Miracle-dz/UniFAR-FTUs huggingface dataset:
Summer time predation on the obligatory off-host stage of an invasive ectoparasite

SUMMARY Predation can regulate populations and strongly affect invasion success of novel prey. The deer ked (Lipoptena cervi; Linnaeus 1758) is an invasive ectoparasite of cervids that spends a long period of its life cycle outside the host. Prior to this study, virtually nothing was known about natural summer time predation on the deer ked. We aimed to evaluate the magnitude of summer time predation on L. cervi pupae in different habitats and to identify potential predators. We conducted a set of field experiments, where we exposed L. cervi pupae to various ground-dwelling vertebrate and invertebrate predators. The loss of pupae was monitored for different predator guilds. Three habitats of the moose, the main host species, were studied: (1) moist heath forest; (2) dry, logged heath forest; and (3) moist meadow. The results indicate notable summer time predation on L. cervi pupae, and the pupal predation varied within and between habitats, being lowest in the meadow habitat. We found a positive correlation between pupal loss and abundance of the common lizard (Zootoca vivipara), harvestmen (Opiliones), ground spiders (Gnaphosidae) and Formicinae-ants. We conclude that summer time predation during the pupal phase can have a notable local importance for the L. cervi abundance.
Epidemiology of invasive bacterial infections in pneumococcal conjugate vaccine-vaccinated and -unvaccinated children under 5 years of age in Soweto, South Africa: a cohort study from a high-HIV burden setting

ABSTRACT Background: There are limited data on paediatric invasive bacterial infections (IBI) and the impact of pneumococcal conjugate vaccine (PCV) on the spectrum of IBI pathogens, specifically in African countries with a high prevalence of HIV infection. Aim: To describe the epidemiology of IBI in a cohort of children <5 years of age in Soweto, South Africa. Methods: A cohort of children enrolled into a PCV9 efficacy trial conducted from 1998 until 2005 was used for secondary data analysis. Surveillance data were collected from admission wards at Chris Hani Baragwanath Academic Hospital. The incidence of IBI was calculated using person-time, stratified by age group, gender, PCV9 vaccination status and HIV infection status. Risk factors for IBI were investigated using binomial logistic regression. Results: A total of 395 cases of laboratory-confirmed IBI were identified. HIV infection and not receiving PCV9 vaccination were risk factors for IBI hospitalisation. PCV9 vaccination was associated with reductions in IBI hospitalisation (IRR 0.76, p = 0.006) solely owing to reductions in the incidence of Streptococcus pneumoniae (IRR 0.56, p < 0.001). PCV9 vaccination had no effect on the incidence of Haemophilus influenza type b or Salmonella species IBI. There was an increase in Klebsiella species IBI (IRR 3.50, p = 0.019) and a trend towards a higher incidence of Staphylococcus aureus IBI (IRR 1.90, p = 0.099) in PCV9-vaccinated children. Conclusions: PCV9 vaccination was effective in reducing the incidence of IBI hospitalisation in children through reductions in the incidence of S. pneumoniae. The results show that trends in other IBI causative pathogens (specifically S. aureus and Klebsiella species) should be monitored in the era of PCV vaccination. Abbreviations: ART, antiretroviral therapy; CI, confidence interval; Hib, Haemophilus influenza type b; HIV, human immunodeficiency virus; HIV+PCV-, HIV-infected, placebo-vaccinated group; HIV+PCV+, HIV-infected, PCV9-vaccinated group; HIV-PCV-, HIV-uninfected, placebo-vaccinated group; HIV+PCV+, HIV-infected, PCV9-vaccinated group; IBI, invasive bacterial infection; IPD, invasive pneumococcal disease; IRR, incidence rate ratio; IQR, interquartile range; OR, odds ratio; PCV, pneumococcal conjugate vaccine; PCV7, 7-valent pneumococcal conjugate vaccine; PCV9, 9-valent pneumococcal conjugate vaccine; PY, person-years; RCT, randomised control trial
Reverse shoulder arthroplasty has a higher risk of revision due to infection than anatomical shoulder arthroplasty: 17 730 primary shoulder arthroplasties from the Nordic Arthroplasty Register Association.

