Miracle-dz/UniFAR-FTUs huggingface dataset:
Systematic review of birth cohort studies in Africa

Aim In sub-Saharan Africa, unacceptably high rates of mortality amongst women and children continue to persist. The emergence of research employing new genomic technologies is advancing knowledge on cause of disease. This review aims to identify birth cohort studies conducted in sub-Saharan Africa and to consider their suitability as a platform to support genetic epidemiological studies. Methods A systematic literature review was conducted to identify birth cohort studies in sub-Saharan Africa across the following databases: MEDLINE, EMBASE, AFRO and OpenSIGLE. A total of 8110 papers were retrieved. Application of inclusion/exclusion criteria retained only 189 papers, of which 71 met minimum quality criteria and were retained for full text analysis. Results The search revealed 28 birth cohorts: 14 of which collected biological data, 10 collected blood samples and only one study collected DNA for storage. These studies face many methodological challenges: notably, high rates of attrition and lack of funding for several rounds of study follow up. Population-based ‘biobanks’ have emerged as a major approach to harness genomic technologies in health research and yet the sub-Saharan African region still awaits large scale birth cohort biobanks collecting DNA and associated health and lifestyle data. Conclusion Investment in this field, together with related endeavours to foster and develop research capacity for these studies, may lead to an improved understanding of the determinants of intrauterine growth and development, birth outcomes such as prematurity and low birth weight, the links between maternal and infant health, survival of infectious diseases in the first years of life, and response to vaccines and antibiotic treatment.
Networks in the Legislative Arena: How Group Dynamics Affect Cosponsorship

In this study, we explore the determinants of cosponsorship activity within state legislatures. Utilizing a social dynamic framework, we develop and test a model of the interplay of the activities of sponsorship and cosponorship that includes both individual-level and social network characteristics as determinants of agenda-setting behavior; the latter demonstrating how collaboration and mutual interests shape the agenda setting process. We find several consistent factors that influence the frequency of cospsonsorship activity: 1) ideological distance 2) proximity of legislators’ districts 3) homophily (similar characteristics such as race, gender, and ethnicity) and 4) transitivity (the idea that friends of my friends are also my friends).
Randomized Study Comparing Cyclosporine With Azathioprine One Year After Renal Transplantation–15-Year Outcome Data

Background. The introduction of cyclosporine (CsA) improved 1-year graft survival and reduced the incidence of acute rejection episodes after renal transplantation compared to azathioprine (Aza). However, CsA has many side effects and reducing exposure of this drug after the first year may benefit long-term patient and graft survival. Methods. We report 15-year outcome data from a single center, randomized controlled study comparing CsA withdrawal and conversion to Aza with continuation of CsA 1-year posttransplant. Results. Two hundred sixteen patients who showed a serum creatinine less than 300 &mgr;mol/L with no acute rejection episodes in the preceding 6 months were enrolled (CsA 114, Aza 102). There was no difference in patient survival at 15 years: 62.4% in the CsA group and 64.4% in the Aza group (P=0.6). Fifteen-year transplant survival was 41.9% for the CsA group and 48.8% for the Aza group (P=0.8). Fifteen-year graft survival censoring for death with a functioning graft was 58% in the CsA group and 72% in the Aza group (P=0.5). Predictors of patient survival were younger recipient age (P<0.001) and lower systolic blood pressure at randomization (P=0.01). Predictors of graft survival were older recipient age (P<0.001) and better renal function at randomization (P=0.01). Assigned drug showed no effect on graft or patient survival. Patients assigned to CsA showed significantly worse renal function up to 10 years posttransplantation and required more anti-hypertensive treatment throughout the study period. Conclusion. In a selected group of patients, either Aza or low-dose CsA is safe and effective. Despite lower estimated glomerular filtration rate (eGFR) up to 10 years posttransplantation and increased use of anti-hypertensive agents, low-dose CsA was not associated with a worse patient or graft survival.
Center-level factors and racial disparities in living donor kidney transplantation.

