Miracle-dz/UniFAR-FTUs huggingface dataset:
A two years audit of complications of hysterectomy at Ayub Teaching Hospital Abbottabad.

BACKGROUND Hysterectomy is one of the most common major surgical procedures performed in Gynaecology. Our objective was to determine the operative and postoperative complications of this procedure with an aim to improve management at our unit. METHODS This study was conducted in the Department of Gynaecology, Ayub Teaching Hospital, Abbottabad form January 2002 to December 2003. Indications, complications and mortality associated with hysterectomy were assessed. RESULTS Total number of hysterectomies performed in two years at our unit was 316. Major Indications for hysterectomies were dysfunctional uterine bleeding (38%) and fibroid uterus, (27%) followed by prolapse (22%). Complications developed in 14% out of these. The frequency of complications was related with indication for hysterectomy, age, parity and history of associated serious illness. It was found that frequency of complications in fibroid uterus was higher (1.2%) than that for Dysfunctional uterine bleeding (DUB) (1.0%). There was no operative death, while 5 (1.5%) patients died within 2 weeks of surgery. CONCLUSION We have a fairly high frequency of morbidity and mortality associated with hysterectomy. In order to reduce these proper selection, pre-operative preparation and less invasive alternative treatment for the commonest indications of hysterectomy (that is fibroids and DUB) for example various methods of endometrial ablation or resections can be employed.
A dose-response perspective on college drinking and related problems.

AIMS In order to examine the degree to which heavy drinking contributes to risks for problems among college drinkers this paper develops and tests a dose-response model of alcohol use that relates frequencies of drinking specific quantities of alcohol to the incidence of drinking problems. METHODS A mathematical model was developed that enabled estimation of dose-response relationships between drinking quantities and drinking problems using self-report data from 8698 college drinkers across 14 campuses in California, USA. The model assumes that drinking risks are a direct monotone function of the amount consumed per day and additive across drinking days. Drinking problems accumulate across drinking occasions and are the basis for cumulative reports of drinking problems reported by college drinkers. RESULTS Statistical analyses using the model showed that drinking problems were related to every drinking level, but increased fivefold at three drinks and more gradually thereafter. Problems were associated most strongly with occasions on which three drinks were consumed, and more than half of all reported problems were related to occasions on which four or fewer drinks were consumed. There were some important differences in dose-responsiveness between men and women and between different groups of 'light', 'moderate' and 'heavier' drinkers. CONCLUSION Many problems among college students are associated with drinking relatively small amounts of alcohol (two to four drinks). Programs to reduce college drinking problems should emphasize risks associated with low drinking levels.
Role of Biofilms in Children with Chronic Adenoiditis and Middle Ear Disease

Chronic adenoiditis occurs frequently in children, and it is complicated by the subsequent development of recurrent or chronic middle ear diseases, such as recurrent acute otitis media, persistent otitis media with effusion and chronic otitis media, which may predispose a child to long-term functional sequalae and auditory impairment. Children with chronic adenoidal disease who fail to respond to traditional antibiotic therapy are usually candidates for surgery under general anaesthesia. It has been suggested that the ineffectiveness of antibiotic therapy in children with chronic adenoiditis is partially related to nasopharyngeal bacterial biofilms, which play a role in the development of chronic nasopharyngeal inflammation due to chronic adenoiditis, which is possibly associated with chronic or recurrent middle ear disease. This paper reviews the current evidence concerning the involvement of bacterial biofilms in the development of chronic adenoiditis and related middle ear infections in children.
Deep Neural Network Classifier for Variable Stars with Novelty Detection Capability

