Miracle-dz/UniFAR-FTUs huggingface dataset:
Exaggerated GLP-1 and Blunted GIP Secretion are Associated with Roux-en-Y Gastric Bypass but not Adjustable Gastric Banding

Aim—The Aim of this study was to measure circulating levels of glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), and glucagon in patients who had undergone adjustable gastric banding (BND) or Roux-en-Y gastric bypass (RYGB) in order to understand differences in glucose and insulin regulation after these procedures. Methods—This was a cross-sectional study of three groups of women matched for age and body mass index: 1) overweight controls (OW, n = 13); 2) BND (n = 10); and 3) RYGB (n = 13). Venous blood was drawn in the fasted state and throughout a 3-h period after a liquid meal. Results—Fasting glucose was similar between surgery groups, however, fasting insulin concentrations were greater in BND (10.0 μU/ml) compared with RYGB (6.2 μU/ml; P<0.05). Glucose at 60 minutes was significantly lower in RYGB (70 mg/dl; range 38–82) compared with BND (83 mg/dl; range 63–98). GLP-1 levels at 30 minutes were over three-fold higher in RYGB (96 pmol/l) compared with BND and OW (28 pmol/l) controls. GLP-1 and insulin concentrations correlated at 30 minutes only in RYGB (r=0.66; P=0.013). GIP levels at 30 minutes were lower in RYGB (20 pmol/l) compared with BND (31 pmol/l) and OW (33 pmol/l) controls. Peak glucagon levels were similar between groups. Conclusions/interpretation—Exaggerated postprandial GLP-1 and blunted GIP secretion after RYGB may contribute to greater weight loss and improved glucose homeostasis in comparison to BND.
OP-JNCI190013 531..537

Although recent scientific advances have improved our understanding of basic biological mechanisms underlying chemotherapy-induced peripheral neuropathy (CIPN), few interventions are available to prevent or treat CIPN. Although some biological targets from preclinical studies show promise in nonhuman animal models, few targets have been translated to successful clinical trials. To address this problem, the National Cancer Institute’s Symptom Management and HealthRelated Quality of Life Steering Committee convened a meeting of experts in the CIPN and oncology symptom management fields to participate in a Clinical Trials Planning Meeting (CTPM). Investigators presented data from preclinical and translational studies for possible CIPN interventions; these were evaluated for readiness of randomized clinical trial testing by experts, and recommendations were provided. Breakout sessions were convened to discuss and develop future studies. The CTPM experts concluded that there is compelling evidence to move forward with selected pharmacological and nonpharmacological clinical trials for the prevention and treatment of CIPN. Several key feasibility issues need to be addressed, however. These include identification of optimal outcome measures to define the CIPN phenotype, establishment of parameters that guide the evaluation of clinically meaningful effects, and adoption of approaches for inclusion of translational and biomarker and/or genetic measures. The results of the CTPM provide support for conducting clinical trials that include both pharmacological and nonpharmacological approaches, alone or in combination, with biomarkers, genetics, or other measures designed to inform underlying CIPN mechanisms. Several working groups were formed to design rigorous CIPN clinical trials, the results of which are ongoing. Chemotherapy-induced peripheral neuropathy (CIPN) is a devastating consequence of cancer treatment regimens that include neurotoxic chemotherapeutic agents (eg, taxanes, platinum compounds, vinca alkaloids, proteasome inhibitors) (1). Symptoms of CIPN include some combination of tingling, numbness, stabbing pain, shooting pain, burning, and increased C O M M EN T A R Y Received: October 3, 2018; Revised: January 4, 2019; Accepted: January 25, 2019 Published by Oxford University Press 2019. This work is written by US Government employees and is in the public domain in the US. 531 JNCI J Natl Cancer Inst (2019) 111(6): djz011 doi: 10.1093/jnci/djz011 First published online January 31, 2019
Measuring the effectiveness of a maths learning support centre-The Dublin City University experience

