Miracle-dz/UniFAR-FTUs huggingface dataset:
Greater adherence to a Mediterranean-like diet is associated with later breast development and menarche in peripubertal girls

Abstract Objective: To examine adherence to a Mediterranean-like diet at age 9–10 years in relation to onset of breast development (thelarche) and first menstruation (menarche). Design: We evaluated the associations of adherence to a Mediterranean-like diet (measured by an adapted Mediterranean-like Diet Score, range 0–9) with thelarche at baseline, age at thelarche and time to menarche. Data were collected at baseline during a clinic visit, complemented with a mailed questionnaire and three 24 hour telephone dietary recalls, followed by annual follow-up questionnaires. Multivariable Poisson regression, linear regression and Cox proportional hazards regression were used to evaluate timing of pubertal development in relation to diet adherence. Setting: New Jersey, USA. Participants: Girls aged 9 or 10 years at baseline (2006–2014, n 202). Results: High Mediterranean-like diet adherence (score 6–9) was associated with a lower prevalence of thelarche at baseline compared with low adherence (score 0–3; prevalence ratio = 0·65, 95 % CI 0·48, 0·90). This may have been driven by consumption of fish and non-fat/low-fat dairy. Our models also suggested a later age at thelarche with higher Mediterranean-like diet adherence. Girls with higher Mediterranean-like diet adherence had significantly longer time to menarche (hazard ratio = 0·45, 95 % CI 0·28, 0·71 for high v. low adherence). Further analysis suggested this may have been driven by vegetable and non-fat/low-fat dairy consumption. Conclusions: Consuming a Mediterranean-like diet may be associated with older age at thelarche and menarche. Further research is necessary to confirm our findings in other US paediatric populations and elucidate the mechanism through which Mediterranean-like diet may influence puberty timing.
The biological basis of the experience and categorization of colour

We used the Land Colour Mondrian experiments in a Bayesian context to test the degree to which subjects vary in categorizing the colour of different patches, when each patch is made to reflect light of the identical wavelength‐energy composition. The brain uses a ratio‐taking mechanism to determine the ratio of light of every waveband reflected from a surface and from its surrounds. Our (Bayesian) hypothesis was that this ratio‐taking mechanism is similar in all humans and therefore leads to a constant categorization of colours that differs little between them. The similarly categorized colours are the initial priors, with initial hues attached to them. Twenty subjects of different ethnic and cultural backgrounds, for all but one of whom English was not the primary language, viewed eight patches of different colour in two Mondrian displays; each patch, when viewed, was made to reflect identical ratios of long‐, middle‐ and short‐wave light. Subjects were asked to match the colour of the viewed patch with that of the Munsell chip coming closest in colour to that of the viewed patch, without using language. In terms of hue, there was less variability in matching warm hues than cool ones. In terms of colour categorization, there was little variability overall. We take the lack of significant variability between subjects in the matches made as a pointer to similar computational mechanisms being employed in different subjects to perceive colours, thus permitting them to assume that their categorization of colours has universal agreement and assent.
Phase Angle is Moderately Associated with Short-term Maximal Intensity Efforts in Soccer Players

Abstract This study examined the relationship between PhA and short-term maximal intensity efforts in soccer players, and was conducted in 99 male soccer players, ages 19–36 years. Bioelectrical impedance was used to assess body fat, fat free mass (FFM) and PhA (phase angle). Running Anaerobic Sprint Test (RAST) was used to evaluate physical performance. Food consumption was assessed through the 24-hour dietary recall method. Pearson correlation and multiple regressions were used for statistical analysis. Phase angle exhibited a positive relationship with maximum power (β=0.66; P<0.001), even after adjustment for the co-variables FFM and body fat (β=0.52; P=0.02). Phase angle was inversely related with fatigue index (β=− 0.61; P=0.04), even after adjusting for FFM (β=− 0.70; P=0.020). Our results indicated that independently of FFM and body fat, PhA was inversely associated with fatigue index and positively related with maximum power, revealing the PhA appeared as a valid predictor of fatigue.
The Effect of Tai Chi Chuan on Negative Emotions in Non-Clinical Populations: A Meta-Analysis and Systematic Review

