Miracle-dz/UniFAR-FTUs huggingface dataset:
Outbreak of Vancomycin-resistant Enterococcus faecium in Interventional Radiology: Detection Through Whole Genome Sequencing-Based Surveillance.

BACKGROUND Vancomycin-resistant enterococci (VRE) are a major cause of hospital-acquired infections. The risk of infection from interventional radiology (IR) procedures is not well documented. Whole genome sequencing (WGS) surveillance of clinical bacterial isolates among hospitalized patients can identify previously-unrecognized outbreaks. METHODS We analyzed WGS surveillance data from November 2016 to November 2017 for evidence of VRE transmission at our hospital. A previously-unrecognized cluster of ten genetically-related VRE (Enterococcus faecium) infections was discovered. Electronic health record review identified IR procedures as a potential transmission route. An outbreak investigation was conducted, which included a matched case-control study. RESULTS Of the ten patient VRE infections, nine had undergone an IR procedure with intravenous (IV) contrast ≤22 days before infection. In the matched case-control study, preceding IR procedure and IR procedure with contrast were associated with VRE infection (matched odds ratio 16.72, 95% CI 2.01 to 138.73 and p=0.009; MOR=39.35, 95% CI 7.85 to infinity, p<0.001, respectively). Investigation of IR practices and review of the manufacturer's training video revealed sterility breaches in contrast preparation. Our investigation also supported possible transmission from an IR technician. Infection prevention interventions were implemented and no further IR-associated VRE transmissions have been observed. CONCLUSIONS A prolonged outbreak of VRE infections related to IR procedures with IV contrast resulted from non-sterile preparation of injectable contrast. The fact that our VRE outbreak was discovered through WGS surveillance and the manufacturer's training video demonstrating non-sterile technique raise the possibility that infections following invasive IR procedures may be more common than previously recognized.
Concise Review: Challenges in Clinical Development of Mesenchymal Stromal/Stem Cells.

Identified 50 years ago, mesenchymal stromal/stem cells (MSC) immediately generated a substantial interest among the scientific community because of their differentiation plasticity and hematopoietic supportive function. Early investigations provided evidence of a relatively low engraftment rate and a transient benefit for challenging congenital and acquired diseases. The reasons for these poor therapeutic benefits forced the entire field to reconsider MSC mechanisms of action together with their ex vivo manipulation procedures. This phase resulted in advances in MSCs processing and the hypothesis that MSC-tissue supportive functions may be prevailing their differentiation plasticity, broadening the spectrum of MSCs therapeutic potential far beyond their lineage-restricted commitments. Consequently, an increasing number of studies have been conducted for a variety of clinical indications, revealing additional challenges and suggesting that MSCs are still lagging behind for a solid clinical translation. For this reason, our aim was to dissect the current challenges in the development of still promising cell types that, after more than half a century, still need to reach their maturity. Stem Cells Translational Medicine2019.
Difficulties adapting to Nail‐Patella syndrome: A qualitative study of patients' perspectives

Nail‐Patella syndrome (NPS) is a genetic disorder generating physical malformations and, in approximately one in three cases, ocular and renal damage. The present research aimed to deeply understand patients' subjective experience with NPS, particularly the aspects of the syndrome that affect patients' adaptation and to propose interventions that can improve genetic and psychological counseling and help patients cope with their condition. Semi‐structured interviews of nine people diagnosed with NPS were analyzed using interpretative phenomenological analysis. Results highlighted attempts to look like a person without disabilities by hiding malformations and not telling the truth about symptoms' genetic origin because of patients' poor self‐esteem, negative self‐cognition, and social isolation experienced from childhood to adulthood. Difficulties of adaptation to physical limits and pain were also identified. The majority of participants who were not diagnosed at birth tended to consider physical symptoms as “birth malformations” without imagining other potential implications until receiving a diagnosis. Despite the diagnosis, the majority continued to minimize the potential complications by considering NPS as a “physical difference” and not adhering to medical surveillance.
Temporal patterns of diversification in Brassicaceae demonstrate decoupling of rate shifts and mesopolyploidization events.

