Miracle-dz/UniFAR-FTUs huggingface dataset:
Determinants of Decision to Delivery Interval (DDI) in Emergency Caesarean Sections in Ladoke Akintola University of Technology Teaching Hospital Ogbomoso, Nigeria

Background: Emergency caesarean sections are invaluable when vaginal delivery is either impossible or possess risk to the life of mother and or the foetus. Patients however still encounter delays after the decision has been made, despite recommended time frame. Objective: This is to identify the common indications for emergency caesarean section, factors responsible for delays after decision has been made and the short-term effect on the mother and neonate. Materials and methods: This was a retrospective study in which case records of patients who had emergency caesarean section were retrieved. Information about sociodemographic characteristics, booking status, parity, indication for surgery, decision time, incision time and short term feto-maternal outcomes were collected with the aid of structured proforma. Data was analyzed with Stata: Release 13 statistical software. Results: The mean age of participants was 28.9 ± 5.1 years, 51.3% were booked, primary caesarean section rate was 84.0%. The commonest indication was cephalo-pelvic disproportion (40.5%). The mean DDI was 145.3 ± 69.2 min. Patients’ factor was the leading cause of delay due to lack of funds and non-provision of surgical materials (53.5%). Leading hospital factors were non-availability of blood and blood products (32.8%) and power outage (28.0%). Five min APGAR score was normal in 92.3% of the neonates and 0.5% had severe asphyxia. Conclusion: This study shows that there are still avoidable delays in emergency caesarean section. Although there were no immediate neonatal complications, improving health care delivery so as to eliminate the identified causes would go a long way in reducing these delays.
Baseline factors associated with response to ruxolitinib: an independent study on 408 patients with myelofibrosis

In patients with Myelofibrosis (MF) treated with ruxolitinib (RUX), the response is unpredictable at therapy start. We retrospectively evaluated the impact of clinical/laboratory factors on responses in 408 patients treated with RUX according to prescribing obligations in 18 Italian Hematology Centers. At 6 months, 114 out of 327 (34.9%) evaluable patients achieved a spleen response. By multivariable Cox proportional hazard regression model, pre-treatment factors negatively correlating with spleen response were: high/intermediate-2 IPSS risk (p=0.024), large splenomegaly (p=0.017), transfusion dependency (p=0.022), platelet count <200×109/l (p=0.028), and a time-interval between MF diagnosis and RUX start >2 years (p=0.048). Also, patients treated with higher (≥10 mg BID) average RUX doses in the first 12 weeks achieved higher response rates (p=0.019). After adjustment for IPSS risk, patients in spleen response at 6 months showed only a trend for better survival compared to non-responders. At 6 months, symptoms response was achieved by 85.5% of 344 evaluable patients; only a higher (>20) Total Symptom Score significantly correlated with lower probability of response (p<0.001). Increased disease severity, a delay in RUX start and titrated doses <10 mg BID were associated with patients achievinglower response rates. An early treatment and higher RUX doses may achieve better therapeutic results.
Tearing of Stagnant Slab

Tearing the Plate Recent seismic data show a widely variable geometry of subduction: Some plates penetrate deep into the mantle; others bend and become horizontal at 670 kilometers near a prominent phase boundary. Obayashi et al. (p. 1173; see the Perspective by Nolet) provide a detailed view of a situation where subduction of juxtaposed plates in the western Pacific, in somewhat different directions, seems to have ripped a gash in the plates starting at a depth of about 300 kilometers. The geometry of the gash provides information on the past evolution of this plate boundary. A tear in the plate in the mantle provides information on the subduction history of the western Pacific. Subducted slabs of oceanic lithosphere below the western Pacific tend to be stagnant in the transition zone with poorly known mechanical properties. Typical examples are the Izu-Bonin and Japan slabs that meet each other to form a cusplike junction beneath southwest Japan. Here, we show that these two slabs are torn apart at their junction when they bend to flatten over the 660-kilometer discontinuity, as is expected from a simple geometric argument. We present three lines of evidence for this ongoing slab tear.
Negative Impact of Noise and Noise Sensitivity on Mental Health in Childhood

