Miracle-dz/UniFAR-FTUs huggingface dataset:
The Development and Evaluation of a Combined Infection–Rheumatology Assessment Service in Response to the Chikungunya Fever Epidemic

ABSTRACT. The chikungunya virus is an arthritogenic alphavirus. Acute infection may be followed by persistent arthralgia, often causing significant functional impairment. The 2014–2015 chikungunya fever (CHIKF) epidemic resulted in a marked increase in cases presenting to rheumatology and tropical diseases services. A combined multidisciplinary rheumatology–tropical diseases service for assessment, management, and follow-up of patients with proven CHIKF and persistent (≥ 4 weeks) arthralgia was proposed and rapidly developed at The Hospital for Tropical Diseases in London. Rapid set up of a multidisciplinary clinic in response to the epidemic was achieved. Of a total of 54 patients, 21 (38.9%) patients with CHIKF developed persistent arthralgia and were reviewed by the multidisciplinary service. A combined assessment approach enabled comprehensive multidisciplinary assessment of CHIKF, assessment of joint pathology through ultrasound, and appropriate follow-up. A combined rheumatology–tropical diseases service was successfully used to identify and assess CHIKF-associated morbidity. Future outbreaks may be approached by establishing tailored multidisciplinary clinics.
VLT/FORS Surveys of Wolf-Rayet Stars in the Nearby Universe

Abstract We present results from a series of VLT/FORS narrow-band imaging and spectroscopic surveys of Wolf-Rayet (WR) stars in nearby spiral galaxies and compare observed populations in high- and low metallicity environments. The metal-rich galaxy M 83 is seen to host an exceptional WR content, with over 1000 WR stars being detected. N(WC)/N(WN) ~ 1.2 and late-type WC subtypes dominate the WC population. At low metallicity, ~100 stars has been identified within NGC 1313, with N(WC)/N(WN) ~ 0.5. In contrast to M83, the WC population of NGC 1313 comprises solely early subtypes plus a WO star (the first WO star to be identified beyond the Local Group). Consequently, the dominant WC subtype may serve as a crude metallicity diagnostic for WR galaxies. In addition, the WR content of the blue compact dwarf galaxy NGC 3125 is examined. Previous UV and optical spectroscopic studies of knot A in NGC 3125 derive WR populations which differ by more than an order of magnitude. New VLT observations and archival HST spectroscopy reconcile this discrepancy via the use of LMC WR spectral templates and a reduced nebular-derived interstellar extinction. Empirical N(WR)/N(O) ratios for clusters within NGC 3125 are a factor of two higher than evolutionary synthesis predictions but are consistent with those observed for other young massive clusters.
Volumetric differences of thalamic nuclei in children with trisomy 21

Objectives Histological studies have shown alterations of thalamic nuclei in patients with Down syndrome (DS). The correlation of these changes on MRI (magnetic resonance imaging) is unclear. Therefore, this study investigates volumetric differences of thalamic nuclei in children with DS compared to controls. Methods Patients were retrospectively identified between 01/2000 and 10/2021. Patient inclusion criteria were: (1) 0–18 years of age, (2) diagnosis of DS, and (3) availability of a brain MRI without parenchymal injury and a non-motion-degraded volumetric T1-weighted sequence. Whole thalamus and thalamic nuclei (n = 25) volumes were analyzed bilaterally relative to the total brain volume (TBV). Two-sided t-tests were used to evaluate differences between groups. Differences were considered significant if the adjusted p-value was <0.05 after correction for multiple hypothesis testing using the Holm-Bonferroni method. Results 21 children with DS (11 females, 52.4%, mean age: 8.6 ± 4.3 years) and 63 age- and sex-matched controls (32 females, 50.8%, 8.6 ± 4.3 years) were studied using automated volumetric segmentation. Significantly smaller ratios were found for nine thalamic nuclei and the whole thalamus on the right and five thalamic nuclei on the left. TBV was significantly smaller in patients with DS (p < 0.001). No significant differences were found between the groups for age and sex. Conclusions In this exploratory volumetric analysis of the thalamus and thalamic nuclei, we observed statistically significant volumetric changes in children with DS. Our findings confirm prior neuroimaging and histological studies and extend the range of involved thalamic nuclei in pediatric DS.
Optimal Renal Artery-Aorta Angulation Revealed by Flow Simulation

