Miracle-dz/UniFAR-FTUs huggingface dataset:
“Selling” chronic pain: physiotherapists’ lived experiences of communicating the diagnosis of chronic nonspecific lower back pain to their patients

ABSTRACT Introduction: Chronic nonspecific lower back pain (CNSLBP) is a common musculoskeletal condition which can be a source of significant distress and disability for patients. Approaches to managing CNSLBP have been explored in healthcare literature, as has the importance of communication in physiotherapy practice. However, no previous studies have explored clinicians’ experiences of communicating their understanding of this diagnosis to their patients. Methods: A qualitative research design, using hermeneutic phenomenological methodology, was employed. Five participants were purposively recruited for the research and data collected via semi-structured interviews. Interpretative phenomenological analysis (IPA) methods were used to analyze the data. Emergent, super-ordinate and master themes were developed to help convey the qualitative significant meanings of the lived-through experiences. Findings: Three master themes were identified, with each comprising two sub-themes. These were: 1) Patient-centeredness (1a. Understanding the patient; and 1b. emotional awareness and adaptability); 2) Getting patients “on board” (2a. the “selling” process; and 2b. paternalism and the clinician’s perspective); and 3) Dealing with conflict and uncertainty (3a. fear of interpersonal conflict; and 3b. personal doubts and uncertainty). Conclusions: Personal conflicts were identified between clinicians’ descriptions of their wishes to “sell” their own perspectives to patients while simultaneously wanting to demonstrate a patient-focused approach and avoid the interpersonal conflicts which arose from clashes with patients’ beliefs. Building a good initial rapport, showing empathy and adapting approaches in response to perceptions of patients’ reactions were perceived as strategies to help mitigate the risks of failed communication, but this was something for which participants felt unprepared by their prior training.
Investigating the Movement Components of Host Preference in a Highly Mobile Insect Herbivore, Nephotettix cincticeps (Hemiptera: Cicadellidae)

Abstract Effective insect management strategies require a firm understanding of the factors determining host preference, particularly in highly mobile insect herbivores. Host preference studies commonly employ average or first position as a proxy for preference. Yet few studies have explored host preference in relation to transitory attraction and leaving rates, yet these are both components of host plant selection. We investigated the transitory dynamics of preference by the green rice leafhopper, Nephotettix cincticeps (Uhler) (Hemiptera: Cicadellidae) by conducting experiments on groups of females, males, or mixed-sex leafhoppers, and recording their position over time between low-N and normal-N rice plants. Utilizing a log-linear model and variants of a biostatistical model we used these positional data to extract attraction, leaving and tenure rates to better understand the process of host-plant selection. We found a general preference for normal-N over low-N plants at equilibrium. However, between sexes there was variation in the relative significance of attraction or leaving rates on that preference. Female leafhoppers were more attracted to host plants with higher nitrogen content. Male leafhoppers were less discriminate in their initial attraction to hosts but left low-N hosts at a faster rate. Whereas estimated tenure times on both normal- and low-N plants exceeded transmission times for the leafhopper-transmitted rice dwarf virus, longer tenure on normal-N plants likely increases the likelihood of virus acquisition from these plants. Our findings support previous recommendations that growers can mitigate the risks of leafhopper damage and pathogen transmission by optimizing their application of nitrogenous fertilizers.
Prediction of clinical benefit from androgen deprivation therapy in salivary duct carcinoma patients