Introduction: Noise and noise sensitivity have negative effects on mental health and are not well-studied in children and adolescents. In this study, we investigated these effects in the aforementioned population with respect to sociodemographic variables and environmental factors. Materials and Methods: In this population-based study conducted in two large cities in South Korea, 918 elementary and middle-school students were included. After direct measurements at the selected sites, a noise map was created using an interpolation method. The road traffic noise of the participants’ residential areas was calculated based on this noise map. Noise sensitivity was assessed on an 11-point Likert scale. Using multivariate logistic regression, we investigated the relationship among noise, noise sensitivity, and the Child Behavior Checklist. Further analyses were performed subdividing the data according to household income levels. Results: Noise sensitivity was significantly associated with internalizing, externalizing, and total behavioral problems. Noise was positively associated with total behavioral problems. In the low-income group, the degree of association with problem behaviors was higher, whereas the relationship between noise sensitivity and externalization problems disappeared in the high-income group. Conclusion: Noise and noise sensitivity are negatively associated with the mental health of children and adolescents, particularly in low-income groups. The findings of this study suggest that noise sensitivity and socioeconomic status should be considered in coping with negative effects of noise in children and adolescents.
Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand

Background Countries are increasingly considering how to reduce or even end tobacco consumption, and raising tobacco taxes is a potential strategy to achieve these goals. We estimated the impacts on health, health inequalities, and health system costs of ongoing tobacco tax increases (10% annually from 2011 to 2031, compared to no tax increases from 2011 [“business as usual,” BAU]), in a country (New Zealand) with large ethnic inequalities in smoking-related and noncommunicable disease (NCD) burden. Methods and Findings We modeled 16 tobacco-related diseases in parallel, using rich national data by sex, age, and ethnicity, to estimate undiscounted quality-adjusted life-years (QALYs) gained and net health system costs over the remaining life of the 2011 population (n = 4.4 million). A total of 260,000 (95% uncertainty interval [UI]: 155,000–419,000) QALYs were gained among the 2011 cohort exposed to annual tobacco tax increases, compared to BAU, and cost savings were US$2,550 million (95% UI: US$1,480 to US$4,000). QALY gains and cost savings took 50 y to peak, owing to such factors as the price sensitivity of youth and young adult smokers. The QALY gains per capita were 3.7 times greater for Māori (indigenous population) compared to non-Māori because of higher background smoking prevalence and price sensitivity in Māori. Health inequalities measured by differences in 45+ y-old standardized mortality rates between Māori and non-Māori were projected to be 2.31% (95% UI: 1.49% to 3.41%) less in 2041 with ongoing tax rises, compared to BAU. Percentage reductions in inequalities in 2041 were maximal for 45–64-y-old women (3.01%). As with all such modeling, there were limitations pertaining to the model structure and input parameters. Conclusions Ongoing tobacco tax increases deliver sizeable health gains and health sector cost savings and are likely to reduce health inequalities. However, if policy makers are to achieve more rapid reductions in the NCD burden and health inequalities, they will also need to complement tobacco tax increases with additional tobacco control interventions focused on cessation.
Infectious and Non-Infectious Pulmonary Complications in Primary Immunodeficiencies.

