Miracle-dz/UniFAR-FTUs huggingface dataset:
FOUR NEW BLACK HOLE CANDIDATES IDENTIFIED IN M31 GLOBULAR CLUSTERS WITH CHANDRA AND XMM-NEWTON

We have identified four new black hole candidates (BHCs) in M31 globular clusters (GCs) using 123 Chandra and 4 XMM-Newton observations of the M31 central region. The X-ray source associated with Bo 163 (XB163) is a recurrent transient with the highest observed luminosity, ∼1.4× 1038 erg s−1, considerably brighter than any outbursts from neutron star transients Aql X-1 or 4U 1608-452; the outburst apparently started ∼45 days earlier than the observed peak, and hence the luminosity may have been considerably higher. We identified XB082, XB153, and XB185 as BHCs by observing “low state” emission spectra at luminosities that exceed the threshold for neutron star binaries. The probability that these are neutron star systems with anisotropic emission beamed toward us is ≲ 4 × 10−4, and their variability suggests emission from a single source. We therefore conclude that these systems likely contain black holes rather than neutron stars. We have now identified four persistently bright BHCs in the region; the probability that these are all background active galactic nuclei is ≲1×10−20. According to theory, the donors could be tidally captured main-sequence stars or white dwarfs in ultracompact binaries. We find that GCs that are particularly massive (XB082) or metal-rich (XB144) can host bright X-ray sources in addition to GCs that are both (XB163). Our method may reveal BHCs in other bright X-ray sources.
Early immune markers of clinical, virological, and immunological outcomes in patients with COVID-19: a multi-omics study

Background: The great majority of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infections are mild and uncomplicated, but some individuals with initially mild COVID-19 progressively develop more severe symptoms. Furthermore, there is substantial heterogeneity in SARS-CoV-2-specific memory immune responses following infection. There remains a critical need to identify host immune biomarkers predictive of clinical and immunological outcomes in SARS-CoV-2-infected patients. Methods: Leveraging longitudinal samples and data from a clinical trial (N=108) in SARS-CoV-2-infected outpatients, we used host proteomics and transcriptomics to characterize the trajectory of the immune response in COVID-19 patients. We characterized the association between early immune markers and subsequent disease progression, control of viral shedding, and SARS-CoV-2-specific T cell and antibody responses measured up to 7 months after enrollment. We further compared associations between early immune markers and subsequent T cell and antibody responses following natural infection with those following mRNA vaccination. We developed machine-learning models to predict patient outcomes and validated the predictive model using data from 54 individuals enrolled in an independent clinical trial. Results: We identify early immune signatures, including plasma RIG-I levels, early IFN signaling, and related cytokines (CXCL10, MCP1, MCP-2, and MCP-3) associated with subsequent disease progression, control of viral shedding, and the SARS-CoV-2-specific T cell and antibody response measured up to 7 months after enrollment. We found that several biomarkers for immunological outcomes are shared between individuals receiving BNT162b2 (Pfizer–BioNTech) vaccine and COVID-19 patients. Finally, we demonstrate that machine-learning models using 2–7 plasma protein markers measured early within the course of infection are able to accurately predict disease progression, T cell memory, and the antibody response post-infection in a second, independent dataset. Conclusions: Early immune signatures following infection can accurately predict clinical and immunological outcomes in outpatients with COVID-19 using validated machine-learning models. Funding: Support for the study was provided from National Institute of Health/National Institute of Allergy and Infectious Diseases (NIH/NIAID) (U01 AI150741-01S1 and T32-AI052073), the Stanford’s Innovative Medicines Accelerator, National Institutes of Health/National Institute on Drug Abuse (NIH/NIDA) DP1DA046089, and anonymous donors to Stanford University. Peginterferon lambda provided by Eiger BioPharmaceuticals.
Hierarchical amplitude modulation structures and rhythm patterns: Comparing Western musical genres, song, and nature sounds to Babytalk