Tai Chi Chuan (TCC) as a typical mind-body practice has been investigated for its preventive role on negative emotions and has demonstrated its efficacy in healthy populations. However, the results are not consistent. We performed a meta-analysis and systematically evaluated the effect of TCC on selected negative emotions (i.e., anxiety and depression). Fourteen experimental studies from three English-and two Chinese-language databases were evaluated. The results showed that the positive effects of TCC on negative emotions were moderately to largely significant. In addition, although TCC significantly improved negative emotions in both the young adults and the older adults, old adults benefited more from TCC than young adults. These findings suggest that TCC is a worthy complementary non-pharmacological resource towards depression and anxiety and, thus, has great implications for the public health domain.
From Fax to Blockchain: Sharing Health Information Democratically and Safely

Information sharing in healthcare remains an unsolved problem despite a plethora of standards and architectures. Effective information sharing is difficult because of the heterogeneity of health information users and data sources, organisational, ethical and legislative constraints and the very demanding requirements of clinical practice. This paper argues that the key requirement of a viable sharing architecture is to support trust in the system and between stakeholders. It uses the concept of a "democratic" approach where citizens can control and verify the use and sharing of data about them and identify ways that some of the value extracted from the data could be assigned to the patient themselves. The reasons for the survival of obsolescent methods are used to inform the design of a proposed citizen-centric architecture using blockchain technology.
The Emotional and Behavioral Impact of Delivering Bad News to Virtual versus Real Standardized Patients: A Pilot Study

Abstract Phenomenon: Virtual standardized patients (vSPs) are becoming increasingly common in medical education, though one limitation of vSPs is the artificiality of computer-based simulators. Past research on the use of vSPs has not clearly established whether learners have different emotional responses to real SPs (rSPs) compared with vSPs; however, understanding learners’ emotional responses to vSPs is important in providing realistic learning experiences and establishing the validity of this teaching and assessment tool. This study compared the emotional experiences of individuals who interacted with rSPs and vSPs. Approach: Sixty medical students at a medical school in the southeastern United States participated in the study. Participants were randomly assigned to deliver bad news to an rSP or vSP. The vSP for this study used a hybrid intelligence model that allowed a person to “inhabit” the vSP. Salivary cortisol and a self-report measure of mood—the Profile of Mood States, Second Edition (POMS 2)—were gathered before and after delivering the bad news. The SP and 2 independent evaluators rated the behavioral performance of each participant in real and virtual conditions. Participants also rated the performance of the SP. Findings: Participants in both conditions reported increased negative emotionality on the POMS 2 following the SP interaction. There were no significant between-group differences on the POMS 2 or salivary cortisol concentration following the SP interaction. Ratings by the SP and independent evaluators indicated that participants performed similarly on most interpersonal dimensions, except tone of voice. Participants perceived the vSP as less realistic than the rSP. Insights: These results suggest that medical students may have similar emotional and behavioral responses when delivering bad news to a vSP when compared to an rSP. These findings provide support for the continued use of vSPs in training learners to deliver bad news and other communication-based skills and to assess their performance on these tasks.
Psychiatric Illness and Mortality in Hospitalized ESKD Dialysis Patients.