Primary immunodeficiency disorders (PIDs) have been described as diseases caused by one or more defects of the immune system. These patients are more likely to experience recurrent and/or severe infections and have a tendency to develop a wide range of complications. Respiratory diseases are the main and initial manifestation for the majority of PID patients and most common complication in this group of patients. Pulmonary complications present a significant cause of morbidity and also mortality among patients suffering from different forms of PIDs. Early diagnosis and appropriate treatment can prevent or at least slow down the development of respiratory complications of PIDs. Since the spectrum of pulmonary complications in PIDs is broad, we divided pulmonary complications into upper respiratory (e.g., sinusitis, otitis media and laryngeal angioedema) and lower respiratory (e.g., pneumonia, bronchitis, bronchiectasis, interstitial lung diseases, organizing pneumonia, pulmonary adenopathies and malignancies, hyperreactive airway diseases, pulmonary dysgenesis and treatment side effects) complications. This review covers the most important respiratory manifestations observed in patients with PIDs.
Modulation of Type III Secretion System in Pseudomonas aeruginosa: Involvement of the PA4857 Gene Product

Pseudomonas aeruginosa is an opportunistic pathogen that causes serious acute or chronic infections in humans. Acute infections typically involve the type III secretion systems (T3SSs) and bacterial motility, whereas chronic infections are often associated with biofilm formation and the type VI secretion system. To identify new genes required for pathogenesis, a transposon mutagenesis library was constructed and the gene PA4857, named tspR, was found to modulate T3SS gene expression. Deletion of P. aeruginosa tspR reduced the virulence in a mouse acute lung infection model and diminished cytotoxicity. Suppression of T3SS gene expression in the tspR mutant resulted from compromised translation of the T3SS master regulator ExsA. TspR negatively regulated two small RNAs, RsmY and RsmZ, which control RsmA. Our data demonstrated that defects in T3SS expression and biofilm formation in retS mutant could be partially restored by overexpression of tspR. Taken together, our results demonstrated that the newly identified retS-tspR pathway is coordinated with the retS-gacS system, which regulates the genes associated with acute and chronic infections and controls the lifestyle choice of P. aeruginosa.
Unsupervised Degradation Learning for Single Image Super-Resolution

Deep Convolution Neural Networks (CNN) have achieved significant performance on single image super-resolution (SR) recently. However, existing CNN-based methods use artificially synthetic low-resolution (LR) and high-resolution (HR) image pairs to train networks, which cannot handle real-world cases since the degradation from HR to LR is much more complex than manually designed. To solve this problem, we propose a real-world LR images guided bi-cycle network for single image super-resolution, in which the bidirectional structural consistency is exploited to train both the degradation and SR reconstruction networks in an unsupervised way. Specifically, we propose a degradation network to model the real-world degradation process from HR to LR via generative adversarial networks, and these generated realistic LR images paired with real-world HR images are exploited for training the SR reconstruction network, forming the first cycle. Then in the second reverse cycle, consistency of real-world LR images are exploited to further stabilize the training of SR reconstruction and degradation networks. Extensive experiments on both synthetic and real-world images demonstrate that the proposed algorithm performs favorably against state-of-the-art single image SR methods.
Structural basis of Toxoplasma gondii perforin-like protein 1 membrane interaction and activity during egress

Intracellular pathogens must egress from the host cell to continue their infectious cycle. Apicomplexans are a phylum of intracellular protozoans that have evolved members of the membrane attack complex and perforin (MACPF) family of pore forming proteins to disrupt cellular membranes for traversing cells during tissue migration or egress from a replicative vacuole following intracellular reproduction. Previous work showed that the apicomplexan Toxoplasma gondii secretes a perforin-like protein (TgPLP1) that contains a C-terminal Domain (CTD) which is necessary for efficient parasite egress. However, the structural basis for CTD membrane binding and egress competency remained unknown. Here, we present evidence that TgPLP1 CTD prefers binding lipids that are abundant in the inner leaflet of the lipid bilayer. Additionally, solving the high-resolution crystal structure of the TgPLP1 APCβ domain within the CTD reveals an unusual double-layered β-prism fold that resembles only one other protein of known structure. Three direct repeat sequences comprise subdomains, with each constituting a wall of the β-prism fold. One subdomain features a protruding hydrophobic loop with an exposed tryptophan at its tip. Spectrophotometric measurements of intrinsic tryptophan fluorescence are consistent with insertion of the hydrophobic loop into a target membrane. Using CRISPR/Cas9 gene editing we show that parasite strains bearing mutations in the hydrophobic loop, including alanine substitution of the tip tryptophan, are equally deficient in egress as a strain lacking TgPLP1 altogether. Taken together our findings suggest a crucial role for the hydrophobic loop in anchoring TgPLP1 to the membrane to support its cytolytic activity and egress function. Author Summary Toxoplasma gondii has a complex life cycle that involves active invasion of the host cell, the formation of a replicative compartment, and egress from the replicative niche. T. gondii encodes a pore-forming protein, TgPLP1, that contains a C-terminal domain that is crucial for efficient exit from both the parasite containing vacuole and the host cell. However, the mechanism by which TgPLP1 recognizes and binds to the appropriate membrane is unclear. Here we use a combination of biochemistry, structural biology, and parasitology to identify the a preference of TgPLP1 for specific lipids and show that a loop within the structure of the C-terminal domain inserts into the membrane and is necessary for egress from the parasite containing vacuole. Our study sheds light into the determinants of membrane binding in TgPLP1 which may inform the overall mechanism of pore formation in similar systems
Aiding the diagnosis of dissociative identity disorder: pattern recognition study of brain biomarkers

