Miracle-dz/UniFAR-FTUs huggingface dataset:
GENERAL ORAL GLUCOSE TOLERANCE TEST DURING PREGNANCY, AN OPPORTUNITY FOR IMPROVED PREGNANCY OUTCOME AND IMPROVED FUTURE HEALTH.

Gestational diabetes mellitus (GDM) is associated with a risk of adverse pregnancy outcome and is a predictor of subsequent diabetes. The aims of this work were to describe a reliable routine to diagnose abnormal glucose tolerance during pregnancy, to investigate women’s opinions of the specialist care provided, to determine the prevalence of diabetes one year after giving birth, and to elucidate the effect of abnormal glucose tolerance on pregnancy outcome and on the women’s future health. Routines for a general decentralised oral glucose tolerance test (OGTT) at antenatal clinics, with high quality and high compliance of the patients are described. Perinatal outcome was determined and compared for the years 1995-1999 and 2000-2003, and in two geographical areas with different screening routines (OGTT and random glucose measurements, RGM). The routine use of OGTTs identified twice as many cases of GDM as RGM. Those not identified with RGM were as affected. The women’s opinions of the extended care programme were analysed using a questionnaire. The results showed great satisfaction with the care provided, especially the sound knowledge of the staff. However, a desire for better preparation before the OGTT, better information flow and more information on normal pregnancy was expressed. Women delivered in 2003-2005 who had undergone an OGTT during pregnancy participated in a follow-up study 1-2 years after delivery. Different cut-off limits were used for 2-h capillary plasma glucose concentrations at OGTT during pregnancy. GDM >10.0 mmol/L, gestational impaired glucose tolerance (GIGT) 8.6-9.9 mmol/L, and a control group <8.6 mmol/L. At follow-up, 11% (n=160) of the GDM group, 4% (n=309) of the GIGT group and none of the controls had diabetes. When diagnosed with GIGT a retest was offered. Two-thirds of the women with diabetes after GIGT were found in the group diagnosed as having GDM after retest during pregnancy. Adverse pregnancy outcome was observed in both the GDM and GIGT groups compared with the controls. Women with previous GDM were more than 3 times as likely as a group to consume health care resources in a year after delivery (odds ratio 3.5, 95% CI 2.5-5.0), leading to an average 50% higher cost (p<0.001). Annual excess cost was apparent up to 7 years after childbirth (p<0.01). A general routine OGTT during pregnancy identifies women with GDM, providing the opportunity to improve the pregnancy outcome and to make lifestyle changes that can improve the future health of both mother and child.
Parcours ethnographiques dans l’histoire des deltas

I. Introduction Il sera question dans cet article tout d’abord de l’histoire des Karakalpaks. En nous servant tantot des sources ecrites tantot des traditions orales nous essaierons de retracer leur histoire depuis le debut du XVIe siecle. Deux questions retiendront notre attention plus particulierement : l’economie traditionnelle des Karakalpaks et leur dependance des rivages ; puis leur insertion dans le milieu multiethnique du delta de l’Amou Darya. Nous aborderons les Karakalpaks d’aujour.
A Review of Web Portal Use by Oncology Patients

Background: Patient portals and other Internet-based technologies have been increasingly used to improve cancer care coordination. Patient portals may introduce special considerations in oncology populations where longitudinal outpatient care is often more intensive than in most other specialties. Methods: This article, which is based upon bibliographic searches in PubMed, reviews the literature on web portal use by cancer patients. Articles published in English from 2000 to August 2018 were identified using the following MeSH search terms and Boolean algebra commands: web portal AND cancer. Information obtained from bibliographic searches (title and topic of article, information in abstract, and keywords) was used to determine whether to retain each article identified in this way. Results: A total of 263 article citations were identified in the bibliographic searches. Of these, 10 met the eligibility criteria. A variety of study designs were used including focus groups, usability testing, in-person interviews, questionnaire surveys, retrospective cohort, and non-randomized trial. Cancer patients had reached modest levels of portal use. Increased portal use has been associated with younger age, white race, and higher socioeconomic status. Most cancer patients used portals to look up testing results and provide notes, but had difficulty in interpreting the results appropriately. Conclusions: Our study adds to the growing evidence that patient portals play a significant role in promoting self-management in cancer survivors. Additional studies are needed to determine factors influencing portal use, so effective interventions can be developed to enhance portal use.
"La educación tradicional de la comunidad cabécar de Chirripó: algunas consideraciones"

