Miracle-dz/UniFAR-FTUs huggingface dataset:
Regression of a large inflammatory abdominal aortic aneurysm with high‐dose steroids

A 57-year-old man presented to his general practitioner with a history of several months of abdominal pain. Initial duplex ultrasound (DUS) demonstrated an abdominal aortic aneurysm (AAA) of 54 mm in diameter with a markedly thickened vessel wall of 13 mm, suggestive of an inflammatory aneurysm (Fig. 1a). A computed tomography scan confirmed an infrarenal AAA with maximum dimensions of 59 mm (Fig. 2a), with features of active aortitis including aortic wall thickening and stranding (Fig. 2b). His past medical history included multiple abdominal hernia repairs, type II diabetes mellitus, hypercholesterolaemia and current smoking with an 80 pack-year history. Initial blood results were relatively unremarkable, with a weakly positive anti-nuclear antibody staining (mitotic spindle apparatus pattern), and the remaining of autoimmune screens, including immunoglobulin G, were negative. His initial erythrocyte sedimentation rate (ESR) was 37 mm/h, with a C-reactive protein of 5.1 mg/L. A positron emission tomography (PET) scan confirmed marked local fluorodeoxyglucose uptake in the abdominal aortic wall in keeping with active inflammation (Fig. 3).
Two-hit mechanism of cardiac arrhythmias in diabetic hyperglycemia: reduced repolarization reserve, neurohormonal stimulation and heart failure exacerbate susceptibility.

AIM Diabetic hyperglycemia is associated with increased arrhythmia risk. We aimed to investigate whether hyperglycemia alone can be accountable for arrhythmias or whether it requires the presence of additional pathological factors. METHODS AND RESULTS Action potentials (APs) and arrhythmogenic spontaneous diastolic activities were measured in isolated murine ventricular, rabbit atrial and ventricular myocytes acutely exposed to high glucose. Acute hyperglycemia increased the short-term variability (STV) of action potential duration (APD), enhanced delayed afterdepolarizations and the inducibility of APD alternans during tachypacing in both murine and rabbit atrial and ventricular myocytes. Hyperglycemia also prolonged APD in mice and rabbit atrial cells but not in rabbit ventricular myocytes. However, rabbit ventricular APD was more strongly depressed by block of late Na+ current (INaL) during hyperglycemia, consistent with elevated INaL in hyperglycemia. All the above proarrhythmic glucose effects were Ca2+-dependent and abolished by CaMKII inhibition. Importantly, when the repolarization reserve was reduced by pharmacological inhibition of K+ channels (either Ito, IKr, IKs or IK1) or hypokalemia, acute hyperglycemia further prolonged APD and further increased STV and alternans in rabbit ventricular myocytes. Likewise, when rabbit ventricular myocytes were pretreated with isoproterenol or angiotensin II, hyperglycemia significantly prolonged APD, increased STV and promoted alternans. Moreover, acute hyperglycemia markedly prolonged APD and further enhanced STV in failing rabbit ventricular myocytes. CONCLUSION We conclude that even though hyperglycemia alone can enhance cellular proarrhythmic mechanisms, a second hit which reduces the repolarization reserve or stimulates G protein-coupled receptor signaling greatly exacerbates cardiac arrhythmogenesis in diabetic hyperglycemia.
Study of injectable PNIPAAm hydrogels containing niosomal angiogenetic drug delivery system for potential cardiac tissue regeneration