Background A diagnosis of dissociative identity disorder (DID) is controversial and prone to under- and misdiagnosis. From the moment of seeking treatment for symptoms to the time of an accurate diagnosis of DID individuals received an average of four prior other diagnoses and spent 7 years, with reports of up to 12 years, in mental health services. Aim To investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis. Method Structural brain images of 75 participants were included: 32 female individuals with DID and 43 matched healthy controls. Individuals with DID were recruited from psychiatry and psychotherapy out-patient clinics. Probabilistic pattern classifiers were trained to discriminate cohorts based on measures of brain morphology. Results The pattern classifiers were able to accurately discriminate between individuals with DID and healthy controls with high sensitivity (72%) and specificity (74%) on the basis of brain structure. These findings provide evidence for a biological basis for distinguishing between DID-affected and healthy individuals. Conclusions We propose a pattern of neuroimaging biomarkers that could be used to inform the identification of individuals with DID from healthy controls at the individual level. This is important and clinically relevant because the DID diagnosis is controversial and individuals with DID are often misdiagnosed. Ultimately, the application of pattern recognition methodologies could prevent unnecessary suffering of individuals with DID because of an earlier accurate diagnosis, which will facilitate faster and targeted interventions. Declaration of interest The authors declare no competing financial interests.
Entrainment and its implications on microclimate ventilation systems: Scaling the velocity and temperature field of a round free jet

Research on microclimate ventilation systems, which mostly involve free jets, points to delivery of better ventilation in breathing zones. While the literature is comprehensive, the influence of contaminant entrainment in jet flows and its implications on the delivery of supplied air is not fully addressed. This paper presents and discusses entrainment characteristics of a jet issued from a round nozzle (0.05 m diameter), in relation to ventilation, by exploring the velocity and temperature fields of the jet flow. The results show a trend suggesting that increasing the Reynold number (Re) reduces ambient entrainment. As shown herein, about 30% concentration of ambient air entrained into the bulk jet flow at Re 2541 while Re 9233 had about 13% and 19% for Re = 6537/12 026 at downstream distance of 8 diameters (40 cm). The study discusses that "moderate to high" Re may be ideal to reduce contaminant entrainment, but this is limited by delivery distance and possibly the risk of occupant discomfort. Incorporating the entrainment mixing factor (the ratio of room contaminants entrained into a jet flow) in performance measurements is proposed, and further studies are recommended to verify results herein and test whether this is general to other nozzle configurations.
Decreasing the Cholesterol Burden in Heterozygous Familial Hypercholesterolemia Children by Dietary Plant Stanol Esters