AIMS The aim of this study was to use national registry database information to estimate cumulative rates and relative risk of revision due to infection after reverse shoulder arthroplasty. PATIENTS AND METHODS We included 17 730 primary shoulder arthroplasties recorded between 2004 and 2013 in The Nordic Arthroplasty Register Association (NARA) data set. With the Kaplan-Meier method, we illustrated the ten-year cumulative rates of revision due to infection and with the Cox regression model, we reported the hazard ratios as a measure of the relative risk of revision due to infection. RESULTS In all, 188 revisions were reported due to infection during a mean follow-up of three years and nine months. The ten-year cumulative rate of revision due to infection was 1.4% overall, but 3.1% for reverse shoulder arthroplasties and 8.0% for reverse shoulder arthroplasties in men. Reverse shoulder arthroplasties were associated with an increased risk of revision due to infection also when adjusted for sex, age, primary diagnosis, and year of surgery (relative risk 2.41 (95% conﬁdence interval 1.26 to 5.59); p = 0.001). CONCLUSION The overall incidence of revision due to infection was low. The increased risk in reverse shoulder arthroplasty must be borne in mind, especially when offering it to men. Cite this article: Bone Joint J 2019;101-B:702-707.
Laparoscopic radical hysterectomy with transvaginal closure of vaginal cuff – a multicenter analysis

Objective Laparoscopic/robotic radical hysterectomy has been historically considered oncologically equivalent to open radical hysterectomy for patients with early cervical cancer. However, a recent prospective randomized trial (Laparoscopic Approach to Cervical Cancer, LACC) has demonstrated significant inferiority of the minimally invasive approach. The aim of this study is to evaluate the oncologic outcomes of combined laparoscopic-vaginal radical hysterectomy. Methods Between August 1994 and December 2018, patients with invasive cervical cancer were treated using minimally-invasive surgery at the Universities of Jena, Charité Berlin (Campus CCM and CBF) and Cologne and Asklepios Clinic Hamburg. 389 patients with inclusion criteria identical to the LACC trial were identified. In contrast to the laparoscopic/robotic technique used in the LACC trial, all patients in our cohort underwent a combined transvaginal-laparoscopic approach without the use of any uterine manipulator. Results A total of 1952 consecutive patients with cervical cancer were included in the analysis. Initial International Federation of Gynecology and Obstetrics (FIGO) stage was IA1 lymphovascular space invasion (LVSI+), IA2 and IB1/IIA1 in 32 (8%), 43 (11%), and 314 (81%) patients, respectively, and histology was squamous cell in 263 (68%), adenocarcinoma in 117 (30%), and adenosquamous in 9 (2%) patients. Lymphovascular invasion was confirmed in 106 (27%) patients. The median number of lymph nodes was 24 (range 2–86). Lymph nodes were tumor-free in 379 (97%) patients. Following radical hysterectomy, 71 (18%) patients underwent adjuvant chemoradiation or radiation. After a median follow-up of 99 (range 1–288) months, the 3-, 4.5-, and 10-year disease-free survival rates were 96.8%, 95.8%, and 93.1 %, and the 3-, 4.5-, and 10-year overall survival rates were 98.5%, 97.8%, and 95.8%, respectively. Recurrence location was loco-regional in 50% of cases with recurrence (n=10). Interestingly, 9/20 recurrences occurred more than 39 months after surgery. Conclusion The combined laparoscopic-vaginal technique for radical hysterectomy with avoidance of spillage and manipulation of tumor cells provides excellent oncologic outcome for patients with early cervical cancer. Our retrospective data suggest that laparoscopic-vaginal surgery may be oncologically safe and should be validated in further randomized trials.
Factors affecting bone union after distal shortening oblique osteotomy of the lesser metatarsals

