Miracle-dz/UniFAR-FTUs huggingface dataset:
How I approach new onset thrombocytopenia

Abstract Thrombocytopenia is a common reason for referral to hematologists in community and hospital practice. A broad differential diagnosis, combined with the potentially life-threatening nature of some presentations necessitates a rapid evaluation of the situation and potential need for emergency intervention; followed by further comprehensive investigation to confirm the diagnosis and institution of longer term management. This review offers an approach to the initial assessment, diagnosis, and referral. We then highlight aspects of the clinical history, examination and laboratory investigations which may provide critical insights into the most likely diagnosis. ITP is the commonest cause of severe isolated thrombocytopenia in the general community and is the most common cause of thrombocytopenia in patients referred to our hematology service. It remains a diagnosis of exclusion and a high degree of vigilance for alternative diagnoses should be maintained, particularly if presentations are atypical or expected response to treatment is not seen. Adult presentation of hereditary thrombocytopenia syndromes can mimic new onset thrombocytopenia, however, improving access to genetic testing will facilitate accurate diagnosis and avoid unnecessary treatment.
Reassessing the Role of Eosinophils as a Biomarker in Chronic Obstructive Pulmonary Disease

Blood eosinophils measurement, as proxy for tissue eosinophils, has become an important biomarker for exacerbation risk and response to inhaled corticosteroids (ICS) in Chronic Obstructive Pulmonary Disease (COPD). Its use to determine the pharmacological approach is recommended in the latest COPD guidelines. The potential role of blood eosinophils is mainly based on data derived from post-hoc and retrospective analyses that showed an association between increased blood eosinophils and risk of exacerbations, as well as mitigation of this risk with ICS. Yet other publications, including studies in real life COPD, do not confirm these assumptions. Moreover, anti-eosinophil therapy targeting interleukin (IL)-5 failed to reduce exacerbations in COPD patients with high blood eosinophils, which casts significant doubts on the role of eosinophils in COPD. Furthermore, a reduction of eosinophils might be harmful since COPD patients with relatively high eosinophils have better pulmonary function, better life quality, less infections and longer survival. These effects are probably linked to the role of eosinophils in the immune response against pathogens. In conclusion, in COPD, high blood eosinophils are widely used as a biomarker for exacerbation risk and response to ICS. However, much is yet to be learned about the reasons for the high eosinophil counts, their variations and their controversial effects on the fate of COPD patients.
Parametric modeling of picosecond pulse propagation on integrated circuit interconnections

Parametric models of dispersive microstrip transmission lines are presented. Autoregressive moving-average and autoregressive models are derived from a lumped-distributed equivalent circuit of the microstrip. Modern system identification techniques are used to estimate the model parameters and physical microstrip properties. Experimental data are compared with model simulation results. <<ETX>>
Pathogenomics of Emerging Campylobacter Species

Campylobacter is among the four main causes of gastroenteritis worldwide and has increased in both developed and developing countries over the last 10 years. The vast majority of reported Campylobacter infections are caused by Campylobacter jejuni and, to a lesser extent, C. coli; however, the increasing recognition of other emerging Campylobacter pathogens is urgently demanding a better understanding of how these underestimated species cause disease, transmit, and evolve. SUMMARY Campylobacter is among the four main causes of gastroenteritis worldwide and has increased in both developed and developing countries over the last 10 years. The vast majority of reported Campylobacter infections are caused by Campylobacter jejuni and, to a lesser extent, C. coli; however, the increasing recognition of other emerging Campylobacter pathogens is urgently demanding a better understanding of how these underestimated species cause disease, transmit, and evolve. In parallel to the enhanced clinical awareness of campylobacteriosis due to improved diagnostic protocols, the application of high-throughput sequencing has increased the number of whole-genome sequences available to dozens of strains of many emerging campylobacters. This has allowed for comprehensive comparative pathogenomic analyses for several species, such as C. fetus and C. concisus. These studies have started to reveal the evolutionary forces shaping their genomes and have brought to light many genomic features related to pathogenicity in these neglected species, promoting the development of new tools and approaches relevant for clinical microbiology. Despite the need for additional characterization of genomic diversity in emerging campylobacters, the increasing body of literature describing pathogenomic studies on these species deserves to be discussed from an integrative perspective. This review compiles the current knowledge and highlights future work toward deepening our understanding about genome dynamics and the mechanisms governing the evolution of pathogenicity in emerging Campylobacter species, which is urgently needed to develop strategies to prevent or control the spread of these pathogens.
An integrated controller for a high frequency buck converter

