Miracle-dz/UniFAR-FTUs huggingface dataset:
Pseudolesion in the right parafissural liver parenchyma on CT: The base is found in embryology and collagen content

Background Computed tomography (CT) images of livers may show a hypo-attenuated structure alongside the falciform ligament, which can be a focal fatty pseudolesion and can mimic a malignancy. The preferred location is on the right parafissural site, ventral in segment IVa/b. The etiology is not clear, nor is it known how the histology of this location develops. These are evaluated in this study. Methods 40 adult cadavers with autopsy and / or postmortem CT in a university hospital and a forensic center were included. Liver biopsies were taken at the left side of the falciform ligament as control, and at the right side as the possible precursor of a pseudolesion; these were examined for collagen and fat content. Cadavers with steatotic (>5% fat) or fibrotic (>2% collagen) control samples were excluded. Results Significantly more collagen was present in the right parafissural liver parenchyma: median 0.68% (IQR: 0.32 – 1.17%), compared to the left side 0.48% (IQR: 0.21 – 0.75%) (p 0.008), with equal fat content and CT attenuation values. The etiophysiology goes back to the demise of the umbilical venes in the early embryonic and neonatal period. Conclusions The right parafissural area contains more collagen and an equal amount of fat compared to the control left side. This supports the hypothesis of delayed, ‘third’ inflow: the postnatal change in blood supply from umbilical to portal leaves the downstream parafissural area hypoperfused leading to hypoxia which in turn results in collagen accumulation and the persistence of paraumbilical veins of Sappey. Key points The typical location for a parafissural hepatic pseudolesion contains increased collagen. A change in histology is caused by physiological demise of the umbilical venes. The suboptimal blood supply of the right parafissural side leads to hypoxia and collagen deposition. Embryologic knowledge and postmortem histology can help resolve issues in radiology.
A gut feeling about stroke reveals gut-brain axis’ active role in homeostasis and dysbiosis

Peripheral inflammatory responses accompany many neurological disorders, including stroke. The gut-brain axis opens new avenues in our understanding of stroke progression and abrogation of secondary cell death. Certain microbiomes, especially those related to inflammation, appear to closely reflect the homeostasis and dysbiosis of both the brain and the gut, suggesting their potential application as biomarkers and therapeutic targets. A paradigm shift from purely central towards incorporating peripheral sequestration of cell death pathways may improve stroke therapeutic outcomes. Recognizing this gut-brain axis as key to disease pathology and treatment is likely to usher innovative approaches in cell-based regenerative medicine for stroke.
Skeletal Muscle Reflex–Induced Sympathetic Dysregulation and Sensitization of Muscle Afferents in Type 1 Diabetic Rats

Supplemental Digital Content is available in the text. The blood pressure response to exercise is exaggerated in the type 1 diabetes mellitus (T1DM). An overactive exercise pressor reflex (EPR) contributes to the potentiated pressor response. However, the mechanism(s) underlying this abnormal EPR activity remains unclear. This study tested the hypothesis that the heightened blood pressure response to exercise in T1DM is mediated by EPR-induced sympathetic overactivity. Additionally, the study examined whether the single muscle afferents are sensitized by PKC (protein kinase C) activation in this disease. Sprague-Dawley rats were intraperitoneally administered either 50 mg/kg streptozotocin (T1DM) or saline (control). At 1 to 3 weeks after administration, renal sympathetic nerve activity and mean arterial pressure responses to activation of the EPR, mechanoreflex, and metaboreflex were measured in decerebrate animals. Action potential responses to mechanical and chemical stimulation were determined in group IV afferents with pPKCα (phosphorylated-PKCα) levels assessed in dorsal root ganglia. Compared with control, EPR (58±18 versus 96±33%; P<0.05), mechanoreflex (21±13 versus 51±20%; P<0.05), and metaboreflex (40±20 versus 88±39%; P<0.01) activation in T1DM rats evoked significant increases in renal sympathetic nerve activity as well as mean arterial pressure. The response of group IV afferents to mechanical (18±24 versus 61±45 spikes; P<0.01) and chemical (0.3±0.4 versus 1.6±0.8 Hz; P<0.01) stimuli were significantly greater in T1DM than control. T1DM rats showed markedly increased pPKCα levels in dorsal root ganglia compared with control. These data suggest that in T1DM, abnormally muscle reflex-evoked increases in sympathetic activity mediate exaggerations in blood pressure. Further, sensitization of muscle afferents, potentially via PKC activation, may contribute to this abnormal circulatory responsiveness.
Measurement properties and factor analysis of the Diabetic Foot Ulcer Scale‐short form (DFS‐SF)

