Miracle-dz/UniFAR-FTUs huggingface dataset:
Pneumonia in children with juvenile idiopathic arthritis in Finland 1999-2014: a nationwide retrospective register linkage study.

OBJECTIVES To compare the incidence of pneumonia in children with juvenile idiopathic arthritis (JIA) to the aged-matched general population and to evaluate the use of anti-rheumatic medication among children with JIA and pneumonia. METHODS The National Hospital Discharge Register collects data on ICD-diagnoses of hospital patients in Finland. From this register, patients with JIA under 18 years of age with pneumonia from 1999 through 2014 were identified. The control group consisted of age-matched patients derived from the general population with a diagnosis of pneumonia made in the same calendar year as the pneumonia of the JIA patients. The patient records of the children with JIA were scrutinised for the use of anti-rheumatic medication. RESULTS We identified 223 pneumonias among the JIA patients (56,161 patient-years) and 53,058 pneumonias in the control group (17,546,609 person-years). The incidence of pneumonia in children with JIA was 386 (annual range 131-639) and in the control group 303 (annual range 225-438) per 100,000 person-years. The incidence of pneumonia increased significantly over time among JIA patients (p=0.013) and in the control group (p<0.001). Through 2007-2014 the rate of pneumonia was significantly higher among children with JIA (p<0.001) than control children. We found 150 JIA patients with pneumonia confirmed by positive chest radiograph. Altogether 47% of the JIA patients had combination medication. The use of methotrexate and biologic agents increased significantly over time (p=0.016 and p<0.001, respectively). CONCLUSIONS The incidence of pneumonia increased in children with JIA and in the general population from 1999 to 2014. During 2007-2014 JIA patients had a significantly higher rate of pneumonia than age-matched controls. The use of active anti-rheumatic medication was common.
Microheterogeneity of acute phase proteins in patients with ulcerative colitis.

AIM To estimate the serum alpha1-antichymotrypsin (ACT), alpha1-acid glycoprotein (AGP) and transferrin (Tf) concentrations and to evaluate the microheterogeneity of these acute phase proteins in patients with ulcerative colitis. METHODS Twenty-seven patients with ulcerative colitis (UC) and 17 healthy control subjects were studied. The patients were categorised as severe (n = 9), moderate (n = 10) and mild groups (n = 8) using Truelove and Witts' classification of ulcerative colitis. Microheterogeneity of ACT, AGP and Tf was analysed by crossed immunoaffinity electrophoresis (CIAE) with concanavalin A. In all serum samples standard electrophoresis of serum proteins was performed, iron (Fe) concentration, total iron binding capacity (TIBC) and C-reactive protein (CRP) were also measured. RESULTS Our patients suffering from ulcerative colitis had significantly higher serum ACT and AGP concentrations and lower serum transferrin concentration in comparison to healthy subjects. Changes in concentrations of acute phase proteins were dependent on the activity of the inflammatory process. The glycosylation patterns of transferrin were related to the inflammation status. We also observed the correlation between ACT and AGP concentrations, patterns of transferrin glycosylation and changes in standard protein electrophoresis or blood cell count. CONCLUSION The glycosylation patterns of transferrin obtained from patients suffering from ulcerative colitis are highly branched and sialylated compared with those obtained from healthy subjects. In contrast, the glycosylation patterns of transferrin do not differ according to the activity index of ulcerative colitis. The microheterogeneity patterns of AGP and ACT are similar in ulcerative colitis patients and healthy subjects.
Relation between intracellular location and photodynamic efficacy of 5-aminolevulinic acid-induced protoporphyrin IX in vitro. Comparison between human glioblastoma cells and other cancer cell lines

