Miracle-dz/UniFAR-FTUs huggingface dataset:
Feasibility study of prospective audit, intervention and feedback as an antimicrobial stewardship strategy at the Lagos University Teaching Hospital

Background: Antimicrobial resistance, a global problem, is mostly a consequence of misuse or overuse of antimicrobials. This study sought to audit the compliance to hospital antimicrobial policy and determine the ability of medical students to carry out audits. Methodology: This was a retrospective study to determine compliance with departmental policies in the preceding 2 months in the Children's Emergency Room (ChER) using a checklist. The primary outcome was to determine the rational use of antibiotics. The secondary outcomes were to determine whether the de-escalation of antibiotic, change from intravenous to oral or change in prescriptions were performed in line with culture results based on the departmental policy. Results: The records of 450 children who attended ChER of Lagos University Teaching Hospital in January and February 2018 were retrieved for this study, of which 279 (62.0%) were prescribed antimicrobials. A suspected or confirmed diagnosis of infection was made in 214 (76.6%) of the patients, significantly highest in the infant age group (P = 0.03). Cultures were taken from 94 patients (33.7%), and although not statistically significant, cultures were mostly taken from neonatal patients aged <28 days (20/49, 40.8%). Applying the criteria, compliance with departmental guidelines was found in 111 (39.8%) of the cases. Conclusion: We found that the use of antimicrobials was judged unnecessary in 17.2% of the patients seen in ChER. There was a poor practice of collecting samples for culture before prescribing antibiotics. Prospective audit and feedback is feasible and it can be done with medical students who will report their findings to consultants and other doctors knowledgeable in principles of antimicrobial therapy.
The Indian Society for Study of Pain, Cancer Pain Special Interest Group guidelines on palliative care aspects in cancer pain management

The Indian Society for Study of Pain (ISSP), Cancer Pain Special Interest Group guidelines on palliative care aspects in cancer pain in adults provide a structured, stepwise approach which will help to improve the management of cancer pain and to provide the patients with a minimally acceptable quality of life. The guidelines have been developed based on the available literature and evidence, to suit the needs, patient population, and situations in India. A questionnaire based on the key elements of each subdraft addressing certain inconclusive areas where evidence was lacking was made available on the ISSP website and circulated by E-mail to all the ISSP and Indian Academy of Palliative Care members. In a cancer care setting, approaches toward managing pain vary between ambulatory setting, home care setting, acute inpatient setting, and end-of-life care in hospice setting. We aim to expound the cancer pain management approaches in these settings. In an ambulatory palliative care setting, the WHO analgesic step ladder is used for cancer pain management. The patients with cancer pain require admission for acute inpatient palliative care unit for poorly controlled pain in ambulatory and home care settings, rapid opioid titration, titration of difficult drugs such as methadone, acute pain crisis, pain neuromodulation, and pain interventions. In a palliative home care setting, the cancer pain is usually assessed and managed by nurses and primary physicians with a limited input from the specialist physicians. In patients with cancer at the end of life, the pain should be assessed at least once a day. Moreover, physicians should be trained in assessing patients with pain who are unable to verbalize or have cognitive impairment.
Naturalistic clinical and psychosocial outcome of incident cases of schizophrenia in Enugu Federal Psychiatric Hospital: A preliminary report at 4-month follow-up

