Miracle-dz/UniFAR-FTUs huggingface dataset:
The genetic basis of floral mechanical isolation between two hummingbird‐pollinated Neotropical understorey herbs

Floral divergence can contribute to reproductive isolation among plant lineages, and thus provides an opportunity to study the genetics of speciation, including the number, effect size, mode of action and interactions of quantitative trait loci (QTL). Moreover, flowers represent suites of functionally interrelated traits, but it is unclear to what extent the phenotypic integration of the flower is underlain by a shared genetic architecture, which could facilitate or constrain correlated evolution of floral traits. Here, we examine the genetic architecture of floral morphological traits involved in an evolutionary switch from bill to forehead pollen placement between two species of hummingbird‐pollinated Neotropical understorey herbs that are reproductively isolated by these floral differences. For the majority of traits, we find multiple QTL of relatively small effect spread throughout the genome. We also find substantial colocalization and alignment of effects of QTL underlying different floral traits that function together to promote outcrossing and reduce heterospecific pollen transfer. Our results are consistent with adaptive pleiotropy or linkage of many co‐adapted genes, either of which could have facilitated a response to correlated selection and helped to stabilize divergent phenotypes in the face of low levels of hybridization. Moreover, our results indicate that floral mechanical isolation can be consistent with an infinitesimal model of adaptation.
Screening Tools for Depression and Anxiety in Patients with Chronic Obstructive Pulmonary Disease – A Systematic Review

Abstract The diagnosis of depression or anxiety is often difficult to establish in patients with Chronic Obstructive Pulmonary Disease (COPD) as many physical symptoms are shared. There is no consensus on a screening tool for depression and anxiety in patients with COPD. The aim of this systematic review is to review screening tools for depression and anxiety suitable for application among patients with COPD in the clinical setting. A systematic review was made using predefined search terms and eligibility criteria. Of 274 initially screened articles, seven studies were found eligible. Three depression screening tools (BASDEC, BDI-II and HADS-D) had a sensitivity of 100% and a specificity >85%. The best performing anxiety screening tool (GAI) had a sensitivity of 86% and a specificity of 78%. Three screening tools had acceptable psychometric properties according to sensitivity and specificity to detect depression among patients with COPD, but the screening tools for anxiety were of less quality. Further research in and validation of the screening tools is needed to recommend one specific tool.
A comparative anatomical and histological study on the presence of an apical splenic nerve in mice and humans

The cranial pole of the mouse spleen is considered to be parasympathetically innervated by a macroscopic observable nerve referred to as the apical splenic nerve (ASN). Electrical stimulation of the ASN resulted in increased levels of splenic acetylcholine, decreased lipopolysaccharide‐induced levels of systemic tumor necrosis factor alpha and mitigated clinical symptoms in a mouse model of rheumatoid arthritis. If such a discrete ASN would be present in humans, this structure is of interest as it might represent a relatively easily accessible electrical stimulation target to treat immune‐mediated inflammatory diseases. So far, it is unknown if a human ASN equivalent exists. This study aimed to provide a detailed description of the location and course of the ASN in mice. Subsequently, this information was used for a guided exploration of an equivalent structure in humans. Microscopic techniques were applied to confirm nerve identity and compare ASN composition.
Transgender data collection in the electronic health record: Current concepts and issues

There are over 1 million transgender people living in the United States, and 33% report negative experiences with a healthcare provider, many of which are connected to data representation in electronic health records (EHRs). We present recommendations and common pitfalls involving sex- and gender-related data collection in EHRs. Our recommendations leverage the needs of patients, medical providers, and researchers to optimize both individual patient experiences and the efficacy and reproducibility of EHR population-based studies. We also briefly discuss adequate additions to the EHR considering name and pronoun usage. We add the disclaimer that these questions are more complex than commonly assumed. We conclude that collaborations between local transgender and gender-diverse persons and medical providers as well as open inclusion of transgender and gender-diverse individuals on terminology and standards boards is crucial to shifting the paradigm in transgender and gender-diverse health.
Angular‐Adaptive Reconfigurable Spin‐Locked Metasurface Retroreflector

