Miracle-dz/UniFAR-FTUs huggingface dataset:
Estimating the direct healthcare utilization and cost of musculoskeletal pain among people with comorbidity: a retrospective electronic health record study

Abstract Objective To investigate the impact of pre-existing painful musculoskeletal conditions on healthcare utilization and costs among patients with five common conditions: acute coronary syndrome (ACS), stroke, cancer, dementia and pneumonia. Methods Using primary and secondary care services data from electronic health records, a negative binomial regression model was used to compare resource use while a two-part model was used to compare costs across the five conditions, between those with and without a pre-existing musculoskeletal pain. Results The study included 760,792 patients (144,870 with ACS, 121,208 with stroke, 231,702 with cancer, 134,638 with dementia, and 128,374 with pneumonia) in the complete case analysis. Pre-existing musculoskeletal pain had an incident rate ratio of above one for most healthcare resources over the follow-up period and an adjusted additional mean cumulative total healthcare costs per patient of £674.59 (95%CI 570.30 to 778.87) for ACS; £613.34 (95%CI 496.87 to 729.82) for stroke; £459.26 (95%CI 376.60 to 541.91) for cancer; and £766.23 (95%CI 655.06 to 877.39) for dementia over five years after diagnosis; and £200.85 (95%CI 104.16 to 297.55) for pneumonia over one year after diagnosis compared to those without musculoskeletal pain. Conclusion This study highlights that individuals with painful musculoskeletal conditions have higher healthcare utiliszation and costs than those without painful musculoskeletal conditions. Given the high occurrence of musculoskeletal pain in patients with other conditions, effective management strategies are needed to reduce the burden on healthcare resources.
Foraging behavior of juvenile steller sea lions in the Gulf of Alaska

Foraging Behavior of Juvenile Steller Sea Lions in the Gulf of Alaska. (May 2006) Wendy Jane Schrader, B.A., University of California, Santa Cruz Co-Chairs of Advisory Committee: Dr. Markus Horning Dr. Bernd Wursig Relating the behavior of predators to prey density is an important aspect of foraging theory. Changes in prey accessibility may have contributed to a greater-than 80% decline in Steller sea lions (Eumetopias jubatus) throughout the western portion of their range during the last 30 years. A new method was developed for inferring prey accessibility to juveniles of this otariid, from observable features of diving and ranging behavior. Seventeen juveniles (9F, 8M) were monitored in multiple seasons and locations in the Gulf of Alaska via satellite telemetry. Twelve of the 17 had experienced 1-3 months of temporary captivity. Effects of temporary captivity on endurance, habitat use and development of diving and ranging behavior were tested. Diving and ranging patterns of previously captive juveniles were consistent with data reported for freeranging juveniles. Development in mean dive depth and duration after release was likely due to increased foraging. “Focus in time spent at depth” was tested as a proxy for prey accessibility using predictions based on foraging theory. ‘Focus. ’ was defined as vertical concentration in dive distribution and was calculated by comparing the observed time spent at depth with an expected distribution. There was significantly more focus in
Associations of medication regimen complexity with medication adherence and clinical outcomes in patients with chronic obstructive pulmonary disease: a prospective study

