Miracle-dz/UniFAR-FTUs huggingface dataset:
Sustained Malaria Transmission despite Reactive Screen-and-Treat in a Low-Transmission Area of Southern Zambia

Abstract. Malaria elimination strategies are designed to more effectively identify and treat infected individuals to interrupt transmission. One strategy, reactive screen-and-treat, starts with passive detection of symptomatic cases at health facilities. Individuals residing within the index case and neighboring households are screened with a malaria rapid diagnostic test (RDT) and treated if positive. However, it is unclear to what extent this strategy is effective in reducing transmission. Reactive screen-and-treat was implemented in Choma district, Southern Province, Zambia, in 2013, in which residents of the index case and neighboring households within 140 m were screened with an RDT. From March 2016 to July 2018, the screening radius was extended to 250-m, and additional follow-up visits at 30 and 90 days were added to evaluate the strategy. Plasmodium falciparum parasite prevalence was measured using an RDT and by quantitative PCR (qPCR). A 24-single nucleotide polymorphism molecular bar-code assay was used to genotype parasites. Eighty-four index case households with 676 residents were enrolled between March 2016 and March 2018. Within each season, parasite prevalence declined significantly in index households at the 30-day visit and remained low at the 90-day visit. However, parasite prevalence was not reduced to zero. Infections identified by qPCR persisted between study visits and were not identified by RDT. Parasites identified within the same household were most genetically related; however, overall parasite relatedness was low and similar across time and space. Thus, despite implementation of a reactive screen-and-treat program, parasitemia was not eliminated, and persisted in targeted households for at least 3 months.
Isocaloric low protein diet in a mouse model for vanishing white matter does not impact ISR deregulation in brain, but reveals ISR deregulation in liver

ABSTRACT Objective: Vanishing white matter (VWM) is a genetic brain white matter disorder caused by mutations in eIF2B. eIF2B is central in the integrated stress response (ISR), during which its activity is inhibited by various cellular stresses. VWM is a chronic progressive disease with episodes of rapid neurological deterioration provoked by stresses. VWM patients and VWM mouse models show ISR deregulation in brain, correlating with chronic disease development. ISR inhibition ameliorates the chronic disease in VWM mice. The subacute deteriorations have not been modeled yet. We hypothesized that ISR activation could worsen disease progression in mice and model the episodic neurological deterioration. Method: We chose to activate the ISR by subjecting wild-type (wt) and VWM mice to an isocaloric low protein diet. This model would allow us to investigate the contribution of ISR activation in subacute decline in VWM. Results: We found that the low protein diet did not significantly affect amino acid levels nor ISR levels in wt and VWM mouse brain. Our study serendipitously led to the discovery of increased levels of glycine, asparagine and Fgf21 mRNA in VWM mouse brain irrespective of the dietary protein content. Strikingly, the ISR was not activated by the low protein diet in the liver of VWM in contrast to wt mice, due to a modest ISR deregulation in this organ. Discussion: A model for subacute neurological deterioration in VWM was not established. Possibly, ISR deregulation in VWM results in reduced ISR responsiveness.
Debate: Should the dose or duration of anticoagulants for the prevention of venous thrombosis be increased in patients with COVID‐19 while we are awaiting the results of clinical trials?

Keith Gomez, Mike Laffan and Charlotte Bradbury Haemophilia Centre and Thrombosis Unit, Royal Free Hospital London NHS Foundation Trust, London, Department of Immunity and Inflammation, Centre for Haematology, Faculty of Medicine, Imperial College London, London, Faculty of Translational Health Sciences, University of Bristol, Bristol, and University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
A Minimal Metric for the Characterization of Acoustic Noise Emitted by Underwater Vehicles