Common variable star classifiers are built with the singular goal of producing the correct class labels, leaving much of the multi-task capability of deep neural networks unexplored. We present a periodic light curve classifier that combines a recurrent neural network autoencoder for unsupervised feature extraction and a dual-purpose estimation network for supervised classification and novelty detection. The estimation network optimizes a Gaussian mixture model in the reduced-dimension feature space, where each Gaussian component corresponds to a variable class. An estimation network with a basic structure of a single hidden layer attains a cross-validation classification accuracy of ∼99%, which is on par with the conventional workhorses, random forest classifiers. With the addition of photometric features, the network is capable of detecting previously unseen types of variability with precision 0.90, recall 0.96, and an F1 score of 0.93. The simultaneous training of the autoencoder and estimation network is found to be mutually beneficial, resulting in faster autoencoder convergence, as well as superior classification and novelty detection performance. The estimation network also delivers adequate results even when optimized with pre-trained autoencoder features, suggesting that it can readily extend existing classifiers to provide added novelty detection capabilities.
Associations of telomere length in risk and recurrence of prostate cancer: A meta‐analysis

Over the past decades, there is an increasing number of association studies of telomere length (TL) and the risk and recurrence of prostate cancer (PCa), but the results are inconsistent. Hence, we identify the relevant studies published in English on or before 10 January 2019 conducting a literature review in the electronic databases including PubMed, EMBASE and Cochrane Library. Twelve studies (with 19 data sets) were included in this meta‐analysis, five of which were associated with risk assessment, six of which reported recurrence of PCa and one of which included them. Our meta‐analysis demonstrated a positive association of shorter telomeres in patients with PCa, but without statistical significance (OR, 1.23; 95% CI: 0.91–1.66). Shorter telomeres in stroma (OR, 2.40; 95% CI: 1.61–3.56) and epithelium (OR, 1.70; 95% CI: 1.33–2.16) were positively correlated with PCa, but in leucocyte (OR, 0.81; 95% CI: 0.73–0.91) had negative association with PCa. Furthermore, two studies combined yielded a pooled OR of 2.87 (95% CI: 1.22–6.76) for the association between shorter TL and metastasis. These results are novel and give further strength to formulate eligible individualising treatment and surveillance strategies.
Do maternal personality variables influence childbirth satisfaction? A longitudinal study in low-risk pregnancies

ABSTRACT To analyze the influence of maternal personality (big five personality, coping and childbirth expectations) on birth satisfaction. A longitudinal prospective design was used with 116 pregnant women during November 2014-December 2015 at a public hospital (Madrid, Spain) with three assessment stages: first trimester of pregnancy (personality factors), third trimester (childbirth expectations and coping strategies) and 48 hours after childbirth (labor satisfaction). The highest childbirth satisfaction scores were for professional support, support from partner and overall satisfaction. Higher childbirth satisfaction scores were found for vaginal births than for cesarean sections or instrumental births. Childbirth expectation dimensions showed the highest number of associations with childbirth satisfaction. Significant correlations were found between neuroticism and home assessment, agreeableness and environment, and openness to experience and overall satisfaction. Significant positive correlations were found between positive reappraisal and continuity, and negative correlations between avoidance coping and home assessment. Regression analyses showed the predictive role played by the type of birth, and the caregiving environment as childbirth expectation, and positive reappraisal and avoidance as coping strategies. These findings have important implications for health professionals who provide assistance to pregnant women through holistic models which include the assessment and adjustment of childbirth expectations.
Flp, a Fis‐like protein, contributes to the regulation of type III secretion and virulence processes in the phytopathogen Xanthomonas campestris pv. campestris

Summary The ability of the plant pathogen Xanthomonas campestris pv. campestris (Xcc) to cause disease is dependent on its ability to adapt quickly to the host environment during infection. Like most bacterial pathogens, Xcc has evolved complex regulatory networks that ensure expression and regulation of their virulence genes. Here, we describe the identification and characterization of a Fis‐like protein (named Flp), which plays an important role in virulence and type III secretion system (T3SS) gene expression in Xcc. Deletion of flp caused reduced virulence and hypersensitive response (HR) induction of Xcc and alterations in stress tolerance. Global transcriptome analyses revealed the Flp had a broad regulatory role and that most T3SS HR and pathogenicity (hrp) genes were down‐regulated in the flp mutant. β‐glucuronidase activity assays implied that Flp regulates the expression of hrp genes via controlling the expression of hrpX. More assays confirmed that Flp binds to the promoter of hrpX and affected the transcription of hrpX directly. Interestingly, the constitutive expression of hrpX in the flp mutant restored the HR phenotype but not full virulence. Taken together, the findings describe the unrecognized regulatory role of Flp protein that controls hrp gene expression and pathogenesis in Xcc.
Strong chromatic index and Hadwiger number

