Miracle-dz/UniFAR-FTUs huggingface dataset:
Ultrahigh sensitive Raman spectroscopy for subnanoscience: Direct observation of tin oxide clusters

Subnanoclusters were characterized by elaborated spectroscopic methods revealing distinctive natures of subnanomaterials. Subnanometric metal clusters exhibit anomalous catalytic activity, suggesting innovative applications as next-generation materials, although identifying and characterizing these subnanomaterials in atomic detail remains a substantial challenge because of the severely weak signal intensity for the conventional analytical methods. Here, we report a subnanosensitive vibrational technique established based on the surface-enhanced Raman spectroscopy, demonstrating the first-ever detailed vibrational characterization of subnanomaterials. Furthermore, combining with density functional theory calculations, we reveal that inherent surface structures of the tin oxide subnanoclusters determine the size-specific spectral and catalytic characteristics of these clusters. The high-sensitivity characterization methodology elaborated here can provide a comprehensive understanding of the chemical and structural natures of subnanomaterials, which facilitate the rational design of subnanomaterials on the atomic scale for practical applications, such as in catalysts, biosensors, and electronics.
Identifying people with multiple sclerosis in the Canadian Primary Care Sentinel Surveillance Network

Background We validated a case definition for multiple sclerosis using a clinical cohort linked with the Manitoba Primary Care Research Network of the Canadian Primary Care Sentinel Surveillance Network, and applied this definition to describe multiple sclerosis epidemiology using the Canadian Primary Care Sentinel Surveillance Network repository. Methods We developed candidate case definitions for multiple sclerosis in the Manitoba Primary Care Research Network using diagnoses and medications. We compared these case definitions to multiple sclerosis diagnoses identified by applying a validated definition to population-based administrative data (reference standard 1) and multiple sclerosis diagnoses recorded by the provincial Multiple Sclerosis Clinic (reference standard 2) using sensitivity, specificity, positive predictive value and negative predictive value. We applied the preferred case definition to the national Canadian Primary Care Sentinel Surveillance Network dataset. Results The Manitoba Primary Care Research Network included 160,904 patients. The preferred case definition required ≥2 billing records for multiple sclerosis within 2 years or multiple sclerosis listed as a health condition or ≥1 multiple sclerosis-specific prescription. This definition had a low sensitivity versus administrative (44.25%) and clinic datasets (53.41%) but high specificity versus administrative data (99.95%). Specificity was lower versus clinic data (71.43%), but the positive predictive value was high. Conclusion We developed a case definition for multiple sclerosis that can be applied to the Canadian Primary Care Sentinel Surveillance Network dataset for studies examining primary care of persons with multiple sclerosis.
A tale of three cities. The correspondence of William Sharpey and Allen Thomson.

Glasgow University Library possesses an extensive collection of the papers of the Thomsons, a family of eminent nineteenth-century medical men. These form part of a larger set of Cullen-Thomson material. Some of these manuscripts were donated to the Library by John Millar Thomson in 1920; the remainder was discovered in the University Library Store in 1973. Among this latter set are a series of letters between Allen Thomson (1809-84) and William Sharpey (1802-80). ' The bulk of this correspondence consists of letters from Sharpey to Thomson; but there are also several copies and drafts of the letters Thomson sent. These are valuable because Thomson's side of the correspondence has not otherwise survived. Letters from other individuals mentioned in the correspondence are also present. It seems that Thomson brought together all these letters, along with other documents, as sources for the obituary of Sharpey he was writing. A calendar of these letters will be found in the Appendix. This edition consists only of a selection of the letters. I have chosen those of most interest to the historian of medicine, and, in particular, those that bear on the roles played by Thomson and Sharpey as influential medical scientists and medical politicians in nineteenth-century Britain.
Effect of Combination of Ketamine and Propofol (Ketofol) on Cerebral Oxygenation in Neurosurgical Patients: A Randomized Double-Blinded Controlled Trial

