Miracle-dz/UniFAR-FTUs huggingface dataset:
Characteristics of Upper Limb Osteoarticular Infections at the Emergency Department of a Tertiary University Hospital in Spain

Objectives Osteoarticular infections are infrequent in pediatric patients, although their incidence seems to be increasing. They usually affect children younger than 5 years and tend to localize in the lower limbs. Because of their nonspecific symptoms, especially at onset, a timely diagnosis is difficult to achieve, with the subsequent risk of a delay in treatment. We hereby report the management of osteoarticular infections in our pediatric emergency department. Methods This is a retrospective descriptive study of patients diagnosed with osteoarticular upper limb infection in the pediatric emergency department of a tertiary hospital from January 2011 to December 2016. Results From an initial global sample of 170 patients diagnosed with osteomyelitis or septic arthritis at any location at the pediatric emergency department, 32 children (18.82%) with upper limb involvement were included in the study. Of them, 22 were male and the mean age at diagnosis was 14.5 months (interquartile range, 2–106). Eighteen patients (56%) were diagnosed with septic arthritis, and 14 (44%) had a diagnosis of osteomyelitis. The most frequent symptom was pain (50%). More than one third of patients (11) had received a different diagnosis in a previous hospital visit. A traumatic etiology was suspected in 7 cases (21%). Regarding acute phase reactants, the mean value for C-reactive protein was 21.3 mg/L, and erythrocyte sedimentation rate was elevated in 27 cases (84%). In 28 patients, blood cultures were obtained, 24 of which came back negative. All children received antibiotic treatment and achieved a full recovery. Conclusions One third of patients were misdiagnosed at the first consultation, which stresses the importance of a high clinical suspicion to avoid delays in diagnosis and treatment of osteoarticular infections. This study also shows a lower mean age of children with upper limb infection as compared with those with lower limb infection. All patients recovered fully with oral antibiotics.
Low Pretreatment Viral Loads in Infants With HIV in an Era of High-maternal Antiretroviral Therapy Coverage

Supplemental Digital Content is available in the text. Background: With expansion of antiretroviral therapy (ART) programs, transmission rates are low but new infant infections still occur. We investigated predictors of pre-ART viral load (VL) and CD4+ T-cell counts and percentages in infants diagnosed with HIV at birth in a setting with high coverage of maternal ART and infant prophylaxis. Methods: As part of an early treatment study, 97 infants with confirmed HIV-infection were identified at a hospital in Johannesburg, South Africa. Infant VL and CD4+ T-cell parameters were measured before ART initiation. Data were collected on maternal characteristics, including VL, CD4+ T-cell counts and ART, and infant characteristics, including sex, birth weight, and mode of delivery. Results: Pre-ART, median infant VL was 28,405 copies/mL [interquartile range (IQR): 2515–218,150], CD4+ T-cell count 1914 cells/mm3 (IQR: 1474–2639) and percentage 40.8% (IQR: 32.2–51.2). Most (80.4%) infants were born to mothers who received ART during pregnancy and 97.9% of infants received daily nevirapine prophylaxis until ART initiation at median of 2 days of age (IQR: 1−7). Infant pre-ART VL was more likely to be ≥1000 copies/mL when their mothers had VL ≥1000 copies/mL [Odds Ratio (OR): 6.88, 95% confidence interval (CI): 2.32–20.41] and was higher in boys than girls (OR: 3.29, 95% CI: 1.07–9.95). Lower maternal CD4+ T-cell count (<350 cells/mm3) was associated with lower infant CD4+ T-cell count (<1500 cells/mm3) (OR: 3.59, 95% CI: 1.24–10.43). Conclusions: Pre-ART VL and CD4+ T-cell parameters of intrauterine-infected infants were associated with VL and CD4+ T-cell counts of their mothers. Maternal ART during pregnancy may begin treatment of intrauterine infection and may mask the severity of disease in infected infants identified in the current era with high-maternal ART coverage.
Calmodulin and Munc13 Form a Ca 2 Sensor/Effector Complex that