We investigate the effect of a fixed forbidden clique minor upon the strong chromatic index, both in multigraphs and in simple graphs. We conjecture for each k ≥ 4 that any K k ‐minor‐free multigraph of maximum degree Δ has strong chromatic index at most 3 2 ( k − 2 ) Δ . We present a construction certifying that if true the conjecture is asymptotically sharp as Δ → ∞ . In support of the conjecture, we show it in the case k = 4 and prove the statement for strong clique number in place of strong chromatic index. By contrast, we make a basic observation that for K k ‐minor‐free simple graphs, the problem of strong edge‐colouring is “between” Hadwiger's Conjecture and its fractional relaxation. For k ≥ 5 , we also show that K k ‐minor‐free multigraphs of edge‐diameter at most 2 have strong clique number at most ( k − 1 2 ) Δ .
A quantitative description of membrane current and its application to conduction and excitation in nerve

This article concludes a series of papers concerned with the flow of electric current through the surface membrane of a giant nerve fibre (Hodgkinet al., 1952,J. Physiol.116, 424–448; Hodgkin and Huxley, 1952,J. Physiol.116, 449–566). Its general object is to discuss the results of the preceding papers (Section 1), to put them into mathematical form (Section 2) and to show that they will account for conduction and excitation in quantitative terms (Sections 3–6).
Treatment experiences of Latinas with current or past binge eating disorder and/or bulimia nervosa

ABSTRACT This study utilized a female sample of 43 Latinas with a history of binge eating disorder and/or bulimia nervosa to investigate disparities in health care that may act as barriers to or correlates of treatment for these women. Results indicated that 65% of our sample sought treatment for their eating disorder. The most commonly utilized treatment providers were psychologist/therapist for individual therapy and nutritionist/dietician, while therapist-led group therapy was rated as the most helpful treatment and treatment by a physician was rated as least helpful. Participants endorsed eating disorder stigma, eating disorder shame, mental health shame, and cost of treatment as the most influential barriers to seeking or receiving treatment. Acculturation to White dominant society was associated with greater perceived treatment helpfulness. Findings from this study can be used to inform treatments for Latinas in order to potentially increase effectiveness, treatment-seeking, and recovery rates.
Cognitive prerequisites for fitness to drive: Norm values for the TMT, UFOV and NorSDSA tests

Abstract Background: Fitness-to-drive assessment is a growing area for occupational therapists. There are few off-road tests specially developed to assess fitness to drive, and several cognitive tests have no age-specific norms. Aims/objectives: The aim was to identify and describe age-related norm values for the Trail Making Test, Nordic Stroke Driver Screening Assessment and Useful Field of View test, and to study inter-correlation between test results. Materials and methods: The sample included 410 volunteers; 149 men and 261 women, mean age 52 ± 16.8 years. Commonly used off-road tests were used: TMT A and B, UFOV and NorSDSA. Results: Normative data for the specific subtests and total score for NorSDSA and UFOV are provided and presented in four age groups. Age correlated with the results for most of the subtests. Conclusions: Off-road cognitive test scores are necessary and valuable for occupational therapists in their contribution to the final decision on continued driving. In clinical practice, it can be difficult to interpret cognitive test results when working with driving assessments. Age-based norm values are suggested to be a way to provide clinicians with a benchmark against which scores can be compared. Significance: Age-based norms can guide occupational therapists working with fitness to drive.
Dysregulated Autophagy and Lysosome Function Are Linked to Exosome Production by Micro‐RNA 155 in Alcoholic Liver Disease