The Maths Learning Centre in Dublin City University opened in February 2004. Its aim is to provide additional; assistance to all undergraduate students taking a mathematics course as part of their degree programme. ; The Centre has the particular remit of addressing student retention by assisting those first year students; who struggle with their mathematics module. To address the effectiveness of the Centre we studied (i) usage; statistics, (ii) student feedback on the Centre, including interviews and (iii) the pass rates of students who; were judged to be at risk of failing their first-year maths module. Under (iii), this cohort was sub-divided; further into students who attended the Centre and those who did not. By comparing the pass rates of these; two groups, we argue that the Centre has made a positive contribution to student retention. This was among; the points made in an ongoing proposal for the permanent establishment of a Maths Learning Centre.
Haemophilus ducreyi Activates Human NK Cells through Interactions with Macrophages and Dendritic Cells

The role of natural killer (NK) cells in the host response to Haemophilus ducreyi is unclear. In pustules obtained from infected human volunteers, there was an enrichment of CD56bright NK cells bearing the activation markers CD69 and HLA-DR compared to peripheral blood. To study the mechanism by which H. ducreyi activated NK cells, we used peripheral blood mononuclear cells from uninfected volunteers. H. ducreyi activated NK cells only in the presence of antigen presenting cells. H. ducreyi-infected monocytes and monocyte-derived macrophages activated NK cells in a contactand IL-18-dependent manner, while monocyte-derived dendritic cells induced NK activation through soluble IL-12. More lesional NK cells produced IFN-γ in response to IL-12 and IL-18 than peripheral blood NK cells. We conclude that NK cells are recruited to experimental lesions and likely are activated by infected macrophages and dendritic cells. IFN-γ produced by lesional NK cells may facilitate phagocytosis of H. ducreyi.
Classification of Myocardial 18F-FDG PET Uptake Patterns Using Deep Learning.

Purpose To perform automated myocardial segmentation and uptake classification from whole-body fluorine 18 fluorodeoxyglucose (FDG) PET. Materials and Methods In this retrospective study, consecutive patients who underwent FDG PET imaging for oncologic indications were included (July-August 2018). The left ventricle (LV) on whole-body FDG PET images was manually segmented and classified as showing no myocardial uptake, diffuse uptake, or partial uptake. A total of 609 patients (mean age, 64 years ± 14 [standard deviation]; 309 women) were included and split between training (60%, 365 patients), validation (20%, 122 patients), and testing (20%, 122 patients) datasets. Two sequential neural networks were developed to automatically segment the LV and classify the myocardial uptake pattern using segmentation and classification training data provided by human experts. Linear regression was performed to correlate findings from human experts and deep learning. Classification performance was evaluated using receiver operating characteristic (ROC) analysis. Results There was moderate agreement of uptake pattern between experts and deep learning (as a fraction of correctly categorized images) with 78% (36 of 46) for no uptake, 71% (34 of 48) for diffuse uptake, and 71% (20 of 28) for partial uptake. There was no bias in LV volume for partial or diffuse uptake categories (P = .56); however, deep learning underestimated LV volumes in the no uptake category. There was good correlation for LV volume (R 2 = 0.35, b = .71). ROC analysis showed the area under the curve for classifying no uptake and diffuse uptake was high (> 0.90) but lower for partial uptake (0.77). The feasibility of a myocardial uptake index (MUI) for quantifying the degree of myocardial activity patterns was shown, and there was excellent visual agreement between MUI and uptake patterns. Conclusion Deep learning was able to segment and classify myocardial uptake patterns on FDG PET images.Keywords: PET, Heart, Computer Aided Diagnosis, Computer Application-Detection/DiagnosisSupplemental material is available for this article. ©RSNA, 2021.
Fluid Spaces in Canine Bone and Marrow1

