Miracle-dz/UniFAR-FTUs huggingface dataset:
Effectiveness of Gas and Chimney Biomass Stoves for Reducing Household Air Pollution Pregnancy Exposure in Guatemala: Sociodemographic Effect Modifiers

Household air pollution (HAP) due to solid fuel use during pregnancy is associated with adverse birth outcomes. The real-life effectiveness of clean cooking interventions has been disappointing overall yet variable, but the sociodemographic determinants are not well described. We measured personal 24-h PM2.5 (particulate matter <2.5 µm in aerodynamic diameter) thrice in pregnant women (n = 218) gravimetrically with Teflon filter, impactor, and personal pump setups. To estimate the effectiveness of owning chimney and liquefied petroleum gas (LPG) stoves (i.e., proportion of PM2.5 exposure that would be prevented) and to predict subject-specific typical exposures, we used linear mixed-effects models with log (PM2.5) as dependent variable and random intercept for subject. Median (IQR) personal PM2.5 in µg/m3 was 148 (90–249) for open fire, 78 (51–125) for chimney stove, and 55 (34–79) for LPG stoves. Adjusted effectiveness of LPG stoves was greater in women with ≥6 years of education (49% (95% CI: 34, 60)) versus <6 years (26% (95% CI: 5, 42)). In contrast, chimney stove adjusted effectiveness was greater in women with <6 years of education (50% (95% CI: 38, 60)), rural residence (46% (95% CI: 34, 55)) and lowest SES (socio-economic status) quartile (59% (95% CI: 45, 70)) than ≥6 years education (16% (95% CI: 22, 43)), urban (23% (95% CI: −164, 42)) and highest SES quartile (−44% (95% CI: −183, 27)), respectively. A minority of LPG stove owners (12%) and no chimney owner had typical exposure below World Health Organization Air Quality guidelines (35 μg/m3). Although having a cleaner stove alone typically does not lower exposure enough to protect health, understanding sociodemographic determinants of effectiveness may lead to better targeting, implementation, and adoption of interventions.
Interaction between central obesity and frailty on the clinical outcome of peritoneal dialysis patients

Background Frailty and obesity contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients, but the interaction between frailty and obesity remains uncertain. Objective To examine the interaction between frailty and obesity on the clinical outcome of PD patients. Design Single centre prospective observational cohort study. Patients 267 prevalent Chinese PD patients were recruited. Measurements Frailty was identified by a standard score. General and central obesity were determined by body mass index (BMI) and waist-hip ratio (WHR), respectively. Body composition was assessed by bioimpedance spectroscopy. All patients were followed for two years. Outcome measures included all-cause as well as cardiovascular mortality and hospitalization. Results Of the 267 patients, 120 (44.9%) were frail. Frail individuals were more likely to have central obesity (p < 0.001) but not general obesity. Although WHR did not predict patient survival, there was a significant interaction between WHR and frailty on patient survival and cardiovascular survival (p = 0.002 and p = 0.038, respectively). For patients without frailty, the two-year cardiovascular survival was 91.3% and 74.4% for those with and without central obesity, respectively (p = 0.002). For patients with frailty, however, the two-year cardiovascular survival was 64.6% and 66.7% for those with and without central obesity, respectively (p = 0.6). For patients without frailty, the number of hospital admission for cardiovascular disease over 2 years were 0.12 ± 0.37 and 0.34 ± 0.72 for those with and without central obesity, respectively (p = 0.03). For frail patients, however, the number of hospital admission was similar between those with and without central obesity. Conclusion There is a significant interaction between frailty and central obesity on the outcome of PD patients. The protective role of central obesity is only apparent in PD patients without frailty but not the frail ones, and there is a little prognostic value of general (non-central) obesity.
“You have to be okay with okay”: experiences of flourishing among university students transitioning directly from high school

