Miracle-dz/UniFAR-FTUs huggingface dataset:
Long‐term follow‐up of otherwise healthy term infants with marked hyperbilirubinaemia: should the limits of exchange transfusion be changed in Turkey?

Aim: To evaluate prospectively non‐haemolytic term infants with marked hyperbilirubinaemia treated by phototherapy only for evidence of bilirubin toxicity at 2–6 y of age, and to determine the suitability for Turkish children of the exchange transfusion limits recently reported by the American Academy of Pediatrics. Methods: The study group included a total of 30 children, aged 2–6 y, who had developed marked hyperbilirubinaemia (20–24 mg dl−1, 342–410 μmol l−1) during the newborn period (gestational age >37wk, birthweight >2500 g) and were treated without exchange transfusion because intensive phototherapy, instituted during the preparations for exchange transfusion, was successful in decreasing their serum bilirubin levels. The control group consisted of 30 children of the same age group without clinical jaundice in the newborn period. Physical and neurological examinations, brainstem auditory‐evoked potentials (BAEPs) and developmental tests for Turkish children were performed in both the study and control children. Results: There was no difference between the groups with regard to mean BAEP latencies and developmental scores. None of the infants had hearing loss, developmental delay or abnormal neurological findings.
Design and experimental evaluation of yoked hand-clutching for a lever drive chair

Abstract Lever-drive wheelchairs lower physical strain but are less maneuverable than push-rim wheelchairs. Here, we study a possible solution in which the user simultaneously actuates clutches mounted between the levers and wheels each stroke via a clutch handle attached to one lever; this solution is of particular interest for user groups with only one functional hand. First, to demonstrate maneuverability, we show how this “yoked clutch” allows an experienced user to maneuver a constrained space. Then, we compared the difficulty of learning a yoked clutch chair to a conventional lever-drive transmission (i.e. a one-way bearing). Twenty-two unimpaired novice adults navigated a figure-eight track during six training sessions over two weeks. Participant mean speed improved roughly 60% for both chairs, with similar exponential improvement time constants (3 days) and final speeds. However, speed improvement mostly took place overnight rather than within the session for hand-clutching, and the physiological cost index was also about 40% higher. These results indicate that while hand-clutching is no more difficult to learn than a lever-drive, it is reliant on overnight improvement. Also, its increased maneuverability comes with decreased efficiency. We discuss how the yoked clutch may be particularly well suited for individuals with stroke during inpatient rehabilitation.
The effect of weight-based volume loading on the inferior vena cava in fasting subjects: a prospective randomized double-blinded trial.

OBJECTIVES Inferior vena cava ultrasound (IVC-US) assessment has been proposed as a noninvasive method of assessing volume status. Current literature is divided on its ability to do so. The primary objective was to compare IVC-US changes in healthy fasting subjects randomized to either 10 or 30 mL/kg of intravenous (IV) fluid administration versus a control group that received only 2 mL/kg. METHODS This was a prospective randomized double-blinded trial set in emergency department (ED) clinical care rooms. Volunteer subjects with no history of cardiac disease or hypertension fasted for 12 hours. Subjects were randomly assigned to receive IV 0.9% saline bolus of 2 (control group), 10, or 30 mL/kg over 30 minutes. IVC-US was performed before and 15 minutes after each fluid bolus. RESULTS Forty-two fasting subjects were enrolled. Analysis of variance (ANOVA) comparison showed that IVC-US was unable to detect any significant difference between the control group and those given either 10 or 30 mL/kg fluid, whether using maximum or minimum IVC diameter or caval index (IVC-CI). The groups receiving 10 and 30 mL/kg each had a statistically significant change in IVC-CI; however, the 30 mL/kg group had no significant change in either of the mean IVC diameters. CONCLUSIONS Overall, there were statistically significant differences in mean IVC-US measurements before and after fluid loading, but not between groups. Fasting asymptomatic subjects had a wide intersubject variation in both baseline IVC-US measurements and fluid-related changes. The degree of IVC-US change in association with graded acute volume loading was not predictably proportional between our subjects.
Changes in hepatic lobar function after right portal vein embolization. An appraisal by biliary indocyanine green excretion.

