Miracle-dz/UniFAR-FTUs huggingface dataset:
The Effect of Accessory Pathway Location on Cardiac Function in Adult Patients with Wolff–Parkinson–White Syndrome

Introduction The relationship between ventricular pre-excitation and left ventricular dysfunction has been described in the absence of sustained supraventricular tachycardia in a series of case reports. However, there have been no systematic studies about the effect of ventricular pre-excitation on cardiac function in adult patients with different accessory pathway locations. Methods and Results Patients were divided into four groups based on the type and location of their accessory pathway: septal, right free wall, left free wall, and concealed. N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, electrocardiogram recordings, electrophysiological properties, and transthoracic echocardiographic data (septal-to-posterior wall motion delay (SPWMD) and interventricular mechanical delay (IVMD) indicating intraventricular and interventricular dyssynchrony) were compared before and after successful ablation. Before radiofrequency catheter ablation, left ventricular ejection fraction (LVEF) was significantly lower in patients with septal and right free wall accessory pathways. Within three months after radiofrequency catheter ablation, NT-proBNP levels decreased, left ventricular function improved, and intraventricular left ventricular dyssynchrony disappeared. There was a negative correlation between initial LVEF with initial QRS duration and initial SPWMD. Notably, SPWMD had a stronger correlation with LVEF than initial QRS duration. Conclusions Anterograde conduction with a septal or right free wall accessory pathway may cause left ventricular dyssynchrony and impair left ventricular function. Intraventricular left ventricular dyssynchrony seems to be responsible for the pathogenesis of left ventricular dysfunction. Radiofrequency catheter ablation results in decreased NT-proBNP levels, normalized QRS duration, mechanical resynchronization, and improved left ventricular function.
Patterns of Dietary Iron Intake, Iron Status, and Predictors of Haemoglobin Levels among Early Adolescents in a Rural Ghanaian District

Introduction Early adolescents are vulnerable to anaemia due to lean body mass and menarche. The study assessed patterns of dietary iron intake, iron status, and predictors of anaemia among early adolescents. Method One hundred and thirty-seven early adolescents were randomly selected in a rural district in Ghana. Multiple-pass 24-hour recall, iron food frequency questionnaire consisting of 27 food items, and semistructured questionnaire were administered. Variables include sociodemographics, dietary factors, and laboratory investigation including haemoglobin, ferritin, and C-reactive protein examination. Statistical Package for the Social Sciences (SPSS) software was used to calculate odds ratio and perform Mann–Whitney U test, chi-square (X2) test, exploratory factor analysis, and partial correlation (r) tests. Results Participants had mean age of 11.5 years. Three iron dietary patterns explaining 28.7% of the total variance were identified: iron dietary pattern 1 (11%) composed of iron-rich, iron-enhancing, and iron-inhibiting foods; iron dietary pattern 2 (9.9%) comprised of iron-rich, iron-enhancing, and non-iron-inhibiting foods; and iron dietary pattern 3 (7.1%) consisting of stinging nettle, iron-inhibiting foods, non-iron-enhancing foods, non-cocoyam leaves, and non-turkey berries. Meal skipping (X2 = 5.7, p < 0.05), times of eating a day (X2 = 12.6, p < 0.05), and guardian educational status (X2 = 6.7, p < 0.05) significantly affected dietary iron intake. Anaemia was associated with meal skipping (β = 0.367, p > 0.05), snacking (β = 0.484, p > 0.05), and junior high school (JHS) education (β = 0.544, p > 0.05). Partial correlation showed statistically significant relationship between iron dietary pattern 1 and dietary iron (r = −0.234, p < 0.01), iron dietary pattern 2 and dietary iron (r = -0.198, p < 0.05), iron dietary pattern 2 and vitamin C (r = -0.201, p < 0.05), and haemoglobin and ferritin (r = −0.178, p < 0.05). Conclusion Meal skipping, guardian educational status, and number of times of eating a day were significantly associated with dietary iron intake. Meal skipping, snacking, and adolescents with JHS education were positively associated with anaemia.
Mitral valvulitis as a severe extra-articular manifestation of rheumatoid arthritis: a case report