Androgen deprivation therapy (ADT) is first‐line palliative treatment in androgen receptor‐positive (AR+) salivary duct carcinoma (SDC), and response rates are 17.6–50.0%. We investigated potential primary ADT resistance mechanisms for their predictive value of clinical benefit from ADT in a cohort of recurrent/metastatic SDC patients receiving palliative ADT (n = 30). We examined mRNA expression of androgen receptor (AR), AR splice variant‐7, intratumoral androgen synthesis enzyme‐encoding genes AKR1C3, CYP17A1, SRD5A1 and SRD5A2, AR protein expression, ERBB2 (HER2) gene amplification and DNA mutations in driver genes. Furthermore, functional AR pathway activity was determined using a previously reported Bayesian model which infers pathway activity from AR target gene expression levels. SRD5A1 expression levels and AR pathway activity scores were significantly higher in patients with clinical benefit from ADT compared to those without benefit. Survival analysis showed a trend toward a longer median progression‐free survival for patients with high SRD5A1 expression levels and high AR pathway activity scores. The AR pathway activity analysis, and not SRD5A1 expression, also showed a trend toward better disease‐free survival in an independent cohort of locally advanced SDC patients receiving adjuvant ADT (n = 14) after surgical tumor resection, and in most cases a neck dissection (13/14 patients) and postoperative radiotherapy (13/14 patients). In conclusion, we are the first to describe that AR pathway activity may predict clinical benefit from ADT in SDC patients, but validation in a prospective study is needed.
Trade-offs of gaseous emissions from soils under vegetable, wheat-maize and apple orchard cropping systems applied with digestate: An incubation study

ABSTRACT Land application of digestate from anaerobic digestion causes various gaseous emissions. A soil core incubation experiment was carried out in the laboratory to investigate the trade-offs of NH3, N2O and CH4 emissions from soils collected from vegetable, arable and orchard cropping systems. Digestate derived from liquid cattle manure was applied to the soil cores through the surface (SA) and incorporation application (IA) methods under three soil moisture conditions (40%, 60%, and 80% water-filled pore space, WFPS). Gaseous emissions from vegetable soil were significantly greater (P< .05) than those from soils under the other two cropping systems under similar conditions, particularly under a high moisture condition. The greenhouse gas emissions (GHG, in term of CO2-equivalents) of all soils increased with the increasing soil moisture contents, mainly due to rapidly increasing N2O emissions. Trade-offs in the emissions of these three gases were observed between SA and IA. As expected, SA was characterized by greater NH3 and CH4 but lower N2O emissions compared to IA. The increase in GHG under IA could be offset only somewhat by the reduced NH3 (and this reduced indirect N2O) and CH4 emissions under lower moisture conditions (<60% WFPS), which indicates a requirement for other strategies to control gaseous emissions from wet soils applied with digestate. In conclusion, an environmentally friendly strategy for digestate application should consider the soil moisture, types of soils and application methods, and all the presented suggestions need to be verified in the field in the future. Implications: This study shows that digestate incorporation can decrease NH3 but increase GHG emissions verse the surface application method, where the increased GHG could only be offset by the NH3 reductions at relatively dry soil condition, indicating an urgent requirement to mitigating GHG emissions under moist soil condition.
Primary, scatter, and penetration characterizations of parallel-hole and pinhole collimators for I-123 SPECT

Multi-pinhole (MPH) collimators are known to provide better trade-off between sensitivity and resolution for preclinical, as well as for smaller regions in clinical SPECT imaging compared to conventional collimators. In addition to this geometric advantage, MPH plates typically offer better stopping power for penetration than the conventional collimators, which is especially relevant for I-123 imaging. The I-123 emits a series of high-energy (>300 keV, ~2.5% abundance) gamma photons in addition to the primary emission (159 keV, 83% abundance). Despite their low abundance, high-energy photons penetrate through a low-energy parallel-hole (LEHR) collimator much more readily than the 159 keV photons, resulting in large downscatter in the photopeak window. In this work, we investigate the primary, scatter, and penetration characteristics of a single pinhole collimator that is commonly used for I-123 thyroid imaging and our two MPH collimators designed for I-123 DaTscan imaging for Parkinson’s Disease, in comparison to three different parallel-hole collimators through a series of experiments and Monte Carlo simulations. The simulations of a point source and a digital human phantom with DaTscan activity distribution showed that our MPH collimators provide superior count performance in terms of high primary counts, low penetration, and low scatter counts compared to the parallel-hole and single pinhole collimators. For example, total scatter, multiple scatter, and collimator penetration events for the LEHR were 2.5, 7.6 and 14 times more than that of MPH within the 15% photopeak window. The total scatter fraction for LEHR was 56% where the largest contribution came from the high-energy scatter from the back compartments (31%). For the same energy window, the total scatter for MPH was 21% with only 1% scatter from the back compartments. We therefore anticipate that using MPH collimators, higher quality reconstructions can be obtained in a substantially shorter acquisition time for I-123 DaTscan and thyroid imaging.
Efficacy and safety of TPO-receptor agonists in chronic immune thrombocytopenic purpura (ITP) in adults A meta-analysis

