Miracle-dz/UniFAR-FTUs huggingface dataset:
Addressing maternal and child health equity through a community health worker home visiting intervention to reduce low birth weight: retrospective quasi-experimental study of the Arizona Health Start Programme

Objective To test if participation in the Health Start Programme, an Arizona statewide Community Health Worker (CHW) maternal and child health (MCH) home visiting programme, reduced rates of low birth weight (LBW), very LBW (VLBW), extremely LBW (ELBW) and preterm birth (PTB). Design Quasi-experimental retrospective study using propensity score matching of Health Start Programme enrolment data to state birth certificate records for years 2006–2016. Setting Arizona is uniquely racially and ethnically diverse with comparatively higher proportions of Latino and American Indian residents and a smaller proportion of African Americans. Participants 7212 Health Start Programme mothers matched to non-participants based on demographic, socioeconomic and geographic characteristics, health conditions and previous birth experiences. Intervention A statewide CHW MCH home visiting programme. Primary and secondary outcome measures LBW, VLBW, ELBW and PTB. Results Using Health Start Programme’s administrative data and birth certificate data from 2006 to 2016, we identified 7212 Health Start Programme participants and 53 948 matches. Programme participation is associated with decreases in adverse birth outcomes for most subgroups. Health Start participation is associated with statistically significant lower rates of LBW among American Indian women (38%; average treatment-on-the-treated effect (ATT): 2.30; 95% CI −4.07 to –0.53) and mothers with a pre-existing health risk (25%; ATT: -3.06; 95% CI −5.82 to –0.30). Among Latina mothers, Health Start Programme participation is associated with statistically significant lower rates of VLBW (36%; ATT: 0.35; 95% CI −0.69 to –0.01) and ELBW (62%; ATT: 0.31; 95% CI (−0.52 to –0.10)). Finally, Health Start Programme participation is associated with a statistically significant lower rate of PTB for teen mothers (30%; ATT: 2.81; 95% CI −4.71 to –0.91). Other results were not statistically significant. Conclusion A state health department-operated MCH home visiting intervention that employs CHWs as the primary interventionist may contribute to the reduction of LBW, VLBW, ELBW and PTB and could improve birth outcomes statewide, especially among women and children at increased risk for MCH inequity.
Prognostic impact of echocardiographic mean transvalvular gradients in patients with aortic stenosis and low flow undergoing transcatheter aortic valve implantation

Blunted left ventricular hemodynamics reflected by a low stroke volume index (SVI) ≤35 mL/m2 body surface area (low flow [LF]) in patients with severe aortic stenosis (AS) are associated with worse outcomes even after correction of afterload by transcatheter aortic valve implantation (TAVI). These patients can have a low or high transvalvular mean pressure gradient (MPG). We investigated the impact of the pre‐interventional MPG on outcomes after TAVI.
The Experiences of People Living With Chronic Pain During a Pandemic: “Crumbling Dreams With Uncertain Futures”

People living with chronic pain experience multiple challenges in their daily activities. Chronic pain is complex and often provokes life circumstances that create increased social isolation. Living with chronic pain during the pandemic may add additional layers of complexity to their daily lives. The researchers endeavored to explore the experiences of people living with chronic pain during the COVID-19 pandemic. Researchers conducted semi-structured, open-ended interviews about how the pandemic influenced participants’ lives. The interviews were recorded and analyzed using an applied philosophical hermeneutics approach. The findings were feeling socially isolated, losing their sense of livinghood, and experiencing augmented stress levels which, in most cases, aggravated their chronic pain. In addition to gaining an in-depth understanding of the needs of people living with chronic pain, these findings may guide policy decisions with the intention of improving health care access and the overall experiences of people living with chronic conditions during a pandemic.
Interactions of Tc(IV) with citrate in NaCl media