Background: High medication burdens are common in patients with chronic obstructive pulmonary disease (COPD). This study aimed to explore the associations of medication regimen complexity index (MRCI) with medication adherence and clinical outcomes among patients with acute exacerbations of COPD (AECOPD) after hospital discharge. Methods: Data were obtained from a nationwide cohort study of inpatients with AECOPD in China. MRCI scores were calculated using the medication list 30 days after discharge and separated into COPD-specific and non-COPD MRCI scores. Medication adherence was measured by the withdrawal rate of COPD or inhaled long-acting bronchodilators 6 months after discharge. Clinical outcomes included re-exacerbations and COPD-related readmissions during the 30-day to 6-month follow-up period. The associations of MRCI with medication withdrawal and clinical outcomes were evaluated using univariate and multivariate logistic regressions. Potential covariates included sociodemographic factors, year of COPD diagnosis, post-bronchodilator percentage predicted forced expiratory volume in 1 s, mMRC score, CAT score, and comorbidities. Results: Among the 2853 patients included, the median total MRCI score was 7 [interquartile range (IQR), 7−13]. A high MRCI score (>7) was presented in 1316 patients (46.1%). Of the MRCI score, 91% were COPD specific. The withdrawal rates of the COPD and inhaled long-acting bronchodilators were 24.2% and 24.4%, respectively. Re-exacerbation and COPD-related readmission rates were 10.2% and 7.5%, respectively. After adjusting for covariates, patients with high total MRCI scores were less likely to discontinue COPD drugs [odds ratio (OR), 0.62; 95% confidence interval (CI), 0.52−0.74] and inhaled long-acting bronchodilators (OR, 0.68; 95%CI, 0.57−0.81); conversely, these patients were more likely to experience re-exacerbation (OR, 1.64; 95% CI, 1.27−2.11) and readmission (OR, 1.57; 95% CI, 1.17−2.10). Conclusion: MRCI scores were relatively low among post-hospitalized patients with AECOPD in China. Higher MRCI scores were positively associated with adherence to COPD or inhaled medications, and risk of re-exacerbation and readmission. Registration: ClinicalTrials.gov identifier: NCT02657525.
Dehydroepiandrosterone mediates associations between trauma‐related symptoms and anterior pituitary volume in children and adolescents

The anterior pituitary gland (PG) is a potential locus of hypothalamic–pituitary–adrenal (HPA) axis responsivity to early life stress, with documented associations between dehydroepiandrosterone (DHEA) levels and anterior PG volumes. In adults, elevated anxiety/depressive symptoms are related to diminished DHEA levels, and studies have shown a positive relationship between DHEA and anterior pituitary volumes. However, specific links between responses to stress, DHEA levels, and anterior pituitary volume have not been established in developmental samples.
Primary antiphospholipid syndrome with and without limb ischemia: A retrospective observational study

Objective To compare clinical and laboratory data obtained from patients with primary Antiphospholipid Syndrome (PAPS) with and without limb ischemia (LI). Methods A transverse study with 66 (83.3% female) PAPS patients was performed. All data were evaluated. Patients were subdivided into one of two groups: PAPS with LI and PAPS without LI and compared. Results Sixty-six primary APS were selected. PAPS with LI group exhibited a longer disease duration (p = .012) and more arterial events (p = .002). A lower frequency of venous events was observed in PAPS with LI (p = .007), and deep venous thrombosis (p = .016). Furthermore, PAPS with LI patients had more deficiency of protein C of coagulation (p = .015) than the others. Conclusion PAPS and LI have a distinct clinical and laboratory spectra from those without LI and it is characterized by an increased frequency of protein C deficiency, and a lower frequency of venous events, deep venous thrombosis and IgM anticardiolipin.
The genetics and chronobiology of cluster headache

Background/Hypothesis Cluster headache displays uniquely rhythmic patterns in its attack manifestation. This strong chronobiological influence suggests that part of the pathophysiology of cluster headache is distinctly different from migraine and has prompted genetic investigations probing these systems. Methods This is a narrative overview of the cluster headache chronobiological phenotype from the point of view of genetics covering existing knowledge, highlighting the specific challenges in cluster headache and suggesting novel research approaches to overcome these. Results The chronobiological features of cluster headache are a hallmark of the disorder and while discrepancies between study results do exist, the main findings are highly reproducible across populations and time. Particular findings in subgroups indicate that the heritability of the disorder is linked to chronobiological systems. Meanwhile, genetic markers of circadian rhythm genes have been implicated in cluster headache, but with conflicting results. However, in two recently published genome wide association studies two of the identified four loci include genes with an involvement in circadian rhythm, MER proto-oncogene, tyrosine kinase and four and a half LIM domains 5. These findings strengthen the involvement of circadian rhythm in cluster headache pathophysiology. Conclusion/Interpretation Studying chronobiology and genetics in cluster headache presents challenges unique to the disorder. Researchers are overcoming these challenges by pooling various data from different cohorts and performing meta-analyses providing novel insights into a classically enigmatic disorder. Further progress can likely be made by combining deep pheno- and genotyping.
Prehistoric Coastal Adaptations at Seaside, Oregon: Vertebrate Fauna From the Palmrose and Par-Tee Sites

