Miracle-dz/UniFAR-FTUs huggingface dataset:
Baseline graft status is a critical predictor of kidney graft failure after diarrhoea.

Background Diarrhoea is one of the most frequent complications after kidney transplantation (KT). Non-infectious diarrhoea has been associated with reduced graft survival in kidney transplant recipients. However, the risk factors for renal allograft loss following diarrhoea remain largely unknown. Methods Between January 2010 and August 2011, 195 consecutive KT recipients who underwent standardized microbiological workups for diarrhoea at a single centre were enrolled in this retrospective study. Results An enteric pathogen was readily identified in 91 patients (47%), while extensive microbiological investigations failed to find any pathogen in the other 104. Norovirus was the leading cause of diarrhoea in these patients, accounting for 30% of the total diarrhoea episodes. The baseline characteristics were remarkably similar between non-infectious and infectious diarrhoea patients, with the exception that the non-infectious group had significantly lower graft function before diarrhoea (P = 0.039). Infectious diarrhoea was associated with a longer duration of symptoms (P = 0.001) and higher rates of acute kidney injury (P = 0.029) and hospitalization (P < 0.001) than non-infectious diarrhoea. However, the non-infectious group had lower death-censored graft survival than the infectious group (Gehan-Wilcoxon test, P = 0.038). Multivariate analysis retained three independent predictors of graft failure after diarrhoea: diarrhoea occurring ≥5 years after KT [hazard ratio (HR) 4.82; P < 0.001], re-transplantation (HR 2.38; P = 0.001) and baseline estimated glomerular filtration rate <30 mL/min/1.73 m2 (HR 11.02; P < 0.001). Conclusion Our study shows that pre-existing conditions (re-transplantation, chronic graft dysfunction and late occurrence) determine the primary functional long-term consequences of post-transplant diarrhoea.
Somatostatin Receptor Expression Is Associated With Metastasis and Patient Outcome in Pulmonary Carcinoid Tumors.

CONTEXT Pulmonary carcinoids (PCs) belong to neuroendocrine tumors that often overexpress somatostatin receptors (SSTRs). This overexpression provides a molecular basis for tumor imaging and treatment with somatostatin analogs. OBJECTIVE To evaluate SSTR1 to SSTR5 distribution in a large set of PC tumors and to investigate whether the expression is associated with clinicopathological and outcome data. DESIGN, SETTING, AND PATIENTS This retrospective study was conducted at Helsinki University Hospital and University of Helsinki. It included 178 PC tumors coupled with patients' clinical data retrieved through Finnish biobanks. After histological reclassification, tissue specimens were processed into next-generation tissue microarray format and stained immunohistochemically with monoclonal SSTR1 to SSTR5 antibodies. MAIN OUTCOME MEASURE SSTR1 to SSTR5 expression in PC tumors. RESULTS Expression of SSTR1 to SSTR5 was detected in 52%, 75%, 56%, 16%, and 32% of the tumors, respectively. Membrane-bound staining was observed for all receptors. SSTR2 negativity and SSTR4 positivity was associated with lymph node involvement at the time of surgery (P = 0.014 and P = 0.017, respectively) and with distant metastasis (P = 0.027 and P = 0.015, respectively). SSTR3 and SSTR4 expression was associated with increased risk of shorter survival [P = 0.046, hazard ratio (HR) 4.703, 95% CI 1.027 to 21.533; and P = 0.013, HR 6.64, 95% CI 1.48 to 29.64, respectively], whereas expression of SSTR1 and SSTR2 was associated with improved outcome (P = 0.021, HR 0.167, 95% CI 0.037 to 0.765; and P = 0.022, HR 0.08, 95% CI 0.01 to 0.70, respectively). CONCLUSION SSTR1 to SSTR5 expression is observed in PCs. As SSTR expression is associated with the tumor's metastatic potential and patient outcome, these receptors may offer the possibility for individualized prognosis estimation.
The Physiological Strain Index Modified for Trained Heat-Acclimatized Individuals in Outdoor Heat.

