Miracle-dz/UniFAR-FTUs huggingface dataset:
When birth spacing does and does not matter for child survival: an international comparison using the DHS

A large body of research has found an association between short birth intervals and the risk of infant mortality in developing countries, but recent work from highly developed countries has called these claims into question, arguing that previous estimates have been biased by a failure to adequately control for unobserved heterogeneity. This study addresses this issue by estimating within-family models on a sample of 4.5 million births from 77 countries at various levels of development. We show that even after controlling for unobserved maternal heterogeneity, intervals less than 24 months substantially increase the probability of infant death, and this relationship is present in all countries in our analysis. We do show, however, that the importance of birth intervals as a determinant of infant mortality varies inversely with maternal education. Finally, we demonstrate that the mortality-reducing effects of longer birth intervals are strong at low levels of development but decline steadily towards zero as populations become healthier and wealthier. These findings offer a clear way to reconcile previous research showing that birth intervals are important for infant mortality in low-income countries, but much less consequential in high-income settings.
Microbiology and Risk Factors for Hospital-Associated Bloodstream Infections Among Pediatric Hematopoietic Stem Cell Transplant Recipients

Abstract Background Children undergoing hematopoietic stem cell transplantation (HSCT) are at high risk for hospital-associated bloodstream infections (HA-BSIs). This study aimed to describe the incidence, microbiology, and risk factors for HA-BSI in pediatric HSCT recipients. Methods We performed a single-center retrospective cohort study of children and adolescents (<18 years of age) who underwent HSCT over a 20-year period (1997–2016). We determined the incidence and case fatality rate of HA-BSI by causative organism. We used multivariable Poisson regression to identify risk factors for HA-BSI. Results Of 1294 patients, the majority (86%) received an allogeneic HSCT, most commonly with umbilical cord blood (63%). During the initial HSCT hospitalization, 334 HA-BSIs occurred among 261 (20%) patients. These were classified as gram-positive bacterial (46%), gram-negative bacterial (24%), fungal (12%), mycobacterial (<1%), or polymicrobial (19%). During the study period, there was a decline in the cumulative incidence of HA-BSI (P = .021) and, specifically, fungal HA-BSIs (P = .002). In multivariable analyses, older age (incidence rate ratio [IRR], 1.03; 95% confidence interval [CI], 1.01–1.06), umbilical cord blood donor source (vs bone marrow; IRR, 1.69; 95% CI, 1.19–2.40), and nonmyeloablative conditioning (vs myeloablative; IRR, 1.85; 95% CI, 1.21–2.82) were associated with a higher risk of HA-BSIs. The case fatality rate was higher for fungal HA-BSI than other HA-BSI categories (21% vs 6%; P = .002). Conclusions Over the past 2 decades, the incidence of HA-BSIs has declined among pediatric HSCT recipients at our institution. Older age, umbilical cord blood donor source, and nonmyeloablative conditioning regimens are independent risk factors for HA-BSI among children undergoing HSCT.
Exosome mediated miR-155 delivery confers cisplatin chemoresistance in oral cancer cells via epithelial-mesenchymal transition

Cisplatin is used as chemotherapeutic drug for oral squamous cell carcinoma (OSCC). However, OSCC cells develop resistance following long-term cisplatin exposure. Resistance against cisplatin chemo-therapy is accredited to the process of epithelial-to-mesenchymal transition, which in-turn has been linked to tumor-recurrence. miRNA deregulation, a common event in cancer, plays contributory role in chemo-resistance. Exosomes acts as the natural cargo for miRNA and facilitates inter-cell communication in the tumor micro-environment. Hence, exosomal-mediated miRNA transference may play essential role in drug resistance and serve as a target for cancer-therapy. miR-155 upregulation in OSCC has been described, however, its relevance in the observed chemo-resistance is unclear and also, if exosomes have any role in miR-155 regulation remain elusive. In the present study, we document for the first time the critical role of exosomes in mediating increments in miR-155 expression in OSCC cells that have acquired cisplatin resistance (cisRes cells). Importantly, exosomal transfer from cisRes to the cisplatin sensitive (cisSens) cells was found to confer significant miR-155 induction in the recipient cisSens cells. Restoration of miR-155 expression in cisSens cells following miR-155 mimics treatment led to epithelial to mesenchymal transition, enhancements in their migratory potential as well as acquisition of resistant phenotype. Notably, similar augmentations in the migratory and chemo-resistant traits were seen upon delivery of exosomes from cisRes to the recipient cisSens cells. Overall, our findings establish the significance of exosomal-mediated miR-155 shuttling in the cisplatin-chemoresistance, commonly observed in OSCC cells, thereby providing rationale for targeting miR-155 signalling for oral cancer therapy.
The hypertrophic cardiomyopathy mutations R403Q and R663H increase the number of myosin heads available to interact with actin