Introduction: In the circulatory system, the vessel branching angle may have hemodynamic consequences. We hypothesized that there is a hemodynamically optimal range for the renal artery’s branching angle. Methods: Data on the posttransplant kinetics of estimated glomerular filtration rate (eGFR) were analyzed according to the donor and implant sides (right-to-right and left-to-right position; n = 46). The renal artery branching angle from the aorta of a randomly selected population was measured using an X-ray angiogram (n = 44). Computational fluid dynamics simulation was used to elucidate the hemodynamic effects of angulation. Results and Discussion: Renal transplant patients receiving a right donor kidney to the right side showed faster adaptation and higher eGFR values than those receiving a left donor kidney to the right side (eGFR: 65 ± 7 vs. 56 ± 6 mL/min/1.73 m2; p < 0.01). The average branching angle on the left side was 78° and that on the right side was 66°. Simulation results showed that the pressure, volume flow, and velocity were relatively constant between 58° and 88°, indicating that this range is optimal for the kidneys. The turbulent kinetic energy does not change significantly between 58° and 78°. Conclusion: The results suggest that there is an optimal range for the renal artery’s branching angle from the aorta where hemodynamic vulnerability caused by the degree of angulation is the lowest, which should be considered during kidney transplantations.
Individually guided training prescription by heart rate variability and self-reported measure of stress tolerance in recreational runners: Effects on endurance performance

ABSTRACT The aim of this study was to determine the effect of endurance training individually guided by objective (Heart Rate Variability-HRV) or self-report measure of stress (DALDA-questionnaire) in comparison to predefined endurance training prescription for improving endurance performance in recreational runners. After a 2-week preliminary baseline period to establish resting HRV and self-reported measure of stress, thirty-six male recreational runners were randomly assigned to HRV-guided (GHRV; n = 12), DALDA-guided (GD; n = 12) or predefined training (GT; n = 12) prescription groups. Before and after 5-weeks of endurance training, participants performed a track field peak velocity (Vpeak_TF), time limit (Tlim) at 100% of Vpeak_TF and 5 km time-trial (5 km TT) tests. GD lead to higher improvements in Vpeak_TF (8.4 ± 1.8%; ES = 1.41) and 5 km TT (−12.8 ± 4.2%; ES = −1.97), than GHRV (6.6 ± 1.5% and −8.3 ± 2.8%; ES = −1.20; 1.24) and GT (4.9 ± 1.5% and −6.0 ± 3.3%; ES = −0.82; 0.68), respectively, with no differences for Tlim. Self-report measures of stress may be used to individualize endurance training prescription on a daily basis leading to better performance enhancement, which may be used with HRV for a holistic understanding of daily training-induce adaptations.
Safflower yellow and its main component hydroxysafflor yellow A alleviate hyperleptinemia in diet-induced obesity mice through a dual inhibition of the GIP-GIPR signaling axis.

Glucose-dependent insulinotropic polypeptide (GIP) is a gastrointestinal hormone secreted by K cells in the small intestine and is considered an obesity-promoting factor. In this study, we systematically investigated the anti-obesity effects of intragastric safflower yellow (SY)/hydroxysafflor yellow A (HSYA) and the underlying mechanism for the first time. Our results showed that intragastric SY/HSYA, rather than an intraperitoneal injection, notably decreased serum GIP levels and GIP staining in the small intestine in diet-induced obese (DIO) mice. Moreover, intragastric SY/HSYA was also first found to significantly suppress GIP receptor (GIPR) signaling in both the hypothalamus and subcutaneous White adipose tissue. Our study is the first to show that intragastric SY/HSYA obviously reduced food intake and body weight gain in leptin sensitivity experiments and decreased serum leptin levels in DIO mice. Further experiments demonstrated that SY treatment also significantly reduced leptin levels, whereas the inhibitory effect of SY on leptin levels was reversed by activating GIPR in 3 T3-L1 adipocytes. In addition, intragastric SY/HSYA had already significantly reduced serum GIP levels and GIPR expression before the serum leptin levels were notably changed in high-fat-diet-fed mice. These findings suggested that intragastric SY/HSYA may alleviate diet-induced obesity in mice by ameliorating hyperleptinemia via dual inhibition of the GIP-GIPR axis.
Clinical Aureobasidium Isolates Are More Fungicide Sensitive than Many Agricultural Isolates