Purpose: To determine if the Physiological Strain Index (PSI), in original or modified form, can evaluate heat strain on a 0-10 scale, in trained and heat-acclimatized men undertaking a competitive half-marathon run in outdoor heat. Methods: Core (intestinal) temperature (TC) and heart rate (HR) were recorded continuously in 24 men (mean [SD] age = 26 [3] y, VO2peak = 59 [5] mL·kg·min-1). A total of 4 versions of the PSI were computed: original PSI with upper constraints of TC 39.5°C and HR 180 beats·min-1 (PSI39.5/180) and 3 modified versions of PSI with each having an age-predicted maximal HR constraint and graded TC constraints of 40.0°C (PSI40.0/PHRmax), 40.5°C (PSI40.5/PHRmax), and 41.0°C (PSI41.0/PHRmax). Results: In a warm (26.1-27.3°C) and humid (79-82%) environment, all runners finished the race asymptomatic in 107 (10) (91-137) min. Peak TC and HR were 39.7°C (0.5°C) (38.5-40.7°C) and 186 (6) (175-196) beats·min-1, respectively. In total, 63% exceeded TC 39.5°C, 71% exceeded HR 180 beats·min-1, and 50% exceeded both of the original PSI upper TC and HR constraints. The computed heat strain was significantly greater with PSI39.5/180 than all other methods (P < .003). PSI >10 was observed in 63% of runners with PSI39.5/180, 25% for PSI40.0/PHRmax, 8% for PSI40.5/PHRmax, and 0% for PSI41.0/PHRmax. Conclusions: The PSI was able to quantify heat strain on a 0-10 scale in trained and heat-acclimatized men undertaking a half-marathon race in outdoor heat, but only when the upper TC and HR constraints were modified to 41.0°C and age-predicted maximal HR, respectively.
Clinical Correlates of Aortic Stiffness and Wave Amplitude in Black Men and Women in the Community

Background Black individuals have greater risk for cardiovascular disease (CVD) than whites. Identifying CVD risk factors associated with abnormal aortic hemodynamics in blacks may optimize CVD prevention and treatment strategies. Methods and Results Jackson Heart Study participants underwent applanation tonometry (2011–2016) with assessment of carotid‐femoral pulse wave velocity (CFPWV) and forward wave amplitude (FWA). CVD risk factors were assessed during examination 3 (2009–2012). We examined the association of risk factors with binary and continuous CFPWV and FWA in multivariable stepwise models. We evaluated for effect modification by sex to determine differential associations of risk factors with aortic hemodynamics in men and women. We examined 1322 individuals (mean age 66±11 years, 66% women). Age was strongly associated with elevated CFPWV (odds ratio, 4.76; 95% confidence interval, 3.84–5.89 [P<0.0001]) and FWA (odds ratio, 2.30; 95% CI, 1.98–2.69 [P<0.0001]). Men had greater odds of elevated CFPWV compared with women (odds ratio, 1.54; 95% confidence interval, 1.11–2.13 [P=0.009]). Heart rate, mean arterial pressure, and use of antihypertensive medications were associated with elevated CFPWV and FWA (all P≤0.02). Additionally, total/high‐density lipoprotein cholesterol and fasting glucose were associated with elevated CFPWV (both P≤0.002) and use of diabetes mellitus medications was associated with elevated FWA (P≤0.0001). We observed a steeper association of age and mean arterial pressure with unfavorable aortic hemodynamics in women than men. Conclusions In blacks in the community, differential CVD risk factors are associated with aortic stiffness and FWA. Future work may determine the impact of risk factor modification on abnormal central aortic hemodynamics and CVD outcomes.
A Pilot Randomized Controlled Trial Comparing Mindfulness Meditation, Cognitive Therapy, and Mindfulness-Based Cognitive Therapy for Chronic Low Back Pain.