Statistical learning of physical stimulus characteristics is important for the development of cognitive systems like language and music. Rhythm patterns are a core component of both systems, and rhythm is key to language acquisition by infants. Accordingly, the physical stimulus characteristics that yield speech rhythm in “Babytalk” may also describe the hierarchical rhythmic relationships that characterize human music and song. Computational modelling of the amplitude envelope of “Babytalk” (infant-directed speech, IDS) using a demodulation approach (Spectral-Amplitude Modulation Phase Hierarchy model, S-AMPH) can describe these characteristics. S-AMPH modelling of Babytalk has shown previously that bands of amplitude modulations (AMs) at different temporal rates and their phase relations help to create its structured inherent rhythms. Additionally, S-AMPH modelling of children’s nursery rhymes shows that different rhythm patterns (trochaic, iambic, dactylic) depend on the phase relations between AM bands centred on ~2 Hz and ~5 Hz. The importance of these AM phase relations was confirmed via a second demodulation approach (PAD, Probabilistic Amplitude Demodulation). Here we apply both S-AMPH and PAD to demodulate the amplitude envelopes of Western musical genres and songs. Quasi-rhythmic and non-human sounds found in nature (birdsong, rain, wind) were utilized for control analyses. We expected that the physical stimulus characteristics in human music and song from an AM perspective would match those of IDS. Given prior speech-based analyses, we also expected that AM cycles derived from the modelling may identify musical units like crotchets, quavers and demi-quavers. Both models revealed an hierarchically-nested AM modulation structure for music and song, but not nature sounds. This AM modulation structure for music and song matched IDS. Both models also generated systematic AM cycles yielding musical units like crotchets and quavers. Both music and language are created by humans and shaped by culture. Acoustic rhythm in IDS and music appears to depend on many of the same physical characteristics, facilitating learning.
The effect of breast cancer surgery on spine alignment: Whole-spine radiograph analysis

Breast cancer survivors may experience spinal deformity following breast cancer surgery. This study investigated the long-term effects of breast cancer surgery on whole-spine alignment. This retrospective study included 200 patients who underwent breast cancer surgery and ≥2 anteroposterior standing whole-spine X-rays. The curvature of the spine was measured using the Cobb angle; changes in Cobb angle between X-rays were compared among three groups according to breast cancer surgery type. The mean interval between initial and follow-up X-ray was 28.46 ± 13.39 months. The change in Cobb angle was 0.40 ± 1.65 degrees and the absolute value of that change was 1.25 ± 1.15 degrees in all patients with breast cancer. There were no significant differences in angular change among groups according to breast cancer surgery type. Most patients showed minimal changes in spinal alignment after breast cancer surgery. Our findings indicate that breast cancer surgery does not negatively affect spinal alignment.
Novel scoring system based on clinical examination for prediction of in-hospital mortality in acute coronary syndrome patients: a retrospective cohort study

Background This study aims to develop PADjadjaran Mortality in Acute coronary syndrome (PADMA) Score to predict in-hospital mortality in acute coronary syndrome (ACS) patients based on clinical examination only. Additionally, we also compared the predictive value of the PADMA Score with the Global Registry of Acute Coronary Events (GRACE), Canada Acute Coronary Syndrome (C-ACS), and The Portuguese Registry of Acute Coronary Syndromes (ProACS) risk scores. Methods This retrospective cohort study included all ACS patients aged≥18 years who were admitted to Dr. Hasan Sadikin Central General Hospital from January 2018 to January 2022. Patients’ demographic, comorbidities and clinical presentation data were collected and analysed using multivariate logistic regression to create two models of scoring system (probability and cut-off model) to predict in-hospital all-cause mortality. The area under the curve (AUC) among PADMA, GRACE, C-ACS and ProACS risk scores was compared using the fisher Z test. Results Multivariate regression analysis of 1359 patients showed that older age, history of cerebrovascular disease, tachycardia, high Shock Index and Killip class III and IV were independent mortality predictors and included in the PADMA Score. PADMA Score ranged from 0 to 20, with a score≥5 that can predict all-cause mortality with 82.78% sensitivity and 72.35% specificity. The difference in AUC between PADMA and GRACE scores was insignificant (p=0.126). Moreover, the AUC of the PADMA Score was significantly higher compared with the C-ACS (p=0.002) and ProACS risk scores (p<0.001). Conclusion PADMA Score is a simple scoring system to predict in-hospital mortality in ACS patients. PADMA Score≥5 showed an accurate discriminative capability to predict in-hospital mortality, comparable with the GRACE Score and superior to C-ACS and ProACS scores.
Long‐term drought effects on the thermal sensitivity of Amazon forest trees

