Miracle-dz/UniFAR-FTUs huggingface dataset:
Knowledge and practice of birth preparedness and complication readiness among pregnant women attending antenatal clinic in Openzinzi Hciii, Adjumani District, Uganda

Introduction Every day, approximately 830 women globally die from pregnancy-child birth related complications and all maternal deaths are mainly due to the three phases of delay usually experienced in maternal care which originates from inadequate or lack of birth and emergency preparedness. Despite the benefit of Birth Preparedness and Complications Readiness (BPACR) in the reduction of the three phases of delay and thus reduction of maternal deaths and complications, no study has been conducted in Adjumani district to assess the knowledge and practice of birth preparedness and complication readiness, thus our objective was to assess the knowledge and practice of Birth Preparedness and Complications Readiness (BPACR) among pregnant women attending antenatal clinic at Openzinzi Health Centre (HC) III in Adjumani District. Methods A descriptive cross sectional study design with a sample of 80 respondents was used for the study. Simple random sampling was used to select the respondents in the study area. A research administered questionnaire was used for data collection. Results Most of the respondents (27.5%) were in the age group of 26-35 years. The majority 43.75% ended at primary level of education, 50% were unemployed, and the majority 71.25% and 70% knew identifying skilled birth attendants and health facilities respectively as components of BPACR. 76.25% of the respondents mentioned vaginal bleeding and 62.5% over vomiting as danger signs in pregnancy while 12.5% did not know any danger sign in pregnancy. 76.25% identified place for skilled birth, 66.25% identified skilled birth attendant, and only 15% identified blood donor. Conclusion The practice of BPACR was poor among the pregnant women attending antenatal care at Openzinzi Health Centre III in Adjumani District. The knowledge about BPACR was higher among the educated respondents involved in the study.
A conserved ATP- and Scc2/4-dependent activity for cohesin in tethering DNA molecules

Reconstitution of ATP-dependent cohesion by purified yeast and human cohesin complexes shows distinct types of cohesin bridges. Sister chromatid cohesion requires cohesin to act as a protein linker to hold chromatids together. How cohesin tethers chromatids remains poorly understood. We have used optical tweezers to visualize cohesin as it holds DNA molecules. We show that cohesin complexes tether DNAs in the presence of Scc2/Scc4 and ATP demonstrating a conserved activity from yeast to humans. Cohesin forms two classes of tethers: a “permanent bridge” resisting forces over 80 pN and a force-sensitive “reversible bridge. ” The establishment of bridges requires physical proximity of dsDNA segments and occurs in a single step. “Permanent” cohesin bridges slide when they occur in trans, but cannot be removed when in cis. Therefore, DNAs occupy separate physical compartments in cohesin molecules. We finally demonstrate that cohesin tetramers can compact linear DNA molecules stretched by very low force (below 1 pN), consistent with the possibility that, like condensin, cohesin is also capable of loop extrusion.
Symptom burden and work-related impairment among patients with PTSD and complex PTSD