Este articulo es producto de la investigacion “Una mirada a la educacion de la comunidad cabecar de Chirripo, desde la perspectiva de diferentes actores sociales” que se desarrolla en el Instituto de Investigacion en Educacion (INIE) de la Universidad de Costa Rica. El proposito de este trabajo es la construccion de una aproximacion a la concepcion de la educacion tradicional de la etnia cabecar, para lo cual participaron personas que estan implicadas en los procesos educativos tradicionales y formales de estas comunidades. El estudio implica la caracterizacion de la comunidad cabecar de Chirripo para estudiar el concepto de educacion y la identificacion de instancias sociales participantes en los procesos educativos para proponer para proponer insumos que aporten a la discusion de la pertinencia cultural en las instituciones educativas cabecares. Se determino que la educacion tradicional en las comunidades indigenas cabecares debe fortalecerse desde diferentes instancias como la familia, la comunidad y la escuela pues constituye la posibilidad de que esta etnia siga conservando su acervo cultural y de que las nuevas generaciones lo asuman con orgullo y se comprometan a preservarlo.
Efficient Nonviral Transfection of Human Bone Marrow Mesenchymal Stromal Cells Shown Using Placental Growth Factor Overexpression

Background Human mesenchymal stromal/stem cells (hMSCs) hold great therapeutic potential due to their immunomodulatory and tissue regenerative properties. Enhancement of biological features of hMSCs by transfection has become a focus of investigation for cell- and gene-based therapies. However, many of the current transient transfection methods result in either low transfection efficiency or high cytotoxicity. Methods In order to find a transfection method that would address the current issues of low transfection efficiency and high cytotoxicity, 6 commercially available cationic lipid and polymer reagents were tested on human bone marrow-derived MSCs (hBM-MSCs) using GFP as a reporter gene. One transfection method using TransIT-2020 was selected and tested with an emphasis on cell quality (viability, identity, and yield), as well as efficacy with a human placental growth factor (PlGF) plasmid. Results TransIT-2020 yielded the highest fluorescence signal per cell out of the methods that did not decrease cell recovery. Transfecting GFP to 5 hBM-MSC donors using TransIT-2020 yielded 24–36% GFP-expressing cells with a viability of 85–96%. hBM-MSC identity was unaffected as CD90, CD105, and CD73 markers were retained (>95%+) after transfection. When this method was applied to PlGF expression, there was up to a 220-fold increase in secretion. Both growth and secretion of PlGF in overexpressing hBM-MSC were sustained over 7 days, confirming the sustainability and applicability of the TransIT-2020 transfection system. Discussion We report a simple and efficient method for transient transfection that has not been reported for hBM-MSCs, encompassing high levels of plasmid expression without significant changes to fundamental hBM-MSC characteristics.
Quiescent Human Mesenchymal Stem Cells Are More Resistant to Heat Stress than Cycling Cells

Quiescence is the prevailing state of many cell types under homeostatic conditions. Yet, surprisingly, little is known about how quiescent cells respond to environmental challenges. The aim of the present study is to compare stress responses of cycling and quiescent mesenchymal stem cells (MSC). Human endometrial mesenchymal cells (eMSС) were employed as adult stem cells. eMSC quiescence was modeled by serum starvation. Sublethal heat shock (HS) was used as a stress factor. Both quiescent and cycling cells were heated at 45°C for 30 min and then returned to standard culture conditions for their recovery. HS response was monitored by DNA damage response, stress-induced premature senescence (SIPS), cell proliferation activity, and oxidative metabolism. It has been found that quiescent cells repair DNA more rapidly, resume proliferation, and undergo SIPS less than proliferating cells. HS-enforced ROS production in heated cycling cells was accompanied with increased expression of genes regulating redox-active proteins. Quiescent cells exposed to HS did not intensify the ROS production, and genes involved in antioxidant defense were mostly silent. Altogether, the results have shown that quiescent cells are more resistant to heat stress than cycling cells. Next-generation sequencing (NGS) demonstrates that HS-survived cells retain differentiation capacity and do not exhibit signs of spontaneous transformation.
Adapting a Behavioral Weight Loss Intervention for Delivery via Facebook: A Pilot Series Among Low-Income Postpartum Women