Abstract The continued functioning of tropical forests under climate change depends on their resilience to drought and heat. However, there is little understanding of how tropical forests will respond to combinations of these stresses, and no field studies to date have explicitly evaluated whether sustained drought alters sensitivity to temperature. We measured the temperature response of net photosynthesis, foliar respiration and the maximum quantum efficiency of photosystem II (F v/F m) of eight hyper‐dominant Amazonian tree species at the world's longest‐running tropical forest drought experiment, to investigate the effect of drought on forest thermal sensitivity. Despite a 0.6°C–2°C increase in canopy air temperatures following long‐term drought, no change in overall thermal sensitivity of net photosynthesis or respiration was observed. However, photosystem II tolerance to extreme‐heat damage (T 50) was reduced from 50.0 ± 0.3°C to 48.5 ± 0.3°C under drought. Our results suggest that long‐term reductions in precipitation, as projected across much of Amazonia by climate models, are unlikely to greatly alter the response of tropical forests to rising mean temperatures but may increase the risk of leaf thermal damage during heatwaves.
After-effects of thixotropic conditionings on operational chest wall and compartmental volumes of patients with Parkinson’s disease

Individuals with Parkinson’s disease (PD) present respiratory dysfunctions, mainly due to decreased chest wall expansion, which worsens with the course of the disease. These findings contribute to the restrictive respiratory pattern and the reduction in chest wall volume. According to literature, inspiratory muscle thixotropic conditioning maneuvers may improve lung volumes in these patients. The study aimed to determine the after-effects of respiratory muscle thixotropic maneuvers on breathing patterns and chest wall volumes of PD. A crossover study was performed with twelve patients with PD (8 males; mean age 63.9±8.8 years, FVC%pred 89.7±13.9, FEV1%pred 91.2±15, FEV1/FVC%pred 83.7±5.7). Chest wall volumes were assessed using OEP during thixotropic maneuvers. Increases in EIVCW (mean of 126mL, p = 0.01) and EEVCW (mean of 150mL, p = 0.005) were observed after DITLC (deep inspiration from total lung capacity) due to increases in pulmonary (RCp) and abdominal (RCa) ribcage compartments. Changes in ICoTLC (inspiratory contraction from TLC) led to significant EIVCW (mean of 224mL, p = 0.001) and EEVCW (mean of 229mL, p = 0.02) increases that were mainly observed in the RCp. No significant changes were found when performing DERV (deep expiration from residual volume) and ICoRV (Inspiratory contraction from RV). Positive correlations were also observed between the degree of inspiratory contraction during ICoTLC and EEVRCp (rho = 0.613, p = 0.03) and EIVRCp (rho = 0.697, p = 0.01) changes. Thixotropy conditioning of inspiratory muscles at an inflated chest wall volume increases EIVCW and EEVCW in the ten subsequent breaths in PD patients. These maneuvers are easy to perform, free of equipment, low-cost, and may help patients improve chest wall volumes during rehabilitation.
Are binocular alignment and convergence amplitude different between phakic and pseudophakic older patients?

ABSTRACT Purpose To compare the binocular alignment status and convergence amplitude between phakic and pseudophakic older adults. Methods The present report is a part of the Tehran Geriatric Eye Study (TGES), a population-based study performed on the elderly population above 60 years of age in Tehran, Iran. All study participants were transferred to the examination site and underwent complete ocular examinations including the measurement of uncorrected and best-corrected visual acuity, objective and subjective refraction, unilateral and alternating cover tests, and slit-lamp biomicroscopy. Results Of 3791 invitees, 3310 participated in the TGES (response rate: 87.3%). After applying the exclusion criteria, the data of 1969 individuals were analyzed for this report. The mean of far exophoria, far esophoria, near exophoria, and near esophoria was 5.09 ± 3.66, 8.20 ± 9.60, 6.94 ± 3.69, 7.00 ± 5.83 prism diopter in phakic and 5.15 ± 2.43, 6.50 ± 5.80, 7.77 ± 4.00, 4.75 ± 1.50 prism diopter in pseudophakic individuals, respectively. The mean of far exotropia, far esotropia, near exotropia, and near esotropia was 14.92 ± 9.49, 22.00 ± 13.86, 15.09 ± 7.20, 21.33 ± 14.47 prism diopter in phakic and 19.67 ± 22.5, 8.00 ± 0, 17.36 ± 7.55, 17.36 ± 7.55, 0 prism diopter in pseudophakic individuals, respectively. Near exophoria (P = .003) was significantly higher in pseudophakic than in phakic participants after controlling the effects of age, sex, body mass index, diabetes, and hypertension. The mean near point of convergence was 7.94 ± 3.27 cm in phakic and 7.99 ± 3.3 cm in pseudophakic participants. Conclusion Near exophoria was significantly higher in pseudophakic compared to phakic individuals while other deviations and near point of convergence were not significantly different between phakic and pseudophakic groups.
Risk factors and recurrence of cause-specific postpartum hemorrhage: A population-based study

