Miracle-dz/UniFAR-FTUs huggingface dataset:
Sustained Clinical Efficacy and Mucosal Healing of Thiopurine Maintenance Treatment in Ulcerative Colitis: A Real-Life Study

Background and Aims Thiopurines are commonly used for treating ulcerative colitis (UC), despite the fact that controlled evidence supporting their efficacy is limited. The aim of this study was to evaluate the long-term outcome of thiopurines as maintenance therapy in a large cohort of UC patients. Methods All UC patients receiving thiopurine monotherapy at three tertiary IBD centers from 1995 to 2015 were identified. The primary endpoint was steroid-free clinical remission. Secondary endpoints were mucosal healing (MH), defined as Mayo endoscopic subscore 0, long-term safety, and predictors of sustained clinical remission. Results We identified 192 patients, contributing a total of 747 person-years of follow-up (median follow-up 36 months, range 1–210 months). Steroid dependency was the most common indication for thiopurine treatment (58%). Steroid-free remission occurred in 45.3% of patients; 36.3% stopped thiopurines because of treatment failure and 18.2% for adverse events or intolerance. The cumulative probability of maintaining steroid-free remission while on thiopurine treatment was 87%, 76%, 67.6%, and 53.4% at 12, 24, 36, and 60 months, respectively. MH occurred in 57.9% of patients after a median of 18 months (range 5–96). No independent predictors of sustained clinical remission could be identified. Conclusions Thiopurines represent an effective and safe long-term maintenance therapy for UC patients.
Universal protection against influenza infection by a multidomain antibody to influenza hemagglutinin

Durable influenza protection Vaccines are indispensable for the control and prevention of influenza, but there are several challenges to efficacy. Some individuals respond poorly to vaccination, and virus variation makes targeting optimal antigens difficult. Broadly neutralizing antibodies are one solution, but they have their own pitfalls, including limited cross-reactivity to both influenza A and B strains and the need for repeated injections. Now, Laursen et al. have developed multidomain antibodies with breadth and potency. Administered intranasally to mice with an adeno-associated virus vector, the antibodies provided durable and continuous protection from a panoply of influenza strains. Science, this issue p. 598 Llama nanobodies can be used to generate comprehensive and long-lasting flu protection. Broadly neutralizing antibodies against highly variable pathogens have stimulated the design of vaccines and therapeutics. We report the use of diverse camelid single-domain antibodies to influenza virus hemagglutinin to generate multidomain antibodies with impressive breadth and potency. Multidomain antibody MD3606 protects mice against influenza A and B infection when administered intravenously or expressed locally from a recombinant adeno-associated virus vector. Crystal and single-particle electron microscopy structures of these antibodies with hemagglutinins from influenza A and B viruses reveal binding to highly conserved epitopes. Collectively, our findings demonstrate that multidomain antibodies targeting multiple epitopes exhibit enhanced virus cross-reactivity and potency. In combination with adeno-associated virus–mediated gene delivery, they may provide an effective strategy to prevent infection with influenza virus and other highly variable pathogens.
Knowledge Is Power: Prior Knowledge Aids Memory for Both Congruent and Incongruent Events, but in Different Ways

Events that conform to our expectations, that is, are congruent with our world knowledge or schemas, are better remembered than unrelated events. Yet events that conflict with schemas can also be remembered better. We examined this apparent paradox in 4 experiments, in which schemas were established by training ordinal relationships between randomly paired objects, whereas event memory was tested for the number of objects on each trial. Better memory was found for both congruent and incongruent trials, relative to unrelated trials, producing memory performance that was a “U-shaped” function of congruency. The congruency advantage but not incongruency advantage was mediated by postencoding processes, whereas the incongruency advantage, but not congruency advantage, emerged even if the information probed by the memory test was irrelevant to the schema. Schemas therefore augment event memory in multiple ways, depending on the match between novel and existing information.
Serum Metrnl is associated with the presence and severity of coronary artery disease