Underwater robots emit sound during operations which can deteriorate the quality of acoustic data recorded by on-board sensors or disturb marine fauna during in vivo observations. Notwithstanding this, there have only been a few attempts at characterizing the acoustic emissions of underwater robots in the literature, and the datasheets of commercially available devices do not report information on this topic. This work has a twofold goal. First, we identified a setup consisting of a camera directly mounted on the robot structure to acquire the acoustic data and two indicators (i.e., spectral roll-off point and noise introduced to the environment) to provide a simple and intuitive characterization of the acoustic emissions of underwater robots carrying out specific maneuvers in specific environments. Second, we performed the proposed analysis on three underwater robots belonging to the classes of remotely operated vehicles and underwater legged robots. Our results showed how the legged device produced a clearly different signature compared to remotely operated vehicles which can be an advantage in operations that require low acoustic disturbance. Finally, we argue that the proposed indicators, obtained through a standardized procedure, may be a useful addition to datasheets of existing underwater robots.
Compression Ratio and Catalyst Aging Effects on Aqueous Ethanol Ignition (Year 2): Part 1. Compression Ratio Effects on Aqueous Ethanol Ignition

The lean burning of water ethanol blends has the potential to reduce NOx, CO, and HC emissions while reducing the ethanol fermentation production cost of distillation and dehydration. The torch style ignition produced by the catalytic igniter allows for the operation and cold start of a typical SI engine on ethanol/water fuels up to a 50/50 blend. This work reported here targets multiple operating conditions of a Cooperative Fuels Research (CFR) engine and monitors in-cylinder pressure and emission characteristics. Premixing ethanol/water blends showed a reduction in NOx over separately injecting water and ethanol for blends up to 70/30 ethanol/water. Altering catalytic igniter voltage showed no control over CA50. This investigation will help researchers better understand the performance and emission characteristics of timing control in addition to different injection techniques for ethanol/water blends for catalytic ignition implementations focused on improving thermal efficiency and emission reduction.
Testing a Proactive Model of Successful Aging Among Older Adults in Costa Rica and Spain

The purpose of this study is to examine successful aging among Spanish-speaking older adults in Costa Rica and in Spain using the proactive framework proposed by Kahana et al. (2014). More specifically, we hypothesized that older adults’ life satisfaction would be positively associated with the frequency and perceived level of social support, spirituality/having purpose in life, and the use of proactive physical, cognitive, and social self-care behaviors. Our results confirmed these hypotheses, not only for the overall group of participants, but also separately for older adults in Costa Rica and in Spain. The present study contributes to the literature of successful aging among older adults, by examining the protective factors associated with life satisfaction among Spanish speaking older adults in Costa Rica and in Spain. It identifies specific protective factors (spirituality/purpose in life, social support, and self-care) associated with the values and preferences held by participants in the study.
SPATIAL CHARACTERIZATION OF THE OCCURRENCE OF ROAD SALTS AND THEIR ENVIRONMENTAL CONCENTRATIONS AS CHLORIDES IN CANADIAN SURFACE WATERS AND BENTHIC SEDIMENTS

The purpose of this report is to: provide information on the physical/chemical properties in inorganic salts commonly used for road maintenance; provide an overview of their fate and transportation in surface waters and sediments; present environmental concentrations of road salt constituents in Canadian surface waters in the context of watershed geology and other environmental factors governing their concentrations in surface waters; provide a spatial map of chloride concentrations as a basis for developing an understanding of a spatially based, ecological risk assessment for surface water systems; and relate the spatial risk map to observed concentrations of chlorides.
Detection of KRAS G12/G13 Mutations in Cell Free-DNA by Droplet Digital PCR, Offers Prognostic Information for Patients with Advanced Non-Small Cell Lung Cancer

KRAS mutations are found in approximately one third of non-small cell lung cancer (NSCLC) patients. In this study, we aim to investigate whether KRAS G12/G13 mutant allele fraction (MAF) in cell-free DNA (cfDNA) can provide meaningful prognostic information in NSCLC. Multiplex droplet-digital PCR was used to quantitatively assess KRAS G12/G13 MAF in cfDNA from 114 pre-treated advanced disease NSCLC patients. In 14 patients, changes in KRAS G12/G13 MAF were longitudinally monitored during treatment. Plasma KRAS G12/G13 status was associated with poor patients’ outcome in terms of progression-free survival (PFS) (p < 0.001) and overall survival (OS) (p < 0.001). In multivariate analysis, the detection of plasma KRAS mutations was an independent predictor of adverse PFS (HR = 3.12; p < 0.001) and OS (HR = 2.53; p = 0.002). KRAS G12/G13 MAF at first treatment evaluation (T1) was higher (p = 0.013) among patients experiencing progressive disease compared to those with disease control, and increased KRAS MAF at T1 was associated (p = 0.005) with shorter PFS. On the contrary, no association was observed between tissue KRAS mutation status and patients’ prognosis. Our results show that ddPCR-based detection of KRAS G12/G13 mutations in plasma could serve as an independent biomarker of unfavorable prognosis in NSCLC patients. Changes in KRAS MAF can provide valuable information for monitoring patient outcome during treatment.
Curvature-Dependent Electrostatic Field as a Principle for Modelling Membrane-Based MEMS Devices. A Review