ABSTRACT Background: The 11th revision of the International Classification of Diseases includes a new chapter of stress-related disorders and presents two distinct sibling conditions: Posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). Studies show that PTSD and CPTSD are associated with different levels of symptom burden, comorbidity and functional impairment, but have not yet addressed the qualitative and quantitative differences in work-related impairment between the two diagnoses. Objective: The aim of this study was to replicate differences in symptom severity, global distress, and the number of comorbid diagnoses between three groups that suffer from no PTSD, PTSD, or CPTSD. More importantly, we evaluated whether the three groups differ in indicators of functional impairment such as qualitative and quantitative working capacity. Finally, this study supplies information on prevalence rates of PTSD and CPTSD in a clinical sample suffering from psychosomatic complaints. Methods: Participants were 662 patients of a Psychosomatic Rehabilitation Clinic (age M = 50.99, SD 8.99 years; 70.1% female). Self-report screening instruments were administered to participants at the beginning of their inpatient psychotherapy. Multivariate analysis of variance and Chi Square tests were utilized to assess group differences in symptom severity, comorbidity and work-related impairment. Results: A prevalence of 13.3% CPTSD and 9.5% PTSD was found among the current sample. CPTSD was associated with heightened symptom burden and more comorbid diagnoses. More importantly, CPTSD was associated with a significantly lowered qualitative and quantitative working capacity compared to PTSD and no-PTSD. Conclusions: The high prevalence, greater psychopathological burden and work-related impairments in CPTSD compared to PTSD highlight the need for developing and evaluating new interventions in rehabilitation that address the complexity of the new disorder. HIGHLIGHTS • A prevalence of 13.3% CPTSD and 9.5% PTSD was found among patients of a psychosomatic rehabilitation clinic. • CPTSD was associated with substantially heightened psychiatric distress compared to PTSD. • CPTSD was associated with lowered working capacity and treatment response compared to PTSD. • Disorder-specific interventions are needed to address not only the unique symptom spectrum of CPTSD but also to increase patients’ working capacity.
Development Of Novel Liposome-Encapsulated Combretastatin A4 Acylated Derivatives: Prodrug Approach For Improving Antitumor Efficacy

Purpose The objective of the present study was to develop a liposomal drug delivery system based on combretastatin A4 (CA4) prodrugs modified with varying alkyl chains and investigate the in vitro drug conversion from prodrug and in vivo antitumor effect. Methods The prodrug of CA4 was synthesized with stearyl chloride (18-carbon chain), palmitoyl chloride (16-carbon chain), myristoyl chloride (14-carbon chain), decanoyl chloride (10-carbon chain), and hexanoyl chloride (6-carbon chain) at the 3′-position of the CA4. Subsequently, it was encapsulated with liposomes through the thin-film evaporation method. Furthermore, the characteristics of prodrug-liposome were evaluated using in vitro drug release, conversion, and cytotoxicity assays, as well as in vivo pharmacokinetic, antitumor, and biodistribution studies. Results The liposome system with loaded CA4 derivatives was successfully developed with nano-size and electronegative particles. The rate of in vitro drug release and conversion was reduced as the fatty acid carbon chain lengthened. On the contrary, in vivo antitumor effects were improved with the enlargement of the fatty acid carbon chain. The results of the in vivo pharmacokinetic and tissue distribution studies indicated that the reduced rate of CA4 release with a long carbon chain could prolong the circulation time and increase the drug concentration in the tumor tissue. Conclusion These results suggested that the release or hydrolysis of the parent drug from the prodrug was closely related with the in vitro and in vivo properties. The slow drug release of CA4 modified with longer acyl chain could prolong the circulation time and increase the concentration of the drug in the tumor tissue. These effects play a critical role in increasing the antitumor efficacy.
Life history response of Echinops gmelinii Turcz. to variation in the rainfall pattern in a temperate desert

Background Current and future changes in rainfall amount and frequency may particularly impact annual plants in desert ecosystems. The winter annual Echinops gmelinii Turcz. is widely distributed in the desert habitats of northern China and is a dominant pioneer annual plant following sand stabilization in the Tengger Desert. This species plays a vital role in dune stabilization during spring and early summer, when wind erosion is the most severe and frequent. However, seedling emergence and regeneration in sandy soil are mainly determined by rainfall patterns. Therefore, understanding the life history response of this species to rainfall variation is necessary for understanding the change of population dynamics under the future climate change. Methods A field simulation rainfall pot experiment using rainout shelter was conducted that included five amounts and five frequencies of rainfall based on historical and predicted values to monitor the life history responses of E. gmelinii in a near-natural habitat. Results We found that rainfall amount and frequency significantly affected seedling survival, growth and reproduction. The plant height, biomass, capitula number, seed number, seed mass and reproductive effort, but not the root/shoot ratio, significantly increased with increasing rainfall. Further, these traits exhibited the greatest response to low-frequency and larger rainfall events, especially the optimal rainfall frequency of 10-day intervals. Offspring seed germination showed increasing trends with decreasing rainfall, suggesting that the maternal effects may have occurred. Conclusions Our study shows that the plasticity in growth and reproduction of E. gmelinii in response to rainfall variations may help it to gain dominance in the harsh and unpredictable desert environment. Furthermore, population development of this winter annual species should be promoted under the likely future scenarios of large rainfall events and increasing cool-season precipitation in temperate desert.
Does watching a movie improve empathy? A cluster randomized controlled trial