Metasurface retroreflectors, which scatter the incident electromagnetic wave back to incoming direction, have received significant attention due to their compelling advantages of low profile and light weight compared with conventional bulky retroreflection devices. However, the current metasurface retroreflectors still have limitations in wide‐angle and omnidirectional operations. This work proposes a high‐efficiency, wide‐angle, reconfigurable, and omnidirectional retroreflector composed of spin‐locked phase gradient metasurface with a thickness of only 5.2 mm or 0.07 operating wavelength. The reflection phase of constituent meta‐atoms can be controlled dynamically and continuously by altering their orientation states through individually addressing each mechanically rotational meta‐atom, whereas the reflection handedness is kept the same as incidence. Therefore, adaptive and arbitrary momentum can be imparted to the incident wave, providing high‐efficiency retroreflection over a wide continuous range from −47° to 47°. Moreover, such high‐performance retroreflection is extended to omnidirectional level, enabling great degrees of freedom that are unavailable by previous researches. As a proof of concept, a retroreflective metasurface is fabricated and experimentally demonstrated at microwave frequencies. The proposed thin thickness, high efficiency, and reconfigurable metasurface retroreflector can be extended to other frequencies that may offer an untapped platform toward reconfigurable spin‐based retroreflection devices for electromagnetic signal processing.
Vitamin D and associated factors, among pregnant women in southeastern Nigeria

Abstract In this prospective study on vitamin D and its associated factors conducted on 256 pregnant women from Anambra state of southeastern Nigeria, Vitamin D deficiency (VDD) occurred in 36 (14.1%). Vitamin D levels were significantly associated with parity, gestational age, social class, place of abode, skin colour, workplace location, and compliance to ANC drugs. Pregnant women with these features are considered to be at risk for vitamin D deficiency. The study however did not show any association between vitamin D and maternal age, social class of the pregnant women, and the season of the year. It is recommended that vitamin D supplementation be considered routinely for women with the risk factors - especially for the grandmultipara, women at term gestational age, women of dark complexion, those with indoor work location, and of urban habitat. Impact statement What is already known on this subject? Vitamin D is a fat-soluble vitamin primarily responsible for calcium and phosphorous homeostasis in the human body. it is derived in the human body both from endogenous sources through cutaneous synthesis following exposure to sunlight, and from endogenous conversion from pre-vitamin D to 25-hdroxycholecalciferol (25 (OH)D. Vitamin D is essential in pregnancy for maternal health, foetal skeletal growth and bone development. Vitamin D deficiency (VDD) in pregnancy occurs globally with a prevalence of 4.7% to as high as 80%. What do the results of this study add? This study shows that parity, gestational age, social class, place of domicile, skin colour, workplace location, and compliance to ANC drugs constitutes associated factors to vitamin D levels. What are the implications of these findings for clinical practice and/or further research? These findings imply that grandmultiparous pregnant women, women at term gestational age, of dark complexion, with indoor work location, and of urban habitat, by virtue of their relatively lower levels of vitamin D, should be considered for routine vitamin D supplementation.
Rapamycin modulates pulmonary pathology in a murine model of Mycobacterium tuberculosis infection

ABSTRACT Tuberculosis (TB) treatment regimens are lengthy, causing non-adherence to treatment. Inadequate treatment can lead to relapse and the development of drug resistance TB. Furthermore, patients often exhibit residual lung damage even after cure, increasing the risk for relapse and development of other chronic respiratory illnesses. Host-directed therapeutics are emerging as an attractive means to augment the success of TB treatment. In this study, we used C3HeB/FeJ mice as an experimental model to investigate the potential role of rapamycin, a mammalian target of rapamycin inhibitor, as an adjunctive therapy candidate during the treatment of Mycobacterium tuberculosis infection with moxifloxacin. We report that administration of rapamycin with or without moxifloxacin reduced infection-induced lung inflammation, and the number and size of caseating necrotic granulomas. Results from this study strengthen the potential use of rapamycin and its analogs as adjunct TB therapy, and importantly underscore the utility of the C3HeB/FeJ mouse model as a preclinical tool for evaluating host-directed therapy candidates for the treatment of TB.
A folliculocentric perspective of dandruff pathogenesis: Could a troublesome condition be caused by changes to a natural secretory mechanism?