The evolution of engineering applications is increasingly shifting towards the embedded nature, resulting in low-cost solutions, micro/nano dimensional and actuators being exploited as fundamental components to connect the physical nature of information with the abstract one, which is represented in the logical form in a machine. In this context, the scientific community has gained interest in modeling membrane Micro-Electro-Mechanical-Systems (MEMS), leading to a wide diffusion on an industrial level owing to their ease of modeling and realization. Physically, once the external voltage is applied, an electrostatic field, orthogonal to the tangent line of the membrane, is established inside the device, producing an electrostatic pressure that acts on the membrane, deforming it. Evidently, the greater the amplitude of the electrostatic field is, the greater the curvature of the membrane. Thus, it seems natural to consider the amplitude of the electrostatic field proportional to the curvature of the membrane. Starting with this principle, the authors are actively involved in developing a second-order semi-linear elliptic model in 1D and 2D geometries, obtaining important results regarding the existence, uniqueness and stability of solutions as well as evaluating the particular operating conditions of use of membrane MEMS devices. In this context, the idea of providing a survey matures to discussing the similarities and differences between the analytical and numerical results in detail, thereby supporting the choice of certain membrane MEMS devices according to the industrial application. Finally, some original results about the stability of the membrane in 2D geometry are presented and discussed.
Outcomes of Occipital Nerve Stimulation for Craniofacial Pain Syndromes

Occipital nerve regional stimulation (ONS) is reported to improve pain in several studies. We examined long-term pain and functional outcomes of ONS in an open-label prospective study.Patients with medically refractory and disabling craniofacial pain were prospectively selected for ONS. Primary outcome was a change in mean daily pain intensity on the numeric pain rating scale (NPRS) at 6 months. Secondary outcomes included changes in NPRS, Headache Impact Test-6 (HIT-6), Migraine Disability Assessment (MIDAS), Pain Disability Index (PDI), Center for Epidemiologic Studies Depression Scale – Revised (CESD-R), and Short Form-36 version 2 (SF36) at last follow-up.Thirteen patients (mean age 49.7 ± 8.4) diagnosed with occipital neuralgia (6), hemicrania continua (2), persistent idiopathic facial pain (2), post-traumatic facial pain (1), cluster headache (1), and chronic migraine (1) were enrolled. Mean NPRS improved by 2.1 ± 2.1 at 6 months and 2.1 ± 1.9 at last follow-up (23.5 ± 18.1 months). HIT-6 decreased by 8.7 ± 8.8, MIDAS decreased by 61.3 ± 71.6, and PDI decreased by 17.9 ± 18. SF36 physical functioning, bodily pain, and social functioning improved by 16.4 ± 19.6, 18.0 ± 31.6, and 26.1 ± 37.3, respectively. Moderate to severe headache days (defined as ≥50% of baseline mean NPRS) were reduced by 8.9 ± 10.2 days per month with ONS.ONS reduced the long-term NPRS and moderate–severe monthly headache days by 30% and improved functional outcomes and quality of life. A prospective registry for ONS would be helpful in accumulating a larger cohort with longer follow-up in order to improve the use of ONS.
Calciprotein Particles Cause Endothelial Dysfunction under Flow

