Miracle-dz/UniFAR-FTUs huggingface dataset:
FRI0295 Relationship Between Lumbar Bone Mineral Density (BMD) and Body Mass Index (BMI) in Italian Population

Background It's well known that higher BMI scores are protective for osteoporosis in postmenopausal women. Several studies have evaluated the relationship between Bone Mineral Density (BMD) and Body Mass Index (BMI) in patients affected by osteoporosis in different parts of world but few data are present among Italian population. Objectives Primary aim of this study was to obtain data about BMI and bone mineral levels in the lumbar spine of Italy adult females based on a nationally representative sample of more than 15000 women aged 20 years and older and so to determine the relationship between BMI and BMD. Data were retrospectively extracted from the Magenta's Rheumatology Unit Densitometry Registry Methods Demographic (age, age at menarche and menopause) and anthropometric (BMI) data of females aged 20 years and older that performed their first DEXA in our Hospital between 2006 and 2014 were extracted from our local registry using a random sampling technique. Bone mineral density (BMD) was determined using dual-energy X-ray absorptiometry (DXA) on a Hologic bone densitometer (QDR 9000 Hologic, Waltham, Mass.). Subjects performed the DEXA scan for screening for osteopenia or because of their increased awareness of their health. Criteria for patient selection were: absence of known risk factors of Osteoporosis (eg smoke, alcohol, metabolic disease that affects bone, fractures), a concomitant or previous treatment of osteoporosis or corticosteroids. Patients with low or high BMI (over 95 percentile) were eligible. Osteopenia and osteoporosis were defined by T-score< -1 and < -2.5, respectively. In this study we used the WHO BMI classification: underweight <18.5 kg/m2; normal weight 18.5-24.9 kg/m2; over weight 25-29.9 kg/m2; obese>30 kg/m2 Results 15335 DEXA scan analysed. Mean age was 64.2±12.8 years (range 20.8 to 90). 14138 patients were post menopausal. Mean BMI was 26.4±5.1 (range 15 to 36). Mean menopause age was 48.3±5 (range 31-54). Mean menarche age was 16.3±5 (range 11-17). The prevalence of osteoporosis and osteopenia in post menopausal women were 34,3% and 43,9% respectively. In post menopausal subjects we found a positive correlation between BMD and the other variables collected BMI and age at menopause (0.271 and 0.114 respectively, p<0.001). An ANOVA univariate confirmed the direct relationship between BMD and BMI for every value of BMI. In the pre menopausal women we found a relationship with a inverted U-shape. In this subpopulation the lowest and highest BMI values were associated to the lowest BMD values Conclusions Our study shown a different role of BMI on BMD values: in post menopausal women the BMD seems to have a direct relationship with BMI for every BMI value. On the other hand there is a trend like a parabolic curve, with lower BMD at BMI levels of underweight or overweight, in the premenopausal women. Disclosure of Interest None declared
Hemostatic Alterations in Patients With Cirrhosis: From Primary Hemostasis to Fibrinolysis

In the setting of liver cirrhosis (LC), profound hemostatic changes occur, which affect primary hemostasis, coagulation, and fibrinolysis. They involve prohemorrhagic and prothrombotic alterations at each of these steps. Patients with cirrhosis exhibit multifactorial thrombocytopenia and in vitro thrombocytopathy, counterbalanced by increased von Willebrand factor. The resultant shift is difficult to assess, but overall these changes probably result in a rebalanced primary hemostasis. Concerning coagulation, the reduced activity of coagulation factors is counterbalanced by an increase in factor VIII (produced by liver sinusoidal endothelial cells), a decrease of the natural anticoagulants, and complex changes, including changes in circulating microparticles, cell‐free DNA, and neutrophil extracellular traps. Overall, these alterations result in a procoagulant state. As for fibrinolysis, increased tissue‐type and urokinase‐type plasminogen activators, a relatively decreased plasminogen activator inhibitor 1, and decreased levels of thrombin‐activatable fibrinolysis inhibitor and α2‐antiplasmin are counterbalanced by decreased plasminogen and a decreased fibrin clot permeability. Whether and how these changes shift fibrinolysis remains to be determined. Overall, the current consensus is that in patients with cirrhosis, the hemostasis is shifted toward a procoagulant state. We review the published evidence for the concept of LC as a prothrombotic state, discuss discordant data, and highlight the impact of the underlying cause of LC on the resultant imbalance.
Automatic segmentation of brain tumor resections in intraoperative ultrasound images using U-Net

