Miracle-dz/UniFAR-FTUs huggingface dataset:
Pulmonary nodules in patients with drug-resistant tuberculosis who have undergone adjuvant lung resection in a high-HIV-burden setting

Introduction. Radiological findings of drug-resistant tuberculosis (DR-TB) have been described; however, results were focused on HIVnegative patients. Objectives . To describe the radiological distribution of pulmonary nodules in patients who have undergone lung resection. Furthermore, the study establishes the association between perioperative nodules and sputum culture conversion in HIV-positive and -negative patients. Methods . A retrospective review was conducted of clinical and radiological records of adult patients who had undergone lung resections for DR-TB, between 1 January 2011 and 31 December 2013, at a hospital in Durban, South Africa. Results . Lung resections were undertaken in 47 patients with drug-resistant tuberculosis (DR-TB.) Among patient infections, 74.5% were multidrug-resistant TB (MDR-TB) and 25.5% were extensively drug-resistant TB (XDR-TB). The prevalence of HIV was 54.3% in patients with MDR-TB and 66.7% in XDR-TB. Pre-operative radiological studies showed a similar distribution of pulmonary nodules in HIV-positive and -negative patients. Positive pre-operative sputum cultures were noted in 34% of patients, but were not associated with pulmonary nodules on pre-operative radiological evaluation ( p =0.81). At 1 month postoperatively, 81.3% of patients with a positive pre-operative sputum culture converted to negative sputum culture. The cumulative culture conversion rate was 87.5% at 2 months postoperatively. Using composite sputum culture outcomes, a good outcome was defined as consistently negative postoperative sputum cultures. There was no association between poor outcomes and the presence of nodules, either pre-operatively ( p =0.73) or postoperatively ( p =0.52), irrespective of HIV status. Conclusion. The presence of pulmonary nodules on pre-operative images was not associated with perioperative positive sputum results or poor outcomes. The clinical significance of residual pulmonary nodules in DR-TB, following lung resection, remains uncertain.
Make Me a Better Offer: Developer Threats and Regional Competition for Land Development Projects

To extract favorable terms from local governments, developers can take advantage of intermunicipal competition and threaten to relocate or abandon a land development project. Some say that model of regional competition undercuts the economic, environmental, and societal benefits of development while others claim it boosts the efficiency of municipal operations. The authors examine the likelihood that land developers will push local governments to compete against each other for projects. Their study of New York municipalities (N = 306) finds that one third of local governments have been threatened and that one third of those reacted by reducing burdens or increasing incentives for developers. Their logistic regression model reveals that more cooperative intermunicipal relations across a region decrease the chances of developers threatening to move projects. Interestingly, the model suggests that public participation increases the chances of a threat.
Rural family physician system in Iran: Key challenges from the perspective of managers and physicians, 2016

ABSTRACT This research is a descriptive analytical study that determines the existing challenges of the family physician program in 2016 in the largest province of Iran, Grate Khorasan, from the views of physicians and managers working in this program. The data collection tool was a researcher-made questionnaire. The questionnaire validity was investigated using experts’ opinions while its reliability was evaluated using Cronbach’s alpha. To analyze data, statistical tests of Mann–Whitney U, T test and ANOVA were used at a significance level of 0.05. Results of the study indicate that in managers’ view, the largest and smallest challenges pertain to the information system (3.95 ± 0.72) and performance appraisal (3.42 ± 0.75), respectively. The highest and lowest differences of opinion between managers and physicians are in the domain of welfare facilities (0.20 ± 0.61) and (0.17 ± 0.04), respectively. It should be noted that the family physician program has had some difficulties and challenges. Results of this study indicate that the biggest challenges are in the domains of service compensation, healthcare insurance system, recruitment and retention of human resources and finance.
Effect of Polycystic Ovarian Syndrome and Obesity on Women Fertility in Erbil Governorate