ABSTRACT Archaeological investigations at two sites in Seaside, Oregon, during the 1960s and 1970s produced a substantial coastal faunal assemblage, among the largest ever recovered from western North America. The two sites, Palmrose (35CLT47) and Par-Tee (35CLT20), were occupied between about 2,700 and 800 years ago. Analysis of a sample of the vertebrate fauna indicates differences between the two assemblages despite overlapping ages and close proximity. While there is similarity in the predominance of marine mammals and fish in both samples, the habitats represented by the fauna vary and the fish assemblages are strikingly different. Alternative explanations for the differences in the assemblages are considered including the possibility that the two sites were occupied by different ethnic groups. These data are relevant to broad issues of culture change on the southern Northwest Coast, marine resource exploitation, and hunter-gatherer coastal adaptations and this analysis demonstrates the value of museum collections for archaeological research.
Theoretical and experimental study on the cavitation mechanism of a low viscosity spiral oil wedge journal bearing

The generalized Reynolds equation is established considering cavitation mechanism based on modified Elrod method in theory. The cavitation characteristics of spiral oil wedge hydrodynamic bearings are investigated experimentally using transparent bearing and high-speed camera. The influence of speed of rotation and supply pressures on the shape of the cavitation and the location of the cavitation is analyzed, and the experimental results are compared with the modified Elrod calculation results. The results show that the cavitation of oil film is strip-shaped. With the increase in supply pressure, the rupture location of the oil film moves along the direction of rotation of the axis, the reformation location of the oil film moves along the opposite direction of rotation of the axis, the rupture area of the oil film decreases and the speed of rotation of the bearing increases when cavitation begins to occur; with the increase in speed of rotation, the reformation location of the oil film moves along the direction of rotation of the axis and the rupture area of the oil film increases. The experimental cavitation region is larger than the theoretical cavitation region; however, the theoretical results generally coincide with experimental results.
The relation of polymer structure of stent used in patients with acute coronary syndrome revascularized by stent implantation with long‐term cardiovascular events

Drug‐eluting stents (DES) have revolutionized percutaneous coronary intervention (PCI) by improving event‐free survival compared to older stent designs. However, early‐generation DES with polymer matrixes have raised concerns regarding late stent thrombosis due to delayed vascular healing. To address these issues, biologically bioabsorbable polymer drug‐eluting stents (BP‐DES) and polymer‐free drug‐eluting stents (PF‐DES) have been developed.
Observational longitudinal association between waking movement behaviours and psychological distress among adolescents using isotemporal analysis: DADOS study

ABSTRACT This study aimed to examine the impact of reallocating time spent in waking movement behaviours at baseline on indicators of psychological distress at 24-month follow-up using isotemporal substitution regression models among a sample of Spanish adolescents. The DADOS (Deporte, ADOlescencia y Salud) study is a 3-year longitudinal observational research project carried out between years 2015–2017. The analyses included 197 adolescents (91 girls) aged 13.9 ± 0.3 years at baseline. Waking movement behaviours were assessed by a wrist-worn GENEActiv triaxial accelerometer and expressed as minutes/day of light physical activity (LPA), moderate-vigorous physical activity (MVPA) and time spent in sedentary behaviour (SB). The Behaviour Assessment System for Children and Adolescents (level 3 for adolescents) was used to assess psychological distress indicators (i.e., anxiety, social stress, and risk of depression). Results showed significant associations only for girls. The substitution of 10 min/day of SB or LPA at baseline with 10 min/day of MVPA was associated with lower levels of anxiety (both p ≤ 0.01) and social stress (both p < 0.05) at follow-up. The substitution of 10 min/day of SB with 10 min/day of LPA was associated with higher levels of anxiety at follow-up (p = 0.01). These findings highlight the need of specific physical activity recommendations for mental health paying special attention to sex-differences.
Gut microbiota changes in patients with hypertension: A systematic review and meta‐analysis