ABSTRACT Mental health is central to overall wellbeing and, for students attending university, mental health is critical for learning and academic success. A wealth of research has focused on young people who experience psychosocial declines during academic and developmental transitions, but little is known about how young people flourish in this transition. The first to explore the experiences of flourishing among first-year Canadian university students making the transition directly from high school, this study sought to develop an understanding of: 1) the factors that promote flourishing amidst this academic and developmental transition, and 2) how first-year students define and experience flourishing. An interpretive phenomenological approach underpinned by Gadamerian hermeneutic philosophy was used to explore experiences of flourishing, using semi-structured interviews, in a sample of nine full-time, first-year university students, ages 18–20 years. What it meant to flourish amidst this developmental and academic transition and how participants defined flourishing offer new understandings of the concept associated with: 1) personal/individual aspects of flourishing, 2) contextual nature of flourishing, 3) temporality of flourishing, 4) dialectic aspects of flourishing. Implications for practice, policy, and research in light of these new understandings are discussed.
Geographical Distribution of Borrelia burgdorferi sensu lato in Ticks Collected from Wild Rodents in the Republic of Korea

Lyme disease is a tick-borne zoonotic disease caused by Borrelia burgdorferi sensu lato (s. l.) via transmission cycles involving competent tick vectors and vertebrate reservoirs. Here, we determined the prevalence and distribution of Borrelia genospecies in 738 ticks of at least three species from wild rodents in nine regions of the Republic of Korea (ROK). Ticks were analyzed using nested PCR targeting partial flagellin B gene sequences, followed by sequence analysis. The prevalence of Borrelia infection was 33.6%, and the most common genospecies were B. afzelii (62.5%), B. valaisiana (31.9%), B. yangtzensis (2.4%), B. garinii (1.6%), and B. tanukii (1.6%). Borrelia afzelii was found in all regions except Jeju Island; this predominant genospecies was found in the northern and central sampling regions. Borrelia valaisiana, B. yangtzensis, and B. tanukii were found only in the southern regions with B. valaisiana being the most common, whereas B. yangtzensis and B. tanukii were only found on Jeju Island. Our study is the first to describe the nationwide prevalence of B. burgdorferi s. l. in ticks from wild rodents in the ROK. Continuous surveillance in ticks, animals, humans, and different regions is required to avoid disease distribution and possible transmission to humans in the ROK.
Knockout of Cyp26a1 and Cyp26b1 during postnatal life causes reduced lifespan, dermatitis, splenomegaly, and systemic inflammation in mice

All‐trans‐retinoic acid (atRA), the active metabolite of vitamin A, is an essential signaling molecule in all chordates. Global knockouts of the atRA clearing enzymes Cyp26a1 or Cyp26b1 are embryonic lethal. In adult rodents, inhibition of Cyp26a1 and Cyp26b1 increases atRA concentrations and signaling. However, postnatal knockout of Cyp26a1 does not cause a severe phenotype. We hypothesized that Cyp26b1 is the main atRA clearing Cyp in postnatal mammals. This hypothesis was tested by generating tamoxifen‐inducible knockout mouse models of Cyp26b1 alone or with Cyp26a1. Both mouse models showed dermatitis, blepharitis, and splenomegaly. Histology showed infiltration of inflammatory cells including neutrophils and T lymphocytes into the skin and hyperkeratosis/hyperplasia of the nonglandular stomach. The mice lacking both Cyp26a1 and Cyp26b1 also had a reduced lifespan, failed to gain weight, and showed fat atrophy. There were significant changes in vitamin A homeostasis. Postnatal knockout of Cyp26b1 resulted in increased atRA concentrations in the skin while the postnatal knockout of both Cyp26a1 and Cyp26b1 resulted in increased atRA concentrations in the liver, serum, skin, spleen, and intestines. This study demonstrates the paramount role of Cyp26b1 in regulating retinoid homeostasis in postnatal life.
Efficacy and Safety of Kudzu Flower–Mandarin Peel on Hot Flashes and Bone Markers in Women during the Menopausal Transition: A Randomized Controlled Trial

This randomized controlled study aimed to assess the efficacy and safety of an extract mixture of kudzu flower and mandarin peel (KM) on hot flashes (HFs) and markers of bone turnover in women during the menopausal transition. Healthy women aged 45–60 years with the menopausal HFs were randomly assigned in a 1:1 ratio to either KM (1150 mg/day) or placebo arms for 12 weeks (n = 84). The intent-to-treat analysis found that compared with the placebo, the KM significantly attenuated HF scores (p = 0.041) and HF severities (p < 0.001), with a mean difference from baseline to week 12. The KM also improved bone turnover markers, showing a significant reduction in bone resorption CTx (p = 0.027) and a tendency of increasing bone formation OC relative to the placebo. No serious adverse events and hormonal changes were observed in both groups. These findings suggest that KM consumption may improve the quality of life in ways that are important to symptomatic menopausal women.
Diagnosis and Treatment of Headache in a Pediatric Emergency Department.

