Miracle-dz/UniFAR-FTUs huggingface dataset:
Variations and characteristics of the various clinical phenotypes in a cohort of Nigerian sickle cell patients

ABSTRACT Background Sickle cell anaemia affects about 4 million people across the globe, making it an inherited disorder of public health importance. Red cell lysis consequent upon haemoglobin crystallization and repeated sickling leads to anaemia and a baseline strain on haemopoiesis. Vaso-occlusion and haemolysis underlies majority of the chronic complications of sickle cell. We evaluated the clinical and laboratory features observed across the various clinical phenotypes in adult sickle cell disease patients. Methods Steady state data collected prospectively in a cohort of adult sickle cell disease patients as out-patients between July 2010 and July 2020. The information included epidemiological, clinical and laboratory data. Results About 270 patients were captured in this study (165 males and 105 females). Their ages ranged from 16 to 55 years, with a median age of 25 years. Sixty-eight had leg ulcers, 43 of the males had priapism (erectile dysfunction in 8), 42 had AVN, 31 had nephropathy, 23 had osteomyelitis, 15 had osteoarthritis, 12 had cholelithiasis, 10 had stroke or other neurological impairment, 5 had pulmonary hypertension, while 23 had other complications. Frequency of crisis ranged from 0 to >10/year median of 2. Of the 219 recorded, 148 of the patients had been transfused in the past, while 71 had not. Conclusion The prevalence of SLU, AVN, priapism, nephropathy and the other complications of SCD show some variations from other studies. This variation in the clinical parameters across different clinical phenotypes indicates an interplay between age, genetic and environmental factors.
Effect of Biochar and Inorganic Fertilizer on the Soil Properties and Growth and Yield of Onion (Allium cepa) in Tropical Ethiopia

Biochar is a carbon-rich product, which is processed by pyrolyzing biomass to improve soil properties and maintain environmental sustainability. This study aim was to investigate the effect of biochar and inorganic fertilizer on soil properties, growth, and yield. Four treatments and four replications have been used for the experimental plots using Randomized Complete Block Design (RCBD). Soil physiochemical properties have been investigated based on soil samples within 0–30 cm depth in each plot. The two types of biochar (grass and chat waste) have been used for the treatments. The pyrolyzing temperature required for grass and chat waste is 250°C and 1100°C, respectively. The plant height, total yield, and the marketable and nonmarketable yield of onion have been examined. The analysis showed that treatment with grass biochar and inorganic fertilizer had a similar effect on soil properties but chat (Catha edulis) biochar had a lower effect on soil properties. The total yield and days to 70% maturity have been increased due to the cumulative treatment of grass biochar and inorganic fertilizer. The biochar of grass and inorganic fertilizer have been significantly increased in marketable bulb yield, but unmarketable yield becomes decreased. The chat waste and controlled treatments shown an increased unmarketable yield and declined marketable bulb yield. Overall, biochar can substitute the inorganic fertilizer, which can help to improve the w soil fertility and environmental sustainability. Therefore, biochar has a win-win solution.
Relational binding and holistic retrieval in ageing

ABSTRACT Episodic memory binds together diverse elements of an event into a cohesive unit. This property enables the reconstruction of multidimensional experiences when triggered by a cue related to a past event via pattern completion processes. Such holistic retrieval is evident in young adults, as shown by dependency in the retrieval success for different associations from the same event [Horner, A. J., & Burgess, N. The associative structure of memory for multi-element events. Journal of Experimental Psychology: General, 142(4), 1370–1383. https://doi.org/10.1037/a0033626, 2013; Horner, A. J., & Burgess, N. (2014). Pattern completion in multielement event engrams. Current Biology, 24(9), 988–992. https://doi.org/10.1016/j.cub. 2014.03. 012, 2014]. Aspects of episodic memory capacity are vulnerable to ageing processes, including reduced abilities to form linkages among aspects of an event through relational binding (Naveh-Benjamin, 2000). Here, we used dependency analyses to examine whether older adults retrieve events holistically, and whether the degree of holistic retrieval declines with old age. We found that both young and older adults retrieved events as an integrated unit, but older adults showed a lower magnitude of holistic retrieval compared to young adults. Holistic retrieval declined with advancing age, even after controlling for pairwise relational binding performance. These results suggest that a decline in holistic retrieval is an aspect of episodic memory decrements in cognitive ageing.
Characterizing Out-of-Pocket Payments and Financial Assistance for Patients Prescribed Abiraterone and Enzalutamide at an Academic Cancer Center Specialty Pharmacy