Nowadays, heart disease, especially myocardial infarction, is one of the most astoundingly unfortunate causes of mortality in the world. That is why special attention has been paid toward tissue engineering techniques for curing and regeneration of heart tissue. In this study, poly(N-isopropyl acrylamide) (PNIPAAm), a temperature-sensitive injectable hydrogel, was selected as a minimally invasive scaffold to accommodate, carry, and release of niosomal rosuvastatin to the inflicted area for inducing angiogenesis and thus accelerating the healing process. The characteristics of PNIPAAm were studied by scanning electron microscopy, rheology tests, and Fourier transform infrared spectroscopy. The properties of the niosomal rosuvastatin release system, including particle size distribution, zeta potential, encapsulation efficiency (EE), and drug release, were also studied. The results showed that niosomes (358 nm) had a drug EE of 78% and a loading capacity of 53%. The drug was sustainably released from the system up to about 54% in 5 d. Cellular studies showed no toxicity to the endothelial cell lines, and the niosomal drug with a concentration of 7.5 nM enhanced cell proliferation, and cell migration increased from 72% to 90% compared to the control sample. Therefore, the controlled-release of niosomal rosuvastatin enhanced angiogenesis in a dose-dependent manner. Taken together, these advantages suggest that PNIPAAm-based niosomal hydrogel provides a promising candidate as an angiogentic injectable scaffold for potential cardiac tissue regeneration.
Chemical and Microbiological Characteristics of Mineral Spoils and Drainage Waters at Abandoned Coal and Metal Mines

Mining is a long-established human activity. Abandonedmines, tailings, and mine spoils may have considerable impacton neighboring environments long after the sites are abandoned. Of greatest concern are derelict mines and wastes that generateacidic discharge waters that are enriched with iron and othermetals and metalloids. The chemistry and microbiology of thesesites are intricately intertwined. Whilst some indigenousmicroorganisms are responsible for accelerating sulfide mineraloxidation, thereby generating acidity and mobilizing metals,others catalyze reductive processes that essentially reversethese reactions and thereby ameliorate polluted mine waters.This article reviews current knowledge on the chemistry and microbiology of abandoned coal and metal mines, mine spoils and tailings.
A century later, still fighting back: antigen‐specific immunotherapies for type 1 diabetes

Type 1 diabetes (T1D) is a chronic metabolic disease caused by the autoimmune destruction of insulin‐producing β‐cells. Ever since the 1920s, the fate of patients suffering from T1D was dramatically improved owing to the isolation and production of insulin, and the scientific field has largely progressed as a result of the evidence gathered about its underpinnings and mechanisms. The last years have seen this knowledge transformed into actual antigen‐specific immunotherapies with potential to restore selectively the breach of tolerance to β‐cell autoantigens and halt the autoimmune aggression. However, so far, the results of both prevention and reversion trials in T1D have been rather discouraging, so there is still an urgent need to optimize those immunotherapies and their associated factors, for example, posology and administration patterns, route and timing. In this review, we look back on what has been achieved in the last century and identify the main autoantigens driving the autoimmune attack in T1D. Then, we take a deep dive into the numerous antigen‐specific immunotherapies trialed and the ones still at a preclinical phase, ranging from peptides, proteins and agent combinations to gene transfer, nanoparticles, cell‐based strategies and novel approaches exploiting naturally occurring tolerogenic processes. Finally, we provide insight into the several features to be considered in a T1D clinical trial, the ideal time point for intervention and the biomarkers needed for monitoring the successful regulatory effect of the antigen‐specific immunotherapy. Although further research and optimization remain imperative, the development of a therapeutic armamentarium against T1D autoimmunity is certainly advancing with a confident step.
Aragonite-Based Scaffold for the Treatment of Joint Surface Lesions in Mild to Moderate Osteoarthritic Knees: Results of a 2-Year Multicenter Prospective Study