Cellular homeostais, that is normally maintained through autophagy, is disrupted in alcoholic liver disease (ALD). Because autophagy and exosome biogenesis share common elements, we hypothesized that increased exosome production in ALD may be linked to disruption of autophagic function. We found impaired autophagy both in ALD and alcoholic hepatitis (AH) mouse models and human livers with ALD as indicated by increased hepatic p62 and LC3‐II levels. Alcohol reduced autophagy flux in vivo in chloroquine‐treated mice as well as in vitro in hepatocytes and macrophages treated with bafilomycin A. Our results revealed that alcohol targets multiple steps in the autophagy pathway. Alcohol‐related decrease in mechanistic target of rapamycin (mTOR) and Ras homolog enriched in brain (Rheb), that initiate autophagy, correlated with increased Beclin1 and autophagy‐related protein 7 (Atg7), proteins involved in phagophore‐autophagosome formation, in ALD. We found that alcohol disrupted autophagy function at the lysosomal level through decreased lysosomal‐associated membrane protein 1 (LAMP1) and lysosomal‐associated membrane protein 2 (LAMP2) in livers with ALD. We identified that micro‐RNA 155 (miR‐155), that is increased by alcohol, targets mTOR, Rheb, LAMP1, and LAMP2 in the authophagy pathway. Consistent with this, miR‐155‐deficient mice were protected from alcohol‐induced disruption of autophagy and showed attenuated exosome production. Mechanistically, down‐regulation of LAMP1 or LAMP2 increased exosome release in hepatocytes and macrophages in the presence and absence of alcohol. These results suggested that the alcohol‐induced increase in exosome production was linked to disruption of autophagy and impaired autophagosome and lysosome function. Conclusion: Alcohol affects multiple genes in the autophagy pathway and impairs autophagic flux at the lysosome level in ALD. Inhibition of LAMP1 and LAMP2 promotes exosome release in ALD. We identified miR‐155 as a mediator of alcohol‐related regulation of autophagy and exosome production in hepatocytes and macrophages.
Predictors of Adverse Outcomes in Uncomplicated Lower Respiratory Tract Infections

PURPOSE Presentation with acute lower respiratory tract infection (LRTI) in primary care is common. The aim of this study was to help clinicians treat patients presenting with LRTI in primary care by identifying those at risk of serious adverse outcomes (death, admission, late-onset pneumonia). METHODS In a prospective cohort study of patients presenting with LRTI symptoms, patient characteristics and clinical findings were recorded and adverse events identified over 30 days by chart review. Multivariable logistic regression analyses identified predictors of adverse outcomes. RESULTS Participants were recruited from 522 UK practices in 2009-2013. The analysis was restricted to the 28,846 adult patients not referred immediately to the hospital. Serious adverse outcomes occurred in 325/28,846 (1.1%). Eight factors were independently predictive; these characterized symptom severity (absence of coryza, fever, chest pain, and clinician-assessed severity), patient vulnerability (age >65 years, comorbidity), and physiological impact (oxygen saturation <95%, low blood pressure). In aggregate, the 8 features had moderate predictive value (area under the receiver operating characteristic curve 0.71, 95% CI, 0.68-0.74); the 4% of patients with ≥5 features had an approximately 1 in 17 (5.7%) risk of serious adverse outcomes, the 35% with 3 or 4 features had an intermediate risk (1 in 50, 2.0%), and the 61% with ≤2 features had a low (1 in 200, 0.5%) risk. CONCLUSIONS In routine practice most patients presenting with LRTI in primary care can be identified as at intermediate or low risk of serious outcome.
Hyperbolic nodal band structures and knot invariants

We extend the list of known band structure topologies to include a large family of hyperbolic nodal links and knots, occurring both in conventional Hermitian systems where their stability relies on discrete symmetries, and in the dissipative non-Hermitian realm where the knotted nodal lines are generic and thus stable towards any small perturbation. We show that these nodal structures, taking the forms of Turk’s head knots, appear in both continuum- and lattice models with relatively short-ranged hopping that is within experimental reach. To determine the topology of the nodal structures, we devise an efficient algorithm for computing the Alexander polynomial, linking numbers and higher order Milnor invariants based on an approximate and well controlled parameterisation of the knot.
Chelate-assisted phytoextraction of lead using Fagopyrum esculentum: laboratory vs. field experiments