In order to provide a firm basis for the analysis of experiments on the kinetics of ion and solute exchange in bone, the total water space, extracellular space, and vascular (plasma plus erythrocyte) space in the tibial diaphysis in adult dogs were estimated. Tracers were injected intravenously into 40 dogs after ligation of the renal pedicles. Estimates were made of the volumes of distribution of radioactive tracers of varying characteristics (molecular weight, solubility, and charge), by taking samples of blood, plasma, and bone 3 hr after injection. The volumes of distribution (milliliters per milliliter of cortical bone) were: for tritiated water (a total water marker) 0.245 ± 0.003 (mean ± SD); for [14C]sucrose (an extracellular marker) 0.043 ± 0.001; for 111In-labeled transferrin (a plasma marker) 0.008 ± 0.003; and for red blood cells 0.005 ± 0.002. Interstitial fluid space was estimated by subtracting the estimated plasma space from the estimated extracellular space and it was 0.034 ml/ml of bone. Estimates of haversian canal volumes, obtained morphometrically, were 0.015 ml/ml bone and were compatible with the estimates of the vascular space.
BOTANICAL BRIEFING: PART OF A SPECIAL ISSUE ON MORPHOLOGY AND ADAPTATION

• Background The velamen radicum, a spongy and usually multiple-layered root epidermis composed of dead cells at maturity, is a textbook example of an adaptation that is typically associated with epiphytic orchids. • Scope Based on an extensive literature review, the occurrence of this structure was documented in approximately 240 genera of terrestrial monocotyledons (162 orchid and 74 non-orchid genera) and in one genus of dicotyledons. Mapping this character on a phylogenetic tree reveals that a velamen is found throughout the monocotyledons, ranging from members of early-branching Araceae to derived Cyperaceae. • Conclusion The current depiction of the velamen radicum in angiosperms and its almost exclusive association with the epiphytic lifestyle in orchids is misleading, which inevitably leads to a biased view of its evolution and function. The findings propose a re-evaluation of the occurrence, evolution and function of the velamen radicum in both terrestrial and epiphytic angiosperms.
Splenic irradiation for splenomegaly: a systematic review and meta-analysis

Splenic irradiation (SI) is a palliative treatment option for symptomatic splenomegaly (i.e. for pain, early satiety, pancytopenia from sequestration) secondary to hematologic malignancies and disorders. The purpose of the current article is to review the literature on SI for hematologic malignancies and disorders, including: (1) patient selection and optimal technique; (2) efficacy of SI; and (3) toxicities of SI. PICOS/PRISMA methods are used to select 27 articles including 766 courses of SI for 486 patients from 1960 to 2016. The most common cancers treated included chronic lymphocytic leukemia and myeloproliferative disorders; the most common regimen was 10 Gy in 1 Gy fractions over two weeks, and 27% of patients received retreatment. A partial or complete response (for symptoms, lab abnormalities) was obtained in 85–90% of treated patients, and 30% were retreated within 6–12 months. There was no correlation between biologically equivalent dose of radiation therapy and response duration, pain relief, spleen reduction, or cytopenia improvement (r2 all <0.4); therefore, lower doses (e.g. 5 Gy in 5 fractions) may be as effective as higher doses. Grade 3–4 toxicity (typically leukopenia, infection) was noted in 22% of courses, with grade 5 toxicity in 0.7% of courses. All grade 5 toxicities were due to either thrombocytopenia with hemorrhage or leukopenia with sepsis (or a combination of both); they were sequelae of cancer and not directly caused by SI. In summary, SI is generally a safe and efficacious method for treating patients with symptomatic splenomegaly. Corresponding author: Nicholas G Zaorsky, MD, Department of Radiation Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111-2497, USA. Tel: +1-215-728-2581, Fax: +1-215-214-4038, nicholaszaorsky@gmail.com. *The authors contributed equally to this work Author agreement/declaration: All authors have seen an approved of the final version of this manuscript. This article represents original work that has not been previously published and is otherwise not under consideration for publication. Approval/disclosures: All authors have read and approved the manuscript. We have no financial disclosures. We are not using any copyrighted information, patient photographs, identifiers, or other protected health information in this paper. No text, text boxes, figures, or tables in this article have been previously published or owned by another party. Conflicts of interest: none Content: All figures and tables included are original content developed by the authors. HHS Public Access Author manuscript Cancer Treat Rev. Author manuscript; available in PMC 2020 October 06. Published in final edited form as: Cancer Treat Rev. 2017 February ; 53: 47–52. doi:10.1016/j.ctrv. 2016.11. 016. A uhor M anscript
Complications of Percutaneous Kidney Allograft Biopsy: Systematic Review and Meta-analysis