OBJECTIVES The aims of the study were (1) to analyze the etiology and clinical management of headaches in children in the emergency department and (2) to analyze the treatment used in children diagnosed with headaches and with migraines. METHODS Retrospective study of all the patients who were admitted to the pediatric emergency department of Hospital Professor Doutor Fernando Fonseca, Lisbon, in 2014, with a chief complaint of headaches or the primary discharge diagnosis was headache/migraine. RESULTS Headache related cases represented 3.8% of all the visits, a total of 2354 subjects. The median age was 10 years and 52.6% were female. The most frequent diagnoses were as follow: headaches (21.3%), upper respiratory infections (18.4%), and migraines (6.1%). There were 4 cases of meningitis, 6,5% of all patients underwent computed tomography which was mostly requested in school-age children and adolescents. The average time from the first medical observation until discharge was 85 minutes. Fifty-five percent did not take any pain relief medication, 17.2% took acetaminophen, and 11.1% took ibuprofen. Patients who received ondansetron had less revisits (P = 0.000). Subjects with mild-moderate pain treated with acetaminophen or no medication had more revisits (P = 0.000). CONCLUSIONS Secondary benign headaches were the most common and very rarely headache as a symptom was associated with life-threatening situations. Antiemetics seem to be efficient ally in the treatment of primary headaches, but it is important to consider alternative pharmacological regimes in patients who present with higher pain scores.
The critical role of cloud–infrared radiation feedback in tropical cyclone development

Significance The deep clouds that make up tropical disturbances, the precursors to more intense tropical cyclones (TCs) (including hurricanes and typhoons), effectively trap infrared radiation emitted by Earth’s surface and lower atmosphere. Our results demonstrate that the local atmospheric warming caused by this “cloud greenhouse effect” is a key trigger for promoting and accelerating the evolution of such precursor storms into intense TCs. The forecasting of TC formation remains extremely challenging, while the representation of cloud processes and their feedback with radiation is a large source of uncertainty in the numerical models that forecasts rely upon. Our results suggest that focusing future research on constraining these processes in models holds promise for key progress in the prediction of these devastating storms. The tall clouds that comprise tropical storms, hurricanes, and typhoons—or more generally, tropical cyclones (TCs)—are highly effective at trapping the infrared radiation welling up from the surface. This cloud–infrared radiation feedback, referred to as the “cloud greenhouse effect,” locally warms the lower–middle troposphere relative to a TC’s surroundings through all stages of its life cycle. Here, we show that this effect is essential to promoting and accelerating TC development in the context of two archetypal storms—Super Typhoon Haiyan (2013) and Hurricane Maria (2017). Namely, this feedback strengthens the thermally direct transverse circulation of the developing storm, in turn both promoting saturation within its core and accelerating the spin-up of its surface tangential circulation through angular momentum convergence. This feedback therefore shortens the storm’s gestation period prior to its rapid intensification into a strong hurricane or typhoon. Further research into this subject holds the potential for key progress in TC prediction, which remains a critical societal challenge.
Lower Limb Strength Profile in Elderly with Different Pathologies: Comparisons with Healthy Subjects

Sarcopenia and muscle strength reduction are a frequent disorder in non-communicable chronic diseases. The aims of this study are: (a) to verify if the absolute and relative to body weight muscle strength of lower limb is affected by the presence of pathology; (b) to verify if the trends are different among knee and ankles joints. One-hundred and forty-five elderly were recruited (16 liver transplant recipients, 48 kidney transplant recipients, 52 elderly with obesity, 30 healthy elderly). Muscular strength of lower limb was evaluated. Evaluation protocol included maximal isometric knee extension, maximal isokinetic knee extension and flexion, maximal isokinetic ankle (both right and left) extension and flexion. A statistically significant interaction between measurement and group membership was found for absolute strength measure (F (4.23, 170.56) = 3.316, p = 0.011, partial η2 (η2p) = 0.076), and relative strength measure(F (4.44, 174.72) = 16.407, p < 0.01, partial η2 (η2p) = 0.294). Elderly patients living with kidney transplants showed the lower level of absolute muscular strength, while relative muscular strength is mainly lacking in the elderly with obesity. The strength profile of elderly subjects is affected by obesity, liver transplantation, and kidney transplantation.
Human Papillomavirus Same Genotype Persistence and Risk: A Systematic Review

