Miracle-dz/UniFAR-FTUs huggingface dataset:
Screening for Autism Spectrum Disorders in South Africa : Using the Modified Checklist for Autism in Toddlers ( M-CHAT )

Autism Spectrum Disorder (ASD) occurs at a rate of 1 in 100 children worldwide, making it one of the most common neurodevelopmental disorders. Early detection, diagnosis and intervention results in significantly improved outcomes. However, there are currently no screening protocols available for use in South Africa. Therefore, this pilot study provides a preliminary investigation into the applicability of adapted and translated versions (English, Afrikaans and Xhosa) of the Modified Checklist for Autism in Toddlers (M-CHAT) screening tool in South Africa. The M-CHAT was given to parents (N=64) of children (18 months4 years 11 months) with (n=16) and without ASD (n=48). A subgroup (n=15) underwent formal diagnosis using the Autism Diagnostic Observation Schedule (ADOS). Logistic regression indicated that M-CHAT scores were significant predictors of ASD or non-ASD classifications, when using all 23 items (Nagelkerke R =.70; χ (1) = 41.80, p < . 001) as well as when only using the six critical items (Nagelkerke R =.62; χ (1) = 34.69, p < . 001). Preliminary cut-off scores for optimal sensitivity and specificity were determined by Receiver Operating Characteristic analyses. When using the 23-item scale, failure on three items had the best sensitivity (.94) for identifying ASD while maintaining high specificity (.98). When using the six critical items, failure on one item was the optimal cut-off to maintain high specificity (.92) and sensitivity (.81). The results are promising in terms of classifying ASD or non-ASD with a high sensitivity and specificity. The M-CHAT proved to be successful in predicting ASD, indicating its possible future use in the South African population.
Correlation between child and parental perceptions of health-related quality of life in epilepsy using the PedsQL.v4.0 measurement model

Health-related quality-of-life measures in childhood epilepsy are typically limited to a particular functional domain, specific age group, parent proxy-report, or child self-report. Generic health-related quality-of-life instruments in paediatric epilepsy comparing child self-reports with simultaneous parent proxy-reports have not been previously investigated. A previously validated generic questionnaire, the Pediatric Quality of Life version 4 (PedsQL.v4.0), was used to prospectively assess parental and child perceptions of health-related quality of life in 100 children with epilepsy. The correlation between child and parental health-related quality-of-life perceptions across all domains was excellent (p < 0.001) and both were significantly lower than those for healthy controls (p < 0.001). Parents’ perceptions of their children’s healthrelated quality of life were lower than those for other chronic illnesses (p < 0.001), especially for refractory epilepsy. The presence of neurological or psychiatric comorbidities also had an adverse impact on health-related quality of life. The PedsQL.v4. 0 measures health-related quality of life from both the parent’s and child’s perspective. Ease of use makes this instrument attractive for routine clinical use.
Apoptosis of cardiac myocytes during cardiac allograft rejection. Relation to induction of nitric oxide synthase.

BACKGROUND Apoptosis is a distinct form of programmed cell death characterized by activation of endonucleases that cleave nuclear DNA, condensation and fragmentation of nuclear chromatin, blebbing of intact membranes, and cell shrinkage and fragmentation. The mechanisms responsible are unclear, but nitric oxide (NO) generated by inducible NO synthase (iNOS) has been demonstrated to induce apoptosis in macrophages in vitro. This study investigated whether apoptosis occurs during cardiac allograft rejection and examined the relationship of apoptosis to iNOS expression. METHODS AND RESULTS Heterotopic abdominal transplantation from Lewis to Wistar-Furth rats was used as a model of cardiac allograft rejection; Lewis-to-Lewis grafts served as controls. Apoptosis was identified by DNA ladders after electrophoresis on agarose gels and by in situ labeling of DNA fragments; cell types were determined by immunohistochemistry. The number of apoptotic cardiac myocytes increased sharply from day 3 (0.31/mm2 ventricular tissue) to day 5 (1.27/mm2) after transplantation. At day 5, allografts showed a significant increase (P < .01) in apoptotic cardiac myocytes, macrophages, and endothelial cells compared with syngeneic grafts. The expression of iNOS mRNA, protein, and enzyme activity paralleled in time and extent the apoptosis of cardiac myocytes. iNOS immunostaining of infiltrating macrophages and cardiac muscle fibers increased significantly in the allografts at days 3 to 5 and was accompanied by immunostaining of both cell types for nitrotyrosine, which is indicative of peroxynitrite formation. CONCLUSIONS Apoptosis of myocardial cells occurs during cardiac allograft rejection. Apoptosis during rejection parallels the expression of iNOS, which suggests that apoptosis may be triggered by NO and peroxynitrite.
[Laparoscopic treatment of ventral hernia under spinal anesthesia].

