Miracle-dz/UniFAR-FTUs huggingface dataset:
A Prospective Observational Study to Determine the Predictors of Increased Number of Attempts at Labour Epidural Placement

Objective Multiple attempts at labour epidural placement result in patient discomfort and high incidence of complications. Identifying the factors that lead to more than one attempt would help anaesthesiologists prepare in advance such as getting expert help and additional equipment, patient counselling or planning alternative management. Methods This prospective observational study was conducted on 500 patients from July 2017 to June 2018 after obtaining approval from the institutional Ethics Review Committee. The study patients consisted of full-term parturient women who were admitted in the labour room suite of Aga Khan Hospital requesting for labour epidural and consented to participate in the study. A predesigned form was used to collect the following data: number of attempts at epidural insertion and factors such as patients’ demographics, cervical dilatation, anatomical grading of spine according to visibility and palpation of spinous process and vertebral interspace, experience level of the anaesthesiologist, patient satisfaction and pain score during labour. Results The average age of the patients was 28.11±4.02 years. The total number of epidural attempts varied between one and four; the median number of attempts was 1 [IQR=1–2]. Anatomical grade of the spine was the only factor that was significantly associated with more than one attempt at epidural insertion (p=0.0005). Patient satisfaction was negatively associated with the number of attempts (p=0.04), but mean pain difference at different time points during the course of labour was not statistically significant between patients with one attempt and those with more than one attempt. Conclusion Determining the anatomical grade of the spine is the most reliable method for predicting a technically difficult neuraxial block that requires more than one attempt at epidural insertion.
PAKC: A novel panel of HLA class I antigen presentation machinery knockout cells from the same genetic origin

With the emergence of immunotherapies, the understanding of functional HLA class I antigen presentation to T cells is more relevant than ever. Current knowledge on antigen presentation is based on decades of research in a wide variety of cell types with varying antigen presentation machinery (APM) expression patterns, proteomes and HLA haplotypes. This diversity complicates the establishment of individual APM contributions to antigen generation, selection and presentation. Therefore, we generated a novel Panel of APM Knockout Cell lines (PAKC) from the same genetic origin. After CRISPR/Cas9 genome-editing of ten individual APM components in a human cell line, we derived clonal cell lines and confirmed their knockout status and phenotype. We then show how PAKC will accelerate research on the functional interplay between APM components and their role in antigen generation and presentation. This will lead to improved understanding of peptide-specific T cell responses in infection, cancer and autoimmunity. Key points We generated a panel of cell lines to study HLA class I antigen presentation We show how this will spark research in infection, tumor biology and autoimmunity
Les spécificités du self dans les troubles du spectre de l'autisme sans déficience intellectuelle à l'âge adulte

Des les descriptions princeps des Troubles du Spectre de l’Autisme (TSA), l’accent a ete mis sur les perturbations de l’identite subjective qu’il est possible d’etudier grâce a la conceptualisation de Conway qui fait interagir le self et la memoire autobiographique. En nous basant sur ce modele, nous avons explore les specificites du self dans les TSA Sans Deficience Intellectuelle (TSASDI) a travers l’etude de ses dimensions subjectives, conceptuelles et structurelles. Nos resultats retrouvent une atteinte du self au niveau structurel mais pas conceptuel ou subjectif. De plus, nous avons montre une atteinte de la fonction sociale de la memoire autobiographique et que les images de soi sociales appartenant au self etaient associees a des souvenirs qualitativement differents. Nos resultats nuancent l’alteration de la composante episodique de la memoire autobiographique et invitent a preciser l’influence des relations sociales sur le self et la memoire autobiographique dans ces troubles.
Causes and Consequences of Drug Abuse among Youth in Kwara State, Nigeria