Abstract. To compensate for the intraoperative brain tissue deformation, computer-assisted intervention methods have been used to register preoperative magnetic resonance images with intraoperative images. In order to model the deformation due to tissue resection, the resection cavity needs to be segmented in intraoperative images. We present an automatic method to segment the resection cavity in intraoperative ultrasound (iUS) images. We trained and evaluated two-dimensional (2-D) and three-dimensional (3-D) U-Net networks on two datasets of 37 and 13 cases that contain images acquired from different ultrasound systems. The best overall performing method was the 3-D network, which resulted in a 0.72 mean and 0.88 median Dice score over the whole dataset. The 2-D network also had good results with less computation time, with a median Dice score over 0.8. We also evaluated the sensitivity of network performance to training and testing with images from different ultrasound systems and image field of view. In this application, we found specialized networks to be more accurate for processing similar images than a general network trained with all the data. Overall, promising results were obtained for both datasets using specialized networks. This motivates further studies with additional clinical data, to enable training and validation of a clinically viable deep-learning model for automated delineation of the tumor resection cavity in iUS images.
Transgenerational Studies: How Do We Investigate Multigenerational Effects?

No genes have been identified that explain a major proportion of the heritability of most health outcomes (1). Several vertebrate studies have demonstrated effects of generation 1 nutrition on generation 3 phenotypes (2), and recent work in epigenetics and developmental origins of health and disease has increased interest in transgenerational effects in humans. These effects could be examined in a three-generation cohort; however, best-practice methods for analyzing such multigenerational data, with the associated confounding and selection bias, have not been established.
Cross-Cultural Adaptation of the Communication Assessment Tool for Use in a Simulated Clinical Setting

Abstract Construct: The Communication Assessment Tool (CAT) is a 14-item instrument developed in English to assess medical trainees’ interpersonal communication skills from the patient’s perspective in clinical settings. Background: Using validated instruments and simulated patients constitutes good practice in assessing doctor-patient communication. The CAT was designed for use in real practice, but has not yet been applied to assessing OB-GYN residents’ delivery of bad news in Objective Structured Clinical Examination (OSCE) stations. This study aims to provide validity evidence for using the CAT to assess residents’ interpersonal communication skills under difficult circumstances in a simulated clinical setting in Brazil. Approach: Cross-cultural adaptation comprised translation into Portuguese, synthesis of translations, and back-translation. Next, a committee of 10 external and independent experts rated the items for linguistic equivalence and relevance to the overall scale. Researchers used the expert ratings to produce a preliminary Brazilian-Portuguese version. This version was applied by four simulated patients to assess 28 OB-GYN residents completing two, 10-minute OSCE stations focused on delivering bad news. Item and scale content validity indices and internal-consistency reliability were calculated. Simulated patients were interviewed to clarify any doubt regarding the content and usability of the tool and their response process. Findings: Thirteen of the 14 items in the Brazilian-Portuguese version were considered “equivalent” by at least 70% of the experts. All items were considered relevant by 100% of the experts. The Item Content Validity Index ranged from . 9 to 1, and the Scale Content Validity Index was . 99. The instrument showed good reliability for both scenarios (Cronbach’s alpha > .90). Simulated patients considered the CAT easy to understand and complete. Conclusions: This study provides validity evidence for using the Brazilian-Portuguese CAT in a simulated clinical environment to assess OB-GYN residents’ delivery of bad news. Based on this study’s findings, the OB-GYN Department organized an annual formative assessment for residents to improve their interpersonal communication skills. This version of the CAT may also be applicable to other specialties.
Emotional Intelligence and Critical Thinking in Nursing Students