Environmental microbiota are regularly found in clinical samples and can cause disease, in particular, in immunocompromised individuals. Organisms of the genus Aureobasidium belonging to this group are highly abundant, and some species are even described as pathogens. ABSTRACT Fungicide applications in agriculture and medicine can promote the evolution of resistant, pathogenic fungi, which is a growing problem for disease management in both settings. Nonpathogenic mycobiota are also exposed to fungicides, may become tolerant, and could turn into agricultural or medical problems, for example, due to climate change or in immunocompromised individuals. However, quantitative data about fungicide sensitivity of environmental fungi is mostly lacking. Aureobasidium species are widely distributed and frequently isolated yeast-like fungi. One species, A. pullulans, is used as a biocontrol agent, but is also encountered in clinical samples, regularly. Here, we compared 16 clinical and 30 agricultural Aureobasidium isolates based on whole-genome data and by sensitivity testing with the 3 fungicides captan, cyprodinil, and difenoconazole. Our phylogenetic analyses determined that 7 of the 16 clinical isolates did not belong to the species A. pullulans. These isolates clustered with other Aureobasidium species, including A. melanogenum, a recently separated species that expresses virulence traits that are mostly lacking in A. pullulans. Interestingly, the clinical Aureobasidium isolates were significantly more fungicide sensitive than many isolates from agricultural samples, which implies selection for fungicide tolerance of non-target fungi in agricultural ecosystems. IMPORTANCE Environmental microbiota are regularly found in clinical samples and can cause disease, in particular, in immunocompromised individuals. Organisms of the genus Aureobasidium belonging to this group are highly abundant, and some species are even described as pathogens. Many A. pullulans isolates from agricultural samples are tolerant to different fungicides, and it seems inevitable that such strains will eventually appear in the clinics. Selection for fungicide tolerance would be particularly worrisome for species A. melanogenum, which is also found in the environment and exhibits virulence traits. Based on our observation and the strains tested here, clinical Aureobasidium isolates are still fungicide sensitive. We, therefore, suggest monitoring fungicide sensitivity in species, such as A. pullulans and A. melanogenum, and to consider the development of fungicide tolerance in the evaluation process of fungicides.
Developmental dysplasia of the hip and ultrasound reading by pediatric orthopedic surgeons: a pilot study

Ultrasound is an imaging modality utilized for early detection and follow-up of developmental dysplasia of the hip (DDH) in infants. Traditionally, pediatric orthopedic surgeons have relied on radiologists to perform ultrasound examinations and interpret the imaging. Today, however, many orthopedic surgeons are performing and interpreting ultrasound themselves. The purpose of this paper was to evaluate the reliability of pediatric orthopedic surgeons in interpreting ultrasound imaging of infant hips. This was a prospective observational pilot study. After reading an instructional handout about the Graf method of hip ultrasonography, eight pediatric orthopedic surgeons measured 28 hip ultrasound images to determine the alpha angle and percent femoral head coverage. On the basis of cited intraclass correlation coefficient cutoff values, interrater reliability was found to be ‘good’ for percent femoral head coverage and ‘fair’ for alpha angle. These findings are equivalent to findings of similar studies using radiologists as examiners. Pediatric orthopedic surgeons can interpret ultrasound exams for diagnosing DDH.
Monte carlo comparison of wald's, likelihood ratio and rao's tests