Abstract Objectives: There have been few reports on factors affecting bone union after metatarsal osteotomies. The purpose of this study was to clarify the factors affecting bone union after distal shortening oblique osteotomy of the lesser metatarsals. Methods: Patients who underwent distal shortening oblique osteotomy of the lesser metatarsals were retrospectively investigated. Failure to achieve bone union at 6 months after surgery was defined as delayed union. Background characteristics and radiographic measurements were compared between patients with and those without delayed union, and factors affecting bone union were assessed using multivariate analysis. Results: Among 204 toes in 58 patients evaluated in this study, delayed union occurred in 28%. In multivariate analysis, corticosteroid use (odds ratio (OR), 3.68; 95% confidence interval (CI), 1.65–8.16; p< . 01), larger preoperative overlap between the metatarsal and the proximal phalanx (OR, 1.11 (per 1 mm increase); 95% CI, 1.02–1.21; p= . 02), and larger gap at the osteotomy site (OR, 3.02 (per 1 mm increase); 95% CI, 1.76–5.16; p< . 01) were identified as independent risk factors of delayed union. Conclusion: The identified risk factors of delayed union after distal shortening metatarsal osteotomies were corticosteroid use, preoperative overlap between the metatarsal and the proximal phalanx, and a gap at the osteotomy site.
Cognitive behaviour language therapy for speech anxiety among stuttering school adolescents

Objective To determine the effectiveness of a cognitive behaviour language therapy (CBLT) programme to reduce speech anxiety among stuttering school adolescents. Methods This was a group randomized clinical trial that enrolled stuttering school adolescents who had severe speech anxiety. The participants were randomized to either the treatment group or the control group. The Speech Anxiety Thoughts Inventory (SATI) score was recorded before and after a 12-week CBLT programme was delivered in 24 group sessions to the treatment group. The control group did not receive any therapy. Results A total of 92 stuttering school adolescents who met the inclusion criteria were randomized to the treatment group (n = 46; 22 males, 24 females; mean ± SD age, 16.36 ± 2.20 years) or the control group (n = 46; 28 males, 18 females; mean ± SD age, 15.45 ± 2.10 years). Results showed that the CBLT intervention significantly reduced speech anxiety among stuttering school adolescents compared with the control group (post-test SATI assessment, mean ± SD 26.52 ± 1.67 versus 89.92 ± 3.17, respectively). Conclusion These findings suggest that speech educators and therapists in educational institutions and hospitals should follow the principles of CBLT when treating speech anxiety.
Frailty Syndrome and the Use of Frailty Indices as a Preoperative Risk Stratification Tool in Spine Surgery: A Review

This comprehensive narrative literature review aims to extract studies related to frailty indices and their use in elective spine procedures, as limited studies regarding frailty exist in the spine literature. Most studies are retrospective analyses of prospectively collected databases. Evidence suggests a positive correlation between frailty level and mortality rate, postoperative complication rate, length of stay, and the possibility of discharge to a skilled nursing facility; these correlations have been illustrated across various spine procedures. The leading index is the modified frailty index, which measures 11 deficits. The development of more comprehensive frailty indices, such as the Adult Spinal Deformity Frailty Index, are promising and have high predictive value regarding postoperative complication rate in patients with spinal deformity. However, a frailty index that combines clinical, radiographic, and laboratory measures awaits development. Perhaps, the use of a frailty index in preoperative risk stratification for elective spine procedures could serve multiple purposes, including screening for high-risk patients, enhancement of operative decision making, approximation of complication rate for informed decision making, and refinement of perioperative care. Further prospective studies are warranted to determine clinically meaningful interventions in frail individuals.
Unravelled facets of milk derived opioid peptides: a focus on gut physiology, fractures and obesity

Abstract Beyond being a source of key nutrients, bovine milk influences physiological functions by synthesising bioactive peptides during the process of digestion. Some of the claimed negative health outcomes associated with milk consumption, such as cardiovascular diseases and type 1 diabetes may be attributed to an opioid peptide, beta-casomorphin-7 (BCM-7), derived from A1 beta-casein. BCM-7 exerts its function by binding to the μ-opioid receptors in the body. It is hypothesised that activation of the μ-opioid receptors in the gut can alter gut microbial composition, impair gut barrier integrity and bile acid metabolism, in addition to increasing gastrointestinal transit time and gut inflammation. Further, it is hypothesised that BCM-7 may influence fractures and obesity via μ-opioid receptor pathways. In conclusion, it appears that BCM-7 might have multiple functions pertinent to human health; however, the evidence is limited and warrants further pre-clinical and clinical studies for hypothesis confirmation.
Endometriosis does not Increase Risk of Surgical Complications. A Comparative Study