A second well-known form of STP is STE (Eccles et al. Summary sustained activity, the efficacy of release is increased in STE, but it is unclear whether this is due to increased The efficacy of synaptic transmission between neurons vesicular P r or RRP size or both. STE is critically depen-can be altered transiently during neuronal network dent on increased concentrations of residual Ca 2ϩ activity. This phenomenon of short-term plasticity is ([Ca 2ϩ ] res), which accumulates during action potential ac-a key determinant of network properties; is involved in tivity due to incomplete elimination. According to the many physiological processes such as motor control, original residual Ca 2ϩ hypothesis (Katz and Miledi, 1968), sound localization, or sensory adaptation; and is criti-[Ca 2ϩ ] res was thought to act on the secretory Ca 2ϩ sensor. cally dependent on cytosolic [Ca 2؉ ]. However, the un-However, given the differences in Ca 2ϩ requirements of derlying molecular mechanisms and the identity of the fast neurotransmitter release and STE, additional, high-Ca 2؉ sensor/effector complexes involved are unclear. affinity Ca 2ϩ sensors likely contribute to STE (Zucker We now identify a conserved calmodulin binding site and Regehr, 2002). The identification of such high-affin-in UNC-13/Munc13s, which are essential regulators of ity Ca 2ϩ sensors whose characteristics are compatible synaptic vesicle priming and synaptic efficacy. Ca 2؉ with the Ca 2ϩ dynamics in presynaptic terminals and of sensor/effector complexes consisting of calmodulin molecules that transduce the residual Ca 2ϩ signal to and Munc13s regulate synaptic vesicle priming and the secretory machinery during STE is essential for a synaptic efficacy in response to a residual [Ca 2؉ ] signal mechanistic understanding of STE. and thus shape short-term plasticity characteristics The Munc13 proteins (Munc13-1, the splice isoforms during periods of sustained synaptic activity. bMunc13-2 and ubMunc13-2, and Munc13-3) are candidate mediators of STP (Rosenmund et al., 2002). Genetic Introduction studies in mouse, fly, and nematode have established an essential role for this presynaptic protein family in Neurons transfer information at chemical synapses. In-synaptic vesicle priming and RRP generation (Aravamu-terestingly, synaptic activity does not only transmit infor-dan et al., 1999; Augustin et al., 1999; Richmond et al., mation but also regulates synaptic strength. Such activ-1999). Munc13s regulate the SNARE protein Syntaxin ity-dependent modification of synaptic performance, or (Betz et al., 1997) and promote SNARE complex forma-synaptic plasticity, is essential for information processing, tion and fusion competence of synaptic vesicles …
Small Vessel Disease and Associations with Cerebrospinal Fluid Amyloid, Tau, and Neurodegeneration (ATN) Biomarkers and Cognition in Young Onset Dementia.

BACKGROUND Small vessel disease (SVD) and Alzheimer's disease (AD) frequently coexist; however, it remains unclear how they collectively affect cognition. OBJECTIVE We investigated associations between SVD and AD biomarkers, namely amyloid, tau, and neurodegeneration (ATN) in young onset dementia (YOD) and explored how SVD and ATN interact to affect cognition. METHODS 80 YOD individuals were recruited from a memory clinic. SVD burden (SVD+) was operationalized as a score >1 on the Staals scale and ATN was measured using cerebrospinal fluid (CSF). RESULTS SVD+ was associated with lower CSF Aβ1-42 (B = - 0.20, 95% CI: - 0.32 to - 0.008) and greater neurodegeneration, indexed as lower grey matter (B = - 0.15, 95% CI: - 0.28 to 0.02) and hippocampal volume (B = - 0.24, 95% CI: - 0.40 to - 0.04). SVD+ was not associated with tau. Cognitive impairment was associated with CSF Aβ1-42 (B = - 0.35, 95% CI: - 0.55 to - 0.18) but not SVD. Rather, SVD was indirectly associated with cognition via reduced CSF Aβ1-42, specifically with global cognition (B = - 0.03, 95% CI: - 0.09 to - 0.01) and memory (B = 0.08, 95% CI: - 0.09 to - 0.01). SVD was indirectly associated with cognition via increased neurodegeneration in grey matter (Global cognition: B = - 0.06, 95% CI: - 0.09 to - 0.03; Memory: B = 0.05, 95% CI: 0.01 to 0.18) and the hippocampus (Global cognition: B = - 0.05, 95% CI: - 0.11 to - 0.01; Memory: B = 0.06, 95% CI: 0.01 to 0.17). CONCLUSION In YOD, SVD burden was associated with AD pathology, namely CSF Aβ1-42. SVD indirectly contributed to cognitive impairment via reducing CSF Aβ1-42 and increasing neurodegeneration.
Interrupting Prolonged Sitting and Endothelial Function in Polycystic Ovary Syndrome.