This paper reports on the design, fabrication, and test of a controller IC for a buck converter, designed to operate with synchronous rectification in a constant off-time, variable frequency mode. This mode is advantageous to support soft-switching over a wide input voltage range. Operation up to 5 MHz allows potential use with a microfabricated inductor. Considerable attention is paid to the control of deadtimes. Specifically, the adaptive deadtime control scheme proposed in our earlier work was successfully implemented and tested.
British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update

This British Association for Psychopharmacology guideline replaces the original version published in 2010, and contains updated information and recommendations. A consensus meeting was held in London in October 2017 attended by recognised experts and advocates in the field. They were asked to provide a review of the literature and identification of the standard of evidence in their area, with an emphasis on meta-analyses, systematic reviews and randomised controlled trials where available, plus updates on current clinical practice. Each presentation was followed by discussion, aiming to reach consensus where the evidence and/or clinical experience was considered adequate, or otherwise to flag the area as a direction for future research. A draft of the proceedings was circulated to all speakers for comments, which were incorporated into the final statement.
Associations of perinatal characteristics with endometriosis: a nationwide birth cohort study

Abstract Background Perinatal characteristics are associated with subsequent risk of several chronic diseases. Previous studies regarding endometriosis were based on small samples and retrospective data and were limited by unmeasured confounding bias, leading to conflicting and inconclusive findings. We investigated the associations of maternal and birth characteristics with risk of endometriosis among Swedish women of reproductive age. Methods This total-population register-based cohort study consisted of 628 312 singleton women born in Sweden between 1973 and 1987, who were followed for diagnosed endometriosis from age 15 years until the end of 2012. Multivariable Cox regression was applied to examine associations with perinatal characteristics. Residual unmeasured confounding was assessed through within-family and E-value analyses. Results During follow-up, 8262 women received an endometriosis diagnosis. There were clear dose−response/linear associations of endometriosis with lower maternal education, endometriosis in the mother [adjusted hazard ratio (aHR): 2.24, 95% confidence interval (CI): 2.04–2.46], maternal smoking during pregnancy (aHR: 1.18, 95% CI: 1.04–1.33 for moderate smoker and aHR: 1.36, 95% CI: 1.18–1.57 for heavy smoker vs non-smoker), lower birthweight, and lower birthweight-for-gestational age (aHR: 0.93 per standard deviation increase, 95% CI: 0.91–0.95). Within-family and E-value analyses suggested that these perinatal characteristics are robust predictors of the incidence of endometriosis. We also found that an estimated 26% of the association between maternal smoking and early-onset endometriosis could be explained by birthweight-for-gestational age. Conclusion This study finds support for fetal origins of endometriosis, in that exposure to adverse environment or restricted development during the perinatal period may increase the risk. Further research is needed to provide an understanding of the underlying mechanisms.
Pegfilgrastim and linagliptin potentiate chemoattraction of Ccr2 and Cd44 stem cells accompanied by alterations of cardiac Hgf, Igf‐1 and Mcp‐1 in daunorubicin cardiomyopathy

Daunorubicin (DAU) downregulates cytokines promoting stem cell migration and homing into the heart, reducing cardiac regeneration after anticancer chemotherapy. Pegfilgrastim (PFIL) protects from DAU‐induced neutropenia but its cardioprotective potential remains unclear. We tested whether pegfilgrastim and a dipeptidyl peptidase‐4 inhibitor linagliptin, potential enhancers of stem cells migration and homing, would improve DAU‐cardiomyopathy.
Dementia-related anxiety and coping styles associated with suicidal ideation