BACKGROUND On average, African Americans attain living donor kidney transplantation (LDKT) at decreased rates compared with their non-African American counterparts. However, center-level variations in this disparity or the role of center-level factors is unknown. STUDY DESIGN Observational cohort study. SETTING & PARTICIPANTS 247,707 adults registered for first-time kidney transplants from 1995-2007 as reported by the Scientific Registry of Transplant Recipients. PREDICTORS Patient-level factors (age, sex, body mass index, insurance status, education, blood type, and panel-reactive antibody level) were adjusted for in all models. The association of center-level characteristics (number of candidates, transplant volume, LDKT volume, median time to transplant, percentage of African American candidates, percentage of prelisted candidates, and percentage of LDKT) and degree of racial disparity in LDKT was quantified. OUTCOMES Hierarchical multivariate logistic regression models were used to derive center-specific estimates of LDKT attainment in African American versus non-African American candidates. RESULTS Racial parity was not seen at any of the 275 transplant centers in the United States. At centers with the least racial disparity, African Americans had 35% lower odds of receiving LDKT; at centers with the most disparity, African Americans had 76% lower odds. Higher percentages of African American candidates (interaction term, 0.86; P = 0.03) and prelisted candidates (interaction term, 0.80; P = 0.001) at a given center were associated with increased racial disparity at that center. Higher rates of LDKT (interaction term, 1.25; P < 0.001) were associated with less racial disparity. LIMITATIONS Some patient-level factors are not captured, including a given patient's pool of potential donors. Geographic disparities in deceased donor availability might affect LDKT rates. Center-level policies and practices are not captured. CONCLUSIONS Racial disparity in attainment of LDKT exists at every transplant center in the country. Centers with higher rates of LDKT attainment for all races had less disparity; these high-performing centers might provide insights into policies that might help address this disparity.
Performance characteristics of postpartum screening tests for type 2 diabetes mellitus in women with a history of gestational diabetes mellitus: a systematic review.

BACKGROUND Women with a history of gestational diabetes mellitus are at high risk for type 2 diabetes mellitus. We systematically reviewed and synthesized the literature on the sensitivity, specificity, and reproducibility of postpartum screening tests for type 2 diabetes in women with prior gestational diabetes to inform screening guidelines. METHODS We searched electronic databases through October 1, 2008. Two investigators independently reviewed titles, abstracts, and articles, performed serial data abstraction, and independently assessed quality. We calculated standard errors and confidence intervals for sensitivity and specificity using the exact binomial formula. RESULTS Eleven studies contained 13 evaluations of a comparison screening test with the 2-h 75-g oral glucose tolerance test (OGTT) reference. All studies used a cross-sectional study design. There were ten comparisons of a single fasting blood glucose (FBG) >=7.0 mmol/L (>=126 mg/dL) with the OGTT. The sensitivity ranged from 14%-100% in five studies using the 1985 World Health Organization's (WHO) criteria as the reference and from 16%-89% in five studies using the 1999 WHO criteria as the reference. Variation in the sensitivities may be due to the limited number of comparisons, differences in populations, and timing of screening. There were high losses to follow-up, limiting generalizability. CONCLUSIONS When compared with the OGTT, the single FBG alone was not consistently reported to be a sensitive screening test for type 2 diabetes in women with a history of gestational diabetes. Longitudinal studies are needed to address the natural history of glucose metabolism in women with a history of gestational diabetes, the optimal approach to diagnostic testing for type 2 diabetes in this population, and the short-term and long-term outcomes of testing.
Détection de thème et adaptation des modèles de langage pour la reconnaissance automatique de la parole

Une des facons de proceder pour l'amelioration de la qualite des systemes de Reconnaissance Automatique de la Parole (RAP) consiste a adapter le modele de langage utilise au theme du texte en cours de traitement. Nous proposons dans cette these une nouvelle approche de la selection de vocabulaire pour la detection de theme, qui permet d'ameliorer legerement les performances. Nous proposons egalement une methode originale de detection de theme qui atteint des performances comparables a celles de l'etat de l'art en exploitant un vocabulaire reduit. Nous avons egalement etudie la combinaison des methodes de detection de theme. Celle-ci nous permet d'ameliorer les performances de 10%, atteignant ainsi plus de 93% de detection de theme correcte. Dans le cadre de l'integration dans un systeme de RAP, nous avons montre amelioration consequente de la perplexite.
Pooled Nucleic Acid Testing to Detect Antiretroviral Treatment Failure in HIV-Infected Patients in Mozambique

Background:In resource-limited settings, viral load monitoring of HIV-infected patients receiving antiretroviral therapy (ART) is not readily available because of high costs. Here, we compared the accuracy and costs of quantitative and qualitative pooled methods with standard viral load testing. Methods:Blood was collected prospectively from 461 patients receiving first-line ART in Mozambique who had not been evaluated previously with viral load testing. Screening for virologic failure of ART was performed quantitatively (ie, standard viral loads) and qualitatively [one and 2 rounds of polymerase chain reaction (PCR)]. Individual samples and minipools of 5 samples were then analyzed using both methods. The relative efficiency, accuracy, and costs of each method were calculated based on viral load thresholds for ART failure. Results:Standard viral load testing of individual samples revealed a high rate of ART failure (19%–23%) across all virologic failure thresholds, and the majority of the patients (93%) with viral loads >1500 copies per milliliter had genotypic resistance to drugs in their ART regimen. Pooled quantitative screening and deconvolution testing had positive and negative predictive values exceeding 95% with cost savings of $11,250 compared with quantitative testing of each sample individually. Pooled qualitative screening and deconvolution testing had a higher cost savings of $30,147 for 1 PCR round and $25,535 for 2 PCR rounds compared with quantitative testing each sample individually. Both pooled qualitative PCR methods had positive and negative predictive values ≥90%, but the pooled 1-round PCR method had a sensitivity of 64%. Conclusions:Given the high rate of undiagnosed ART failure and drug resistance in this cohort, it is clear that virologic monitoring is urgently needed in this population. Here, we compared alternative methods of virologic monitoring with standard viral load testing of individual samples and found these methods to be cost saving and accurate. The test characteristics of each method will likely need to be considered for each local population before it is adopted.
Continuous positive airway pressure requirement during the first month of treatment in patients with severe obstructive sleep apnea.