Hypertension is a major public health issue worldwide. The imbalance of gut microbiota is thought to play an important role in the pathogenesis of hypertension. The authors conducted the systematic review and meta‐analysis to clarify the relationship between gut microbiota and hypertension through conducting an electronic search in six databases. Our meta‐analysis included 19 studies and the results showed that compared with healthy controls, Shannon significantly decreased in hypertension [SMD = −0.13, 95%CI (−0.22, −0.04), p = . 007]; however, Simpson [SMD = −0.01, 95%CI (−0.14, 0.12), p = . 87], ACE [SMD = 0.18, 95%CI (−0.06, 0.43), p = . 14], and Chao1 [SMD = 0.11, 95%CI (−0.01, 0.23), p = . 08] did not differ significantly between hypertension and healthy controls. The F/B ratio significantly increased in hypertension [SMD = 0.84, 95%CI (0.10, 1.58), p = . 03]. In addition, Shannon index was negatively correlated with hypertension [r = −0.12, 95%CI (−0.19, −0.05)], but had no significant correlation with SBP [r = 0.10, 95%CI (−0.19, 0.37)] and DBP [r = −0.39, 95%CI (−0.73, 0.12)]. At the phylum level, the relative abundance of Firmicutes [SMD = −0.01, 95%CI (−0.37, 0.34), p = . 94], Bacteroidetes [SMD = −0.15, 95%CI (−0.44, 0.14), p = . 30], Proteobacteria [SMD = 0.25, 95%CI (−0.01, 0.51), p = . 06], and Actinobacteria [SMD = 0.21, 95%CI (−0.11, 0.53), p = . 21] did not differ significantly between hypertension and healthy controls. At the genus level, compared with healthy controls, the relative abundance of Faecalibacterium decreased significantly [SMD = −0.16, 95%CI (−0.28, −0.04), p = . 01], while the Streptococcus [SMD = 0.20, 95%CI (0.08, 0.32), p = . 001] and Enterococcus [SMD = 0.20, 95%CI (0.08, 0.33), p = . 002] significantly increased in hypertension. Available evidence suggests that hypertensive patients may have an imbalance of gut microbiota. However, it still needs further validation by large sample size studies of high quality.
Acinetobacter baumannii coordinates central metabolism, plasmid dissemination, and virulence by sensing nutrient availability

ABSTRACT Plasmid conjugation plays an important role in the dissemination of antibiotic-resistance genes. The emergence of multidrug-resistant isolates of Acinetobacter baumannii poses grave challenges in treating infections caused by this notorious nosocomial pathogen. Yet, the composition, functionality, and regulation of conjugative machinery utilized by A. baumannii remain poorly understood. Here, we found that conjugation of the major plasmid pAB3 of A. baumannii is mediated by a type IVB secretion system similar to the Dot/Icm transporter of Legionella pneumophila. Furthermore, the expression of the structural genes of the Dot/Icm-like system is co-regulated with genes involved in central metabolism by the GacS/GacA two-component system in response to various metabolites, including intermediates of the tricarboxylic acid cycle. Loss of GacS/A also severely impaired bacterial virulence. These results establish that A. baumannii coordinates metabolism with plasmid conjugation and virulence by sensing nutrient availability, which may be exploited to develop inhibitory agents for controlling the spread of drug-resistance genes and virulence factors. IMPORTANCE Plasmid conjugation is known to be an energy-expensive process, but our understanding of the molecular linkage between conjugation and metabolism is limited. Our finding reveals that Acinetobacter baumannii utilizes a two-component system to co-regulate metabolism, plasmid transfer, and virulence by sensing reaction intermediates of key metabolic pathways, which suggests that nutrient availability dictates not only bacterial proliferation but also horizontal gene transfer. The identification of Dot/Icm-like proteins as components of a conjugation system involved in the dissemination of antibiotic-resistance genes by A. baumannii has provided important targets for the development of agents capable of inhibiting virulence and the spread of anti-microbial-resistance genes in bacterial communities. Plasmid conjugation is known to be an energy-expensive process, but our understanding of the molecular linkage between conjugation and metabolism is limited. Our finding reveals that Acinetobacter baumannii utilizes a two-component system to co-regulate metabolism, plasmid transfer, and virulence by sensing reaction intermediates of key metabolic pathways, which suggests that nutrient availability dictates not only bacterial proliferation but also horizontal gene transfer. The identification of Dot/Icm-like proteins as components of a conjugation system involved in the dissemination of antibiotic-resistance genes by A. baumannii has provided important targets for the development of agents capable of inhibiting virulence and the spread of anti-microbial-resistance genes in bacterial communities.
RNase H2 degrades toxic RNA:DNA hybrids behind stalled forks to promote replication restart