OBJECTIVE The changes in the functional capacity of the hepatic lobe after right portal vein embolization (RPE) were investigated in patients with complete obstruction of the hepatic hilus who had undergone multiple percutaneous transhepatic biliary drainage catheterizations. METHODS After injection of 0.5 mg/kg of indocyanine green (ICG), bile draining from each hepatic lobe was collected separately for 6 hours. Biliary ICG excretion in each hepatic lobe was estimated and compared with hepatic lobar volume measured by computed tomographic volumetry before and an average of 11 days after RPE. RESULTS Right portal vein embolization produced a significant increase in bile volume and biliary ICG concentration in the left lobe, resulting in a significant increase in ICG excretion in the left lobe. The percentage of ICG excretion in the left lobe to the whole-liver excretion showed a mean increase of 20.1%, which was statistically significant. In contrast, the percentage of left lobar volume to the total liver volume increased by only 8.3%. CONCLUSIONS Measurement of biliary ICG excretion is useful for estimating changes of hepatic lobar function and has revealed that within 11 days RPE enhances functional capacity in the left lobe compared with volume gain without affecting total liver function.
Insertion Mutagenesis as a Tool in the Modification of Protein Function

The TEM-1 β-lactamase enzyme efficiently hydrolyzes β-lactam antibiotics such as ampicillin but cleaves third generation cephalosporin antibiotics poorly. Variant β-lactamases that conferred elevated levels of resistance to the cephalosporin ceftazidime were identified in a set of β-lactamase derivatives previously generated by pentapeptide scanning mutagenesis in which a variable 5-amino acid cassette was introduced randomly in the target protein. This mutagenesis procedure was also modified to allow the direct selection of variant β-lactamases with pentapeptide insertions that conferred extended substrate specificities. All insertions associated with enhanced resistance to ceftazidime were targetted to the 19-amino acid Ω-loop region, which forms part of the catalytic pocket of the β-lactamase enzyme. However, pentapeptide insertions in the C- and N-terminal halves of this region had different effects on the ability of the enzyme to hydrolyze ampicillin in vivo. Larger insertions that increased the length of the Ω-loop by up to 2-fold also retained catalytic activity toward ampicillin and/or ceftazidime in vivo. In accord with previous substitution mutation studies, these results emphasize the extreme flexibility of the Ω-loop with regards the primary structure requirements for ceftazidime hydrolysis by β-lactamase. The potential of pentapeptide scanning mutagenesis in mimicking evolution events that result from the insertion and excision of transposons in nature is discussed.
Relational Mixture of Experts: Explainable Demographics Prediction with Behavioral Data

Given a collection of basic customer demographics (e.g., age and gender) andtheir behavioral data (e.g., item purchase histories), how can we predictsensitive demographics (e.g., income and occupation) that not every customermakes available? This demographics prediction problem is modeled as a classification task inwhich a customer's sensitive demographic y is predicted from his featurevector x. So far, two lines of work have tried to produce a"good" feature vector x from the customer's behavioraldata: (1) application-specific feature engineering using behavioral data and (2) representation learning (such as singular value decomposition or neuralembedding) on behavioral data. Although these approaches successfullyimprove the predictive performance, (1) designing a good feature requiresdomain experts to make a great effort and (2) features obtained fromrepresentation learning are hard to interpret. To overcome these problems, we present a Relational Infinite SupportVector Machine (R-iSVM), a mixture-of-experts model that can leveragebehavioral data. Instead of augmenting the feature vectors of customers, R-iSVM uses behavioral data to find out behaviorally similar customerclusters and constructs a local prediction model at each customer cluster. In doing so, R-iSVM successfully improves the predictive performance withoutrequiring application-specific feature designing and hard-to-interpretrepresentations. Experimental results on three real-world datasets demonstrate the predictiveperformance and interpretability of R-iSVM. Furthermore, R-iSVM can co-existwith previous demographics prediction methods to further improve theirpredictive performance.
Bacterioplankton Community Composition along a Salinity Gradient of Sixteen High-Mountain Lakes Located on the Tibetan Plateau, China