Abstract Objective: Dementia-related anxiety is associated with general anxiety and depression, which are risk factors for suicidal ideation. Consequently, dementia-related anxiety may be associated with suicidal ideation. When faced with a negative event (e.g. developing dementia), individuals primarily employ monitoring or blunting styles of coping. The present study investigated whether dementia-related anxiety and coping styles were associated with suicidal ideation in adults and whether coping styles moderated the relation between dementia-related anxiety and suicidal ideation. Methods: Online Mturk participants (n = 330) completed the Miller Behavioral Style Scale, Dementia Worry Scale, and Patient Health Questionnaire-9. Suicidal ideation was assessed with the Patient Health Questionnaire. Results: Dementia-related anxiety and monitor/blunter coping styles were independently associated with suicidal ideation in a multiple logistic regression; coping styles did not moderate the relation between dementia-related anxiety and suicidal ideation. Discussion: Greater dementia-related anxiety and less use of monitoring coping style were associated with suicidal ideation. Interventions to decrease suicide risk may benefit from taking into account individual differences in dementia-related anxiety and coping styles.
Mycoplasma pneumoniae-induced non-sexually acquired genital ulceration (Lipschütz ulcers)

We read with interest the case report by Fremlin and colleagues1 on non-sexually acquired genital ulceration (NSAGU), also termed Lipschutz ulcers. NSAGU is characterised by acute painful genital ulcerations in girls and young women and has been associated with a large spectrum of acute infections, for example, Epstein-Barr virus (EBV), cytomegalovirus (CMV) and parvovirus.2 3 We would like to draw attention to the possibility of another important cause of this condition. …
Novel prime-boost vaccine strategies against HIV-1

ABSTRACT Introduction: Given the complexities of HIV infection and the HIV genetic heterogeneity, a successful HIV vaccine should elicit broad adaptive and innate immune responses. Vaccine prime-boost platforms may achieve this goal. Several factors including selection of antigen, type of vector, delivery route, dose, adjuvant, boosting regimen, order of vector injection, and intervals between vaccinations influence the outcome. Areas covered: We reviewed the literature on the latest findings of the various prime-boost HIV vaccine clinical trials, with particular emphasis on the most advanced and promising strategies. Expert opinion: Data suggest that heterologous may be better than homologous prime-boost regimens for protection. The most advanced strategies to have reached efficacy trials use either canarypox vector (ALVAC) boosted by adjuvanted gp120 protein or adenovirus (Ad26) vector expressing mosaic antigens boosted by gp140 protein. DNA prime and vectors and/or protein boost regimens are at less advanced development stage. These regimens, while imperfect (efficacy ≥50%), could contribute substantially to the control of HIV epidemics as a part of a comprehensive HIV prevention program. To ensure prompt vaccine access in populations with the greatest need, attention should be given to post-efficacy activities necessary to achieve appropriate uptake and implementation of effective vaccines.
Anterior CNS expansion driven by brain transcription factors

During CNS development, there is prominent expansion of the anterior region, the brain. In Drosophila, anterior CNS expansion emerges from three rostral features: (1) increased progenitor cell generation, (2) extended progenitor cell proliferation, (3) more proliferative daughters. We find that tailless (mouse Nr2E1/Tlx), otp/Rx/hbn (Otp/Arx/Rax) and Doc1/2/3 (Tbx2/3/6) are important for brain progenitor generation. These genes, and earmuff (FezF1/2), are also important for subsequent progenitor and/or daughter cell proliferation in the brain. Brain TF co-misexpression can drive brain-profile proliferation in the nerve cord, and can reprogram developing wing discs into brain neural progenitors. Brain TF expression is promoted by the PRC2 complex, acting to keep the brain free of anti-proliferative and repressive action of Hox homeotic genes. Hence, anterior expansion of the Drosophila CNS is mediated by brain TF driven ‘super-generation’ of progenitors, as well as ‘hyper-proliferation’ of progenitor and daughter cells, promoted by PRC2-mediated repression of Hox activity.
Exploring the Meaning of Cognitive Behavioral Therapy for Insomnia for Patients with Chronic Pain.