PURPOSE: Abiraterone and enzalutamide are commonly used oral cancer therapies for patients with prostate cancer, both with potentially high out-of-pocket costs for patients. We investigated the prevalence of financial assistance mechanisms used to alleviate out-of-pocket costs and the association of these mechanisms with timing of treatment initiation of abiraterone or enzalutamide. METHODS: Using data from the medical center's specialty pharmacy, we identified first prescriptions for abiraterone or enzalutamide between January 1, 2017, and March 31, 2019. Prescriptions dispensed at an external pharmacy or that were discontinued for reasons unrelated to cost were excluded. Patient demographics, insurance coverage, out-of-pocket cost, and number of days between prescribed date and pill-to-mouth date were collected. RESULTS: Among 220 prescriptions in our final cohort, 185 were filled through our internal specialty pharmacy, 23 through a manufacturer-sponsored patient assistance program (PAP), and 12 were never filled because of cost. One third of the prescriptions in our final cohort (n = 66) were filled with financial assistance: PAP (10%), copay cards (9%), and grants (11%). The median amount of assistance received for the first fill was $2,860 US dollars (USD) (interquartile range $1,856-$10,717 USD). Prescriptions with an out-of-pocket cost < $100 USD were filled in the shortest time (median 5 days), whereas those filled through a PAP had the longest time to initiation (median 30.5 days). CONCLUSION: Among patients prescribed oral therapies for prostate cancer at a single institution, one third of patients received financial assistance. Although receiving assistance is likely to improve financial toxicity, waiting for assistance may lead to longer time to initiation of medication.
Inappropriate use of antibiotics, its reasons and contributing factors among communities of Yirgalem town, Sidama regional state, Ethiopia: A cross-sectional study

Objectives: The aim of this study was to assess the inappropriate use of antibiotics, its reasons and contributing factors among communities of Yirgalem town, Sidama regional state, Ethiopia. Methods: The study was conducted in Yirgalem town from 1 March to 30 March 2019. A cross-sectional study with interviewer administered structured and pretested questionnaire was used. A multistage sampling procedure was employed involving a total of 568 participants who used antibiotics in the past 1 year prior to the study period. Data were entered into Epi data version 3.1, and then exported to statistical package for social science version 20 for analysis. Descriptive statistics, bivariate and multivariate logistic regression analysis were done. p-value < 0.05 was used to consider significant variables. Results: The magnitude of inappropriate use of antibiotics was 37.9% (95% confidence interval (34.0, 41.5)). Main reason(s) for inappropriate use were long delays in health facility, cost-cutting and busy day’s program. Being employed (adjusted odds ratio = 3.45, 95% confidence interval (1.98, 6.02)), age 25–34 years (adjusted odds ratio = 2.89, 95% confidence interval (1.43, 5.84)), being male (adjusted odds ratio = 1.90, 95% confidence interval (1.20, 3.02)), seeking modern healthcare in private clinic (adjusted odds ratio = 2.54, 95% confidence interval (1.20, 5.36)), delayed waiting time in healthcare facilities (adjusted odds ratio = 4.87, 95% confidence interval (2.17, 10.91)), experienced with similar symptom/disease (adjusted odds ratio = 3.02, 95% confidence interval (1.89, 4.83)) and family size above five (adjusted odds ratio = 8.92, 95% confidence interval (3.56, 22.38)) were predictors positively associated with inappropriate use of antibiotics. Conclusion: The magnitude of inappropriate antibiotics use was high. Attention should be given to community education through involvement of the private health sector and healthcare providers about rational use of antibiotics.
Outbreaks of SARS-CoV-2 in naturally infected mink farms: Impact, transmission dynamics, genetic patterns, and environmental contamination

