Miracle-dz/UniFAR-FTUs huggingface dataset:
Do changing medical admissions practices in the UK impact on who is admitted? An interrupted time series analysis

Introduction Medical admissions must balance two potentially competing missions: to select those who will be successful medical students and clinicians and to increase the diversity of the medical school population and workforce. Many countries address this dilemma by reducing the heavy reliance on prior educational attainment, complementing this with other selection tools. However, evidence to what extent this shift in practice has actually widened access is conflicting. Aim To examine if changes in medical school selection processes significantly impact on the composition of the student population. Design and setting Observational study of medical students from 18 UK 5-year medical programmes who took the UK Clinical Aptitude Test from 2007 to 2014; detailed analysis on four schools. Primary outcome Proportion of admissions to medical school for four target groups (lower socioeconomic classes, non-selective schooling, non-white and male). Data analysis Interrupted time-series framework with segmented regression was used to identify the impact of changes in selection practices in relation to invitation to interview to medical school. Four case study medical schools were used looking at admissions within for the four target groups. Results There were no obvious changes in the overall proportion of admissions from each target group over the 8-year period, averaging at 3.3% lower socioeconomic group, 51.5% non-selective school, 30.5% non-white and 43.8% male. Each case study school changed their selection practice in decision making for invite to interview during 2007–2014. Yet, this within-school variation made little difference locally, and changes in admission practices did not lead to any discernible change in the demography of those accepted into medical school. Conclusion Although our case schools changed their selection procedures, these changes did not lead to any observable differences in their student populations. Increasing the diversity of medical students, and hence the medical profession, may require different, perhaps more radical, approaches to selection.
Enhanced Degradation of Rh 6G by Zero Valent Iron Loaded on Two Typical Clay Minerals With Different Structures Under Microwave Irradiation

Nanoscale zero valent iron has been a widespread concern in various fields due to its large specific surface area and high reactivity. However, nanoscale zero valent iron (nZVI) is very likely to aggregate and be oxidized, which limit its wide application in industry. Most clay minerals have a large adsorption capacity of cations due to their negative charges and high specific surface areas. In the present work, nZVI was loaded onto two typical clay minerals: kaolinite and sepiolite, to inhibit its oxidation and aggregation. The composites were applied to degrade Rhodamine 6G (Rh 6G) under microwave irradiation. The effects of pH value and microwave power on degradation were studied. The results showed that the removal amount of Rh 6G by nZVI/kaolinite was 110 mg/g in 15 min, while it reached 300 mg/g by nZVI/sepiolite. The difference between these two composites was mostly determined by the structures of these two clay minerals.
Characterization of the CYP11A1 Nonsynonymous Variant p.E314K in Children Presenting With Adrenal Insufficiency

Context Cholesterol side-chain cleavage enzyme (P450scc), encoded by CYP11A1, catalyzes the first step of steroidogenesis. Complete P450scc deficiency leads to primary adrenal insufficiency (PAI) and 46,XY disordered sexual development. Partial impairment can cause variable adrenal and gonadal dysfunction. Objective Our aim was to evaluate the effects of the CYP11A1 variant p.E314K, identified in patients with PAI, specifically on P450scc enzyme stability and function. Patients and Methods We studied four boys from two unrelated families presenting with PAI during childhood (3.6 to 9 years old). All patients were compound heterozygous for c.940G>A (p.E314K), a CYP11A1 nonsynonymous variant likely to be pathogenic by some but not all in silico prediction models, and c.835delA (p.I79Yfs*10), a known pathogenic variant. HEK293T cells were transfected with wild type (WT) and p.E314K mutant vectors, and a cycloheximide chase assay was performed to analyze protein stability. Pregnenolone production was assayed from cells expressing WT and p.E314K-F2 fusion proteins. Results Two boys experienced spontaneous puberty but then developed evidence of primary gonadal failure at 14 and 18 years old. Two boys had testicular adrenal rest tumor (TART), detected by ultrasound at ages 8.6 and 16 years. Compared with WT, mutant protein synthesis was reduced (P = 0.0006) with increased protein turnover, and mutant P450scc half-life was decreased by ~50%. p.E314K mutant P450scc retained 60% of WT enzymatic activity (P = 0.007). Conclusions The CYP11A1 p.E314K variant impairs P450scc stability and is a possible cause of PAI in childhood. Pathogenic CYP11A1 variants potentially affect both adrenal and gonadal function, and male patients may develop TART.
Behavioral effects of copper on larval white sturgeon

