Miracle-dz/UniFAR-FTUs huggingface dataset:
Rheumatoid Arthritis Initiating as Palindromic Rheumatism: A Distinct Clinical Phenotype?

Objective. To analyze the prevalence of preexisting palindromic rheumatism (PR) in patients with established rheumatoid arthritis (RA) and to evaluate whether these patients have a distinctive clinical and serological phenotype. Methods. Cross-sectional study in patients with established RA. Preexisting PR was determined using a structured protocol and confirmed by retrospective review of medical records. Demographic, clinical, radiological, immunological, and therapeutic features were compared in patients with and without PR. Results. Included were 158 patients with established RA (78% female) with a mean disease duration since RA onset of 5.1 ± 2.7 years. Preexisting PR was recorded in 29 patients (18%). The median time from the onset of PR to progression to RA was 1.2 years. No between-group differences in demographic features, current disease activity, radiographic erosive disease, or disability were observed. Patients with PR had a higher prevalence of smoking (72% vs 40%). Positive rheumatoid factor, anticitrullinated peptide antibodies, and anticarbamylated protein antibodies were numerically higher in patients with PR. No differences in treatment were observed except for greater hydroxychloroquine (HCQ) use in patients with PR (38% vs 6%). Palindromic flares persisted in a significant proportion of patients during the RA course, including patients in clinical remission or receiving biological disease-modifying antirheumatic drugs. Conclusion. Eighteen percent of patients with RA had a history compatible with PR previous to RA onset. No specific clinical or serological phenotype was identified in these patients, although higher HCQ use and smoking prevalence were identified. Palindromic flares may persist during the RA disease course despite treatment.
Laminin α2 controls mouse and human stem cell behaviour during midbrain dopaminergic neuron development

ABSTRACT Development of the central nervous system requires coordination of the proliferation and differentiation of neural stem cells. Here, we show that laminin alpha 2 (lm-α2) is a component of the midbrain dopaminergic neuron (mDA) progenitor niche in the ventral midbrain (VM) and identify a concentration-dependent role for laminin α2β1γ1 (lm211) in regulating mDA progenitor proliferation and survival via a distinct set of receptors. At high concentrations, lm211-rich environments maintain mDA progenitors in a proliferative state via integrins α6β1 and α7β1, whereas low concentrations of lm211 support mDA lineage survival via dystroglycan receptors. We confirmed our findings in vivo, demonstrating that the VM was smaller in the absence of lm-α2, with increased apoptosis; furthermore, the progenitor pool was depleted through premature differentiation, resulting in fewer mDA neurons. Examination of mDA neuron subtype composition showed a reduction in later-born mDA neurons of the ventral tegmental area, which control a range of cognitive behaviours. Our results identify a novel role for laminin in neural development and provide a possible mechanism for autism-like behaviours and the brainstem hypoplasia seen in some individuals with mutations of LAMA2. Summary: The proliferation and survival of midbrain dopaminergic neurons is regulated by laminin α2, mutations in which can cause abnormalities in dopaminergic neuron number.
Usefulness of the Delay Alternating with Nutation for Tailored Excitation Pulse with T1-Weighted Sampling Perfection with Application-Optimized Contrasts Using Different Flip Angle Evolution in the Detection of Cerebral Metastases: Comparison with MPRAGE Imaging