Drug abuse is one of the health-related problems among Nigerian youth and has been a source of concern to educational stakeholders. Its social implications to undergraduate students cannot be quantified. In light of this, this study examined causes and consequences of drug abuse among undergraduates at the University of Ilorin, Kwara State, Nigeria. A descriptive survey design was adopted for the study and a simple random sampling technique was used to select the respondents for the study. The instrument used was a researcher-designed questionnaire on the causes and consequences of drug abuse among undergraduates. The instrument was validated by lecturers in the Department of Social Sciences Education and it possessed a coefficient of 0.72 using a test re-test method. All of the undergraduate students of the University of Ilorin formed the population of the study. The demographic data of the respondents and drug abuse variable were described and analyzed using percentages. Means were used to analyze the research question, while t-test and Analysis of Variance (ANOVA) were used to test the null hypotheses at a 0.05 level of significance. The findings of the study revealed that the major cause of drug abuse among undergraduates at the University of Ilorin was the need to cope with academic challenges. Findings also revealed that the main consequences of drug abuse among undergraduates of the University of Ilorin was low self-esteem. It was further revealed that there were no significant differences in the causes and consequences of drug abuse among undergraduates of the University of Ilorin based on gender and their faculty. It was, however, recommended among others that the government should enact measures on people that are selling drugs indiscriminately and should be supervising the target area, and if possible, check the activities of the victims of drug abuse. The Ministry of Education in conjunction with the National Campaign against Drug Abuse (NACADA) should engage in appropriate interagency agreements in order to streamline the provision of services to support students with social and behavioral problems emanating from drug abuse.
Ballistic performance and damage simulation of fiber metal laminates under high-velocity oblique impact

Fiber metal laminates have been successfully applied in military aircrafts, armor vehicles and other modern engineering industries as protective structures due to their outstanding impact resistant properties. Prediction of the ballistic performance and investigation on the damage mechanism of the fiber metal laminates under general oblique impact conditions still remain a very challenging issue. In this study, a nonlinear dynamic finite element model in terms of continuum damage mechanics including intra- and inter-layer failure modes is presented. The accuracy of this model is validated with available experimental data. The damage and ballistic performance of two different structural fiber metal laminates subjected to high-velocity oblique impact by rigid hemispherical nose projectile with angles of 0°, 30°, 45° and 60° are studied. The numerical results show that the projectile deflects when the oblique impact occurs and the deflection angle decreases with increasing the impact velocity. The residual velocity of the projectile and the energy absorption of the target are related to the initial impact velocity and impact angle of the projectile. The proposed simulation approach offers a new proper reference for numerical investigations of common oblique impact problems in other fiber metal laminates.
Reducing HIV infection in young women in Southern Africa: the key to altering epidemic trajectories in a generalized hyperendemic setting.

Spotlight On Prevention is a quarterly editorial series of expert voices on current topics in HIV prevention. The authors call on prevention programs in southern Africa--burdened with the highest prevalence in the world--to target girls and young women who are especially vulnerable to HIV. Bold prevention options are needed. Yet as the search for biomedical solutions continue it is important to develop a balanced portfolio that addresses the real risks facing young women in the region.
Identifying predictors of teachers’ intention and willingness to teach about cancer by using direct and belief-based measures in the context of the theory of planned behaviour

ABSTRACT This study investigated factors influencing teachers’ intention and willingness to teach about cancer in the context of the theory of planned behaviour. Because teaching about cancer is mandatory in Germany, we compared n=355 teachers’ intention to teach about cancer under mandatory conditions and their willingness to teach about cancer if they had free choice. Teachers signalled strong intention and a strong willingness to teach about cancer. Teachers did not perceive teaching about cancer to be a burden and strongly considered it to be necessary. Structural equation modelling showed that perceived autonomy was the only significant predictor of teachers’ intention, whereas attitude towards the perceived necessity to teach about cancer, attitude towards the perceived burden of teaching about cancer and social norm were significant predictors of willingness. We attributed these differences to the observation of a ceiling effect for intention but not for willingness. There were systematic differences among the variables predicting teachers’ intention and willingness depending on whether the teachers had personal experience with cancer. Indirect measures yielded insights into which teacher beliefs affected the direct measures. We discuss implications for professional development, such as reducing the burden of teaching about cancer by adequately addressing emotionally-charged classroom situations.
Methotrexate and cytarabine for adult patients with newly diagnosed Langerhans cell histiocytosis: A single arm, single center, prospective phase 2 study