Background: Osteoarthritis (OA) is considered a contraindication to most cartilage repair techniques. Several regenerative approaches have been attempted with the aim of delaying or preventing joint replacement, with controversial results. Currently, there is a paucity of data on the use of single-step techniques, such as cell-free biomimetic scaffolds, for the treatment of joint surface lesions (JSLs) in OA knees. Purpose: To present the 2-year follow-up clinical and radiological outcomes after implantation of a novel, cell-free aragonite-based scaffold for the treatment of JSLs in patients with mild to moderate knee OA in a multicenter prospective study. Study Design: Case series; Level of evidence, 4. Methods: A total of 86 patients, 60 male and 26 female, with a mean age of 37.4 ± 10.0 years, mild to moderate knee OA, and a mean defect size of 3.0 ± 1.7 cm2, were recruited at 8 medical centers according to the following criteria: radiographic mild to moderate knee OA (Kellgren-Lawrence grade 2 or 3); up to 3 treatable chondral/osteochondral defects (International Cartilage Repair Society grades 3 and 4) on the femoral condyles or trochlea; a total defect size ≤7 cm2; and no concurrent knee instability, severe axial malalignment, or systemic arthropathy. All patients were evaluated at baseline and at 6, 12, 18, and 24 months after implantation using the Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) subjective score. Additionally, magnetic resonance imaging (MRI) was performed to assess the amount of cartilage defect filling at the repaired site. Results: Significant improvement on all KOOS subscales was recorded from baseline (Pain: 49.6 ± 13.1; Activities of Daily Living [ADL]: 56.1 ± 18.4; Sport: 22.8 ± 18.8; Quality of Life [QoL]: 23.5 ± 16.5; Symptoms: 55.4 ± 19.9) to the 24 months’ follow-up (Pain: 79.5 ± 21.1 [P < .001]; ADL: 84.1 ± 21.4 [P < .001]; Sport: 60.8 ± 31.9 [P < .001]; QoL: 54.9 ± 30.4 [P < .001]; Symptoms: 77.7 ± 21.2 [P < .001]). The IKDC subjective score showed a similar trend and improved from 37.8 ± 14.7 at baseline to 65.8 ± 23.5 at 24 months (P < .001). MRI showed a significant increase in defect filling over time: up to 78.7% ± 25.3% of surface coverage after 24 months. Treatment failure requiring revision surgery occurred in 8 patients (9.3%). Conclusion: The use of an aragonite-based osteochondral scaffold in patients with JSLs and mild to moderate knee OA provided significant clinical improvement at the 24-month follow-up, as reported by the patients. These findings were associated with good cartilage defect filling, as observed on MRI.
Correlation of Mehlich 3, bray 1, and ammonium acetate extractable P, K, Ca, and Mg for Alaska agricultural soils

Abstract Soil test recommendations currently used in Alaska are based on a limited amount of in‐state data along with consideration of data from other states. Recently, Mehlich 3 extractable P has been found to be highly correlated to yield on representative agricultural soils in Alaska. To fully use its multi‐element capability, a study was conducted to correlate Mehlich 3 extractable P and cations (K, Ca, and Mg) with the P and cations extracted by the Bray 1 and ammonium acetate methods respectively. When Mehlich 3 extractable K and Mg were regressed with ammonium acetate extractable K and Mg respectively, the relationship was essentially one‐to‐one and the relationship held across all soils tested. Significant variation was observed among soils in the extraction of Mehlich 3‐P and Ca relative to Bray 1‐P and ammonium acetate‐Ca. Individual soil character appeared to affect the regressions for extractable P and Ca, even though the R2 values were generally high. The regression slopes for Mehlich 3‐P ver.
Reduced differentiation of emotion-associated bodily sensations in autism

Differences in understanding emotion in autism are well-documented, although far more research has considered how being autistic impacts an understanding of other people’s emotions, compared to their own. In neurotypical adults and children, many emotions are associated with distinct bodily maps of experienced sensation, and the ability to report these maps is significantly related to the awareness of interoceptive signals. Here, in 100 children who either carry a clinical diagnosis of autism (n = 45) or who have no history of autism (n = 55), we investigated potential differences in differentiation across autistic children’s bodily maps of emotion, as well as how such differentiation relates to the processing of interoceptive signals. As such, we measured objective interoceptive performance using the heartbeat-counting task, and participants’ subjective experience of interoceptive signals using the child version of the Body Perception Questionnaire. We found less differentiation in the bodily maps of emotion in autistic children, but no association with either objective or subjective interoceptive processing. These findings suggest that, in addition to previously reported differences in detecting others’ emotional states, autistic children have a less differentiated bodily experience of emotion. This does not, however, relate to differences in interoceptive perception as measured here. Lay abstract More research has been conducted on how autistic people understand and interpret other people’s emotions, than on how autistic people experience their own emotions. The experience of emotion is important however, because it can relate to difficulties like anxiety and depression, which are common in autism. In neurotypical adults and children, different emotions have been associated with unique maps of activity patterns in the body. Whether these maps of emotion are comparable in autism is currently unknown. Here, we asked 100 children and adolescents, 45 of whom were autistic, to color in outlines of the body to indicate how they experienced seven emotions. Autistic adults and children sometimes report differences in how they experience their internal bodily states, termed interoception, and so we also investigated how this related to the bodily maps of emotion. In this study, the autistic children and adolescents had comparable interoception to the non-autistic children and adolescents, but there was less variability in their maps of emotion. In other words, they showed more similar patterns of activity across the different emotions. This was not related to interoception, however. This work suggests that there are differences in how autistic people experience emotion that are not explained by differences in interoception. In neurotypical people, less variability in emotional experiences is linked to anxiety and depression, and future work should seek to understand if this is a contributing factor to the increased prevalence of these difficulties in autism.
Renal function in a cohort of HIV-infected patients initiating antiretroviral therapy in an outpatient setting in Ethiopia