The purpose of this paper is to provide measurement properties evaluation and factor analysis of the Brazilian version of the diabetic foot ulcer scale‐short form (DFS‐SF). This methodological study evaluated the measurement properties of the DFS‐SF by ceiling and floor effect reliability, responsiveness, and structural construct validity. The study included 290 people with diabetic foot under regular follow‐up in a specialised outpatient clinic in inland São Paulo. Reliability was assessed by internal consistency using Cronbach's alpha and composite reliability. Ceiling and floor effects were assessed by the percentage of participants who scored the 15% worst (floor) and 15% best (ceiling) possible scale results. Validity was tested by correlating the instrument values with the domains of the Brazilian version of the Short Form Health Survey (SF‐36). Responsiveness (n = 34) was accessed through the wound area obtained by photography and evaluated by the Image J Features program and the DFS‐SF score at two moments, with a 4‐week interval between them. The instrument had good evidence of reliability, shown by adequate internal consistency (Cronbach's alpha in domains >0.70) and compound reliability (0.84 > CC > 0.92); and of convergent validity, by significant positive correlations of moderate to strong magnitude with SF‐36. Structural construct validity was examined by applying the DFS‐SF confirmatory factor analysis, which indicated that the Brazilian version of the instrument is properly fitted to the original dimensional structure. The ceiling and floor effect analysis showed no ceiling or floor effects. Responsiveness was observed in the wound area, but not in the DFS‐SF scores in the times. The Brazilian version of the DFS‐SF presented evidence of validity and reliability, suggesting that this instrument is a valid tool for assessing the quality of life of people with diabetic foot in the Brazilian population.
Promising platelets: potential benefits and extended life-span of cold-stored and cryopreserved platelets

The advent of component therapy and evolution of Apheresis technology has led to widespread usage of platelet transfusions. It is estimated that over 2·9 million platelet products are used annually in Europe alone [1]. The storage temperature of platelets has been the subject of much controversy and scrutiny within transfusion science. The current storage temperature of platelets prepared by both pooled buffy coats and by apheresis is 22+2°C.
Genetic investigation and phylogenetic analysis of three Chinese ethnic groups using 16 X chromosome STR loci

Abstract Background: The value of using X-chromosomal short tandem repeats (X-STRs) as genetic markers in human genetics has been widely recognised. However, the 16 X-STRs in the Goldeneye® DNA ID System 17X kit have not been thoroughly applied. Aim: To investigate the genetic polymorphisms of 16 X-STRs in three main ethnic minorities (Tibetan, Mongolian and Kazakh) in China and to reveal the phylogenetic relationships of different populations. Subjects and methods: A total of 245 Tibetan, 168 Mongolian and 105 Kazakh individuals were genotyped using this 17X kit. The allelic frequencies and other parameters were calculated. An additional eight Chinese populations and nine global populations were included in genetic comparisons based on 16 or 8 overlapped X-STRs. Results: A total of 147 alleles were observed from 16 X-STRs with allelic frequencies ranging from 0.0024 to 0.7952 in the three studied groups. Based on 16 X-STRs, Tibetans, Kazakhs and Mongolians showed more similarity to each other and were genetically distinct from the Shanghai Han group; based on 8 X-STRs, only the genetic relationships between different nations could be clarified. Conclusions: Our study presents an extensive report on a novel X-STR assay in three Chinese ethnic groups and a comprehensive genetic comparison between different populations based on these X-STRs.
Association between fall history and performance-based physical function and postural sway in patients with rheumatoid arthritis