ABSTRACT The influence of altitude and salinity on bacterioplankton community composition (BCC) in 16 high-mountain lakes located at altitudes of 2,817 to 5,134 m on the Eastern Qinghai-Xizang (Tibetan) Plateau, China, spanning a salinity gradient from 0.02% (freshwater) to 22.3% (hypersaline), was investigated. Three different methods, fluorescent in situ hybridization, denaturing gradient gel electrophoresis (DGGE) with subsequent band sequencing, and reverse line blot hybridization (RLB) with probes targeting 17 freshwater bacterial groups, were used for analysis of BCC. Furthermore, the salt tolerances of 47 strains affiliated with groups detected in or isolated from the Tibetan habitats were investigated. Altitude was not found to influence BCC significantly within the investigated range. Several groups of typical freshwater bacteria, e.g., the ACK-M1 cluster and the Polynucleobacter group, were detected in habitats located above 4,400 m. Salinity was found to be the dominating environmental factor controlling BCC in the investigated lakes, resulting in only small overlaps in the BCCs of freshwater and hypersaline lakes. The relative abundances of different classes of Proteobacteria showed a sharp succession along the salinity gradient. Both DGGE and RLB demonstrated that a few freshwater bacterial groups, e.g., GKS98 and LD2, appeared over wide salinity ranges. Six freshwater isolates affiliated with the GKS98 cluster grew in ecophysiological experiments at maximum salinities of 0.3% to 0.7% (oligosaline), while this group was detected in habitats with salinities up to 6.7% (hypersaline). This observation indicated ecologically significant differences in ecophysiological adaptations among members of this narrow phylogenetic group and suggested ecological significance of microdiversity.
Acute illnesses in children. A description and analysis of parents' perception of illness threat.

OBJECTIVES To identify families in which the parents reported the child's illness as particularly stressful (high perception of illness threat), and to find out which health problems the parents perceive as particularly threatening. DESIGN The parents registered the diagnosis and perception of illness threat in relation to the child's latest illness within a four-week retrospective period. Selected psychosocial conditions of the families were recorded in the same questionnaire. SETTING 18,949 families with at least one child under the age of 8 years, resident in the County of Ringkøbing in western Denmark at 1 March 1988. SUBJECTS An age-stratified random sample of 1982 families was entered in the study. 85% of the families returned the questionnaire. RESULTS There was a considerable variation in the parents' perception of illness threat. On the basis of a score it was possible to group parents with a high, medium, and low perception of illness threat. Every fourth family reported a high perception of illness threat. A multivariate analysis, with a high perception of illness threat as dependent and selected psychosocial conditions and the diagnosis as independent variables, led to the following main results: 1) parents with a high perception of the general health threat ("worried" parents) most frequently reported a high perception of illness threat, 2) the diagnoses were decisive; in particular, inflammation in the middle ear, bronchitis, pneumonia, and accidents led to the parents' reporting a high perception of illness threat, 3) parents without experience of children and children's illnesses more frequently perceived an actual illness as a high illness threat than parents with this experience, 4) parents more frequently perceive an illness in girls as a high illness threat. CONCLUSIONS "Worried" parents, without experience of children and children's illnesses, perceive the child's latest illness as a high illness threat. These families need special care.
Membrane protein SMP-1 is required for normal flagellum function in Leishmania

