Miracle-dz/UniFAR-FTUs huggingface dataset:
Management of dysphagia and gastroparesis in Parkinson’s disease in real-world clinical practice – Balancing pharmacological and non-pharmacological approaches

Gastrointestinal (GI) issues are commonly experienced by patients with Parkinson’s disease (PD). Those that affect the lower GI tract, such as constipation, are the most frequently reported GI problems among patients with PD. Upper GI issues, such as swallowing dysfunction (dysphagia) and delayed gastric emptying (gastroparesis), are also common in PD but are less well recognized by both patients and clinicians and, therefore, often overlooked. These GI issues may also be perceived by the healthcare team as less of a priority than management of PD motor symptoms. However, if left untreated, both dysphagia and gastroparesis can have a significant impact on the quality of life of patients with PD and on the effectiveness on oral PD medications, with negative consequences for motor control. Holistic management of PD should therefore include timely and effective management of upper GI issues by utilizing both non-pharmacological and pharmacological approaches. This dual approach is key as many pharmacological strategies have limited efficacy in this setting, so non-pharmacological approaches are often the best option. Although a multidisciplinary approach to the management of GI issues in PD is ideal, resource constraints may mean this is not always feasible. In ‘real-world’ practice, neurologists and PD care teams often need to make initial assessments and treatment or referral recommendations for their patients with PD who are experiencing these problems. To provide guidance in these cases, this article reviews the published evidence for diagnostic and therapeutic management of dysphagia and gastroparesis, including recommendations for timely and appropriate referral to GI specialists when needed and guidance on the development of an effective management plan.
Gut microbiota: A new target for T2DM prevention and treatment

Type 2 diabetes mellitus (T2DM), one of the fastest growing metabolic diseases, has been characterized by metabolic disorders including hyperglycemia, hyperlipidemia and insulin resistance (IR). In recent years, T2DM has become the fastest growing metabolic disease in the world. Studies have indicated that patients with T2DM are often associated with intestinal flora disorders and dysfunction involving multiple organs. Metabolites of the intestinal flora, such as bile acids (BAs), short-chain fatty acids (SCFAs) and amino acids (AAs)may influence to some extent the decreased insulin sensitivity associated with T2DM dysfunction and regulate metabolic as well as immune homeostasis. In this paper, we review the changes in the gut flora in T2DM and the mechanisms by which the gut microbiota modulates metabolites affecting T2DM, which may provide a basis for the early identification of T2DM-susceptible individuals and guide targeted interventions. Finally, we also highlight gut microecological therapeutic strategies focused on shaping the gut flora to inform the improvement of T2DM progression.
Variable effects of omaveloxolone (RTA408) on primary fibroblasts with mitochondrial defects

Omaveloxolone (RTA408) is a second-generation oleanane triterpenoid Nrf2 inducer with antioxidant and anti-inflammatory properties and was reported to improve mitochondrial bioenergetics. It is currently being tested in medical trials for Friedrich ataxia, a genetic, multi-organ disease involving mitochondrial dysfunction. Thus, omaveloxolone could potentially be beneficial for additional disorders involving mitochondrial dysfunction. To this end, we investigated its effect on primary fibroblasts derived from patients with mitochondrial complex I deficiency, mitochondrial cytochrome oxidase deficiency, and two recessive forms of Parkinson’s disease. Patients and control cells were incubated in the presence or absence of 50 nM omaveloxolone for 72 h prior to measurements. Generally, growth on galactose medium and ATP production were unaltered. Mitochondrial membrane potential was slightly but significantly decreased, while reactive oxygen species (ROS) production was variably decreased. Mitochondrial mass and mitochondrial DNA (mtDNA) contents were significantly increased in the patient’s cells. These results were partially confirmed by the results of oxygen consumption studies which disclosed increased maximal oxygen consumption rates in most cells and increased energy status in all treated cells. Further investigation is required to explore the precise effect of omaveloxolone on mitochondrial function in disease.
Image quality and whole-lesion histogram and texture analysis of diffusion-weighted imaging of breast MRI based on advanced ZOOMit and simultaneous multislice readout-segmented echo-planar imaging