BACKGROUND AND PURPOSE: Contrast-enhanced T1-weighted sampling perfection with application-optimized contrasts by using different flip angle evolution (SPACE) with the delay alternating with nutation for tailored excitation (DANTE) pulse could suppress the blood flow signal and provide a higher contrast-to-noise ratio of enhancing lesion-to-brain parenchyma than the MPRAGE sequence. The purpose of our study was to evaluate the usefulness of SPACE with DANTE compared with MPRAGE for detecting brain metastases. MATERIALS AND METHODS: Seventy-one patients who underwent contrast-enhanced SPACE with DANTE and MPRAGE sequences and who were suspected of having metastatic lesions were included. Two neuroradiologists determined the number of enhancing lesions, and diagnostic performance was evaluated using figure of merit, sensitivity, positive predictive value, interobserver agreement, and reading time. Contrast-to-noise ratiolesion/parenchyma and contrast-to-noise ratiowhite matter/gray matter were also assessed. RESULTS: SPACE with DANTE (observer one, 328; observer two, 324) revealed significantly more small (<5 mm) enhancing lesions than MPRAGE (observer one, 175; observer two, 150) (P < 0.001 for observer 1, P ≤ .0001 for observer 2). Furthermore, SPACE with DANTE showed significantly higher figure of merit and sensitivity and shorter reading time than MPRAGE for both observers. The mean contrast-to-noise ratiolesion/parenchyma of SPACE with DANTE (52.3 ± 43.1) was significantly higher than that of MPRAGE (17.5 ± 19.3) (P ≤ .0001), but the mean contrast-to-noise ratiowhite matter/gray matter of SPACE with DANTE (−0.65 ± 1.39) was significantly lower than that of MPRAGE (3.08 ± 1.39) (P ≤ .0001). CONCLUSIONS: Compared with MPRAGE, SPACE with DANTE significantly improves the detection of brain metastases.
The influence of the HEART Camp intervention on physical function, health-related quality of life, depression, anxiety and fatigue in patients with heart failure

Background: Regular exercise training has beneficial effects on quality of life, physical function, depression and anxiety in individuals with heart failure. Unfortunately, individuals with heart failure have low levels of adherence to exercise. Thus, studies are needed to assess intervention strategies which may enhance clinical outcomes. Aim: The aim of this study was to identify the components of the HEART Camp intervention, which contributed to optimizing clinical outcomes. Methods: The Heart Failure Exercise and Resistance Training Camp (HEART Camp) was a randomized controlled trial to evaluate the effect of a multicomponent intervention on adherence to exercise (6, 12 and 18 months) compared to an enhanced usual care group. This study assessed various components of the intervention on the secondary outcomes of physical function, health-related quality of life, depression, anxiety, and fatigue. Results: Individuals participating (n=204) in this study were 55.4% men and the average age was 60.4 (11.5) years. A combination of individualized and group-based strategies demonstrated clinical improvements, HEART Camp versus enhanced usual care groups, in physical function, positive trends in health-related quality of life and positive changes in the minimally important differences for depression, anxiety, and fatigue. Conclusions: Individualized coaching by an exercise professional and group-based educational sessions were identified as important components of patient management contributing to improvements in the secondary outcomes of physical function, health-related quality of life, depression, anxiety and fatigue.
Trace Gas Detection System Based on All-Optical Quartz-Enhanced Photoacoustic Spectroscopy

An all-optical quartz-enhanced photoacoustic spectroscopy system (QEPAS) with quadrature point stabilization for trace gas detection was reported. The extrinsic interferometry-based optical fiber Fabry–Perot sensor with quadrature point self-stabilization for detection of quartz prong vibration was used to replace the conventional one. The optimal coefficient of the modulation depth was ∼2.2 theoretically and experimentally, corresponding to the modulation depth of ∼0.1795 cm−1 at an acetylene (C2H2) absorption line of 6534.36 cm−1. Furthermore, the enhancement of QEPAS signal was obtained by using different microresonators. The minimum detectable limit of ∼580 parts per billion by volume (ppbv) was obtained. A normalized noise equivalent absorption coefficient for C2H2 of 2.95 × 10−7 cm−1·W·Hz–1/2 was obtained. The detection sensitivity was enhanced by a factor of ∼2.1 in comparison to the conventional QEPAS system. The linear correlation coefficient of the QEPAS signal response to the C2H2 concentration was 0.998 within the range from 10 parts per million by volume (ppmv) to 500 ppmv. Finally, the long-term stability of the QEPAS system was evaluated using Allan deviation analysis, and the ultimate detection limit of ∼130 ppbv was reached for an optimum averaging time of ∼108 s at atmospheric pressure and ambient temperature.
Metabolic Plasticity of Acute Myeloid Leukemia