Aim To evaluate the prevalence and associated factors of abnormal renal function among Ethiopian HIV-infected patients at baseline prior to initiation of antiretroviral therapy (ART) and during follow-up. Methods We conducted a retrospective observational cohort study of HIV infected patients who initiated ART at the outpatient ART clinic of Mehal Meda Hospital of North Shewa, Ethiopia from January 2012 to August 2018. Demographic and clinical data were abstracted from the medical records of patients. Renal function was assessed by estimated glomerular filtration rate (eGFR) calculated using the Modification of Diet in Renal Disease (MDRD) equation. Univariate and multivariate analysis were conducted to determine the factors associated with abnormal renal function at baseline and during follow-up. Results Among 353 patients, 70 (19.8%) had baseline eGFR <60 ml/min/1.73m2 and 102 (28.9%) had eGFR = 60–89.9 ml/min/1.73m2. Factors associated with baseline renal impairment (eGFR <60 ml/min/1.73m2) included female sex (AOR = 3.52, CI 1.75–7.09), CD4 count < 200 cells/mm3 (AOR = 2.75, CI 1.40–5.42), BMI < 25 Kg/m2 (AOR = 3.04, CI 1.15–8.92), low hemoglobin (AOR = 2.19, CI 1.16–4.09) and high total cholesterol (AOR = 3.15, CI 1.68–5.92). After a median of 3.0 years of ART, the mean eGFR declined from 112.9 ± 81.2 ml/min/1.73m2 at baseline to 93.9 ± 60.6 ml/min/1.73m2 (P < 0.001). The prevalence of renal impairment increased from 19.8% at baseline to 22.1% during follow-up. Of 181 patients with baseline normal renal function, 49.7% experienced some degree of renal impairment. Older age (AOR = 3.85, 95% CI 2.03–7.31), female sex (AOR = 4.18, 95% CI 2.08–8.40), low baseline CD4 (AOR = 2.41, 95% CI 1.24–4.69), low current CD4 count (AOR = 2.32, 95% CI 1.15–4.68), high BMI (AOR = 2.91, 95% CI 1.49–5.71), and low hemoglobin (AOR = 3.38, 95% CI 2.00–7.46) were the factors associated with renal impairment during follow-up. Conclusion Impaired renal function was common in HIV-infected patients initiating ART in an outpatient setting in Ethiopia, and there appears to be a high prevalence of renal impairment after a median ART follow-up of 3 years. There is a need for assessment of renal function at baseline before ART initiation and regular monitoring of renal function for patients with HIV during follow-up.
Accuracy of periocular lesion assessment using telemedicine