a Objective: To determine the efficacy and safety of two TPO receptor agonists (TPO-RAs) in the treatment of chronic ITP in adult patients. We compared these drugs to each other, placebo and the standard of care. Methods: We searched PubMed in January 2013 for eligible randomized controlled trials (RCTs). The primary outcome was the platelet response and the secondary outcomes were bleeding episodes and other adverse events. A meta-analysis was performed to assess the effect of TPO-RAs on platelet response. Results: We selected 7 studies, which included 845 patients in total (592 TPO-RA and 253 either placebo or standard of care). The response rates were significantly higher for TPO-RAs compared to placebo (RR 3.83; 95 CI 2.78 - 5.29; p<0.001). TPO-RAs decreased bleeding episodes in all studies. Generally, TPO-RAs were well tolerated; grade 3-4 adverse occurred in only 3% to 15% of patients. Discussion: TPO-RAs are an effective and safe treatment for chronic ITP in adults. However, as platelet counts return to base- line after discontinuation of treatment, further research is needed to assess the efficacy and safety of long-term use.
VEGF signalling enhances lesion burden in KRIT1 deficient mice

The exact molecular mechanisms underlying CCM pathogenesis remain a complicated and controversial topic. Our previous work illustrated an important VEGF signalling loop in KRIT1 depleted endothelial cells. As VEGF is a major mediator of many vascular pathologies, we asked whether the increased VEGF signalling downstream of KRIT1 depletion was involved in CCM formation. Using an inducible KRIT1 endothelial‐specific knockout mouse that models CCM, we show that VEGFR2 activation plays a role in CCM pathogenesis in mice. Inhibition of VEGFR2 using a specific inhibitor, SU5416, significantly decreased the number of lesions formed and slightly lowered the average lesion size. Notably, VEGFR2 inhibition also decreased the appearance of lesion haemorrhage as denoted by the presence of free iron in adjacent tissues. The presence of free iron correlated with increased microvessel permeability in both skeletal muscle and brain, which was completely reversed by SU5416 treatment. Finally, we show that VEGFR2 activation is a common downstream consequence of KRIT1, CCM2 and CCM3 loss of function, though the mechanism by which VEGFR2 activation occurs likely varies. Thus, our study clearly shows that VEGFR2 activation downstream of KRIT1 depletion enhances the severity of CCM formation in mice, and suggests that targeting VEGF signalling may be a potential future therapy for CCM.
Encapsulating Peritoneal Sclerosis: Pathophysiology and Current Treatment Options

Encapsulating peritoneal sclerosis (EPS) is a life-threatening complication of long-term peritoneal dialysis (PD), which may even occur after patients have switched to hemodialysis (HD) or undergone kidney transplantation. The incidence of EPS varies across the globe and increases with PD vintage. Causative factors are the chronic exposure to bioincompatible PD solutions, which cause long-term modifications of the peritoneum, a high peritoneal transporter status involving high glucose concentrations, peritonitis episodes, and smoldering peritoneal inflammation. Additional potential causes are predisposing genetic factors and some medications. Clinical symptoms comprise signs of intestinal obstruction and a high peritoneal transporter status with incipient ultrafiltration failure. In radiological, macro-, and microscopic studies, a massively fibrotic and calcified peritoneum enclosed the intestine and parietal wall in such cases. Empirical treatments commonly used are corticosteroids and tamoxifen, which has fibrinolytic properties. Immunosuppressants like azathioprine, mycophenolate mofetil, or mTOR inhibitors may also help with reducing inflammation, fibrin deposition, and collagen synthesis and maturation. In animal studies, N-acetylcysteine, colchicine, rosiglitazone, thalidomide, and renin-angiotensin system (RAS) inhibitors yielded promising results. Surgical treatment has mainly been performed in severe cases of intestinal obstruction, with varying results. Mortality rates are still 25–55% in adults and about 14% in children. To reduce the incidence of EPS and improve the outcome of this devastating complication of chronic PD, vigorous consideration of the risk factors, early diagnosis, and timely discontinuation of PD and therapeutic interventions are mandatory, even though these are merely based on empirical evidence.
Acute volume expansion decreased baroreflex response after swimming but not after running exercise training in hypertensive rats