Abstract Background Extra-articular manifestations (EAMs) are common in patients with rheumatoid arthritis (RA). Cardiac EAMs are rare but may cause complete heart block and damage to the heart valves. Case summary We present the case of a middle-aged woman with long-standing RA and EAMs as the most prominent symptoms. The patient experienced complete atrioventricular heart block and developed nodular vegetations affecting the mitral valve, ultimately leading to severe mitral regurgitation and valve replacement. Discussion The diagnosis of cardiac EAMs in RA may be challenging for the clinicians. Symptoms and findings may mimic more common conditions such as malignancy and infectious endocarditis. A multidisciplinary approach is of paramount importance in order to make an early diagnosis and to provide optimal treatment to patients with RA and cardiac complications.
Donor KIR3DL1/receptor HLA-Bw4-80I Combination Reduces Acute Leukemia Relapse after Umbilical Cord Blood Transplantation without in Vitro T-cell Depletion

Background Donor natural killer (NK) cell alloreactivity in umbilical cord bone marrow transplantation (UCBT) can lead to leukemic relapse. However, NK cell function is calibrated by interaction with human leukocyte antigens (HLAs). This study aimed to investigate graft-resistant leukemia after transplantation and compared specific genotypes of killer immunoglobulin-like receptors (KIRs) in donors and human leukocyte antigen ligands in patients. Methods We retrospectively analyzed 232 patients with acute leukemia from a single center. Patients had undergone UCBT with myeloablative conditioning and without anti-thymocyte globulin. We identified the KIR genotypes of cord blood donors using polymerase chain reaction with sequence-specific primers. All of the donors contained KIR3DL1. Results The patients were divided into three groups according to the HLA-B locus. The donor KIR3DL1 and recipient HLA-Bw4-80I combination was predictive of being highly educated and was associated with a lower relapse (P=0.006) and better overall survival (probability of relapse=0.13, P < 0.001) than the uneducated group. We found no significant increase in the incidence of acute or chronic graft-versus-host disease. Conclusions Our data suggest that the donor KIR3DL1/receptor and HLA-Bw4-80I combination in UCBT results in stronger graft-versus-leukemia effects and improved outcomes in patients with acute leukemia.
Real-World Outcome in the pre-CAR-T Era of Myeloma Patients Qualifying for CAR-T Cell Therapy

Background CAR-T cell therapy is likely to be introduced starting from 2021 in patients with relapsed/refractory myeloma (r/r MM) in Europe. In order to qualify for commercial CAR-T treatment, it is assumed that r/r MM patients will have to be exposed to at least three lines of previous treatments including lenalidomide, bortezomib and anti-CD38 treatment. However, the outcome of this particular subgroup of r/r MM patients is largely unknown whereas this knowledge is crucial to estimate the possible benefit of eventual CAR-T treatment. Methods In this non-interventional, retrospective single-center study, we analyzed all subsequent r/r MM patients treated between 01/2016 (when anti-CD38 treatment was commercially introduced in Switzerland) and 04/2020 at the University Hospital of Bern. Patients were eligible for the study if they had received at least three lines of treatment including one proteasome inhibitor (PI), one immunomodulatory drug (IMID) and one anti-CD38 antibody, and if they were in need of subsequent treatment and effectively received further lines of treatment. Results Among 56 patients fulfilling the criteria of at least three lines of treatment including PI, IMID and anti-CD38 treatment, only 34 (60%) effectively received subsequent further therapy. This suggests that 40% of r/r MM patients never receive additional treatment after at least three lines of treatment including PI, IMID and anti-CD38 treatment. For patients receiving further treatment, the median number of previous lines of treatment was 4.5 (range 2–12), including autologous stem cell transplantation in 31 (91%) patients. 13 (37%) patients were penta-refractory. The most frequently used treatment options were IMID/dexamethasone treatment in 11 (32%) patients, followed by PI/dexamethasone in 10 (29%) patients. 21 (62%) patients received two or more additional lines of therapy. The median PFS was 6.6 months (range 0–36.6 months), the median TTNT was 7.5 months (range 1.4–24.5 months) and the median OS was 13.5 months, (range 0.1–38 months) for the first subsequent treatment. The overall response rate (ORR) to the first subsequent treatment was 41%, with a median duration of the response of 5 months (range 1–37 months). 12% of the patients achieved VGPR or better, with a median duration of response of 8 months (range 3–37 months). Conclusions Myeloma patients refractory after at least three lines of anti-CD38/PI/IMID treatment have a poor prognosis with a PFS of 6.6 months and OS of 13.5 months. These data may serve as reference to compare the potential benefit of CAR-T treatment in this group of myeloma patients when available in the near future.
lncRNA RAET1K Promotes the Progression of Acute Myeloid Leukemia by Targeting miR-503-5p/INPP4B Axis