Supplemental digital content is available in the text. Background Emotional intelligence (EI) and critical thinking (CT) are positive attributes for nursing students throughout their nursing education and in future professional practice. Purpose The purpose was to review the literature investigating both EI and CT in prelicensure nursing students. Methods A systematic literature search of original research articles published between 2003 and 2018 was conducted using electronic databases. Emerging themes were identified using integrative review methodological strategies. Results Three themes emerged: (1) EI and CT are interdependent; (2) EI and CT are critical for success in nursing education; and (3) nursing education should enhance EI and CT. Findings are mixed regarding the usefulness of screening applicants for EI prior to admission. Conclusions Developing EI and CT skills in nursing students deserves thoughtful consideration. Further research is warranted regarding integrating strategies to enhance EI and CT skills as well as adopting EI as an adjunct admissions criterion for entrance into a prelicensure program.
Psychometric properties of the Teenage Executive Functioning Inventory (TEXI): A freely available questionnaire for assessing deficits in working memory and inhibition among adolescents

ABSTRACT The Childhood Executive Functioning Inventory (CHEXI) and the Adult Executive Functioning Inventory (ADEXI) are reliable and valid rating instruments for assessing working memory and inhibitory control. However, a teenage version of this instrument has not been available, and the aim of the present study was therefore to investigate the psychometric properties of the Teenage Executive Functioning Inventory (TEXI). After interviewing both researchers/clinicians and adolescents themselves, a questionnaire with 20 items was created. Data from adolescents age 13–19 years (n = 302) and their parents were thereafter collected. Factor analysis showed that the TEXI has two clear factors: working memory and inhibition. Further, the TEXI was shown to have high reliability in terms of internal consistency (≥ .85), split-half reliability (≥ .81) and inter-rater reliability between self-ratings and parent ratings (.82). In sum, the TEXI is a reliable questionnaire for measuring working memory and inhibition in adolescents. The two versions of the TEXI are presented in the appendices of this paper and they will be freely available on the Internet.
Machine Learning Framework to Identify Individuals at Risk of Rapid Progression of Coronary Atherosclerosis: From the PARADIGM Registry

Background Rapid coronary plaque progression (RPP) is associated with incident cardiovascular events. To date, no method exists for the identification of individuals at risk of RPP at a single point in time. This study integrated coronary computed tomography angiography–determined qualitative and quantitative plaque features within a machine learning (ML) framework to determine its performance for predicting RPP. Methods and Results Qualitative and quantitative coronary computed tomography angiography plaque characterization was performed in 1083 patients who underwent serial coronary computed tomography angiography from the PARADIGM (Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging) registry. RPP was defined as an annual progression of percentage atheroma volume ≥1.0%. We employed the following ML models: model 1, clinical variables; model 2, model 1 plus qualitative plaque features; model 3, model 2 plus quantitative plaque features. ML models were compared with the atherosclerotic cardiovascular disease risk score, Duke coronary artery disease score, and a logistic regression statistical model. 224 patients (21%) were identified as RPP. Feature selection in ML identifies that quantitative computed tomography variables were higher‐ranking features, followed by qualitative computed tomography variables and clinical/laboratory variables. ML model 3 exhibited the highest discriminatory performance to identify individuals who would experience RPP when compared with atherosclerotic cardiovascular disease risk score, the other ML models, and the statistical model (area under the receiver operating characteristic curve in ML model 3, 0.83 [95% CI 0.78–0.89], versus atherosclerotic cardiovascular disease risk score, 0.60 [0.52–0.67]; Duke coronary artery disease score, 0.74 [0.68–0.79]; ML model 1, 0.62 [0.55–0.69]; ML model 2, 0.73 [0.67–0.80]; all P<0.001; statistical model, 0.81 [0.75–0.87], P=0.128). Conclusions Based on a ML framework, quantitative atherosclerosis characterization has been shown to be the most important feature when compared with clinical, laboratory, and qualitative measures in identifying patients at risk of RPP.
Augmented patient‐specific functional medical imaging by implicit manifold learning