Introduction: Longitudinal outcome studies based on incident and predominantly neuroleptic-naïve cases of schizophrenia are uncommon in the modern literature. Aims: To determine the proportion of persons with schizophrenia with different levels of clinical and functional outcome at monthly intervals of naturalistic treatment follow-up for 4 months: response, remission and recovery; and to examine the predictors of outcome. Subjects and Methods: Consecutive incident cases that fulfilled stringent criteria for schizophrenia were recruited into the study. After a baseline assessment, 160 incident cases of schizophrenia were followed up 4-weekly for indicators of symptomatic and functional outcome for 16 weeks. Standard rating scales were used to assess clinical and functional outcome. Sociodemographic and clinical variables were evaluated as predictors of outcome using multiple regression analysis. Results: The attrition rate at week 16 was 29.4%; hence, 113 subjects (out of 160) were available for assessment at the end of follow-up. Of the 113, 66.4%, by Brief Psychiatric Rating Scale (BPRS), met criteria for response (i.e., >50% reduction), while 20.3% could be judged to be clinically non-responsive to treatment (i.e., <20% decrease). Also, 60.2%, by BPRS, met the criteria for remission, while 44.5% met the criteria for recovery. The most important predictor, at week 16, of clinical and psychosocial outcome was social support (48.7%–51.8% of variance). Conclusion: Although as a preliminary report, the present findings are hypothesis-generating, the implication of the results is that, as a group, over a 4-month period of modern hospital treatment, schizophrenia patients who were incident cases progressively experienced significant reduction in psychopathology. The findings, therefore, support earlier international cross-cultural reports of relatively good clinical outcome from developing countries, thereby encouraging the idea of treatment optimism in schizophrenia in Africa.
Management of autoimmune ear disease and idiopathic polyarthritis with adalimumab

Autoimmune inner ear disease (AIED) is a rare form of sensorineural hearing loss of autoimmune origin and responding to immunosuppressive therapy with corticosteroids or other immunosuppressants. Novel treatment approaches include intratympanic steroids and biological response modulators against tumor necrosis factor-α. We present a case of AIED, who concomitantly developed seronegative inflammatory polyarthritis (IPA). The treatment for IPA was initiated with methotrexate, hydroxychloroquine, and intra-articular methyl prednisolone. When there was no adequate response, the patient was started on adalimumab, which in addition to IPA also showed beneficial effects on AIED.
Adrenocorticotropic Hormone-Producing Paraganglioma With Low Plasma ACTH Level: A Case Report and Review of the Literature

Ectopic adrenocorticotropic hormone (ACTH) syndrome caused by paraganglioma is extremely rare. It usually accompanied by high or normal plasma ACTH level. Here we described a male who presented with ectopic ACTH-producing paraganglioma and a low plasma ACTH level. Immunohistochemistry and immunofluorescence confirmed ACTH production in focal paraganglioma cells. This unusual case expanded the spectrum of ACTH-dependent Cushing's syndrome and revealed a potential mechanism of this unique clinical phenotype. Besides, the literature concerning ACTH-producing paraganglioma is reviewed.
Mysteries, Epistemological Modesty, and Artificial Intelligence in Surgery

Life is filled with puzzles and mysteries, and we often fail to recognize the difference. As described by Gregory Treverton and Malcolm Gladwell, puzzles are solved by gathering and assimilating all relevant data in a logical, linear fashion, as in deciding which antibiotic to prescribe for an infection. In contrast, mysteries remain unsolved until all relevant data are analyzed and interpreted in a way that appreciates their depth and complexity, as in determining how to best modulate the host immune response to infection. When investigating mysteries, we often fail to appreciate their depth and complexity. Instead, we gather and assimilate more data, treating the mystery like a puzzle. This strategy is often unsuccessful. Traditional approaches to predictive analytics and phenotyping in surgery use this strategy.
Direct-Write Bioprinting Approach to Construct Multilayer Cellular Tissues

As a cellular-assembly technique, bioprinting has been extensively used in tissue engineering and regenerative medicine to construct hydrogel-based three-dimensional (3D) tissue-like models with prescribed geometry. Here, we introduced a unique direct-write bioprinting strategy to fabricate a bilayer flat tissue in a hydrogel-free approach. A printed retina pigmented epithelium layer (RPE) was applied as living biopaper for positioning a fibroblast layer without using any hydrogel in bioink. We adjusted the number of cells in the inkjet droplets in order to obtain a uniform printed cell layer and demonstrated the formation of a bilayer construct through confocal imaging. Since our printing system introduced low levels of shear stress to the cells, it did not have a negative effect on cell survival, although cell viability was generally lower than that of control group over 1 week post-printing. In conclusion, our novel direct-write bioprinting approach to spatiotemporally position different cellular layers may represent an efficient tool to develop living constructs especially for regeneration of complex flat tissues.
The Dynamic Responses of Cell Walls in Resurrection Plants During Dehydration and Rehydration