OBJECTIVES (1) To compare the continuous positive airway pressure (CPAP) requirement at the time of diagnosis (T0), after 2 weeks (T2), and after 4 weeks (T4) of CPAP treatment, in patients with severe obstructive sleep apnea (OSA); and (2) to assess whether any alteration in CPAP requirement over the first 4 weeks of CPAP treatment would influence daytime alertness, subjective sleepiness, or mood. DESIGN A prospective, controlled, single-blind crossover study. SETTING University teaching hospital. PATIENTS Ten patients with newly diagnosed and previously untreated severe OSA (aged 52+/-9 years, apnea hypopnea index [AHI] of 99+/-31) and subsequently 10 control patients (aged 52+/-11 years, AHI 85+/-17). MEASUREMENTS Overnight polysomnography with CPAP titration to determine the CPAP requirement, which was standardized for body position and sleep stage, on all three occasions (T0, T2, T4). Objective sleep quality, daytime alertness, subjective sleepiness (Epworth Sleepiness Scale), and mood (Hospital Anxiety and Depression Scale). RESULTS CPAP requirement decreased from T0 to T2 (median difference, 1.5 cm H2O, 95% confidence interval [CI], 1.1 to 2.7 cm H2O, p=0.0004) and did not differ between T2 and T4. Use of the lower CPAP pressure during T2 to T4 was associated with a decrease in Epworth scale (mean difference, 2.6, 95% CI, 1.2 to 4; p=0.01) and anxiety (median change, 2; 95% CI, 0.5 to 2.9, p=0.03) scores, as compared with the first 2 weeks. Daytime alertness did not differ between T0 to T2 and T2 to T4. CONCLUSION CPAP requirement falls within 2 weeks of starting CPAP treatment. A change to the lower required CPAP was not associated with any deterioration in daytime alertness but was associated with small subjective improvements in sleepiness and mood.
Normalization of equinus forces with gastrocnemius recession after Evans calcaneal lengthening osteotomy

Evans calcaneal lengthening osteotomy is a powerful surgical technique utilized in the correction of a flatfoot deformity. The known biomechanical complications associated with performing the calcaneal osteotomy alone involve increased lateral column pressures. The present study involves a patient who developed a sub fifth metatarsal ulceration with weightbearing after an Evans calcaneal osteotomy. The ulceration was resolved by addressing the concomitant equinus deformity through a gastrocnemius recession. The development of an ulceration with weightbearing acceptance after an Evans calcaneal lengthening osteotomy has not been reported to the author’s knowledge.
Volume Balance and Toxicity Analysis of Highway Stormwater Discharge from Cross Lake Bridge

The Cross Lake Bridge in Shreveport, Louisiana, spans Cross Lake that serves as the city’s water supply. Concern about accidents on the bridge contaminating the lake prompted the Louisiana Department of Transportation and Development (LADOTD) to construct a closed drainage system on the bridge to convey precipitation falling on the bridge deck to a concrete lined holding pond on the east side of the lake. Once there, bridge runoff is tested for oil and grease, pH, and lead before discharge to 12-mile bayou. This report describes the methodology and results of two studies dealing with runoff from the Cross Lake Bridge. The first examined the degree to which repairs to the Cross Lake Bridge’s closed drainage system were successful in capturing runoff from the bridge. An earlier study found that, because of leakage, only about one half of the precipitation falling on the bridge actually ended up in the holding pond. This is substantially less than would be expected from a catchment that is essentially impervious. To test the success of repairs to the drainage system, volume balances for 22 precipitation events were conducted by comparing the rainfall on the bridge to the subsequent flow into the pond. The ratio of the volume of runoff to the volume of precipitation was found to average 0.86, which when compared to values from the previous study as well as published values, suggested a successful repair of the drainage system. The second study examined the use of the Microtox toxicity analysis system manufactured by Azur Environmental for use as a screening tool to assess toxicity of the pond contents. Microtox protocols rely on measurement of light output from a specific strain of luminescent bacteria. Toxicity is indicated when light output from the bacteria decreases. Tests can be run in time periods ranging from 5 to 30 minutes. The standard endpoint of the tests occurs once light output has dropped 50 percent and is termed the EC50. Samples from the water column and sediment were collected and analyzed for toxicity using the basic test (liquid) and the basic solid phase test (sediment).
Value-driven management.