Objectives To investigate the image quality and diagnostic capability a of whole-lesion histogram and texture analysis of advanced ZOOMit (A-ZOOMit) and simultaneous multislice readout-segmented echo-planar imaging (SMS-RS-EPI) to differentiate benign from malignant breast lesions. Study design From February 2020 to October 2020, diffusion-weighted imaging (DWI) using SMS-RS-EPI and A-ZOOMit were performed on 167 patients. Three breast radiologists independently ranked the image datasets. The inter-/intracorrelation coefficients (ICCs) of mean image quality scores and lesion conspicuity scores were calculated between these three readers. Histogram and texture features were extracted from the apparent diffusion coefficient (ADC) maps, respectively, based on a WL analysis. Student’s t-tests, one-way ANOVAs, Mann–Whitney U tests, and receiver operating characteristic curves were used for statistical analysis. Results The overall image quality scores and lesion conspicuity scores for A-ZOOMit and SMS-RS-EPI showed statistically significant differences (4.92 ± 0.27 vs. 3.92 ± 0.42 and 4.93 ± 0.29 vs. 3.87 ± 0.47, p < 0.0001). The ICCs for the image quality and lesion conspicuity scores had good agreements among the three readers (all ICCs >0.75). To differentiate benign and malignant breast lesions, the entropy of ADCA-Zoomit had the highest area (0.78) under the ROC curve. Conclusions A-ZOOMit achieved higher image quality and lesion conspicuity than SMS-RS-EPI. Entropy based on A-ZOOMit is recommended for differentiating benign from malignant breast lesions.
Case report: Goiter and overt hypothyroidism in an iodine-deficient toddler on soy milk and hypoallergenic diet

Soy-based infant formulas (SFs) are often consumed by cow’s milk allergic children. However, some concerns have risen since soy intake may adversely affect thyroid function in iodine-deficient or subclinical hypothyroid individuals. We report the first Italian case of SF induced goiter and hypothyroidism registered in our country since National Iodine program has been instituted. Finally, we review cases previously reported in literature. A 22-month-old toddler with a previous diagnosis of cow’s milk protein allergy came to clinical attention for important goiter and overt hypothyroidism. Detailed dietary anamnesis revealed that he was on a restrictive dietary regimen based on soymilk since 12 months of age. A temporary levothyroxine substitution was instituted to avoid hypothyroidism complications. Adequate iodine supplementation and diet diversification completely reversed SF-induced hypothyroidism and goiter, confirming the diagnostic suspicion of soymilk-induced thyroid dysfunction in a iodine-deficient toddler. This case report demonstrates the importance of careful dietary habits investigation and adequate micronutrients supplementation in children on a restrictive diet due to multiple food allergies in order to prevent nutritional deficits.
Seasonal mesozooplankton patterns and timing of life history events in high-arctic fjord environments

Seasonal patterns in mesozooplankton composition, vertical distribution, and timing of reproduction are challenging to study in the open sea due to ocean currents and mix of populations of different origins. Sill fjords, on the other hand, with restricted water exchange, are ideal locations for studying taxa- and community-specific adaptations to the prevailing environment. Here, we present re-occurring patterns in the mesozooplankton community structure in Billefjorden, Svalbard, a high Arctic sill fjord with extensive seasonal ice cover, based on monthly sampling from 2011 to 2013. The zooplankton community composition confirmed the Arctic character of this fjord. Predominantly herbivorous taxa, such as Calanus glacialis and Pseudocalanus spp. , showed strong seasonal variation in abundance and depth distribution, with population minima in spring being compensated by a rapid population recovery during summer. Omnivorous taxa, such as Microcalanus spp. and copepods of the family Aetideidae, largely remained at depth throughout the year and had an extended or year-round reproductive period. Deep-dwelling omnivorous/carnivorous species peaked in abundance in winter–spring when herbivorous populations were severely depleted. Taxa with seasonally limited occurrences, i.e., meroplankton, peaked in spring and summer at the surface, but were largely absent for the rest of the year. The different life histories, with contrasting feeding modes, depth preferences, and timing of reproduction lead to reduced interspecies competition and allow for a rather high and stable abundance of mesozooplankton year-round despite the short primary production window at high latitudes.
Women and adaptive capacity to climate change in East African seascapes – Zanzibar as an example

As the climate crisis persists, there is a crucial need to increase knowledge on adaptive capacity and the underlying factors building it. This is particularly important for disadvantaged groups, such as coastal women in East Africa. Women’s livelihoods in these seascapes are and will be more severely affected by climate change and the capacity of East African states to deal with these challenges is limited in terms of financial and human capital. In this research, we investigated the underlying factors building the adaptive capacity of coastal women in Zanzibar (Unguja Island), Tanzania. Coastal women (N=117) were interviewed in villages around the island to gather information about potential factors supporting adaptive capacity. This was analysed applying Cinner et al (2018) five domains typology for adaptive capacity, i.e. assets, flexibility, organizations, learning and agency. The results show that women had relatively low adaptive capacity, extended poverty and very high dependence on seaweed farming of red algae, a livelihood providing low income and already being seriously affected by climate variability and change. Women’s observations of key variables related to environmental changes corresponded to most scientific findings. It was, however, unclear how that knowledge is useful and enhances adaptive capacity. Adaptive capacity was generally low but individual differences were found in which ten women had a high income. The results show that the factors underlying adaptive capacity are complex and interact with each other, being positive, negative and unclear. Many of the identified factors deserve future research. This study adds to the pool of knowledge by addressing women (not only men); coastal ecosystems (as land and freshwater systems are more studied) and the individual level (since most studies focus on national and community levels). The study illustrates that institutional renewal, bridging and cooperation is possible in Zanzibar bringing good news to the region.
Epigenetics of functional hypothalamic amenorrhea