Plant cell walls define the shape of the cells and provide mechanical support. They function as osmoregulators by controlling the transport of molecules between cells and provide transport pathways within the plant. These diverse functions require a well-defined and flexible organization of cell wall components, i.e., water, polysaccharides, proteins, and other diverse substances. Cell walls of desiccation tolerant resurrection plants withstand extreme mechanical stress during complete dehydration and rehydration. Adaptation to the changing water status of the plant plays a crucial role during this process. This review summarizes the compositional and structural variations, signal transduction and changes of gene expression which occur in cell walls of resurrection plants during dehydration and rehydration.
Differential Gene Expression Patterns Between Apical and Basal Inner Hair Cells Revealed by RNA-Seq

Tonotopic differences in the structure and physiological function, e.g., synapse number, membrane properties, Ca2+ channels, Ca2+ dependence of exocytosis and vesicle pool replenishment of inner hair cells (IHCs) along the longitudinal cochlear axis have recently been discovered, suggesting different gene expression patterns of IHCs. To determine whether IHCs present different gene expression patterns along the longitudinal cochlear axis, apical and basal IHCs were collected separately using the suction pipette technique from adult mouse cochleae for RNA-seq and genome-wide transcriptome analysis. We found 689 annotated genes showed more than 2-fold increase in expression. Interestingly, 93.4% of the differentially expressed genes (DEGs) was upregulated in apical IHCs. Although a subset of genes that related to IHC machinery and deafness were found to be differentially expressed, a gradient of gene expression was indeed detected in Ocm, Pvalb, Prkd1, Fbxo32, Nme2, and Sncg, which may play putative roles in the Ca2+ buffering and survival regulation. The expression of these genes was validated by real-time quantitative PCR (RT-qPCR) or immunostaining. We conclude that IHCs from different mouse cochlear longitudinal position have different gene expression profiles. Our data might serve as a valuable resource for exploring the molecular mechanisms underlying different biological properties as well as the survival regulation of IHCs.
Sedentary Behavior and Problematic Smartphone Use in Chinese Adolescents: The Moderating Role of Self-Control

This study investigated smartphone use characteristics including the purpose of smartphone use (i.e., leisure, learning, or work) and situational smartphone use (i.e., sitting, standing, or moving about) in Chinese adolescents. Moreover, it tested the moderating role of self-control in the link between sedentary behavior and problematic smartphone use. A total of 947 adolescents completed measures of the purpose of their smartphone use, situational smartphone use, sedentary behavior, self-control, time on smartphone, and smartphone addiction. Results showed that the majority of smartphone use was for leisure and learning, and 90.9% of adolescents reported typically sitting as they used the smartphone. Problematic smartphone use was positively correlated with sedentary behavior and negatively correlated with self-control. Moreover, the relationship between sedentary behavior and problematic smartphone use was moderated by self-control, in that the negative correlation was stronger for adolescents with low self-control and weaker for those with high self-control. These results contribute to the understanding of when sedentary behavior is associated with problematic smartphone use. Several limitations and implications are discussed in this study.
Bacterial Communities of Mojave Desert Biological Soil Crusts Are Shaped by Dominant Photoautotrophs and the Presence of Hypolithic Niches