OBJECTIVE Insomnia is one of the most common, persistent, and distressing symptoms associated with chronic pain. Cognitive behavioral therapy for insomnia (CBT-I) is the firstline treatment for insomnia, but patient preferences and perspectives about CBT-I within the context of chronic pain are unknown. The current qualitative study sought to understand the experience of CBT-I among patients with chronic pain, including aspects of CBT-I that were found to be difficult (e.g., pain as a specific barrier to adherence/dropout), changes in sleep and pain functioning after CBT-I, and aspects of CBT-I that were appreciated. DESIGN Qualitative semistructured interviews. METHODS We conducted individual semistructured interviews with 17 veterans with chronic pain and insomnia who had recently participated in CBT-I, as well as their CBT-I therapists, and used thematic analysis to identify conceptual themes. RESULTS Results revealed that patients and CBT-I therapists found changing sleep habits during CBT-I challenging due to anxiety and temporary increases in fatigue, but did not identify major pain-related barriers to adhering to CBT-I recommendations; patients experienced better sleep, mood, energy, and socialization after CBT-I despite minimal changes in pain intensity; and patients highly valued CBT-I as a personalized treatment for sleep and strongly recommended it for other patients with chronic pain. CONCLUSIONS Findings of improved sleep and functional outcomes support efforts to incorporate CBT-I into chronic pain treatment, including educating patients and providers about the strong feasibility of improving sleep and quality of life despite ongoing pain.
Microstructure and Mechanical Properties of Al–(12-20)Si Bi-Material Fabricated by Selective Laser Melting

In this study, a combination of Al–12Si and Al–20Si (Al–(12-20)Si) alloys was fabricated by selective laser melting (SLM) as a result of increased component requirements such as geometrical complexity and high dimensional accuracy. The microstructure and mechanical properties of the SLM Al–(12-20)Si in as-produced as well as in heat-treated conditions were investigated. The Al–(12-20)Si interface was in the as-built condition and it gradually became blurry until it disappeared after heat treatment at 673 K for 6 h. This Al–(12-20)Si bi-material displayed excellent mechanical properties. The hardness of the Al–20Si alloy side was significantly higher than that of the Al–12Si alloy side and the disparity between both sides gradually decreased and tended to be consistent after heat treatment at 673 K for 6 h. The tensile strength and elongation of the Al–(12-20Si) bi-material lies in between the Al–12Si and Al–20Si alloys and fracture occurs in the Al–20Si side. The present results provide new insights into the fabrication of bi-materials using SLM.
Context based document searching using Apriori Association for Mobile Devices

Now a day’s numbers of documents on Internet are increasing. Many traditional searching techniques may not return most accurate results in some cases. This can overcome by considering context of document i.e. content profile. In this paper we have proposed a system which tries to address this issue with novel method of content profiling. Proposed system is using Naive Bayes text classifier and Apriori association rule to build content profile. This system accepts document from users and reply with set of similar documents based on context of document. Here we are considering document context of both input document and stored documents. This gives system where searching can also be done without using keywords.Content profile: Set of simple sentences that capture essence of document.
Survival after stereotactic radiotherapy in patients with early-stage non-small cell lung cancer

