Miracle-dz/UniFAR-FTUs huggingface dataset:
Pattern and determinant factors of birth intervals among Iranian women: a semi-parametric multilevel survival model

Abstract The interval between successive pregnancies (birth interval) is one of the main indexes used to evaluate the health of a mother and her child. This study evaluated birth intervals in Iran using data from the Iranian Multiple Indicators Demographic and Health Survey (IrMIDHS) conducted in 2010–2011. A total of 20,093 married Iranian women aged 15–54 years from the whole country constituted the study sample. Based on the nature of sampling and the unobserved population heterogeneity for birth intervals in each city and province, a multilevel survival frailty model was applied. Data were analysed for women’s first three birth intervals. The median first and second birth intervals were 30.3 and 39.7 months respectively. Higher education, Caesarean delivery, contraceptive use and exposure to public mass media were found to decrease the hazard rate ratio (HRR) of giving birth. Meanwhile, higher monthly income increased the hazard of giving birth. The results suggest that public mass media can play an effective role in encouraging women to have the recommended birth interval. Furthermore, increasing family income could encourage Iranian couples to decrease the time to their next birth.
Clinicopathologic and survival characteristics of malignant pleural mesothelioma: A single institutional experience

The single institution study of 7 years experience was performed to investigate clinicopathologic and therapeutic characteristics and the factors affecting survival in malignant pleural mesothelioma patients, who had treated with combined or multimodality treatment. A total of 53 patients were included into the study. The median age was 58 (33 to 79) years. The mean duration of follow-up was 14 months (4-82). Disease-free and overall survivals are 11 months (3-50) and 14 (4-82) months, respectively. Factors that individually predicted better prognosis were younger age (
A machine learning approach for automatic detection and classification of changes of direction from player tracking data in professional tennis

ABSTRACT The purpose of this study was to develop an automated method for identifying and classifying change of direction (COD) movements in professional tennis using tracking data. Three sport science and strength and conditioning experts coded match-play footage of nineteen professional tennis players (9 male and 10 female) from the Australian Open Grand Slam for COD of medium and high intensity. A total of 1,494 changes were identified and aligned with 2D player position sampled at 25 Hz based on camera tracking data. Several machine learning classifiers were trained and tested on a set of 1,128 time-motion features. A random forest algorithm was found to have the best out-of-sample performance, classifying medium and high intensity changes with an F1-score of 0.729. This research offers a novel and applicable way for utilising player tracking data and machine learning techniques to automatically identify and classify COD movements in professional tennis.
Childhood Trauma and Stressful Life Events Are Independently Associated with Sleep Disturbances in Adolescents

Adolescence is a critical developmental period associated with an increase in stress, the appearance of anxiety and depressive symptoms, and changes in sleep patterns. Even though the disruption of sleep patterns in stress and anxiety and depressive disorders is well known, the independent effects of childhood trauma and stressful life events on sleep patterns are less understood. We tested the independent effects of stress (childhood trauma and stressful life events) while controlling for anxiety and depression on adolescent sleep patterns. Seven hundred fifty-two adolescents (age 12–15 years) completed self-report questionnaires about childhood trauma, stressful life events, anxiety, and depression. Four sleep factors identifying movement during sleep, sleep regularity, sleep disturbances, and sleep pressure were extracted in the principal component analysis of sleep questions. Both childhood trauma and recent stressful life events were significantly associated with sleep disturbances before and after controlling for anxiety and depression.
OPERATIONAL EFFICIENCY MAP & FLOW CHARACTERIZATION FOR STEADY-STATE TWO- PHASE FLOWS IN POROUS MEDIA

An extended retrospective examination of relative permeability diagrams revealed a latent characteristic of steady-state two-phase flows in porous media, the existence of optimum operating conditions, i.e. conditions whereby process efficiency -considered in terms of oil produced per kW dissipated in pumpsattains locally maximum values. A total number of 83 published relative permeability diagrams, pertaining to a variety of flow conditions and core types, were reconstructed into energy utilization diagrams, providing ample evidence on the existence of optimum operating conditions and showing a universal trend that can be cast into an operational efficiency map over the domain of the independent variables, the capillary number, Ca, and the oil/water flow ratio, r. This universal map demarcates the overall efficiency of steady-state two-phase flow processes in terms of pertinent system parameters. The map not only provides a guiding tool for designing more efficient processes, but can be used for the normative characterization of two-phase flows as to the predominance of capillary or viscous effects. The proposed concept is based on the existence of a unique locus of optimum operating conditions, r*(Ca), for each particular oil-water-p.m. system. INTRODUCTION Conventional relative permeability diagrams are records of experimental evidence on the phenomenology of steady-state two-phase flow in porous media processes. They contain untapped latent information that may enrich our knowledge and deeper understanding of the process and may be used constructively to back-up, or provide further evidence on theoretical inferences. A particular inference of utmost importance is the existence of conditions whereby the efficiency of steady-state two-phase flow processes -considered in terms of oil produced per kW dissipated in pumpsattains locally maximum values. Optimum operating conditions (OOC) were first predicted and identified by the DeProF theory for steady-state two-phase flow in pore networks [1]. The operational efficiency of the process can be measured by the energy utilization index, W r fEU  (1) where: r is the oil/water flowrate ratio and   2 ow w Ca ~ ~ k ~ W~ W     is the reduced mechanical power dissipation (including the effect of bulk viscosities and interfacial
Clinical decision making by South African paramedics in the management of acute traumatic pain