Biocrust communities are often heterogeneous and affected by small-scale environmental features, including both physical and biotic factors. The presence of moss in biocrusts, for example, is likely to create a set of physical conditions distinct from those found in microbial biocrusts that lack mosses. Similarly, hypolithic organisms living under and on the belowground surface of translucent and opaque stones (typically quartz) experience a distinct environment relative to surrounding soil surface organisms. To understand the impact of these factors on biocrust bacterial community composition, we performed 16S rRNA sequencing from surface and hypolithic biocrusts with and without the common biocrust moss, Syntrichia caninervis. While alpha diversity indices did not differ significantly between any of the biocrust habitats sampled, we did observe differences in overall community composition. Cyanobacterial abundance and diversity decreased in the presence of moss and in surface samples compared to hypolithic biocrusts, while Proteobacteria showed the opposite pattern. Acidobacteria were significantly more abundant in hypolithic niches, and Patescibacteria were found to be restricted to moss-dominated surface biocrusts. Notably, bacterial community composition was found to shift significantly between surface and hypolithic microbial biocrusts (Adonis, R2 = 0.122, p = 0.002) and between surface moss and microbial biocrusts (R2 = 0.107, p = 0.002). These findings support the idea that even at small spatial scales (e.g., within <10 cm), desert biocrust bacterial community composition varies based on the habitat structure and cohabitants.
Influence of Attention Control on Implicit and Explicit Emotion Processing of Face and Body: Evidence From Flanker and Same-or-Different Paradigms

Many existing findings indicate that processing of emotional information is pre-attentive, largely immune from attentional control. Nevertheless, inconsistent evidence on the interference of emotional cues on cognitive processing suggests that this influence may be a highly conditional phenomenon. The aim of the present study was twofold: (1) to examine the modulation of attention control on emotion processing using facial expressions (2) explore the very same effect for emotional body expressions. In Experiment 1, participants performed a Flanker task in which they had to indicate either the emotion (happy/fearful) or the gender of the target stimulus while ignoring the distracting stimuli at the side. We found evidence for intrusion of the emotional dimension of a stimulus in both the emotion and gender discrimination performance, thus when either task-relevant or task-irrelevant. To further explore the influence of attention control mechanisms, in Experiment 2 participants performed a same-or-different judgment task in which they were asked to pay attention to both the central and lateral stimuli and indicated whether the central stimulus matched the lateral for emotion or gender. Results showed that emotional features exerted an influence at an implicit level (i.e., during gender judgments) for bodies only. Gender features did not affect emotional processing in either experiments. To rule out the possibility that this effect was driven by postural rather than emotional features of fearful vs. happy stimuli, a control experiment was conducted. In Experiment 3, bodies with an opening/up-ward or closing/down-ward posture but with no emotional valence were presented. Results revealed that the body posture did not influence gender discrimination. Findings suggest that the emotional valence of a face or body stimulus can overpass attention filtering mechanisms, independently from the level of attentional modulation (Experiment 1). However, broadening the focus of attention to include the lateral stimuli led emotional information to intrude on the main task, exerting an implicit, bottom–up influence on gender processing, only when conveyed by bodies (Experiment 2). Results point to different mechanisms for the implicit processing of face and body emotional expressions, with the latter likely having role on action preparation processes.
Human Pluripotent Stem Cells: A Relevant Model to Identify Pathways Governing Thermogenic Adipocyte Generation

Brown and brown-like adipocytes (BAs) are promising cell targets to counteract obesity thanks to their potential to drain and oxidize circulating glucose and triglycerides. However, the scarcity of BAs in human adults is a major limitation for energy expenditure based therapies. Enhanced characterization of BA progenitor cells (BAPs) and identification of critical pathways regulating their generation and differentiation into mature BAs would be an effective way to increase the BA mass. The identification of molecular mechanisms involved in the generation of thermogenic adipocytes is progressing substantially in mice. Much less is known in humans, thus highlighting the need for an in vitro model of human adipocyte development. Pluripotent stem cells (PSCs), i.e., embryonic stem cells and induced pluripotent stem cells, help gain insight into the different phases in the development of multiple cell types. We will discuss the capacity of human PSCs to differentiate into BAs in this review. Several groups, including ours, have reported low spontaneous adipocyte generation from PSCs. However, factors governing the differentiation of induced pluripotent stem cell-derived BA progenitors cells were recently identified, and the TGFβ signaling pathway has a pivotal role. The development of new relevant methods, such as the differentiation of hPSC-BAPs into 3D adipospheres to better mimick the lobular structure of human adipose tissue, will also be discussed. Differentiation of human PSCs into thermogenic adipocytes at high frequency provides an opportunity to characterize new targets for anti-obesity therapy.
Rare Species Shift the Structure of Bacterial Communities Across Sphagnum Compartments in a Subalpine Peatland