Solveig Skrede1,Torbjorg Standal Skaravik1 and Mette Haase Moen1,2* 1Department of Laboratory Medicine, Children’s and Women’s Health, Faculty of Medicine, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway 2Department of Obstetrics and Gynecology, Trondheim University Hospital [St Olav’s Hospital], Olav Kyrres gate 17, NO-7006 Trondheim, Norway SOJ Surgery Open Access Research Article
ON THE BIMODALITY OF THE DISTRIBUTION OF ELECTRODERMAL ORIENTING RESPONSES IN SCHIZOPHRENIC PATIENTS

Data are presented from four of the author's studies on the electrodermal orienting response (OR) in drug-free schizophrenics which fail to confirm the findings of Gruzelier and Venables of a markedly bimodal distribution of ORs in schizophrenic populations. A review of the findings of other earlier studies, none of which confirm the bimodal hypothesis although some used patients taking phenothiazines, shows that differential effects of drugs, although probably an important factor, by itself cannot account entirely for the discrepancies in results. It is hypothesized that due to changes in hospital discharge policies, the groups of patients tested by Gruzelier and Venables, compared to those tested in earlier studies, were more heavily weighted with patients whose symptoms were resistant to phenothiazines. These patients may either have come from the extremes of the responsivity distribution or have atypical reactions to neuroleptic drugs.
Dietary l-arginine supplementation influences growth performance and B-cell secretion of immunoglobulin in broiler chickens.

Our previous study has shown that high levels of l-arginine (ARG) have reduced serum and mucosal antibody concentrations. In order to provide a better understanding in the application of ARG supplementation in the poultry industry, the study was conducted to investigate the effect of high levels of ARG on performance and B-cell secretion of immunoglobulin M (IgM) and IgG development in broiler chickens. A total of 192 1-day-old male Arbor Acres Plus broilers were randomly allocated into 4 groups (8 replicates per group, 6 birds per replicate) fed diets containing one of four ARG concentrations (analysed): 9.8, 14.7, 19.1 and 23.4 g/kg respectively. Growth performance was measured based on body weight gain (BWG), feed intake (FI) and feed conversion ratio (FCR). Increasing ARG quadratically increased (p < 0.05) BWG and FI with reaching plateau at 14.7 g/kg, while linearly decreased (p < 0.05) FCR, indicating that maximal performance required ARG no more than 14.7 g/kg in diets. Serum IgG and IgM concentrations were linearly reduced (p < 0.05) with increasing ARG. Chickens fed 19.1 g/kg or 23.4 g/kg ARG had lower (p < 0.05) serum IgG or IgM than chickens fed 9.8 g/kg ARG. As for the mRNA expression of bursal IgG and IgM, they were significantly downregulated with increasing ARG (p < 0.05). Chickens on ARG (>19.1 g/kg) had a lower (p < 0.05) IgG and IgM mRNA expression than chickens fed 9.8 g/kg. Activator of transcription 3 (STAT3) mRNA expression was linearly reduced with increasing ARG (p < 0.05), the transcriptional repressor B-cell lymphoma 6 (BCL6) mRNA expression was quadratically (p < 0.05) responded, and these cytokines had the lowest expression at 19.1 g/kg. ARG supplementation (>14.7 g/kg) did not significantly improve the growth performance, while it may have a potential negative regulatory effect on B-cell-mediated humoral immunity in chickens associated with suppression of the STAT3 expression associated with the JAK/STAT3 pathway.
Fetal heart rate monitoring system with mobile internet

The fetal heart rate is vital for monitoring fetal well-being. Fetal heart rate monitoring based on acoustic techniques is passive and noninvasive. In this work, a fetal heart rate monitoring system based on phonocardiographic method is proposed. A portable low-power stethoscope is customized which meets the need for sensitivity in the monitoring. A noise cancellation method and adaptive matching method are applied to extract the fetal heart rate effectively. Clinical trials are carried out on pregnant women, and the comparison of fetal heart rates given by the proposed system with those given by the Doppler monitor is given to show the accuracy.
Correlates of Physicians’ and Patients’ Language Use during Surgical Consultations

