Miracle-dz/UniFAR-FTUs huggingface dataset:
Aetiology, antimicrobial susceptibility and outcome of children with sepsis, admitted at Muhimbili National Hospital, Dar es Salaam

Introduction sepsis is defined as a systemic inflammatory host response syndrome (SIRS) to infection, commonly bacterial. The global prevalence of sepsis is 8.2% with a mortality rate of 25%, whilst in Tanzania the prevalence is 6.6%. Treatment of sepsis involves early initiation of antibiotics based on local sensitivity patterns. However, there is an increase in antimicrobial resistance to commonly used antibiotics. Hence to promote rational use of antibiotics, we aimed at establishing the etiology, local susceptibility patterns and outcome of children with sepsis aged 2 months to 15 years, admitted at Muhimbili National Hospital (MNH), Dar es Salaam. Methods a hospital based prospective cross sectional study was conducted among 245 participants who were consecutively recruited. A standardized structured questionnaire was used to collect information. Blood cultures and complete blood counts were done. Antimicrobial susceptibility was also done on positive cultures using disc diffusion method. Data were analyzed using SPSS version 20. Frequencies and proportions were used to summarize categorical data, whilst median and interquartile range was used to summarize continuous data. Student T test was used to compare means of data which were normally distributed and the differences in proportions were tested using Chi square test or Fisher’s exact test. A p value of = 0.05 was considered to be statistically significant. Results there was predominance of male participants (67.5%) with a median age was 2 years and an interquartile range (IQR) 10 months to 4 years. Culture positive sepsis was detected among 29.8% of the participants, and the common Gram-positive bacterial isolates were S. aureus (39.7%) Coagulase Negative Staphylococcus (CoNS) (35.6%) and Gram-negative isolates were E. coli (12.3%), Klebsiella spp (6.8%) and Pseudomonas aeruginosa (5.5%). All bacteria showed a high resistance to ampicillin (80%- 100%) followed by ceftriaxone (40 - 70%). All Pseudomonas aeruginosawere 100% resistant to ampicillin, gentamycin and ceftriaxone but were sensitive to amikacin. There was less than 40% resistance to co-amoxiclav, meropenem, ciprofloxacin, amikacin, and clindamycin. The overall case mortality rate from sepsis was 9.4%. Among children discharged 59.3% had prolonged hospital stay of more than 7 days. Age group 1 to 5 years, prior use of antibiotics, tachycardia, and leukocytosis were significantly associated with high mortality. Conclusion bacterial sepsis is prevalent at Muhimbili National Hospital contributing to 9.4% of mortality and a prolonged hospital stay of more than 7 days among 59.3% of the participants. Gram-positive bacteria were found to be predominant cause of sepsis, whereas both Gram-positive and Gram-negative bacteria had a high resistance to first and second line antimicrobials including: ampicillin, gentamycin, and ceftriaxone.
Fluctuation and Complex Stochastic Dynamics : From Micro-system to Macro-system

Ple prqposed the method of'complex da7itsion equation, 71ien, we started ",ith a general stochastic deferential equation, and got to a generat complex equation whieh is similar to wave equation of quantum mechanics. ij'a change ofthe.floating dtfiiision co j}cient is so sJnal4 the eonzptex equation is almost equivalent to Sthrtidinger Eguation. PPk showed that it is sclfi]ty to adopt a same complex dtt7itsion equation if there are the eommon . fitnclamental phenomena as Mtirkov process or stochastie clynamics. 77ie concqpt ofthe seating law is related with a renormalization gnotrp. An expectation vatue and dispersion were dofned by the wavejunction qfthe complex d4tiitsion equation. 7iiie method qfthe complex dij7itsion equation ewCDE) is a generatization f.fiinetionat clata analysis, }fe think that minimuin uncertainties have essentially nothing to db with the.fitzziness oj'statistical method At the next stqp, we have shown a ne"' mplication ofthe . spJstem analysis, where probabitity densityjunction obelys the wave equation or Fokker-Planck eqttation. Pfe eonsider thefazziness ofthe data by introducingfaay derivative, rve can estimate the wicith ofthe precficted duta by the.fitzrp, integration. 77iis method does not assume the shape of the poputation ofsample dtita. lti this method eveipJ knowlecige ofthe system is accumulated in the real and imaginaF)] potentials, so ij'we accumutate the knowlecige, we can read the trend ofthe past data orforetell thefature events Kaywortts: potentiatseomplex dtfiitsion eguation, ,iiinctionatdota analysis, system analysis, real and imaginaoJ
Challenges and coping mechanisms among women living with unrepaired obstetric fistula in Ethiopia: A phenomenological study