Meteorin‐like (Metrnl) is a novel adipokine that is highly expressed in white adipose tissue. Metrnl stimulates energy expenditure and improves glucose tolerance in rodents. However, whether Metrnl plays a role in coronary artery disease (CAD) remains to be elucidated. The present study aimed to investigate the association of serum Metrnl with CAD in Chinese patients. A total of 193 patients with CAD and 156 control subjects were enrolled in this study. Serum Metrnl concentration was measured by enzyme‐linked immunosorbent assay. Anthropometric phenotypes, fasting glucose, serum lipids, and inflammatory cytokines were measured. Serum Metrnl was lower in CAD patients when compared to those controls (132.41 vs 173.17 pg/mL, P < 0.001). Serum Metrnl was negatively correlated with metabolic parameters, including body mass index, total cholesterol, and low‐density lipoprotein cholesterol as well as inflammatory markers including high‐sensitivity C‐reactive protein, IL‐1β, and IL‐11 even after adjustment for potential confounding variables (P < 0.05). In multivariable logistic regression analyses, compared to those in the highest tertile of serum Metrnl levels, subjects in the lowest tertile had the highest risks for CAD (adjusted OR = 2.63, 95% CI = 1.46‐4.27, P = 0.001). After adjustment for potential confounding variables, serum Metrnl was also decreased as the number of stenosed vessels increased (P < 0.001). Furthermore, decreased Metrnl level was negatively correlated with the severity of CAD quantified by the Gensini score. This first case‐control study shows significant associations of serum Metrnl with the presence and severity of CAD, suggesting Metrnl might be a new promising therapeutic target for CAD.
Impact of tiered interventions to decrease routine urine cultures in asymptomatic patients undergoing arthroplasty

Prosthetic joint infection (PJI) is a challenging complication after joint arthroplasty. Our institution performed preoperative screening and treatment of asymptomatic bacteriuria (ASB) prior to joint replacements. This is a common practice despite a lack of evidence showing benefit or a decrease in postoperative PJI. This practice can lead to increased rates of Clostridioides (Clostridium) difficile infection, multidrug-resistant organisms, higher costs, and adverse reactions. Furthermore, in patients who have both ASB and PJI, studies show that the causative organisms are usually discordant. In April 2016, the antimicrobial stewardship team (AST) met with the orthopedic surgery department to provide education and recommended removing routine urine culture from preoperative order sets for joint arthroplasty. The purpose of this project was to evaluate the impact of education alone followed by the removal of urine culture from the preoperative order set on screening and treatment of ASB prior to elective hip and knee joint arthroplasty.
Effects of Monolaurin on Oral Microbe–Host Transcriptome and Metabolome

The aim of this in vitro study was to evaluate the effects of monolaurin against Aggregatibacter actinomycetemcomitans (Aa) and determine their effects on the host transcriptome and metabolome, using an oral cell/bacteria co-culture dual-chamber model to mimic the human periodontium. For this, the Aa, was applied to cross the monolayer of epithelial keratinocytes (OBA-9) to reach the fibroblasts layer (HGF-1) in the basal chamber. The Monolaurin treatments (25 or 50 μM) were added immediately after the inoculation of the dual-chamber with Aa. After 24 h, the transcriptional factors and metabolites produced were quantified in the remaining cell layers (insert and basal chamber) and in supernatant released from the cells. The genes IL-1α, IL-6, IL-18, and TNF analyzed in HGF-1 concentrations showed a decreased expression when treated with both concentration of Monolaurin. In keratinocytes, the genes IL-6, IL-18, and TNF presented a higher expression and the expression of IL-1α decreased when treated with the two cited concentrations. The production of glycerol and pyruvic acid increased, and the 2-deoxytetronic acid NIST, 4-aminobutyric acid, pinitol and glyceric acid, presented lower concentrations because of the treatment with 25 and/or 50 μM of Monolaurin. Use of monolaurin modulated the immune response and metabolite production when administered for 24 h in a dual-chamber model inoculated with A. actinomycetemcomitans. In summary, this study indicates that monolaurin had antimicrobial activity and modulated the host immune response and metabolite production when administered for 24 h in a dual-chamber model inoculated with A. actinomycetemcomitans.
Dynamic Pricing (and Assortment) under a Static Calendar

This work is motivated by our collaboration with a large consumer packaged goods (CPG) company. We have found that whereas the company appreciates the advantages of dynamic pricing, they deem it operationally much easier to plan out a static price calendar in advance. We investigate the efficacy of static control policies for revenue management problems whose optimal solution is inherently dynamic. In these problems, a firm has limited inventory to sell over a finite time horizon, over which heterogeneous customers stochastically arrive. We consider both pricing and assortment controls, and derive simple static policies in the form of a price calendar or a planned sequence of assortments, respectively. In the assortment planning problem, we also differentiate between the static vs. dynamic substitution models of customer demand. We show that our policies are within 1-1/e (approximately 0.63) of the optimum under stationary demand, and 1/2 of the optimum under nonstationary demand, with both guarantees approaching 1 if the starting inventories are large. We adapt the technique of prophet inequalities from optimal stopping theory to pricing and assortment problems, and our results are relative to the linear programming relaxation. Under the special case of stationary demand single-item pricing, our results improve the understanding of irregular and discrete demand curves, by showing that a static calendar can be (1-1/e)-approximate if the prices are sorted high-to-low. Finally, we demonstrate on both data from the CPG company and synthetic data from the literature that our simple price and assortment calendars are effective. This paper was accepted by Hamid Nazerzadeh, big data analytics.
Transfer Learning in Multilingual Neural Machine Translation with Dynamic Vocabulary