Abstract This paper presents the experimental determination of the stability constant for the citrate complexes with TcO(OH)+ and TcO(OH)20 at different ionic strengths (NaCl), using a solvent extraction method. Data show that the stability constants for the formation of TcO(OH)Cit2− and TcO(OH)2Cit3− are 107.5 ± 0.2 and 102.8 ± 0.2, respectively, at zero ionic strength, with an average of 106.5 ± 0.3 and 102.8 ± 0.2, respectively, in the 1.0–3.0 M ionic strength range. PHREEQC calculations based on these stability constants show that the TcO(OH)Cit2− is the predominant species between pH 3 and 8 and that 50 mM citrate leads to a Tc(IV) solubility of 2 × 10−5 M at pH 5.
Arabidopsis vascular complexity and connectivity controls PIN-FORMED1 dynamics and lateral vein patterning during embryogenesis.

Arabidopsis VASCULATURE COMPLEXITY AND CONNECTIVITY (VCC) is a plant-specific transmembrane protein that controls the development of veins in cotyledons. Here we show that the expression and localization of the auxin efflux carrier PIN-FORMED1 (PIN1) is altered in vcc developing cotyledons and that overexpression of PIN1-GFP partially rescues vascular defects of vcc in a dosage-dependent manner. Genetic analyses suggest that VCC and PINOID (PID), a kinase that regulates PIN1 polarity, are both required for PIN1-mediated control of vasculature development. VCC expression is upregulated by auxin, likely as part of a positive feedback loop for the progression of vascular development. VCC and PIN1 localized to the plasma membrane in pre-procambial cells but are actively redirected to vacuoles in procambial cells for degradation. In the vcc mutant, PIN1 failed to properly polarize in pre-procambial cells during the formation of basal strands and instead, it is prematurely degraded in vacuoles. VCC plays a role in localization and stability of PIN1, which is critical for the transition of pre-procambial into procambial cells involved in the formation of basal lateral strands in embryonic cotyledons.
VPS13D interacts with VCP/p97 and negatively regulates endoplasmic reticulum–mitochondria interactions

Membrane contact sites (MCSs) between the endoplasmic reticulum (ER) and mitochondria are emerging as critical hubs for diverse cellular events, and alterations in the extent of these contacts are linked to neurodegenerative diseases. However, the mechanisms that control ER–mitochondria interactions are so far elusive. Here, we demonstrate a key role of vacuolar protein sorting–associated protein 13D (VPS13D) in the negative regulation of ER–mitochondria MCSs. VPS13D suppression results in extensive ER–mitochondria tethering, a phenotype that can be substantially rescued by suppression of the tethering proteins VAPB and PTPIP51. VPS13D interacts with valosin-containing protein (VCP/p97) to control the level of ER-resident VAPB at contacts. VPS13D is required for the stability of p97. Functionally, VPS13D suppression leads to severe defects in mitochondrial morphology, mitochondrial cellular distribution, and mitochondrial DNA synthesis. Together, our results suggest that VPS13D negatively regulates the ER–mitochondria MCSs, partially through its interactions with VCP/p97.
Pathogenic Effect of TP73 Gene Variants in People With Amyotrophic Lateral Sclerosis

Objective To identify novel disease associated loci for amyotrophic lateral sclerosis (ALS), we used sequencing data and performed in vitro and in vivo experiments to demonstrate pathogenicity of mutations identified in TP73. Methods We analyzed exome sequences of 87 patients with sporadic ALS and 324 controls, with confirmatory sequencing in independent ALS cohorts of >2,800 patients. For the top hit, TP73, a regulator of apoptosis and differentiation and a binding partner and homolog of the tumor suppressor gene TP53, we assayed mutation effects using in vitro and in vivo experiments. C2C12 myoblast differentiation assays, characterization of myotube appearance, and immunoprecipitation of p53-p73 complexes were performed in vitro. In vivo, we used clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 targeting of zebrafish tp73 to assay motor neuron number and axon morphology. Results Four heterozygous rare, nonsynonymous mutations in TP73 were identified in our sporadic ALS cohort. In independent ALS cohorts, we identified an additional 19 rare, deleterious variants in TP73. Patient TP73 mutations caused abnormal differentiation and increased apoptosis in the myoblast differentiation assay, with abnormal myotube appearance. Immunoprecipitation of mutant ΔN-p73 demonstrated that patient mutations hinder the ability of ΔN-p73 to bind p53. CRISPR/Cas9 knockout of tp73 in zebrafish led to impaired motor neuron development and abnormal axonal morphology, concordant with ALS pathology. Conclusion Together, these results strongly suggest that variants in TP73 correlate with risk for ALS and indicate a role for apoptosis in ALS disease pathology.
RNase H1C collaborates with ssDNA binding proteins WHY1/3 and recombinase RecA1 to fulfill the DNA damage repair in Arabidopsis chloroplasts