Introduction Obstetric fistula remains a debilitating complication of childbirth and maternal morbidity in developing countries. Few studies document the challenges and coping mechanisms among women living with obstetric fistula in Ethiopia. Therefore, this study aimed to explore the challenges and coping mechanisms among women with obstetric fistula in Ethiopia. Methods A phenomenological study was employed among purposively selected eleven women with obstetric fistula and three key informants at five fistula treatment centers in Ethiopia. An in-depth interview was conducted, audio-recorded, and transcribed into a Microsoft Word document. The transcripts were imported into Atlas. ti version 8.4 for thematic analyses. Results Painful social life, consequences of fistula, and coping mechanisms with fistula problems were the main themes in this study. Difficult social life, stigma, discrimination, impaired marital status; psychological, physical, sexual, and reproductive health problems were the major challenges for women with obstetric fistulas. Women with fistulas used coping mechanisms such as—going to spiritual sites and drinking alcohol to cope with their fistula disease; separating themselves from community participation and living alone in the forest to cope with a painful social life; restricting the amount of drinking water and wearing many clothes at a time to cope with wetness and odors, and allowing their husband to marry a new wife to cope with the impaired marital responsibilities. Conclusion Women with obstetric fistulas encountered challenges such as a painful social life, impaired marital status, psychological, physical, sexual, and reproductive health problems; and used coping mechanisms with their fistula condition, difficult social life, and impaired marital responsibility that may have an added negative effect on their overall health. Therefore, policymakers need to prioritize the availability and early utilization of obstetric fistula surgery in all settings for all women living with obstetric fistulas to restore their holistic health.
ANGULAR MOMENTUM TRANSPORT IN PROTOPLANETARY AND BLACK HOLE ACCRETION DISKS: THE ROLE OF PARASITIC MODES IN THE SATURATION OF MHD TURBULENCE

The magnetorotational instability (MRI) is considered a key process for driving efficient angular momentum transport in astrophysical disks. Understanding its nonlinear saturation constitutes a fundamental problem in modern accretion disk theory. The large dynamical range in physical conditions in accretion disks makes it challenging to address this problem only with numerical simulations. We analyze the concept that (secondary) parasitic instabilities are responsible for the saturation of the MRI. Our approach enables us to explore dissipative regimes that are relevant to astrophysical and laboratory conditions that lie beyond the regime accessible to current numerical simulations. We calculate the spectrum and physical structure of parasitic modes that feed off the fastest, exact (primary) MRI mode when its amplitude is such that the fastest parasitic mode grows as fast as the MRI. We argue that this “saturation” amplitude provides an estimate of the magnetic field that can be generated by the MRI before the secondary instabilities suppress its growth significantly. Recent works suggest that the saturation amplitude of the MRI depends mainly on the magnetic Prandtl number. Our results suggest that, as long as viscous effects do not dominate the fluid dynamics, the saturation level of the MRI depends only on the Elsasser number Λη. We calculate the ratio between the stress and the magnetic energy density, αsatβsat, associated with the primary MRI mode. We find that for Ληgt;1 Kelvin–Helmholtz modes are responsible for saturation and αsatβsat = 0.4, while for Λη < 1 tearing modes prevail and αsatβsat ≃ 0.5 Λη. Several features of numerical simulations designed to address the saturation of the MRI in accretion disks surrounding young stars and compact objects can be interpreted in terms of our findings.
An Alternative for Time Series Models