E.E. M. : Consulting fees from Adaptive Biotechnologies, Celgene, Takeda, Sanofi, Janssen; Research Funding to University of Texas MD Anderson from: Merck, Quest Diagnostics, Sanofi, JW Pharma. M.I. W. : consulting for Acerta Pharma, Janssen; Research Funding to UT MD Anderson from: Acerta Pharma, Asana Biosciences, BeiGene, Celgene, Janssen, Juno Therapeutics, Kite Pharma, Onyx, Pharmacyclics, Proteolix; Honoraria from Celgene, Dava Oncology, Janssen, Proteolix,; Membership on an entity's Board of Directors or advisory committees: Janssen. R.Z. O. : Consulting for Amgen, Bristol-Myers-Squibb, Celgene, GSK Biologicals, Ionis Pharmaceuticals, Janssen, Juno Therapeutics, Kite Pharma, Legend Biotech, Molecular Partners, Sanofi, Servier, Takeda; Research funding to UT MD Anderson from: BioTheryX. Other authors declare no potential conflict of interest.
A histological study of alloxan-induced diabetes on experimental male Wistar rats

Background: Alloxan is a toxic chemical which is used for induction of diabetes in experimental animals. In the light of various earlier researches which showed different dosages for induction, it has been decided to select and optimize the correct dosage. Alloxan which is a urea derivative is known for its diabetogenic action and causes damage to β-cells. A histological study is conducted for dosage selection of alloxan causing diabetes. Aims and Objectives: This study strives to establish the correct dose which is 120 mg/kg body weight (b.w) intraperitoneally to Wistar rats. Material and Methods: Male albino rats were procured and grouped as Group 1 (control), and alloxanized groups as Group II: 90 mg/kg b.w, Group III: 120 mg/kg b.w, and Group IV: 150 mg/kg b.w the biochemical parameters like blood glucose, urea, creatinine, uric acid, etc., were determined. Animals were sacrificed, and 5 mm pancreatic tissues from various groups were processed for histological examination. Results: Among all, a significant difference in biochemical parameters was observed with 120 mg/kg b.w (Group III) when compared to control group. There was marked degeneration and necrosis in the pancreatic β-cells of islets. Conclusion: Although earlier works have studied the diabetic effect of alloxan, it is pertinent to optimize and standardize the dose selection of alloxan with desirable effects.
Assessment of homocysteine, Vitamin B12, and Zinc levels among patients with acute ischemic stroke in Northwestern Nigeria

Background: Stroke has been a global burden, with increasing morbidity and mortality. Several risk factors have been identified, which are the target of preventive strategies, they include hyperhomocysteinemia, hypovitaminosis B12, and low zinc levels. There is paucity of data on the biochemical risk factors in our environment which necessitated this study. Objective: To evaluate the serum levels of homocysteine, vitamin B12, and zinc in patients with acute ischemic stroke in Zaria. Patients and Methods: This is a case-control study conducted over 13 months in ABUTH Zaria. One hundred patients with clinical diagnosis of ischemic stroke diagnosed, confirmed by brain CT-scan and Siriraj stroke score of less than -1, and equal number of apparently healthy age, and sex-matched were recruited. Their fasting serum homocysteine and vitamin B12 were measured using enzyme-linked immunosorbent assay, while zinc was measured using direct colorimetric method. Stroke severity was determined using National Institute of Health Stroke Score (NIHSS), patients with NIHSS score of 1–4, 5–15, and 16–42 were classified as mild, moderate, and severe stroke respectively. Results: Mean serum homocysteine for patients was significantly higher than that of controls (P < 0.05) and mean serum zinc and vitamin B12significantly lower compared to that of controls (P < 0.05). There was no association between hyperhomocysteinemia, low vitaminB12, and low zinc concentrations with the severity of stroke using NHISS Score. Conclusion: Elevated serum homocysteine, low vitamin B12, and zinc were found to be significant risk factors associated with ischemic stroke.
PD-L1 Is Frequently Expressed in Acute Myeloid Leukemia Patients with Leukocytosis

