Miracle-dz/UniFAR-FTUs huggingface dataset:
Acquired Lipodystrophy Associated With Nivolumab in a Patient With Advanced Renal Cell Carcinoma.

CONTEXT Lipodystrophy syndromes are rare disorders characterized by the selective loss of adipose tissue. We aimed to report a case of acquired generalized lipodystrophy possibly associated with nivolumab. CASE DESCRIPTION A woman was referred to our Endocrinology Department for uncontrolled diabetes mellitus. At 50 years of age, she was diagnosed with type 2 diabetes after a routine laboratory test and her diabetes was well controlled with low doses of metformin. In 2010, she was diagnosed with clear cell renal carcinoma. The cancer progressed in the following years, leading to the initiation of treatment with nivolumab in 2017. Two months later she presented with facial lipoatrophy, with loss of the buccal fat pads and prominent zygomatic arch. Her neck, shoulders, arms, and buttocks were also affected. Her diabetes control worsened. She received maximal doses of metformin and pioglitazone and was administered 1.5 units/kg/d insulin. Subcutaneous biopsy of medial surface of the arm revealed chronic lobular panniculitis. Despite nivolumab's possible involvement in the onset of lipodystrophy, the maintenance of nivolumab therapy was justified by the observed reduction in the progression of the cancer, combined with the lack of an alternative chemotherapy. The therapy was withdrawn after 8 months of treatment because of grade 3 hepatitis. CONCLUSION Anti-PD1 therapy has great potential. Early recognition of the onset of unusual collateral effects is important to improve decision making regarding the treatment of patients with tumors.
Characteristics and Prognosis of Patients With Moderate Aortic Stenosis and Preserved Left Ventricular Ejection Fraction

Background Moderate aortic stenosis (MAS) has not been extensively studied and characterized, as no published study has been specifically devoted to this condition. Methods and Results We aimed to describe the characteristics of patients with MAS and to evaluate their long‐term survival compared with that of the general population. This study included 508 patients (mean±SD age, 75±11 years) with MAS (aortic valve area between 1 and 1.5 cm2; mean±SD aortic valve area, 1.2±0.15 cm2) and preserved left ventricular ejection fraction. Patients were mostly (86.4%) asymptomatic or minimally symptomatic, 78.3% had hypertension, 36.2% were diabetics, and 48.3% had dyslipidemia. Each patient with MAS was matched for the average survival (per year) of all patients of the same age and same sex from our region (Somme department, north of France). During follow‐up (median 47 months), 113 patients (22.2%) underwent aortic valve replacement for severe AS. The mean±SD time between inclusion and surgery was 37±22 months. During follow‐up, 255 patients (50.2%) died. The 6‐year survival of patients with MAS was lower than the expected survival (53±2% versus 65%). In multivariate analysis, age (hazard ratio, 1.04 [95% CI, 1.02–1.05]; P<0.001), prior atrial fibrillation (hazard ratio, 1.35 [95% CI, 1.05–1.73]; P=0.019), and Charlson comorbidity index (hazard ratio, 1.11 [95% CI, 1.05–1.18]; P=0.002) were associated with increased mortality. Aortic valve replacement was associated with better survival (hazard ratio, 0.38 [95% CI, 0.27–0.54]; P<0.001). Conclusions The results of this study show that patients with MAS present many cardiovascular risk factors, a high rate of surgery during follow‐up, and increased mortality compared with the general population mainly related to associated comorbidities. Patients with MAS should, therefore, be managed for their cardiovascular risk factors and comorbidities. They require close follow‐up, especially when the aortic valve area is close to 1 cm2, as aortic valve replacement performed when patients transition to severe AS and develop indications for surgery during follow‐up is associated with better survival.
Local Strand-Breakage Detection in Multi-Strand Anchorage System Using an Impedance-Based Stress Monitoring Method—Feasibility Study