ABSTRACT Background: Physical training (ET) is important to restore the reflex sensitivity involved in controlling blood pressure in various diseases. Recent investigations have demonstrated an interaction between cardiopulmonary baroreceptors and arterial baroreflex during dynamic exercise.Objective: Considering that acute and chronic hemodynamic responses to swimming (SW) are different from the race (RUN), the objective of this study was to evaluate the effect of SW and RUN on baroreflex response before and after acute volume expansion in spontaneously hypertensive rats (SHR). Methods: SHR were divided into three groups: RUN, SW and sedentary (SED) groups. After training, the mean arterial pressure (MAP) and heart rate (HR) were recorded. Baroreflex response was assessed before and after acute volume expansion.Results: Both ET conditions reduced basal levels of HR and MAP. The first volume of injected isotonic saline solution (1.25% of body weight) produced a greater decrease in HR for the SW group (−105.8 ± 8.7 bpm) compared to RUN groups (−68 ± 5.2 bpm) and SED (−49.8 ± 7.2 bpm). Both training modalities increase the baroreflex response in relation to the SED group, but after the total volume expansion, the SW group presented attenuated response (0.7 ± 0.1 μPIms/mmHg) compared to RUN (1.5 ± 0.17 PIms/mmHg) and was not different from SED group (0.8 ± 0.2 mPIms/mmHg). Conclusion: The results show that the swim-trained group has a different baroreflex response to that observed by the run-trained group after the activation of the load receptors by saline expansion. Graphical abstract
Parcellation influence on the connectivity‐based structure–function relationship in the human brain

One of the fundamental questions in neuroscience is how brain structure and function are intertwined. MRI‐based studies have demonstrated a close relationship between the physical wiring of the brain (structural connectivity) and the associated patterns of synchronization (functional connectivity). However, little is known about the spatial consistency of such a relationship and notably its potential dependence on brain parcellations. In the present study, we performed a comparison of a set of state‐of‐the‐art group‐wise brain atlases, with various spatial resolutions, to relate structural and functional connectivity derived from high quality MRI data. We aim to investigate if the definition of brain areas influences the relationship between structural and functional connectivity. We observed that there is a significant effect of brain parcellations, which is mainly driven by the number of areas; there are mixed differences in the SC–FC relationship when compared to purely random parcellations; the influence of the number of areas cannot be attributed solely to the reliability of the connectivity estimates; and beyond the influence of the number of regions, the spatial embedding of the brain (distance effect) can explain a large portion of the observed relationship. As such the choice of a brain parcellation for connectivity analyses remains most likely a matter of convenience.
Epigenetic modifications associated with aortic remodeling in hyperhomocysteinemia.

vi TABLE OF CONTENTS ix LIST OF TABLES xi LIST OF FIGURES xii CHAPTER I: INTRODUCTION 1 CHAPTER II: BACKGROUND Aortic diseases 4 Homocysteine 9 Hyperhomocysteinemia and vascular dysfunction 16 Extracellular matrix remodeling 17 Epigenetic Modifications 25 CHAPTER III: HYPOTHESIS AND SPECIFIC AIMS 31 CHAPTER IV: AORTIC REMODELING IN HYPERHOMOCYSTEINEMIA 34
Effectiveness of Stem Cell Therapy in Treatment of Ovarian Disorders and Female Infertility: A Systematic Review.