Acute myeloid leukemia (AML) is one of the most common and life-threatening leukemias. A highly diverse and flexible metabolism contributes to the aggressiveness of the disease that is still difficult to treat. By using different sources of nutrients for energy and biomass supply, AML cells gain metabolic plasticity and rapidly outcompete normal hematopoietic cells. This review aims to decipher the diverse metabolic strategies and the underlying oncogenic and environmental changes that sustain continuous growth, mediate redox homeostasis and induce drug resistance in AML. We revisit Warburg’s hypothesis and illustrate the role of glucose as a provider of cellular building blocks rather than as a supplier of the tricarboxylic acid (TCA) cycle for energy production. We discuss how the diversity of fuels for the TCA cycle, including glutamine and fatty acids, contributes to the metabolic plasticity of the disease and highlight the roles of amino acids and lipids in AML metabolism. Furthermore, we point out the potential of the different metabolic effectors to be used as novel therapeutic targets.
Molecular detection of multidrug and colistin resistant Escherichia coli isolated from house flies in various environmental settings.

Aim: To detect antibiotic-resistant pathogenic Escherichia coli in house flies captured from various environmental settings. Materials & methods: Isolation and identification of E. coli was performed based on culture and PCR. Antimicrobial susceptibility testing was conducted using disk diffusion test. Detection of virulence and antimicrobial resistance genes was carried out using PCR methods. Results: The prevalence of E. coli in flies was 61% with highest in dairy farms (70.67%) followed by food centers (65.33%), dustbins (64%) and area close to hospital (44%). The prevalence rates of tetA, tetB, ereA, CITM, SHV, mcr-3 and catA1 resistance determinants were 88.75, 48.52, 41.67, 37.17, 27.77, 18.37 and 14.81%, respectively. Conclusion: Multidrug-resistant pathogenic E. coli are widely distributed in house flies, which requires a one-health approach to delineate their control.
Association between insulin and post‐caesarean resuscitation rates in infants of women with GDM: A retrospective study

Gestational diabetes mellitus (GDM) and caesarean deliveries independently increase the risk of postoperative complications. There are limited data on the influence of insulin use on the outcomes of neonates who were delivered via caesarean section. We sought to investigate the impact of insulin use in women with GDM on resuscitation rates of infants post caesarean delivery.
Central sleep apnea in children with obstructive sleep apnea syndrome and improvement following adenotonsillectomy

Although the pathogenesis of central and obstructive events seems to be different, these two entities may somehow be related. We aimed to determine whether, as reported in previous research, the number of central sleep apnea (CSA) cases in a population of children with obstructive sleep apnea syndrome (OSAS) was greater than in patients without obstructive events, and if CSA worsens with increasing OSAS severity. As a second objective, we analyzed changes in central apnea index (CAI) after adenotonsillar surgery compared to changes when no surgery has been performed.
Substitution of outpatient hospital care with specialist care in the primary care setting: A systematic review on quality of care, health and costs

Rationale, aims and objective Substituting outpatient hospital care with primary care is seen as a solution to decrease unnecessary referrals to outpatient hospital care and decrease rising healthcare costs. This systematic review aimed to evaluate the effects on quality of care, health and costs outcomes of substituting outpatient hospital care with primary care-based interventions, which are performed by medical specialists in face-to-face consultations in a primary care setting. Method The systematic review was performed using the PICO framework. Original papers in which the premise of the intervention was to substitute outpatient hospital care with primary care through the involvement of a medical specialist in a primary care setting were eligible. Results A total of 14 papers were included. A substitution intervention in general practitioner (GP) practices was described in 11 papers, three described a joint consultation intervention in which GPs see patients together with a medical specialist. This study showed that substitution initiatives result mostly in favourable outcomes compared to outpatient hospital care. The initiatives resulted mostly in shorter waiting lists, shorter clinic waiting times and higher patient satisfaction. Costs for treating one extra patient seemed to be higher in the intervention settings. This was mainly caused by inefficient planning of consultation hours and lower patient numbers. Conclusions Despite the fact that internationally a lot has been written about the importance of performing substitution interventions in which preventing unnecessary referrals to outpatient hospital care was the aim, only 14 papers were included. Future systematic reviews should focus on the effects on the Triple Aim of substitution initiatives in which other healthcare professions than medical specialists are involved along with new technologies, such as e-consults. Additionally, to gain more insight into the effects of substitution initiatives operating in a dynamic healthcare context, it is important to keep evaluating the interventions in a longitudinal study design.
Post-transcriptional gene silencing triggers dispensable DNA methylation in gene body in Arabidopsis