This review covers the current knowledge about plant stanol esters as a dietary treatment option for heterozygous familial hypercholesterolemia (he-FH) children. The current estimation of the prevalence of he-FH is about one out of 200–250 persons. In this autosomal dominant disease, the concentration of plasma low-density lipoprotein cholesterol (LDL-C) is strongly elevated since birth. Quantitative coronary angiography among he-FH patients has revealed that stenosing atherosclerotic plaques start to develop in he-FH males in their twenties and in he-FH females in their thirties, and that the magnitude of the plaque burden predicts future coronary events. The cumulative exposure of coronary arteries to the lifelong LDL-C elevation can be estimated by calculating the LDL-C burden (LDL-C level × years), and it can also be used to demonstrate the usefulness of dietary stanol ester treatment. Thus, when compared with untreated he-FH patients, the LDL-C burden of using statin from the age of 10 is 15% less, and if he-FH patients starts to use dietary stanol from six years onwards and a combination of statin and dietary stanol from 10 years onwards, the LDL-C burden is 21% less compared to non-treated he-FH patients. We consider dietary stanol treatment of he-FH children as a part of the LDL-C-lowering treatment package as safe and cost-effective, and particularly applicable for the family-centered care of the entire he-FH families.
Cellular and Molecular Life Sciences the Absence of Melanopsin Alters Retinal Clock Function and Dopamine Regulation by Light

we further examined dopamine (DA) synthesis in Opn 4 −/− mice. The lack of melanopsin prevented the light-dependent increase of tyrosine hydroxylase (TH) mRNA and of DA and, in constant darkness, led to comparatively high levels of both components. These results suggest that mel-anopsin is required for molecular clock function and DA regulation in the retina, and that Period gene induction by light is mediated by a melanopsin-dependent, DA-driven signal acting on retinal photoreceptors.
Reassimilation of Photorespiratory Ammonium in Lotus japonicus Plants Deficient in Plastidic Glutamine Synthetase

It is well established that the plastidic isoform of glutamine synthetase (GS2) is the enzyme in charge of photorespiratory ammonium reassimilation in plants. The metabolic events associated to photorespiratory NH4 + accumulation were analyzed in a Lotus japonicus photorespiratory mutant lacking GS2. The mutant plants accumulated high levels of NH4 + when photorespiration was active, followed by a sudden drop in the levels of this compound. In this paper it was examined the possible existence of enzymatic pathways alternative to GS2 that could account for this decline in the photorespiratory ammonium. Induction of genes encoding for cytosolic glutamine synthetase (GS1), glutamate dehydrogenase (GDH) and asparagine synthetase (ASN) was observed in the mutant in correspondence with the diminishment of NH4 +. Measurements of gene expression, polypeptide levels, enzyme activity and metabolite levels were carried out in leaf samples from WT and mutant plants after different periods of time under active photorespiratory conditions. In the case of asparagine synthetase it was not possible to determine enzyme activity and polypeptide content; however, an increased asparagine content in parallel with the induction of ASN gene expression was detected in the mutant plants. This increase in asparagine levels took place concomitantly with an increase in glutamine due to the induction of cytosolic GS1 in the mutant, thus revealing a major role of cytosolic GS1 in the reassimilation and detoxification of photorespiratory NH4 + when the plastidic GS2 isoform is lacking. Moreover, a diminishment in glutamate levels was observed, that may be explained by the induction of NAD(H)-dependent GDH activity.
Computer model for harmonic ultrasound imaging

Harmonic ultrasound imaging has received great attention from ultrasound scanner manufacturers and researchers. In this paper, we present a computer model that can generate realistic harmonic images. In this model, the incident ultrasound is modeled after the "KZK" equation, and the echo signal is modeled using linear propagation theory because the echo signal is much weaker than the incident pulse. Both time domain and frequency domain numerical solutions to the "KZK" equation were studied. Realistic harmonic images of spherical lesion phantoms were generated for scans by a circular transducer. This model can be a very useful tool for studying the harmonic buildup and dissipation processes in a nonlinear medium, and it can be used to investigate a wide variety of topics related to B-mode harmonic imaging.