BACKGROUND AND OBJECTIVES Limited existing data on psychiatric illness in ESKD patients suggest these diseases are common and burdensome, but under-recognized in clinical practice. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We examined hospitalizations with psychiatric diagnoses using inpatient claims from the first year of ESKD in adult and pediatric Medicare recipients who initiated treatment from 1996 to 2013. We assessed associations between hospitalizations with psychiatric diagnoses and all-cause death after discharge in adult dialysis patients using multivariable-adjusted Cox proportional hazards regression models. RESULTS In the first ESKD year, 72% of elderly adults, 66% of adults and 64% of children had at least one hospitalization. Approximately 2% of adults and 1% of children were hospitalized with a primary psychiatric diagnosis. The most common primary psychiatric diagnoses were depression/affective disorder in adults and children, and organic disorders/dementias in elderly adults. Prevalence of hospitalizations with psychiatric diagnoses increased over time across groups, primarily from secondary diagnoses. 19% of elderly adults, 25% of adults and 15% of children were hospitalized with a secondary psychiatric diagnosis. Hazards ratios of all-cause death were higher in all dialysis adults hospitalized with either primary (1.29; 1.26 to 1.32) or secondary (1.11; 1.10 to 1.12) psychiatric diagnoses than in those hospitalized without psychiatric diagnoses. CONCLUSIONS Hospitalizations with psychiatric diagnoses are common in pediatric and adult ESKD patients, and are associated with subsequent higher mortality, compared with hospitalizations without psychiatric diagnoses. The prevalence of hospitalizations with psychiatric diagnoses likely underestimates the burden of mental illness in the population.
6-minute walking test: a useful tool in the management of heart failure patients

Reduced functional ability and exercise tolerance in patients with heart failure (HF) are associated with poor quality of life and a worse prognosis. The 6-minute walking test (6MWT) is a widely available and well-tolerated test for the assessment of the functional capacity of patients with HF. Although the cardiopulmonary exercise test (a maximal exercise test) remains the gold standard for the evaluation of exercise capacity in patients with HF, the 6MWT (submaximal exercise test) may provide reliable information about the patient’s daily activity. The current review summarizes the value of 6MWT in patients with HF and identifies its usefulness and limitations in everyday clinical practice in populations of HF. We aimed to investigate potential associations of 6MWD with other measures of functional status and determinants of 6MWD in patients with HF as well as to review its prognostic role and changes to various interventions in these patients.
Tissue-specific NIA1 and NIA2 expression in Arabidopsis thaliana

ABSTRACT Nitrogen (N) is an essential macronutrient for optimal plant growth and ultimately for crop productivity Nitrate serves as the main N source for most plants. Although it seems a well-established fact that nitrate concentration affects flowering, its molecular mode of action in flowering time regulation was poorly understood. We recently found how nitrate, present at the shoot apical meristem (SAM), controls flowering time In this short communication, we present data on the tissue-specific expression patterns of NITRATE REDUCTASE 1 (NIA1) and NIA2 in planta. We show that transcripts of both genes are present throughout the life cycle of Arabidopsis thaliana plants with NIA1 being predominantly active in leaves and NIA2 in meristematic tissues.
Regulation of PRMT5–MDM4 axis is critical in the response to CDK4/6 inhibitors in melanoma

Significance Targeting CDK4/6 shows great promise in the treatment of many solid cancers, including melanoma. This study has uncovered a mechanism of action of CDK4/6 inhibitors in regulating the MDM4 oncogene and the tumor suppressor, p53. In melanoma, palbociclib activates p53 via modulating PRMT5-dependent alternate MDM4 pre-mRNA splicing, which results in a robust decrease in MDM4 protein expression. Loss of palbociclib regulation of the PRMT5–MDM4 axis leads to drug resistance. Dual inhibition of CDK4/6 and PRMT5 potently suppresses melanoma tumor growth and is well tolerated in vivo. Our findings not only have immediate implications for the advancement of CDK4/6 inhibition for treating melanoma, but also more generally offer insights into CDK4/6 mechanism of action. Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors are an established treatment in estrogen receptor-positive breast cancer and are currently in clinical development in melanoma, a tumor that exhibits high rates of CDK4 activation. We analyzed melanoma cells with acquired resistance to the CDK4/6 inhibitor palbociclib and demonstrate that the activity of PRMT5, a protein arginine methyltransferase and indirect target of CDK4, is essential for CDK4/6 inhibitor sensitivity. By indirectly suppressing PRMT5 activity, palbociclib alters the pre-mRNA splicing of MDM4, a negative regulator of p53, leading to decreased MDM4 protein expression and subsequent p53 activation. In turn, p53 induces p21, leading to inhibition of CDK2, the main kinase substituting for CDK4/6 and a key driver of resistance to palbociclib. Loss of the ability of palbociclib to regulate the PRMT5–MDM4 axis leads to resistance. Importantly, combining palbociclib with the PRMT5 inhibitor GSK3326595 enhances the efficacy of palbociclib in treating naive and resistant models and also delays the emergence of resistance. Our studies have uncovered a mechanism of action of CDK4/6 inhibitors in regulating the MDM4 oncogene and the tumor suppressor, p53. Furthermore, we have established that palbociclib inhibition of the PRMT5–MDM4 axis is essential for robust melanoma cell sensitivity and provide preclinical evidence that coinhibition of CDK4/6 and PRMT5 is an effective and well-tolerated therapeutic strategy. Overall, our data provide a strong rationale for further investigation of novel combinations of CDK4/6 and PRMT5 inhibitors, not only in melanoma but other tumor types, including breast, pancreatic, and esophageal carcinoma.
Expectation in motor planning and execution