Abstract Spontaneous post-transcriptional silencing of sense transgenes (S-PTGS) is established in each generation and is accompanied by DNA methylation, but the pathway of PTGS-dependent DNA methylation is unknown and so is its role. Here we show that CHH and CHG methylation coincides spatially and temporally with RDR6-dependent products derived from the central and 3′ regions of the coding sequence, and requires the components of the RNA-directed DNA methylation (RdDM) pathway NRPE1, DRD1 and DRM2, but not CLSY1, NRPD1, RDR2 or DCL3, suggesting that RDR6-dependent products, namely long dsRNAs and/or siRNAs, trigger PTGS-dependent DNA methylation. Nevertheless, none of these RdDM components are required to establish S-PTGS or produce a systemic silencing signal. Moreover, preventing de novo DNA methylation in non-silenced transgenic tissues grafted onto homologous silenced tissues does not inhibit the triggering of PTGS. Overall, these data indicate that gene body DNA methylation is a consequence, not a cause, of PTGS, and rule out the hypothesis that a PTGS-associated DNA methylation signal is transmitted independent of a PTGS signal.
Non‐invasive imaging of oxygen concentration in a complex in vitro biofilm infection model using 19F MRI: Persistence of an oxygen sink despite prolonged antibiotic therapy

Oxygen availability is a critical determinant of microbial biofilm activity and antibiotic susceptibility. However, measuring oxygen gradients in these systems remains difficult, with the standard microelectrode approach being both invasive and limited to single‐point measurement. The goal of the study was to develop a 19F MRI approach for 2D oxygen mapping in biofilm systems and to visualize oxygen consumption behavior in real time during antibiotic therapy.
Adaptation by Loss of Heterozygosity in Saccharomyces cerevisiae Clones Under Divergent Selection

Loss of heterozygosity (LOH) is observed during vegetative growth and reproduction of diploid genotypes through mitotic crossovers, aneuploidy caused by nondisjunction, and gene conversion. We aimed to test the role that LOH plays during adaptation of two highly heterozygous Saccharomyces cerevisiae genotypes to multiple environments over a short time span in the laboratory. We hypothesized that adaptation would be observed through parallel LOH events across replicate populations. Using genome resequencing of 70 clones, we found that LOH was widespread with 5.2 LOH events per clone after ∼500 generations. The most common mode of LOH was gene conversion (51%) followed by crossing over consistent with either break-induced replication or double Holliday junction resolution. There was no evidence that LOH involved nondisjunction of whole chromosomes. We observed parallel LOH in both an environment-specific and environment-independent manner. LOH largely involved recombining existing variation between the parental genotypes, but also was observed after de novo, presumably beneficial, mutations occurred in the presence of canavanine, a toxic analog of arginine. One highly parallel LOH event involved the ENA salt efflux pump locus on chromosome IV, which showed repeated LOH to the allele from the European parent, an allele originally derived by introgression from S. paradoxus. Using CRISPR-engineered LOH we showed that the fitness advantage provided by this single LOH event was 27%. Overall, we found extensive evidence that LOH could be adaptive and is likely to be a greater source of initial variation than de novo mutation for rapid evolution of diploid genotypes.
Increased risk of sudden death in untreated primary carnitine deficiency