Background In the emergency setting, the onus is on the individual practitioner’s ability to make critical decisions at critical moments in order to provide the best level of care to their patient. In order to ensure that these decisions fall in line with the best interests of the patient, the South African paramedic requires a better understanding of how to arrive at such a decision; they need to understand the clinical decision making process. This study focused on South African paramedic clinical decision making with specific reference to acute traumatic pain management, with the aim of determining the factors which influence South African paramedic clinical decision making by revealing the current method of pain management employed by South African paramedics, how they view the priority of pain management in the continuum of care and if there were any context specific factors influencing their clinical decision making. Methods A mixed method design was used to determine the factors contributing to the clinical decision making process of South African paramedics in the acute pain management of patients with acute traumatic pain. A mixture of qualitative and quantitative approaches was utilized by means of a research questionnaire as well as in-depth interviews. The questionnaires were targeted at all South African paramedics while the in-depth interviews were conducted with five participants who had been purposefully selected from the questionnaire respondents. The data analysis was conducted in a descriptive manner in order to inform the explanatory nature of the answers to the research questions and objective. Results The results provided insight into the current methods and clinical decision making processes employed by South African paramedics in the management of patients’ experiencing acute traumatic pain. The study determined that the South African paramedic’s clinical decision making process involves three key phases in the acute traumatic pain management setting, the assessment phase, the initiation/pain management phase and the conclusion/re-evaluation phase, with each phase utilizing different decision making models, the intuitive/humanist model, the hypothetico- deductive model and a model which combined both of the aforementioned models. In addition to this, numerous factors such as the provision of care in order to facilitate further management and transportation to an appropriate facility, which influenced clinical decision making, were identified. Amongst South African paramedics, pain management was identified as coming second only to the interventions required to manage immediately life threatening conditions in terms of the prioritization of treatment. Recommendations A variety of recommendations which included the need to further the development of clinical decision making and pain management through research and education as well as considerations for investigation into the potential expansion of South African paramedic scope of practice in the pain management environment were made.
Novel Regulators of Low-Density Lipoprotein Receptor and Circulating LDL-C for the Prevention and Treatment of Coronary Artery Disease

Low-density lipoprotein cholesterol (LDL-C) is a major risk factor for atherosclerosis and coronary artery disease (CAD). The role of LDL-C in CAD has been established through experimental studies, epidemiological and genetic studies and the elucidation of the lowdensity lipoprotein receptor (LDLR) pathway (Brown and Goldstein, 1986). LDLR deficient mice develop frank hypercholesterolemia and atherosclerosis on western diet (Ishibashi et al., 1994). In humans, people with low LDL-C have very low risk of developing CAD and plasma LDL-C is positively associated with CAD (Stamler et al., 2000). Mutations in LDLR in humans form the molecular basis for familial hypercholesterolemia and patients with this disease develop premature CAD (Hobbs et al., 1990). Statins are a class of small molecule compounds that inhibit HMG-CoA reductase, a rate-limiting enzyme in cholesterol biosynthesis, thereby reducing LDL-C in humans. Statins effectively reduce LDL-C and the associated cardiovascular disease risk by about 30%, but residual risks for developing cardiovascular disease remain. In recent years, clinical studies have suggested that further lower circulating LDL-C is closely associated with additional reduction of cardiovascular risk. The majority of the high risk patients often fail to reach their LDL-C goal, and thus, novel targets and medications are highly desirable for the prevention and treatment of cardiovascular disorders. In the last few years, novel regulators of LDLR and/or circulating LDL-C have emerged that suggest potentially more therapeutic opportunities. These include proprotein convertase subtilisin/kexin type 9 (PCSK9) and the inducible degrader of LDLR (Idol) that regulate LDLR and LDL-C levels. Novel therapeutic modalities thus may provide additional clinical options to further reduce LDL-C and cardiovascular disease risk.
Hyderabad Ocular Morbidity in Elderly Study (HOMES) – Rationale, Study Design and Methodology