Sphagnum-associated microbiomes are crucial to Sphagnum growth and peatland ecological functions. However, roles of rare species in bacterial communities across Sphagnum compartments are poorly understood. Here the structures of rare taxa (RT) and conditionally abundant and rare taxa (CART) from Sphagnum palustre peat (SP), S. palustre ectosphere (Ecto) and S. palustre endosphere (Endo) were investigated in the Dajiuhu Peatland, central China. Our results showed that plant compartment effects significantly altered the diversities and structures of bacterial communities. The Observed species and Simpson indices of RT and CART in alpha diversity significantly increased from Endo to SP, with those of Ecto in-between. The variations of community dissimilarities of RT and CART among compartments were consistent with those of whole bacterial communities (WBC). Network analysis indicated a non-random co-occurrence pattern of WBC and all keystone species are affiliated with RT and CART, indicating their important role in sustaining the WBC. Furthermore, the community structures of RT and CART in SP were significantly shaped by water table and total nitrogen content, which coincided with the correlations between WBC and environmental factors. Collectively, our results for the first time confirm the importance of rare species to bacterial communities through structural and predicted functional analyses, which expands our understanding of rare species in Sphagnum-associated microbial communities in subalpine peatlands.
Intra- and Inter-subject Variability in EEG-Based Sensorimotor Brain Computer Interface: A Review

Brain computer interfaces (BCI) for the rehabilitation of motor impairments exploit sensorimotor rhythms (SMR) in the electroencephalogram (EEG). However, the neurophysiological processes underpinning the SMR often vary over time and across subjects. Inherent intra- and inter-subject variability causes covariate shift in data distributions that impede the transferability of model parameters amongst sessions/subjects. Transfer learning includes machine learning-based methods to compensate for inter-subject and inter-session (intra-subject) variability manifested in EEG-derived feature distributions as a covariate shift for BCI. Besides transfer learning approaches, recent studies have explored psychological and neurophysiological predictors as well as inter-subject associativity assessment, which may augment transfer learning in EEG-based BCI. Here, we highlight the importance of measuring inter-session/subject performance predictors for generalized BCI frameworks for both normal and motor-impaired people, reducing the necessity for tedious and annoying calibration sessions and BCI training.
Rhizobium Inoculation Drives the Shifting of Rhizosphere Fungal Community in a Host Genotype Dependent Manner

Rhizosphere microorganisms play important roles in plant health and nutrition, and interactions among plants and microorganisms are important for establishment of root microbiomes. As yet, plant-microbe and microbe-microbe interactions in the rhizosphere remain largely mysterious. In this study, rhizosphere fungal community structure was first studied in a field experiment with two soybean cultivars contrasting in nodulation grown in two rhizobium inoculation treatments. Following this, recombinant inbred lines (RILs) contrasting in markers across three QTLs for biological nitrogen fixation (BNF) were evaluated for effects of genotype and rhizobium inoculation to the rhizosphere fungal community as assessed using ITS1 amplicon sequencing. The soybean plants tested herein not only hosted rhizosphere fungal communities that were distinct from bulk soils, but also specifically recruited and enriched Cladosporium from bulk soils. The resulting rhizosphere fungal communities varied among soybean genotypes, as well as, between rhizobium inoculation treatments. Besides, Cladosporium were mostly enriched in the rhizospheres of soybean genotypes carrying two or three favorable BNF QTLs, suggesting a close association between soybean traits associated with nodulation and those affecting the rhizosphere fungal community. This inference was bolstered by the observation that introduction of exogenous rhizobia significantly altered rhizosphere fungal communities to the point that these communities could be distinguished based on the combination of soybean genotype and whether exogenous rhizobia was applied. Interestingly, grouping of host plants by BNF QTLs also distinguished fungal community responses to rhizobium inoculation. Taken together, these results reveal that complex cross-kingdom interactions exist among host plants, symbiotic N2 fixing bacteria and fungal communities in the soybean rhizosphere.