BACKGROUND AND AIMS Whole-genome duplication (WGD) events are considered important driving forces of diversification. At least 11 out of 52 Brassicaceae tribes had independent mesopolyploid WGDs followed by diploidization processes. However, the association between mesopolyploidy and subsequent diversification is equivocal. Herein we show the results from a family-wide diversification analysis on Brassicaceae, and elaborate on the hypothesis that polyploidization per se is a fundamental driver in Brassicaceae evolution. METHODS We established a time-calibrated chronogram based on whole plastid genomes comprising representative Brassicaceae taxa and published data spanning the entire Rosidae clade. This allowed to set multiple calibration points and anchored various Brassicaceae taxa for subsequent downstream analyses. All major splits among Brassicaceae lineages were used in BEAST analyses of individually analysed 48 tribes comprising 2101 taxa in total using the internal transcribed spacers of nuclear ribosomal DNA. Diversification patterns were investigated on these tribe-wide chronograms using BAMM and were compared with family-wide data on genome size variation and species richness. KEY RESULTS Brassicaceae diverged 29.9 Mya during the Oligocene, and the majority of tribes started diversification in the Miocene with an average crown group age of about 12.5 Mya. This matches the cooling phase right after the Mid Miocene climatic optimum. Significant rate shifts were detected in 12 out of 52 tribes during the Mio- and Pliocene, decoupled from preceding mesopolyploid WGDs. Among the various factors analysed the combined effect of tribal crown group age and net diversification rate (speciation minus extinction) is likely to explain sufficiently species richness across Brassicaceae tribes. CONCLUSIONS The onset of the evolutionary splits among tribes took place under cooler and drier conditions. Pleistocene glacial cycles may have contributed to the maintenance of high diversification rates. Rate shifts are not consistently associated with mesopolyploid WGD. We propose, therefore, that WGDs in general serve as a constant "pump" for continuous and high species diversification.
How does the modern football goalkeeper train? – An exploration of expert goalkeeper coaches’ skill training approaches

ABSTRACT The football goalkeeper position arguably represents a unique role within the team sport. Despite its highly complex skill demands, research on football goalkeeping has only sporadically examined the position within isolated and limited parameters. In particular, there is limited literature on “modern” skill acquisition training methods and approaches within the field of goalkeeper training. In a cross-cultural study with fifteen expert goalkeeper coaches, researchers here examined the overarching research question of “how does the modern football goalkeeper train? ”. Semi-structured interviews explored expert coaches’ views on critical skills for performance in goalkeeping and the training approaches used to develop these critical skills. Results indicate that four skill sets are considered essential by goalkeeper coaches, these are: decision-making skills, athleticism, mentality, and technical skills. In terms of developing these skills in goalkeeper-specific training, the majority of expert coaches apply a similar microstructure to training sessions. This structure involves a steady progression from simple to complex training tasks, where for large parts, isolated technical training appears to be prioritised over a holistic training approach that integrates technical skills and perceptual-cognitive components (e.g., decision making). Scientific and practical recommendations for researchers and practitioners in the field of football goalkeeper coaching are provided.
Variations in sleep associated with different types of hormonal contraceptives