This study investigates the feasibility of impedance-based stress monitoring method for local-strand breakage detection in multi-strand anchorage systems. Firstly, stress fields of a multi-strand anchorage system are numerically analyzed to examine anchorage’s responses sensitive to local strand breakage. Secondly, an impedance-based stress monitoring technique via the PZT interface is outlined. Thirdly, a novel hoop-type PZT interface is designed for the multi-strands anchorage to monitor the stress variation induced by the strand breakage. Local dynamic responses of the hoop-type PZT interface are analyzed to predetermine the effective frequency ranges. Finally, the numerical feasibility of the proposed method is verified on a seven-strand anchorage system under various strand breakage cases. Variations in impedance responses are statistically quantified, and broken strands are localized by linear tomography analysis of damage indices. A lab-scale experiment is also conducted on a multi-strands anchorage to evaluate the realistic performance of the hoop PZT interface for impedance-based stress monitoring method.
Similar Anaerobic and Aerobic Adaptations After 2 High-Intensity Interval Training Configurations: 10:5 s vs. 20:10 s Work-to-Rest Ratio

Abstract Moghaddam, M, Estrada, CA, Muddle, TWD, Magrini, MA, Jenkins, NDM, and Jacobson, BH. Similar anaerobic and aerobic adaptations after 2 high-intensity interval training configurations: 10:5 s vs. 20:10 s work-to-rest ratio. J Strength Cond Res 35(6): 1685–1692, 2021—This study compares the effects of 2 high-intensity interval training (HIIT) configurations, a 10-5 vs. a 20-10 second work-to-rest ratio, on anaerobic and aerobic performance. Thirty-four individuals were randomly assigned to 10-5-HIIT (n = 17) and 20-10-HIIT (n = 17) groups to complete 6 cycles of 6 exercises, 3 days a week for 4 weeks. The 10-5-HIIT was performed with 10 s:5 s work-to-rest ratio with 1-minute recovery between cycles, while the 20-10-HIIT was performed with 20 s:10 s work-to-rest ratio followed by a 2-minute recovery. Anaerobic (i.e., peak power [PP], anaerobic capacity [AC], anaerobic power [AP], and total work [TW]) and aerobic fitness (i.e., time to exhaustion [TE], absolute V̇o2max [A-V̇o2max], relative V̇o2max [R-V̇o2max]) were measured with pre-training and post-training intervention. A significant main effect time was observed for both 10-5-HIIT and 20-10-HIIT (p < 0.05) in PP (9.2%, 5.7%); AC (14.9%, 8.6%); AP (9.0%, 6.2%); TW (15.1%, 8.5%); TE (4.3%, 5.5%); A-V̇o2max (9.4%, 8.9%); R-V̇o2max (8.5%, 8.2%), respectively. In conclusion, individuals may be able to achieve similar health benefits as 20-10-HIIT by performing 10-5-HIIT, despite exercising for 50% less total time. High-intensity interval training has been suggested as a “time-efficient” mode of exercise that can mitigate the most significant barrier to physical activity, “lack of time. ” Both 10-5-HIIT and 20-10-HIIT can induce performance adaptations to a similar extent. However, because of shorter time commitment, performing 10-5-HIIT at 10 s:5 s work-to-rest ratio may offer a shorter and equally efficient interval. Functional fitness training during HIIT protocols seems to be as beneficial as ergometer-based HIIT to improve anaerobic and aerobic performance.
Boost your brain, while having a break! The effects of long-term cognitively engaging physical activity breaks on children’s executive functions and academic achievement

Classroom-based physical activity (PA) is gaining attention in terms of its potential to enhance children’s cognitive functions, but it remains unclear as to which specific modality of PA affects cognitive functions most. The aim of the study was to examine the effects of qualitatively different PA breaks on children’s cognitive outcomes. Children (N = 142) aged between 7 and 9 years were allocated to a 20-week classroom-based PA program, with either high physical exertion and high cognitive engagement (combo group), high physical exertion and low cognitive engagement (aerobic group), or low physical exertion and high cognitive engagement (cognition group). Executive functions (updating, inhibition, shifting) and academic achievement (mathematics, spelling, reading) were measured pre- and post-intervention. Results showed that the combo group profited the most displaying enhanced shifting and mathematic performance. The cognition group profited only in terms of enhanced mathematic performance, whereas the aerobic group remained unaffected. These results suggest that the inclusion of cognitively engaging PA breaks seem to be a promising way to enhance school children’s cognitive functions.
Classification of suspicious lesions on prostate multiparametric MRI using machine learning