Eukaryotic flagella and cilia are surrounded by a membrane that is continuous with, but distinct from, the rest of the plasma membrane. In Leishmania parasites, the inner leaflet of the flagellar membrane is coated with the acylated membrane protein, SMP-1. Here, we provide evidence that SMP-1 stabilizes the flagellar membrane and is required for flagella elongation and function. The expression and flagella targeting of SMP-1 is tightly associated with flagella elongation during amastigote to promastigote differentiation. Deletion of the genes encoding SMP-1 and the flagellar pocket protein SMP-2, led to the production of short flagella and defects in motility. Alterations in the physical properties of the smp-1/smp-2−/− flagellar membrane were suggested by: (1) the accumulation of membrane vesicles in the flagellar matrix, and (2) further retraction of flagella following partial inhibition of sterol and sphingolipid biosynthesis. The flagella phenotype of the smp-1/smp-2−/− null mutant was reversed by re-expression of SMP-1, but not SMP-2. SMP-1 contains a jelly-roll β-sheet structure that is probably conserved in all SMP proteins, and forms stable homo-oligomers in vivo. We propose that the SMP-1 coat generates and/or stabilizes sterol- and sphingolipid-rich domains in the flagellar membrane.
A prospective case control comparison of the ZeroGravity system versus a standard lead apron as radiation protection strategy in neuroendovascular procedures

Background and purpose We aimed to compare the performance of the ZeroGravity (ZG) system (radiation protection system composed by a suspended lead suit) against the use of standard protection (lead apron (LA), thyroid shield, lead eyeglasses, table skirts, and ceiling suspended shield) in neuroangiography procedures. Materials and methods Radiation exposure data were prospectively collected in consecutive neuroendovascular procedures between December 2014 and February 2015. Operator No 1 was assigned to the use of an LA (plus lead glasses, thyroid shield, and a 1 mm hanging shield at the groin) while operator No 2 utilized the ZG system. Dosimeters were used to measure peak skin dose for the head, thyroid, and left foot. Results The two operators performed a total of 122 procedures during the study period. The ZG operator was more commonly the primary operator compared with the LA operator (85% vs 71%; p=0.04). The mean anterior-posterior (AP), lateral, and cumulative dose area product (DAP) radiation exposure as well as the mean fluoroscopy time were not statistically different between the operators’ cases. The peak skin dose to the head of the operator with LA was 2.1 times higher (3380 vs 1600 μSv), while the thyroid was 13.9 (4460 vs 320 μSv), the mediastinum infinitely (520 vs 0 μSv), and the foot 3.3 times higher (4870 vs 1470 μSv) compared with the ZG operator, leading to an overall accumulated dose 4 times higher. The ratio of cumulative operator received dose/total cumulative DAP was 2.5 higher on the LA operator. Conclusions The ZG radiation protection system leads to substantially lower radiation exposure to the operator in neurointerventional procedures. However, substantial exposure may still occur at the level of the lens and thyroid to justify additional protection.
FOOTWEAR AND POSTURE: Compensatory Strategies for Heel Height

The belief that wearing high-heeled shoes increases lumbar lordosis is firmly ingrained in clinical folklore. Proponents of negative heel footwear argue that because high positive heels increase the lumbar lordosis, negative heels will decrease the lumbar lordosis. Quantitative documentation of the assumption regarding high heels is not to be found in the literature, although sporadic attempts to prove this assumption have been made throughout the 20th Century. Although other effects, such as decreased gait speed and step length, and increased knee flexion at heel strike have been found in more than one study, no increase in lumbar lordosis has been found. Where an actual decrease in lordosis has been found, authors tend to explain it away as inconsistent with what every clinician feels that he or she has observed. We felt it appropriate, then, to conduct both a static and a dynamic study to assess the effects of heel height on lumbar spine and lower limb joint kinematics in the sagittal plane, as well as other strategies to compensate for heel height. The results indicate that the greatest compensation is at the ankle and knee. Where a significant effect occurred in the lumbar spine (males, dynamic study), high heels decreased the lumbar lordosis, i.e., resulted in less swayback rather than more.
Tic Disorders