Background: The effects of ketofol (a combination of ketamine and propofol) on systemic hemodynamics and requirement of opioids/Propofol have already been studied and published. However, there is paucity in the literature on the effects of ketofol on cerebral oxygenation. This study aims to compare the effects of ketofol (ketamine + propofol [1:5]) with propofol on cerebral oxygenation using jugular venous oxygen saturation (SjVO2), in patients undergoing surgical clipping of intracranial aneurysms. Materials and Methods: A total of 40 World Federation of Neurosurgeons I and II patients were randomized into ketofol (n = 20) and propofol (n = 20) groups. Postinduction, SjVO2 catheter was inserted, and anesthesia was maintained with propofol and fentanyl in the propofol group and ketofol and fentanyl in the ketofol group. Jugular venous oxygen saturation (SjVO2) was obtained at baseline, 1 h and 2 h intraoperatively, and at 6 h after the surgery. Intraoperative hemodynamics and brain relaxation scores were also noted. Results: Entire SjVO2 values in both groups were within the normal limits. Higher SjVO2 values were observed in ketofol group compared to propofol at 1 and 2 h after starting of the drug and at 6 h after surgery (P < 0.05). In propofol group, a significant fall in SjVO2 was recorded at 2 h after beginning the drug as compared to the baseline (P = 0.001). More than 20% fall in mean arterial pressure (MAP) compared to baseline MAP was noted in 75% of patients in propofol group and 15% of patients in ketofol group (P = 0.002). In propofol group, 55% of patients required rescue drug phenylephrine to treat hypotension, whereas only 15% of patients required it in ketofol group (P = 0.02). Fentanyl requirement in ketofol group was less as compared to the propofol group (P = 0.022). Brain relaxation scores were comparable in both the study groups (P = 0.887). Conclusion: Maintenance of anesthesia with ketofol provides better cerebral oxygenation and hemodynamic stability compared to propofol in neurosurgical patients.
Effects of Non-Invasive Brain Stimulation on Clinical Pain Intensity and Experimental Pain Sensitivity Among Individuals with Central Post-Stroke Pain: A Systematic Review

Purpose Central post-stroke pain (CPSP) is a neuropathic disorder resulting in pain and disability. An emerging treatment for CPSP is non-invasive brain stimulation including direct current stimulation [tDCS] and repetitive transcranial magnetic stimulation [rTMS]. This systematic review analyzes the efficacy and quality of non-invasive brain stimulation intervention studies for CPSP. Methods Studies were sought from three research databases published between 2007 and 2017. Studies were included if the sole intervention was non-invasive brain stimulation and the primary outcome either clinical or experimental pain intensity. Studies were qualitatively assessed for risk of bias. Results Of 1107 articles extracted, six met eligibility criteria. Five studies found a decrease in pain intensity (p<0.05) immediately and 3 weeks after rTMS or tDCS was delivered over the primary motor cortex. For experimental pain, one study found thermal pain thresholds improved for those receiving tDCS compared to sham (p<0.05), while another found normalization of the cold detection threshold only after rTMS (p<0.05). Qualitative assessment revealed only one study rated as “excellent/good” quality, while the other five were rated as “fair” or “poor”. Conclusion Non-invasive brain stimulation may have a therapeutic effect on pain level for individuals with CPSP, as evidenced by significant decreases in clinical and experimental pain scores. However, despite the impact of CPSP and the promise of non-invasive brain stimulation, few rigorous studies have been performed in this area. Future studies should aim to standardize treatment parameters, measure both clinical and experimental pain, and include long-term follow-up.
The Impact of Removing both Phlegm and Blood Stasis Granule on TC TG LDL-C and HDL-C in patients with Coronary Heart Disease

Objective:To explore the potential mechanism on curing coronary heart disease with removing both phlegm and blood stasis granule by detecting the levels of plasma TC,TG,LDL-C and HDL-C before and after treatment.Methods:64 patients with CHD were divided into two groups,the control group(n=33) and the treatment group(n=31) ,with and without granule of removing both phlegm and blood stasis treatment addition to conventional therapy(such as aspirin,statins,angiotensin converting enzyme inhibitor,β-adrenergic receptor blockers,calcium channel antagonists,nitrates and so on) for 3 months.The levels of TC,TG,LDL-C and HDL-C were determined by full automatic biochemical analysor.Results:At the end of 3 months,the serum levels of TC,TG,LDL-C decreased significant(P 0.01) and the HDL-C level increased(P 0.05) in both groups than that of the baseline.Moreover,compare with the control group,removing both phlegm and blood stasis granule could reduce the levels of TC and LDL-C further(P 0.05) . Conclusion:In our study we discovered that the removing both phlegm and blood stasis granule could decrease the serum levels of TC and LDL-C.
ASIC design protection against reverse engineering during the fabrication process using automatic netlist obfuscation design flow