INTRODUCTION Laparoscopic surgery is usually performed with the patient under general anesthesia. In open surgery, regional anesthesia has been found to have fewer adverse effects than general anesthesia. We studied whether spinal anesthesia is feasible in laparoscopic ventral hernia repair. PATIENTS AND METHOD Bupivacaine and fentanyl were administered to obtain T2 block; midazolam was used for sedation. Patients underwent laparoscopic intraperitoneal hernia repair using an ePTFE prosthesis fixed with a double crown technique. An intra-abdominal pressure of 12 mmHg and low-flow insufflation (1.5 L/minute) were used for pneumoperitoneum. RESULTS Nineteen out of 23 patients underwent laparoscopic ventral hernia repair under spinal anesthesia; conversion to open surgery or general anesthesia was required in four patients. Additional sedation successfully relieved pain in patients with abdominal and shoulder discomfort (10.5%). Hypotension occurred in 68% of patients but was easily resolved by fluid administration. CONCLUSIONS Spinal anesthesia is feasible and well tolerated in laparoscopic hernia repair. Studies comparing spinal and general anesthesia in this field are warranted.
Minimally invasive laser procedure for early stages of stress urinary incontinence

The objective of this labeled, prospective, single center pilot study study was to assess the efficacy and safety of a novel minimally invasive, nonablative laser treatment in the early stages of SUI. A total of 39 patients suffering from mildtomoderate stress urinary incontinence underwent treatment with an Er:YAG (2940 nm) laser in nonablative fractional mode. Assessment tools included the ICIQUI SF questionnaire for assessing the degree of incontinence and its impact on the quality of life, the Qtip test for evaluating the mobility of the urethra and bladder neck, PISQ12 for assessing quality of life in the area of sexuality, and perineometry for the measurement of muscle strength. Followups were scheduled after 1 month for 39 patients, after 3 months for 22 patients and after 6 months for 6 patients. Preliminary results of posttreatment evaluation showed significant improvement (p< 0.05) in all the domains tested: ICIQUI scores decreased by more than 3 points at all followups. A mean duration of muscle contraction measured with perineometry at 1 month increased by 4.7 s, at 3 months by 11.8 s and at 6 months by 22.8 s. Qtip angle decreased by 14.7˚ at 1 month followup, by 15.9˚ at 3 months and by 22.5˚ at 6 months. PISQ12 scores increased after 1 month by 5.4 points, after 3 months by 5.9 points and after 6 months by 6.6 points. The preliminary results confirm that a minimally invasive, nonablative fractional laser treatment (IncontiLaseTM) is an effective, safe and comfortable treatment option for symptom relief in patients with mild and moderate SUI.
Development of an Intravenous-to-Oral Route Conversion Program for Antimicrobial Therapy at a Canadian Tertiary Care Health Facility

OBJECTIVE: To describe the effect of introducing a route conversion program on the prescribing of antimicrobials for the treatment of respiratory tract infections and skin/soft tissue infections in a sample population. DESIGN: Concurrent, pre- and postintervention study. SETTING: Four general internal medicine wards at The Toronto Hospital, a 1170-bed, tertiary care health center in Toronto, Ontario, Canada. PARTICIPANTS: Patients receiving antimicrobial therapy for respiratory tract infections and skin/soft tissue infections. INTERVENTION: Written guidelines and education sessions were presented to residents, interns, medical students, and pharmacists responsible for the care of patients admitted to four general internal medicine wards. MAIN OUTCOME MEASURES: Clinical and laboratory parameters related to the status of the infection were monitored prospectively and compared with the course of drug therapy, with consideration of the patient's ability to meet the criteria established in the guidelines. The number of days of intravenous therapy prescribed despite appropriateness of oral therapy was tallied. RESULTS: Twenty-seven patients (28 infections) were identified for inclusion in the 7-week preliminary audit, and 30 patients (32 infections) were included in the audit after the program, which continued for 5 weeks. Following implementation of the program, the number of days that intravenous therapy was continued despite the appropriateness of oral therapy was reduced from 41% to 26% of the total days of intravenous therapy prescribed. CONCLUSIONS: The program had a positive influence on antimicrobial prescribing behavior in the population studied. Strategies to ensure continued benefit from the program have been developed.
Análisis y Modelización del contexto sedimentario y los atributos tafonómicos de los yacimientos pleistocénicos del borde nororiental de la Cuenca de Guadix-Baza