Purpose of ReviewPrimary tic disorders are complex, multifactorial disorders in which tics are accompanied by other sensory features and an array of comorbid behavioral disorders. Secondary tics are proportionally much less frequent, but their etiology is diverse. This review aims to guide clinicians in the recognition of the phenomenology, pathophysiology, and treatment of these disorders. Recent FindingsAdvances include greater phenomenologic insights, particularly of nonmotor (sensory) features; increased knowledge of disease mechanisms, particularly coming from neuropsychological, functional imaging, pathologic, and animal model studies; growing evidence on the efficacy of alpha-2 agonists and the newer generation of dopamine-modulating agents; and recent strides in the evaluation of cognitive-behavioral therapy and deep brain stimulation surgery. SummaryThe correct diagnostic approach to tic disorders requires accurate historical gathering, a thorough neurologic examination, and detailed definition of the patient’s psychopathologic profile. Treatment should always begin with individualized psychoeducational strategies. Although pharmacologic treatments remain beneficial for most patients, cognitive-behavioral treatments have thus far shown promising efficacy. Deep brain stimulation surgery should still be limited to adult patients refractory to pharmacotherapy and cognitive-behavioral therapy.
Mitochondria DNA replication and DNA methylation in the metabolic memory associated with continued progression of diabetic retinopathy.

PURPOSE Diabetic retinopathy fails to halt after cessation of hyperglycemic insult, and a vicious cycle of mitochondria damage continues. The aim of our study was to investigate the effect of termination of hyperglycemia on retinal mtDNA replication, and elucidate the mechanism responsible for the continued mtDNA damage. METHODS Polymerase gamma 1 (POLG1), the catalytic subunit of the mitochondrial DNA replication enzyme, and the damage to the displacement loop region of mtDNA (D-loop) were analyzed in the retina from streptozotocin-diabetic rats maintained in poor glycemic control (PC, glycated hemoglobin ∼11%) or in good glycemic control (GC, glycated hemoglobin ∼6%) for 6 months, or in PC for three months followed by GC for three months (Rev). To understand the mechanism DNA methylation status of POLG1 promoter was investigated by methylation-specific PCR. The key parameters were confirmed in the isolated retinal endothelial cells exposed to high glucose, followed by normal glucose. RESULTS POLG1 continued to be down-regulated, the D-loop region damaged, and the CpG islands at the regulatory region of POLG hyper-methylated even after three months of GC that had followed three months of PC (Rev group). Similar results were observed in the retinal endothelial cells exposed to normal glucose after being exposed to high glucose. CONCLUSIONS Continued hypermethylation of the CpG sites at the regulatory region of POLG affects its binding to the mtDNA, compromising the transcriptional activity. Modulation of DNA methylation using pharmaceutic or molecular means could help maintain mitochondria homeostasis, and prevent further progression of diabetic retinopathy.
Identification of an elaborate complex mediating postsynaptic inhibition

Inhibitory synapses dampen neuronal activity through postsynaptic hyperpolarization. The composition of the inhibitory postsynapse and the mechanistic basis of its regulation, however, remain poorly understood. We used an in vivo chemico-genetic proximity-labeling approach to discover inhibitory postsynaptic proteins. Quantitative mass spectrometry not only recapitulated known inhibitory postsynaptic proteins but also revealed a large network of new proteins, many of which are either implicated in neurodevelopmental disorders or are of unknown function. Clustered regularly interspaced short palindromic repeats (CRISPR) depletion of one of these previously uncharacterized proteins, InSyn1, led to decreased postsynaptic inhibitory sites, reduced the frequency of miniature inhibitory currents, and increased excitability in the hippocampus. Our findings uncover a rich and functionally diverse assemblage of previously unknown proteins that regulate postsynaptic inhibition and might contribute to developmental brain disorders.
Tax Incentives and the Price of Conservation

We study the role of tax incentives in promoting a fast-growing and novel type of conservation: voluntary, permanent restrictions on private land use through conservation easements. In the United States, easements represent the largest charitable gift on a per-donation basis, but skeptics wonder if their tax preference merely subsidizes wealthy landowners rather than inducing conservation. We incorporate federal and state income tax codes into a calculator to quantify the after-tax donation price and demonstrate its sensitivity to landowner income and state and federal policies. Using a 1987–2012 panel, we measure the response of state-level easements to the price. Our large elasticity estimates, spanning −2.4 to −6.1, indicate that tax incentives induce conservation and do not merely subsidize it. We find no evidence that generous tax benefits have caused less strategic patterns of land conservation.