This paper uses machine learning to enrich magnetic resonance angiography and magnetic resonance imaging acquisitions. A convolutional neural network is built and trained over a synthetic database linking geometrical parameters and mechanical characteristics of the arteries to blood flow rates and pressures in an arterial network. Once properly trained, the resulting neural network can be used in order to predict blood pressure in cerebral arteries noninvasively in nearly real‐time. One challenge here is that not all input variables present in the synthetic database are known from patient‐specific medical data. To overcome this challenge, a learning technique, which we refer to as implicit manifold learning, is employed: in this view, the input and output data of the neural network are selected based on their availability from medical measurements rather than being defined from the mechanical description of the arterial system. The results show the potential of the method and that machine learning is an alternative to costly ensemble based inversion involving sophisticated fluid structure models.
Transcriptome analyses reveal molecular mechanisms underlying phenotypic differences among transcriptional subtypes of glioblastoma

Using molecular signatures, previous studies have defined glioblastoma (GBM) subtypes with different phenotypes, such as the proneural (PN), neural (NL), mesenchymal (MES) and classical (CL) subtypes. However, the gene programmes underlying the phenotypes of these subtypes were less known. We applied weighted gene co‐expression network analysis to establish gene modules corresponding to various subtypes. RNA‐seq and immunohistochemical data were used to validate the expression of identified genes. We identified seven molecular subtype‐specific modules and several candidate signature genes for different subtypes. Next, we revealed, for the first time, that radioresistant/chemoresistant gene signatures exist only in the PN subtype, as described by Verhaak et al, but do not exist in the PN subtype described by Phillips et al PN subtype. Moreover, we revealed that the tumour cells in the MES subtype GBMs are under ER stress and that angiogenesis and the immune inflammatory response are both significantly elevated in this subtype. The molecular basis of these biological processes was also uncovered. Genes associated with alternative RNA splicing are up‐regulated in the CL subtype GBMs, and genes pertaining to energy synthesis are elevated in the NL subtype GBMs. In addition, we identified several survival‐associated genes that positively correlated with glioma grades. The identified intrinsic characteristics of different GBM subtypes can offer a potential clue to the pathogenesis and possible therapeutic targets for various subtypes.
A possible antiviral effect of amantadine in an AH1N1 influenza-infected patient – a case report

1Clinic of Anesthesiology and Intensive Therapy, Department of Anesthesiology, Intensive Therapy and Emergency Medicine, Medical University of Silesia, Katowice, Poland 2Postgraduate Study, Clinic of Anesthesiology and Intensive Therapy, Department of Anesthesiology, Intensive Therapy and Emergency Medicine, Medical University of Silesia, Katowice, Poland LETTERS TO THE EDITOR DOI: https://doi.org/10.5114/ait.2020. 93137
Epigenome-wide association study reveals a molecular signature of response to phylloquinone (vitamin K1) supplementation

ABSTRACT Evidence suggests there are roles for vitamin K in various chronic disease outcomes, but population-level diet and supplement recommendations are difficult to determine due to high levels of variability in measures of status and response to intake compared to other nutrients. In this preliminary investigation, a blood-based epigenome-wide association study (EWAS) comparing responders and non-responders to phylloquinone (vitamin K1) supplementation (NCT00183001) was undertaken in order to better understand the molecular underpinnings of this observed variability. Responders (n = 24) and non-responders (n = 24) were identified in a prior 3-year phylloquinone supplementation trial based on their changes in plasma phylloquinone concentrations. Differential DNA methylation was identified in multiple regions with previously unknown relationships to phylloquinone absorption and metabolism, such as at the TMEM263 locus. A hypothesis-driven analysis of lipid-related genes highlighted a site in the NPC1L1 gene, supplementing existing evidence for its role in phylloquinone absorption. Furthermore, an EWAS for baseline plasma phylloquinone concentrations revealed a strong correlation between the epigenomic signatures of phylloquinone baseline status and response to supplementation. This work can guide future epigenomic research on vitamin K and contributes to the development of more personalized dietary recommendations for vitamin K.
Seeing your own or someone else's hand moving in accordance with your action: The neural interaction of agency and hand identity