Hypertrophic cardiomyopathy–causing mutations disrupt a key regulatory off state of myosin in thick filaments. Hypertrophic cardiomyopathy (HCM) mutations in β-cardiac myosin and myosin binding protein-C (MyBP-C) lead to hypercontractility of the heart, an early hallmark of HCM. We show that hypercontractility caused by the HCM-causing mutation R663H cannot be explained by changes in fundamental myosin contractile parameters, much like the HCM-causing mutation R403Q. Using enzymatic assays with purified human β-cardiac myosin, we provide evidence that both mutations cause hypercontractility by increasing the number of functionally accessible myosin heads. We also demonstrate that the myosin mutation R403Q, but not R663H, ablates the binding of myosin with the C0-C7 fragment of MyBP-C. Furthermore, addition of C0-C7 decreases the wild-type myosin basal ATPase single turnover rate, while the mutants do not show a similar reduction. These data suggest that a primary mechanism of action for these mutations is to increase the number of myosin heads functionally available for interaction with actin, which could contribute to hypercontractility.
TIRADS Management Guidelines in the Investigation of Thyroid Nodules; Illustrating the Concerns, Costs, and Performance

Abstract Context Ultrasound (US) risk-stratification systems for investigation of thyroid nodules may not be as useful as anticipated. Objective We aimed to assess the performance and costs of the American College of Radiology Thyroid Image Reporting And Data System (ACR-TIRADS). Design, Settings and Participants We examined the data set upon which ACR-TIRADS was developed, and applied TR1 or TR2 as a rule-out test, TR5 as a rule-in test, or applied ACR-TIRADS across all nodule categories. We assessed a hypothetical clinical comparator where 1 in 10 nodules are randomly selected for fine needle aspiration (FNA), assuming a pretest probability of clinically important thyroid cancer of 5%. Results The gender bias (92% female) and cancer prevalence (10%) of the data set suggests it may not accurately reflect the intended test population. Applying ACR-TIRADS across all nodule categories did not perform well, with sensitivity and specificity between 60% and 80% and overall accuracy worse than random selection (65% vs 85%). Test performance in the TR3 and TR4 categories had an accuracy of less than 60%. Using TR5 as a rule-in test was similar to random selection (specificity 89% vs 90%). Using TR1 and TR2 as a rule-out test had excellent sensitivity (97%), but for every additional person that ACR-TIRADS correctly reassures, this requires >100 ultrasound scans, resulting in 6 unnecessary operations and significant financial cost. Conclusions Perhaps surprisingly, the performance ACR-TIRADS may often be no better than random selection. The management guidelines may be difficult to justify from a cost/benefit perspective. A prospective validation study that determines the true performance of TIRADS in the real-world is needed.
Quantum computation solves a half-century-old enigma: Elusive vibrational states of magnesium dimer found

Quantum computations unravel the mystery of spectral lines that have escaped experimental detection for decades. The high-lying vibrational states of the magnesium dimer (Mg2), which has been recognized as an important system in studies of ultracold and collisional phenomena, have eluded experimental characterization for half a century. Until now, only the first 14 vibrational states of Mg2 have been experimentally resolved, although it has been suggested that the ground-state potential may support five additional levels. Here, we present highly accurate ab initio potential energy curves based on state-of-the-art coupled-cluster and full configuration interaction computations for the ground and excited electronic states involved in the experimental investigations of Mg2. Our ground-state potential unambiguously confirms the existence of 19 vibrational levels, with ~1 cm−1 root mean square deviation between the calculated rovibrational term values and the available experimental and experimentally derived data. Our computations reproduce the latest laser-induced fluorescence spectrum and provide guidance for the experimental detection of the previously unresolved vibrational levels.
The Calorie Densities of Gruels Made from Extruded Corn-Soy Blends