Functional hypothalamic amenorrhea (FHA) is a temporary infertility characterized by the suppression of the hypothalamic–pituitary–gonadal (HPG) axis, induced by the inhibition of the hypothalamic pulsatile secretion of the gonadotropin-releasing hormone (GnRH), in the presence of stressors, including eating disorders, excessive exercise, and psychological distress. Although the stressful factors that may lead to FHA are well-established, little is known about the inter-individual variability in response to stress and the consequent inhibition of the HPG axis. Not all women, indeed, manifest FHA in presence of stressful conditions. Recent studies highlighted a genetic contribution to FHA. Rare or polymorphic variants in genes that control the development and/or function of GnRH neurons may contribute, indeed, to the adaptability of the reproductive axis to stress factors. Also epigenetic changes have been associated with different pathways involved in the HPG axis and therefore, take part in FHA and confer a personal predisposition to anovulation consequent to a stressful event, or represent biological markers of response to stress. This review summarizes recent advances in the identification of the contribution of (epi)genetics to FHA and to long-term complications of functional amenorrhea, and reports insights into the involvement of additional genetic loci in FHA development on the bases of the clinical and molecular overlap with other gynecological and/or psychological conditions. Finally, we describe the promising application of induced pluripotent stem cells (iPSCs) as a new approach to investigate the molecular pathways involved in FHA.
Is exercise/physical activity effective at reducing symptoms of post-traumatic stress disorder in adults — A systematic review

Background Exercise has been used to manage symptoms of post-traumatic stress disorder (PTSD). The effect of exercise on PTSD outcomes has been previously explored in several studies. However, it still remains unclear what type of exercise/physical activity, intensity and duration is most effective for reducing symptoms of PTSD. A systematic review was conducted to determine which forms of exercise or physical activity have the greatest effect on PTSD outcome scores including an evaluation of exercise frequency and volume. Methods The following electronic databases were systematically searched from January 1980 to June 2021: MEDLINE, PsycINFO, PubMed and Web of Science. Inclusion criteria were studies investigating adults aged 18 or over, reporting the effect of exercise and physical activities on PTSD symptom outcome scores. Two reviewers independently extracted information on study characteristics, exposure and outcomes. In total of 3,217 articles were screened and 23 full text articles further assessed, with 13 RCT's included in the review, covering seven exercise/physical activity interventions. The study protocol was registered prospectively with PROSPERO (CRD42021255131). Results Thirteen studies from four countries involving a total of 531 patients were selected for inclusion. Individual forms of exercise/physical activity examined showed some effect on reducing PTSD symptoms but combined exercises (resistance training, aerobic, strength and yoga) administered over a 12 week period, three times a week for 30–60 min showed greater effects on PTSD symptoms. Conclusion The limited evidence suggests that a combined exercise intervention has the best evidence for a having a beneficial effect on PTSD symptoms. Systematic review registration https://www.crd. york.ac. uk/prospero/display_record. php? RecordID=255131.
Time Zero for Net Zero: A Coal Mine Baseline for Decarbonising Heat

Mine water geothermal energy could provide sustainable heating, cooling and storage to assist in the decarbonisation of heat and achieving Net Zero carbon emissions. However, mined environments are highly complex and we currently lack the understanding to confidently enable a widespread, cost-effective deployment of the technology. Extensive and repeated use of the mined subsurface as a thermal source/store and the optimisation of operational infrastructure encompasses a range of scientific and technical challenges that require broad partnerships to address. We present emerging results of a pioneering multidisciplinary collaboration formed around an at-scale mine water geothermal research infrastructure in Glasgow, United Kingdom. Focused on a mined, urban environment, a range of approaches have been applied to both characterise the environmental change before geothermal activities to generate “time zero” datasets, and to develop novel monitoring tools for cost-effective and environmentally-sound geothermal operations. Time zero soil chemistry, ground gas, surface water and groundwater characterisation, together with ground motion and seismic monitoring, document ongoing seasonal and temporal variability that can be considered typical of a post-industrial, urban environment underlain by abandoned, flooded coal mine workings. In addition, over 550 water, rock and gas samples collected during borehole drilling and testing underwent diverse geochemical, isotopic and microbiological analysis. Initial results indicate a connected subsurface with modern groundwater, and resolve distinctive chemical, organic carbon and stable isotope signatures from different horizons that offer promise as a basis for monitoring methods. Biogeochemical interactions of sulphur, carbon and iron, plus indications of microbially-mediated mineral oxidation/reduction reactions require further investigation for long term operation. Integration of the wide array of time zero observations and understanding of coupled subsurface processes has significant potential to inform development of efficient and resilient geothermal infrastructure and to inform the design of fit-for-purpose monitoring approaches in the quest towards meeting Net Zero targets.
Functional brain imaging and central control of the bladder in health and disease