Background: The immune response is probably important for the long-term outcome of patients with tumours, including leukemias. However, its efficiency is often modulated by various immunosuppressive mechanisms, such as the expression of inhibitory receptors on the surface of the immune cells and of their ligands on tumor cells. The introduction of blocking antibodies against these receptors and ligands has gained considerable interest in the past several years and renewed the relevance of the stimulation of anti-tumor immune responses in the treatment of cancers. The significance of PD-1/PD-L1 expression in leukemias is not yet well established, although monoclonal antibodies targeting either PD-1 or PD-L1 are currently in clinical trials also for hematologic malignancies. Aim and methods: We have recently shown that the surface expression of PD-L1 protein correlates with the ratio of two PD-L1 transcript variants (v1/v2) in hematopoietic cells (Brodska et al., submitted to Cancer Immunotherapy Research). This finding has enabled a retrospective examination of PD-L1 expression in frozen cDNA samples obtained from the peripheral blood of AML patients at diagnosis. A total of 55 patients with high leukocyte counts were selected for this analysis as their samples were presumed to be predominantly composed of leukemic cells. As our previous findings suggested the existence of anti-nucleophosmin immune response in vivo, the patients were divided into two groups according to the nucleophosmin mutation status. Results: The majority of the tested samples were PD-L1-positive (Fig. 1). The positivity was of 65% in patients with nucleophosmin mutations (NPM1mut, N = 31) and of 88% in patients with wild-type nucleophosmin (NPM1wt, N = 24). A better overall survival for PD-L1-low patients was observed in NPM1mut patient group, although the difference was not statistically significant (p = 0.21, Fig.2). The cutoff value for v1/v2 transcript levels was of 8.25. Conclusions: Although PD-L1 expression in AML patients at diagnosis is usually low, we found very high incidence of PD-L1 positivity among patients with leukocytosis. Therefore, a high diagnostic leukocyte count may be associated with immune response failure in AML. Acknowledgment: The work was supported by the Ministry of Health of the Czech Republic (grant No 16-30268A and the project for conceptual development of the research organization No 00023736). Disclosures No relevant conflicts of interest to declare.
The impact of religion on language maintenance and shift

ABSTRACT This article explores religious impact on language maintenance and language shift in two Hakka communities in Malaysia. While research has shown a trend towards language shift in these communities, whether religious institutions can play a role in heritage language maintenance remained unclear. The key findings are as follows: (i) language use patterns differ among various religious groups; (ii) this difference is due mainly to religious practices, that is, whether a heritage language is used as the ‘language of religion’; and (iii) most religious institutions, except Taoist temples and Basel churches, seem to fuel shifting. However, the tendency to move towards the ‘bi-language of religion’ threatens even the efforts of Basel churches. The study indicates interesting possibilities regarding religious impact but also shows, paradoxically, that the priority of Hakka-based religious institutions is to promote their religions, not to sustain the threatened heritage language. (Language maintenance, language shift, religious impact, Hakka Chinese community)*
Early Complications Following Articular Calcaneus Fracture Repair