Abstract Proper repair of damaged DNA is crucial for genetic integrity and organismal survival. As semi-autonomous organelles, plastids have their own genomes whose integrity must be preserved. Several factors have been shown to participate in plastid DNA damage repair; however, the underlying mechanism remains unclear. Here, we elucidate a mechanism of homologous recombination (HR) repair in chloroplasts that involves R-loops. We find that the recombinase RecA1 forms filaments in chloroplasts during HR repair, but aggregates as puncta when RNA:DNA hybrids accumulate. ssDNA-binding proteins WHY1/3 and chloroplast RNase H1 AtRNH1C are recruited to the same genomic sites to promote HR repair. Depletion of AtRNH1C or WHY1/3 significantly suppresses the binding of RNA polymerase to the damaged DNA, thus reducing HR repair and modulating microhomology-mediated double-strand break repair. Furthermore, we show that DNA polymerase IB works with AtRNH1C genetically to complete the DNA damage repair process. This study reveals the positive role of R-loops in facilitating the activities of WHY1/3 and RecA1, which in turn secures HR repair and organellar development.
Thermal imaging ruled out as a supplementary assessment in patients with fibromyalgia: A cross-sectional study

Background The diagnosis of fibromyalgia syndrome (FMS) syndrome is often complicated and relies on diagnostic criteria based mostly on the symptoms reported by patients. Implementing objective complementary tests would be desirable to better characterize this population. Objective The purpose of this cross-sectional study was to compare the skin temperature at rest using thermography in women with FMS and healthy women. Methods Eighty-six women with FMS and 92 healthy controls volunteered to participate. The temperature of all participants was measured by infra-red thermography, registering the skin surface temperature (minimum, maximum and average) at rest in different areas: neck, upper and lower back, chest, knees and elbows. In order to analyze the differences in the skin temperature between groups, inferential analyses of the data were performed using Mann-Whitney U test. Results The results showed no significant difference in skin temperature between groups in the neck, upper back, chest and elbows (p>0.05). The lower back and knees areas showed significant differences between groups (p<0.05), although these differences did not reach a minimum of clinically detectable change. Conclusions Women with fibromyalgia presented no clinically meaningful reduction or difference in skin temperature at rest when compared with a group of healthy women. The infra-red thermography is not an effective supplementary assessment tool in women with fibromyalgia.
Women's satisfaction with childbirth and postpartum care and associated variables.

OBJECTIVE To determine the level of satisfaction with childbirth and the postpartum period. METHOD This is a longitudinal, observational study. Clinical variables of the patients and delivery were collected, and a descriptive and inferential analysis was performed. The validated state-trait anxiety inventory (STAI) and the satisfaction survey Care in Obstetrics Measure For Testing Satisfaction Scale (COMFORTS) in Spanish were used. RESULTS A total of 381 women was included in the study and grouped into satisfied vs. dissatisfied (94.54% vs. 5.46%). Women having given birth by eutocic delivery (p = 0.005), as well as those who had skin-to-skin time with their newborn (p = 0.012) after delivery, report more satisfaction. Mothers who were separated from their babies reported being less satisfied (p = 0.004), as did those who did not meet the expectations raised in the birth plan (p = 0.013). All the women with minimal anxiety are satisfied (p = 0.004), the same happening for those showing postpartum anxiety (p <0.001). CONCLUSION The percentage of satisfied women is high; it is necessary to monitor childbirth and postpartum care, promoting good practices in childbirth care, as well as in women's emotional well-being.
Social Disconnection and Living Arrangements among Older Adults: The Singapore Chinese Health Study