Objective This pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM), cognitive therapy (CT), and mindfulness-based cognitive therapy (MBCT) for chronic low back pain (CLBP). Setting University of Queensland Psychology Clinic. Subjects Participants were N = 69 (intent-to-treat [ITT] sample) adults with CLBP. Design A pilot, assessor-blinded randomized controlled trial. Methods Participants were randomized to treatments. The primary outcome was pain interference; secondary outcomes were pain intensity, physical function, depression, and opioid medication use. The primary study end point was post-treatment; maintenance of gains was evaluated at three- and six-month follow-up. Results Ratings of acceptability, and ratios of dropout and attendance showed that MBCT was acceptable, feasible, and well tolerated, with similar results found across conditions. For the ITT sample, large improvements in post-treatment scores for pain interference, pain intensity, physical function, and depression were found (P < 0.001), with no significant between-group differences. Analysis of the follow-up data (N = 43), however, revealed that MBCT participants improved significantly more than MM participants on pain interference, physical function, and depression. The CT group improved more than MM in physical function. The MBCT and CT groups did not differ significantly on any measures. Conclusions This is the first study to examine MBCT for CLBP management. The findings show that MBCT is a feasible, tolerable, acceptable, and potentially efficacious treatment option for CLBP. Further, MBCT, and possibly CT, could have sustained benefits that exceed MM on some important CLBP outcomes. A future definitive randomized controlled trial is needed to evaluate these treatments and their differences.
Antagonistic paralogs control a switch between growth and pathogen resistance in C. elegans

Immune genes are under intense pressure from pathogens, which cause these genes to diversify over evolutionary time and become species-specific. Through a forward genetic screen we recently described a C. elegans-specific gene called pals-22 to be a repressor of “Intracellular Pathogen Response” or IPR genes. Here we describe pals-25, which, like pals-22, is a species-specific gene of unknown biochemical function. We identified pals-25 in a screen for suppression of pals-22 mutant phenotypes and found that mutations in pals-25 suppress all known phenotypes caused by mutations in pals-22. These phenotypes include increased IPR gene expression, thermotolerance, and immunity against natural pathogens. Mutations in pals-25 also reverse the reduced lifespan and slowed growth of pals-22 mutants. Transcriptome analysis indicates that pals-22 and pals-25 control expression of genes induced not only by natural pathogens of the intestine, but also by natural pathogens of the epidermis. Indeed, in an independent forward genetic screen we identified pals-22 as a repressor and pals-25 as an activator of epidermal defense gene expression. These phenotypic and evolutionary features of pals-22 and pals-25 are strikingly similar to species-specific R gene pairs in plants that control immunity against co-evolved pathogens.
Tailoring Magnetoelectric Coupling in BiFeO3/La0.7Sr0.3MnO3 Heterostructure through the Interface Engineering

Electric field control of magnetism ultimately opens up the possibility of reducing energy consumption of memory and logic devices. Electric control of magnetization and exchange bias are demonstrated in all‐oxide heterostructures of BiFeO3 (BFO) and La0.7Sr0. 3MnO3 (LSMO). However, the role of the polar heterointerface on magnetoelectric (ME) coupling is not fully explored. Here, the ME coupling in BFO/LSMO heterostructures with two types of interfaces, achieved by exploiting the interface engineering at the atomic scale, is investigated. It is shown that both magnetization and exchange bias are reversibly controlled by switching the ferroelectric polarization of BFO. Intriguingly, distinctly different modulation behaviors that depend on the interfacial atomic sequence are observed. These results provide new insights into the underlying physics of ME coupling in the model system. This study highlights that designing interface at the atomic scale is of general importance for functional spintronic devices.
A review of ASA physical status – historical perspectives and modern developments

The American Society of Anesthesiologists (ASA) physical status is a tool commonly used to classify a patient's physical fitness before surgery. Since its introduction in 1941 it has undergone very few modifications to improve its reliability and to eliminate subjectivity, despite vast changes in both surgical and anaesthetic technique. We present the history of the ASA physical status and review the literature on its applicability to contemporary anaesthetic practice.
Computational investigations on the hemodynamic performance of a new swirl generator in bifurcated arteries

Abstract Hemodynamic behaviour of blood in the bifurcated arteries are closely related to the development of cardiovascular disease. The secondary flows generated at the bifurcation zone promotes the deposition of atherogenic particles on the outer walls. The present study aims at suppressing the development of atherosclerosis plaque by inducing helical flow structure in the arterial passage. To realize this objective a novel swirl generator (stent like structure with an internal groove) has been developed to induce helicity in the bifurcated passage. The functional requirement of the swirl generator is to minimize the relative residence time (RRT) of the fluid layer near the endothelial wall without generating any additional pressure drop. Different configurations of the swirl generator have been tested computationally using large eddy simulation (LES) model. It is observed that the induced helical flow redistributes the kinetic energy from the centre to the periphery. A single rib swirl flow generator proximal to the stent treated passage can generate sufficient helicity to bring down the RRT by 36% without generating any additional pressure drop. The swirl flow adds azimuthal instability which increase vortex formations in the passage. The induced helical flow in the domain provokes more linked vortices, which may act as self-cleaning mechanism to the arterial wall.
Pharmacokinetic effects of capsaicin on vinblastine in rats mediated by CYP3A and Mrp2