The Food and Agriculture Organization, the World Health Organization, and the United Nations University will hold an expert committee meeting on protein energy requirements in October 1981. For the guidance of committee members, the following data on child growth are needed urgently: Data on variations in normal growth within short periods, i.e., daily, weekly, bi-weekly, or even monthly. In particular, data on individual children are sought. Data from longitudinal studies relating growth to diet with special reference to dietary protein versus energy. Data on the age at which growth stops in various populations; i.e., do disadvantaged populations show any compensation by extending the normal growth period? Individuals with relevant data are urged to communicate directly with Dr. Julien Périsse, Food Policy and Nutrition Division, Food and Agriculture Organization, Via delle Terme di Caracalla, 00100 Rome, Italy.
The Thermoelectric Properties of n-Type Bismuth Telluride: Bismuth Selenide Alloys Bi2Te3−xSex

Alloying bismuth telluride with antimony telluride and bismuth selenide for p- and n-type materials, respectively, improves the thermoelectric quality factor for use in room temperature modules. As the electronic and thermal transports can vary substantially, the alloy composition is a key engineering parameter. The n-type Bi2Te3-xSex alloy lags its p-type counterpart in thermoelectric performance and does not lend itself as readily to simple transport modeling which complicates engineering. Combining literature data with recent results across the entire alloy composition range, the complex electronic structure dynamics and trends in lattice thermal conductivity are explored. Spin-orbit interaction plays a critical role in determining the position and degeneracy of the various conduction band minima. This behavior is incorporated into a two-band effective mass model to estimate the transport parameters in each band. An alloy scattering model is utilized to demonstrate how phonon scattering behaves differently on either side of the intermediate ordered compound Bi2Te2Se due to chalcogen site occupancy preference. The parametrization of the electronic and thermal transports presented can be used in future optimization efforts.
Specialist physician perspectives on non-medical switching of prescription medications

ABSTRACT Introduction: A non-medical switch is a change to a patient’s medication regimen for reasons other than lack of clinical response, side-effects or poor adherence. Specialist physicians treat complex patients who may be vulnerable to non-medical switching. Objectives: To evaluate specialist physicians’ perceptions regarding the frequency of non-medical switch requests, and the impact on their patients’ outcomes and healthcare utilization. Methods: An online survey of randomly sampled physicians spending ≥10% of time providing patient care and having received ≥1 non-medical switch request during the prior 12-months. Results: Among 404 specialist physicians surveyed, non-medical switch requests were reported as very frequent or frequent by 35.0% of oncologists (for injectable cancer agents) and up to 80.3% of endocrinologists (for injectable anti-hyperglycemics). Respondents reported decreased medication effectiveness (25.0% of oncologists to 75.0% of dermatologists) and increased side-effects (32.5% of oncologists to 66.7% of psychiatrists). Most specialists reported very frequent or frequent increases in non-office visits (52.5% of oncologists to 75.3% of endocrinologists) and calls with pharmacies (57.5% of oncologists to 80.5% of rheumatologists) due to non-medical switching. Conclusions: Receipt of non-medical switching requests were common among specialist physicians. Non-medical switching may lead to negative effects on patient care and require increased healthcare utilization.
LIN28B gene polymorphisms modify hepatoblastoma susceptibility in Chinese children