SARS-CoV-2 infection outbreaks in minks have serious implications associated with animal health and welfare, and public health. In two naturally infected mink farms (A and B) located in Greece, we investigated the outbreaks and assessed parameters associated with virus transmission, immunity, pathology, and environmental contamination. Symptoms ranged from anorexia and mild depression to respiratory signs of varying intensity. Although the farms were at different breeding stages, mortality was similarly high (8.4% and 10.0%). The viral strains belonged to lineages B.1. 1.218 and B.1. 1.305, possessing the mink-specific S-Y453F substitution. Lung histopathology identified necrosis of smooth muscle and connective tissue elements of vascular walls, and vasculitis as the main early key events of the acute SARS-CoV-2-induced broncho-interstitial pneumonia. Molecular investigation in two dead minks indicated a consistently higher (0.3–1.3 log10 RNA copies/g) viral load in organs of the male mink compared to the female. In farm A, the infected farmers were responsible for the significant initial infection of 229 out of 1,000 handled minks, suggesting a very efficient human-to-mink transmission. Subsequent infections across the sheds wherein animals were being housed occurred due to airborne transmission. Based on a R0 of 2.90 and a growth rate equal to 0.293, the generation time was estimated to be 3.6 days, indicative of the massive SARS-CoV-2 dispersal among minks. After the end of the outbreaks, a similar percentage of animals were immune in the two farms (93.0% and 93.3%), preventing further virus transmission whereas, viral RNA was detected in samples collected from shed surfaces and air. Consequently, strict biosecurity is imperative during the occurrence of clinical signs. Environmental viral load monitoring, in conjunction with NGS should be adopted in mink farm surveillance. The minimum proportion of minks that need to be immunized to avoid outbreaks in farms was calculated at 65.5%, which is important for future vaccination campaigns.
Management of Flap Failure After Head and Neck Reconstruction: A Systematic Review and Meta-analysis

Objective To systematically review management of flap loss in head and neck construction with free tissue transfer as compared with locoregional flap or conservative management. Data Sources Medline, Embase, Scopus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ClinicalTrials.gov were searched up to October 2019. Review Methods Candidate articles were independently reviewed by 2 authors. Articles were considered eligible if they included adequate reporting of flap management after flap loss and outcomes for survival of reconstruction, length of hospitalization, and perioperative complications. Results A total of 429 patients had acute flap failure in the perioperative period. The overall success with a secondary free flap was 93% (95% CI, 0.89-0.97; n = 26 studies, I2 = 12.8%). There was no difference in hospitalization length after secondary reconstruction between free tissue transfer and locoregional flaps or conservative management (relative risk of hospitalization ≥2 weeks, 96%; 95% CI, 0.80-1.14; n = 3 studies, I2 = 0). The pooled relative risk of perioperative complications following free tissue transfer was 0.60 when compared with locoregional flap or conservative management (95% CI, 0.40-0.92; n = 5 studies, I2 = 0). Conclusion Salvage reconstruction with free tissue transfer has a high success rate. Second free flaps following flap failure had a similar length of hospitalization and lower overall complication rate than locoregional reconstruction or conservative management. A second free tissue transfer, when feasible, is likely a more reliable and effective procedure for salvage reconstruction.
Concurrent sexual partnerships and HIV testing among heterosexual Black men in Ontario, Canada: findings from the weSpeak study