Early–life stage white sturgeon are sensitive to copper (Cu), with adverse behavioral responses observed during previous studies. The objectives of the present study were to quantify the effects of Cu exposure on white sturgeon swimming and feeding behaviors and determine their time to response. Larval sturgeon (1–2, 28, or 35 d posthatch [dph]) were exposed to Cu (0.5–8 μg/L) for 4 to 14 d. Abnormal behavioral changes were observed within the first few days of exposure including loss of equilibrium and immobilization. Digital video tracking software revealed decreased swimming activity with increasing Cu concentration. Significant changes in behavior and mortality occurred at concentrations of Cu between 1 and 8 μg/L. Juvenile white sturgeon, 58 dph, exposed to 12 μg/L Cu consumed 37 to 60% less food than controls after 3 d of exposure. The present results indicate that behavioral endpoints were more sensitive than some standard toxicity test endpoints and can effectively expand the sensitivity of standard toxicity tests for white sturgeon. Swimming behavior was impaired to the extent that survival in the field would likely be jeopardized. Such data would provide managers a useful metric for characterizing the risks of Cu contamination to white sturgeon. Environ Toxicol Chem 2019;38:132–144. Published 2018 Wiley Periodicals Inc. on behalf of SETAC. This article is a US government work and, as such, is in the public domain in the United States of America.
Search Smart for Your Health - A Statewide Health Literacy Campaign

ABSTRACT The Georgia Health Sciences Library Association (GHSLA) and the Georgia Alliance for Health Literacy (GAHL) partnered to educate residents about reliable health information online to raise health literacy awareness across the state of Georgia. The two groups received a gubernatorial declaration designating October as Health Literacy Month in Georgia. Information was posted online and demonstration workshops were held. The networking opportunities that resulted have allowed for additional partnerships and grant support to address the vital health literacy information needs of those with health disparities through clinician training and additional workshops.
Association of mean platelet volume and red blood cell distribution width with coronary collateral development in stable coronary artery disease

Introduction The prognostic value of hematological indices in cardiovascular diseases and the association between these parameters and cardiovascular conditions have been established in the literature. Aim In this study, we aimed to investigate the relation of mean platelet volume (MPV), MPV to platelet ratio (MPR) and red cell distribution width (RDW) with degree of coronary collateral development (CCD) in stable coronary artery disease (CAD) subjects with established critical coronary artery stenosis. Material and methods A total of 306 patients with stable angina pectoris undergoing coronary arteriography were enrolled and divided on the basis of the development of CCD into two groups: a group with adequate CCD (n = 214) and a group with impaired CCD (n = 92). Routine complete blood count and biochemical parameters were measured before coronary arteriography. Results The MPV and MPR levels were significantly higher in the inadequate CCD group (10.5 ±1.8 fl vs. 8.7 ±1.9 fl, p < 0.001 and 0.06 ±0.08 vs. 0.05 ±0.07, p = 0.036). Patients with inadequate CCD had significantly higher RDW levels compared to patients with adequate CCD (15.5 ±1.7% vs. 15.0 ±1.9%, p = 0.01). MPV and RDW were significantly associated with Rentrop collateral grading (r = –0.523, p < 0.001 and r = –0.239, p < 0.001, respectively), whereas the association with MPR was not significant. An MPV value greater than 9.95 fl, determined with ROC curve analysis, had 71% sensitivity and 70% specificity in predicting inadequate CCD. An RDW greater than 14.3% has 71% sensitivity and 53% specificity in selecting patients with adequate CCD. Conclusions The present study suggests that MPV and MPR may be associated with the degree of collateral development in chronic stable CAD. However, the negative association of RDW with inadequate CCD, in combination with previous contradictory reports, raises a doubt about the possible value of RDW in stable CAD. Although these parameters may be affected by various conditions, a high MPV may lead clinicians to suspect possible inadequate collateral development in stable CAD patients.
Annotating Transcriptional Effects of Genetic Variants in Disease‐Relevant Tissue: Transcriptome‐Wide Allelic Imbalance in Osteoarthritic Cartilage