Expectation has been studied extensively in the decision-making field and its possible implementation in influential decision-making models has been formulated. Decision-making has historically been studied separately to motor planning. However, recent data suggest decisionmaking and motor planning overlap in time, with competing action plans in motor cortex biased by the ongoing decision. There has therefore been increasing interest in studying the interplay between decision-making and motor planning. Past experiments have typically studied the decision between two movements, when each movement is equally likely to be chosen. This aims to mimic the everyday situation in which we prepare a movement before knowing which it will be. However, a more common situation is that we expect to make one movement with a high likelihood, but also know there is a low likelihood of making a different movement. It is this uneven expectation across potential movements, and its effect on motor planning and execution, that is the focus of this thesis. I first investigate expectation in motor planning. I propose expectation may play the same role in motor cortical excitability as it is proposed to in theoretical decision making models. A series of experiment did not support this hypothesis; I discuss possible reasons for this. I next turn to an aspect of action execution: motor variability. There has been increasing interest in the idea that noise during motor planning is an important cause of motor variability. One theory has proposed that neural resources are divided when there are multiple motor plans, increasing motor variability. I propose that expectation interacts with this process by sharing these neural resources unevenly, so that variability is lower in the high-likelihood movement. I conduct two experiments to test this idea, and, based on the results, propose that expectation interacts with the motor control policy to determine motor variability.
The influence of zinc supplementation on metabolic status in gestational diabetes: a meta-analysis of randomized controlled studies

Abstract Introduction Zinc supplementation has emerged as an important approach to improve metabolic status in gestational diabetes. However, its use has not been well established. We conduct a systematic review and meta-analysis to evaluate the efficacy of zinc supplementation to improve metabolic status for gestational diabetes. Methods PubMed, Embase, and the Cochrane Central Register of Controlled Trials are searched. Randomized controlled trials (RCTs) assessing the influence of zinc supplementation (or its combination) versus placebo on metabolic status of gestational diabetes are included. Two investigators independently have searched articles, extracted data, and assessed the quality of included studies. Meta-analysis is performed using the random-effect model. Results Five RCTs involving 263 patients are included in the meta-analysis. Compared with control intervention for gestational diabetes, zinc supplementation is associated with significantly reduced FPG (std. MD = −0.52; 95% CI = −0.82 to −0.21; p = .0008), insulin (std. MD = −0.68; 95% CI = −0.98 to −0.37; p < .0001), HOMA-IR (std. MD = −0.77; 95% CI = −1.08 to −0.45; p < .00001), and increased QUICKI (std. MD = 0.58; 95% CI = 0.28–0.89; p = .0002) as well as zinc change (std. MD = 0.90; 95% CI = 0.58–1.21; p < .00001), but has no remarkable influence on LDL-cholesterol (std. MD = −0.13; 95% CI = −0.43–0.17; p = .40), and total cholesterol (std. MD = −0.28; 95% CI = −0.63–0.07; p = .11). Conclusions Zinc supplementation is effective to decrease FPG, insulin, HOMA-IR and improve QUICKI in gestational diabetes, but has no significant impact on LDL-cholesterol and total cholesterol.
Mining Social Media for Perceptions and Trends on HIV Pre-Exposure Prophylaxis