This paper, through a simulation study, examines the behaviour of Wald's, the likelihood ratio and Rao's tests for testing (a) simple hypotheses, (b) one-dimensional composite hypotheses, as well as (c) multi-dimensional composite hypotheses. Peers (1971) has shown that none of these three asymptotic test procedures is uniformly superior to the other two tests for testing simple hypotheses versus composite hypotheses. In a series of papers, Chandra and Joshi (1983), Chandra and Mukerjee (1985), and Chandraand Samanta (1988) have claimed that for large sample size, Rao's size-adjusted test is locally more powerful than either the size-adjusted likelihood ratio test or the size-adjusted Wald test, when these tests are performed at a common and sufficiently low level of significance. In the present study, the tests were performed at the standard levels (5% and 1%) of significance, and various local alternatives were considered. For sample size as small as 20, the simulation study appears to support the resul.
Esophageal and gastric cancer incidence trends in Golestan, Iran: An age‐period‐cohort analysis 2004 to 2018

Golestan province in the northeast of Iran is part of the Asian esophageal cancer belt and is known as a high‐risk area for esophageal (EC) and gastric cancers (GC). Data on incident cases of EC and GC during 2004 to 2018 were obtained from the Golestan Population‐based Cancer Registry (GPCR). The age‐standardized incidence rates (ASRs) were calculated and presented per 100 000 person‐years. The estimated annual percentage change (EAPC) with 95% confidence interval (95% CI) were calculated. We also fitted age‐period‐cohort (APC) models to assess nonlinear period and cohort effects as incidence rate ratios (IRRs). Overall, 3004 new cases of EC (ASR = 15.7) and 3553 cases of GC (ASR = 18.3) were registered in the GPCR. We found significant decreasing trends in incidence rates of EC (EAPC = −5.0; 95% CI: −7.8 to −2.2) and less marked nonsignificant trends for GC (EAPC = −1.4; 95% CI: −4.0 to 1.4) during 2004 to 2018. There was a strong cohort effect for EC with a consistent decrease in the IRR across successive birth cohorts, starting with the oldest birth cohort (1924; IRR = 1.9 vs the reference birth cohort of 1947) through to the most recent cohort born in 1988 (IRR = 0.1). The marked declines in EC incidence rates in Golestan relate to generational changes in its underlying risk factors. Despite favorable trends, this population remains at high risk of both EC and GC. Further studies are warranted to measure the impact of the major risk factors on incidence with a view to designing effective preventative programs.
Stochastic Approach to Planning of Spares for Complex Deteriorating Industrial System

Abstract An easily implementable stochastic model for planning the inventory of spare components needed for corrective replacements of system components is presented. The probability of spare shortage in a given time interval is chosen as the decision criterion. The model is based on the assumption that the system contains a great number of identical independent components subject to wear-out. It can be used to determine the minimal number of spare components needed at the beginning of the planning interval to fulfil the requirement for an acceptable shortage probability during this interval. Besides, the model enables calculation of the probability of spare shortage during a given time interval considering the existing inventory level at the beginning of this interval. The model contains a few constant parameters that can be estimated from the component field data. It also includes two time dependent parameters which are calculated using the renewal function from the renewal theory. A discrete approximation which enables relatively simple calculation of the renewal function for any peak-shaped probability density function is derived. Assuming that the probability density function of component failure times is described by the normal density function, the renewal process characteristics are presented in terms of component mean time to failure and corresponding standard deviation. The error of our approximation for the renewal function is estimated. The model is applied to two components of electric locomotives in Slovenian Railways. The results obtained show that even small changes of the level of spares in the existing inventory can result in considerable changes of the spare shortage probability.
Photoluminescence from silicon nitride—no quantum effect

Silicon nitride compounds emit photoluminescence all over the visible range. Recent studies ascribed this luminescence to quantum-size effects within silicon nanocrystals that were either shown or assumed to form inside the silicon nitride matrix; the luminescence of the matrix itself was ignored. In contrast, observing the same luminescence even without the presence of silicon crystallites, our work identifies the silicon nitride matrix itself as responsible for the photoluminescence. All experimental observations are well explained by band tail luminescence from the silicon matrix. In contrast to the silicon nanocrystal approach, our model explains all aspects of the luminescence. As a consequence, we conclude that silicon nitride films are inappropriate if one aims at investigating photoluminescence from silicon nanocrystals within such a matrix.
Etanercept originator versus etanercept biosimilar for the treatment of rheumatoid arthritis as a first biologic: results from the BSRBR-RA