Multiple single‐nucleotide polymorphisms (SNPs) conferring susceptibility to osteoarthritis (OA) mark imbalanced expression of positional genes in articular cartilage, reflected by unequally expressed alleles among heterozygotes (allelic imbalance [AI]). We undertook this study to explore the articular cartilage transcriptome from OA patients for AI events to identify putative disease‐driving genetic variation.
Efficacy of dry needling in patients with myofascial temporomandibular disorders related to the masseter muscle

ABSTRACT Objective This randomized, single-center clinical trial aimed to compare the efficacy of superficial dry needling (SDN) and deep dry needling (DDN) in patients with myofascial temporomandibular disorder (MTMD) related to the masseter muscle.Methods: Forty patients showing MTMD with trigger points in the masseter muscle were randomly assigned to groups. Dry needling of the masseter muscle was performed once per week for three weeks. Pressure pain threshold (PPT) measurements, visual analog scale scores, and maximal jaw opening were assessed.Results: Both patient groups showed significant pain reduction, but the SDN group showed significantly better pain reduction. The PPT measurements obtained in the follow-up examinations at three and six weeks were significantly better than the values in SDN and DDN groups.Discussion: SDN showed better pain-reduction efficacy in patients with MTMD. Further research with a larger size sample and a longer follow-up period will help elucidate the benefits of SDN.
Assessment of Instrumental Activities of Daily Living in Older Adults with Subjective Cognitive Decline Using the Virtual Reality Functional Capacity Assessment Tool (VRFCAT)

BackgroundContinuing advances in the understanding of Alzheimer’s disease progression have inspired development of disease-modifying therapeutics intended for use in preclinical populations. However, identification of clinically meaningful cognitive and functional outcomes for individuals who are, by definition, asymptomatic remains a significant challenge. Clinical trials for prevention and early intervention require measures with increased sensitivity to subtle deficits in instrumental activities of daily living (IADL) that comprise the first functional declines in prodromal disease. Validation of potential endpoints is required to ensure measure sensitivity and reliability in the populations of interest.ObjectivesThe present research validates use of the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) for performance-based assessment of IADL functioning in older adults (age 55+) with subjective cognitive decline.DesignCross-sectional validation study.SettingAll participants were evaluated on-site at NeuroCog Trials, Durham, NC, USA.ParticipantsParticipants included 245 healthy younger adults ages 20–54 (131 female), 247 healthy older adults ages 55–91 (151 female) and 61 older adults with subjective cognitive decline (SCD) ages 56–97 (45 female). MeasuresVirtual Reality Functional Capacity Assessment Tool; Brief Assessment of Cognition App; Alzheimer’s Disease Cooperative Study Prevention Instrument Project–Mail-In Cognitive Function Screening Instrument; Alzheimer’s Disease Cooperative Study Instrumental Activities of Daily Living–Prevention Instrument, University of California, San Diego Performance-Based Skills Assessment–Validation of Intermediate Measures; Montreal Cognitive Assessment; Trail Making Test- Part B.ResultsParticipants with SCD performed significantly worse than age-matched normative controls on all VRFCAT endpoints, including total completion time, errors and forced progressions (p≤0001 for all, after Bonferonni correction). Consistent with prior findings, both groups performed significantly worse than healthy younger adults (age 20-54). Participants with SCD also performed significantly worse than controls on objective cognitive measures. VRFCAT performance was strongly correlated with cognitive performance. In the SCD group, VRFCAT performance was strongly correlated with cognitive performance across nearly all tests with significant correlation coefficients ranging from 0.3 to 0.7; VRFCAT summary measures all had correlations greater than r=0.5 with MoCA performance and BAC App Verbal Memory (p<0.01 for all). ConclusionsFindings suggest the VRFCAT provides a sensitive tool for evaluation of IADL functioning in individuals with subjective cognitive decline. Strong correlations with cognition across groups suggest the VRFCAT may be uniquely suited for clinical trials in preclinical AD, as well as longitudinal investigations of the relationship between cognition and function.
Detecting lenticulostriate artery lesions in patients with acute ischemic stroke using high-resolution MRA at 7 T