Supplemental digital content is available in the text. Objective The aim of the study was to examine whether high-grade cervical intraepithelial neoplasia (CIN) was more closely associated with human papillomavirus (HPV) same-genotype persistence (SGTP) versus clearance of prior infection with a subsequent infection by a new genotype (genotype switch [GS]), clearance of HPV infection, or acquisition of a new HPV infection after a negative infection status, during a follow-up testing subsequent to abnormal screening results. Materials and Methods MEDLINE, Cochrane Library, Health Technology Assessment, and clinicaltrials.gov were searched from January 2000 to July 2019 for prospective controlled trials and observational studies of women and retrospective studies using HPV assays with extended- or full-genotype reporting. The primary outcome was high-grade CIN after at least 2 rounds of testing. Overall quality of evidence for the risk estimate outcomes was assessed. Of the 830 identified abstracts, 66 full-text articles were reviewed, and 7 studies were included in the synthesis. The study protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42018091093). Results Continued HPV-positive women falls in 2 equally large groups: SGTP and GS. Sensitivity, positive predictive value, and positive likelihood ratio of SGTP were significantly higher than for GS. Human papillomavirus genotypes may be ranked into 3 tiers (immediate colposcopy, follow-up testing, return to routine screening), according to associated risk of persistence for high-grade CIN and to prevailing clinical action thresholds. Conclusions There is moderately high-quality evidence to support the clinical utility of SGTP to improve risk discrimination for high-grade CIN compared with qualitative HPV testing without genotype-specific information.
The Mediating Role of Parental Influence on the Relationship Between Adult Children’s Filial Piety Beliefs and Mate Preferences

In the present study, we aim to examine the mediating roles of the two types of perceived parental influence in the relation between the dual filial piety model and adult children’s long-term mate preferences. A survey was administered to 499 Chinese adult children on their filial piety beliefs, perceptions about parental influence, and long-term mate preferences. Structural equation modeling revealed the following findings. (a) For both genders, reciprocal filial piety was positively correlated with good father/mother traits, and authoritarian filial piety was positively correlated with good gene traits. (b) For both genders, sensitivity from the perceived parental influence mediated the link between authoritarian filial piety and good provider traits. (c) For females, sensitivity mediated the link between authoritarian filial piety and good gene traits. (d) For males, parental monitoring from perceived parental influence mediated the link between authoritarian filial piety and good gene and good mother traits. In addition, authoritarian filial piety was positively correlated with good provider and good mother traits. In summary, filial piety can link both directly and indirectly to mate preference through parental sensitivity for males and females and through parental monitoring mainly for males.
Biochemical Transformation of Bacterial Lipopolysaccharide by acyloxyacyl hydrolase reduces host injury and promotes recovery.

Animals can sense the presence of microbes in their tissues and mobilize their own defenses by recognizing and responding to conserved microbial structures (often called Microbe-Associated Molecular Patterns or "MAMPs"). Successful host defenses may kill the invaders, yet the host animal may fail to restore homeostasis if the stimulatory microbial structures are not silenced. Although mice have many mechanisms for limiting their responses to lipopolysaccharide (LPS), a major Gram-negative bacterial MAMP, a highly conserved host lipase is required to extinguish LPS sensing in tissues and restore homeostasis. We review recent progress in understanding how this enzyme, acyloxyacyl hydrolase (AOAH), transforms LPS from stimulus to inhibitor, reduces tissue injury and death from infection, prevents prolonged post-infection immunosuppression, and keeps stimulatory LPS from entering the bloodstream. We also discuss how AOAH may increase sensitivity to pulmonary allergens. Better appreciation of how host enzymes modify LPS and other MAMPs may help prevent tissue injury and hasten recovery from infection.
The role of Ca2+ and protein scaffolding in the formation of nature’s water oxidizing complex