ABSTRACT A multi-method approach was used to explore correlates of technical and complex language use within 145 audio-recorded physician-patient interactions. When discussing the prospect of surgery, physicians used more technical and complex language (more jargon, larger words, longer sentences) than patients on average. Patients’ demographic characteristics (education, health literacy, English fluency) and markers of health (condition severity) inconsistently predicted physicians’ and patients’ use of complex and technical language. Interactions with happier and more hopeful patients involved less technical and complex language, but physicians’ language use was unrelated to patients’ emotions following the consultation. Finally, physicians’ use of more technical language predicted greater patient satisfaction following the consultation, and physicians’ use of more complex language at the initial consultation predicted better adherence by patients following surgery. Our results highlight the nuanced role of language use within healthcare interactions and identifies language complexity as a novel target for health communication research.
Sexual dimorphism in upper gastrointestinal motility is dependent on duration of fast, time of day, age, and strain of mice

An important limitation of gastrointestinal motility testing is high variability. Conditions that could contribute to variability, including the duration of pretest fasting and time of day, are rarely reported and have not been examined systematically. This study aimed to explore whether these conditions, as well as age, sex, and strain of mice, affect the results of a standard laboratory test of upper gastrointestinal motility.
Better preserved pulmonary endothelium-dependent vasodilation with off-pump coronary surgery.

OBJECTIVE To investigate if endothelium-dependent vasodilation in the pulmonary circulation was better maintained after off-pump coronary artery bypass grafting (CABG). An impaired pulmonary vascular response to acetylcholine has been observed after cardiopulmonary bypass (CPB) in children, adults and experimentally. DESIGN Fourteen patients operated off-pump were compared with 21 patients undergoing conventional CABG with CPB. The indexed pulmonary vascular resistance was measured before and during an infusion of acetylcholine, aiming at a concentration of 10(-6) mol/l in the pulmonary artery. Twelve patients operated on-pump received saline instead of acetylcholine. RESULTS Before surgery pulmonary vascular resistance decreased during infusion of acetylcholine by 28% and 25% in the off-pump and on-pump groups. After surgery the decrease was 16% and 6%, respectively (p = 0.028 and p < 0.001, compared to preoperative response). The response did not differ between the two groups before, but did so after surgery (p = 0.01). Saline had no effect. CONCLUSION The better maintained endothelium-dependent vasodilation in the off-pump group indicated less endothelial dysfunction.
Dynamics of Minimal Residual Disease in Neuroblastoma Patients

Neuroblastoma is a common extracranial solid tumor of neural crest (NC) origin that accounts for up to 15% of all pediatric cancer deaths. The disease arises from a transient population of NC cells that undergo an epithelial-mesenchymal transition (EMT) and generate diverse cell-types and tissues. Patients with neuroblastoma are characterized by their extreme heterogeneity ranging from spontaneous regression to malignant progression. More than half of newly diagnosed patients present highly metastatic tumors and are stratified into a high-risk group with dismal outcome. As many as 20% of high-risk patients have residual disease that is refractory or progressive during induction chemotherapy. Although a majority of high-risk patients achieve remission, larger part of those patients has minimal residual disease (MRD) that causes relapse even after additional consolidation therapy. MRD is composed of drug-resistant tumor cells and dynamically presented as cancer stem cells (CSCs) in residual tumors, circulating tumor cells (CTCs) in peripheral blood (PB), and disseminated tumor cells (DTCs) in bone marrow (BM) and other metastatic sites. EMT appears to be a key mechanism for cancer cells to acquire MRD phenotypes and malignant aggressiveness. Due to the restricted availability of residual tumors, PB and BM have been used to isolate and analyze CTCs and DTCs to evaluate MRD in cancer patients. In addition, recent technical advances make it possible to use circulating tumor DNA (ctDNA) shed from tumor cells into PB for MRD evaluation. Because MRD can be detected by tumor-specific antigens, genetic or epigenetic changes, and mRNAs, numerous assays using different methods and samples have been reported to detect MRD in cancer patients. In contrast to the tumor-specific gene-rearrangement-positive acute lymphoblastic leukemia (ALL) and the oncogenic fusion-gene-positive chronic myelogenous leukemia (CML) and several solid tumors, the clinical significance of MRD remains to be established in neuroblastoma. Given the extreme heterogeneity of neuroblastoma, dynamics of MRD in neuroblastoma patients will hold a key to the clinical validation. In this review, we summarize the biology and detection methods of cancer MRD in general and evaluate the available assays and clinical significance of neuroblastoma MRD to clarify its dynamics in neuroblastoma patients.