Abstract Objectives Patients with rheumatoid arthritis (RA) are at increased risk of falling; therefore, fall prevision and prevention are critical. The present study aimed to evaluate the ability of physical performance assessments to discriminate between RA patients with and without a history of falling. Methods Fifty patients with RA were divided into two groups according to the presence or absence of a history of falls within the previous 1 year. Physical performance was assessed using the short physical performance battery (SPPB), which consists of the timed standing balance, gait speed, and chair stand tests. Standing balance was also assessed as postural sway using a force platform in several positions including standing with both feet together, semitandem, and tandem. Backgrounds, SPPB, and postural sway were compared between the two groups. Results Fourteen patients (28%) reported one or more falls within the previous year. There were no significant intergroup differences in baseline characteristics or SPPB score. The group with a history of falls had significantly longer measured time for the 5-repetition chair stand test and significantly longer postural sway in the semitandem position. The discriminate analysis revealed that 5-repetition chair stand test or its combination with postural sway in the semitandem position significantly discriminated between fallers and non-fallers. Conclusion Numerical evaluation of the chair stand test and postural sway in the semitandem position seems more appropriate than SPPB for assessing the fall risk of patients with RA.
Does axillary lymph node size predict better metastatic involvement than apparent diffusion coefficient (ADC) value in women with newly diagnosed breast cancer?

Background It has been demonstrated that the number of metastatic axillary lymph nodes (mALNs) influence disease-free and overall survival in patients with breast cancer. Purpose To determine if the ALN size is more accurate than the ALN apparent diffusion coefficient (ADC) value to predict metastatic involvement in newly diagnosed breast cancer. Material and Methods A total of 44 patients with breast cancer were included. Magnetic resonance imaging (MRI) examinations were performed on a 1.5-T system with sagittal T1-weighted fast spin-echo non-fat saturated, sagittal T2-weighted fast spin-echo non-fat saturated, axial diffusion-weighted imaging echo-planar (b values of 0 and 700 s/mm2), and non-contrast axial VIBRANT sequences. The size and the ADC value were obtained for ALN ipsilateral and contralateral to breast cancer. The reference standard was the histopathologic lymph node status. Results mALN had a greater cortical thickness compared to contralateral non-mALN (10.3 ± 5.32 mm vs. 4 ± 1.17 mm, P ≤ 0.001). The threshold of ≥6.7 mm for predicting axillary metastatic involvement had a sensitivity and a specificity of 80.0% and 97.7%, respectively. The ADC value of mALN was significantly higher than the contralateral non-mALN (0.90 ± 0.12 × 10−3mm2/s vs. 0.78 ± 0.12 × 10−3mm2/s; P = 0.001). The threshold of ≥0.86 × 10−3mm2/s had a sensitivity and a specificity of 66.7% and 76.7%, respectively. Conclusion Our results indicate that the cortical thickness has a better diagnostic performance in the differentiation of metastatic and non-metastatic lymph nodes than the lymph node ADC.
Shiga Toxin-Producing Escherichia coli Contamination of Raw Beef and Beef-Based Ready-to-Eat Products at Retail Outlets in Pretoria, South Africa.

ABSTRACT A cross-sectional study was conducted to determine the prevalence of and factors associated with Shiga toxin-producing Escherichia coli (STEC) in raw beef and ready-to-eat (RTE) beef products sold in 31 retail outlets in Pretoria, South Africa, and nearby areas. A total of 463 beef and RTE samples were screened for four STEC virulence genes (stx1, stx2, eaeA, and hlyA) and seven O-serogroups (O113, O157, O26, O91, O145, O111, and O103) with a multiplex PCR assay. The total aerobic plate count (TAPC) per gram was also determined. A total of 38 STEC isolates were recovered and characterized by conventional PCR assay and serotyping. The overall prevalence of STEC in the beef and RTE samples tested was 16.4% (76 of 463 samples; 95% confidence interval, 13 to 20%). The prevalence of STEC differed significantly by product type (P < 0.0001), with the highest prevalence (35%) detected in boerewors (spicy sausage). The STEC prevalences in minced beef, brisket, RTE cold beef, and biltong were 18, 13, 9, and 5%, respectively. The most frequently detected stx gene was stx2 (13%), and STEC serogroups from recovered isolates were detected at the following prevalences: O2, 15%; O8, 12%; O13, 15%; O20, 8%; O24, 3%; O39, 3%; O41, 8%; O71, 3%; O76, 3%; O150, 12%; and O174, 3%. A high proportion (77%) of the samples had TAPCs that exceeded the South African microbiological standards for meat export (5.0 log CFU/g). The prevalence of O157 STEC (16%) and the diversity of non-O157 STEC serogroups found in five common beef-based products from retail outlets in South Africa suggest exposure of raw beef and beef products to multiple contamination sources during carcass processing and/or cutting and handling at retail outlets. These data provide direct estimates of the potential health risk to consumers from undercooked contaminated products and indicate the need to improve sanitary practices during slaughter and processing of beef and beef-based RTE products. A risk-based surveillance system for STEC may be needed. HIGHLIGHTS
Pyridine levels in ceftazidime – peritoneal dialysis admixtures stored at body temperature