Se analizan y modelizan tafonomicamente los yacimientos del Pleistoceno inferior de Venta Micena, Fuente Nueva-3 y Barranco Leon. La ingente asociacion fosil de Venta Micena ofrece datos valiosisimos sobre la etologia del hienido Pachycrocuta brevirostris como principal agente acumulador y modificador de restos oseos de grandes mamiferos en el continente euroasiatico durante el Pleistoceno inferior y principal competidor de los hominidos en el acceso a los cadaveres de ungulados. Asimismo, los analisis tafonomicos y paleobiologicos de la fauna de grandes mamiferos registrada en este yacimiento ayudan a caracterizar el escenario ecologico durante el Villafranquiense superior en el sur de Europa. Por otro lado, en los yacimientos de Barranco Leon y Fuente Nueva-3 se han localizado, ademas de ricas asociaciones faunisticas con registro de la hiena P. brevirostris, importantes acumulaciones de industrias liticas de tipologia preachelense, con evidencias de su uso por los hominidos en la produccion de marcas de corte y de fracturacion por percusion sobre los elementos oseos relacionados con la evisceracion, descarnacion y desarticulacion de los cadaveres de grandes mamiferos. Estos dos ultimos yacimientos constituyen un referente estrategico, tanto por su cronologia como por su localizacion geografica, en el suroeste de Europa y su estudio ofrece excelentes posibilidades con vistas a caracterizar el contexto paleoambiental y el marco faunistico en el que se produjo la primera dispersion de los hominidos fuera del continente africano, abriendo la posibilidad de establecer el modo de vida y las estrategias de subsistencia de estos paleopobladores, bien representados a las puertas de Europa en el importante yacimiento caucasico de Dmanisi.
Is the food‐entrainable circadian oscillator in the digestive system?

Food‐anticipatory activity (FAA) is the increase in locomotion and core body temperature that precedes a daily scheduled meal. It is driven by a circadian oscillator but is independent of the suprachiasmatic nuclei. Recent results that reveal meal‐entrained clock gene expression in rat and mouse peripheral organs raise the intriguing possibility that the digestive system is the site of the feeding‐entrained oscillator (FEO) that underlies FAA. We tested this possibility by comparing FAA and Per1 rhythmicity in the digestive system of the Per 1‐luciferase transgenic rat. First, rats were entrained to daytime restricted feeding (RF, 10 days), then fed ad libitum (AL, 10 days), then food deprived (FD, 2 days). As expected FAA was evident during RF and disappeared during subsequent AL feeding, but returned at the correct phase during deprivation. The phase of Per1 in liver, stomach and colon shifted from a nocturnal to a diurnal peak during RF, but shifted back to nocturnal phase during the subsequent AL and remained nocturnal during food deprivation periods. Second, rats were entrained to two daily meals at zeitgeber time (ZT) 0400 and ZT 1600. FAA to both meals emerged after about 10 days of dual RF. However, all tissues studied (all five liver lobes, esophagus, antral stomach, body of stomach, colon) showed entrainment consistent with only the night‐time meal. These two results are inconsistent with the hypothesis that FAA arises as an output of rhythms in the gastrointestinal (GI) system. The results also highlight an interesting diversity among peripheral oscillators in their ability to entrain to meals and the direction of the phase shift after RF ends.
Clinical Overestimation of HER2 Positivity in Early Estrogen and Progesterone Receptor–Positive Breast Cancer and the Value of Molecular Subtyping Using BluePrint