A promising clinical application of 5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX (PP IX) is fluorescence detection and photodynamic treatment of residual tumour tissue during surgical resection of high grade malignant glioma. U373 MG human glioblastoma cells were used as a model system to study the relation between intracellular location and photodynamic efficacy of 5-ALA-induced PP IX in more detail. Therefore, ultra-sensitive fluorescence microscopy, using either optical excitation of whole cells or selective excitation of the plasma membrane by an evanescent electromagnetic field, was combined with quantitative measurements of intracellular porphyrin amount and phototoxicity. Glioblastoma cells accumulated PP IX to a moderate extent as compared to T47D breast cancer cells (high accumulation) or OV2774 ovarian cancer cells (low accumulation). Although photodynamic inactivation of the different cell lines (decreasing in the order T47D > U373 MG > OV2774) seemed to be directly related to PP IX accumulation, examination of the data in more detail revealed that photodynamic efficacy per photosensitizer molecule (PE) was about two times higher in glioblastoma and ovarian cancer cells as compared to breast cancer cells. The different photodynamic efficacy of PP IX was related to the different intracellular location. In contrast to breast cancer cells where PP IX fluorescence was localized in small granules, PP IX fluorescence in glioblastoma cells and ovarian cancer cells originated mainly from cellular membranes. Thus, the intracellular location of PP IX in a predominantly lipophilic environment, characterized by a comparably high photostability (probed by photobleaching and photoproduct formation) and a lower degree of porphyrin aggregation (probed previously by fluorescence decay kinetics), seems to be the key factor for high photodynamic efficacy of 5-ALA-induced PP IX. In the case of OV2774 ovarian cancer cells, however, a low PP IX accumulation limited cell inactivation upon irradiation, whereas the results obtained for glioblastoma cells are encouraging to develop PDT to an additional therapeutic option for the treatment of tumour margins in patients who underwent fluorescence-guided resection of high grade malignant glioma after 5-ALA administration.
Assessment of Patient Factors, Surgeons, and Surgeon Teams in Immediate Implant-Based Breast Reconstruction Outcomes

Background: Outcome studies of immediate implant-based breast reconstruction have focused largely on patient factors, whereas the relative impact of the surgeon as a contributing variable is not known. As the procedure requires collaboration of both a surgical oncologist and a plastic surgeon, the effect of the surgeon team interaction can have a significant impact on outcome. This study examines outcomes in implant-based breast reconstruction and the association with patient characteristics, surgeon, and surgeon team familiarity. Methods: A retrospective review of 3142 consecutive implant-based breast reconstruction mastectomy procedures at one institution was performed. Infection and skin necrosis rates were measured. Predictors of outcomes were identified by unadjusted logistic regression followed by multivariate logistic regression. Surgeon teams were grouped according to number of cases performed together. Results: Patient characteristics remain the most important predictors for outcomes in implant-based breast reconstruction, with odds ratios above those of surgeon variables. The authors observed significant differences in the rate of skin necrosis between surgical oncologists with an approximately two-fold difference between surgeons with the highest and lowest rates. Surgeon teams that worked together on fewer than 150 procedures had higher rates of infection. Conclusions: Patient characteristics are the most important predictors for surgical outcomes in implant-based breast reconstruction, but surgeons and surgeon teams are also important variables. High-volume surgeon teams achieve lower rates of infection. This study highlights the need to examine modifiable risk factors associated with optimum implant-based breast reconstruction outcomes, which include patient and provider characteristics and the surgical team treating the patient. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
Pacemaker properties of tunicate heart cells.

1. The primary pacemakers in the tunicate heart are located near the cardiovascular junctions close to the raphe that connects the V-shaped heart to the pericardium. However, small isolated pieces of the ring of myocardial cells at the ends of the heart were found to have nearly equal pacemaker capabilities. Arrhythmia in one primary pacemaker region was found to result from activity of two or more centers.2. Following isolation of a small piece of tissue in sea water, 20-50% of the cells were observed to pulsate and usually within a few minutes all cells contracted synchronously. Reversals in the direction of conduction in strips of myocardium without any primary pacemaker region were observed.3. The C center located in the middle of the heart was found to be dormant during normal heart activity but in opened animals it was activated by increasing the blood pressure.
Role of Blood-borne Cells in Organization of Mural Thrombi