Introduction: Although living alone is associated with social disconnection, older adults could be socially disconnected despite living with others. Understanding the factors associated with social disconnection by living arrangement could help identify vulnerable older adults in the community. We examined the sociodemographic and health factors associated with social disconnection among two groups of older adults: those living alone and those living with others. Methods: We used data from 16,943 community-dwelling older adults from the third follow-up of the Singapore Chinese Health Study (mean age: 73 years, range: 61–96 years). We defined social disconnection as having no social participation and scoring in the lowest decile on the Duke Social Support Scale of perceived social support. We ran logistic regression models to study the sociodemographic (age, gender, and education) and health (self-rated health, instrumental limitations, cognitive function, and depression) factors associated with social disconnection, stratified by living arrangement. Results: About 6% of our participants were socially disconnected. Although living alone was significantly associated with social disconnection (OR 1.93, 95% CI: 1.58–2.35), 85.6% of socially disconnected older adults lived with others, most of them (92%) with family. Lower education level, cognitive impairment, fair/poor self-rated health, instrumental limitations, and depression were independently associated with social disconnection. Among those living alone, men were more likely to experience social disconnection than women (OR 2.18, 95% CI: 1.43–3.32). Discussion/Conclusion: Though living alone is associated with social disconnection, most socially disconnected individuals lived with family. Community interventions could focus on those in poor health despite living with family and older men living alone.
Neuronal selectivity to complex vocalization features emerges in the superficial layers of primary auditory cortex

Early in auditory processing, neural responses faithfully reflect acoustic input. At higher stages of auditory processing, however, neurons become selective for particular call types, eventually leading to specialized regions of cortex that preferentially process calls at the highest auditory processing stages. We previously proposed that an intermediate step in how nonselective responses are transformed into call-selective responses is the detection of informative call features. But how neural selectivity for informative call features emerges from nonselective inputs, whether feature selectivity gradually emerges over the processing hierarchy, and how stimulus information is represented in nonselective and feature-selective populations remain open question. In this study, using unanesthetized guinea pigs (GPs), a highly vocal and social rodent, as an animal model, we characterized the neural representation of calls in 3 auditory processing stages—the thalamus (ventral medial geniculate body (vMGB)), and thalamorecipient (L4) and superficial layers (L2/3) of primary auditory cortex (A1). We found that neurons in vMGB and A1 L4 did not exhibit call-selective responses and responded throughout the call durations. However, A1 L2/3 neurons showed high call selectivity with about a third of neurons responding to only 1 or 2 call types. These A1 L2/3 neurons only responded to restricted portions of calls suggesting that they were highly selective for call features. Receptive fields of these A1 L2/3 neurons showed complex spectrotemporal structures that could underlie their high call feature selectivity. Information theoretic analysis revealed that in A1 L4, stimulus information was distributed over the population and was spread out over the call durations. In contrast, in A1 L2/3, individual neurons showed brief bursts of high stimulus-specific information and conveyed high levels of information per spike. These data demonstrate that a transformation in the neural representation of calls occurs between A1 L4 and A1 L2/3, leading to the emergence of a feature-based representation of calls in A1 L2/3. Our data thus suggest that observed cortical specializations for call processing emerge in A1 and set the stage for further mechanistic studies.
Laboratory testing for suspected COVID‐19 vaccine–induced (immune) thrombotic thrombocytopenia