Dandruff is a common scalp condition, which frequently causes psychological distress in those affected. Dandruff is considered to be caused by an interplay of several factors. However, the pathogenesis of dandruff remains under‐investigated, especially with respect to the contribution of the hair follicle. As the hair follicle exhibits unique immune‐modulatory properties, including the creation of an immunoinhibitory, immune‐privileged milieu, we propose a novel hypothesis taking into account the role of the hair follicle. We hypothesize that the changes and imbalance of yeast and bacterial species, along with increasing proinflammatory sebum by‐products, leads to the activation of immune response and inflammation. Hair follicle keratinocytes may then detect these changes in scalp microbiota resulting in the recruitment of leukocytes to the inflammation site. These changes in the scalp skin immune‐microenvironment may impact hair follicle immune privilege status, which opens new avenues into exploring the role of the hair follicle in dandruff pathogenesis. Also see the video abstract here: https://youtu.be/mEZEznCYtNs
Intraoperative OCT vs Scheimpflug and swept-source OCT measurements for anterior eye parameters

The iOCT showed no clinically relevant differences in anterior segment parameters compared with the swept-source OCT. A small clinically relevant difference for ACD was found in comparison with that of a Scheimpflug device. Purpose: To compare agreement of anterior segment parameter measurements using an intraoperative optical coherence tomography (iOCT) of a femtosecond laser (LenSx) during interface docking to the eye with preoperative Scheimpflug tomography (Pentacam AXL) and swept-source optical coherence tomography (SS-OCT) (IOLMaster 700). Setting: Department of Ophthalmology, Goethe University, Frankfurt, Germany. Design: Retrospective study. Methods: Anterior segment measurements were performed in mydriasis prior to surgery using Scheimpflug tomography and SS-OCT. Postoperatively, iOCT images were analyzed using a modification of the FIJI image-processing program. Outcome measures included external anterior chamber depth (ACD), central corneal thickness (CCT), and central lens thickness (LT). Results: 95 eyes of 66 patients who underwent planned OCT guided femtosecond laser-assisted lens surgery were included. The ACD measured with the iOCT was −0.011 ± 0.126 mm smaller (P = .389) than that with the SS-OCT and −0.059 ± 0.185 mm than with the Scheimpflug tomography (P = .003). The SS-OCT measured a −0.047 ± 0.146 mm smaller ACD than the Scheimpflug tomography (P = .002). The measurements of CCT using the iOCT and the Scheimpflug tomography (−0.705 ± 20.837 μm, P = .742) and the LT measurements using SS-OCT and iOCT (−0.050 ± 0.089 mm, P < .001) showed no clinically relevant difference. Only the ACD between the iOCT and the Scheimpflug tomography showed a clinically relevant difference. Conclusions: The comparison of the anterior segment parameters of iOCT with SS-OCT showed no clinically relevant differences regarding the ACD and the LT. However, Scheimpflug tomography vs iOCT measured a small clinically relevant difference for ACD. The iOCT showed no clinically relevant differences in anterior segment parameters compared with the SS-OCT. A small clinically relevant difference for ACD was found in comparison with that of a Scheimpflug device.
The lymphatic vasculature: An active and dynamic player in cancer progression

The lymphatic vasculature has been widely described and explored for its key functions in fluid homeostasis and in the organization and modulation of the immune response. Besides transporting immune cells, lymphatic vessels play relevant roles in tumor growth and tumor cell dissemination. Cancer cells that have invaded into afferent lymphatics are propagated to tumor‐draining lymph nodes (LNs), which represent an important hub for metastatic cell arrest and growth, immune modulation, and secondary dissemination to distant sites. In recent years many studies have reported new mechanisms by which the lymphatic vasculature affects cancer progression, ranging from induction of lymphangiogenesis to metastatic niche preconditioning or immune modulation. In this review, we provide an up‐to‐date description of lymphatic organization and function in peripheral tissues and in LNs and the changes induced to this system by tumor growth and progression. We will specifically focus on the reported interactions that occur between tumor cells and lymphatic endothelial cells (LECs), as well as on interactions between immune cells and LECs, both in the tumor microenvironment and in tumor‐draining LNs. Moreover, the most recent prognostic and therapeutic implications of lymphatics in cancer will be reported and discussed in light of the new immune‐modulatory roles that have been ascribed to LECs.
Call for emergency action to limit global temperature increases, restore biodiversity, and protect health