activity would have produced substantially the same subgroups. It should also be pointed out that if the mean plasma fibrinolytic activity were calculated for all the post-cardiac-infarction subjects it would not differ greatly from the mean obtained from a group of normal subjects. This would agree with the findings of Nestel (1960), Merskey et al. (1960), and Goldrick (1961). This calculation, however, obscures the clear differences which exist between the two subgroups. It would appear that subgroup B consists of subjects whose fibrinolytic activity and mucoprotein levels are essentially normal, while the subjects in subgroup A, with raised mucoproteins and low fibrinolytic activity, have some metabolic disturbance resulting in these and possibly other changes. Goldrick (1961) observed that plasma fibrinolytic activity decreased with increasing body bulk in both healthy and atherosclerotic Australians. Our finding that a decreased height: weight ratio is associated with low fibrinolytic activity tends to confirm this observation. The measurements used in this study to assess body build, however, are insufficient to determine whether the variations are due to differences of somatotype or of nutritional status. From the finding of previous workers that the serum mucoprotein level is raised in atherosclerosis (Antonini and Salvini, 1957; Schwartz and Gilmore, 1958) it might be inferred that the subjects in subgroup A have more generalized atherosclerosis. Alternatively the subjects in subgroup B may have a different type of coronaryartery disease, since the parameters used in this study do not differentiate them from healthy subjects. This study of the relationships between serum mucoprotein levels, plasma fibrinolytic activity, and body build in subjects who have sustained a cardiac infarction must be regarded as a preliminary survey. It is clear that further investigation is required to elucidate fully these relationships and to evaluate their importance against the background of coronary-artery disease.
Hemodialysis access failure: a call to action.

Recent evidence suggests that the cost as well as the morbidity associated with the maintenance of hemodialysis access is increasing rapidly; currently, the cost exceeds 1 billion dollars and access related hospitalization accounts for 25% of all hospital admissions in the U.S.A. This increase in cost and morbidity has been associated with several epidemiological trends that may contribute to access failure. These include late patient referral to nephrologists and surgeons, late planning of vascular access as well as a shift from A-V fistulaes to PTFE grafts and temporary catheters, which have a higher failure rate. The reasons for this shift in the types of access is multifactorial and is not explained by changes in the co-morbidities of patients presenting to dialysis. Surgical preference and training also appear to play an important role in the large regional variation and patency rate of these PTFE grafts. We propose a program for early placement of A-V fistulae, a continuous quality improvement, multidisciplinary program to monitor access outcome, the development of new biomaterials, and a research plan to investigate pharmacological intervention to reduce development of stenosis and clinical interventions to treat those that do develop, prior to thrombosis.
Cytomegalovirus Vaccine Strain Towne-Derived Dense Bodies Induce Broad Cellular Immune Responses and Neutralizing Antibodies That Prevent Infection of Fibroblasts and Epithelial Cells

ABSTRACT Human cytomegalovirus (HCMV), a betaherpesvirus, can cause severe disease in immunosuppressed patients and following congenital infection. A vaccine that induces both humoral and cellular immunity may be required to prevent congenital infection. Dense bodies (DBs) are complex, noninfectious particles produced by HCMV-infected cells and may represent a vaccine option. As knowledge of the antigenicity and immunogenicity of DB is incomplete, we explored characterization methods and defined DB production methods, followed by systematic evaluation of neutralization and cell-mediated immune responses to the DB material in BALB/c mice. DBs purified from Towne-infected cultures treated with the viral terminase inhibitor 2-bromo-5,6-dichloro-1-beta-d-ribofuranosyl benzimidazole riboside (BDCRB) were characterized by nanoparticle tracking analysis (NTA), two-dimensional fluorescence difference gel electrophoresis (2D-DIGE), immunoblotting, quantitative enzyme-linked immunosorbent assay, and other methods. The humoral and cellular immune responses to DBs were compared to the immunogenicity of glycoprotein B (gB) administered with the adjuvant AddaVax (gB/AddaVax). DBs induced neutralizing antibodies that prevented viral infection of cultured fibroblasts and epithelial cells and robust cell-mediated immune responses to multiple viral proteins, including pp65, gB, and UL48. In contrast, gB/AddaVax failed to induce neutralizing antibodies that prevented infection of epithelial cells, highlighting a critical difference in the humoral responses induced by these vaccine candidates. Our data advance the potential for the DB vaccine approach, demonstrate important immunogenicity properties, and strongly support the further evaluation of DBs as a CMV vaccine candidate.
Asthma control and concordance of opinions between patients and pulmonologists