Background Recent advances in high-resolution (HR) magnetic resonance angiography (MRA) using ultrahigh-field systems enable direct visualization of the lenticulostriate arteries (LSAs), which had been hardly achieved by conventional MRA. Hence, by using HR-MRA at 7 T, we attempted to assess occlusive changes in the LSAs in patients with LSA territorial infarcts. Methods We prospectively examined 34 consecutive patients with acute ischemic stroke in the LSA territory using a 7 T scanner. We measured the lengths of the relevant LSAs on HR-MRA and the diameters/volume of the infarcts and compared these between the patients with/without occlusive changes in the LSAs. Results On HR-MRA, occlusion of the LSAs was observed in 19 (59%) of 32 patients who were eligible for the analyses. The curved/straight lengths of the LSAs in the patients with LSA occlusion (23.1–31.1/17.8–24.3 mm) were significantly shorter than in those without apparent LSA occlusion (25.8–39.5/24.0–30.4 mm) (P = 0.027/0.003). The anteroposterior/superoinferior diameters of the infarcts were significantly larger in the occluded-LSA group (14.5–21.4/14.9–22.2 mm) than in the intact-LSA group (10.9–16.8/10.8–16.2 mm) (P = 0.041/0.011). In addition, the curved lengths of the relevant LSAs showed significant correlations with the superoinferior diameters of the infarcts (r = 0.38, P = 0.034). Conclusion Occlusive changes in the LSAs were frequently found in patients with acute ischemic stroke within the LSA territory when using HR-MRA at 7 T and were substantially related to superoinferior extension of the infarcts.
Vowel formant dispersion reflects severity of apraxia of speech

ABSTRACT Background: Apraxia of Speech (AOS) has been associated with deviations in consonantal voice onset time (VOT), but studies of vowel acoustics have yielded conflicting results. However, a speech motor planning disorder that is not bound by phonological categories is expected to affect vowel as well as consonant articulations. Aims: We measured consonant VOTs and vowel formants produced by a large sample of stroke survivors, and assessed to what extent these variables and their dispersion are predictive of AOS presence and severity, based on a scale that uses clinical observations to rate gradient presence of AOS, aphasia, and dysarthria. Methods & Procedures: Picture-description samples were collected from 53 stroke survivors, including unimpaired speakers (12) and speakers with primarily aphasia (19), aphasia with AOS (12), primarily AOS (2), aphasia with dysarthria (2), and aphasia with AOS and dysarthria (6). The first three formants were extracted from vowel tokens bearing main stress in open-class words as well as VOTs for voiced and voiceless stops. Vowel space was estimated as reflected in the formant centralisation ratio. Stepwise Linear Discriminant Analyses were used to predict group membership and ordinal regression was used to predict AOS severity, based on the absolute values of these variables as well as the standard deviations of formants and VOTs within speakers. Outcomes and Results: Presence and severity of AOS were most consistently predicted by the dispersion of F1, F2, and voiced-stop VOT. These phonetic-acoustic measures do not correlate with aphasia severity. Conclusions: These results confirm that the AOS affects articulation across-the-board and does not selectively spare vowel production.
Influence maximization in noisy networks

We consider the problem of identifying the most influential nodes for a spreading process on a network when prior knowledge about structure and dynamics of the system is incomplete or erroneous. Specifically, we perform a numerical analysis where the set of top spreaders is determined on the basis of prior information that is artificially altered by a certain level of noise. We then measure the optimality of the chosen set by measuring its spreading impact in the true system. Whereas we find that the identification of top spreaders is optimal when prior knowledge is complete and free of mistakes, we also find that the quality of the top spreaders identified using noisy information does not necessarily decrease as the noise level increases. For instance, we show that it is generally possible to compensate for erroneous information about dynamical parameters by adding synthetic errors in the structure of the network. Further, we show that, in some dynamical regimes, even completely losing prior knowledge on network structure may be better than relying on certain but incomplete information.
The Rapidly Assessed Predictor of Intraoperative Damage (RAPID) Score: An In-Clinic Predictive Model for High-Grade Acetabular Chondrolabral Disruption