Fab-less business model in semiconductor industry has led to serious concerns about trustworthy hardware. In untrusted foundries and manufacturing companies, submitted layout may be analyzed and reverse engineered to steal the information of a design or insert malicious Trojans. Understanding the netlist topology is the ultimate goal of the reverse engineering process. In this paper, we propose a netlist encryption mechanism to hide the interconnect topology inside an IC. Moreover, new special standard cells (Wire Scrambling cells) are designed to play the role of netlist encryption. Furthermore, a design ﬂow is proposed to insert the WS-cells inside the netlist with the aim of maximum obfuscation and minimum overhead. It is worth noting that this mechanism is fully automated with no need to detail information of the functionality and structure of the design. Our proposed mechanism is implemented in an academic physical design framework (EduCAD). Experimental results show that reverse engineering can be hindered considerably in cost of negligible overheads by 23% in area, 3.25% in delay and 14.5% in total wire length. Reverse engineering is evaluated by brute-force attack, and the learned information is 0% and the Hamming distance is approximately 50%.
Vulval squamous cell carcinoma and its precursors

Vulval squamous cell carcinoma (VSCC) can arise through two distinct pathways [human papillomavirus (HPV)‐associated and HPV‐independent], and these VSCC variants are recognised as different disease entities on the basis of different aetiologies, morphological features, molecular events during oncogenesis, precursor lesions, prognosis, and response to treatment. The precursor of HPV‐associated VSCC, variously referred to as high‐grade squamous intraepithelial lesion (HSIL) [vulvar intraepithelial neoplasia (VIN) 2/3] or usual‐type VIN, is morphologically identical to the more common HSIL (cervical intraepithelial neoplasia 2/3) of the cervix. The precursor lesions of HPV‐independent VSCC include differentiated VIN, differentiated exophytic vulvar intraepithelial lesion, and vulvar acanthosis with altered differentiation; these have been under‐recognised by pathologists in the past, leading to delays in treatment. This review will discuss the recent advances in diagnostic surgical pathology of VSCC and its precursors, and how these diagnoses can impact on patient management.
First Trimester Maternal Vitamin D Status and Risks of Preterm Birth and Small-For-Gestational Age

Maternal 25-hydroxyvitamin D (25-OHD) deficiency during pregnancy may increase the risk of preterm and small-for-gestational age (SGA) birth, but studies report conflicting results. We used a multicenter prospective cohort of 2813 pregnant women assessed for 25-OHD levels in the first trimester of pregnancy to investigate the association between maternal 25-OHD concentrations and risks of preterm birth (<37 weeks) and SGA (birthweight <10th percentile). Odds ratios were adjusted (aOR) for potential cofounders overall and among women with light and dark skin separately, based on the Fitzpatrick scale. 25-OHD concentrations were <20 ng/mL for 45.1% of the cohort. A total of 6.7% of women had a preterm birth. The aOR for preterm birth associated with the 1st quartile of 25-OHD concentrations compared to the 4th quartile was 1.53 (95% confidence interval (CI): 0.97–2.43). In stratified analyses, an association was observed for women with darker skin (aOR = 2.89 (95% CI: 1.02–8.18)), and no association with lighter skin. A total of 11.9% of births were SGA and there was no association overall or by skin color. Our results do not provide support for an association between maternal first trimester 25-OHD deficiency and risk of preterm or SGA birth overall; the association with preterm birth risk among women with darker skin requires further investigation.
Multi-Level Factors Associated with Social Participation among Stroke Survivors: China’s Health and Retirement Longitudinal Study (2011–2015)