Abstract. We present a radiomics-based approach developed for the SPIE-AAPM-NCI PROSTATEx challenge. The task was to classify clinically significant prostate cancer in multiparametric (mp) MRI. Data consisted of a “training dataset” (330 suspected lesions from 204 patients) and a “test dataset” (208 lesions/140 patients). All studies included T2-weighted (T2-W), proton density-weighted, dynamic contrast enhanced, and diffusion-weighted imaging. Analysis of the images was performed using the MIM imaging platform (MIM Software, Cleveland, Ohio). Prostate and peripheral zone contours were manually outlined on the T2-W images. A workflow for rigid fusion of the aforementioned images to T2-W was created in MIM. The suspicious lesion was outlined using the high b-value image. Intensity and texture features were extracted on four imaging modalities and characterized using nine histogram descriptors: 10%, 25%, 50%, 75%, 90%, mean, standard deviation, kurtosis, and skewness (216 features). Three classification methods were used: classification and regression trees (CART), random forests, and adaptive least absolute shrinkage and selection operator (LASSO). In the held out by the organizers test dataset, the areas under the curve (AUCs) were: 0.82 (random forests), 0.76 (CART), and 0.76 (adaptive LASSO). AUC of 0.82 was the fourth-highest score of 71 entries (32 teams) and the highest for feature-based methods.
Effect of Leaf Wetness Duration, Temperature, and Conidial Inoculum Dose on Apple Scab Infections.

Apple seedlings (2 months old, 'Idared' × 'Golden Delicious') were inoculated with conidia of Venturia inaequalis in order to study the effects of inoculum dose and leaf wetness duration on development of apple scab symptoms. For each experiment, the C3 curve (indicating heavy infection levels) was used as the basis for relating infection to temperature and leaf wetness duration. In one series of experiments, seedlings were treated with inoculum doses of 1.5, 5.4, 15.6, 32.2, 81.2, and 250 × 103 conidia/ml and leaves were kept wet during C3 infection periods at temperatures of 6, 11, 16, and 22°C. At all four temperatures, disease incidence (scab lesions/plant) increased with increasing inoculum doses up to about 81.2 × 103 conidia/ml. Disease incidence was lower at 22°C than at the other temperatures. In a second series of experiments, seedlings inoculated with 10 × 103 conidia/ml were kept moist for infection periods ranging from 0.6 to 2.0 times the C3 leaf wetness duration curve at 6, 11, 16, and 22°C. Disease incidence increased with increasing duration of leaf wetness and generally leveled off between 150 and 200% of the C3 curve. At this inoculum dose (10 × 103 conidia/ml), doubling the leaf wetness duration indicated by the C3 curve resulted in high disease incidence, similar to levels obtained with a higher inoculum (250 × 103 conidia/ml) and shorter wetness period (1.0 C3).
Resolving Age-Related Differences in Working Memory: Equating Perception and Attention Makes Older Adults Remember as Well as Younger Adults

ABSTRACT Objectives: Older adults show clear deficits in working memory functioning. Here, we investigate the often-reported decline in focus switching, that is, the ability to shift items from the focus of attention into working memory, and back. Specifically, we examined whether equating subjects on early processing (perception and attention) might ameliorate the deficit. Method: We examined 1-Back and 2-Back performance in younger and older adults, with line segments of different orientation as the stimuli. Stimuli were calibrated depending on each individual’s 75% threshold for 1-Back performance. Subjects made match/mismatch judgments. Results: After the calibration on 1-Back performance, no age-related differences were found on either accuracy or sensitivity in the 2-Back task. Additionally, when investigating focus-switch trials versus non-focus-switch trials in a random-order 2-Back task, older adults were more efficient at switching the focus of attention than younger adults. Discussion: These results provide evidence for the view that age-related limitations in focus switching in working memory are caused (at least in part) by changes in early processing (perception and attention), suggesting that (at least some of the) age-related differences in working memory functioning may be due to shifts in trade-off between early processing and memory-related processing.
Effects of soy protein and isoflavones on glycemic control and insulin sensitivity: a 6-mo double-blind, randomized, placebo-controlled trial in postmenopausal Chinese women with prediabetes or untreated early diabetes.