ABSTRACT Purpose: To describe the study design, interobserver variability of the questionnaires and clinical procedures of Hyderabad Ocular Morbidity in Elderly Study (HOMES) designed to, (a) to investigate the prevalence, causes and risk factors for visual impairment, and (b) to assess the impact of dispensing spectacles and cataract surgery on visual functions, fear of falls (FOF) and depression among the elderly in India. Methods: Individuals aged ≥60 years are considered elderly. The non-clinical protocol was administered by two trained investigators and included collection of personal, sociodemographic information, ocular and systemic history, Indian Visual Function Questionnaire (IND-VFQ33), Patient Health Questionnaire (PHQ9), Mini-Mental State Examination (MMSE) questionnaire, Hearing Handicap Inventory for the Elderly Screening (HHIE), Short Falls Efficacy Scale (SFES) questionnaire. The eye examination was conducted by a trained optometrist and vision technicians in clinics set-up in the homes and included visual acuity (VA) assessment for distance and near, anterior segment examination and fundus examination, and imaging. The reliability assessments were carried out among 138 participants. Result: The intraclass correlation (ICC) coefficients for MMSE, PHQ9, HHIE, SFES was 0.73 (95% CI: 0.62–0.81), 0.67 (95% CI: 0.54–0.77), 0.63 (95% CI: 0.48–0.74) and 0.70 (95% CI: 0.58–0.79) respectively. The ICC for INDVFQ domains ranged from 0.66 (95% CI: 0.55–0.74) for Psychosocial Impact to 0.88 (95% CI: 0.84–0.91) for activity limitation. The ICC for VA was 0.94 (95% CI: 0.92–0.96). Conclusion: All questionnaires demonstrated acceptable reliability and can be applied in the main study. HOMES is expected to provide data that will help plan strategies to contribute towards ‘healthy aging’ in India.
Heads or tails? Differential translational regulation in cercarial heads and tails of schistosome worms

Schistosomes are obligate helminths responsible for over 218 million cases of human schistosomiasis in 78 countries around the world. Infection occurs when free-swimming cercariae penetrate human skin and initiate developmental progression into parasitic obligate worms that consume red blood cells. Transcriptomic studies of infectious cercariae reveal abundant mRNAs associated with energy metabolism and host invasion. However, the cercaria is mostly transcriptionally quiescent, suggesting that most mRNAs are primed prior to cercarial escape from the snail host. The use of transcriptomics to understand protein expression presumes that transcription and translation are functionally coupled and the cercarial stage has categorically been treated as a single unit for -omic analysis. Per contra, the relationship between transcription and translation in infectious cercariae has not been described. To understand the correlation between transcription and translation in cercariae, we separately measured nascent translation levels in cercarial heads, cercarial tails and in the developing schistosomula, the next stage of its life cycle. The loss of the cercarial tail is essential for the transformation from a cercaria to a schistosomulum. We observed that translation was initially limited and the translation rate accelerated during the first 72-hours after tail loss. When we tested nascent translation in cercarial heads, cercarial tails, whole cercariae, and 4-hour schistosomula, we found that translation is significantly upregulated in the cercarial tail when compared to the cercarial head and that translation was undetectable in heads using immunofluorescent image quantification (p = .0005). These data represent a major shift in how we understand the cercarial stage. The cercarial head is mostly transcriptionally and translationally quiescent while being sufficient for progression into a schistosomulum. In addition, transcription and translation are not linked in Schistosoma mansoni cercaria. Thus, our current conceptual approach of treating the cercaria as a single functional unit for -omic studies may be insufficient to understand cercarial development.
Evolution of the nonsense-mediated decay pathway is associated with decreased cytolytic immune infiltration