Background We studied if watching a movie about the patient physician encounter alone or in combination with a communication skills training workshop could improve empathy score of medical students. Methods One hundred and thirty three medical students participated in one of the following four groups of the study. Group A: a three hour workshop (42 students); group B: watching the movie “The Doctor” (23 students); group C: watching the movie “The Doctor”, then, participating in a three hour workshop the next day (22 students); group D: control group with no intervention (46 students). Participants completed Jefferson Scale of Empathy (JSE), Student Version to assess empathy score before and after the intervention, and one month later. A linear mixed effect model analyzed the effect of intervention across groups considering the effects of other significant variables. Results All of the three interventions had an immediate improving effect on empathy scores compared to control group. However, the improvement effect remained significant only in groups A (p=.015) and C (p=.001) one month later. Conclusions Watching selected movies has a significant but transient effect on empathy of students. Combining two methods of watching the movie and communication skills workshop, seems to add the beneficial effects.
Nanosome-Mediated Delivery Of Protein Kinase D Inhibitor Protects Chondrocytes From Interleukin-1β-Induced Stress And Apoptotic Death

Background Inflammatory stress caused by protein kinase D (PKD) plays a critical role in damaging chondrocytes and extracellular matrix (ECM) during osteoarthritis (OA). The PKD inhibitor (PKDi) (CRT0066101) has been used to overcome inflammation in different cell types. However, the efficacy of a therapeutic drug can be limited due to off-target distribution, slow cellular internalization, and limited lysosomal escape. In order to overcome this issue, we developed nanosomes carrying CRT0066101 (PKDi-Nano) and tested their efficacy in vitro in chondrocytes. Methods Chondrocytes were subjected to IL-1β-induced inflammatory stress treated with either PKDi or PKDi-Nano. Effects of treatment were measured in terms of cytotoxicity, cellular morphology, viability, apoptosis, phosphorylation of protein kinase B (Akt), and anabolic/catabolic gene expression analyses related to cartilage tissue. Results and Discussion The effects of PKDi-Nano treatment were more pronounced as compared to PKDi treatment. Cytotoxicity and apoptosis were significantly reduced following PKDi-Nano treatment (P < 0.001). Cellular morphology was also restored to normal size and shape. The viability of chondrocytes was significantly enhanced in PKDi-Nano-treated cells (P < 0.001). The data indicated that PKDi-Nano acted independently of the Akt pathway. Gene expression analyses revealed significant increases in the expression levels of anabolic genes with concomitant decreases in the level of catabolic genes. Our results indicate that PKDi-Nano attenuated the effects of IL-1β via the nuclear factor kappa-light-chain enhancer of activated B cells (NF-κB) pathway. Conclusion Taken together, these results suggest that PKDi-Nano can be used as a successful strategy to reduce IL1β-induced inflammatory stress in chondrocytes.
Resilience In Nepalese Adolescents: Socio-Demographic Factors Associated With Low Resilience