BACKGROUND In vitro and animal studies have suggested that soy protein and isoflavones have favorable effects on glucose and insulin regulation, but intervention studies in humans are limited, and the results are controversial. OBJECTIVE We investigated whether soy protein with isoflavones and soy isoflavone extracts could improve glycemic control and insulin sensitivity in postmenopausal women with early hyperglycemia. DESIGN This was a randomized, double-blind, placebo-controlled trial that included 180 postmenopausal Hong Kong Chinese women with prediabetes or early untreated diabetes. After a 2-wk adaptation period, participants were randomly assigned to 1 of 3 arms to receive 15 g soy protein and 100 mg isoflavones, 15 g milk protein and 100 mg isoflavones, or 15 g milk protein on a daily basis for 6 mo. RESULTS Three- or 6-mo treatments with soy protein with or without isoflavone supplementation did not result in favorable changes in the descriptors for glycemic control and insulin resistance, namely fasting and 2-h postload glucose, fasting and postload insulin, glycated serum protein, and homeostasis model assessment for insulin resistance and beta-cell function. CONCLUSIONS This 6-mo randomized controlled trial did not support the hypothesis that soy protein with or without isoflavone supplementation had favorable effects on glycemic control and insulin sensitivity among postmenopausal Chinese women. The favorable change in postload glucose needs to be further confirmed.
Species delimitation in the lichenized fungal genus Vulpicida (Parmeliaceae, Ascomycota) using gene concatenation and coalescent-based species tree approaches.

UNLABELLED • PREMISE OF THE STUDY Species boundaries in many organism groups are still in a state of flux, and for empirical species delimitation, finding appropriate character sets and analytical tools are among the greatest challenges. In the lichenized fungal genus Vulpicida, six morphologically circumscribed species have been distinguished, but phenotypic characters partly overlap for three of these and intermediate forms occur. We used a combination of phylogenetic strategies to delimit the species in this genus. • METHODS Five DNA loci were sequenced and analyzed. Single-locus gene trees and a five-locus concatenated phylogeny were constructed to assess current Vulpicida species. Species boundaries were inferred from molecular data using two coalescent-based species delimitation methods (BP&P and Brownie) and from species trees reconstructed with three different algorithms (*BEAST, BEST, and STEM). • KEY RESULTS The two species restricted to North America, Vulpicida canadensis and V. viridis, are clearly distinct in all analyses. The four other traditionally accepted species form two strongly supported, closely related species-level lineages within the core group of the genus. On the basis of these results, we propose four instead of the current six species in the genus: V. canadensis, V. juniperinus, V. pinastri, and V. viridis, while V. tilesii and V. tubulosus are reduced to synonymy under V. juniperinus. • CONCLUSIONS Coalescent species delimitation and tree inference give consistent results for fully distinct Vulpicida species but not for diverging populations. Even the inconsistent results were informative, revealing developing isolation despite a complex history of recombination and incomplete lineage sorting.
UPA effects on endometrium - what is the significance?

INTRODUCTION Selective progesterone receptor modulators (SPRMs), such as Mifepristone, Asoprisnil, Ulipristal acetate (UPA) and Vilaprisan, were tested for their antiproliferative effects on uterine fibroids. In Romania, despite the UPA availability, physicians remained reserved on the lack of experience and concerns about the safety of the drug on endometrium. PATIENTS, MATERIALS AND METHODS We performed an observational study on premenopausal women with symptomatic uterine fibroids. The patients received UPA in doses of 5 mg for 12-13 weeks. The fibroids dimensions and endometrium thickness were recorded at before and after the treatment. The pathological samples were assessed by two pathologists, and they recorded progesterone receptor modulator associated endometrial changes (PAEC) as extensive PAEC (EPAEC), minimally PAEC (MPAEC), absent PAEC (APAEC) and Ki67 immunoexpression in endometrium. RESULTS A number of 57 women were introduced in our study and we had a dropout of one patient. The fibroid dimensions and endometrial thickness decreased after UPA. The pathological exam of the endometrium revealed: APAEC in 26.8% of cases, MPAEC in 60.7% of cases and EPAEC in 12.5% of cases. EPAEC were more frequent in patients with larger fibroids. PAEC had a strong correlation with Ki67 index (p≤0.01). PAEC were more frequent in older women (p≤0.01). Ki67 had a higher expression in EPAEC - mean: 69% (range: 63-75%), standard deviation (SD): 3.95. CONCLUSIONS UPA treatment decreased fibroids dimension and improved patients' symptoms in our study. EPAEC was associated with abundant Ki67 antigen. UPA administration for three months is a safe method without endometrial atypia but longer protocols require extended studies about the proliferative potential of the endometrium.
The Trouble With Burnout: An Update on Burnout-Depression Overlap.