Editor in Chief, East African Medical Journal; Editor in Chief, Journal of Health, Population and Nutrition; Editor in Chief, Danish Medical Journal; Editor in Chief, PLOS Medicine; Editor in Chief, The BMJ; Editor in Chief, British Dental Journal; Editor in Chief, The Lancet; Senior Adviser, UK Health Alliance on Climate Change; Editor in Chief, Revista de Saúde Pública; Editor in Chief, International Journal of Nursing Studies; Interim Editor in Chief, CMAJ; Executive Editor, Pharmaceutical Journal; Editor in Chief, Dutch Journal of Medicine; Editor in Chief, NEJM; Editor in Chief, National Medical Journal of India; Chair, UK Health Alliance on Climate Change; Editor in Chief, Medical Journal of Australia; Editor in Chief, International Nursing Review; and Editor in Chief, Pan American Journal of Public Health
Satisfactory treatment of mucocutaneous lesions in hereditary hemorrhagic telangiectasia patients with dual pulsed dye laser and neodymium: yttrium–aluminum–garnet

Hereditary hemorrhagic telangiectasia (HHT) is characterized by telangiectasia and larger arteriovenous malformations (AVM) in different organs. Mucocutaneous telangiectasia can bleed and cause stigmatization, but the best treatment approach has not been defined yet. The aim of the study was to evaluate the efficacy and safety of dual pulsed dye laser and neodymium: yttrium–aluminum–garnet (PDL‐Nd:YAG) laser treatment for mucocutaneous telangiectasia in HHT patients. It is a retrospective case series, where clinical files of all HHT patients treated with PDL‐Nd:YAG laser at our Department between December 2010 and July 2019 were reviewed. Demographic, clinical, and treatment characteristics were recorded. The severity and degree of improvement were evaluated by three blinded examiners scoring pretreatment and posttreatment pictures on a 5‐point scale. Patient satisfaction and procedure pain were assessed using an ordinal scale (0–10). Forty‐three treatment areas from 26 patients were analyzed. Lesions were predominantly located on the lower lip and cheeks. The median number of laser sessions per patient was 3 (interquartile range [IQR] 2–4). The median global severity score at baseline was 2 and became 0 at endpoint (p < 0.0001), with a median improvement rate of 4 (IQR 3–4). All patients reported a high degree of satisfaction (median 9) and tolerable pain (median 5). In conclusion, dual PDL‐Nd: YAG laser is a convenient, safe, and effective treatment option for mucocutaneous telangiectasia in HHT patients.
Gallbladder wall thickening in patients with IgG4-related diseases, with special emphasis on IgG4-related cholecystitis

Abstract Objectives Gallbladder (GB) wall thickening sometimes occurs in patients with autoimmune pancreatitis (AIP), a condition for which the name, IgG4-related cholecystitis, was proposed. We examined the radiological findings of the GB in patients with IgG4-related diseases and clinical features of patients with GB wall thickening and presented a hypothesis of its pathogenesis. Materials and methods GB wall thickening was defined by thickness ≥ 4 mm. GB wall thickness was examined in 258 patients with IgG4-related disease. Clinical and imaging findings of 200 patients with AIP with and without GB wall thickening were then compared. Results GB wall thickening was detected in 58 patients (29%) with AIP and two patients with isolated IgG4-related sclerosing cholangitis. In the 60 GBs examined, wall thickening was diffuse, with the walls possessing a smooth inner surface. No GB wall thickening was detected among the 56 patients with IgG4-related disease without AIP or IgG4-related sclerosing cholangitis. Bile duct stenosis was detected in 56 patients (97%) with AIP with GB wall thickening. Intraductal ultrasonography indicated cystic duct wall thickening connected to bile duct wall thickening in 11 of 14 (79%) patients with AIP or IgG4-related sclerosing cholangitis with GB wall thickening. Forty-eight patients in whom IgG4-related cholecystitis was diagnosed experienced resolution of the GB wall thickening after receiving steroid therapy. Conclusions Most cases of GB wall thickening in IgG4-related diseases are closely associated with IgG4-related sclerosing cholangitis and may be a manifestation of IgG4-related disease throughout the biliary tract, including the bile duct, cystic duct, and GB.
Pericardial Adipose Tissue–Derived Leptin Promotes Myocardial Apoptosis in High‐Fat Diet–Induced Obese Rats Through Janus Kinase 2/Reactive Oxygen Species/Na+/K+‐ATPase Signaling Pathway