Abstract Introduction: Stereotactic radiotherapy (SBRT) is the treatment of choice for inoperable early stage non-small cell lung cancer (NSCLC). We report analyses of the influence of age on survival after SBRT. Methods and material: From 2005 to 2017, 544 previously un-irradiated patients with early stage NSCLC had SBRT. The data were analyzed in four age groups: A: –69 (176 pts), B: 70–74 (115 pts), C: 75–79 (131 pts) and D: 80 years or older (122 pts). Two SBRT dose regimes were used: 45 Gy/3F (N = 103) and 66 Gy/3F (N = 441). Results: All patients had a follow up (time to censoring, FU) of at least 16 months, the median FU being 48.0 months. The median age was 74.4 years. The overall survival (OS) was associated with age. The median OS was 50.7, 45.9, 45.4 and 33.0 months, and the 5-year OS was 45%, 32%, 33% and 18% in groups A, B, C and D, respectively. No difference was found between groups B and C, while OS in group A was significantly better than remaining groups, and the OS in group D significantly poorer. In multivariable analyses, OS was heavily influenced by age, Charlson’s comorbidity index (CCI) and performance status (PS). For lung cancer-specific survival (LCSS), only increasing tumor diameter and PS were associated with poor survival. Conclusions: The OS was influenced by age, but the study suggests that a cut point of 75 year is inappropriate in evaluating the effect of old age on survival. Poor PS was associated with poor OS. CCI influenced OS, but not LCSS, which was only affected by PS and tumor size.
Significance of Lymph Node Metastasis in Resectable Well-differentiated Pancreatic Neuroendocrine Tumor.

OBJECTIVES Understanding the effect of lymph node metastasis (LNM) on prognosis in pancreatic neuroendocrine neoplasm is helpful for surgery and follow-up. In this study, we investigated the significance of LNM in well-differentiated pancreatic neuroendocrine tumors (PanNETs) according to the World Health Organization 2017 classification. METHODS We retrospectively collected data for 95 consecutive patients with PanNET who underwent pancreatic resection with curative intent between January 2008 and December 2017 at 6 institutions. The clinicopathological factors were compared in patients with and without LNM, and prognostic factors were analyzed. RESULTS Lymph node metastasis was significantly associated with malignant potential of PanNET, such as larger tumor size, higher Ki-67 index, higher tumor grade, and higher incidence of lymphatic, vessel, and neural invasion. Lymph node metastasis was also associated with disease-free but not overall survival. Multivariate analysis identified NET grade 2 (G2) and G3 as independent risk factors for recurrence after curative resection. CONCLUSIONS World Health Organization 2017 classification was the most independent prognostic factor in patients with resectable well-differentiated PanNETs. Patients with G2 and higher-grade tumors require lymph node dissection to improve prognosis.
High-Flow Nasal Cannula Versus Standard Oxygen Therapy After Extubation in Liver Transplantation: A Matched Controlled Study

BACKGROUND: High-flow nasal cannula (HFNC) is a key component of oxygen therapy and has largely been used in patients with acute respiratory failure. We conducted a matched controlled study with the aim to compare the preventive use of oxygen therapy delivered by HFNC versus via air-entrainment mask (standard O2) after extubation in adult subjects with liver transplantation for reducing postextubation hypoxemia. METHODS: Twenty-nine subjects with liver transplantation who received HFNC after extubation (HFNC group) were matched 1:1 with 29 controls (standard O2 group) chosen from an historical group of 90 subjects admitted to the ICU during the previous 36 months. The primary outcome of the study was the incidence of hypoxemia at 1 h and 24 h after extubation. Secondary outcomes were the rate of weaning failure, ICU length of stay, and 28-d mortality. RESULTS: The incidence of hypoxemia was not significantly different between the HFNC and standard O2 groups at 1 h and 24 h after extubation. In the HFNC group, there was a trend toward a lower rate of weaning failure compared with the standard O2 group. ICU length of stay and 28-d mortality were similar in both groups. CONCLUSIONS: Early application of HFNC in the subjects with liver transplantation did not reduce the incidence of hypoxemia after extubation compared with standard O2 and did not modify the incidence of weaning failure, ICU length of stay, and 28-d mortality in this high-risk population of subjects. (ClinicalTrials.gov registration NCT03441854.)