Background Although long non-coding RNA (lncRNA) RAET1K has been observed to be abnormally expressed in patients with various cancers, its role and molecular mechanism in acute myeloid leukemia (AML) remain unclear. Methods The expression of RAET1K and miR-503-5p in bone marrow tissues and cell lines was detected by qRT-PCR. Cell proliferation was evaluated by cell counting kit-8 and 5-ethynyl-20-deoxyuridine (EdU) staining assay. Cell invasion and migration were detected by transwell assay. Cell apoptosis was evaluated by flow cytometry. The relationship between RAET1K and miR-503-5p, as well as miR-503-5p and INPP4B, was determined by luciferase reporter assay and RNA immunoprecipitation (RIP) assay. In addition, the tumorigenesis of leukemia cells was evaluated by using a xenograft mouse model in vivo. Results RAET1K was significantly upregulated and miR-503-5p was markedly downregulated in bone marrow tissues and cell lines (HL-60 and THP-1). Silencing of RAET1K (si-RAET1K) and overexpression of miR-503-5p inhibited cell proliferation, migration, and invasion but promoted apoptosis of HL-60 and THP-1 cells. RAET1K functioned as a sponge of miR-503-5p, and miR-503-5p inhibitor obviously attenuated the effect of si-RAET1K on AML progression in vitro. INPP4B was identified as a target of miR-503-5p, and INPP4B overexpression obviously reversed the effect of miR-503-5p mimics on cell proliferation, migration, invasion, and apoptosis of HL-60 and THP-1 cells in vitro. Knockdown of RAET1K effectively inhibited the tumorigenesis of leukemia cells in vivo. Conclusion Our results demonstrated that RAET1K/miR-503-5p/INPP4B axis contributed to AML progression, suggesting that RAET1K might be a potential target for the treatment of AML.
Ac breakdown in near-atmospheric pressure noble gases: I. Experiment

Ac-driven breakdown processes have been explored much less than the pulsed or dc breakdown, even though they have possible applications in industry. This paper focuses on the frequency range between 60 kHz and 1 MHz, at a pin–pin electrode geometry and gap lengths of 4 or 7 mm. The breakdown process was examined in argon and xenon at 0.3 and 0.7 bar. We used electrical and optical measurements to characterize the breakdown process, to observe the influence of frequency change and the effect of ignition enhancers—UV irradiation and radioactive material.
In Situ Representations and Access Consciousness in Neural Blackboard or Workspace Architectures

Phenomenal theories of consciousness assert that consciousness is based on specific neural correlates in the brain, which can be separated from all cognitive functions we can perform. If so, the search for robot consciousness seems to be doomed. By contrast, theories of functional or access consciousness assert that consciousness can be studied only with forms of cognitive access, given by cognitive processes. Consequently, consciousness and cognitive access cannot be fully dissociated. Here, the global features of cognitive access of consciousness are discussed based on neural blackboard or (global) workspace architectures, combined with content addressable or “in situ” representations as found in the brain. These representations allow continuous cognitive access in the form of a process of covert or overt queries and answers that could underlie forms of access consciousness. A crucial aspect of this process is that it is controlled by the activity of the in situ representations themselves and the relations they can initiate, not by an external controller like a CPU that runs a particular program. Although the resulting process of access consciousness is indeed based on specific features of the brain, there are no principled reasons to assume that this process cannot be achieved in robots either.
Synergistic inhibitory effects of low-dose decitabine in combination with bortezomib in the AML cell line Kasumi-1

