Miracle-dz/UniFAR-FTUs huggingface dataset:
Membranous Nephropathy and Anti-Podocytes Antibodies: Implications for the Diagnostic Workup and Disease Management

The discovery of circulating antibodies specific for native podocyte antigens has transformed the diagnostic workup and greatly improved management of idiopathic membranous nephropathy (iMN). In addition, their identification has clearly characterized iMN as a largely autoimmune disorder. Anti-PLA2R1 antibodies are detected in approximately 70% to 80% and anti-THSD7A antibodies in only 2% of adult patients with iMN. The presence of anti-THSD7A antibodies is associated with increased risk of malignancy. The assessment of PLA2R1 and THSD7A antigen expression in glomerular immune deposits has a better sensitivity than measurement of the corresponding autoantibodies. Therefore, in the presence of circulating anti-podocytes autoantibodies and/or enhanced expression of PLA2R1 and THSD7A antigens MN should be considered as primary MN (pMN). Anti-PLA2R1 or anti-THSD7A autoantibodies have been proposed as biomarkers of autoimmune disease activity and their blood levels should be regularly monitored in pMN to evaluate disease activity and predict outcomes. We propose a revised clinical workup flow for patients with MN that recommends assessment of kidney biopsy for PLA2R1 and THSD7A antigen expression, screening for circulating anti-podocytes antibodies, and assessment for secondary causes, especially cancer, in patients with THSD7A antibodies. Persistence of anti-podocyte antibodies for 6 months or their increase in association with nephrotic proteinuria should lead to the introduction of immunosuppressive therapies. Recent data have reported the efficacy and safety of new specific therapies targeting B cells (anti-CD20 antibodies, inhibitors of proteasome) in pMN which should lead to an update of currently outdated treatment guidelines.
Association of Treatment at High-Volume Facilities With Survival in Patients Receiving Chemoradiotherapy for Nasopharyngeal Cancer

Association of Treatment at High-Volume Facilities With Survival in Patients Receiving Chemoradiotherapy for Nasopharyngeal Cancer Similar to other head and neck cancers, successful delivery of radiation therapy (RT) in nasopharyngeal cancer (NPC) is challenging. Reasons include technical aspects, such as treatment planning (especially in the era of intensity-modulated RT and simultaneous integrated boosting), physician experience in target delineation (eg, knowing routes of subclinical nodal spread), available technologies (eg, image-guided RT), coordination of multimodality therapy, and treatment of acute and late toxic effects. Thus, there may be advantages to administering chemoradiotherapy (CRT) at high-volume facilities (HVFs). For similar reasons as the aforementioned, treatment at HVFs and/or from more experienced clinicians have been associated with improved outcomes in the surgical literature.1 Analogously, we hypothesized that treatment at an HVF could improve outcomes in a nonsurgical disease such as NPC, which we evaluated in this study. The National Cancer Database (NCDB) provides a unique resource with which to address this novel and clinically important issue and has been proven to be of great utility for similar studies in other tumor types.2,3
On Multidecadal and Quasi-Decadal North Atlantic Variability

Observed sea surface temperatures (SSTs) in the North Atlantic from 1958 through 2000, as well as data from an ocean model simulation driven with the atmospheric variability observed during the same period, are examined using multichannel singular spectrum analysis. The two leading oscillatory modes are associated with a multidecadal and a quasi-decadal period. The former is connected to a basinwide uniform SST pattern and changes in the deep North Atlantic meridional overturning circulation. The quasi-decadal mode involves a tripolar SST anomaly pattern forced by atmospheric variability with a spatial structure resembling that of the North Atlantic Oscillation (NAO). The upper ocean’s dynamical response to this NAO variability provides an instantaneous positive feedback to the SST pattern, while a delayed negative feedback is due to shallow overturning circulation anomalies.
Nationwide Trend of Sepsis: A Comparison Among Octogenarians, Elderly, and Young Adults