Background Pathophysiologic mechanisms underlying cardiac structural and functional changes in obesity are complex and linked to adipocytokines released from pericardial adipose tissue (PAT) and cardiomyocyte apoptosis. Although leptin is involved in various pathological conditions, its role in paracrine action of pericardial adipose tissue on myocardial apoptosis remains unknown. This study was designed to investigate the role of PAT‐derived leptin on myocardial apoptosis in high‐fat diet–induced obese rats. Methods and Results Hearts were isolated from lean or high‐fat diet–induced obese Wistar rats for myocardial remodeling studies. Obese rats had abnormal myocardial structure, diastolic dysfunction, greatly elevated cardiac apoptosis, enhanced cardiac fibrosis, and increased oxidative stress level. ELISA detected significantly higher than circulating leptin level in PAT of obese, but not lean, rats. Western blot and immunohistochemical analyses demonstrated increased leptin receptor density in obese hearts. H9c2 cardiomyoblasts, after being exposed to PAT‐conditioned medium of obese rats, exhibited pronounced reactive oxygen species–mediated apoptosis, which was partially reversed by leptin antagonist. Moreover, leptin derived from PAT of obese rats inhibited Na+/K+‐ATPase activity of H9c2 cells through stimulating reactive oxygen species, thereby activating calcium‐dependent apoptosis. Pretreatment with specific inhibitors revealed that Janus kinase 2/signal transducer and activator of transcription 3 and phosphoinositide 3‐kinase/protein kinase B signaling pathways were involved in leptin‐induced myocardial apoptosis. Conclusions PAT‐derived leptin induces myocardial apoptosis in high‐fat diet–induced obese rats via activating Janus kinase 2/signal transducer and activator of transcription 3/reactive oxygen species signaling pathway and inhibiting its downstream Na+/K+‐ATPase activity.
Fetal malnutrition is associated with impairment of endogenous melatonin synthesis in pineal via hypermethylation of promoters of protein kinase C alpha and cAMP response element‐binding

This study investigated whether and how fetal malnutrition would influence endogenous melatonin synthesis, and whether such effect of fetal malnutrition would transmit to the next generation. We enrolled 2466 participants and 1313 of their offspring. The urine 6‐hydroxymelatonin sulfate and serum melatonin rhythm were measured. Methylation microarray detection and bioinformatics analysis were performed to identify hub methylated sites. Additionally, rat experiment was performed to elucidate mechanisms. The participants with fetal malnutrition had lower 6‐hydroxymelatonin sulfate (16.59 ± 10.12 μg/24 hours vs 24.29 ± 11.99 μg/24 hours, P < .001) and arear under curve of melatonin rhythm (67.11 ± 8.16 pg/mL vs 77.11 ± 8.04 pg/mL, P < .001). We identified 961 differentially methylated sites, in which the hub methylated sites were locating on protein kinase C alpha (PRKCA) and cAMP response element‐binding protein (CREB1) promoters, mediating the association of fetal malnutrition with impaired melatonin secretion. However, such effects were not observed in the offspring (all P > .05). Impaired histomorphology of pineal, decreased melatonin in serum, pineal, and pinealocyte were also found in the in vivo and in vitro experiments (P < .05 for the differences of the indicators). Hypermethylation of 10 CpG sites on the PRKCA promoter and 8 CpG sites on the CREB1 promoter were identified (all P < .05), which down‐regulated PRKCA and CREB1 expressions, leading to decreased expression of AANAT, and then resulting in the impaired melatonin synthesis. Collectively, fetal malnutrition can impair melatonin synthesis through hypermethylation of PRKCA and CREB1 promoters, and such effects cannot be transmitted to the next generation.