Abstract Progesterone and some of its metabolites are neuroactive steroids that affect sleep by increasing melatonin secretion and stimulating GABA-A receptors. The effect of progestogens in hormonal contraceptives on sleep has not been thoroughly investigated. This observational study assessed possible associations in sleep changes induced by estrogen–progestogens in contraceptives in 108 women between the ages of 20 and 50 years. We assessed mean nightly sleep time with a 31-day sleep diary, and subjective sleep quality with the five subjective subscores of the Pittsburgh Sleep Quality Index (PSQI). Included women were of childbearing age, healthy, sexually active and had been using a hormonal contraceptive method (pill, intrauterine system (IUS), subcutaneous implant, vaginal ring) for at least six months. Results were compared to a matched control group that did not use hormonal contraceptives. The longest mean nightly sleep time, compared to control (450 min), occurred in women who used progestogen-only oral contraception (510 min), followed by IUS delivery of levonorgestrel 13.5 mg (480 min) and oral ethinylestradiol 0.02/0.03 mg plus gestodene 0.075 mg (475 min). Global subjective sleep quality was influenced most by the administration of etonorgestrel 0.120 mg/ethinylestradiol 0.015 mg via the vaginal route. Our results show that low-doses of progestins affect various aspects of sleep, and that this is influenced by the route of administration.
Out-of-hospital cardiac arrests in a large metropolitan area: synergistic effect of exposure to air particulates and high temperature

Aims Air pollution and climate change are intrinsically linked to emerging hazards for global health. High air particulate matter (PM) levels may trigger out-of-hospital cardiac arrest (OHCA). High temperature could act synergistically with PM in determining OHCA. The aim of the present study was to investigate the effect of PM exposure alone, and in combination with temperature, on the risk of OHCA, in a large European metropolitan area with population >4 million. Methods We evaluated the association between short-term PM exposure, temperature, and the risk of OHCA over a two-year study period, allowing us to investigate 5761 events using a time-stratified case-crossover design combined with a distributed lag non-linear model. Results Higher risk of OHCA was associated with short-term exposure to PM10. The strongest association was experienced three days before the cardiac event where the estimated change in risk was 1.70% (0.48–2.93%) per 10 µg/m3 of PM. The cumulative exposure risk over the lags 0–6 was 8.5% (0.0–17.9%). We observed a joint effect of PM and temperature in triggering cardiac arrests, with a maximum effect of 14.9% (10.0–20.0%) increase, for high levels of PM before the cardiac event, in the presence of high temperature. Conclusion The present study helps to clarify the controversial role of PM as OHCA determinant. It also highlights the role of increased temperature as a key factor in triggering cardiac events. This evidence suggests that tackling both air pollution and climate change might have a relevant impact in terms of public health.
Suppression of the innate cancer-killing activity in human granulocytes by stress reaction as a possible mechanism for affecting cancer development

Abstract Psychological stress may be linked to cancer incidence; however, more direct evidence is required to support this viewpoint. In this study, we investigated the effects of stress on immunosurveillance against cancer cells using a previously established examination stress model. We showed that the cancer killing activity (CKA) of granulocytes (also known as polymorphic nuclear cells, PMNs) is sharply reduced during examination stress stimulation in some donors who are psychologically sensitive to examination stress, with the concentration of plasma stress hormones (cortisone, epinephrine, and norepinephrine) increasing accordingly. The effects of stress hormones on immune cell CKA were also investigated under two in vitro co-incubation conditions, with all three hormones found to exert inhibitory effects on the CKA of PMNs and mononuclear cells. We showed that stress triggered the release of stress hormones which had profound inhibitory effects on the innate anticancer functions of PMNs. These results provide a possible explanation for the relationship between psychological stress and cancer incidence.
Novel oral transforming growth factor‐β signaling inhibitor potently inhibits postsurgical adhesion band formation

Here, we have investigated the therapeutic potency of EW‐7197, a transforming growth factor‐β type I receptor kinase inhibitor, against postsurgical adhesion band formation. Our results showed that this pharmacological inhibitor prevented the frequency and the stability of adhesion bands in mice model. We have also shown that downregulation of proinflammatory cytokines, reduce submucosal edema, attenuation of proinflammatory cell infiltration, inhibition of oxidative stress, decrease in excessive collagen deposition, and suppression of profibrotic genes at the site of surgery are some of the mechanisms by which EW‐7197 elicits its protective responses against adhesion band formation. These results clearly suggest that EW‐7197 has novel therapeutic properties against postsurgical adhesion band formation with clinically translational potential of inhibiting key pathological responses of inflammation and fibrosis in postsurgery patients.
A prophage and two ICESa2603-family integrative and conjugative elements (ICEs) carrying optrA in Streptococcus suis.