Objective: We aimed to compare the sepsis incidence, mortality rates, and primary sites of infection among adult, elderly, and octogenarian patients with sepsis. Design: Population-based cohort study. Setting: The entire health insurance claims data of Taiwan, which enrolled 99.8% of the 23 million Taiwanese population. Patients: Sepsis patients were identified by International Classification of Diseases, 9th Edition, Clinical Modification codes for both infection and organ dysfunction from January 1, 2002, to December 31, 2012. Patients were categorized into three age groups: 1) adults (18–64 yr); 2) elderly (65–84 yr); and 3) oldest old (≥ 85 yr). The 30-day all-cause mortality was verified by a linked national death certificate database. Interventions: None. Measurements and Main Results: From 2002 to 2012, we identified 1,259,578 patients with sepsis, of which 417,328 (33.1%) were adults, 652,618 (51.8%) were elderly, and 189,632 (15.1%) were oldest old. We determined that the incidence of sepsis in the oldest old was 9,414 cases per 100,000 population on 2012, which was 31-fold greater than the adult incidence (303 cases per 100,000 population) and three-fold greater than the elderly incidence (2,908 cases per 100,000 population). Despite the increasing trend in incidence, the mortality decreased by 34% for adults, 24% for elderly, and 22% for oldest old. However, systemic fungal infection was disproportionately increased in oldest old patients (1.76% annual increase) and the elderly patients (1.00% annual increase). Conclusion: The incidence of sepsis is disproportionately increased in elderly and oldest old patients. Despite the increasing trend in incidence, the mortality rate in geriatric patients with sepsis has decreased. However, the increased incidence of fungal infections in the geriatric population warrants further attention.
Cognitive Impairment and Structural Neuroimaging Abnormalities Among Patients with Chronic Kidney Disease

Background/Aims: Cognitive impairment and abnormal structural neuroimaging is common in chronic kidney disease patients. We aimed to explore its association with dialysis modality and the relationship between cognitive impairment and abnormal structural neuroimaging. Methods: Sixty peritoneal dialysis patients and 30 hemodialysis and 30 non-dialyzed stage 3-5 chronic kidney disease patients without history of stroke were enrolled for the study. Participants were matched for age, gender, education, diabetes status, and dialysis duration (if appropriate). Cognitive functions were measured using a battery of recognized instruments. Brain features were examined with 3-dimensional magnetic resonance imaging. Results: Cognitive impairment was significantly more severe in dialysis patients than in non-dialyzed patients. The global and specific cognitive function were not significantly different between patients on peritoneal dialysis and hemodialysis. Hemodialysis patients had more severe white matter hyperintensity, sulcal and ventricular atrophy, and SVIs than other patients. In all groups, higher white matter grade, ventricular grade, and hippocampal atrophy were significantly associated with global cognitive impairment, with hazard ratios of 1.80 (1.22-2.64), 1.67 (1.09-2.57), and 2.49 (1.07-5.77), respectively. White matter grade was also significantly associated with delayed memory (hazard ratio 1.63; 1.12-2.39). Conclusion: Dialysis modality showed no association with cognitive impairment, although hemodialysis patients had more severe neuroimaging abnormalities. For the whole group, white matter hyperintensity, and ventricular and hippocampal atrophy, were independently associated with global cognitive impairment in chronic kidney disease patients.
Delta‐amino‐levulinic acid dehydratase gene and essential tremor

Several reports found a relationship between increased serum lead levels and the risk for essential tremor (ET), especially in carriers of the minor allele of the single nucleotide polymorphism (SNP) rs1800435 in the aminolevulinate dehydratase (ALAD) gene, which is involved in the synthesis of haem groups. Our group reported decreased risk for ET in carriers of the minor alleles of the rs2071746 and rs1051308 SNPs in the haem‐oxygenases 1 and 2 (HMOX1 and HMOX2), respectively, involved in haem metabolism. We analysed whether ALAD rs1800435 alone and their interactions with the four common SNPs in the HMOX1 and HMOX2 genes are associated with the risk for ET.
Parity of access to memory services in London for the BAME population: a cross-sectional study