Purpose Human epidermal growth factor receptor 2 (HER2) positivity is an important prognostic and predictive indicator in breast cancer. HER2 status is determined by immunohistochemistry and fluorescent in situ hybridization (FISH), which are potentially inaccurate techniques as a result of several technical factors, polysomy of chromosome 17, and amplification or overexpression of CEP17 (centromeric probe for chromosome 17) and/or HER2. In South Africa, HER2-positive tumors are excluded from a MammaPrint (MP; Agendia BV, Amsterdam, Netherlands) pretest algorithm. Clinical HER2 status has been reported to correlate poorly with molecular subtype. The aim of this study was to investigate the correlation of clinical HER2 status with BluePrint (BP) molecular subtyping. Methods Clinico-pathologic and genomic information was extracted from a prospectively collected central MP database containing records of 256 estrogen receptor–positive and/or progesterone receptor–positive tumors. Twenty-one tumors considered HER2 positive on immunohistochemistry or FISH were identified for this study. Results The median age of patients was 56 years (range, 34 to 77 years), with a median tumor size of 16 mm (3 to 27 mm). Four (19%) tumors were confirmed HER2-enriched subtype, six (29%) were luminal A, and 11 (52%) were luminal B. The positive predictive values of HER2/CEP17 ratio ≥ 2 and HER2 copy number ≥ 6 were only 29% and 40%, respectively. The differences in means for HER2/CEP17 ratio were significant between BP HER2-enriched versus luminal (P = .0249; 95% CI, 0.12 to 1.21) and MP high-risk versus low-risk tumors (P = .0002; 95% CI, 0.40 to 1.06). Conclusion Of the 21 tumors considered clinically HER2 positive, only four were HER2-enriched subtype with BP, indicating an overestimation of HER2 positivity. FISH testing has a poor positive predictive value.
A universal self-calibrating Dynamic Voltage and Frequency Scaling (DVFS) scheme with thermal compensation for energy savings in FPGAs

Field Programmable Gate Arrays (FPGAs) are widely used in telecom, medical, military and cloud computing applications. Unlike in microprocessors, the routing and critical path delay of FPGAs is user dependent. The design tool suggests a maximum operating frequency based on the worst-case timing analysis of the critical paths at a fixed nominal voltage, which usually means there is significant voltage or frequency margin in a typical chip. This paper presents a universal offline self-calibration scheme, which automatically finds the FPGA frequency and core voltage operating limit at different self-imposed temperatures by monitoring design-specific critical paths. These operating points are stored in a calibration table and used to dynamically adjust the frequency and core voltage according to the FPGA temperature when the application circuit is running. The self-calibration process is demonstrated on an Altera Cyclone IV 65-nm FPGA with a digitally controlled dc-dc converter, leading to 40% power savings in a typical digital filter application.
Acute Pancreatitis in Scorpion Envenoming Syndrome: Insulin- Glucose Administration Reverses Haemodynamic Changes, Pulmonary Edema and Other Clinical Manifestations Due to Scorpion (Mesobuthus tamulus Concanesis, Pocock (Buthidae family)) Stings

Death due to poisonous scorpion (Buthidae family) stings is a common event in the developing countries. Scorpion envenoming syndrome results in autonomic storm, release of catecholamines, angiotensin II, glucagon, glucocorticoids, either suppressed insulin secretion or hyperinsulinemia; hyperglycemia, lipolysis – sudden increase in free fatty acids (FFA), acute myocarditis, disseminated intravascular coagulation, cardiovascular disturbances, pulmonary oedema, acute pancreatitis, and many clinical manifestations. Under these altered hormonal mileu, insulin administration reversed the metabolic and ECG changes induced by scorpion envenoming in the experimental animals and in scorpion sting victims. Insulin has a primary metabolic role in preventing, counter-acting and reversing the metabolic, cardiovascular, haemodynamic, and neurological manifestations and pulmonary oedema induced by scorpion envenoming and reversing all the deleterious effects of FFA by inhibiting the catecholamine induced lipolysis, and increase intra-cellular K+, facilitating glucose transport to the myocardium and glucose metabolism through different pathways. Profuse sweating, excessive salivation and abdominal pain are the triad of symptoms of ominous significance in scorpion sting victims with acute pancreatitis. Laryngeal spasm and respiratory failure are more common with acute pancreatitis. Continuous infusion of regular crystalline insulin should be given at the rate of 0.3 U/g glucose and glucose at the rate of 0.1 g/kg body weight/hour, for 48–72 hours, with supplementation of potassium as needed and maintenance of fluid, electrolytes and acid-base balance.
Gallic War Songs (II): Marcus Cicero, Quintus Cicero, and Caesar’s Invasion of Britain