Background: For the treatment of peritoneal dialysis-associated peritonitis (PDAP), ceftazidime is routinely admixed with peritoneal dialysis (PD) solutions before its intraperitoneal administration. One of the major degradation products of ceftazidime is pyridine, a potentially toxic compound. Depending on the type of PD solution, ceftazidime is exposed to an environment with acidic or basic pH, and depending on the type of dosing and individual unit practices related to preparation and storage, ceftazidime can be at body temperature for 4–10 h, resulting in potentially varying rates of degradation to pyridine by-product. No study has investigated whether the amount of generated pyridine exceeds the maximum daily exposure limit of 2 mg when ceftazidime-PD admixtures are kept at body temperature. Therefore, the current study aimed to determine the levels of pyridine generated in PD-ceftazidime admixtures kept at 37°C for various time points. Methods: Ceftazidime was admixed with 2 L Dianeal (1.5%, 2.5% and 4.25% dextrose) and 2 L Physioneal (1.36%, 2.27% and 3.86% glucose) PD solutions to obtain a concentration of 125 mg/L (continuous dosing model) or 500 mg/L (intermittent dosing model). A total of 36 PD admixtures (3 bags for each type of PD solution and 3 bags for each type of dosing) were prepared and stored at 37°C for 10 h. An aliquot was withdrawn at time 0 (baseline) and after 2, 6, 8 and 10 h of storage. The withdrawn samples were then analysed to determine the concentrations of ceftazidime and pyridine using high-performance liquid chromatography. Results: With the intermittent dosing model (500 mg/L), ceftazidime was found to be stable for only 2 and 6 h when admixed with 3.86% and 2.27% glucose Physioneal PD solutions, respectively. While ceftazidime (500 mg/L) retained more than 90% of its initial concentration in the three types of Dianeal and 1.36% dextrose Physioneal solutions for 10 and 8 h, respectively, the generated amount of pyridine ranged between approximately 290% and 371% more than the daily recommended limit. With the continuous dosing model (125 mg/L), ceftazidime was found to be stable for 6 h in all three types of Physioneal PD solutions, but the total amount of generated pyridine with four daily exchanges (6 h each) was estimated to be 170–360% over the daily recommended limit. Ceftazidime (125 mg/L) was chemically stable when admixed with three types of Dianeal PD solutions and stored at 37°C for 10 h, and the levels of pyridine were estimated to be less than the maximum recommended daily limit. Conclusions: Until the outcomes of this in vitro study are confirmed by appropriate in vivo studies, continuous dosing of ceftzadime–Dianeal admixtures for the treatment of PDAP may be preferred over continuous dosing of ceftazidime–Physioneal admixtures, and intermittent dosing of ceftazidime–Physioneal and ceftazidime–Dianeal admixtures, as ceftazidime remains stable and the generated levels of pyridine are below the maximum recommended daily exposure.
Oocyte maturation arrest produced by TUBB8 mutations: impact of genetic disorders in infertility treatment

Abstract Oocyte maturation defect is a challenging situation in the management of infertility, the etiology may be related to endocrine causes, protocols used in ovarian stimulation, oocyte intrinsic defects or procedures in embryology laboratory. We report three Mexican females in treatment for primary infertility with non-mature oocytes after ovary stimulation and oocyte capture in whom a genetic diagnosis of TUBB8-oocyte maturation defect was revealed by exome sequencing. Two couples achieved pregnancies though oocyte donation after establishing the genetic etiology. Our results expand the role of TUBB8-disorders in patients of non-Asian ethnicity. Oocyte maturation defects of monogenic origin are a growing group of disorders that endocrinologists and reproductive medicine specialists should be aware in order to provide referral to genetics for establish a correct and opportune diagnosis.
[Spatio-temporal analysis of Oncomelania hupensis along Jiangsu section of the Yangtze River from 2015 to 2017].