ABSTRACT Objective: To investigate whether referrals to memory services in London reflect the ethnic diversity of the population. Methods: Memory service data including referral rates of BAME was collected from London Clinical Commissioning Groups (CCGs). Results: The expected percentage of BAME referrals using census data was compared against White British population percentages using the chi squared test. We found that within 13,166 referrals to memory services across London, the percentage of people from BAME groups was higher than would be expected (20.3 versus 19.4%; χ2 = 39.203, d.f. = 1, p < 0.0001) indicating that generally people from BAME groups are accessing memory services. Seventy-nine percent of memory services had more referrals than expected or no significant difference for all BAME groups. When there were fewer referrals then expected, the largest difference in percentage for an individual ethnic group was 3.3%. Conclusions: Results are encouraging and may indicate a significant improvement in awareness of dementia and help seeking behaviour among BAME populations. Prevalence of dementia in some ethnic groups may be higher so these numbers could still indicate under-referral. Due to the data available we were unable to compare disease severity or diagnosis type.
Nature's Swiss Army Knives: Ovipositor Structure Mirrors Ecology in a Multitrophic Fig Wasp Community

Background Resource partitioning is facilitated by adaptations along niche dimensions that range from morphology to behaviour. The exploitation of hidden resources may require specially adapted morphological or sensory tools for resource location and utilisation. Differences in tool diversity and complexity can determine not only how many species can utilize these hidden resources but also how they do so. Methodology and Principal Findings The sclerotisation, gross morphology and ultrastructure of the ovipositors of a seven-member community of parasitic wasps comprising of gallers and parasitoids developing within the globular syconia (closed inflorescences) of Ficus racemosa (Moraceae) was investigated. These wasps also differ in their parasitism mode (external versus internal oviposition) and their timing of oviposition into the expanding syconium during its development. The number and diversity of sensilla, as well as ovipositor teeth, increased from internally ovipositing to externally ovipositing species and from gallers to parasitoids. The extent of sclerotisation of the ovipositor tip matched the force required to penetrate the syconium at the time of oviposition of each species. The internally ovipositing pollinator had only one type of sensillum and a single notch on the ovipositor tip. Externally ovipositing species had multiple sensilla types and teeth on their ovipositors. Chemosensilla were most concentrated at ovipositor tips while mechanoreceptors were more widely distributed, facilitating the precise location of hidden hosts in these wasps which lack larval host-seeking behaviour. Ovipositor traits of one parasitoid differed from those of its syntopic galler congeners and clustered with those of parasitoids within a different wasp subfamily. Thus ovipositor tools can show lability based on adaptive necessity, and are not constrained by phylogeny. Conclusions/Significance Ovipositor structure mirrored the increasingly complex trophic ecology and requirements for host accessibility in this parasite community. Ovipositor structure could be a useful surrogate for predicting the biology of parasites in other communities.
Evaluation of a Multicomponent Psychosocial Skill Training Program for Junior Physicians in Their First Year at Work: A Pilot Study.

BACKGROUND The present study was designed to gather preliminary information regarding the feasibility of implementing a psychosocial resilience program and to assess if the program would potentially promote protective factors (such as resiliency, self-efficacy) and job satisfaction as well as decreasing perceived stress among a sample of German junior physicians. METHODS Eighty-two junior physicians in their first year after graduation took part in the project and were randomized in a controlled trial to either an intervention or a control group for 3 months. The intervention group was offered resilience training combined with cognitive behavioral and solution-focused counseling. Primary outcome measures included scales of the PSQ, BRCS, SWOPE, and COPSOQ. Two post-intervention follow-up measurements proved the effectiveness of the intervention. RESULTS There was a significant improvement between baseline and follow-up intervention scores on measures of resilience, self-efficacy, optimism, and perceived stress observed in the intervention group compared to the control group. Job satisfaction did not significantly differ between baseline and follow-ups. CONCLUSIONS These results indicate that the program to enhance resilience and decrease stress among physicians is feasible to implement as a group training program in a workplace setting. Further, the intervention provides statistically significant improvement in perceptions of distress and strengthens protective factors (such as resiliency).
Association between polycyclic aromatic hydrocarbon exposure and peripheral blood mononuclear cell DNA damage in human volunteers during fire extinction exercises