Two methods for construction of new stochastic processes with discrete time are presented. One of the methods employs as the defining tool “triangular (more specifically ‘pseudoaffine’) transformations” which are extended from the Euclidean R to infinite dimension space. They transform any well-known discrete time stochastic process into the constructed one. The other more flexible method is the “method of parameter dependence”, extended to infinite dimension. Properties of the obtained stochastic processes (by either method) indicate the possibility to apply them for financial analysis, as an alternative for the classical time series models. The advantage of the presented models over the existing ones first of all relies on expected better accuracy. This follows from the fact that the typically held assumption on Markovianity in the existing models can easily be relaxed. The defined processes may incorporate a quite long memory including, among others, the k-Markovian cases for k ≥ 2. Regardless the non-Markovianity of the models they still are tractable in an analytical or numerical way. The stochastic processes defined in this paper provide more flexible and more general tools than the existing time series models for modeling financial problems. Among others, they make it possible to incorporate the influence of environmental (explanatory) random variables on the underlying stochastic models’ behavior. These additional features turn out to be describable by the method of parameter dependence. Some suggestions for an associated preliminary statistical analysis are included.
Influence of physical and psychological stress on decision-making performance of soccer referees

ABSTRACT Soccer referees have to make quick and accurate decisions while experiencing physical stress (i.e., fatigue) and psychological stress (i.e., pressure from the crowd). Researchers have examined the influence of physical and psychological stress on skilled referees’ decision-making performance separately; however, referees usually experience both types of stress simultaneously. The aim of the study was to investigate the influence of both physical and psychological stress on skilled and less-skilled soccer referees’ decision-making performance. To simulate the physical and psychological stress during a game, 25 referees were asked to make foul decisions while running on a treadmill and/or being exposed to auditory stress. Referees were more physically fatigued in the physical and psychologically stressed in the psychological stress condition. However, this only negatively influenced their decision-making performance in the video test during the submaximal physical stress condition, when compared to the resting condition. The results also indicate that the experienced referees learned to cope with fatigue and psychological stress regarding their cognitive processes. The effects seem to be differentially detrimental, depending on the league level of refereeing, but also whether physical and psychological stress are induced separately. The study protocol could help referees train in a simulated learning environment, besides on-field games.
ESTIMATING THE DRAG COEFFICIENTS OF METEORITES FOR ALL MACH NUMBER REGIMES.

Accurate values for the drag coefficient are essential to determine the trajectories that meteoroids follow during atmospheric entry. Most models that describe the descent of meteors or witnessed falls find that a constant drag coefficient, Γ, of 0.7 reproduces the observations rather well (e.g. [1], [2]). However, experimental data obtained from studies of regular solids indicate that the drag coefficient is a strong function of Mach number, especially in the low supersonic and subsonic Mach regimes (see Figure 1). For instance, Γ for a sphere ranges from less than 0.5 at subsonic speeds, rapidly increases to ~1 in the transonic regime, and levels off to about 0.9 in the hypersonic limit. When estimating the aerodynamic properties of meteorites, it is helpful to assume that they are aerodynamically similar to a simple shape. Although meteorites are not perfect spheres, it is likely that their drag coefficients follow a similar trend, such that Γ drops by a factor of ~2 as the bolide slows from supersonic to subsonic speeds. These generalizations provide a framework for a meteorite’s drag coefficient function to be dependent on Mach number, such that Γ decreases as the meteorite’s speed decreases. If the Γ of 0.7 represents every portion of the bolide’s flight, current models may be significantly overestimating the drag in the subsonic regime, and underestimating the drag in the supersonic and hypersonic regimes. To address this issue, we present a numerical method to calculate Γ as a function of Mach number. This method can be used to more accurately model the trajectories of meteors, particularly the dark-flight portion. First we gather drag coefficient data for spheres in every Mach number regime [3], [4]. It is especially important to have experimental data during Mach number regime changes. Spheres are aerodynamically simple objects, and drag coefficient data from past experiments is plentiful. We can derive a best fit function over the data points to estimate drag values in between measurements. This best fit function is composed of two base functions that connect in the subsonic regime. During the majority of the subsonic regime, Γ is represented by a quadratic function. At speeds slightly less than Mach one, the best fit function switches to the second base function, which is a sum of two exponentials:
Quantifying Mutational Response to Track the Evolution of SARS-CoV-2 Spike Variants: Introducing a Statistical-Mechanics-Guided Machine Learning Method