This article assembles and examines the evidence for the poetic outputs of Marcus and Quintus Cicero related to Caesar’s invasion of Britain. Following the establishment of a relative chronology of the evidence for their work, it is argued that Quintus Cicero most likely produced a fabula praetexta (not an epic poem, as commonly assumed). His brother, in turn, wrote an epic, based on Quintus’ eye-witness reports. Careful analysis of the ancient discourse about this piece reveals insights in Cicero’s poetic workshop and the creation of ‘archival truth’ through narrativising historical events in epic poetry. Finally, a case is made for greater attention to financial affairs between Caesar and the Ciceros that happen to coincide with the drafting process of their respective literary works.
SURFACE REACTIVITY, CYTOTOXICITY, AND TRANSFORMING POTENCY OF IRON-COVERED COMPARED TO UNTREATED REFRACTORY CERAMIC FIBERS

Untreated and iron-coated refractory ceramic fibers (RCFs) 1, 3, and 4 were examined for their potential to generate free radicals and to catalyze hydrogen peroxide decomposition in cell-free assays and were compared for cytotoxic and transforming potencies in Syrian hamster embryo (SHE) cell system. Coating with a high quantity of iron increased the capability of RCFs to generate hydroxyl radicals and to catalyze the decomposition of hydrogen peroxide. In the SHE cells, the untreated RCFs had varying ability to induce inhibition of cell proliferation, cytotoxicity (as measured by the colony-forming efficiency, CE) and morphological transformation, in a concentration-dependent manner. According to cytotoxic and transforming potencies, they ranged as follows: RCF3 > RCF1 > RCF4. The lethal concentration 50 (LC50; decrease of CE to 50% of controls after 7 d of treatment) expressed per number of RCF3 and RCF1/cm 2 of culture dish was 2.5 2 10 4 and 3.7 2 10 4 , respectively, whereas RCF4 was not cytotoxic up to the highest concentration tested (23.7 2 10 4 fibers/cm 2 ). At LC50, RCF3 was 1.4-fold more transforming than RCF1, and the weakest, RCF4, induced less than 1% transformation. Iron coating of RCF1 and RCF3 markedly attenuated their cytostatic, cytotoxic, and transforming potencies without a linear concentration-transformation relationship. In contrast, iron coating of RCF4 affected slightly its low transforming potency, although the growth inhibitory effect was reduced. The observed decrease rather than increase in the cytotoxic and transforming potencies of the active samples RCF1 and RCF3 by their coating with large amounts of ferric iron suggests that it is not the quantity or any form of iron on the surface of fibers but the iron, even in trace, in a particular redox and coordinate state that might play a role in the fiber's surface reactivity with regard to the biological material. Surface chemical functions involved in the interaction with the cell could be inactivated by the deposition of a high quantity of Fe(III) on the surface of fibers. Physicochemical studies correlated to biological effects is an approach for understanding the properties of solids related to a given biological response and for elucidating the cellular and molecular mechanisms.
Anthropometric data indicate nutritional homogeneity in Hadza foragers of Tanzania

We analyzed body mass index (BMI = wt/height2) and percent body fat (BF%) in adults of the Hadza, an egalitarian society with a strong food‐sharing ethic, to examine variation in energetic status in relation to sex, age, and time of year. Data collected from 26 camps over six field seasons gave a cross‐sectional sample of 238 males and 235 females and a small longitudinal sample (n = 54). We found that mean BMI showed no sex difference [20.1 ± 1.6 (SD) kg/m2 for males and 20.3 ± 2.2 kg/m2 for females] and remained similar, regardless of age or time of year. Mean BF% showed a significant sex difference, as expected [10.6 ± 3.2 (SD) % for males and 19.0 ± 7.0% for females (P < 0.0001)], with two significant age departures from uniformity: (1) males in the prime age group (30–45 years, n = 79) had a higher mean BF% (11.7%) compared to other ages (P < 0.03), and (2) females in the extreme elderly age group (> 75 years, n = 11) had a lower mean BF% (11.3%) compared to other ages (P < 0.004). In the longitudinal sample, we found no significant change over time in mean BMI or BF%. However, relative change in BF% fluctuated within individuals by as much as 20% of initial values for both sexes. Taken collectively, our results support the idea of broad nutritional homogeneity among the Hadza, but indicate that subtle, potentially important differences in energetic condition exist as well. Am. J. Hum. Biol. 19:107–118, 2007. © 2006 Wiley‐Liss, Inc.