The present study was done to assess the effect of polycystic ovarian syndrome and obesity on women fertility by investigating the alteration in some hormonal, the state of menstrual cycle and some serum biochemical parameters of women in the reproductive age in Erbil city. The study was included 53 women with the ages between (25- 30) years, thirty five females of them diagnosed with fertility problems and eighteen of fertile women as matching control. The results of polycystic ovarian syndrome (PCOS) group showed highly significant increases in serum LH, Estradiol, Testosterone and AMH levels, and significant decreases in FSH were observed. The study indicated a higher prevalence of irregular menstruation and amenorrhea in PCOS group compared with control group, on the other hand no significant change of lipid profile (Cholesterol, TG, HDL, LDL, VLDL) were observed between control and PCOS group. The results showed significant increase in testosterone, estradiol and prolactin with significant decrease in LH, FSH and AMH in obese group when compared with control group. The data revealed a positive correlation between obesity, irregular menstruation and amenorrhea. Furthermore the results demonstrated significant elevation in serum cholesterol, TG, LDL, and VLDL with significant decrease in concentration of HDL- cholesterol in obese group when compared with control.
Being taken seriously. Person-centredness and person-centred climate as experienced by patients and significant others when the patient is assessed as non-urgent by the Swedish Ambulance Service

Background: The experience of person-centredness and person-centred climate is poorly understood in the context of being assessed as non-urgent and, in many cases, left at home by the Ambulance Service.Aim: The overall objective of this thesis was to explore experiences of person-centredness and the person-centred climate among patients and significant others when patients were assessed as non-urgent by the Swedish Ambulance Service. Methods: Both an inductive and deductive approach has been used in combination with qualitative and quantitative research methods.The study group consisted of I) 12 patients and II) 111 patients who were considered non-urgent and thus recommended for triage and non-conveyance by the Ambulance Service as well as III) 11 significant others and IV) 100 significant others of patients considered non-urgent and therefore not conveyed to the Accident and Emergency Department. Interviews were performed and analysed by means of phenomenological hermeneutics developed by Lindseth and Norberg. The instruments used for data collection were the Person-centred Climate Questionnaire, Patient/Family version. In addition, questions from the inductive studies were tested for construct validity.Results: The meaning of person-centredness among the patients was a strong wish to be taken seriously. The climate was perceived as highly person-centred. Being taken seriously resulted in feelings of trust and being an activepartner in the decision-making process. In contrast, a sense of being rejected and insulted arose when not taken seriously. Eight aspects of person-centredness were established psycho¬metrically with a one-factor solution covering 79.9 % of the variance. The patients reported the climate as person-centred. Significant others wished to be de-burdened from their caring responsibilities and not abandoned in the present situation. The single most important factor for achieving this was ensuring that the patient was takenseriously. The significant others reported that the psychosocial climate was person-centred. Eight aspects of person-centredness and being de-burdened were established psychometrically with a onefactor solution explaining 58.8 % of the variance.Conclusion: It is possible to achieve a person-centred climate within in the Ambulance Service irrespective of time and location, due to the fact that person-centredness mainly concerns taking patients seriously and providing a moment of de-burdening for significant others.
Feature-based comparison of sea ice deformation in lead-permitting sea ice simulations