OBJECTIVE To investigate the spatio-temporal characteristics of Oncomelania hupensis snails along the Jiangsu section of the Yangtze River, so as to provide evidence for eliminating schistosomiasis and formulating precision control measures in Jiangsu Province. METHODS A total of 75 marshlands were randomly sampled from Nanjing, Zhenjiang and Yangzhou cities along the Jiangsu section of the Yangtze River basin, and the spatio-temporal distribution and changing patterns of O. hupensis snails were investigated using the spatial autocorrelation analysis, kernel density analysis and hotspot analysis during the period from 2015 through 2017. RESULTS There was a spatial autocorrelation in the mean snail density along the Jiangsu section of the Yangtze River basin during the period from 2015 through 2017. The number of living snails and the density of living snails showed an overall decline in Yangzhou City; however, both showed a slight increase in 2016. Kernel density analysis and hotspot analysis showed that the hotspots of living snails were located in the regions neighboring the marshlands at the Yangzhou-Zhenjiang boundary areas along the Jiangsu section of the Yangtze River basin. CONCLUSIONS There is a spatial autocorrelation in the snail distribution with hotspots along the Jiangsu section of the Yangtze River basin, and the surveillance of snails should not be neglected in the marshlands in Jiangsu Province.
Advances in knowledge of inhibitor formation in severe haemophilia A

Anti‐drug antibody formation following factor VIII (FVIII) replacement therapy is the most important treatment‐related complication in patients with severe haemophilia A. A significant number of these antibodies show neutralising activity against FVIII and are referred to as FVIII inhibitors. Alloimmunity to FVIII, given the absence of endogenous circulating FVIII protein, may be predictable to some extent; however, only 30% of patients develop inhibitors. Genetic and environmental risk factors have been identified, contributing to the likelihood of inhibitor development. Multiple immunological theories have been proposed which in part explain the outcomes of many epidemiological studies. Significant differences exist among replacement therapies, including the source, FVIII sequence, glycosylation, formulation components, impurities and aggregation potential, which significantly complicate interpretation of the results from these studies. In this review, we present recent advances in the understanding of the cellular mechanisms of inhibitor formation and highlight some areas of uncertainty requiring further investigation.
Measurement of the useful field of view for single slices of different imaging modalities and targets

Abstract. Purpose: With three-dimensional (3-D) images displayed as stacks of 2-D images, radiologists rely more heavily on vision away from their fixation point to visually process information, guide eye movements, and detect abnormalities. Thus the ability to detect targets away from the fixation point, commonly characterized as the useful field of view (UFOV), becomes critical for these 3-D imaging modalities. We investigate how the UFOV, defined as the eccentricity, in which detection performance degrades to a given probability, varies across imaging modalities and targets. Approach: We measure the detectability of different targets at various distances from gaze locations for single slices of liver computed tomography (CT), 2-D digital mammograms (DM), and single slices of digital breast tomosynthesis (DBT) cases. Observers with varying expertise were instructed to maintain their gaze at a point while a short display of the image was flashed and an eye tracker verified observer’s steady fixation. Display times were 200 and 1000 ms for CT images and 500 ms for DM and DBT images. Results: We find variations in the UFOV from 9 to 12 deg for liver CT to as small as 2.5 to 5 deg for calcification clusters in breast images (DM and DBT). We compare our results to those reported in the literature for lung nodules and discuss the differences across methods used to measure the UFOV, their dependence on case selection/task difficulty, viewing conditions, and observer expertise. We propose a complementary measure defined in terms of performance degradation relative to the peak foveal performance (relative-UFOV) to circumvent UFOV’s variations with case selection/task difficulty. Conclusion: Our results highlight the variations in the UFOV across imaging modalities, target types, observer expertise, and measurement methods and suggest an additional relative-UFOV measure to more thoroughly characterize the detection performance away from point of fixation.