We propose a method to transfer knowledge across neural machine translation (NMT) models by means of a shared dynamic vocabulary. Our approach allows to extend an initial model for a given language pair to cover new languages by adapting its vocabulary as long as new data become available (i.e., introducing new vocabulary items if they are not included in the initial model). The parameter transfer mechanism is evaluated in two scenarios: i) to adapt a trained single language NMT system to work with a new language pair and ii) to continuously add new language pairs to grow to a multilingual NMT system. In both the scenarios our goal is to improve the translation performance, while minimizing the training convergence time. Preliminary experiments spanning five languages with different training data sizes (i.e., 5k and 50k parallel sentences) show a significant performance gain ranging from +3.85 up to +13.63 BLEU in different language directions. Moreover, when compared with training an NMT model from scratch, our transfer-learning approach allows us to reach higher performance after training up to 4% of the total training steps.
Superiority of Step-up Approach vs Open Necrosectomy in Long-term Follow-up of Patients With Necrotizing Pancreatitis.

BACKGROUND & AIMS In a 2010 randomized trial (the PANTER trial), a surgical step-up approach for infected necrotizing pancreatitis was found to reduce the composite endpoint of death or major complications compared with open necrosectomy; 35% of patients were successfully treated with simple catheter drainage only. There is concern, however, that minimally invasive treatment increases the need for reinterventions for residual peripancreatic necrotic collections and other complications during the long term. We therefore performed a long-term follow-up study. METHODS We reevaluated all the 73 patients (of the 88 patients randomly assigned to groups) who were still alive after the index admission, at a mean 86 months (±11 months) of follow-up. We collected data on all clinical and health care resource utilization endpoints through this follow-up period. The primary endpoint was death or major complications (the same as for the PANTER trial). We also measured exocrine insufficiency, quality of life (using the Short Form-36 and EuroQol 5 dimensions forms), and Izbicki pain scores. RESULTS From index admission to long-term follow-up, 19 patients (44%) died or had major complications in the step-up group compared with 33 patients (73%) in the open-necrosectomy group (P = .005). Significantly lower proportions of patients in the step-up group had incisional hernias (23% vs 53%; P = .004), pancreatic exocrine insufficiency (29% vs 56%; P = .03), or endocrine insufficiency (40% vs 64%; P = .05). There were no significant differences between groups in proportions of patients requiring additional drainage procedures (11% vs 13%; P = .99) or pancreatic surgery (11% vs 5%; P = .43), or in recurrent acute pancreatitis, chronic pancreatitis, Izbicki pain scores, or medical costs. Quality of life increased during follow-up without a significant difference between groups. CONCLUSIONS In an analysis of long-term outcomes of trial participants, we found the step-up approach for necrotizing pancreatitis to be superior to open necrosectomy, without increased risk of reinterventions.
A New Challenge for Radiologists: Radiomics in Breast Cancer

Introduction Over the last decade, the field of medical imaging experienced an exponential growth, leading to the development of radiomics, with which innumerable quantitative features are obtained from digital medical images, providing a comprehensive characterization of the tumor. This review aims to assess the role of this emerging diagnostic tool in breast cancer, focusing on the ability of radiomics to predict malignancy, response to neoadjuvant chemotherapy, prognostic factors, molecular subtypes, and risk of recurrence. Evidence Acquisition A literature search on PubMed and on Cochrane database websites to retrieve English-written systematic reviews, review articles, meta-analyses, and randomized clinical trials published from August 2013 up to July 2018 was carried out. Results Twenty papers (19 retrospective and 1 prospective studies) conducted with different conventional imaging modalities were included. Discussion The integration of quantitative information with clinical, histological, and genomic data could enable clinicians to provide personalized treatments for breast cancer patients. Current limitations of a routinely application of radiomics are represented by the limited knowledge of its basics concepts among radiologists and by the lack of efficient and standardized systems of feature extraction and data sharing.
Anthelmintic resistance and novel control options in equine gastrointestinal nematodes

Abstract Control of equine nematodes has relied on benzimidazoles (BZs), tetrahydropyrimidines and macrocyclic lactones. The intensive use of anthelmintics has led to the development of anthelmintic resistance (AR) in equine cyathostomins and Parascaris equorum. Field studies indicate that BZ and pyrantel resistance is widespread in cyathostomins and there are also increasing reports of resistance to macrocyclic lactones in cyathostomins and P. equorum. The unavailability of reliable laboratory-based techniques for detecting resistance further augments the problem of nematode control in horses. The only reliable test used in horses is the fecal egg count reduction test; therefore, more focus should be given to develop and validate improved methodologies for diagnosing AR at an early stage, as well as determining the mechanisms involved in resistance development. Therefore, equine industry and researchers should devise and implement new strategies for equine worm control, such as the use of bioactive pastures or novel feed additives, and control should increasingly incorporate alternative and evidence-based parasite control strategies to limit the development of AR. This review describes the history and prevalence of AR in equine nematodes, along with recent advances in developing resistance diagnostic tests and worm control strategies in horses, as well as giving some perspective on recent research into novel control strategies.
Rotational thromboelastometry (ROTEM) 24 hours post liver transplantation predicts early allograft dysfunction