Abstract. The sea ice modeling community is progressing towards pan-Arctic simulations that explicitly resolve leads in the simulated sea ice cover. Evaluating these simulations against observations poses new challenges. A new feature-based evaluation of simulated deformation fields is introduced, and the results are compared to a scaling analysis of sea ice deformation. Leads and pressure ridges – here combined into linear kinematic features (LKFs) – are detected and tracked automatically from deformation and drift data. LKFs in two pan-Arctic sea ice simulations with a horizontal grid spacing of 2 km are compared with an LKF dataset derived from the RADARSAT Geophysical Processor System (RGPS). One simulation uses a five-class ice thickness distribution (ITD). The simulated sea ice deformation follows a multi-fractal spatial and temporal scaling, as observed from RGPS. The heavy-tailed distribution of LKF lengths and the scale invariance of LKF curvature, which points to the self-similar nature of sea ice deformation fields, are reproduced by the model. Interannual and seasonal variations in the number of LKFs, LKF densities, and LKF orientations in the ITD simulation are found to be consistent with RGPS observations. The lifetimes and growth rates follow a distribution with an exponential tail. The model overestimates the intersection angle of LKFs, which is attributed to the model's viscous-plastic rheology with an elliptical yield curve. In conclusion, the new feature-based analysis of LKF statistics is found to be useful for a comprehensive evaluation of simulated deformation features, which is required before the simulated features can be used with confidence in the context of climate studies. As such, it complements the commonly used scaling analysis and provides new useful information for comparing deformation statistics. The ITD simulation is shown to reproduce LKFs sufficiently well for it to be used for studying the effect of directly resolved leads in climate simulations. The feature-based analysis of LKFs also identifies specific model deficits that may be addressed by specific parameterizations, for example, a damage parameter, a grounding scheme, and a Mohr–Coulombic yield curve.
Affordable Care Act and Racial Inequity in Breast Cancer Survival Rates

Affordable Care Act and Racial Inequity in Breast Cancer Survival Rates by Nadine Terry-Lawrence MS, Kaplan University, 2013 BS, Kaplan University, 2011 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Healthcare Administration Walden University November 2019
Epidemiological characteristics of pediatrics fracture at tertiary care hospital, Malaysia

Background: Childhood fracture resulting from trauma has become a major cause of morbidity, disability and socioeconomic burden worldwide as well as Malaysia. So, we aim to assess the various epidemiological parameters that influence the etiology of fracture among the pediatrics population at Melaka, Malaysia and to establish data to develop effective preventive strategies. Methods: A hospital based cross sectional study was conducted at Melaka General Hospital, Melaka from January 2013 to December 2013. There were total 369 pediatrics fracture cases admitted to MGH during study period. Results: Among 369 cases, (64.2%) of cases were found among school going age followed by (30.9%) among toddler and (4.9%) of cases among infant. (69.6%) of cases were males and most of them were Malay (87.3%) The incidents occurred mostly in evening around 6pm most significantly in between 10 am to 11 pm. The most common place of injury was at home (40.4%) and fall (77.2%) is the most common mechanism of injury. Left upper extremity involved majority of facture and common site of injuries were around elbow. Epiphyseal injuries account for (9.4 %) and among them distal radius epiphyseal injury account for (68.6 %) which is statically significant (P=0.00). Conclusions: We concluded that the common mechanism of fracture was fall, (low energy trauma) occurred at home involving left upper extremity around elbow. We believed that community based education by health care professionals and paediatricians on prevention strategies can be instrumental in reducing the incidence of paediatric fractures.
Howling by the river: howler monkey (Alouatta palliata) communication in an anthropogenically-altered riparian forest in Costa Rica

The ways that forest edges may affect animal vocalization behaviour are poorly understood. We investigated the effects of various types of edge habitat on the loud calls (howls) of a folivorous-frugivorous primate species, Alouatta palliata, with reference to the ecological resource defence hypothesis, which predicts that males howl to defend vegetation resources. We tested this hypothesis across four forest zones — interior, riparian, anthropogenic, and combined forest edges — in a riparian forest fragment in Costa Rica. We predicted vegetation and howling would differ between forest zones, with riparian and interior zones showing the highest values and anthropogenic edge the lowest. Our results indicated that vegetation was richer and howling longer in riparian and interior zones compared to combined and anthropogenic edges, supporting the resource defence hypothesis and providing some of the first evidence in animal communication scholarship for differences in behavioural edge effects between natural riparian and anthropogenic edges.
Management of Neurogenic Detrusor Overactivity Caused by Spinal Cord Injury - The Case of Botulinum Toxin and Resiniferatoxin