OBJECTIVES To investigate the presence and transfer of the oxazolidinone/phenicol resistance gene optrA and identify the genetic elements involved in the horizontal transfer of the optrA gene in Streptococcus suis. METHODS A total of 237 S. suis isolates were screened for the presence of the optrA gene by PCR. Whole-genome DNA of three optrA-positive strains was completely sequenced using the Illumina MiSeq and Pacbio RSII platforms. MICs were determined by broth microdilution. Transferability of the optrA gene in S. suis was investigated by conjugation. The presence of circular intermediates was examined by inverse PCR. RESULTS The optrA gene was present in 11.8% (28/237) of the S. suis strains. In three strains, the optrA gene was flanked by two copies of IS1216 elements in the same orientation, located either on a prophage or on ICESa2603-family integrative and conjugative elements (ICEs), including one tandem ICE. In one isolate, the optrA-carrying ICE transferred with a frequency of 2.1 × 10-8. After the transfer, the transconjugant displayed elevated MICs of the respective antimicrobial agents. Inverse PCRs revealed that circular intermediates of different sizes were formed in the three optrA-carrying strains, containing one copy of the IS1216E element and the optrA gene alone or in combination with other resistance genes. CONCLUSIONS A prophage and two ICESa2603-family ICEs (including one tandem ICE) associated with the optrA gene were identified in S. suis. The association of the optrA gene with the IS1216E elements and its location on either a prophage or ICEs will aid its horizontal transfer.
Morphological and molecular analyses reveal two new insular species of Cnemaspis Strauch, 1887 (Squamata, Gekkonidae) from Satun Province, southern Thailand

Abstract We describe two new insular gecko species of the genus Cnemaspis from Tarutao, Adang, and Rawi islands in Satun Province, southern Thailand. The new species are distinguished from their congeners in having a unique combination of morphological, scalation, and color pattern characters, and by genetic divergence in the mitochondrial NADH dehydrogenase subunit 2 (ND2) gene. Cnemaspistarutaoensissp. nov. was found to be a member of the C.kumpoli group, but is distinguished from all other species in that group by having 8–9 supralabials and 8 infralabials; 4–5 pore-bearing precloacal scales, pores rounded; 17–19 paravertebral tubercles randomly arranged; 27–29 subdigital lamellae under the fourth toe; subcaudal region yellowish, with smooth scales and a single enlarged median row; black gular markings in males and females; and 17.24–22.36% uncorrected pairwise sequence divergences. Cnemaspisadangrawisp. nov. was found to be a member of the C.siamensis group, but is distinguished from all other species in that group by having 10 supralabials and 9 infralabials; 6–8 pore-bearing precloacal scales, pores rounded and arranged in a chevron shape; 23–25 randomly arranged, separated paravertebral tubercle rows; 26–28 subdigital lamellae under the fourth toe; subcaudal scales keeled, without enlarged median row; gular region, abdomen, limbs and subcaudal region yellowish in males only; gular marking absent in males and females; and 8.30–26.38 % uncorrected pairwise sequence divergences. Cnemaspistarutaoensissp. nov. occurs in karst formations on Tarutao Island, while Cnemaspisadangrawisp. nov. is found near granitic, rocky streams on Adang and Rawi islands.
Acute Kidney Injury after Cardiac Surgery: Risk Factors and Novel Biomarkers