Background: The preoperative assessment of cartilage lesions is critical to surgical planning and decision making. The accurate radiographic determination of acetabular cartilage damage has remained elusive for modern imaging modalities, including magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA). While risk factors have been individually described, no multivariable system exists for predicting high-grade cartilage damage. Purpose: To determine the preoperative predictors of grade 3 to 4 acetabular labrum articular disruption (ALAD) lesions. Study Design: Case-control study; Level of evidence, 3. Cohort study (diagnosis); Level of evidence, 1. Methods: Retrievable radiographs were reviewed from primary hip arthroscopic procedures performed at 2 high-volume institutions between December 2007 and April 2017. The predictive value of demographic and radiographic factors for the intraoperative documentation of ALAD grade 3 to 4 damage was analyzed and entered into a multivariable model, and a statistically guided scoring system for the damage risk was created using the Akaike information criterion. The scoring system was then prospectively validated on 167 patients who underwent primary hip arthroscopy between April 2017 and February 2018. Results: A total of 652 primary hip arthroscopic procedures in 614 patients (390 female, 224 male; mean age, 33.2 ± 12.5 years; mean body mass index, 26.9 ± 5.5 kg/m2) from 2007 to 2017 were analyzed. Male sex (odds ratio [OR], 3.11; P < .01), age ≥35 years (OR, 1.96; P < .01), cam morphology (alpha angle >55°) (OR, 2.96; P < .01), and Tönnis grade 1 to 2 (grade 1: OR, 4.14; P < .01, and grade 2: OR, 9.29; P < .01) were univariate risk factors for intraoperatively documented high-grade damage. A multivariable scoring system, the Rapidly Assessed Predictor of Intraoperative Damage (RAPID) score (0-5 points), was generated based on sex, Tönnis grade, and cam morphology. Patients with increasing RAPID scores had an increasing risk of damage, with a 10.5% risk for those with 0 points and an 88.0% risk for those with 5 points (P < .01). The area under the curve was 0.75 for the study group and 0.76 for the validation group (P = .94). Conclusion: While preoperative MRI has diagnostic value for hip arthroscopic surgery, the RAPID score provides added benefit as a readily employable, in-clinic system for predicting high-grade cartilage damage. The discriminatory value of the RAPID score compares favorably with previous MRI and MRA studies. This information will help the clinician and patient plan for high-grade damage and identify potential targets for cartilage treatment.
Toxicity Reduction in the Treatment of HPV Positive Oropharyngeal Cancer: Emerging Combined Modality Approaches

Human papillomavirus positive (HPV+) oropharyngeal squamous cell carcinoma (OPC) is a distinct clinical entity within the head and neck cancers, with a unique epidemiology and, in general, a favorable prognosis. Because of this favorable prognosis, researchers have considered de-intensifying the current standard treatment of HPV+ OPC in order to reduce acute and late treatment related toxicity without compromising outcome. Current ongoing trials can be divided in three main categories: de-intensification of the chemotherapy by replacing concomitant platinum-based chemotherapy with the EGFR-inhibitor cetuximab, or de-intensification of the radiation dose of either the primary radiotherapy of selected, good-responding patients after induction chemotherapy or of the adjuvant radiotherapy based on pathology features after primary surgery. Despite the good prognosis of the majority of HPV+ OPC patients, a proportion of them still have poor prognosis. This unmet need has led clinical research on new treatment strategies focused on influencing the unique micro-environment of HPV+ OPC with for example immunotherapy. This article summarizes the current understanding regarding the optimal treatment of non-metastatic HPV+ OPC. Ongoing and published clinical trials regarding de-intensification strategies, immunotherapy and proton therapy are described focusing on the rationale and underlying evidence of these emerging treatment strategies. Nevertheless, until the results of the ongoing trials are known, the treatment of HPV+ OPC in clinical practice should remain identical to the treatment of HPV negative OPC.