Urinary dysfunction is a very common and one of the most debilitating consequences of spinal cord injury (SCI), being in the top list of treatment priorities. The direct damage to central nerves implicated in the control of lower urinary tract (LUT) lead to bladder areflexia and voiding deficiency that is subsequently overcome by neurogenic detrusor overactivity (NDO). This condition affects nearly 90% of SCI patients and is characterized by periods of extremely high intravesical pressures, which compromise kidneys’ integrity, and frequent episodes of urinary incontinence that strongly affect their quality of life. Thus, management of NDO is of foremost importance and still a clinical challenge. Botulinum toxin A (BoNT/A) is a powerful tool in the management of hyperactive muscles and is currently the gold standard treatment for NDO, for patients who are refractory to antimuscarinics, the first line of therapy. Numerous studies support the efficacy of bladder wall injections of BoNT/A in reducing bladder pressure and episodes of urinary incontinence. BoNT/A therapeutic effects last for several months and produce tremendous positive impact in patients’ quality of life. However, severe urinary retention is still commonly pointed as an adversity of the treatment that needs to be overcome. In Publications I and II included in this dissertation we addressed that issue and conducted research aiming to improve BoNT/A-based treatment strategies. In Publication I we defined an accurate conversion ratio for bladder-wall administration of the two BoNT/A formulations mostly used in clinics, onabotulinumtoxin/A (Onabot/A) and abobotulinumtoxin/A (Abobot/A). Onabot/A has been particularly well studied and it is the unique toxin product licensed for the treatment of NDO. Thus, doses of Abobot/A used in clinical urology are inaccurately established based on unspecific conversion ratios. With a fine analysis of toxin catalytic activity on SNAP-25, the specific target of the toxin, in bladders of mice
Rural-Urban Differences in Hypertension among the Hmars of Manipur in Northeast India

ABSTRACT This paper aims to identify the risk factors for the rural-urban differences in hypertension. A crosssectional sample of 1,207 adult Hmars (18-70 years) was collected from rural and urban areas of Manipur, India. The results showed that there were significant differences in blood pressure and hypertension within and between the two settings. Urban participants had higher rates of hypertension than their rural counterparts at a given age or physical activity level, but similar at the same BMI level. Hypertension was higher in men than women, but urban men had higher risk of hypertension than their rural counterparts, whereas rural and urban women experienced a similar risk. Using multivariate-logistic regression, the rural-urban difference (OR = 1.55; CI = 1.75-2.06, p < 0.01) in hypertension was mainly due to variation in physical activity and household income. These results indicated that there was an intra-variation in acculturation within the Hmar community.
Loading influence on the corrosion assessment during stress-induced martensite reorientation in nickel-titanium SMA

The effect of stress-induced martensite reorientation on the corrosion behavior of a nickel-titanium (NiTi) shape memory alloy (SMA) was characterized by mechanical-electrochemical techniques. This martensite reorientation influenced the passive state of NiTi SMA. These passive to active state transitions could be sensed by the global interfacial electrochemical measurements, such as electrochemical impedance spectroscopy (EIS), open circuit potential (OCP) and linear polarization resistance (LPR) methods. The increase in the loading when exposed to a corrosive environment resulted in the breakdown of the passive layer. A later repassivation stage was reached due to the formation rate becoming more dominant than the breakdown rate during loading conditions. The integration of the mechanical loading by tensile testing, strain distribution by digital image correlation (DIC) and electrochemical methods by OCP and EIS, characterized and detected the influence of the mechanical effect in the corrosion assessment and interfacial mechanisms.
Rapid Arctic Sea Ice Loss on the Synoptic Time Scale and Related Atmospheric Circulation Anomalies