Abstract Patient–physician opinion concordance could play a key role in asthma control. There have been no studies evaluating this association in large samples of patients. Objectives: To determine opinion concordance between asthma patients and their pulmonologists on the impact of the disease and to correlate concordance to asthma control. Methods: This was a cross-sectional multicentre study including 1160 patients and 300 pulmonologists. Patient–physician concordance rates were assessed by two semi-structured qualitative questionnaires: (1) impact of the disease and (2) treatment satisfaction. Subsequently, participating pulmonologists determined the concordance between their perceptions and their patient’s. Sociodemographic and clinical data were recorded for all patients. Results: In 53.6% of cases, asthma was controlled. The rate of patient–pulmonologist concordance on disease impact on patient daily life was 57%, with physicians underestimating the impact (compared to patients) in 26% of cases. Concordance on satisfaction with treatment was 56%, with physicians underestimating satisfaction in 26% of cases. Patient–physician discordance rates were significantly lower among patients with controlled asthma (29 and 32.1%) than those with poor control (73.7 and 73.1%). Conclusions: Patient–pulmonologist concordance on perceptions of disease impact is low, particularly in uncontrolled asthma. This poor concordance should be addressed in education programmes, particularly for patients with uncontrolled symptoms.
Penicillin Allergy Skin Testing: What Do We Do Now?

Drug‐induced anaphylaxis remains a relatively infrequent event. However, penicillin and associated β‐lactam antibiotics remain a primary cause of anaphylaxis. Penicillin allergies are undoubtedly overreported, and patients with suspected penicillin allergy can be treated with antibiotic alternatives. Penicillin allergy skin testing is a simple and effective way to identify true penicillin allergy. Skin testing involves testing for both major and minor determinants and should be conducted in a facility with available life‐support equipment. The commercial major determinant product, benzylpenicilloyl‐polylysine, was removed from the market in 2004; this action compromised the ability of clinicians to evaluate a patient's likely response to penicillin therapy. Alternatives to skin testing include laboratory synthesis of major determinants, use of the radioallergosorbent test (RAST), or a combination of RAST and minor determinant skin testing. Patients with suspected penicillin allergy can undergo desensitization if they require penicillin therapy. The planned return of a commercial major determinant will hopefully resolve this issue.
Grape seed as a functional food ingredient in bread-making

The objective of this study was to determine the effects of grape seed (GS) on the rheological and bread-making properties, antioxidant activity and phenolic composition of bread. Wheat flour was replaced with GS at levels of 2.5%, 5.0% and 7.5%. GS increased the dough development time at a level of 5.0% but did not change it at levels of 2.5% and 7.5%. The dough stability value increased from 6.4 to 12.3 min with the increase of GS content from 0% to 7.5%. Mixing tolerance index decreased from 41.1 to 6.4 Brabender Units Equivalent. Extensibility of dough containing GS was higher than that of the control dough. The antioxidant activities of the bread increased significantly with the increased GS substitution. Gallic acid and catechin content increased in the bread containing GS. It was concluded that GS could be added to the formulae to improve functionality of the bread.
Maximizing the Benefits of Model-Based Period Analysis of Cancer Patient Survival