Background Resilience can be viewed as the potential to deal with stress positively. Resilient adolescents are likely to enter adulthood with a greater capacity to cope well in difficult circumstances. The purpose of this study was to measure resilience and the socio-demographic characteristics of Nepalese adolescents with low resilience. Methods A cross-sectional study of 4 randomly selected secondary schools in Lalitpur, Nepal, was conducted with 416 adolescent students (54.8% girls; M=16.1 years, SD=1.5). Resilience was measured using the Adolescent Resilience Questionnaire (ARQ) in Nepali. Socio-demographic factors investigated included personal (e.g. gender, age, ethnicity, religion, birth order, and participation in exercise), family (e.g. type of family, parents’ relationship status, employment and literacy) and community factors (e.g. living in an urban area). Results Mean resilience score was 311.7 (95% CI 308.6–314.5; SD=32.1) with 17.5% of adolescents classified as having low resilience. Socio-demographic factors associated with having low resilience included female gender (OR=1.73, 95% CI=1.03–2.95), attending a private school (OR=1.77, 95% CI=1.06–2.98), higher birth order compared to first born (OR=4.79, 95% CI=2.46–9.32), living in an urban area (OR=2.18, 95% CI=1.28–3.71); and being physically inactive (OR=3.0, 95% CI=1.77–5.08). Conclusion This first investigation of resilience in Nepalese adolescents using a standardised measure of resilience identified a number of socio-demographic factors as being associated with low resilience. While most socio-demographic factors are not modifiable, they can be used to guide educators and health professionals working with adolescents to identify those who may need greater support to achieve positive outcomes in the often challenging transition through adolescence and into adulthood.
Participating In The Race Across AMerica In A Team Of Eight Cyclists: Do Not Neglect Crew Preparation

Background The Race Across AMerica (RAAM) is considered as one of the longest, and most difficult cycling races in the world. It can be performed in solo or in relay of two, four or eight persons. Purpose/method The aim of the present study was to investigate several physiological, perceptual and psychological responses before, during and after RAAM in a team of eight amateur cyclists. Because logistics of all team is demanding and complex, crew members have followed the same testing procedure. Results The main result is that parameters were globally not altered to a greater extent in cyclists than in crew members over the course of the RAAM, and that all variables returned to pre-race levels 1 week after the end of the race in both groups. In crew, body fat was decreased (p < 0.05) at mid-race (Mid) vs 1 week before the RAAM (Pre) (−1.5%) and total body water was increased (p < 0.05) at Mid vs Pre (+2.5%). In pre-relay quadriceps strength in cyclists was significantly lower (p < 0.05) at Mid vs Pre (41.6 ± 9.1 vs 45.0 ± 11.2 N, d = 0.36). Therefore, performing the race with eight well-prepared amateur cyclists seems to decrease potential risks on health. In crew, quadriceps strength remained stable at each assessment time but general fatigue increased all along the race. Anger was increased (p < 0.05) at Mid vs Pre in crew. Conclusion The most important message of this study is that crew members for a team of eight require adequate and sufficient preparation and training. Roles and responsibilities need to be thoroughly defined; individuals need to know each other beforehand and they must be prepared for sleep deprivation. The results of this study show the importance of the preparation of two teams: crew members, as well as cyclists.
Lightness Discrimination Depends More on Bright Rather Than Shaded Regions of Three-Dimensional Objects

The brighter portions of a shaded complex object are in principle more informative about its lightness and are preferentially fixated during lightness judgments. In this study, we investigate whether preventing this strategy also has measurable detrimental effects on performance. Observers were presented with a reference and a comparison three-dimensional rendered object and had to choose which one was “painted with a lighter gray. ” The comparison was rendered with different diffuse reflectance values. We compared precision between three different conditions: full image, 20% of the lightest pixels removed, or 20% of the darkest pixels removed. Removing the bright pixels maximally impaired performance. The results confirm that the strategy of relying on the brightest areas of a complex object in order to estimate lightness is functionally optimal, yielding more precise representations.
Association Between Glucose Metabolism And Vascular Aging In Chinese Adults: A Cross-Sectional Analysis In The Tianning Cohort Study