Large sea ice loss on the synoptic time scale is examined in various subregions in the Arctic as well as at the pan-Arctic scale. It is found that the frequency of large daily sea ice loss (LDSIL) days is significantly correlated with the September sea ice extent over the Beaufort–Chukchi–Siberian Seas, the Laptev–Kara Seas, the central Arctic, and the all-Arctic regions, indicating a link between the synoptic sea ice variability and the interannual variability of the annual minimum sea ice extent. A composite analysis reveals dipoles of anomalous cyclones and anticyclones associated with LDSIL days. Different from the well-known Arctic dipole pattern, the east–west dipoles are found over the corresponding regions of LDSIL in the Arctic marginal seas and are associated with the increasing occurrence of Rossby wave breaking and atmospheric rivers. The anticyclones of the dipoles are persistent and quasi-stationary, reminiscent of blocking. The anomalous poleward flow between the cyclone and the anticyclone enhances the poleward transport of heat and water vapor in the lower troposphere. Although enhanced downward shortwave radiation, associated with reduced cloud fraction, is found in some regions, it is not collocated with the regions of LDSIL. In contrast, enhanced downward longwave radiation owing to increasing column water vapor shows good spatial correspondence with LDSIL, indicating the importance of atmospheric rivers in LDSIL events. Lead/lag composites with respect to the onset of LDSIL episodes reveal precursor wave trains spanning the midlatitudes. The wave trains have predominantly zonal energy propagation in the midlatitudes and do not show a clear link to tropical or subtropical forcing.
Accurate localization of linear probe electrodes across multiple brains

Recently developed silicon probes have large numbers of recording electrodes on long linear shanks. Specifically, Neuropixels probes have 960 recording electrodes distributed over 9.6 mm shanks. Because of their length, Neuropixels probe recordings in rodents naturally span multiple brain areas. Typical studies collate recordings across several recording sessions and animals. Neurons recorded in different sessions and animals have to be aligned to each other and to a standardized brain coordinate system. Here we report a workflow for accurate localization of individual electrodes in standardized coordinates and aligned across individual brains. This workflow relies on imaging brains with fluorescent probe tracks and warping 3-dimensional image stacks to standardized brain atlases. Electrophysiological features are then used to anchor particular electrodes along the reconstructed tracks to specific locations in the brain atlas and therefore to specific brain structures. We performed ground-truth experiments, in which motor cortex outputs are labelled with ChR2 and a fluorescence protein. Recording from brain regions targeted by these outputs reveals better than 100 μm accuracy for electrode localization.
Evaluation of genotoxic effects of methanolic extract of brown seaweed Stoechospermum marginatum

Seaweeds are considered as a valuable source of bioactive compounds produced as secondary metabolites having a broad spectrum of biological activities. Recently seaweed has been extensively utilized by pharmaceutical, chemical and nutraceutical industries as valuable sources of raw material of natural origin. The present study aimed at evaluating the mutagenic and genotoxic effects of methanolic extract of brown seaweed Stoechospermum marginatum. The test extract was assessed for its potential mutagenic effect using in vitro bacteria reverse mutation assay (Ames test) and for its potential clastogenic and DNA damaging effects using in vivo rodent bone marrow micronucleus and alkaline comet assay respectively. The test extract did not produce a two-fold increase or a reproducible dose-dependent increase in the number of revertant colonies in all the bacterial tester strains at the highest dose of 5000 μg/plate tested both with and without metabolic activation. No significant clastogenic and DNA damaging effects were observed at the highest dose of 2000 mg/kg body weight when the test extract was assayed in-vivo in mice bone marrow erythrocytes and peripherally in lymphocytes respectively. The result obtained from this study revealed that methanolic extract of Stoechospermum marginatum is safe to living cells genome and does not produce significant mutagenic and genotoxic effect when assayed in both in vitro and in vivo testing systems.
Desflurane in neurosurgery: Pros

Abstract Neurosurgery and neuroanaesthesia are making rapid progress, and with this progress, there is the search for excellence and ideal results. The practice of neuroanaesthesia is fairly standardised today, and any debate can only be on the fine-tuning aspects of the techniques. The aim of all research in anaesthesia is to provide the best possible and safest operating conditions and to have a complete recovery at the end of the surgery. The maintenance of anaesthesia for neurosurgery is with balanced general anaesthesia which combines intravenous and inhalational agents. A review of literature shows that desflurane has definite advantages, and hence, it is an integral part of modern neuroanaesthesia.