Background Efforts to translate evidence-based weight loss interventions, such as the Diabetes Prevention Program (DPP), to low-income postpartum women have resulted in poor intervention attendance and high attrition. Strategies that improve engagement and retention in this population are needed to maximize the reach of evidence-based weight loss interventions. Objective The objective of this study was to adapt a DPP-based weight loss intervention (Fresh Start) for Facebook delivery and to evaluate its feasibility among low-income postpartum women. Methods This study comprised 3 single-group pilot studies where feasibility outcomes iteratively informed changes from one pilot to the next. We paralleled the in-person program for Facebook delivery by translating the protocol to a content library of Facebook posts with additional posts from lifestyle coaches. Low-income postpartum women were recruited from Women, Infants, and Children (WIC) clinics in Worcester, Massachusetts. Participants were enrolled into a 16-week weight loss intervention delivered via Facebook. During the first 8 weeks, Facebook intervention posts were delivered 2 times per day, with additional posts from coaches aiming to stimulate interaction among participants or respond to participants’ questions and challenges. For the following 8 weeks, posts were delivered once per day without additional coaching. Feasibility outcomes were engagement (defined by number of likes, comments, and posts measured throughout intervention delivery), acceptability, and retention (survey at follow-up and assessment completion rate, respectively). Changes in weight were also assessed at baseline and follow-up. Results Pilot 1 had a retention rate of 89% (24/27), and on average, 62% (17/27) of women actively engaged with the group each week during the 8-week coached phase. Mean weight loss was 2.6 (SD 8.64) pounds, and 79% (19/27) would recommend the program to a friend. Pilot 2 had a retention rate of 83% (20/24), and on average, 55% (13/24) of women actively engaged with the group weekly during the 8-week coached phase. Mean weight loss was 2.5 (SD 9.23) pounds, and 80% (16/24) would recommend the program to a friend. Pilot 3 had a retention rate of 88% (14/16), and on average, 67% (11/16) of women actively engaged with the group weekly during the 8-week coached phase. Mean weight loss was 7.0 (SD 11.6) pounds, and 100% (16/16) would recommend the program to a friend. Conclusions Our findings demonstrated that a Facebook-delivered intervention was acceptable and could be feasibly delivered to low-income postpartum women. Future research is needed to evaluate the efficacy of a Facebook-delivered weight loss intervention.
Acceptance of Mobile Health Apps for Disease Management Among People With Multiple Sclerosis: Web-Based Survey Study

Background Mobile health (mHealth) apps might have the potential to promote self-management of people with multiple sclerosis (MS) in everyday life. However, the uptake of MS apps remains poor, and little is known about the facilitators and barriers for their efficient utilization, such as technology acceptance. Objective The aim of this study was to examine the acceptance of mHealth apps for disease management in the sense of behavioral intentions to use and explore determinants of utilization among people with MS based on the Unified Theory of Acceptance and Use of Technology (UTAUT). Methods Participants for this Web-based cross-sectional study were recruited throughout Germany with the support of regional MS associations and self-help groups. To identify determinants of intention to use MS apps, a measure based on the UTAUT was adapted with 4 key determinants (performance expectancy, effort expectancy, social influence, and facilitating conditions) and extended by Intolerance of Uncertainty (IU) and electronic health literacy. Potential influencing effects of both MS and computer self-efficacy (C-SE) as mediators and fatigue as a moderator were analyzed using Hayes’s PROCESS macro (SPSS version 3.0) for IBM SPSS version 24.0. Results A total of 98 participants (mean age 47.03 years, SD 10.17; 66/98, 67% female) with moderate fatigue levels completed the survey. Although most participants (91/98, 92%) were daily smartphone users, almost two-thirds (62/98, 63%) reported no experience with MS apps. Overall, the acceptance was moderate on average (mean 3.11, SD 1.31, minimum=1 and maximum=5), with lower scores among persons with no experience (P=.04) and higher scores among current users (P<.001). In multiple regression analysis (R2=63% variance explained), performance expectancy (beta=.41) and social influence (beta=.33) were identified as significant predictors of acceptance (all P<.001). C-SE was confirmed as a partial mediator in the relationship between IU and acceptance (indirect effect: B=−.095, 95% CI −0.227 to −0.01). Furthermore, a moderated mediation by C-SE was shown in the relationship between IU and behavioral intentions to use MS apps for low (95% CI −0.42 to −0.01) and moderate levels (95% CI −0.27 to −0.01) of fatigue. Conclusions Overall, this exploratory pilot study indicates for the first time that positive expectations about the helpfulness for self-management purposes and social support might be important factors to be considered for improving the acceptance of MS apps among smartphone users with MS. However, given some inconsistent findings, especially regarding the role of effort expectancy and IU and self-efficacy, the conceptual model needs replication with a larger sample of people with MS, varying more in fatigue levels, and a longitudinal assessment of the actual usage of MS apps predicted by acceptance in the sense of behavioral intentions to use.
Neuronavigated Versus Non-navigated Repetitive Transcranial Magnetic Stimulation for Chronic Tinnitus: A Randomized Study