Background: This study aims to examine the impact of individual-level and community-based factors on popular social participation activities of Chinese middle-aged and older adults post-stroke. Methods: Sub-samples of survivors of stroke (2011: n = 413, 2013: n = 395, 2015: n = 441) recruited by the China Health and Retirement Longitudinal Study (CHARLS) were included in the analysis. Zero-inflated Poisson and multi-level logistic regression models were used to explore factors associated with social participation. Results: More than half of individuals (55.0%) had no social participation and 23.4% participated in multiple social activities. The most popular social activities that individuals participated in were interacting with friends (32.6%) and going to a community club to play table games (22.7%). Multiple individual-level factors were negatively related to social participation (e.g., depressive symptoms and multiple measures of functional limitations) while the allocation of an outdoor exercise facility in the community/village was positively associated with going to a community club to play table games. Conclusion: Stroke survivors are at high risk of limited social participation. Policymakers and other key stakeholders should consider community design among other potential solutions when identifying ways to link at-risk stroke survivors to both opportunities for rehabilitation (e.g., physical function) and social participation.
Preventing Birth Defects by Changing Maternal Antiepileptic Drug Therapy: We’ve Come a Long Way, Baby

Declining Malformation Rates With Changed Antiepileptic Drug Prescribing: An Observational Study Tomson T, Battino D, Bonizzoni E, et al. Neurology. 2019;93(9):e831-e840. doi:10.1212/WNL.0000000000008001. Epub August 7, 2019. PMID: 31391249. Objective: Changes in prescribing patterns of antiepileptic drugs (AEDs) in pregnant women with epilepsy would be expected to affect the risk of major congenital malformations (MCMs). To test this hypothesis, we analyzed data from an international pregnancy registry (European Registry of AEDs in Pregnancy [EURAP]). Methods: EURAP is an observational prospective cohort study designed to determine the risk of MCMs after prenatal exposure to AEDs. The Cochrane-Armitage linear trend analysis was used to assess changes in AED treatment, prevalence of MCMs, and occurrence of generalized tonic–clonic seizures (GTCS) over 3 time periods: 2000 to 2005 (n = 4760), 2006 to 2009 (n = 3599), and 2010 to 2013 (n = 2949). Results: There were pronounced changes in the use of specific AEDs over time, with a decrease in the use of valproic acid and carbamazepine and an increase in the use of lamotrigine and levetiracetam. The prevalence of MCMs with monotherapy exposure decreased from 6.0% in 2000 to 2005 to 4.4% in 2010 to 2013. The change over time in MCM frequency after monotherapy exposure showed a significant linear trend in the crude analysis (P = .0087), which was no longer present after adjustment for changes in AED treatment (P = .9923). There was no indication of an increase over time in occurrence of GTCS during pregnancy. Conclusions: There have been major changes in AED prescription patterns over the years covered by the study. In parallel, we observed a significant 27% decrease in the prevalence of MCMs. The results of adjusting the trend analysis for MCMs for changes in AED treatment suggest that changes in prescription patterns played a major role in the reduction of teratogenic events.
Effects of mixotrophic cultivation on antioxidation and lipid accumulation of Chlorella vulgaris in wastewater treatment

Abstract The effects of mixotrophic cultivation on antioxidation and lipid production of Chlorella vulgaris in wastewater treatment were analyzed. The biomass and lipid content of the mixotrophic C. vulgaris cultured in wastewater were higher compared with the autotrophic C. vulgaris cultured in BG-11. The mixotrophic C. vulgaris provided more fatty acids as the contents of total fatty acids rose. The unsaturated fatty acid/total fatty acid ratio under mixotrophic cultivation was up to 0.91, indicating the mixotrophic cultivation system was applicable for the generation of unsaturated fatty acids. Activities of antioxidant enzymes such as superoxide dismutase and glutathione peroxidase were improved after the addition of wastewater to algal cultures. Moreover, the activity and starch formation of ADP-glucose pyrophosphorylase decreased and the activity of acetyl-CoA carboxylase was enhanced, which contributed to the lipid production in the mixotrophic C. vulgaris in wastewater. This study suggests mixotrophic cultivation of microalgae in wastewater is an efficient way to improve lipid production.
Health Needs of Trans and Gender Diverse Adults in Australia: A Qualitative Analysis of a National Community Survey