Acute kidney injury (AKI) is a common and severe complication after cardiac surgery. Currently, a series of novel biomarkers have favored the assessment of AKI after cardiac surgery in addition to the conventional indicators. The biomartkers, such as urinary liver fatty acid binding protein (L-FABP), urinary neutrophil gelatinase-associated lipocalin (NGAL), serum L-FABP, heart-type FABP, kidney injury molecule 1 (KIM-1), and interleukin-18 were found to be significantly higher in patients who developed AKI after cardiac surgery than those who did not. Apart from urinary interleukin-18, the novel biomarkers have been recognized as reliable indicators for predicting the diagnosis, adverse outcome, and even mortality of AKI after cardiac surgery. The timing of the renal replacement therapy is a significant predictor relating to patients’ prognoses. In patients with AKI after cardiac surgery, renal replacement therapy should be performed as early as possible in order to achieve promising outcomes. In children, AKI after cardiac surgery can be managed with peritoneal dialysis. AKI after cardiac surgery has received extensive attention as it may increase early mortality and impact long-term survival of patients as well. The purpose of this article was to analyze the changes of the pertinent biomarkers, to explore the related risk factors leading to the occurrence of AKI after cardiac surgery, and to provide a basis for the clinical prevention and reduction of AKI.
Hypoxic augmentation: the tale of a strange contraction.

Almost fifty years ago, experiments on isolated veins showed that acute hypoxia augments venoconstrictor responses in vitro and that such facilitation relied on anaerobic glycolysis. Over the years, this phenomenon was extended to a number of arterial preparations of different species and revisited, from a mechanistic point of view, with the successive demonstration that it depends on calcium-handling in the vascular smooth muscle cells, is endothelium-dependent, requires the production of nitric oxide (NO) by endothelial nitric oxide synthase (eNOS) and the activation of soluble guanylyl cyclase (sGC). However, rather than the vasodilator cyclic nucleotide 3' ,5' -cyclic guanosine monophosphate (cGMP), its canonical product, the latter enzyme produces 3' ,5' -cyclic inosine monophosphate (cIMP) instead during acute hypoxia; this non-canonical cyclic nucleotide facilitates the contractile process in the vascular smooth muscle cells. This "biased" activity of soluble guanylyl cyclase appears to involve stimulation of NAD(P)H: quinone oxidoreductase 1 (NQO-1). The exact interactions between hypoxia, anaerobic metabolism and NQO-1 leading to biased activity of soluble guanylyl cyclase remain to be established. This article is protected by copyright. All rights reserved.
Up‐regulation of syndecan‐2 in proximal colon correlates with acute inflammation

We previously reported that syndecan‐2 expression is increased on the colonic epithelium during chronic inflammation. Here, we report that syndecan‐2 exhibits a different pattern of site‐specific colonic expression during acute inflammation. Syndecan‐2 expression was up‐regulated predominantly in the proximal colon of dextran sulfate sodium‐induced colitis mice. The colitis‐associated up‐regulation of syndecan‐2 was barely detected in Rag‐1−/− (recombination activating gene 1 knockout) mice under colitis‐inducing conditions. Increased syndecan‐2 expression correlated with increased levels of infiltrated CD4+IL‐17A+ T cells in the proximal colon. Serum levels of IL‐17A were increased during the acute inflammatory response in normal mice but not Rag‐1−/− mice. IL‐17A directly induced IL‐17 receptor (IL‐17RA) and syndecan‐2 expression in ex vivo‐cultured proximal colon tissues and adenoma cell lines from proximal colon. IL‐17RA knockdown reduced the IL‐17A‐mediated syndecan‐2 expression in SNU1235 cells. No elevation of syndecan‐2 or IL‐17RA was observed in colonic tissues from IL‐17A−/− mice during colitis induction. Finally, increased expression of syndecan‐2 and IL‐17RA was observed in the proximal colons of cecal ligation and puncture‐induced sepsis mice and infectious pan colitis patients. Together, these data suggest that acute inflammation induces syndecan‐2 expression predominantly in the proximal colon via IL‐17A‐IL‐17RA signaling during the early stage of the inflammatory response and that proximal colonic syndecan‐2 might be a biomarker for acute inflammation. —Hong, H. , Song, H. ‐K. , Hwang, E. S. , Lee, A. R. , Han, D. S. , Kim, S. ‐E. , Oh, E. ‐S. Up‐regulation of syndecan‐2 in proximal colon correlates with acute inflammation. FASEB J. 33, 11381–11395 (2019). www.fasebj. org