Hepatoblastoma is one of the malignant liver tumors in children. However, genetic mechanisms underpinning the initiation of hepatoblastoma remain largely unclear. The previous study showed that lin-28 homolog B (LIN28B) might play a role in the development of hepatoblastoma. To detect the association between LIN28B gene polymorphisms and hepatoblastoma risk in Chinese children, we conducted a five-center case-control study of 275 hepatoblastoma patients and 1018 cancer-free controls. Four potentially functional polymorphisms were genotyped using the Taqman method. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the strength of the associations. We found that the rs314276 C>A polymorphism (AA vs. CC: adjusted OR=2.05, 95% CI=1.36-3.10, P=0.0006; AA vs. CA/CC: adjusted OR=2.11, 95% CI=1.43-3.12, P=0.0002) and rs9404590 T>G (GG vs. TT: adjusted OR=1.89, 95% CI=1.20-3.00, P=0.007; GG vs. TT/TG: adjusted OR=1.87, 95% CI=1.20-2.92, P=0.006) were associated with increased hepatoblastoma risk. Combination analysis of risk genotypes showed that patients with four risk genotypes had a higher chance of developing hepatoblastoma than carriers of 1 to 3 risk genotypes. Stratification analysis showed the significant association between the rs314276 AA genotype and hepatoblastoma risk in both age and sex groups, as well as clinical stages III+IV cases. The rs9404590 GG genotype was associated with hepatoblastoma risk in participants' ≥17 months, in females, and for those with clinical stages III+IV disease. Furthermore, four risk genotypes confer higher hepatoblastoma susceptibility in both age and sex groups, as well as groups with clinical stages III+IV disease. Genotype-based gene expression analysis confirmed that the rs9404590 T>G polymorphism was significantly associated with altered LIN28B gene expression. We further validated our findings using false-positive probability analysis. This finding suggested that LIN28B gene polymorphisms may be associated with an increased predisposition to hepatoblastoma.
Predictive Factors for Failure of Meniscal Repair: A Retrospective Dual-Center Analysis of 918 Consecutive Cases

Background: Meniscal surgery is one of the most common surgical procedures performed by orthopaedic surgeons. Over the past decade, awareness has increased regarding the importance of meniscal preservation to prevent the development of osteoarthritis in the knee joint. Removal of meniscal tissue can lead to a high risk of cartilage degeneration, and moreover, meniscus-preserving surgery rather than meniscal resection is likely to have better long-term outcomes. Success rates after meniscal repair range from 60% to 95%, but many reports are based on a small number of patients. Purpose/Hypothesis: The purpose of this study was to review all meniscal repairs and potential predictors for failure during a 12-year period. We hypothesized that meniscal anchors, lateral repairs, and repairs made in conjunction with an anterior cruciate ligament reconstruction (ACLR) would have fewer failures than meniscal arrows, medial repairs, and isolated repairs. We also hypothesized that younger patients and acute tears would be associated with fewer failures. Study Design: Case-control study; Level of evidence, 3. Methods: This study was a dual-center, retrospective analysis on consecutive meniscal repairs. The surgical protocols were reviewed, including type of tear, location, associated injury to the knee, and surgery. The study endpoint was failure of repair, defined as a need for reoperation and secondary partial or total meniscal resection, within 3 years. Kaplan-Meier analysis was performed to assess repair survival, with multivariate Cox regression to adjust for confounders. Results: A total of 954 meniscal repairs were performed on 918 patients (536 male patients [58%]; 382 female patients [42%]) with a mean age of 26 years (range, 12-60 years). The failure rate for the entire cohort was 22.5%. Bioabsorbable arrows had significantly more failures than all-inside sutures with anchors (hazard ratio [HR], 1.8; 95% CI, 1.2-2.5; P = .002). Medial meniscal repairs had a higher failure rate than lateral meniscal repairs (HR, 3.7; 95% CI, 2.3-6.0; P < .001). Simultaneous ACLR resulted in less failure than when no simultaneous ACLR was performed (HR, 0.5; 95% CI, 0.3-0.9; P = .009). Age at repair and acuity of tear did not affect the outcome (P = .6 and .07, respectively). Conclusion: The failure rate after meniscal repair was significantly higher on the medial side, especially when using arrows. Meniscal repairs performed concomitantly with an ACLR result in fewer reoperations.
Characterization of the MEQ oncoproteins of Marek's disease virus vaccine strain CVI988/Rispens