Forward models can predict sensory consequences of self‐action, which is reflected by less neural processing for actively than passively generated sensory inputs (BOLD suppression effect). However, it remains open whether forward models take the identity of a moving body part into account when predicting the sensory consequences of an action. In the current study, fMRI was used to investigate the neural correlates of active and passive hand movements during which participants saw either an on‐line display of their own hand or someone else's hand moving in accordance with their movement. Participants had to detect delays (0–417 ms) between their movement and the displays. Analyses revealed reduced activation in sensory areas and higher delay detection thresholds for active versus passive movements. Furthermore, there was increased activation in the hippocampus, the amygdala, and the middle temporal gyrus when someone else's hand was seen. Most importantly, in posterior parietal (angular gyrus and precuneus), frontal (middle, superior, and medial frontal gyrus), and temporal (middle temporal gyrus) regions, suppression for actively versus passively generated feedback was stronger when participants were viewing their own compared to someone else's hand. Our results suggest that forward models can take hand identity into account when predicting sensory action consequences.
Molecular genetic analysis and clinical characterization of Rickettsia species isolated from the Republic of Korea in 2017.

Rickettsia sp. CNH17-7 was isolated from patients' blood and identified by gene analysis as a species distinct from Rickettsia japonica. In addition, similar rickettsial infection was confirmed in two species (Haemaphysalis longicornis and Ixodes nipponensis) of ticks and rodents in northeastern and southwestern provinces, Republic of Korea. Subsequently, the analysis of 16S rRNA, ompA, ompB, and sca4 genes of isolate CNH17-7 revealed 100%, 99.68%, 99.57% and 99.44% sequence similarity with Rickettsia sp. HlR/D91 and Candidatus R. longicornii ROK-HL727. In this study, we report the isolation of a new Rickettsia sp. CNH17-7 and infection of different types of ticks with the same rickettsial agents.
Associations between schizophrenia polygenic risk and apathy in schizophrenia spectrum disorders and healthy controls

Apathy is a central predictor of a poor functional outcome in schizophrenia. Schizophrenia polygenic risk scores (PRSs) are used to detect genetic associations to key clinical phenotypes in schizophrenia. We explored the associations between schizophrenia PRS and apathy levels in schizophrenia spectrum disorders (n = 281) and matched healthy controls (n = 298), and further how schizophrenia PRS contributed in predicting apathy when added to premorbid and clinical factors in the patient sample.
The relation of hearing-specific patient-reported outcome measures with speech perception measures and acceptable noise levels in cochlear implant users

Abstract Objective: To investigate the relation of a hearing-specific patient-reported outcome measure (PROM) with speech perception and noise tolerance measurements. It was hypothesised that speech intelligibility in noise and noise tolerance may explain a larger part of the variance in PROM scores than speech intelligibility in quiet. Design: This cross-sectional study used the Speech, Spatial, Qualities (SSQ) questionnaire as a PROM. Speech recognition in quiet, the Speech Reception Threshold in noise and noise tolerance as measured with the acceptable noise level (ANL) were measured with sentences. Study sample: A group of 48 unilateral post-lingual deafened cochlear implant (CI) users. Results: SSQ scores were moderately correlated with speech scores in quiet and noise, and also with ANLs. Speech scores in quiet and noise were strongly correlated. The combination of speech scores and ANL explained 10–30% of the variances in SSQ scores, with ANLs adding only 0–9%. Conclusions: The variance in the SSQ as hearing-specific PROM in CI users was not better explained by speech intelligibility in noise than by speech intelligibility in quiet, because of the remarkably strong correlation between both measures. ANLs made only a small contribution to explain the variance of the SSQ. ANLs seem to measure other aspects than the SSQ.