COVID‐19 (coronavirus disease 2019) represents a pandemic, and several vaccines have been produced to prevent infection and/or severe sequelae associated with SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus 2) infection. There have been several reports of infrequent post vaccine associated thrombotic events, in particular for adenovirus‐based vaccines. These have variously been termed VIPIT (vaccine‐induced prothrombotic immune thrombocytopenia), VITT (vaccine‐induced [immune] thrombotic thrombocytopenia), VATT (vaccine‐associated [immune] thrombotic thrombocytopenia), and TTS (thrombosis with thrombocytopenia syndrome). In this report, the laboratory test processes, as utilised to assess suspected VITT, are reviewed. In published reports to date, there are notable similarities and divergences in testing approaches, potentially leading to identification of slightly disparate patient cohorts. The key to appropriate identification/exclusion of VITT, and potential differentiation from heparin‐induced thrombocytopenia with thrombosis (HITT), is identification of potentially differential test patterns. In summary, testing typically comprises platelet counts, D‐dimer, fibrinogen, and various immunological and functional assays for platelet factor 4 (PF4) antibodies. In suspected VITT, there is a generally highly elevated level of D‐dimer, thrombocytopenia, and PF4 antibodies can be identified by ELISA‐based assays, but not by other immunological assays typically positive in HITT. In addition, in some functional platelet activation assays, standard doses of heparin have been identified to inhibit activation in suspected VITT, but they tend to augment activation in HITT. Conversely, it is also important to not over‐diagnose VITT, given that not all cases of thrombosis post vaccination will have an immune basis and not all PF4‐ELISA positive patients will be VITT.
Multisystem Inflammatory Syndrome in Children — Initial Therapy and Outcomes

Abstract Background The assessment of real-world effectiveness of immunomodulatory medications for multisystem inflammatory syndrome in children (MIS-C) may guide therapy. Methods We analyzed surveillance data on inpatients younger than 21 years of age who had MIS-C and were admitted to 1 of 58 U.S. hospitals between March 15 and October 31, 2020. The effectiveness of initial immunomodulatory therapy (day 0, indicating the first day any such therapy for MIS-C was given) with intravenous immune globulin (IVIG) plus glucocorticoids, as compared with IVIG alone, was evaluated with propensity-score matching and inverse probability weighting, with adjustment for baseline MIS-C severity and demographic characteristics. The primary outcome was cardiovascular dysfunction (a composite of left ventricular dysfunction or shock resulting in the use of vasopressors) on or after day 2. Secondary outcomes included the components of the primary outcome, the receipt of adjunctive treatment (glucocorticoids in patients not already receiving glucocorticoids on day 0, a biologic, or a second dose of IVIG) on or after day 1, and persistent or recurrent fever on or after day 2. Results A total of 518 patients with MIS-C (median age, 8.7 years) received at least one immunomodulatory therapy; 75% had been previously healthy, and 9 died. In the propensity-score–matched analysis, initial treatment with IVIG plus glucocorticoids (103 patients) was associated with a lower risk of cardiovascular dysfunction on or after day 2 than IVIG alone (103 patients) (17% vs. 31%; risk ratio, 0.56; 95% confidence interval [CI], 0.34 to 0.94). The risks of the components of the composite outcome were also lower among those who received IVIG plus glucocorticoids: left ventricular dysfunction occurred in 8% and 17% of the patients, respectively (risk ratio, 0.46; 95% CI, 0.19 to 1.15), and shock resulting in vasopressor use in 13% and 24% (risk ratio, 0.54; 95% CI, 0.29 to 1.00). The use of adjunctive therapy was lower among patients who received IVIG plus glucocorticoids than among those who received IVIG alone (34% vs. 70%; risk ratio, 0.49; 95% CI, 0.36 to 0.65), but the risk of fever was unaffected (31% and 40%, respectively; risk ratio, 0.78; 95% CI, 0.53 to 1.13). The inverse-probability-weighted analysis confirmed the results of the propensity-score–matched analysis. Conclusions Among children and adolescents with MIS-C, initial treatment with IVIG plus glucocorticoids was associated with a lower risk of new or persistent cardiovascular dysfunction than IVIG alone. (Funded by the Centers for Disease Control and Prevention.)