Pre-Exposure Prophylaxis (PrEP) is an approach for preventing the human immunodeficiency virus (HIV), which entails the administration of antiretroviral medication to high-risk seronegative persons. If taken correctly, PrEP can reduce HIV infection risk by more than 90%. The aim of this study was to identify and examine PrEP-related perceptions and trends discussed on Twitter. Using open-source technologies, text-mining and interactive visualisation techniques, a comprehensive data gathering and analytics Web-based platform was developed to facilitate the study objectives. Our results demonstrate that monitoring of PrEP-related discussions on Twitter can be detected over time and valuable insights can be obtained concerning issues of PrEP awareness, expressed opinions, perceived barriers and key discussion points on its adoption. The proposed platform could support public-health professionals and policy makers in PrEP monitoring, facilitating informed decision making and strategy planning for efficient HIV combination prevention.
Process Mining in Primary Care: Avoiding Adverse Events Due to Hazardous Prescribing

Process mining helps healthcare professionals understand processes within healthcare. While often used in secondary care, there is little work in process mining using primary care data. Serious adverse events that result from hazardous prescribing are common and costly. For example, non-steroidal anti-inflammatory drugs (NSAIDs) and antiplatelets can cause gastro-intestinal bleeds (GiBs). Prescribing typically occurs during primary care; therefore we used this setting to attempt process mining. We extracted events (drug started, drug stopped, GiB) for understanding three prescribing pathways, and applied process mining. We found NSAIDs are often short-term prescriptions whereas antiplatelets are often long-term. This perhaps explains our finding that co-prescription of gastro-protection is more prevalent for antiplatelets than NSAIDs. We identified reasons why primary care data is harder to process mine and proposed solutions. Process mining primary care data is possible and likely useful for improving patient safety and reducing costs.
Precision nomenclature for the new genomics

Abstract The confluence of two scientific disciplines may lead to nomenclature conflicts that require new terms while respecting historical definitions. This is the situation with the current state of cytology and genomics, which offer examples of distinct nomenclature and vocabularies that require reconciliation. In this article, we propose the new terms C-scaffold (for chromosome-scale assemblies of sequenced DNA fragments, commonly named scaffolds) and scaffotype (the resulting collection of C-scaffolds that represent an organism's genome). This nomenclature avoids conflict with the historical definitions of the terms chromosome (a microscopic body made of DNA and protein) and karyotype (the collection of images of all chromosomes of an organism or species). As large-scale sequencing projects progress, adoption of this nomenclature will assist end users to properly classify genome assemblies, thus facilitating genomic analysis.
Named Entity Recognition in Prehospital Trauma Care

Natural language processing (NLP) methods would improve outcomes in the area of prehospital Emergency Medical Services (EMS) data collection and abstraction. This study evaluated off-the-shelf solutions for automating labelling of clinically relevant data from EMS reports. A qualitative approach for choosing the best possible ensemble of pretrained NLP systems was developed and validated along with a feature using word embeddings to test phrase synonymy. The ensemble showed increased performance over individual systems.
Design and Evaluation of an Automatic Speech Recognition Model for Clinical Notes in Spanish in a Mobile Online Environment

Clinical documentation in healthcare institutions is one of the daily tasks that consumes most of the time for those involved. The adoption of mobile devices in medical practice increases efficiency among healthcare professionals. We describe the design and evaluation of an automatic speech recognition system that enables the transcription of audio to text of clinical notes in a mobile environment. Our system achieved 94.1% word accuracy when evaluated on pediatrics, internal medicine and surgery services.