Calciprotein particles (CPPs), which increasingly arise in the circulation during the disorders of mineral homeostasis, represent a double-edged sword protecting the human organism from extraskeletal calcification but potentially causing endothelial dysfunction. Existing models, however, failed to demonstrate the detrimental action of CPPs on endothelial cells (ECs) under flow. Here, we applied a flow culture system, where human arterial ECs were co-incubated with CPPs for 4 h, and a normolipidemic and normotensive rat model (10 daily intravenous injections of CPPs) to simulate the scenario occurring in vivo in the absence of confounding cardiovascular risk factors. Pathogenic effects of CPPs were investigated by RT-qPCR and Western blotting profiling of the endothelial lysate. CPPs were internalised within 1 h of circulation, inducing adhesion of peripheral blood mononuclear cells to ECs. Molecular profiling revealed that CPPs stimulated the expression of pro-inflammatory cell adhesion molecules VCAM1 and ICAM1 and upregulated transcription factors of endothelial-to-mesenchymal transition (Snail, Slug and Twist1). Furthermore, exposure to CPPs reduced the production of atheroprotective transcription factors KLF2 and KLF4 and led to YAP1 hypophosphorylation, potentially disturbing the mechanisms responsible for the proper endothelial mechanotransduction. Taken together, our results suggest the ability of CPPs to initiate endothelial dysfunction at physiological flow conditions.
Effects of etomidate use in ICU patients on ventilator therapy: a study of 12,526 patients in an open database from a single center

Background There is a debate regarding the safety of etomidate. We evaluated the effects of etomidate on mortality in a large cohort of critical care patients. Methods This retrospective matched-cohort study was performed using the Medical Information Mart for Intensive Care version 3 (MIMIC-III) database. Among 12,526 adult patients who were prescribed etomidate or propofol on the first day of mechanical ventilation, 625 patients administered etomidate were statistically matched with 6,250 patients administered propofol. The primary outcome measures were all-cause in-hospital mortality, 48-hour survival, cardiovascular morbidity, and infectious morbidity. Logistic regression analysis with stepwise selection of variables was performed to examine the dose–mortality relationship of etomidate. Results All-cause in-hospital mortality was 1.84 times higher in the etomidate cohort (OR: 1.84, 98.75% CI: 1.42, 2.37). Compared to the propofol cohort, the etomidate cohort showed 57% lower odds of 48-hour survival (0.43 [0.27, 0.73]), no difference in odds of cardiovascular morbidity (0.86 [0.66, 1.12]), and 1.77 times higher odds of infectious morbidity (1.77 [1.35, 2.31]). Additionally, the odds of mortality increased by 1.36 times per 0.1 mg/kg of etomidate (1.36 [95% CI: 1.23, 1.49]). Conclusions Etomidate is a poor choice as a hypnotic drug on the first day of mechanical ventilation, as it is associated with a dose-dependent increase in all-cause mortality, and does not improve survival for the first 48 h.
Element Levels and Predictors of Exposure in the Hair of Ethiopian Children

Children’s development and health may be affected by toxic heavy metal exposure or suboptimal essential element intake. This study aimed to provide updated information regarding the concentrations of 41 elements in children’s hair (aged under 18) living in a rural area of the Benishangul-Gumuz region, Ethiopia. The highest average levels (as a geometric mean) for toxic heavy metals were obtained for Al (1 mg kg−1), Pb (3.1 mg kg−1), and Ni (1.2 mg kg−1), while the lowest concentrations among the essential elements were found for Co (0.32 mg kg−1), Mo (0.07 mg kg−1), Se (0.19 mg kg−1), and V (0.8 mg kg−1). Hair analysis was combined with a survey to evaluate relationships and variations among subgroups and potential metal exposure predictors. Females showed significantly higher concentrations for most hair elements, excluding Zn, than males, and the 6–11 years age group reported the highest levels for Be, Ce, Co, Fe, La, Li, Mo, and Na. The main predictors of exposure to toxic elements were fish consumption for Hg and drinking water for Ba, Be, Cs, Li, Ni, Tl, and U. The data from this study can be used to develop prevention strategies for children’s health and protection in developing countries.
Determining the Minimal Clinical Important Difference for Medication Quantification Scale III and Morphine Milligram Equivalents in Patients with Failed Back Surgery Syndrome