R‐loops represent a major source of replication stress, but the mechanism by which these structures impede fork progression remains unclear. To address this question, we monitored fork progression, arrest, and restart in Saccharomyces cerevisiae cells lacking RNase H1 and H2, two enzymes responsible for degrading RNA:DNA hybrids. We found that while RNase H‐deficient cells could replicate their chromosomes normally under unchallenged growth conditions, their replication was impaired when exposed to hydroxyurea (HU) or methyl methanesulfonate (MMS). Treated cells exhibited increased levels of RNA:DNA hybrids at stalled forks and were unable to generate RPA‐coated single‐stranded (ssDNA), an important postreplicative intermediate in resuming replication. Similar impairments in nascent DNA resection and ssDNA formation at HU‐arrested forks were observed in human cells lacking RNase H2. However, fork resection was fully restored by addition of triptolide, an inhibitor of transcription that induces RNA polymerase degradation. Taken together, these data indicate that RNA:DNA hybrids not only act as barriers to replication forks, but also interfere with postreplicative fork repair mechanisms if not promptly degraded by RNase H.
The slab ocean El Niño

In a series of Atmospheric model simulations coupled to a simple slab ocean model it is illustrated that El Niño type of SST variability can exist in the absence of any ocean dynamics. Atmospheric feedbacks in cloud cover and changes in the wind field can produce positive and delayed negative feedbacks that together with the heat capacity of the upper ocean can produce a damped interannual oscillation in the equatorial Pacific that is comparable in strength and has characteristics to the observed phenomenon. The evolution of the SST pattern is similar to the SST‐mode of El Niño, but is entirely controlled by atmospheric feedbacks. The results challenge and extend our current understanding of the feedback mechanisms of El Niño in climate models and may also highlight possible atmospheric mechanisms that could partly control some observed ENSO events.
Drosophila Gut Immune Pathway Suppresses Host Development-Promoting Effects of Acetic Acid Bacteria

The physiology of most organisms, including Drosophila, is heavily influenced by their interactions with certain types of commensal bacteria. Acetobacter and Lactobacillus, two of the most representative Drosophila commensal bacteria, have stimulatory effects on host larval development and growth. However, how these effects are related to host immune activity remains largely unknown. Here, we show that the Drosophila development-promoting effects of commensal bacteria are suppressed by host immune activity. Mono-association of germ-free Drosophila larvae with Acetobacter pomorum stimulated larval development, which was accelerated when host immune deficiency (IMD) pathway genes were mutated. This phenomenon was not observed in the case of mono-association with Lactobacillus plantarum. Moreover, the mutation of Toll pathway, which constitutes the other branch of the Drosophila immune pathway, did not accelerate A. pomorum-stimulated larval development. The mechanism of action of the IMD pathway-dependent effects of A. pomorum did not appear to involve previously known host mechanisms and bacterial metabolites such as gut peptidase expression, acetic acid, and thiamine, but appeared to involve larval serum proteins. These findings may shed light on the interaction between the beneficial effects of commensal bacteria and host immune activity.