Objectives To assess the agreement in diagnosis and management plans reached between clinicians reviewing eyelid lesions remotely and in face-to-face clinics. Methods In this single-centre observational case series, data were prospectively collected on 50 consecutive adults referred with eyelid lesions suitable to be seen by a nurse. A proforma was completed to gather salient information. A nurse specialist saw patients in face-to-face clinics and collected information using the proforma, devising a diagnosis and management plan. Photographs of the eyelid lesions were taken by a medical photographer. A subsequent remote review was completed by an oculoplastic consultant using the proforma information and photographs in the absence of the patient. The diagnosis and management plan constructed by the nurse specialist were compared with those reached by the consultant. Results Complete data were available for 44 consecutive cases. There was an overall 91% agreement (40 cases out of 44) between the diagnoses reached by the nurse specialist, and the remote reviewer; kappa coefficient 0.88 (95% CI 0.76 to 0.99). There was an overall 82% agreement (36 out of 44 cases) in the management plans devised by the nurse-led clinic and remote reviewer; kappa coefficient 0.74 (95% CI 0.58 to 0.90). The average time taken for a remote reviewer to reach a diagnosis and management plan was 1 min and 20 s. Conclusions This study evaluated the feasibility of assessing eyelid lesions using asynchronous telemedicine. There was overall a high rate of concordance in the diagnosis reached, and management devised between the clinic and remote review.
Capacitively-coupled ECG and respiration for the unobtrusive detection of sleep apnea

Objective. The performance of a novel unobtrusive system based on capacitively-coupled electrocardiography (ccECG) combined with different respiratory measurements is evaluated for the detection of sleep apnea. Approach. A sleep apnea detection algorithm is proposed, which can be applied to electrocardiography (ECG) and ccECG, combined with different unobtrusive respiratory measurements, including ECG derived respiration (EDR), respiratory effort measured using the thoracic belt (TB) and capacitively-coupled bioimpedance (ccBioz). Several ECG, respiratory and cardiorespiratory features were defined, of which the most relevant ones were identified using a random forest based backwards wrapper. Using this relevant feature set, a least-squares support vector machine classifier was trained to decide if a one minute segment is apneic or not, based on the annotated polysomnography (PSG) data of 218 patients suspected of having sleep apnea. The obtained classifier was then tested on the PSG and capacitively-coupled data of 28 different patients. Main results. On the PSG data, an AUC of 76.3% was obtained when the ECG was combined with the EDR. Replacing the EDR with the TB led to an AUC of 80.0%. Using the ccECG and ccBioz or the ccECG and TB resulted in similar performances as on the PSG data, while using the ccECG and ccECG-based EDR resulted in a drop in AUC to 67.4%. Significance. This is the first study which tests an apnea detection algorithm on capacitively-coupled ECG and bioimpedance signals and shows promising results on the capacitively-coupled data set. However, it was shown that the EDR could not be accurately estimated from the ccECG signals. Further research into the effect that respiration has on the ccECG is needed to propose alternative EDR estimates.
A novel score system of blood tests for differentiating Kawasaki disease from febrile children

Background Kawasaki disease is the most common cause of acquired heart disease among febrile children under the age of 5 years old. It is also a clinically diagnosed disease. In this study, we developed and assessed a novel score system using objective parameters to differentiate Kawasaki disease from febrile children. Methods We analyzed 6,310 febrile children and 485 Kawasaki disease subjects in this study. We collected biological parameters of a routine blood test, including complete blood count with differential, C-reactive protein, aspartate aminotransferase, and alanine aminotransferase. Receiver operating characteristic curve, logistic regression, and Youden’s index were all used to develop the prediction model. Two other independent cohorts from different hospitals were used for verification. Results We obtained eight independent predictors (platelets, eosinophil, alanine aminotransferase, C-reactive protein, hemoglobin, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and monocyte) and found the top three scores to be eosinophil >1.5% (score: 7), alanine aminotransferase >30 U/L (score: 6), and C-reactive protein>25 mg/L (score: 6). A score of 14 represents the best sensitivity value plus specificity prediction rate for Kawasaki disease. The sensitivity, specificity, and accuracy for our cohort were 0.824, 0.839, and 0.838, respectively. The verification test of two independent cohorts of Kawasaki disease patients (N = 103 and 170) from two different institutes had a sensitivity of 0.780 (213/273). Conclusion Our findings demonstrate a novel score system with good discriminatory ability for differentiating between children with Kawasaki disease and other febrile children, as well as highlight the importance of eosinophil in Kawasaki disease. Using this novel score system can help first-line physicians diagnose and then treat Kawasaki disease early.