Characterization of the Meq Oncoproteins of Marek’s Disease Virus Vaccine Strain CVI988/Rispens. (May 2009) Dharani Kumar Ajithdoss, B.V. Sc. , Tamil Nadu Veterinary and Animal Sciences University; M.V. Sc. , A.N. G.Ranga Agricultural University Chair of Advisory Committee: Dr. Blanca Lupiani Marek’s disease virus serotype-1 (MDV-1) causes T cell lymphomas in chickens. Vaccines prepared from attenuated CVI988/Rispens MDV-1 strain currently offer the best protection. Although attenuated CVI988 is non-oncogenic, it codes for two forms of the MDV-1 oncoprotein Meq (CVI-Meq and CVI-L Meq). In this study, both CVI-Meq proteins, like the Meq protein of Md5 (a very virulent oncogenic strain), transformed Rat-2 and NIH3T3 cells. Both CVI-Meq and CVI-L Meq proteins activated the meq promoter only in the presence of chicken c-Jun (CK-Jun) whereas Md5-Meq activated the same promoter irrespective of CK-Jun co-expression. However, all three Meq proteins bound the meq promoter regardless of whether CK-Jun was co-expressed. We constructed three chimeric Meq proteins, namely, Md5-CVI-Meq, CVI-Md5-Meq, and Md5-CVI-L by exchanging domains between Md5 meq and CVI meq genes. Although these chimeric Meq proteins transactivated the meq promoter, the activation was significantly less than Md5-Meq. The current study indicated amino acid residues at positions 71 and 320 were important for Md5-Meq increase transcription of its own
Centrifugal compressor surge : modeling and identification for control

In this chapter a general introduction of centrifugal compression systems is presented. The unstable surge phenomenon in compressors is discussed, as well as possible means to avoid or suppress this instability. From an assessment of the current state of the art in control-oriented modeling and identification, the research objectives are formulated. 1.1 General introduction The general topic of this thesis is surge in centrifugal compression systems. In particular it deals with the modeling and identification for control of the surge phenomenon. Surge is an unstable operating mode of a compression system that occurs at low mass flows. Surge not only limits compressor performance and efficiency but it can also damage the compressor and auxiliaries due to the large thermal and mechanical loads involved. Furthermore, the vibrations associated with surge can result in unacceptable noise levels. A promising technique to cope with surge is the active suppression of aerodynamic flow instabilities. When successful, active surge control enlarges the operational envelope of the compressor towards lowermass flows. Thereby, surge control makes the compression system more versatile and it allows the machine to run at the most efficient operating points, which are usually located near the surge initiation point. Research efforts over the past decades have led to important advancements in the field of surge control. Progress has been made with the analysis, modeling, and suppression of surge and promising experimental results on laboratory setups were reported. However, a real breakthrough in the practical application of active surge control on industrial scale installations has not been achieved, yet. The current research originates from work by Willems (2000) and Meuleman (2002) within theCompressor Surge Control project at the Department of Mechanical Engineering, Technische Universiteit Eindhoven. The project provided valuable new insights in the
Clinico-laboratory Profile and Therapeutic Outcome of Serologically Confirmed Scrub Typhus in Children in Tertiary Care Children's Hospital of Nepal

Introduction: Scrub typhus is an acute febrile illness endemic to tsutsugamushi triangle including Nepal. The WHO identifies scrub typhus as a re-emerging disease in South-East Asia. Scrub typhus can have varied manifestations in children. We aimed to study clinicolaboratory profile and therapeutic outcomes of serologically confirmed scrub typhus in children. Methods: A retrospective study was conducted at Kanti Children’s Hospital, Nepal after obtaining ethical clearance from Institutional Review Committee, and reviewing the medical records of serologically diagnosed scrub typhus admitted to the hospital between August 2016 and January 2018. Relevant data were entered in and analyzed using SPSS 20.0. Results: Children from 9 districts of Nepal severely affected by the 2015 earthquake were admitted; mostly from Dhading (14.5%) and Gorkha (9.7%) districts. All 62 children included in the study had a fever; whereas pain abdomen, vomiting, cough, headache, and generalized body swelling were present in 25.8%, 21.0% 24.2%, 14.5%, and 14.5% cases respectively. Hepatomegaly, splenomegaly, hepatosplenomegaly, lymphadenopathy, and rashes were found in 53.2%, 38.7%, 32.2%, 17.7% and 9.7% cases respectively. Thrombocytopenia and hyponatremia were seen in 72.6% and 28.6% cases respectively. The combination of hepatosplenomegaly and thrombocytopenia was seen in 29.0%. Azithromycin was used as first-line treatment in 56 (90.3%) children while other children were treated with doxycycline and chloramphenicol. Seven (11.3%) children required PICU admission. The mean duration of hospital stay for all children was 6.95 ( ± 2.68) days while it was 9.00 ( ± 3.51) days for children requiring PICU admission. Conclusions: Scrub typhus should be considered in children with an acute febrile illness with hepatosplenomegaly and thrombocytopenia. Azithromycin is the drug of choice. Some children may need intensive care.