Abstract The development of more sustainable remediation techniques has been receiving greater attention, as an alternative to soil excavation plan in urban gardens. An in situ phytoextraction experiment with buckwheat (Fagopyrum esculentum) was performed with a 5 mmol kg−1 citric acid (CA) application. Joint experiments under laboratory conditions were conducted using various cultivars of F. esculentum in two soils with a Pb contamination of either geogenic or anthropogenic origin and various chelate concentrations. Results show that a minimum dose of 50 mmol kg−1 of CA is required to lower soil pH and raise the concentration of mobile Pb–CaCl2 for both soils. Consequently, Pb shoot uptake is increased from 6.3 to 8.9 times depending on soil type. Phytoextraction efficiency is found to be 1.3 to 2.0 times higher in the anthropogenic contaminated soil than in the soil with geogenic Pb. A scale effect has also been identified since Pb root accumulation under laboratory conditions was 2.4 times higher than in the field experiment. Despite an increase in the Pb extraction rate with CA, buckwheat appears to lack the efficiency needed to remove Pb in moderately contaminated soils. The calculated remediation period would last 166 years to remove the mobile Pb fraction.
Upper Airway Stimulation Response in Older Adults with Moderate to Severe Obstructive Sleep Apnea

Objective To evaluate the impact of age on safety, efficacy, and usage of upper airway stimulation (UAS). Study Design Multicenter observational study. Setting Thirteen US hospitals and 3 German hospitals. Subjects and Methods The ADHERE registry is a multicenter database enrolling patients undergoing UAS implantation from October 2016 to April 2018. Outcome measures included the Epworth Sleepiness Scale, apnea-hypopnea index (AHI), therapy usage, and complications. Data were segmented by age (<65 vs ≥65 years). Results Younger adults (n = 365) were a mean ± SD 52.7 ± 7.9 years old and 82% male, with a body mass index of 29.6 ± 3.8. Older adults (n = 235) were 71.1 ± 4.8 years old and 71% male, with a body mass index of 28.8 ± 3.8. Baseline AHI was similar (younger, 36.2 ± 15.9; older, 36.1 ± 14.8). Both groups had lower AHI at 12 months versus baseline (P < .001), but the older group showed a greater reduction (7.6 ± 6.9 vs 11.9 ± 13.4, P = .01). The Epworth Sleepiness Scale score decreased from 12.3 ± 5.4 to 7.1 ± 4.8 (P < .001) among younger adults and from 10.7 ± 5.7 to 6.3 ± 4.4 (P < .001) among older adults. Usage was slightly higher among older adults (6.0 ± 2.0 vs 5.4 ± 2.1 hours/night, P = .02). Surgical time was similar between younger patients (2.4 ± 0.7 hours) and older patients (2.3 ± 0.7 hours, P = .40), with comparably low complications. Conclusion AHI reduction and therapy usage were found to be somewhat higher among patients aged ≥65 years who were treated with UAS. Surgical complications were low, in contrast to traditional sleep surgery.
Structured real radius of controllability for higher order LTI systems

In this paper, we consider the problem of computing the nearest uncontrollable (C-uncontrollable) system to a given higher order system. The distance to the nearest uncontrollable system, also termed as the radius of controllability, is a good measure of gauging the numerical robustness of the given system with respect to controllability. Here, we invoke the equivalence of C-controllability of a higher order system with full rank property of a certain Toeplitz structured matrix. This enables us to pose the problem of computing the radius of controllability as equivalent to the problem of computing the nearest structured low rank approximation of this Toeplitz structured matrix. Through several numerical examples and comparison with the benchmark numerical problem, we illustrate that our approach works well.