat rib bone and based on these observations an improved drilling machine is suggested.