PURPOSE In healthy adults, the impairment of vascular function associated with prolonged sitting can be mitigated with intermittent brief bouts of activity. It is unknown whether these benefits extend to women with polycystic ovary syndrome (PCOS), in whom vascular function is typically impaired and sitting time is high. We examined the acute impact of regularly interrupting sitting time with brief simple resistance activities (SRAs) on vascular function in PCOS. METHODS In a randomized crossover trial, 13 physically inactive women with PCOS (18-45 years) completed two 3.5h conditions: 1) uninterrupted sitting (SIT) and 2) sitting interrupted by 3-min bouts of SRAs every 30 min. Femoral artery flow-mediated dilation (FMD), resting shear rate and resting blood flow were measured at 0h, 1h and 3.5h. RESULTS Mean resting femoral shear rate, averaged across the 3.5h, significantly increased in the SRA condition relative to the SIT condition (40.1 ± 6.1/s vs 62.8 ± 6.1/s, P < 0.0001). In addition, mean resting blood flow also significantly increased across the 3.5h for SRA relative to SIT (45.0 ± 9.8 ml/min vs 72.8 ± 9.9 ml/min, P < 0.0001). There were no differences between conditions in the temporal change in femoral artery FMD across 3.5h (Ptime x condition > 0.05 for all). CONCLUSION Frequently interrupting sitting with SRAs acutely increased resting shear rate and blood flow in women with PCOS, but did not alter FMD. With sedentary behavior increasing in prevalence, longer term studies of similar interventions to reduce and break up sitting time are warranted.
Prevention of Wrong-Level Surgery in the Thoracic Spine: Preoperative Computer Tomography (CT) Fluoroscopy-Guided Percutaneous Gold Fiducial Marker Placement in 57 patients.

STUDY DESIGN Retrospective review OBJECTIVE. : To evaluate the feasibility, safety and complications of computer tomography (CT) fluoroscopy-guided percutaneous transpedicular gold fiducial marker insertion to reduce incidence of wrong level surgery in the thoracic spine. SUMMARY OF BACKGROUND DATA Intraoperative localization of the correct thoracic level can be challenging and time-consuming, especially in obese patients and patients with anatomical variations. In the literature there are very few studies containing low numbers of patients which assessed CT or CT fluoroscopy-guided fiducial marker placement of the thoracic spine. Description of this technique has been similarly scarce. METHODS All patients who underwent percutaneous CT fluoroscopy-guided gold fiducial marker placement of the thoracic spine were retrospectively reviewed. Indications for surgery included degenerative disc disease, infection, spinal metastasis and intra- and extradural tumors. Gold fiducial markers were placed using a percutaneous CT fluoroscopy-guided transpedicular approach with local anesthesia. In addition, sex, age, body mass index (BMI), thoracic level, related pathology and procedure-related complications were also recorded. RESULTS A total of 57 patients (24 female, 33 male) were included. Mean age was 58.6 ± 15.5 years. No complications during CT fluoroscopy-guided gold fiducial marker placement were recorded. Intraoperative localization was successful in all patients. Mean BMI was 32.98 kg/m (range, 18.63 kg/m - 56.03 kg/m), and 63% of patients were obese (>30 kg/m). T7 (n = 11) was the most often marked vertebral body, followed by T10 (n = 10) and T6 (n = 7). The most cranial and most caudal levels marked were T2 and T12, respectively. CONCLUSION Preoperative CT fluoroscopy-guided percutaneous gold fiducial marker placement is safe, feasible and accurate. The resulting facilitated localization of the intended thoracic level of surgery can reduce the length of surgery and prevent wrong-level surgery. Further studies are needed to evaluate in the effect on exposure to radiation and quantify the difference in operating room time. LEVEL OF EVIDENCE 4.
The impact of stressors and overload on informal caregivers of patients with cirrhosis: The first use of the Burden Scale for Family Caregivers in Brazil