BACKGROUND Infertility is a major problem worldwide. Various strategies are being used to develop better treatments for infertility. On trending, the strategy is stem cell therapy. In this study, the literature on stem cell therapy for ovarian disorders is summarized with analysis of current developments. OBJECTIVE Different published studies on stem cell-based therapy for the treatment of various types of ovarian insufficiency and disorders such as Premature Ovarian Insufficiency (POI) in the affected female population in animal or human clinical studies systematically reviewed. METHOD We monitored five databases, including PubMed, Cochrane, Embase, Scopus, and ProQuest. A comprehensive online search was done using including criteria targeting application of stem cells in animal models for menopause. Two independent reviewers carefully evaluated titles and abstracts of studies. The stem cell type, source, dosage, route of administration were highlighted in various POI animals models. Non-relevant and review articles were excluded. OUTCOMES 648 published studies were identified during the initial comprehensive search process from which 41 were selected according to designed criteria. Based on our analysis, stem cells could accelerate ovarian tissues rejuvenation, regulate systemic sex-related hormones levels and eventually increase fertility rate. CONCLUSION The evidence suggests that stem cell-based therapies could be considered as an alternative modality to deal with women undergoing POI.
Extended Perfusion Parameter Estimation from Hyperspectral Imaging Data for Bedside Diagnostic in Medicine

Background: Hyperspectral Imaging (HSI) has a strong potential to be established as a new contact-free measuring method in medicine. Hyperspectral cameras and data processing have to fulfill requirements concerning practicability and validity to be integrated in clinical routine processes. Methods: Calculating physiological parameters which are of significant clinical value from recorded remission spectra is a complex challenge. We present a data processing method for HSI remission spectra based on a five-layer model of perfused tissue that generates perfusion parameters for every layer and presents them as depth profiles. The modeling of the radiation transport and the solution of the inverse problem are based on familiar approximations, but use partially heuristic methods for efficiency and to fulfill practical clinical requirements. Results: The parameter determination process is consistent, as the measured spectrum is practically completely reproducible by the modeling sequence; in other words, the whole spectral information is transformed into model parameters which are easily accessible for physiological interpretation. The method is flexible enough to be applicable on a wide spectrum of skin and wounds. Examples of advanced procedures utilizing extended perfusion representation in clinical application areas (flap control, burn diagnosis) are presented.
Bacteriophages as Potential Tools for Detection and Control of Salmonella spp. in Food Systems

The global problem of antibiotic resistance in bacteria is quickly developing in most antibiotics used in hospitals and livestock. Recently, the infections with multi-drug resistant (MDR) bacteria become a major cause of death worldwide. Current antibiotics are not very effective in treating MDR Salmonella infections, which have become a public health threat. Therefore, novel approaches are needed to rapidly detect and effectively control antibiotic-resistant pathogens. Bacteriophages (phages) have seen renewed attention for satisfying those requirements due to their host-specific properties. Therefore, this review aims to discuss the possibility of using phages as a detection tool for recognizing bacterial cell surface receptors and an alternative approach for controlling antibiotic-resistant pathogens in food systems.
Virtual reality and chronic low back pain

Abstract Aim Chronic low back pain (CLBP) is a highly prevalent and significant cause of disability which is often resistant to pharmacological management. Virtual reality (VR) is an emerging technology with the potential to influence CLBP, and has been suggested as an alternative to opioids for pain management. VR is a goalfocused, computer-simulated reality allowing modification of the user’s experience of their perceived world. Materials/Methods A narrative review of peer-reviewed literature using a systematic search strategy, and sole reviewer for data extraction. Conclusions VR has demonstrated effectiveness in reducing acute, experimental and chronic pain. This review describes the theoretical basis of the therapeutic effects of VR on CLBP via three distinct mechanisms: distraction, neuromodulation and graded exposure therapy. Furthermore, clinical application will be considered, including discussion of ethical issues associated with the technology. Implications for rehabilitation Virtual reality (VR) is suggested as an alternative for opioids in the management of acute and chronic pain. The therapeutic mechanisms of VR in chronic low back pain (CLBP) are equivocal but include distraction, neuromodulation of body perception and graded exposure therapy. VR may show greater efficacy in patients with CLBP with associated kinesiophobia. VR may show greater effect with increased immersion.