ABSTRACT Background African, Caribbean, and Black men constitute the second-highest category of males living with HIV in Ontario, which increased from 15.4% to 17% between 2011 and 2016. Previous studies have attributed this disproportionately higher rate to multiple concurrent sexual partnerships and low rates of HIV testing. Drawing on theoretical constructs of the health belief model (HBM), this study examined the relationship between multiple concurrent sexual partnerships and the uptake of HIV testing services among heterosexual Black men in Ontario. Methods Using a cross-sectional sample data of 829 individuals from four cities in Ontario, we employed the multinomial logit analysis to examine the relationship between multiple sexual partnerships and the uptake of HIV testing services among heterosexual Black men. Results The findings show that heterosexual Black men with multiple concurrent sexual partners were more than twice (RRR = 2.306, P < 0.01) as likely to test for HIV within the past 12 months when compared to those with one partner. Furthermore, being an immigrant, having good knowledge of HIV transmission, and earning lower annual income predicted higher odds of testing while sexual debut between the ages of 16 and 20 years, no visit to a healthcare provider in the past year and difficulty accessing healthcare significantly predicted lower likelihood of testing for HIV. Conclusions These findings align with the theoretical constructs of the health belief model but more importantly, they suggest heterosexual Black men with concurrent sexual partners may be aware of their HIV risk and are taking measures to know their serostatus. Hence, making HIV screening services accessible and at safer spaces could increase their use of HIV screening services.
The expression of matrix metalloproteinases and their tissue inhibitors in the vein wall following superficial venous thrombosis

Objectives Superficial venous thrombosis (SVT) is the complications of varicose great saphenous veins (VGSVs), but its pathogenesis remains unclear. This study was designed to measure the changes in expression of matrix metalloproteinases (MMPs) and the tissue inhibitor of metalloproteinases (TIMPs) from SVT, VGSVs, and great saphenous veins (GSVs). Methods In the venous walls of the three groups, the expression of MMP-2, MMP-9, TIMP-1, and TIMP-2 proteins, protein-positive expression ratios, mRNA expression, and protein expression were determined by immunohistochemistry, polymerase chain reaction, and western blot. Results The MMP-2, MMP-9, TIMP-1, and TIMP-2 protein-positive expression ratios, mRNA and protein expression in the SVT group were significantly higher than those in the VGSV and the GSV groups. The corresponding expression in the VGSV group were significantly higher than those in the GSV group. Conclusion Disequilibrium of MMPs and TIMPs in SVT wall occurs due to underlying high hydrostatic pressure and inflammation. These results suggested that MMPs and TIMPs participate in the process of venous wall remodeling.
Remote Versus In-hand Hardware Laboratory in Digital Circuits Courses

The COVID-19 pandemic has isolated many engineering students at home and complicated access to instrumentation and hardware resources necessary to support laboratory courses. One viable alternative to bringing the hardware to students (and the correspondingly high overhead associated with shipping laboratory kits all over the world) is to enable remote access to that hardware. A remote lab allows students to access real hardware physically located in a single location from anywhere in the world. Advances in cloud computing allow students to take advantage of a full-fledged remote experience without compromising what they could have accomplished if they were physically present in the lab. While remote access laboratories are not new, the COVID-19 pandemic has enabled a unique opportunity to compare learning with how remote access to real hardware vs. hands-on access to the same hardware. Comparisons between the two modes of learning were made for a junior level course in digital circuit design using field programmable gate array (FPGA) hardware offered via remote access in autumn 2020 and via hands-on access in the same course in winter 2020. Detailed assessments of student work were grounded in Bloom's Taxonomy to classify the complexity of student cognition and learning. This study presents assessment results associated with a single laboratory assignment that was the first in a series of laboratory assignments in the digital design course. Work from 41 students from each offering were analyzed within the first five levels of Bloom's Taxonomy. Results show that students performed significantly better in terms of overall scores and analyze skills when presented with remote access to laboratory hardware than when having that hardware in hand. Comparisons between the two settings in the remaining four levels of Bloom's Taxonomy (remember, understand, apply, evaluate) were not significantly different between the two offerings. These results complement other studies that highlight the benefits of remote laboratories. Accordingly, the increased efficiency and cost savings of the remote lab approach can offer stable and reliable instruction well beyond the COVID-19 crisis. © American Society for Engineering Education, 2021
Morphology of the stifle in agouti (Dasyprocta prymnolopha, Wagler 1831)