Introduction: Cirrhosis affects liver functions and compromises much of the body’s organs. The significant increase in chronic diseases, including cirrhosis, has led to changes in medical practice and health systems, leading the informal caregiver to play a major role because of family ties or some level of proximity to the patient, assuming daily care function. However, the burden generated by informal caregivers for uninterrupted care is present at different levels (physical, mental, social, professional, and financial) and even in the prognosis of the patient. Objective: The present study aims to evaluate the impact of stressors and overload on informal caregivers of cirrhosis patients. Method: Cross-sectional study, conducted with 54 informal caregivers of cirrhosis patients, followed up at the Liver Transplant Service Outpatient Clinic of the University of São Paulo School of Medicine Hospital das Clínicas, where they had access to a sociodemographic questionnaire, history of the patient’s disease and the scale Burden Scale for Family Caregivers. Results: It was observed that higher levels of education and income of the caregiver correlates with a lower degree of stress. In addition, there is a significant difference found in the caregiver’s age variable, which indicates that the youngest are those who have the highest degree of stress. The variable Na mEg/l of the patient also presents a statistically significant difference. Conclusion: Our study was a precursor using the BSFC scale of worldwide coverage and that had not yet been applied in any study in Brazil, thus allowing a look at the various aspects that affect the quality of life of caregivers of patients with cirrhosis. Our results and the literature corroborate the importance not only of the patient, but also the informal caregiver’s health.
Phosphoinositide‐dependent Kinase‐1 (PDPK1) regulates serum/glucocorticoid‐regulated Kinase 3 (SGK3) for prostate cancer cell survival

Prostate cancer (PCa) is the most common malignancy and is the second leading cause of cancer among men globally. Using a kinome‐wide lentiviral small‐hairpin RNA (shRNA) library screen, we identified phosphoinositide‐dependent kinase‐1 (PDPK1) as a potential mediator of cell survival in PCa cells. We showed that knock‐down of endogenous human PDPK1 induced significant tumour‐specific cell death in PCa cells (DU145 and PC3) but not in the normal prostate epithelial cells (RWPE‐1). Further analyses revealed that PDPK1 mediates cancer cell survival predominantly via activation of serum/glucocorticoid‐regulated kinase 3 (SGK3). Knock‐down of endogenous PDPK1 in DU145 and PC3 cells significantly reduced SGK3 phosphorylation while ectopic expression of a constitutively active SGK3 completely abrogated the apoptosis induced by PDPK1. In contrast, no such effect was observed in SGK1 and AKT phosphorylation following PDPK1 knock‐down. Importantly, PDPK1 inhibitors (GSK2334470 and BX‐795) significantly reduced tumour‐specific cell growth and synergized docetaxel sensitivity in PCa cells. In summary, our results demonstrated that PDPK1 mediates PCa cells’ survival through SGK3 signalling and suggest that inactivation of this PDPK1‐SGK3 axis may potentially serve as a novel therapeutic intervention for future treatment of PCa.
Mediating role of depressive symptoms linking insecure attachment and disordered eating in adolescents: A multiwave longitudinal study

Abstract Research has supported a link between insecure attachment and disordered eating in adolescents; however, how this influence is exerted remains unclear. This study explored whether depressive symptoms constitute a pathway through which insecure attachment to parents predicts subsequent development of disordered eating in the transition from childhood to adolescence. The study also examines whether there are differential effects regarding the attachment figure, child's gender, or reciprocity between variables. A community-based sample of Spanish youth (n = 904; 49.4% girls) was followed biennially from age 10 to 16 years. Attachment, depressive symptoms, and disordered eating were measured using the Inventory of Parental and Peer Attachment, Children's Depression Inventory, and Children's Eating Attitudes Test, respectively. Prospective data were analyzed using a dynamic panel model, which accounts for unmeasured time-invariant factors. Whereas insecure attachment to the father did not predict later depression or disordered eating, higher insecure attachment to the mother at ages 10 and 12 years predicted more disordered eating at ages 14 and 16 years via increased depressive symptoms at ages 12 and 14 years. No child's gender-specific or reverse mediational effects were found. This study suggests that an increase in depressive symptoms might be one mechanism by which insecure attachment exerts its influence on the development of eating disorders symptomatology in adolescence. Intervention efforts aimed at strengthening particularly the mother–child attachment relationship may reduce the vulnerability to develop depressive symptoms and disordered eating.
Transport of DNA within cohesin involves clamping on top of engaged heads by Scc2 and entrapment within the ring by Scc3