Central control of the bladder is a complex process. With the development of functional imaging technology and analysis methods, research on brain-bladder control has become more in-depth. Here, we review previous functional imaging studies and combine our latest findings to discuss brain regions related to bladder control, interactions between these regions, and brain networks, as well as changes in brain function in diseases such as urgency urinary incontinence, idiopathic overactive bladder, interstitial cystitis/bladder pain syndrome, urologic chronic pain syndrome, neurogenic overactive bladder, and nocturnal enuresis. Implicated brain regions include the pons, periaqueductal grey, thalamus, insula, prefrontal cortex, cingulate cortex, supplementary motor area, cerebellum, hypothalamus, basal ganglia, amygdala, and hippocampus. Because the brain is a complex information transmission and processing system, these regions do not work in isolation but through functional connections to form a number of subnetworks to achieve bladder control. In summarizing previous studies, we found changes in the brain functional connectivity networks related to bladder control in healthy subjects and patients involving the attentional network, central executive network or frontoparietal network, salience network, interoceptive network, default mode network, sensorimotor network, visual network, basal ganglia network, subcortical network, cerebella, and brainstem. We extend the working model proposed by Griffiths et al. from the brain network level, providing insights for current and future bladder-control research.
The association between weight-adjusted-waist index and increased urinary albumin excretion in adults: A population-based study

Aims The negative effect of obesity on kidney health has been reported. The association between weight-adjusted-waist index (WWI, a newly developed adiposity index) and albuminuria has not been reported earlier. Methods This cross-sectional study was conducted among adults with complete data about WWI and urinary albumin-to-creatinine ratio (ACR) in 2005–2018 National Health and Nutrition Examination Survey (NHANES). WWI was calculated as waist circumference (WC) divided by the square root of weight. Weighted multivariable logistic regression and generalized additive model were employed to explore the independent relationship between WWI with albuminuria and its non-linearity. A two-piecewise linear regression model was used to calculate the threshold effect. Subgroup analysis and interaction tests were also performed. Results A total of 36,921 participants were enrolled with a prevalence of albuminuria of 9.32%. The prevalence of albuminuria increased with the higher WWI tertiles (Tertile 1: 5.31%, Tertile 2: 8.23%, Tertile 3: 15.65%). WWI was positively associated with a higher likelihood of albuminuria (OR = 1.28, 95% CI: 1.15–1.43), and this relationship remains stable in subgroups (all P for trend > 0.05). Non-linear positive relationships were detected in females with a breakpoint of 10.93. A positive association between WWI and albuminuria (OR = 1.39, 95% CI: 1.20–1.61) was observed on the right of the breakpoint, while the association on the left was of no statistical significance. WWI showed a stronger correlation with albuminuria (OR = 1.28) than other markers of obesity including body mass index (BMI, OR = 1.02) and WC (OR = 1.01). Conclusion Weight-adjusted-waist index levels were positively related to an increased likelihood of albuminuria in United States adults and showed a stronger relationship than BMI and WC. Our findings indicated that WWI may serve as a simple anthropometric index to predict albuminuria.
Forecasting methods for occurrence and magnitude of proton storms with solar soft X rays

Solar energetic proton (SEP) events in the vicinity of Earth have the potential of affecting the performance of civilian, military, and research satellites, including such diverse functions as communications, spacecraft operations, surveillance, navigation, and life support systems. The National Oceanic and Atmospheric Administration's (NOAA) Space Environment Center and the U. S. Air Force Weather Agency cooperate to provide advance warnings of SEP events. Their explicit duties include the need to continually upgrade and improve the accuracy, timeliness, and scope of SEP forecasts. Previous work on this topic established the empirical connection between SEPs and low‐temperature X‐ray flares. The main focus of the present work is to improve the quality of SEP forecasts by enhancing the size and content of the flare database used to quantify the probability model, tuning the model with imposed operational constraints, and augmenting each SEP prediction with an estimate of the magnitude of the particle event itself.