Repetitive transcranial magnetic stimulation (rTMS) has shown variable effect on tinnitus. A prospective, randomized 6-month follow-up study on parallel groups was conducted to compare the effects of neuronavigated rTMS to non-navigated rTMS in chronic tinnitus. Forty patients (20 men, 20 women), mean age of 52.9 years (standard deviation [SD] = 11.7), with a mean tinnitus duration of 5.8 years (SD = 3.2) and a mean tinnitus intensity of 62.2/100 (SD = 12.8) on Visual Analog Scale (VAS 0–100) participated. Patients received 10 sessions of 1-Hz rTMS to the left temporal area overlying auditory cortex with or without neuronavigation. The main outcome measures were VAS scores for tinnitus intensity, annoyance, and distress, and Tinnitus Handicap Inventory (THI) immediately and at 1, 3, and 6 months after treatment. The mean tinnitus intensity (hierarchical linear mixed model: F3 = 7.34, p = .0006), annoyance (F3 = 4.45, p = .0093), distress (F3 = 5.04, p = .0051), and THI scores (F4 = 17.30, p < .0001) decreased in both groups with non-significant differences between the groups, except for tinnitus intensity (F3 = 2.96, p = .0451) favoring the non-navigated rTMS. Reduction in THI scores persisted for up to 6 months in both groups. Cohen’s d for tinnitus intensity ranged between 0.33 and 0.47 in navigated rTMS and between 0.55 and 1.07 in non-navigated rTMS. The responder rates for VAS or THI ranged between 35% and 85% with no differences between groups (p = .054–1.0). In conclusion, rTMS was effective for chronic tinnitus, but the method of coil localization was not a critical factor for the treatment outcome.
Multidrug-Resistant Bacteria Associated with Cell Phones of Healthcare Professionals in Selected Hospitals in Saudi Arabia

Cell phones may be an ideal habitat for colonization by bacterial pathogens, especially in hot climates, and may be a reservoir or vehicle in transmitting nosocomial infections. We investigated bacterial contamination on cell phones of healthcare workers in three hospitals in Saudi Arabia and determined antibacterial resistance of selected bacteria. A questionnaire was submitted to 285 healthcare workers in three hospitals, and information was collected on cell phone usage at the work area and in the toilet, cell phone cleaning and sharing, and awareness of cell phones being a source of infection. Screening on the Vitek 2 Compact system (bioMérieux Inc., USA) was done to characterize bacterial isolates. Of the 60 samples collected from three hospitals, 38 (63.3%) were positive with 38 bacterial isolates (4 Gram-negative and 34 Gram-positive bacteria). We found 38.3% of cell phones were contaminated with coagulase-negative staphylococci, particularly Staphylococcus epidermidis (10 isolates). Other bacterial agents identified were S. aureus, S. hominis, Alloiococcus otitis, Vibrio fluvialis, and Pseudomonas stutzeri. Antimicrobial susceptibility testing showed that most coagulase-negative staphylococci were resistant to benzylpenicillin, erythromycin, and rifampicin. Eight isolates were resistant to oxacillin, specifically S. epidermidis (3), S. hominis (2), and S. warneri (2). A. otitis, a cause of acute otitis media showed multidrug resistance. One isolate, a confirmed hetero-vancomycin intermediate-resistant S. aureus, was resistant to antibiotics, commonly used to treat skin infection. There was a significant correlation between the level of contamination and usage of cell phone at toilet and sharing. Our findings emphasize the importance of hygiene practices in cell phone usage among healthcare workers in preventing the transmission of multidrug-resistant microbes.
California's Drought of the Future: A Midcentury Recreation of the Exceptional Conditions of 2012–2017