When writing can change your life, when writing can enrich you by offering much money, why don't you try it? Are you still very confused of where getting the ideas? Do you still have no idea with what you are going to write? Now, you will need reading. A good writer is a good reader at once. You can define how you write depending on what books to read. This value driven it management can help you to solve the problem. It can be one of the right sources to develop your writing skill.
ARE WE THERE YET? TIME TO DETECTION OF NANOHERTZ GRAVITATIONAL WAVES BASED ON PULSAR-TIMING ARRAY LIMITS

Decade-long timing observations of arrays of millisecond pulsars have placed highly constraining upper limits on the amplitude of the nanohertz gravitational-wave stochastic signal from the mergers of supermassive black hole binaries (∼10−15 strain at f = 1 yr−1). These limits suggest that binary merger rates have been overestimated, or that environmental influences from nuclear gas or stars accelerate orbital decay, reducing the gravitational-wave signal at the lowest, most sensitive frequencies. This prompts the question whether nanohertz gravitational waves (GWs) are likely to be detected in the near future. In this Letter, we answer this question quantitatively using simple statistical estimates, deriving the range of true signal amplitudes that are compatible with current upper limits, and computing expected detection probabilities as a function of observation time. We conclude that small arrays consisting of the pulsars with the least timing noise, which yield the tightest upper limits, have discouraging prospects of making a detection in the next two decades. By contrast, we find large arrays are crucial to detection because the quadrupolar spatial correlations induced by GWs can be well sampled by many pulsar pairs. Indeed, timing programs that monitor a large and expanding set of pulsars have an ∼80% probability of detecting GWs within the next 10 years, under assumptions on merger rates and environmental influences ranging from optimistic to conservative. Even in the extreme case where 90% of binaries stall before merger and environmental coupling effects diminish low-frequency gravitational-wave power, detection is delayed by at most a few years.
Periodicity in a ratio-dependent predator-prey system with stage structure for predator

With the help of a continuation theorem based on Gaines and Mawhin's coincidence degree, easily verifiable criteria are established for the global existence of positive periodic solutions of a delayed ratio-dependent predator-prey system with stage structure for predator. The approach involves some new technique of priori estimate. For the system without delay, by constructing a suitable Lyapunov function, some sufficient conditions which guarantee the existence of a unique global attractive positive periodic solution are obtained. Those results have further applications in population dynamics.
Ten-year analysis of transfusion in Operation Iraqi Freedom and Operation Enduring Freedom: Increased plasma and platelet use correlates with improved survival

BACKGROUND The Joint Theater Trauma Registry database, begun early in Operation Iraqi Freedom and Operation Enduring Freedom, created a comprehensive repository of information that facilitated research efforts and produced rapid changes in clinical care. New clinical practice guidelines were adopted throughout the last decade. The damage-control resuscitation clinical practice guideline sought to provide high-quality blood products in support of tissue perfusion and hemostasis. The goal was to reduce death from hemorrhagic shock in patients with severe traumatic bleeding. This 10-year review of the Joint Theater Trauma Registry database reports the military’s experience with resuscitation and coagulopathy, evaluates the effect of increased plasma and platelet (PLT)–to–red blood cell ratios, and analyzes other recent changes in practice. METHODS Records of US active duty service members at least 18 years of age who were admitted to a military hospital from March 2003 to February 2012 were entered into a database. Those who received at least one blood product (n = 3,632) were included in the analysis. Data were analyzed with respect to interactions within and between categories (demographics, admission characteristics, hospital course, and outcome). Transfusions were analyzed with respect to time, survival, and effect of increasing transfusion ratios. RESULTS Coagulopathy was prevalent upon presentation (33% with international normalized ratio ≥ 1.5), correlated with increased mortality (fivefold higher), and was associated with the need for massive transfusion. High transfusion ratios of fresh frozen plasma and PLT to red blood cells were correlated with higher survival but not decreased blood requirement. Survival was most correlated with PLT ratio, but high fresh frozen plasma ratio had an additive effect (PLT odds ratio, 0.22). CONCLUSION This 10-year evaluation supports earlier studies reporting the benefits of damage-control resuscitation strategies in military casualties requiring massive transfusion. The current analysis suggests that defects in PLT function may contribute to coagulopathy of trauma. LEVEL OF EVIDENCE Epidemiologic study, level IV.