Objective To explore risk profiles of the different types of postpartum hemorrhage (PPH >500ml or severe PPH >1500ml) and their recurrence risks in a subsequent delivery. Methods With data from The Medical Birth Registry of Norway and Statistics Norway we performed a population-based cohort study including all singleton deliveries in Norway from 1967–2017. Multilevel logistic regression was used to calculate odds ratio (OR), with 95% confidence interval (CI), with different PPH types (PPH >500ml or PPH >1500ml (severe PPH) combined with retained placenta, uterine atony, obstetric trauma, dystocia, or undefined cause) as outcomes. Result We identified 277 746 PPH cases of a total of 3 003 025 births (9.3%) from 1967 to 2017. Retained placenta (and/or membranes) was most often registered as severe PPH (29.3%). Maternal, fetal, and obstetric characteristics showed different associations with the PPH types. Male sex of the neonate was associated with reduced risk of PPH. This effect was strongest on PPH due to retained placenta (adjusted OR, (aOR): 0.80, 95% CI 0.78–0.82), atony (aOR 0.92, 95% CI: 0.90–0.93) and PPH with undefined cause (aOR 0.96, 95% CI: 0.95–0.97). Previous cesarean section showed a strong association with PPH due to dystocia (aOR of 13.2, 95% CI: 12.5–13.9). Recurrence risks were highest for the same type: PPH associated with dystocia (aOR: 6.8, 95% CI: 6.3–7.4), retained placenta and/or membranes (aOR: 5.9, 95% CI: 5.5–6.4), atony (aOR: 4.0, 95% CI: 3.8–4.2), obstetric trauma (aOR: 3.9, 95% CI: 3.5–4.3) and PPH of undefined cause (aOR: 2.2, 95% CI: 2.1–2.3). Conclusion Maternal, fetal and obstetric characteristics had differential effects on types of PPH. Recurrence differed considerably between PPH types. Retained placenta was most frequently registered with severe PPH, and showed strongest effect of sex; delivery of a boy was associated with lower risk of PPH. Previous cesarean increased the risk of PPH due to dystocia.
Improved Sobolev's inequalities, relative entropy and fast diffusion equations

The difference of the two terms in Sobolev's inequality (with optimal constant) measures a distance to the manifold of the optimal functions. We give an explicit estimate of the remainder term and establish an improved inequality, with explicit norms and fully detailed constants. Our approach is based on nonlinear evolution equations and improved entropy - entropy production estimates along the associated flow. Optimizing a relative entropy functional with respect to a scaling parameter, or handling properly second moment estimates, turns out to be the central technical issue. This is a new method in the theory of nonlinear evolution equations, which also applies to other interpolation inequalities of Gagliardo-Nirenberg-Sobolev type.
Accuracy of neuropathic pain measurements in patients with symptoms of polyneuropathy: validation of painDETECT, S-LANSS, and DN4.

ABSTRACT Pain is a common symptom in patients referred to polyneuropathy assessment. Diagnostic evaluation and choice of treatment may depend on whether the pain is likely to be neuropathic or not. The present study aimed to investigate the diagnostic accuracy of three tools commonly used to differentiate between neuropathic and non-neuropathic pain. To accomplish this, we included patients with bilateral distal lower extremity pain, referred to neurological outpatient clinics at five Norwegian University hospitals for polyneuropathy assessment. The patients filled in Norwegian versions of painDETECT, the Self-completed Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), and the clinician-rated Douleur Neuropathique 4 (DN4). All patients underwent a clinical examination and nerve conduction measurements, and were classified according to the NeuPSIG neuropathic pain criteria (reference standard). In total, 729 patients were included, of which 63% had neuropathic pain by the reference standard. Only DN4 demonstrated high sensitivity (0.87), while all three tools had low specificity (≤0.65). Importantly, the tools' predictive ability was unsatisfactory; The probability of getting a correct test result was three quarters at best, and at worst, no better than two fifths. Consequently, we show that neither DN4, painDETECT nor S-LANSS can be confidently used to assess neuropathic pain in a neurological outpatient population with symptoms of polyneuropathy.
Quality of life in older adults with chronic kidney disease and transient changes in renal function: Findings from the Oxford Renal cohort