Abstract Early allograft dysfunction (EAD) represents one of the most common and serious complications after liver transplantation (LT). Methods. One hundred sixty-four patients who underwent LT were prospectively included in the present study. Patient demographics, intraoperative blood loss and transfusion were recorded at the time of LT. Lactate levels were recorded during surgery and daily for the first 3 postoperative days. Standard and derived rotational thromboelastometry (ROTEM) parameters were recorded 24 hours after LT. EAD was diagnosed according to Nanashima criteria and post anaesthesia care unit length of stay was recorded. Results. Forty-seven patients (28.6%) developed EAD. Intraoperative blood loss (p = 0.01), packed red blood cells (p = 0.04) and fresh frozen plasma (p = 0.01) transfusion represented intraoperative risk factors for EAD. Lactate levels were significantly higher in patients with EAD at all time points. Patients with EAD demonstrated an increased clot formation time and decreased maximum clot firmness in both intrinsically (p < 0.01) and extrinsically (p < 0.01) activated assay, a decreased thrombin potential index (p < 0.01), area under the curve (p < 0.01) and clot elasticity (p < 0.01) on ROTEM assay. Conclusion. Our results show that both standard and derived ROTEM parameters may indicate early signs of graft failure and can aid in the diagnosis of EAD.
In Vitro Expansion and Characterization of Mesenchymal Stromal Cells from Peritoneal Dialysis Effluent in a Human Protein Medium

The therapeutic potential of mesenchymal stromal cells (MSCs) from various tissue origins have extensively been explored in both experimental and clinical studies, and peritoneal dialysis effluent-derived MSC (pMSC) may be an easily obtainable MSC source for clinical applications. In this study, we expanded and characterized the pMSCs after expansion in a human protein culture medium. The pMSCs were expanded in plastic dishes with the human protein medium. MSC marker expression was examined by flow cytometry. Spherical formation was tested by hanging drop method, and osteogenic, adipogenic, and chondrogenic differentiation capacities were confirmed by positive staining with Alizarin red, Oil red O, and Alcian blue, respectively. Here, we showed that after four passages of culturing in plastic dishes, pMSCs in the human protein medium displayed a homogeneous pattern of classical MSC markers (positive: CD29, CD44, CD73, CD90, and CD166; negative: CD14, CD34, CD45, CD79a, CD105, CD146, CD271, HLA-DR, SSEA-4, and Stro-1), while in the standard medium, pMSCs from some donors were CD45 or HLA-DR positive. For nonclassical MSC markers, pMSCs were CD200 positive from all the donors, negative for CD163, CD271, CD36, and CD248, and either positive or negative for CD274 and CD140b. Further, pMSCs from the human protein medium had the spherical formation capacity and multipotent differentiation capacity in vitro. In conclusion, upon expansion in a human protein medium, pMSCs showed a differential MSC marker expression profile from those of bone marrow or adipose tissue-derived MSCs and could maintain the multipotency. The therapeutic potential of the pMSCs requires further investigation.
Mediating effect of interpersonal coping on meaning in spirituality and quality of life and the influences of depression and anxiety thereon in cancer patients

Abstract Objective This study aimed to investigate associations among spirituality, coping strategies, quality of life (QOL), and the effects of depression and anxiety thereon in cancer patients. Method In total, 237 cancer patients referred to a psycho-oncology clinic at a university hospital in Korea were enrolled. After identifying predictors of patient QOL in a stepwise regression model, we developed a hypothetical path model wherein interpersonal coping was considered as a mediating variable between spirituality (meaning/peace) and QOL and wherein depression and anxiety affected each of these three variables. Result The direct effect of spirituality (meaning/peace) on QOL was 36.7%. In an indirect model, interpersonal coping significantly mediated the relationship between spirituality (meaning/peace) and QOL. Depression exerted the largest negative effect on spirituality (meaning/peace), interpersonal coping, and QOL. Anxiety had negative effects on spirituality (meaning/peace) and QOL, but a positive effect on interpersonal coping. Significance of results Interpersonal coping strategies work as a partial mediator of the relationship between meaning/peace subscales of spirituality and QOL. Effective management of depression may help in achieving better outcomes associated therewith. Greater attention and efforts to improve social connectedness and meaning of life in spiritual well-being may improve the QOL of cancer patients.