In the present study, the ability of the proteasome inhibitor bortezomib (BZ), an oxidative stress-inducing agent, to sensitize acute myeloid leukemia (AML) cells to decitabine (Dacogen®, DAC; a DNA methyltransferase inhibitor), in terms of cell viability and differentiation, was investigated. Kasumi-1 AML (M2) cells were treated with low-dose DAC (10, 50, 100, 200 or 400 nΜ), with or without BZ (10 nM). Apoptosis and the cell cycle were evaluated after 24 h of treatment through fluorescence-assisted cell sorting (FACS) with Annexin V/propidium iodide and DAPI staining, respectively. The expression levels of CD193, CD11b, CD13, CD14, CD15, CD16 and CD117 surface differentiation markers were evaluated by FACS after 6 days of treatment. The results indicated significant alterations in cell death and cell cycle phases in Kasumi-1 cells following DAC and BZ combination treatment compared to untreated cells and cells with single treatments. Low-dose DAC/BZ combinations significantly enhanced apoptosis and decreased the population of live Kasumi-1 cells, with 100 and 200 nM of DAC and 10 nM BZ appearing to have the most potent synergistic effect according to a combination index. Furthermore, cell cycle profiling revealed that DAC/BZ treatment synergistically led to G0/G1- and G2/M-phase arrest. By contrast, DAC appeared to promote monocytic and granulocytic differentiation of Kasumi-1 cells more effectively alone than in combination with BZ. BZ acted synergistically with low-dose DAC in vitro, leading to enhanced apoptosis and G0/G1- and G2/M-phase arrest in AML cells, hence prohibiting either DNA synthesis or mitosis. Although further in vivo investigation is necessary, these results provide a strong rationale for the implementation of a combination treatment with DAC and bortezomib in AML therapy, followed by DAC alone, which may achieve better clinical responses and possibly partially overcome the frequently encountered DAC resistance of patients with AML.
Interventionist performs a “sham” lumbar microdiscectomy: Should interventionalists be performing spinal surgery?

Background: Neurosurgeons and orthopedists, who have received specific training, should be the ones performing spinal surgery. Here, we present a case in which spinal surgeons secondarily (e.g., 6 months later) found that a patient’s first lumbar discectomy, performed by an interventional specialist, had been a “sham” procedure. Case Description: A 30-year-old male presented with sciatica attributed to a magnetic resonance imaging documented large, extruded disc at the L4-5 level. An interventional pain management specialist (IPMS) performed two epidural steroid injections; these resulted in an exacerbation of his pain. The IPMS then advised the patient that he was a surgeon and performed an “interventional” microdiscectomy. Secondarily, 6 months later, when the patient presented to a spinal neurosurgeon with a progressive cauda equina syndrome, the patient underwent a bilateral laminoforaminotomy and L4-L5 microdiscectomy. Of interest, at surgery, there was no evidence of scarring from the IPMS’ prior “microdiscectomy;” it had been a “sham” operation. Following the second surgery, the patient’s cauda equina syndrome resolved. Conclusion: IMPS, who are not trained as spinal surgeons should not be performing spinal surgery/ microdiscectomy.
Effect of long non-coding RNA AK021443 on promoting hepatic fibrosis in vitro

Long non-coding (lnc)RNAs serves an important role in the occurrence and development of hepatic fibrosis. lncRNA AK021443 is highly expressed in hepatocellular carcinoma (HCC) and promotes HCC cell proliferation, invasion and migration. The present study aimed to investigate the effect of AK021443 on hepatic fibrosis. AK021443 was overexpressed in the human LX-2 hepatic stellate cell (HSC) line using a plasmid to observe its effect on hepatic fibrosis in vitro. A Cell Counting Kit-8 assay was performed to assess cell proliferation, whereas cell cycle distribution and related proteins were analyzed via flow cytometry and western blotting, respectively. The protein expression levels of epithelial-mesenchymal transition (EMT)-associated and extracellular matrix (ECM) proteins were also analyzed via western blotting. Immunofluorescence was conducted to observe the generation of collagen1, and the activity of inflammatory factors and reactive oxygen species (ROS) was also analyzed. Compared with the pcDNA group, AK021443 overexpression significantly promoted cell proliferation, enhanced the transition of cells from G1 to S phase and increased the expression of cyclin-dependent kinase 2 and cyclin D1, but reduced the p21 protein expression levels. In addition, EMT capabilities, ECM deposition and the generation of collagen1 were increased by AK021443 overexpression compared with the pcDNA group. Moreover, AK021443 overexpression significantly increased the release of inflammatory cytokines, including TGF-β, interleukin-1β, platelet derived growth factor, epidermal growth factor and ROS, compared with the pcDNA group. In conclusion, the present study suggested that AK021443 overexpression increased HSC proliferation, activation and the proinflammatory response, indicating the potential role of AK02144 in aggravating hepatic fibrosis.
Regulatory Effect of miR497-5p–CCNE1 Axis in Triple-Negative Breast Cancer Cells and Its Predictive Value for Early Diagnosis