The agouti (Dasyprocta prymnolopha, Wagler 1831) is a wild rodent of great zootechnical potential, a fact that enables anatomical and morphological studies to support management actions with this animal. In this perspective, this study aimed to describe the anatomy and histology of the agouti stifle joint. Four adult agoutis were used, two females and two males. The animals were submitted to dissection and identification of the structures of the stifle joint. For light microscopy study, samples of the patellar ligament, cranial and caudal cruciate ligaments, medial and lateral collateral ligaments were used. Agouti has a highly congruent patellofemoral joint; elongated patella; medial and lateral fabellae at the proximal insertion of the gastrocnemius muscle; medial and lateral meniscus with lunula; in addition to the presence of the following ligament structures: patellar ligament, cranial and caudal cruciate ligaments, medial and lateral collateral ligaments, meniscofemoral ligament, caudal meniscal ligament of the medial meniscus, and medial and lateral cranial ligaments. The patellar ligament presents bundles of parallel collagen fibers with a straight path and coated fibroblasts; collateral and cruciate ligaments had loose and dense connective tissue, coated fibroblasts and collagen bundle undulations, the latter most expressive in the caudal cruciate ligament. Thus, except for the shape and angulation of the stifle, which allows specific movements, the agouti stifle has structures analogous to that of other rodents and domestic animals.
Focally administered succinate improves cerebral metabolism in traumatic brain injury patients with mitochondrial dysfunction

Following traumatic brain injury (TBI), raised cerebral lactate/pyruvate ratio (LPR) reflects impaired energy metabolism. Raised LPR correlates with poor outcome and mortality following TBI. We prospectively recruited patients with TBI requiring neurocritical care and multimodal monitoring, and utilised a tiered management protocol targeting LPR. We identified patients with persistent raised LPR despite adequate cerebral glucose and oxygen provision, which we clinically classified as cerebral ‘mitochondrial dysfunction’ (MD). In patients with TBI and MD, we administered disodium 2,3-13C2 succinate (12 mmol/L) by retrodialysis into the monitored region of the brain. We recovered 13C-labelled metabolites by microdialysis and utilised nuclear magnetic resonance spectroscopy (NMR) for identification and quantification. Of 33 patients with complete monitoring, 73% had MD at some point during monitoring. In 5 patients with multimodality-defined MD, succinate administration resulted in reduced LPR(−12%) and raised brain glucose(+17%). NMR of microdialysates demonstrated that the exogenous 13C-labelled succinate was metabolised intracellularly via the tricarboxylic acid cycle. By targeting LPR using a tiered clinical algorithm incorporating intracranial pressure, brain tissue oxygenation and microdialysis parameters, we identified MD in TBI patients requiring neurointensive care. In these, focal succinate administration improved energy metabolism, evidenced by reduction in LPR. Succinate merits further investigation for TBI therapy.
Anthropogenic climate change has altered lake state in the Sierra Nevada (California, USA)

Climatic changes threaten freshwater resources and aquatic ecosystem health in the Sierra Nevada (California, USA), which has important consequences for millions of people and the world's fifth largest economy. However, the timing and magnitude of ecological changes driven by hydroclimate oscillations remain poorly understood in California's headwater region. Here, we develop a precisely dated, annually to decadally resolved lake sediment record of ecological change from the eastern Sierra Nevada that spans the last three millennia. Diatom paleoecology reveals a detailed history of abrupt limnologic transitions, best explained by modifications in water column stratification, mixing, and nutrient status in response to changing seasonality. Seasonally stratified conditions were registered during the Late Holocene Dry Period and the Medieval Climate Anomaly, illustrating the sensitivity of fossil diatoms to well‐known periods of drought. Yet the most striking feature of the record is the uniqueness of ~1840–2016 CE: a period of singularly strong water column stratification, increased algal diversity, and reduced diatom productivity consistent with unprecedented “hot droughts. ” The data demonstrate that hot–dry conditions of the Industrial Era altered lake state to conditions unseen in the past ~3180 years, and suggest that regional trends identified by historical monitoring began far earlier than previously recognized. Our record illustrates the profound influence of anthropogenic climate warming on high‐elevation lakes and the ecosystem services they provide in the Sierra Nevada, which hold implications for water quality and availability in California.