Abstract Objectives: To assess complications and secondary operations in patients treated with either open reduction and internal fixation (ORIF) versus percutaneous fixation of displaced intra-articular calcaneus fractures. Design: Retrospective comparative study. Setting: Level 1 trauma center. Patients/Participants: Ninety-three adult patients with 111 fractures treated by a single orthopaedic traumatologist between 2001 and 2014. Intervention: ORIF through an extensile lateral approach or percutaneous reduction and internal fixation. Main Outcome Measurements: Wound-healing complications, infections, posttraumatic arthrosis (PTOA), and secondary procedures. Results: Fifty patients with 58 fractures underwent ORIF, and 43 patients with 53 fractures had percutaneous fixation. Mean age was 43 years, and 80% were male. Open fractures and two-part fractures were more often treated percutaneously (26% vs 8%, P = 0.03) and (49% vs 31%, P = 0.02), respectively. Patients undergoing percutaneous fixation were more often tobacco users (58% vs 36%, P = 0.04) and with history of alcohol and other substance abuse. Twenty-seven patients (29%) had 28 complications, including 21% with PTOA, with no differences based on type of treatment. Six patients had secondary procedures, with no difference based on type of treatment. Patients with open fractures (P = 0.001) or tobacco abuse (P = 0.005) were more likely to experience complications. Conclusions: No differences in complication rates were found for ORIF versus percutaneous fixation. Regardless of fixation technique, patients with open fractures or history of tobacco abuse were more likely to develop complications. Percutaneous reduction and fixation represents an alternative to extensile ORIF in terms of similar early and late complications, particularly in high risk patients. Level of Evidence: Therapeutic Level III
Hearing and Vision Screening in Pediatric Primary Care and the Sharing of Results with Early Care and Education Programs

This study explores the extent to which pediatric primary care (PPC) providers share hearing and vision screening results with early care and education (ECE) programs and report being unable to assess hearing and vision among prekindergarten children. Reports of hearing and vision screening are assessed to explore whether national support for early hearing detection and intervention has similarly promoted vision screening in PPC. We evaluated the reporting of hearing and vision screening data from 4,119 early childhood health assessment records, which were obtained from licensed ECE programs in Connecticut. Records were stratified by age group into younger or older per national recommendations for screening type by age. Overall, most PPC providers shared screening results with ECE programs. However, rates of sharing results were lower and unable to assess hearing and vision were higher among younger compared to older children (p<.001). A similar proportion of hearing and vision sensory screens were reported, suggesting that national support for hearing screening may have promoted vision screening in PPC. Findings from this study highlight the need for improved support for PPC providers in implementing sensory screening for younger children and suggest a greater role for ECE programs in screening to ensure healthy development and early learning for young children.
Numerical Treatment of Schrödinger’s Equation for One-Particle and Two-Particle Systems Using Matrix Method

With an increased interest in accurately predicting aerothermal environments for planetary entry, recent researches have concentrated on developing high fidelity computational models using quantum-mechanical first principles. These calculations are dependent on solving the Schrödinger equation using molecular orbital theory techniques. They are either approximate solutions to actual equations or exact solutions to approximate equations. Exact solutions have not found favor due to the computational expense of the problem. Hence, a novel numerical approach is developed and tested here using linear algebraic matrix methods to enable precise solutions. The finite-difference technique is used to cast the Time-Independent Schrödinger equation (TISE) in the form of a matrix eigenvalue problem. The numerical singularity in the Coulomb potential term is handled using Taylor series extrapolation, Least Squares polynomial fit, soft-core potential, and Coulomb potential approximation methods. A C++ code is developed to extract the eigenvalues and eigenfunctions with the help of PETSc and SLEPc open-source packages. The eigenvalues represent the energies, and eigenfunctions represent the orbitals of atoms. The test cases include both one-particle and two-particle systems. The singularity poses an issue in the computation by affecting the accuracy of energies and wavefunctions obtained. Higher-order differences and non-uniform meshes are implemented to resolve the issue, but they provide counterintuitive results and fail to achieve the desired level of accuracy.
Impact of Organizational Citizenship Behavior on Job Performance in Jordan: The Mediating Role of Perceived Training Opportunities

This study examined the effect of Organizational Citizenship Behavior (OCB) on the job performance of Greater Amman Municipality (GAM), through the mediating factor of Perceived Training Opportunities (PTO). This study involved data of 344 employees working in 22 regions in GAM. PLS-SEM was applied to test the hypotheses. The validity and reliability of the measurement and the structural models were confirmed.