Primary carnitine deficiency (PCD) affects fatty acid oxidation and is associated with cardiomyopathy and cardiac arrhythmia, but the risk of sudden death in PCD is unknown. The Faroe Islands have a high prevalence of PCD, 1:300. This study systematically investigated a possible association between untreated PCD and sudden death in young Faroese subjects. We investigated all medico‐legal cases of sudden death between 1979 and 2012 among subjects below the age of 45. Stored biomaterial was examined with molecular genetic analysis to reveal PCD. We compared the prevalence of PCD among sudden death cases with that of the background population (0.23%) to calculate the odds ratio (OR) for sudden death with PCD. Biomaterial was available and genetically analyzed from 53 of 65 sudden death cases (82%) in the Faroe Islands. Six (one male and five females) of the 53 cases were homozygous for the PCD related c.95A>G mutation—a prevalence of 11.3% (95% CI 5%‐23%) and an OR of 54.3 (95% CI 21‐138, P < .0001) for the association between sudden death and untreated PCD. Only 11 of the 53 sudden death cases were women—of whom five were homozygous for the c.95A>G mutation (45.5%) yielding an OR of 348.8 (95% CI 94‐1287, P < .0001) for the association between sudden death and untreated PCD in females. This study showed a strong association between sudden death and untreated PCD, especially in females.
Extracting Global Shipping Networks from Massive Historical Automatic Identification System Sensor Data: A Bottom-Up Approach

The increasing availability of big Automatic Identification Systems (AIS) sensor data offers great opportunities to track ship activities and mine spatial-temporal patterns of ship traffic worldwide. This research proposes a data integration approach to construct Global Shipping Networks (GSN) from massive historical ship AIS trajectories in a completely bottom-up way. First, a DBSCAN (Density-Based Spatial Clustering of Applications with Noise) algorithm is applied to temporally identify relevant stop locations, such as marine terminals and their associated events. Second, the semantic meanings of these locations are obtained by mapping them to real ports as identified by the World Port Index (WPI). Stop events are leveraged to develop travel sequences of any ship between stop locations at multiple scales. Last, a GSN is constructed by considering stop locations as nodes and journeys between nodes as links. This approach generates different levels of shipping networks from the terminal, port, and country levels. It is illustrated by a case study that extracts country, port, and terminal level Global Container Shipping Networks (GCSN) from AIS trajectories of more than 4000 container ships in 2015. The main features of these GCSNs and the limitations of this work are finally discussed.
'Googling' anaphylaxis.

PURPOSE OF REVIEW Anaphylaxis is a systemic allergic reaction and without the appropriate treatment can progress fast and may be fatal. Information about allergy and immunology topics including anaphylaxis can be easily found online and are widely searched by patients as well as medical personnel. Social media and search engines not only bring a number of benefits to users but also carry risks for breaches of confidentiality and privacy, unprofessional behaviour, malpractice and litigation. Social media use by medical healthcare workers has liability risks and can result in malpractice. RECENT FINDINGS We used PubMed with the terms anaphylaxis; social network; mobile apps that revealed a very small number of publications addressing the use of these platforms and anaphylaxis. Google Trends and KWFinder were used to analyse the relative search interest and absolute search volumes on 'anaphylaxis'. SUMMARY Multiple sources exist on the Internet for health-related searches for both healthcare providers and patients. We analysed different websites, mobile apps, Facebook, YouTube and Twitter. To avoid any posting of patient identifiers, it is imperative to be aware of the 18 HIPAA identifiers. We list websites with accurate information about anaphylaxis for the use of both patients and healthcare professionals for purposes of patient education. Further research on health information-seeking behaviour is clearly needed.
Validity and reliability of an adapted German version of the Student Perceptions of Physician‐Pharmacist Interprofessional Clinical Education Instrument, version 2 (SPICE‐2D)

Evaluation of an interprofessional education (IPE) course at a German university was complicated by the lack of validated German versions of IPE assessment instruments. The objectives of this study were to (1) translate version 2 of the Student Perceptions of Physician‐Pharmacist Interprofessional Clinical Education (SPICE‐2) and (2) test its validity and reliability.