Capsaicin (trans‐8‐methyl‐N‐vanillyl‐6‐nonenamide, CAP) is an important ingredient in spicy foods consumed throughout the world. Vinblastine (VBL) is a naturally occurring alkaloid prescribed to cancer patients. Many cancer patients treated with VBL were taking CAP at the same time. This study attempted to investigate the effect of CAP on the pharmacokinetics of VBL, which is the substrate of CYP3A, P‐gp, and Mrp2. CAP, cyclosporine (CsA) or olive oil was given to rats for seven consecutive days, and on the seventh day, VBL (1.3 mg/kg) was administered intravenously. CsA was used as a CYP3A1/2 and transporter inhibitor, and olive oil was used as a vehicle. The results showed that pretreatment of rats with CAP (3.0 mg/kg) for seven consecutive days resulted in an increase in the AUC0–t of VBL of about 29.8% (P < 0.05) compared with the control group. Moreover, CAP decreased the CL of VBL to 75.5% (P < 0.05). At this time, CYP3A1/2 and Mrp2/Abcc2 in the liver was decreased at the mRNA and protein levels. These results demonstrate that chronic ingestion of CAP will increase systemic exposure and reduce clearance of VBL in rats. The food–drug interaction between CAP and VBL appears to be due to modulation of CYP3A1/2 and Mpr2 expression by CAP.
Interactions of Tomato and Botrytis cinerea Genetic Diversity: Parsing the Contributions of Host Differentiation, Domestication, and Pathogen Variation

The necrotrophic pathogen Botrytis cinerea has a highly polygenic basis of virulence across genetically variable tomato, which should be considered when breeding for pathogen resistance. Although the impacts of crop domestication on specialist pathogens are well known, less is known about the interaction of crop variation and generalist pathogens. To study how genetic variation within a crop affects plant resistance to generalist pathogens, we infected a collection of wild and domesticated tomato accessions with a genetically diverse population of the generalist pathogen Botrytis cinerea. We quantified variation in lesion size of 97 B. cinerea genotypes (isolates) on six domesticated tomato genotypes (Solanum lycopersicum) and six wild tomato genotypes (Solanum pimpinellifolium). Lesion size was significantly affected by large effects of the host and pathogen’s genotype, with a much smaller contribution of domestication. This pathogen collection also enables genome-wide association mapping of B. cinerea. Genome-wide association mapping of the pathogen showed that virulence is highly polygenic and involves a diversity of mechanisms. Breeding against this pathogen would likely require the use of diverse isolates to capture all possible mechanisms. Critically, we identified a subset of B. cinerea genes where allelic variation was linked to altered virulence against wild versus domesticated tomato, as well as loci that could handle both groups. This generalist pathogen already has a large collection of allelic variation that must be considered when designing a breeding program.
Neuromuscular Mechanosensitivity in Subjects with Chronic Ankle Sprain: A Cross-Sectional Study.

Background Ankle sprain is one of the most common musculoskeletal injuries in sports, at work, and at home. Subjects who suffer from this injury may develop ankle instability. Functional instability has been associated with a high rate of resprain and impaired neuromuscular control in patients with ankle instability. Objective Measurement of neural and muscular mechanosensitivity after ankle sprain injury and establishment of the relationship between these variables. Methods A cross-sectional case-control study was performed with a sample of 58 students from Alcalá de Henares University (21 males and 37 females, mean age ± SD = 21 ± 3.7 years). Subjects were divided into two groups: a case group (N = 29, subjects with unstable ankle) and a control group (N = 29, healthy subjects). The pressure pain threshold (PPT) of the tibialis anterior, peroneus longus, and peroneus brevis muscles and mechanosensitivity of the common peroneus and tibial nerves were evaluated in all subjects through a manual mechanical algometer. Results Neuromuscular PPTs showed significant differences (P < 0.05) between both groups, such that, compared with the control group, the case group exhibited significantly lower PPT levels. In the case group, a strong positive correlation was observed between neural and muscular homolateral mechanosensitivity in both lower limbs. Conclusions Participants with chronic ankle instability showed higher neuromuscular mechanosensitivity in muscles and nerves surrounding the ankle joint than healthy subjects. These findings indicate that low PPT values may be associated with symptoms that characterize this disease.
AgF desalination procedure for the routine determination of oxygen and hydrogen isotopic composition of saline waters and brines