Background. Kidney biopsy is important to guide the management of allograft dysfunction but has a risk of complications. This review aimed to determine the incidence and risk factors of complications after kidney allograft biopsy. Methods. This is a systematic review and meta-analysis of randomized controlled trials, cohort studies, or case-control studies indexed on PubMed, Embase, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry, and ClinicalTrials.gov, limited to the English language, from January 2000 to December 2020, including adult and pediatric kidney allograft biopsies. Primary outcomes were gross hematuria, bleeding requiring transfusion, and major complications (requiring interventions such as blood transfusion or surgical or radiological interventions). Results. The review included 72 studies (40 082 biopsies). The quality of included studies was suboptimal. Pooled rates of gross hematuria, bleeding requiring transfusion, and major complications were 3.18% [95% confidence interval (95% CI), 2.31-4.19], 0.31% (95% CI, 0.15-0.52) and 0.89% (95% CI, 0.61-1.22), respectively. Gross hematuria rates were lower in high-income compared with middle-income countries (2.59% versus 6.44%, P < 0.01) and biopsies performed by radiology as compared with nephrology departments (1.25% versus 3.71%, P < 0.01). Blood transfusion rates were lower in pediatrics than adults (0.0% versus 0.65%, P < 0.01). Major complications were lower in biopsies performed by specialists as compared with trainees (0.02% versus 3.64%, P < 0.01). Graft loss and mortality were extremely rare. Limitations included missing data, few randomized controlled trials, and possible publication bias. Conclusions. The risk of complications after kidney allograft biopsy was low. Given the low quality of included studies, risk factors for complications should be further examined in future studies.
Chest pain in a pediatric emergency department: clinical assessment and management reality in a third-level Portuguese hospital

Background: Chest pain in children and adolescents is a common complaint in the emergency department (ED), being mostly benign. A thorough patient history and physical examination should be enough in most cases for its proper management. Regarding non-cardiac chest pain, anxiety plays an important role. Methods: Retrospective analysis of all admissions in a pediatric ED of a Portuguese third-level hospital with a chief complaint of chest pain between January and December 2018. Chi-square test was used to compare different etiologies, considering a significance level of 5%. Results: A total of 798 visits were included: 53.6% girls, 80.8% adolescents (mean age: 13years old). According to the Pediatric Canadian Triage and Acuity Scale, 77.7% was prioritized as level IV: less urgent; 65.3% reported associated symptoms including dyspnea (31.8%), cough (18.2%), and palpitations (16.1%). In physical examination, 45.5% had alterations: 62.8% with chest wall tenderness. Further investigation was done in 84% of patients: 62.4% electrocardiograms (altered in 14.7%), 52.6% chest radiographies (altered in 17.1%) and 8.9% cardiac biomarkers (altered in 12.7%). The 3 main causes of chest pain were musculoskeletal (33%), idiopathic (24.4%) and psychogenic (21.6%), with 1.1% of cardiac etiology. Less than 3% needed hospital admission and 18.9% were oriented to an outpatient consultation. 7.1% readmissions reported. When compared to other causes as a group, psychogenic chest pain presented a statistically significant association with female sex, adolescence, psychiatric antecedents, previous stressful event, and normal physical examination. Of these, <30% were oriented to a pedopsychiatry/psychology consultation. Conclusions: Opposing to the low priority level in triage, benign diagnosis found, and low hospital admissions, there was a high percentage of complementary diagnostic tests performed with few altered results. In psychogenic chest pain there was a low postdischarge referral. The authors highlight the importance of clinical algorithms to reduce unnecessary tests performed and readmissions and improve orientation and follow-up, particularly in psychogenic etiology.
The Impact of the Evolving Human Immunodeficiency Virus Response on the Epidemiology of Tuberculosis in South African Children and Adolescents