The emergence of SARS-CoV-2 and its variants that critically affect global public health requires characterization of mutations and their evolutionary pattern from specific Variants of Interest (VOIs) to Variants of Concern (VOCs). Leveraging the concept of equilibrium statistical mechanics, we introduce a new responsive quantity defined as “Mutational Response Function (MRF)” aptly quantifying domain-wise average entropy-fluctuation in the spike glycoprotein sequence of SARS-CoV-2 based on its evolutionary database. As the evolution transits from a specific variant to VOC, we find that the evolutionary crossover is accompanied by a dramatic change in MRF, upholding the characteristic of a dynamic phase transition. With this entropic information, we have developed an ancestral-based machine learning method that helps predict future domain-specific mutations. The feedforward binary classification model pinpoints possible residues prone to future mutations that have implications for enhanced fusogenicity and pathogenicity of the virus. We believe such MRF analyses followed by a statistical mechanics augmented ML approach could help track different evolutionary stages of such species and identify a critical evolutionary transition that is alarming.
Markov processes from K. Itô's perspective

Kiyosi Ito's greatest contribution to probability theory may be his introduction of stochastic differential equations to explain the Kolmogorov-Feller theory of Markov processes. Starting with the geometric ideas that guided him, this book gives an account of Ito's program. The modern theory of Markov processes was initiated by A. N. Kolmogorov. However, Kolmogorov's approach was too analytic to reveal the probabilistic foundations on which it rests. In particular, it hides the central role played by the simplest Markov processes: those with independent, identically distributed increments. To remedy this defect, Ito interpreted Kolmogorov's famous forward equation as an equation that describes the integral curve of a vector field on the space of probability measures. Thus, in order to show how Ito's thinking leads to his theory of stochastic integral equations, Stroock begins with an account of integral curves on the space of probability measures and then arrives at stochastic integral equations when he moves to a pathspace setting. In the first half of the book, everything is done in the context of general independent increment processes and without explicit use of Ito's stochastic integral calculus. In the second half, the author provides a systematic development of Ito's theory of stochastic integration: first for Brownian motion and then for continuous martingales. The final chapter presents Stratonovich's variation on Ito's theme and ends with an application to the characterization of the paths on which a diffusion is supported. The book should be accessible to readers who have mastered the essentials of modern probability theory and should provide such readers with a reasonably thorough introduction to continuous-time, stochastic processes.
Activating EGFR Signaling Attenuates Osteoarthritis Development Following Loading Injury in Mice

Posttraumatic osteoarthritis (PTOA) results in joint pain, loss of joint function, and impaired quality of daily life in patients with limited treatment options. We previously demonstrated that epidermal growth factor receptor (EGFR) signaling is essential for maintaining chondroprogenitors during articular cartilage development and homeostasis. Here, we used a nonsurgical, loading‐induced PTOA mouse model to investigate the protective action of EGFR signaling. A single bout of cyclic tibial loading at a peak force of 6 N injured cartilage at the posterior aspect of lateral femoral condyle. Similar loading at a peak force of 9 N ruptured the anterior cruciate ligament, causing additional cartilage damage at the medial compartment and ectopic cartilage formation in meniscus and synovium. Constitutively overexpression of an EGFR ligand, heparin binding EGF‐like growth factor (HBEGF), in chondrocytes significantly reduced cartilage injury length, synovitis, and pain after 6 N loading and mitigated medial side cartilage damage and ectopic cartilage formation after 9 N loading. Mechanistically, overactivation of EGFR signaling protected chondrocytes from loading‐induced apoptosis and loss of proliferative ability and lubricant synthesis. Overexpressing HBEGF in adult cartilage starting right before 6 N loading had similar beneficial effects. In contrast, inactivating EGFR in adult cartilage led to accelerated PTOA progression with elevated cartilage Mankin score and synovitis score and increased ectopic cartilage formation. As a therapeutic approach, we constructed a nanoparticle conjugated with the EGFR ligand TGFα. Intra‐articular injections of this nanoconstruct once every 3 weeks for 12 weeks partially mitigated PTOA symptoms in cartilage and synovium after 6 N loading. Our findings demonstrate the anabolic actions of EGFR signaling in maintaining articular cartilage during PTOA development and shed light on developing a novel nanomedicine for PTOA. © 2022 American Society for Bone and Mineral Research (ASBMR).
BCL6 deletion in CD4 T cells does not affect Th2 effector mediated immunity in the skin