TO THE EDITOR: Drs. Messias and Flynn (1) wrote in the August 2018 issue of the Journal that “depression and burnout appear to be distinct constructs, the former being categorical and the latter dimensional” (p. 718). On this basis, the authors made suggestions for differentiating burnout from depression in clinical practice. The recommendations of the authors may benefit from additional data addressing the depression-burnout overlap. First, reducing depression to its clinical stage—to a nosological category—is unwarrantedwhen examining the burnoutdepression distinction. Indeed, there is strong evidence that depression is a dimensional phenomenon (2, 3). Clinical depression reflects the high end of the depression continuum, not the entire depression continuum. The reduction of depression to its clinical stage is therefore an amputation of the depression phenomenon. Such an amputation impedes investigators’ ability to consistently compare depression and burnout because burnout is typically treated dimensionally. Second, recent factor analytic studies of burnout and depression measures indicate that the discriminant validity of the burnout construct is not satisfactory (3, 4). These studies relied on advanced factor analytic techniques. Third, exhaustion—the core and only consensual characteristic of burnout—has been repeatedly found to correlate more strongly with depression (including anhedonia and depressed mood) than with the two other components of burnout (cynicism and professional inefficacy). Following the commonly accepted definition that a syndrome is a combination of co-occurring symptoms, there is no reason to consider burnout a syndrome of exhaustion, cynicism, and professional inefficacy rather than a depressive syndrome. Interestingly, DSM-5 underlines that “[o]ften insomnia or fatigue is the presenting complaint [in depression]” (p. 162). Fourth, the authors listed putative differences between burnout and depression (e.g., in terms of self-esteem) based on speculations rather than on well-established empirical findings. Fifth, the notion that burnout is a useful construct because it allows investigators to examine work-induced symptoms is misleading. There is evidence that general factors such as neuroticism explain more variance in burnout than occupational-level factors, that burnout involves contextfree functional alterations, and that burnout and depressive symptoms are subjectively attributed to work to a similar extent (3–5). Innovative approaches to psychopathology, such as the Research Domain Criteria project, should be helpful in the quest to best understand depressive symptoms in response to unresolvable stress (3, 6–7).
Pollen reverses decreased lifespan, altered nutritional metabolism and suppressed immunity in honey bees (Apis mellifera) treated with antibiotics

ABSTRACT Nutrition is involved in regulating multiple aspects of honey bee biology such as caste, immunity, lifespan, growth and behavioral development. Deformed wing virus (DWV) is a major pathogenic factor which threatens honey bee populations, and its replication is regulated by the nutrition status and immune response of honey bees. The alimentary canal of the honey bee is home to a diverse microbial community that provides essential nutrients and serves to bolster immune responses. However, to what extent gut bacteria affect honey bee nutrition metabolism and immunity with respect to DWV has not been investigated fully. In this study, newly emerged worker bees were subjected to four diets that contained (1) pollen, (2) pollen and antibiotics, (3) neither pollen nor antibiotics or (4) antibiotics alone. The expression level of two nutrition genes target of rapamycin (tor) and insulin like peptide (ilp1), one nutritional marker gene vitellogenin (vg), five major royal jelly protein genes (mrjp1–5), one antimicrobial peptide regulating gene relish (rel), and DWV virus titer and its replication intermediate, negative RNA strand, were determined by qRT-PCR from the honey bees at 7 days post-antibiotic treatment. Additionally, honey bee head mass and survival rate were measured. We observed that antibiotics decreased the expression of tor and rel, and increased DWV titer and its replication activity. Expression of ilp1, mrjp1–5 and vg, and honey bee head mass were also reduced compared with bees on a pollen diet. Antibiotics also caused a significant drop in survivorship, which could be rescued by addition of pollen to the diet. Of importance, pollen could partially rescue the loss of vg and mrjp2 while also increasing the head mass of antibiotic-treated bees. Our results illuminate the roles of bacteria in honey bee nutrition, metabolism and immunity, which confer the ability to inhibit virus replication, extend honey bee lifespan and improve overall health. Highlighted Article: Bacteria in pollen confer the ability to inhibit virus replication, extend lifespan and improve overall health in honey bees treated with antibiotics.