Significance Unlike cofactor insertion into other metalloproteins, assembly of the photosynthetic water oxidation complex of photosystem II (PSII) in plants, algae, and cyanobacteria is a light-driven process that photooxidatively incorporates Mn2+ and Ca2+ ions into the protein matrix forming the catalytic Mn4CaO5 metal cluster. This self-assembly process is important both for de novo biogenesis and for the frequent repair of PSII due to its susceptibility to photodamage. While the basic kinetic scheme for this process was established nearly 50 y ago, the molecular details have remained enigmatic. Here we describe results on the role of inorganic and protein cofactors and integrate them with previous information to obtain an important upgrade in our understanding of this process. Photosynthetic O2 evolution is catalyzed by the Mn4CaO5 cluster of the water oxidation complex of the photosystem II (PSII) complex. The photooxidative self-assembly of the Mn4CaO5 cluster, termed photoactivation, utilizes the same highly oxidizing species that drive the water oxidation in order to drive the incorporation of Mn2+ into the high-valence Mn4CaO5 cluster. This multistep process proceeds with low quantum efficiency, involves a molecular rearrangement between light-activated steps, and is prone to photoinactivation and misassembly. A sensitive polarographic technique was used to track the assembly process under flash illumination as a function of the constituent Mn2+ and Ca2+ ions in genetically engineered membranes of the cyanobacterium Synechocystis sp. PCC6803 to elucidate the action of Ca2+ and peripheral proteins. We show that the protein scaffolding organizing this process is allosterically modulated by the assembly protein Psb27, which together with Ca2+ stabilizes the intermediates of photoactivation, a feature especially evident at long intervals between photoactivating flashes. The results indicate three critical metal-binding sites: two Mn and one Ca, with occupation of the Ca site by Ca2+ critical for the suppression of photoinactivation. The long-observed competition between Mn2+ and Ca2+ occurs at the second Mn site, and its occupation by competing Ca2+ slows the rearrangement. The relatively low overall quantum efficiency of photoactivation is explained by the requirement of correct occupancy of these metal-binding sites coupled to a slow restructuring of the protein ligation environment, which are jointly necessary for the photooxidative trapping of the first stable assembly intermediate.
Influence of Silver Addition on Structure, Martensite Transformations and Mechanical Properties of TiNi–Ag Alloy Wires for Biomedical Application

The microstructural and functional behavior of TiNi-based wires with a silver content of 0–1.5 at. % was evaluated. The concentration range for Ag doping determined for the TiNi wires with potential for the medical industry was 0–0.2 at. %. Microstructure analysis of TiNi wires with different silver contents at room temperature indicated a multiphase structural state. Various internal structures with tangled grain boundaries were formed by intense plastic deformation. The nanocrystalline structure and phase state of wire with the minimum silver content (0.1 at.% Ag) provide full shape recovery, the greatest reversible strain, and optimal strength and ductility. TiNi ingots with a high Ag content (0.5–1.5 at.%) cracked under minimum load due to excess silver that crystallized along the grain boundaries and broke cohesion bonds between the TiNi grains.
Clinical Manifestations and Diagnosis of Axial Spondyloarthritis

Background Axial spondyloarthritis (axSpA) is a chronic, rheumatic disease characterized by inflammation of the sacroiliac joint, spine, and entheses. Axial spondyloarthritis affects up to 1.4% of adults in the United States and is associated with decreased quality of life, increased mortality, and substantial health care–related costs, imposing a high burden on patients, their caregivers, and society. Summary of Work Diagnosing axSpA can be difficult. In this review, we seek to help rheumatologists in recognizing and diagnosing axSpA. Major Conclusions A discussion of challenges associated with diagnosis is presented, including use and interpretation of imaging, reasons for diagnostic delays, differences in disease presentation by sex, and differential diagnoses of axSpA. Future Research Directions The early diagnosis of axSpA and advances in available therapeutic options have improved patient care and disease management, but delays in diagnosis and treatment remain common. Additional research and education are critical for recognizing diverse axSpA presentations and optimizing management early in the course of disease.