Recent studies propose that T follicular helper (Tfh) cells possess a high degree of functional plasticity in addition to their well‐defined roles in mediating interleukin‐4‐dependent switching of germinal center B cells to the production of immunoglobulin (Ig)G1 and IgE antibodies. In particular Tfh cells have been proposed to be an essential stage in Th2 effector cell development that are able to contribute to innate type 2 responses. We used CD4‐cre targeted deletion of BCL6 to identify the contribution Tfh cells make to tissue Th2 effector responses in models of atopic skin disease and lung immunity to parasites. Ablation of Tfh cells did not impair the development or recruitment of Th2 effector subsets to the skin and did not alter the transcriptional expression profile or functional activities of the resulting tissue resident Th2 effector cells. However, the accumulation of Th2 effector cells in lung Th2 responses was partially affected by BCL6 deficiency. These data indicate that the development of Th2 effector cells does not require a BCL6 dependent step, implying Tfh and Th2 effector populations follow separate developmental trajectories and Tfh cells do not contribute to type 2 responses in the skin.
Intraoperative monitoring of lymphatic vessel characteristics using video‐capillaroscopy in the procedure of lymphaticovenular anastomosis

In previous reports we have successfully demonstrated the versatility of video-capillaroscopy (VC) (GOKO-BscanZD, GOKO Imaging Devices Co., Ltd., Japan) to evaluate blood flow of free flaps (Matsui, Lao, Tanaka, Escand on, et al., 2022; Matsui, Lao, Tanaka, Tsuji, et al., 2022). VC is a non-invasive imaging modality that benefits from a 1.2 million pixels capillaroscope that can record red blood cell movement of capillary within a 1-mm depth from the surface (Matsui, Lao, Tanaka, Tsuji, et al., 2022). When lymphaticovenular anastomosis (LVA) is performed for lymphedema treatment, indocyanine green (ICG)-lymphography, ultrasound, and laser tomography have been used for lymphedema staging, detection of lymphatic vessels, and assessment of patency of the anastomotic vessels (Chen et al., 2016). However, none of these technologies provide direct visualization, details of microlympathic vessel permeability, and trophic changes of lymphatic vessels (Chen et al., 2016; Tassenoy et al., 2016). Herein, we describe the use of VC for intraoperative observation of LVAs in this letter. VC was used to analyze the status of lymphatic vessels. Type 1-VC: Lymphatic vessels are permeable, allowing the color of the sheet behind the lymphatic vessels to show through. Nutrient vessels run nearly straight and network with each other. Type 2-VC: Lymphatic vessels show decreased permeability and the color of the sheet behind the lymphatic vessels can be visualized, but tends to be whiter than Type 1. Nutrient vessels show mild tortuosity and interruption. Type 3-VC: Considerable decrease in lymphatic permeability, nutrient vessels are tortuous, narrowed, and interrupted. Lymphatic vessels are overall whitened with no or minimal translucency. A 30-year-old female with International Society of Lymphology (ISL) stage II left upper limb lymphedema after mastectomy plus axillary lymphadenectomy with regional radiotherapy, and a 70-year-old male with venous insufficiency and ISL stage II, idiopathic, lower limb lymphedema underwent LVA due to poor response to compression therapy and manual lymphatic drainage. The upper limb initially exhibited ICG stage IV and LVAs were performed in two locations in which Type 1-VC was determined (Figure 1). The lower limb of the other patient showed ICG stage III initially and LVAs were performed in the lower leg in one site, which showed Type 2-VC, and in two sites in the foot dorsum which had lymphatics with Type 3-VC. After LVA, some red blood cells in the lymphatic vessels were evident before the vein was clamped off. After releasing the vein clamp, red blood cells were observed to move toward the vein from the lymphatics, indicating anterograde lymphatic flow (Data S1). Remarkably, the level of fibrosis and permeability differed on VC in lymphatic vessels with the same ISL stage. In our experience, VC is useful to provide detailed intraoperative evaluation of lymphatic vessels. VC does not require dyes, fluorescent imaging, or radioisotopes, and can visualize lymphatic vessels up to