This study investigated a number of biomarkers, associated with systemic inflammation as well as genotoxicity, in 53 young and healthy subjects participating in a course to become firefighters, while wearing personal protective equipment (PPE). The exposure period consisted of a 3-day training course where the subjects participated in various live-fire training exercises. The subjects were instructed to extinguish fires of either wood or wood with electrical cords and mattresses. The personal exposure was measured as dermal polycyclic aromatic hydrocarbon (PAH) concentrations and urinary excretion of 1-hydroxypyrene (1-OHP). The subjects were primarily exposed to particulate matter (PM) in by-stander positions, since the self-contained breathing apparatus effectively prevented pulmonary exposure. There was increased dermal exposure to pyrene (68.1%, 95% CI: 52.5%, 83.8%) and sum of 16 polycyclic aromatic hydrocarbons (ƩPAH; 79.5%, 95% CI: 52.5%, 106.6%), and increased urinary excretion of 1-OHP (70.4%, 95% CI: 52.5%; 106.6%) after the firefighting exercise compared with the mean of two control measurements performed 2 weeks before and 2 weeks after the firefighting course, respectively. The level of Fpg-sensitive sites in peripheral blood mononuclear cells (PBMCs) was increased by 8.0% (95% CI: 0.02%, 15.9%) compared with control measurements. The level of DNA strand breaks was positively associated with dermal exposure to pyrene and ƩPAHs, and urinary excretion of 1-OHP. Fpg-sensitive sites were only associated positively with PAHs. Biomarkers of inflammation and lung function showed no consistent response. In summary, the study demonstrated that PAH exposure during firefighting activity was associated with genotoxicity in PBMCs.
The ‘Real Welfare’ scheme: benchmarking welfare outcomes for commercially farmed pigs

Animal welfare standards have been incorporated in EU legislation and in farm assurance schemes, based on scientific information and aiming to safeguard the welfare of the species concerned. Recently, emphasis has shifted from resource-based measures of welfare to animal-based measures, which are considered to assess more accurately the welfare status. The data used in this analysis were collected from April 2013 to May 2016 through the ‘Real Welfare’ scheme in order to assess on-farm pig welfare, as required for those finishing pigs under the UK Red Tractor Assurance scheme. The assessment involved five main measures (percentage of pigs requiring hospitalization, percentage of lame pigs, percentage of pigs with severe tail lesions, percentage of pigs with severe body marks and enrichment use ratio) and optional secondary measures (percentage of pigs with mild tail lesions, percentage of pigs with dirty tails, percentage of pigs with mild body marks, percentage of pigs with dirty bodies), with associated information about the environment and the enrichment in the farms. For the complete database, a sample of pens was assessed from 1928 farm units. Repeated measures were taken in the same farm unit over time, giving 112 240 records at pen level. These concerned a total of 13 480 289 pigs present on the farm during the assessments, with 5 463 348 pigs directly assessed using the ‘Real Welfare’ protocol. The three most common enrichment types were straw, chain and plastic objects. The main substrate was straw which was present in 67.9% of the farms. Compared with 2013, a significant increase of pens with undocked-tail pigs, substrates and objects was observed over time (P<0.05). The upper quartile prevalence was <0.2% for all of the four main physical outcomes, and 15% for mild body marks. The percentage of pigs that would benefit from being in a hospital pen was positively correlated to the percentage of lame pigs, and the absence of tail lesions was positively correlated with the absence of body marks (P<0.05, R>0.3). The results from the first 3 years of the scheme demonstrate a reduction of the prevalence of animal-based measures of welfare problems and highlight the value of this initiative.
Statistical evidence of anasymptotic geometric structure to the momentum transporting motions in turbulent boundary layers

The turbulence contribution to the mean flow is reflected by the motions producing the Reynolds shear stress (⟨−uv⟩) and its gradient. Recent analyses of the mean dynamical equation, along with data, evidence that these motions asymptotically exhibit self-similar geometric properties. This study discerns additional properties associated with the uv signal, with an emphasis on the magnitudes and length scales of its negative contributions. The signals analysed derive from high-resolution multi-wire hot-wire sensor data acquired in flat-plate turbulent boundary layers. Space-filling properties of the present signals are shown to reinforce previous observations, while the skewness of uv suggests a connection between the size and magnitude of the negative excursions on the inertial domain. Here, the size and length scales of the negative uv motions are shown to increase with distance from the wall, whereas their occurrences decrease. A joint analysis of the signal magnitudes and their corresponding lengths reveals that the length scales that contribute most to ⟨−uv⟩ are distinctly larger than the average geometric size of the negative uv motions. Co-spectra of the streamwise and wall-normal velocities, however, are shown to exhibit invariance across the inertial region when their wavelengths are normalized by the width distribution, W(y), of the scaling layer hierarchy, which renders the mean momentum equation invariant on the inertial domain. This article is part of the themed issue ‘Toward the development of high-fidelity models of wall turbulence at large Reynolds number’.
Analysis of the SYN Flood DoS Attack