The Medication Quantification Scale III (MQS) is a tool to represent the negative impact of medication. A reduction in medication can serve as an indicator to evaluate treatment success. However, no cut-off value has yet been determined to evaluate whether a decrease in medication is clinically relevant. Therefore, the objective is to estimate the thresholds for the MQS and morphine milligram equivalents (MMEs) that best identify a clinically relevant important improvement for patients. Data from the Discover registry, in which patients with failed back surgery syndrome were treated with high-dose spinal cord stimulation, were used. Patient satisfaction was utilized to evaluate a clinically important outcome 12 months after stimulation. Anchor-based and distribution-based methods were applied to determine the minimal clinical important difference (MCID). Distribution-based methods revealed a value of 4.28 for the MQS and 33.61 for the MME as MCID. Anchor-based methods indicated a percentage change score of 41.2% for the MQS and 28.2% for the MME or an absolute change score of 4.72 for the MQS and 22.65 for the MME. For assessing a treatment outcome, we recommend using the percentage change score, which better reflects a clinically important outcome and is not severely influenced by high medication intake at baseline.
Prevalence of early-onset GDM and associated risk factors in a university hospital in Thailand

Abstract This retrospective cohort study aimed to determine prevalence of GDM diagnosed before 24 weeks of gestation (early-onset GDM) and evaluate associated risk factors and compare pregnancy outcomes between different GDM status. A total of 1200 pregnant women attending antenatal clinic before 24 weeks of gestation were included. GDM screening was offered during first visit and repeat during 24–28 weeks of gestation, using 50-g GCT and 100-g OGTT. GDM was diagnosed in 110 women (13.9%) and early-onset GDM was found in 57 women (9.2%), which accounted for 65.9% of all GDM. Early-onset GDM had significant lower gestational weight gain and higher rates of preeclampsia, LGA infants, and NICU admission. Independent associated factors for early-onset GDM were age ≥30 years (aOR 4.89, 95%CI: 2.08–11.50, p < .001), and previous GDM (aOR 12.26, 95%CI: 3.86–38.93, p < .001) while DM in family was the only independent factor for late-onset GDM (aOR 2.53, 95%CI: 1.42–4.51, p = .002). IMPACT STATEMENT What is already known on this subject? Reported prevalence of early-onset GDM varies between studies, depending on the screening strategy and criteria used. Despite treatment, early-onset GDM has been associated with increased adverse maternal and neonatal outcomes in many previous studies. The risks associated with early-onset GDM and the evidence for benefit of early treatment are still unclear. What do the results of this study add? The results showed that early-onset GDM accounted for majority (65.9%) of all GDM. Despite treatment, early-onset GDM increased risk of preeclampsia, LGA infants, and NICU admission. Independent associated factors for early-onset GDM were age ≥30 years, and previous GDM while DM in family was the only independent factor for late-onset GDM. What are the implications of these findings for clinical practice and/or further research? Early GDM screening and intensive management, especially in high-risk women, should be implemented to minimise the risks of adverse outcomes. Further studies are needed to determine appropriate criteria to define early-onset GDM and to identify women at higher risk in different population and settings with different screening strategies. Effective management and approaches for this subgroup of GDM should also be further investigated.
Technology meets tradition: a hybrid model for implementing digital tools in neuropsychology

Abstract The COVID-19 pandemic has significantly impacted the provision of mental health care services and the ability to provide neuropsychological evaluations. The inability to conduct traditional evaluations has left neuropsychologists with the unprecedented task of determining how to modify existing paradigms while balancing the need to provide services and adhere to safety parameters. The COVID-19 literature suggests clinicians are modifying their evaluations based on the following models: (1) continuing to administer in-person evaluations; (2) discontinuing all evaluations due to issues related to standardization, test security, and patient-specific characteristics; (3) conducting virtual evaluations; and/or (4) adopting a hybrid model incorporating both traditional and technology-based modalities. Given the challenges with models 1–3, along with the modifications in telehealth guidelines and insurance reimbursement rates, neuropsychologists are more poised than ever to solidify the implementation of a hybrid model that lasts beyond COVID-19. We introduce the term Hybrid Neuropsychology, a model for the future of neuropsychological evaluations that includes three Action Items: (1) building a technology-based practice; (2) integrating data science; and (3) engaging with innovators in other fields. Hybrid Neuropsychology will enable clinicians to effectively modernize their practice, improve health care equity, and ensure neuropsychology secures its place in a technology-based world.