Background The somatic co-evolution of tumors and the cellular immune responses that combat them drives the diversity of immune-tumor interactions. This includes tumor mutations that generate neo-antigenic epitopes that elicit cytotoxic T-cell activity and subsequent pressure to select for genetic loss of antigen presentation. Most studies have focused on how tumor missense mutations can drive tumor immunity, but frameshift mutations have the potential to create far greater antigenic diversity. However, expression of this antigenic diversity is potentially regulated by Nonsense Mediated Decay (NMD) and NMD has been shown to be of variable efficiency in cancers. Methods Using TCGA datasets, we derived novel patient-level metrics of ‘NMD burden’ and interrogated how different mutation and most importantly NMD burdens influence cytolytic activity using machine learning models and survival outcomes. Results We find that NMD is a significant and independent predictor of immune cytolytic activity. Different indications exhibited varying dependence on NMD and mutation burden features. We also observed significant co-alteration of genes in the NMD pathway, with a global increase in NMD efficiency in patients with NMD co-alterations. Finally, NMD burden also stratified patient survival in multivariate regression models. Conclusions Our work suggests that beyond selecting for mutations that elicit NMD in tumor suppressors, tumor evolution may react to the selective pressure generated by inflammation to globally enhance NMD through coordinated amplification and/or mutation.
Role of Cytokines in Pathophysiology of Asthma

The worldwide incidence, morbidity and mortality of asthma are increasing dramatically. It is one of the most common disorders encountered in clinical medicine in both children and adults. It affects approximately 5% of the adult population in the western world and its reported incidence is increasing vigorously in many developed nations. A network of novel mediators known as ‘pleiotropic cytokines’ regulate the intermittent airway inflammation, bronchial smooth muscle hyperreactivity and bronchoconstricion underlying asthma. Preclinical and clinical data suggest that, the pathophysiological features of asthma are thought to result from the aberrant expansion of cytokines and chemokines. Cytokines are small extracellular signaling protein produced by different cells and possess a wide spectrum of biological activities due to their redundancy and pleiotropic properties. They are critical to the functioning of both innate and adaptive immune responses. Cytokines and their receptors exhibit very high affinity for each other. Because of this high affinity, picomolar concentrations of cytokines can mediate a biological effect. The major groups of cytokines are lymphokines, proinflammatory cytokine, inhibitory cytokines and growth factors. Pathophysiology of asthma is still poorly understood and its cause remains unknown. On this basis, this review will concentrate on the synthesis, release and functional role of each cytokine in the pathophysiology of asthma.
The effectiveness of aromatherapy, massage and reflexology in people with palliative care needs: A systematic review

Background: Aromatherapy, massage and reflexology are widely used in palliative care. Despite this, there are questions about their suitability for inclusion in clinical guidelines. The need to understand their benefits is a public priority, especially in light of funding pressures. Aim: To synthesise current evidence on the effectiveness of aromatherapy, massage and reflexology in people with palliative care needs. Design: A systematic review of randomised controlled trials (PROSPERO CRD42017081409) was undertaken following international standards including Cochrane guidelines. The quality of trials and their pooled evidence were appraised. Primary outcomes on effect were anxiety, pain and quality-of-life. Data sources: Eight citation databases and three trial registries were searched to June 2018. Results: Twenty-two trials, involving 1956 participants were identified. Compared with a control, four evaluated aromatherapy, eight massage and six reflexology. A further four evaluated massage compared with aromatherapy. Trials were at an unclear risk of bias. Many had small samples. Heterogeneity prevented meta-analysis. In comparison with usual care, another therapy or an active control, evidence on the effectiveness of massage and aromatherapy in reducing anxiety, pain and improving quality-of-life was inconclusive. There was some evidence (low quality) that compared to an active control, reflexology reduced pain. Conclusions: This review identified a relatively large number of trials, but with poor and heterogeneous evidence. New clinical recommendations cannot be made based on current evidence. To help provide more definitive trial findings, it may be useful first to understand more about the best way to measure the effectiveness of these therapies in palliative care.
Semi-automated generation of pictures for the Mouse Grimace Scale: A multi-laboratory analysis (Part 2)

The Mouse Grimace Scale (MGS) is an established method for estimating pain in mice during animal studies. Recently, an improved and standardized MGS set-up and an algorithm for automated and blinded output of images for MGS evaluation were introduced. The present study evaluated the application of this standardized set-up and the robustness of the associated algorithm at four facilities in different locations and as part of varied experimental projects. Experiments using the MGS performed at four facilities (F1–F4) were included in the study; 200 pictures per facility (100 pictures each rated as positive and negative by the algorithm) were evaluated by three raters for image quality and reliability of the algorithm. In three of the four facilities, sufficient image quality and consistency were demonstrated. Intraclass correlation coefficient, calculated to demonstrate the correlation among raters at the three facilities (F1–F3), showed excellent correlation. The specificity and sensitivity of the results obtained by different raters and the algorithm were analysed using Fisher's exact test (p < 0.05). The analysis indicated a sensitivity of 77% and a specificity of 64%. The results of our study showed that the algorithm demonstrated robust performance at facilities in different locations in accordance with the strict application of our MGS setup.