Abstract Objectives Etanercept biosimilars show comparable efficacy to their originators among biologic-naïve patients with RA in randomized controlled trials. Nationwide guidelines have obligated prescribing of etanercept biosimilars from 2016, resulting in significant cost savings. This analysis aimed to compare the effectiveness of etanercept originator vs etanercept biosimilar amongst biologic-naïve RA patients treated in routine clinical practice in the UK. Methods Biologic-naïve RA patients starting etanercept in the British Society for Rheumatology Biologics Register in Rhematoid Arthritis (BSRBR-RA) cohort study from 2010 were included. Data collected at start of therapy includes patient demographics and disease activity. Follow-up data includes changes in disease activity and anti-rheumatic therapy. Six- and 12-month primary outcomes include DAS for 28-joints (DAS28) remission, EULAR response and minimal clinically important difference in function. Etanercept drug survival was assessed using Kaplan–Meier and Cox regression, including reasons for treatment withdrawal. Multiple imputation accounted for missing data. Propensity-decile adjustment was used to account for confounding by indication. Results A total of 1806 biologic-naïve RA patients started etanercept: 1009 originator, 797 biosimilar. At 6 and 12 months, the proportion of patients achieving DAS28 remission and EULAR response were similar between treatments. During follow-up, 19% of originator patients switched onto etanercept biosimilar. Patients were censored at time of switch. Patients on originator were no more likely to stop therapy vs biosimilar; 71% of originator and 76% of biosimilar patients remained on therapy at 1 year. Conclusions In one of the largest analyses of patients with RA, biologic-naïve RA patients treated with etanercept originator showed similar outcomes vs biosimilar using real-world data. Drug survival, and disease activity after 6 and 12 months of therapy, was similar between cohorts.
Association of Tirofiban With Functional Outcomes After Thrombectomy in Acute Ischemic Stroke Due to Intracranial Atherosclerotic Disease

Background and Objective To investigate the efficacy and safety of IV infusion of tirofiban before endovascular thrombectomy for patients with large vessel occlusion due to intracranial atherosclerotic disease. The secondary objective was to identify potential mediators for the clinical effect of tirofiban. Methods Post hoc exploratory analysis of the Endovascular Treatment With versus Without Tirofiban for Patients with Large Vessel Occlusion Stroke (RESCUE BT) trial, which was a randomized, double-blinded, placebo-controlled trial at 55 centers in China from October 2018 to October 2021. Patients with occlusion of the internal carotid artery or middle cerebral artery due to intracranial atherosclerosis were included. The primary efficacy outcome was the proportion of patients achieving functional independence (defined as modified Rankin scale 0–2) at 90 days. Binary logistic regression and causal mediation analyses were used to estimate the treatment effect of tirofiban and the potential mediators. Results This study included 435 patients, of whom 71.5% were men. The median age was 65 (interquartile range [IQR] 56–72) years, with a median NIH Stroke Scale of 14 (IQR 10–19). Patients in the tirofiban group had higher rates of functional independence at 90 days than patients in the placebo group (adjusted odds ratio 1.68; 95% CI 1.11–2.56, p = 0.02) without an increased risk of mortality or symptomatic intracranial hemorrhage. Tirofiban was associated with fewer thrombectomy passes (median [IQR] 1 [1–2] vs 1 [1–2], p = 0.004), which was an independent predictor of functional independence. Mediation analysis showed tirofiban-reduced thrombectomy passes explained 20.0% (95% CI 4.1%–76.0%) of the effect of tirofiban on functional independence. Discussion In this post hoc analysis of the RESCUE BT trial, tirofiban was an effective and well-tolerated adjuvant medication of endovascular thrombectomy for patients with large vessel occlusion due to intracranial atherosclerosis. These findings need to be confirmed in future trials. Trial Registration Information The RESCUE BT trial was registered on the Chinese Clinical Trial Registry: chictr.org. cn, ChiCTR-INR-17014167. Classification of Evidence This study provides Class II evidence that tirofiban plus endovascular therapy improves 90-day outcome for patients with large vessel occlusion due to intracranial atherosclerosis.