The paper analyzes systems vulnerability targeted by TCP (Transmission Control Protocol) segments when SYN flag is ON, which gives space for a DoS (Denial of Service) attack called SYN flooding attack or more often referred as a SYN flood attack. The effects of this type of attack are analyzed and presented in OPNET simulation environment. Furthermore, the paper presents two anomaly detection algorithms as an effective mechanism against this type of attack. Finally, practical approaches against SYN flood attack for Linux and Windows environment which are followed by are shown.
The complete chloroplast genome sequence of the evergreen plant Dendropanax dentiger (Araliaceae)

Abstract The complete chloroplast genome of the evergreen plant Dendropanax dentiger (Araliaceae) has been reconstructed from the whole-genome Illumina sequencing data. The circular genome is 156,687 bp in size, and comprises a pair of inverted repeat (IR) regions of 25,880 bp each, a large single-copy (LSC) region of 86,680 bp, and a small single-copy (SSC) region of 18,247 bp. The chloroplast genome contains 134 genes, including 89 protein-coding genes (81 PCG species), eight ribosomal RNA genes (four rRNA species), and 37 transfer RNA genes (30 tRNA species). Out of these genes, 16 harbor a single intron, and two contain a couple of introns. The overall A + T content of the whole genome is 62.0%, while the corresponding values of the LSC, SSC, and IR regions are 63.8%, 68.0% and 56.9%, respectively.
Global Well-Posedness of an Initial-Boundary Value Problem for Viscous Non-Resistive MHD Systems

This paper concerns the viscous and non-resistive MHD systems which govern the motion of electrically conducting fluids interacting with magnetic fields. We consider an initial-boundary value problem for both compressible and (nonhomogeneous and homogeneous) incompressible fluids in an infinite flat layer. We prove the global well-posedness of the systems around a uniform magnetic field which is vertical to the layer. Moreover, the solution converges to the steady state at an almost exponential rate as time goes to infinity. Our proof relies on a two-tier energy method for the reformulated systems in Lagrangian coordinates.
Erythropoietin is equally effective as fresh-blood transfusion at reducing infarct size in anemic rats

Objective:We recently demonstrated that transfusion of anemic animals up to 100 g/L hemoglobin with fresh blood protects the heart from ischemic injuries following myocardial infarction. Erythropoietin has cardioprotective effects independent of its erythropoietic activity. The objective of this study was to compare the cardioprotective effects of erythropoietin treatment to fresh-blood transfusion in anemic rats after acute myocardial infarction. Design:Randomized animal study. Setting:University laboratory. Subjects:Male Sprague-Dawley rats weighing 200–300 g. Intervention:Myocardial infarction was induced by coronary artery ligation in 76 rats, 55 of which were anemic (80–90 g/L) and 21 of which had normal hemoglobin levels. Animals were randomized to erythropoietin (2000 units/kg), fresh-blood transfusion to 100 g/L hemoglobin, or saline-treatment groups immediately following myocardial infarction. Measurements and Main Results:At 24 hrs after myocardial infarction, cardiac function and infarct size were determined. Myocardial apoptosis was determined by caspase-3 activity and terminal deoxynucleotidyl transferase d-UTP nick end labeling (TUNEL) assay. Infarct size was significantly decreased in anemic rats treated with erythropoietin or blood transfusion compared to those in the saline-treatment group. Cardiac function, as measured by maximal positive and minimal negative first derivatives of left ventricular pressure, was better preserved in the normal hemoglobin groups and the erythropoietin- or transfusion-treated anemic animals compared to saline-treated anemic animals. Myocardial caspase-3 activity and TUNEL-positive nuclei were significantly increased in anemic rats but were decreased by erythropoietin treatment or red blood cell transfusion. Conclusions:Erythropoietin treatment is equally effective as fresh-blood transfusion in anemic rats after acute myocardial infarction at reducing infarct size, myocardial apoptosis, and improving cardiac function.