Objective To explore the regulatory role of miR497-5p–CCNE1 axis in triple-negative breast cancer (TNBC) cells and its predictive value for early diagnosis. Methods Cancer tissue and adjacent tissue samples were collected from 86 patients with TNBC.RT-PCR was used to detect the expression of miR497-5p and CCNE1 (target gene) mRNA, determined by biological prediction in tissue and TNBC cells. ROC was used to analyze the diagnostic value of miR497-5p in TNBC. MTT, invasion, and flow cytometry were used to detect the proliferation, invasion, cycle, apoptosis rate, and expression of related proteins of TNBC cells with overexpression of miR497-5p or knockdown of CCNE1. Results RT-qPCR results showed that miR497-5p levels were significantly downregulated in TNBC tissue and cells, while CCNE1 expression was significantly upregulated, and miR497-5p expression was negatively correlated with that of CCNE1 (P<0.001). ROC analysis showed that the AUC of miR497-5p for TNBC was >0.9, which had better diagnostic value. The cell tests revealed that miR497-5p played a role in tumor inhibition, including inhibiting proliferation and invasion of TNBC cells, blocking the cell cycle, and promoting apoptosis. Bioinformatic prediction and subsequent experiments revealed that CCNE1 was the direct target of miR497-5p. Furthermore, after knocking down the expression of CCNE1 in TNBC cells, the proliferation and invasion of TNBC cells were significantly inhibited, the cell cycle blocked, and the apoptosis rate significantly increased (P<0.001), and expression of the proapoptosis-related proteins Bax and caspase 3 (cleaved) were upregulated, while expression of the antiapoptosis-related protein BCL2 was downregulated (P<0.001). Conclusion miR497-5p inhibited the proliferation and invasion of TNBC cells by targeting CCNE1, blocked the cell cycle and promoted the apoptosis of TNBC cells, and had better diagnostic value for TNBC. miR497-5p can be used as a new potential target for the treatment of TNBC.
A Curriculum Innovation on Writing Simulated Patient Cases for Communication Skills Education

Introduction Facilitated communication practice with simulated patients (SPs) is a highly effective form of communication training. Unfortunately, little guidance exists on writing SP cases. Methods We created a curriculum composed of a case-development workbook and case-writing session with input from national communication educators. In November 2017, we implemented the curriculum in a Teaching Communication Skills course for medical educators. Educators divided into four groups to write cases. Primary outcome was the number of criteria that cases fulfilled. Secondary outcomes were SP evaluation and educator-reported confidence and satisfaction. Results Seventeen medical educators (including 15 fellows) completed the curriculum. Four new cases were analyzed against 24 criteria and compared to eight cases written by educators following a previous curriculum. An SP evaluated ease of portrayal for all 12 cases on a 5-point Likert scale (1 = poor, 5 = excellent). Educators completed precurriculum and postcurriculum surveys. Compared to the previous curriculum, cases based on the new curriculum incorporated 26% more case criteria (70% or 16.8 criteria/case vs. 96% or 23.0 criteria/case, p < .01). Ease-of-portrayal rating improved but did not differ statistically (mean: 2.8 vs. 4.5, p = .11). A moderate correlation was found between number of included case criteria and Likert-scale rating (rs = .61, p = .03). Pre- and postcurriculum, educators reported significant increases in confidence (mean: 1.9 vs. 4.0, p < .01) and high curricular satisfaction (mean: 4.8). Discussion A case-development workbook and case-writing session increased the quality of newly developed SP cases as assessed by prespecified case criteria.
Numerical methods for multicenter integrals for numerically defined basis functions applied in molecular calculations

An alternative approach to using functions defined analytically as basis functions for molecular orbital calculations is to use functions defined numerically on some mesh. It is then necessary to evaluate various integrals involving products of such functions that are centered at different points in space, usually the nuclei. This article discusses in detail the problem of evaluating overlap and kinetic energy integrals, nuclear attraction three-center integrals, and electron–electron repulsion four-center integrals for such functions. The problem of evaluating these functions in translated coordinate systems, which arises in density functional theory applications, and the associated convergence problems are also discussed. © 2003 Wiley Periodicals, Inc. Int J Quantum Chem, 2003