The California drought of 2012–2016 was a record‐breaking event with extensive social, political, and economic repercussions. The impacts were widespread and exposed the difficulty in preparing for the effects of prolonged dry conditions. Although the lessons from this drought drove important changes to state law and policy, there is little doubt that climate change will only exacerbate future droughts. To understand the character of future drought, this paper examines this recent drought period retrospectively and prospectively, that is, as it occurred historically and if similar dynamical conditions to the historical period were to arise 30 years later (2042–2046) subject to the effects of climate change. Simulations were conducted using the Weather Research and Forecasting model using the pseudo global warming method. The simulated historical and future droughts are contrasted in terms of temperature, precipitation, snowpack, soil moisture, evapotranspiration, and forest health. Overall, the midcentury drought is observed to be significantly worse, with many more extreme heat days, record‐low snowpack, increased soil drying, and record‐high forest mortality. With these findings in mind, the data sets developed in this study provide a means to structure future drought planning around a drought scenario that is realistic and modeled after a memorable historical analog.
Understanding Rapid Adjustments to Diverse Forcing Agents

Rapid adjustments are responses to forcing agents that cause a perturbation to the top of atmosphere energy budget but are uncoupled to changes in surface warming. Different mechanisms are responsible for these adjustments for a variety of climate drivers. These remain to be quantified in detail. It is shown that rapid adjustments reduce the effective radiative forcing (ERF) of black carbon by half of the instantaneous forcing, but for CO2 forcing, rapid adjustments increase ERF. Competing tropospheric adjustments for CO2 forcing are individually significant but sum to zero, such that the ERF equals the stratospherically adjusted radiative forcing, but this is not true for other forcing agents. Additional experiments of increase in the solar constant and increase in CH4 are used to show that a key factor of the rapid adjustment for an individual climate driver is changes in temperature in the upper troposphere and lower stratosphere.
Unsupervised algorithms for intrusion detection and identification in wireless ad hoc sensor networks

In previous work by the author, parameters across network protocol layers were selected as features in supervised algorithms that detect and identify certain intrusion attacks on wireless ad hoc sensor networks (WSNs) carrying multisensor data. The algorithms improved the residual performance of the intrusion prevention measures provided by any dynamic key-management schemes and trust models implemented among network nodes. The approach of this paper does not train algorithms on the signature of known attack traffic, but, instead, the approach is based on unsupervised anomaly detection techniques that learn the signature of normal network traffic. Unsupervised learning does not require the data to be labeled or to be purely of one type, i.e., normal or attack traffic. The approach can be augmented to add any security attributes and quantified trust levels, established during data exchanges among nodes, to the set of cross-layer features from the WSN protocols. A two-stage framework is introduced for the security algorithms to overcome the problems of input size and resource constraints. The first stage is an unsupervised clustering algorithm which reduces the payload of network data packets to a tractable size. The second stage is a traditional anomaly detection algorithm based on a variation of support vector machines (SVMs), whose efficiency is improved by the availability of data in the packet payload. In the first stage, selected algorithms are adapted to WSN platforms to meet system requirements for simple parallel distributed computation, distributed storage and data robustness. A set of mobile software agents, acting like an ant colony in securing the WSN, are distributed at the nodes to implement the algorithms. The agents move among the layers involved in the network response to the intrusions at each active node and trustworthy neighborhood, collecting parametric values and executing assigned decision tasks. This minimizes the need to move large amounts of audit-log data through resource-limited nodes and locates routines closer to that data. Performance of the unsupervised algorithms is evaluated against the network intrusions of black hole, flooding, Sybil and other denial-of-service attacks in simulations of published scenarios. Results for scenarios with intentionally malfunctioning sensors show the robustness of the two-stage approach to intrusion anomalies.