Received 4 September 2020; editorial decision 25 January 2021; published online 3 February 2021. Correspondence: K. du Preez, Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Parow, 7505, South Africa (karen_dupreez@sun.ac.za). Clinical Infectious Diseases 2021;73(4):e967–75 © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. DOI: 10.1093/cid/ciab095 The Impact of the Evolving Human Immunodeficiency Virus Response on the Epidemiology of Tuberculosis in South African Children and Adolescents
“Drug-resistant tuberculosis and pregnancy: Management and treatment outcomes of 38 cases in Lima, Peru”

Background—Multidrug-resistant tuberculosis (MDR-TB) disproportionately affects young adults, including women of childbearing age; however, treatment of MDR-TB during pregnancy is still controversial. This study looks at the treatment and pregnancy outcomes of a ten-year cohort of women who were treated for MDR-TB during pregnancy. Methods—A retrospective case series was performed using a standardized data collection form and data from three ranked sources of patient records. All 38 participants were treated with individualized regimes which included second-line tuberculosis medications during pregnancy. We examined the frequency of favorable and adverse outcomes in terms of disease and pregnancy. Results—Upon completion of MDR-TB treatment, 61% of the women were cured, 13% died, 13% defaulted, 5% remain in treatment, and 5% failed. Four of the women experienced clinical deterioration of TB during pregnancy. Five of the pregnancies terminated in spontaneous abortions and one child was stillborn. Among the live births, 3 were born with low birth weight, one was premature, and one had fetal distress. Conclusions—The rates of success in treating MDR-TB in our cohort are comparable to those of other MDR-TB treatment programs in Peru. The birth outcomes of our cohort are similar to data on the general Peru population. Therefore, we advocate that a woman should be given the option to continue treatment of MDR-TB rather than termination of pregnancy or discontinuation of MDR-TB treatment. Corresponding author: Eda Palacios, Socios En Salud, Av. Merino Reyna 575, RPB, Carabayllo, Lima, Peru, Phone: 011-511-547-0999, Fax: 011-511-547-2121, epalacios_ses@pih.org; Alternate author: Rebecca Dallman, 571-330-3710, 602 Fairfax Ave, Apt. G, Norfolk, VA 23507, dallmanrd@gmail.com. *co-first authors HHS Public Access Author manuscript Clin Infect Dis. Author manuscript; available in PMC 2016 April 08. Published in final edited form as: Clin Infect Dis. 2009 May 15; 48(10): 1413–1419. doi:10.1086/598191. A uhor M anscript
An introduction to artificial intelligence in sleep medicine

The convergence of large datasets, greater computing power and algorithmic advances has opened the door for AI to be applied across a wide range of industries. In particular, it is the promise of machine learning (ML) which underpins this new potential. ML comprises a versatile range of techniques, from neural networks that can analyse imaging or text, to sophisticated predictive models, and is defined by an ability to ‘learn’ from the data it is shown. Rather than following rules (e.g., “if blood test X is elevated and blood test Y remains static, suggest Z”), a ML algorithm will identify the relevant patterns in the data for performing the task at hand. These techniques excel at identifying complex, nonlinear relationships within large quantities of data and can update their performance as new data are collected. This enables the rapid and scalable development of tools that previously required laborious manual input or were simply not possible. In healthcare, examples where such approaches have matched clinician performance include in the screening of breast cancer (1), identifying colonic polyps (2) and recognising sight-threatening retinal disease (3). In sleep medicine, it has shown promise in supporting the diagnosis of OSA (4-6) and narcolepsy (7), personalising treatment (8) and enhancing pathophysiological understanding.