In addition to extruding DNA loops, cohesin entraps within its SMC-kleisin ring (S-K) individual DNAs during G1 and sister DNAs during S-phase. All three activities require related hook-shaped proteins called Scc2 and Scc3. Using thiol-specific crosslinking we provide rigorous proof of entrapment activity in vitro. Scc2 alone promotes entrapment of DNAs in the E-S and E-K compartments, between ATP-bound engaged heads and the SMC hinge and associated kleisin, respectively. This does not require ATP hydrolysis nor is it accompanied by entrapment within S-K rings, which is a slower process requiring Scc3. Cryo-EM reveals that DNAs transported into E-S/E-K compartments are ‘clamped’ in a sub-compartment created by Scc2’s association with engaged heads whose coiled coils are folded around their elbow. We suggest that clamping may be a recurrent feature of cohesin complexes active in loop extrusion and that this conformation precedes the S-K entrapment required for sister chromatid cohesion.
Always Lost but Never Forgotten: Gas-Phase Wall Losses Are Important in All Teflon Environmental Chambers.

Yields of secondary organic aerosol (SOA) formation from oxidation of volatile organic compounds are measured in laboratory chambers and then applied in regional and global models. Gas-phase losses to large Teflon-walled environmental chambers have been recently shown to reduce SOA yields. Historically, most chambers have operated in batch mode. Increasingly, however, continuous flow (CF) mode is being used, in which reactants and products are continuously introduced and exhausted from the chamber. Recent literature reports indicate a belief that SOA yields measured in CF chambers are not affected by gas-phase wall losses. Here, we use an experimentally-constrained box model to show that gas-phase wall losses impact both types of chambers when run under similar conditions. We find CF experiments do mitigate some effects of gas-phase wall losses after long (> 2 days) experiment run times, but they have significant losses for typical literature experiment times of 1 day. This mitigation phenomenon is experiment and mechanism-dependent, and GWL still affects the absolute SOA yield, however. Finally, we show that limited changes in yield vs. seed surface area do not necessarily indicate whether GWL affects the experiment.
People living with dementia and their family carers’ adherence to home-based Tai Chi practice

Objectives The aim of this study was to understand what influenced people living with dementia and their family carers’ adherence to the home-based component of a Tai Chi exercise intervention. Method Dyads, of people living with dementia and their family carers, who participated in the intervention arm of the Tai Chi for people living with dementia trial, were invited to join weekly Tai Chi classes for 20 weeks and practice at home. Semi-structured dyadic home interviews were conducted on average after 16 weeks of classes. The views of 15 dyads with a range of home practice adherence were sought in semi-structured interviews. The interviews were analysed using an inductive thematic approach. Results Most participants found time to practise Tai Chi at home and practised for 18 hours on average. Amongst the barriers to adherence were participants’ competing commitments and a booklet not sufficiently conveying the Tai Chi movements. Hence, a video or DVD was requested by participants. Facilitators of their adherence to the home-based component of the intervention were their enjoyment of the practice and the development of a habit, which was supported by their commitment to the study and their willingness to benefit from Tai Chi. Conclusion Enjoyment and perceived benefits had a great impact on participants living with dementia and their carers’ adherence to home-based Tai Chi practice. However, difficulties to perceive the Tai Chi movements through images might be hindering sustained participation. Hence, alternative aids such as videos and DVDs should be explored to facilitate adherence.
Osteological description of Pseudopaludicola canga with implications for the taxonomic position of this taxon

Pseudopaludicola canga was described by Giaretta & Kokubum (2003) based on 74 individuals previously assigned to P. mystacalis by Lobo (1995). In the diagnosis of P. canga, the original authors assigned the presence of terminal T-shapedphalanges as a character state for this taxon. However, the osteology of P. canga is not described and the presence of toetips not expanded laterally is a characteristic share with all members of Pseudopaludicola unassigned to any group. In thiswork is describe for first time the osteology of P. canga, re-examining the external morphology providing a new diagnosisand establishing the taxonomic position of P. canga in the framework of phylogenetic hypothesis proposed by Lobo(1995). Additionally, is compared the toe tip digit IV, between P. falcipes and all the species included in the P. pusilla groupand updated the type locality of P. canga. The osteology reveals that P. canga has the toe tips not T-shaped as mentionedby the original authors and this characteristic has important consequences for the diagnosis of the species. Additionally, the erroneous inclusion of P. canga in the P. pusilla group is confirmed by the phylogenetic analysis.