Background Quality of life (QoL) is an important measure of disease burden and general health perception. The relationship between early chronic kidney disease (CKD) and QoL remains poorly understood. The Oxford Renal Study (OxRen) cohort comprises 1063 adults aged ≥60 years from UK primary care practices screened for early CKD, grouped according to existing or screen-detected CKD diagnoses, or biochemistry results indicative of reduced renal function (referred to as transient estimated glomerular filtration rate (eGFR) reduction). Objectives This study aimed to compare QoL in participants known to have CKD at recruitment to those identified as having CKD through a screening programme. Methods Health profile data and multi-attribute utility scores were reported for two generic questionnaires: 5-level EuroQol-5 Dimension (EQ-5D-5L) and ICEpop CAPability measure for Adults (ICECAP-A). QoL was compared between patients with existing and screen-detected CKD; those with transient eGFR reduction served as the reference group in univariable and multivariable linear regression. Results Mean and standard deviation utility scores were not significantly different between the subgroups for EQ-5D-5L (screen-detected:0.785±0.156, n = 480, transient:0.779±0.157, n = 261, existing CKD:0.763±0.171, n = 322, p = 0.216) or ICECAP-A (screen-detected:0.909±0.094, transient:0.904±0.110, existing CKD:0.894±0.115, p = 0.200). Age, smoking status, and number of comorbidities were identified as independent predictors of QoL in this cohort. Conclusion QoL of participants with existing CKD diagnoses was not significantly different from those with screen-detected CKD or transient eGFR reduction and was similar to UK mean scores for the same age, suggesting that patient burden of early CKD is minor. Moreover, CKD-related comorbidities contribute more significantly to disease burden in earlier stages of CKD than renal function per se. Larger prospective studies are required to define the relationship between QoL and CKD progression more precisely. These data also confirm the essentially asymptomatic nature of CKD, implying that routine screening or case finding are required to diagnose it.
Experiences that influence how trained providers support women with breastfeeding: A systematic review of qualitative evidence

Introduction There is a need to improve breastfeeding support interventions as although many are evidence-based, a sequential increase in breastfeeding rates is not evident. It is crucial to understand why the implementation of evidence-based guidelines in practice does not always translate to positive experiences for women and improve breastfeeding rates. This systematic review aims to synthesise breastfeeding support experiences of trained support providers and their impact on breastfeeding support practices. Methods A strategy was developed to search seven databases including Medline and CINAHL and grey literature for qualitative studies. Studies eligible for inclusion reported professional and trained peer experiences of supporting women to breastfeed. PRISMA guidelines were followed and included studies were quality appraised using the CASP Qualitative Checklist. A thematic synthesis of included studies was undertaken and confidence in the review findings was assessed using the CERQual tool. The study protocol, registered in the International Prospective Register of Systematic Reviews PROSPERO registration number: CRD42020207380, has been peer reviewed and published. Findings A total of 977 records were screened, which identified 18 studies (21 papers) eligible for inclusion comprising 368 participants. Following quality appraisal, all studies were deemed suitable for inclusion. The thematic synthesis resulted in four analytical themes: 1) A personal philosophy of breastfeeding support 2) Teamwork and tensions in practice 3) Negotiating organisational constraints and 4) Encounters with breastfeeding women. Findings demonstrated that a range of experiences influence practice, and practice evolves on continued exposure to such experiences. The potential of each experience to facilitate or inhibit breastfeeding support provision is fluid and context specific. Conclusions Experiences, as named above, are modifiable factors contributing to the development of a philosophy of breastfeeding support based on what the provider believes works and is valuable in practice. Further research is required into the range of factors which underpin context-specific breastfeeding support practice, to improve both women’s experiences and intervention effectiveness.