There is an increasing demand for trans and gender diverse (TGD) health services worldwide. Given the unique and diverse healthcare needs of the TGD community, best practice TGD health services should be community-led. We aimed to understand the healthcare needs of a broad group of TGD Australians, how health professionals could better support TGD people, and gain an understanding of TGD-related research priorities. An anonymous online survey received 928 eligible responses from TGD Australian adults. This paper focuses on three questions out of that survey that allowed for free-text responses. The data were qualitatively coded, and overarching themes were identified for each question. Better training for healthcare professionals and more accessible transgender healthcare were the most commonly reported healthcare needs of participants. Findings highlight a pressing need for better training for healthcare professionals in transgender healthcare. In order to meet the demand for TGD health services, more gender services are needed, and in time, mainstreaming health services in primary care will likely improve accessibility. Evaluation of training strategies and further research into optimal models of TGD care are needed; however, until further data is available, views of the TGD community should guide research priorities and the TGD health service delivery.
Factors associated with low Apgar in newborns in birth center.

OBJECTIVE to analyze factors associated with Apgar of 5 minutes less than 7 of newborns of women selected for care at the Center for Normal Birth (ANC). METHOD a descriptive cross-sectional study with data from 9,135 newborns collected between July 2001 and December 2012. The analysis used absolute and relative frequency frequencies and bivariate analysis using Pearson's chi-square test or the exact Fisher. RESULTS fifty-three newborns (0.6%) had Apgar less than 7 in the 5th minute. The multivariate analysis found a positive association between low Apgar and gestational age less than 37 weeks, gestational pathologies and intercurrences in labor. The presence of the companion was a protective factor. CONCLUSION the Normal Birth Center is a viable option for newborns of low risk women as long as the protocol for screening low-risk women is followed.
Expanding boundaries in psychiatry: uncertainty in the context of diagnosis‐seeking and negotiation

Abstract Psychiatric diagnosis has become pervasive in modern culture, exerting an increasing influence on notions of personhood, identity practices and forms of self‐governing. The broadening of diagnostic categories and increasing awareness regarding popular diagnostic categories has led to an increased demand for formal diagnosis within clinical encounters. However, there is continuing ‘epistemological uncertainty’ (Fox 2000) surrounding these entities, in part due to their lack of associated clinical biomarkers and their ‘fuzzy boundaries’. Meanwhile, this diagnostic expansion has encountered resistance from those concerned with the alleged ‘over‐pathologisation’ of emotional distress. Drawing upon the concepts of ‘diagnostic cultures’ (Brinkmann 2016) and the ‘looping effects of human kinds’ (Hacking 1995), this article considers some of the competing forces acting upon the contested boundaries of diagnostic categories as they play out within diagnostic interactions. The study involved ethnographic observations of diagnostic encounters within several UK‐based mental health clinics. By focusing on interactions where diagnosis is negotiated, findings illustrate the role played by different kinds of diagnostic uncertainty in shaping these negotiations. It is argued that diagnostic reification plays a key role in the moral categorisation of patients, particularly where there is uncertainty regarding individual diagnostic status.
Prediction on Compressive and Split Tensile Strengths of GGBFS/FA Based GPC

Based on rate constant concept, empirical models were presented for the predictions of age-dependent development of compressive and split tensile strengths of geopolymer concrete composite (GPCC) with fly ash (FA) blended with ground granulated blast furnace slag (GGBFS). The models were empirically developed based on a total of 180 cylindrical test results of GPCC. Six different independent factors comprising of curing temperature, the weight ratios of GGBFS/binder, the aggregate/binder, the alkali solution/binder, the Na2SiO3/NaOH, and the NaOH concentration were considered as the variables. The ANOVA analyses performed on Taguchi orthogonal arrays with six factors in three levels showed that the curing temperature and ratio of GGBFS to binder were the main contributing factors to the development of compressive strength. The models, functionalized with these contributing factors and equivalent age, reflect the level of activation energy of GPCC similar to that of ordinary Portland cement concrete (OPC) and a higher frequency of molecular collisions during the curing period at elevated temperature. The model predictions for compressive and split tensile strength showed good agreements with tested results.