Period analysis has been shown to provide more up-to-date estimates of cancer survival than traditional methods of survival analysis. There is, however, a tradeoff between up-to-dateness and precision of period survival estimates: increasing up-to-dateness by restricting the analysis to a relatively short period, such as the most recent calendar year, goes along with loss of precision. Recently, a model-based approach was proposed, in which more precise period survival estimates for the most recent year can be obtained through modeling of survival trends within a recent 5-year period. We assess possibilities to extend the time window used for modeling to come up with even more precise, but equally accurate and up-to-date estimates of prognosis. Empirical evaluation using data from the Finnish Cancer Registry shows that extension of the time window to about 10 years provides, in most cases, as accurate results as using a 5-year time window (whereas further extension may lead to considerably less accurate results in some cases). Using 10-year time windows for modeling, SEs of survival estimates can be approximately halved compared with conventional period survival estimates for the most recent calendar year. Furthermore, we present a modification of the modeling approach, which allows extension to 10-year time windows to be achieved without the need to include additional cohorts of patients diagnosed longer time ago and which provides similarly accurate survival estimates at comparable levels of precision in most cases. Our analyses indicate opportunities to further maximize benefits of model-based period analysis of cancer survival. (Cancer Epidemiol Biomarkers Prev 2007;16(8):1675–81)
THE PROPOSED GLOBAL STRATOTYPE SECTION AND POINT FOR THE BASE OF THE JURASSIC SYSTEM IN THE NEW YORK CANYON AREA , NEVADA , USA

At Ferguson Hill in the New York Canyon area of Mineral County, Nevada, USA, marine strata of the Mount Hyatt and Muller Canyon members of the Gabbs Formation and Ferguson Hill Member of the overlying Sunrise Formation encompass a proposed Global Stratotype Section and Point (GSSP) for the base of the Jurassic System in the Muller Canyon Member. This section has been studied for almost a century and is on U.S. Government land with guaranteed conservation and ready access for scientific investigators. At Ferguson Hill, the Muller Canyon Member is ~ 17 m thick and is slope-forming muddy, calcareous siltstone with intercalated, fossiliferous beds of indurated siltstone and bioclastic wackestone. The fossil record of the Muller Canyon Member includes radiolarians, foraminiferans, ostracods, microbivalves, microgastropods, sponge spicules, ichthyoliths, echinoderms, conodonts, ichthyosaurs, brachiopods, bivalves, gastropods, nautiloids and ammonoids. Microfossils from uppermost Triassic strata in the section have been recovered for the first time and include the conodonts Misikella posthersteini and Zieglericonus rhaeticum and radiolarians of the Globolaxtorum tozeri Zone of Rhaetian age. Biostratigraphically significant fossils from the Muller Canyon Member, especially the highest occurrence of conodonts and the distribution of ammonoids such as Choristoceras crickmayi, C. marshi, Arcestes spp. , Psiloceras spelae, P. tilmanni and P. pacificum, provide a strong basis for global correlation to sections in western Canada, Peru, Chile, England and Austria, among others. Other candidate sections for the base of Jurassic GSSP in Canada, Peru, England, Ireland and Austria lack as complete an ammonoid record, but can be correlated to the Ferguson Hill section with confidence. The base of the Jurassic System should be a marker event of optimal global correlatability. Suggested criteria for defining the base of the Jurassic include ammonoid, bivalve and radiolarian bio-events and a carbon isotope excursion. Of these, an ammonoid event provides the highest degree of correlatability. Thus, the lowest occurrence of ammonoids of the Psiloceras tilmanni group (lowest occurrence of P. spelae) in the Ferguson Hill section provides the most globally correlatable datum, and thus the best GSSP, both because of the geographically broad distribution of ammonoids of the P. tilmanni group and because of the close association of the lowest occurrence of P. spelae with other criteria (proxies) that can be used to correlate the base
The spectrum of some compressions of unilateral shifts

Let E be a star-shaped Banach space of analytic functions on the open unit disk D. It is assumed that the unilateral shift S : z → zf and the backward shift T : f → f−f(0) z are bounded on E and that their spectrum is the closed unit disk. Let M be a closed z-invariant subspace of E such that dim(M/zM) = 1, and let g ∈ M . The main result of the paper states that if g has an analytic extension to D∪D(ζ, r) for some r > 0, with g(ζ) = 0, and if S and T satisfy the “nonquasianalytic condition” ∑ n≥0 log ‖Sn‖+ log ‖Tn‖ 1 + n2 < +∞, then ζ does not belong to the spectrum of the compression SM : f +M → zf +M of the unilateral shift to the quotient space E/M . This shows in particular that Spec(SM ) = {1} for some z-invariant subspaces M of weighted Hardy spaces that were constructed by N. K. Nikol′skĭı in the 1970s by using the Keldysh method.