Aim Fasting glucose has been associated with vascular aging, but the association between HbA1c and vascular aging has been limitedly studied in Chinese and other ethnic populations. We aimed to examine this association in a large sample of Chinese adults. Methods In the Tianning Cohort (N=5142), fasting glucose, HbA1c, carotid-femoral pulse wave velocity (cfPWV), and pulse pressure (PP) were measured. Vascular aging was defined as having the highest quartile level of cfPWV or PP. We applied quantile regression models to examine the association between glucose metabolism and vascular aging. Results The median cfPWV was significantly increased as increasing quintiles of fasting glucose (β=0.14, P<0.001) and HbA1c (β=0.07, P=0.0056), respectively. Per 1-mmol/L increment of fasting glucose was significantly associated with a higher risk of having vascular aging defined by cfPWV (OR=1.05, P=0.022), PP (OR=1.06, P=0.048), or either (OR=1.08, P=0.002). Similarly, per 1% increment of HbA1c was significantly associated with a higher risk of having vascular aging defined by cfPWV (OR=1.06, P=0.044), PP (OR=1.10, P=0.012), or either (OR=1.12, P=0.042). Conclusion Glucose metabolism was significantly and positively associated with vascular aging in Chinese adults, but the causality is uncertain.
Effectiveness of flipped classroom as a teaching–learning method among undergraduate medical students – An interventional study

BACKGROUND: Attempts to put the available teaching–learning time to better use and address the needs of students by increasing active involvement led to the evolution of the flipped classroom (FC). It involves providing study resources for students to use outside the class so that class time is freed up for instructional activities. This study was done to assess the effectiveness of flipped classroom activity as a teaching–learning method. MATERIALS AND METHODS: In this interventional study, 98 students were divided into two batches of flipped class and conventional small group teaching (SGT). An online Google group was created for the batch of FC. Brief introduction and prerecorded videos related to the assigned topic were posted in the Google group. Discussion was carried out in the form of solving cases and problem-solving exercises. Pretest and posttest were conducted at each session, and an end of module test was conducted for both the groups. RESULTS: There was a significant difference between the pre- and posttest scores and also the mean scores of summative test between two groups (P < 0.001). The perception of the students regarding FC was also evaluated. Eighty-two percent strongly agreed that FC was more engaging and interesting in comparison to traditional class. Seventy-six percent strongly agreed that more such classes should be conducted in the future. CONCLUSION: Flipped classroom improved the student performance and learning experience effectively as compared to conventional SGT, and students’ response was also largely positive.
Early Start Of Tenofovir Treatment Achieves Better Viral Suppression In Pregnant Women With A High HBV Viral Load: A Real-World Prospective Study

Purpose To investigate whether tenofovir disoproxil fumarate (TDF) treatment that started from the second trimester had an advantage over TDF treatment that started from the third trimester. Patients and methods Twenty 35-year-old pregnant women with hepatitis B virus (HBV) DNA >2×106 IU/mL were prospectively enrolled in this study. All participants were divided into two subgroups: the second trimester group who started TDF treatment at 24–27 weeks and the third trimester group who started TDF treatment at 28–30 weeks. The primary outcome was the change in serum HBV DNA level from baseline to delivery. Each parameter was tested every 4 weeks from TDF initiation to 3 months postpartum. Results There were 80 pregnant women in the second trimester group and 49 pregnant women in the third trimester group. The decline in HBV DNA from baseline to delivery was more obvious in the second trimester group (4.8±1.2 log10 IU/mL) than that in the third trimester group (4.3±1.1 log10 IU/mL, p=0.041). The downward shift of haemoglobin (HB) from baseline to delivery was greater in the second trimester group (10.6±10.7 g/L) than in the third trimester group (6.3±12.3 g/L, p=0.041). The decline in HBV DNA from baseline to delivery was linearly related to the start of TDF treatment from the second trimester (β=0.50 and 95% CI: 0.26–0.75, p<0.001). There were no significant differences between the two groups regarding HBV serologic markers and safety indicators. Conclusion Starting TDF treatment from the second trimester achieved better viral suppression than starting TDF treatment from the third trimester in highly viraemic pregnant women without increasing additional adverse reactions. HB level needed frequent monitoring during treatment to avoid anaemia. Registry number Clinical Trial No. NCT02719808.