ABSTRACT The routine methods for stable oxygen and hydrogen isotope analysis of water involve water–CO2 gas equilibration and water reduction on hot metal (e.g. Zn, Cr, U) and subsequent mass spectrometric analysis of the evolved gases of CO2 and H2 for 18O/16O and 2H/1H ratios, respectively. Precise determination of the isotopic composition of water in brines with application of these standard methods is still problematic and technically often impossible due to detrimental influence of dissolved salts. The new method of brine desalination presented in this study overcomes the problem of the isotope salt effects encountered during the application of the routine techniques for the determination of the isotopic composition of high saline waters. The procedure combines two technical steps: (i) the chemical precipitation of Mg and Ca ions as insoluble non-hydroscopic fluorides, and (ii) the vacuum distillation of water from solution–precipitate mixture. The application of simple vacuum distillation allows full extraction of water and dehydration of remaining salts in a temperature range from 300 to 350 °C without hydrogen and oxygen isotope fractionation. The precision and accuracy of δ18O and δ2H determination of saline waters and brines with prior application of AgF desalination procedure is comparable with that usually obtained for fresh waters.
Feasibility of robotic surgery in a developing country, a public sector Perspective.

OBJECTIVE To assess the clinical feasibility of robotic platform and to calculate cost for sustaining it. METHODS The study was conducted at Sindh Government Qatar Hospital and Civil Hospital Karachi from October 11, 2011, to August 30, 2017. Feasibility was assessed in terms of clinical outcome i.e. surgical complications, duration of stay and readmissions. The cost of doing an individual procedure was calculated along with the projected cost for 150, 200 and 250 cases per year. SPSS 23 was used for data analysis. RESULTS Of the 119 patients, 45(37.8%) were males and 74(62.2%) were females. Overall mean age was 42.10}13.40 years (range: 21-80 years. Mean hospital stay was 3.59}3 (range: 1-19 days). Complications occurred in 17(14.3%) patients ranging from wound infection 7(5.9%), bleeding 5(4.2%), intra-abdominal abscess 3(2.5%) and recurrence 2(1.7%). The total cost of robotic platform was Rs320 million with an annual maintenance contract of 10% of the total cost. The mean cost of performing a robotic procedure was Rs.389,263.05}39,249.63 (range: Rs252,823.09- Rs456,842.79). CONCLUSIONS Robotic surgery was found to be a feasible and viable option. The major hindrance was the cost involved in setting up the system and recurring costs in terms of disposables.
Constitutive BRCA1 Promoter Hypermethylation Can Be a Predisposing Event in Isolated Early-Onset Breast Cancer

Early age at onset of breast cancer (eoBC) is suggestive of an increased genetic risk. Although genetic testing is offered to all eoBC-affected women, in isolated cases the detection rate of pathogenic variants is <10%. This study aimed at assessing the role of constitutive promoter methylation at BC-associated loci as an underlying predisposing event in women with eoBC and negative family history. Promoter methylation at 12 loci was assessed by the MassARRAY technology in blood from 154 BRCA1/2 negative patients with eoBC and negative family history, and 60 healthy controls. Hypermethylation was determined, within each promoter, by comparing the patient’s mean methylation value with thresholds based on one-sided 95% bootstrap confidence interval of the controls’ mean. Three patients had hypermethylated results, two at BRCA1 and one at RAD51C. Analyses on tumor tissue from the patient exceeding the highest threshold at BRCA1 revealed a mean methylation >60% and loss of heterozygosity at chromosome 17q. The patient hypermethylated at RAD51C showed low methylation in the tumor sample, ruling out a role for methylation-induced silencing in tumor development. In isolated eoBC patients, BRCA1 constitutive promoter methylation may be a predisposing event. Further studies are required to define the impact of methylation changes occurring at BC-predisposing genes and their role in tumorigenesis.