Miracle-dz/UniFAR-FTUs huggingface dataset:
Medical management of acute radiation syndrome and associated infections in a high-casualty incident

Abstract A high-casualty incident may result in a significant human toll due to the inability of a community to meet the health care demands of the population. A successful medical response requires health care facilities to not only communicate and integrate medical services, meet surge capacity, protect health care workers and implement triage and treatment protocols, but also to provide the venue for clinical management of acute radiation injuries and their associated infections. Today, clinical management is primarily guided by the recommendations of a Consultancy that were made at the World Health Organization (WHO). This international consensus was reached on evidence-based, clinical management of each of the four sub-syndromes that compose acute radiation syndrome (ARS), including the hematopoietic subsyndrome (HS), gastrointestinal subsyndrome (GIS), neurovascular subsyndrome (NVS) and cutaneous subsyndrome (CS). Major findings in studies meeting inclusion criteria for management strategies for HS were that (i) no randomized controlled studies of medical countermeasures have been (or will likely ever be) performed for ARS cases, (ii) the data for management of HS are restricted by the lack of comparator groups, and (iii) reports of countermeasures for management of injury to non-hematopoietic organs are often incompletely described. Here, (i) recommendations made in Geneva are summarized; (ii) the analysis of countermeasures for HS is updated by review of two additional cases and extended to published reports not meeting inclusion criteria; and (iii) guidelines are provided for management of microbial infections based upon patient risk for prolonged immunosuppression.
The Use of Simulation to Teach Nursing Students and Clinicians Palliative Care and End-of-Life Communication: A Systematic Review

Objectives: To present the findings of a systematic review on the use of simulation-based learning experiences (SBLEs) to teach communication skills to nursing students and clinicians who provide palliative and end-of-life care to patients and their families. Background: Palliative care communication skills are fundamental to providing holistic patient care. Since nurses have the greatest amount of direct exposure to patients, building such communication competencies is essential. However, exposure to patients and families receiving palliative and end-of-life care is often limited, resulting in few opportunities to learn these skills in the clinical setting. Simulation-based learning experiences can be used to supplement didactic teaching and clinical experiences to build the requisite communication skills. Methods: Searches of CINAHL, MEDLINE, PsychINFO, ERIC, and Web of Science electronic databases and Grey Literature returned 442 unique records. Thirty articles met the established criteria, including the SBLE must contain a nursing role. Results: Simulation-based learning experience are being used to teach palliative and end-of-life communication skills to nursing students and clinicians. Lack of standardization, poor evaluation methods, and limited exposure to the entire interprofessional team makes it difficult to identify and disseminate validated best practices. Conclusion: While the need for further research is acknowledged, we recommend this evidence be augmented by training programs that utilize SBLEs through (1) applying standards, (2) clearly specifying goals and objectives, (3) integrating externally validated scenarios, and (4) employing rigorous evaluation methods and measures that link the SBLE to the training objectives and desired clinician practice behaviors and patient outcomes.
The Effect of Aging on Physical Performance Among Elderly Manual Workers: Protocol of a Cross-Sectional Study

Background In 2012, the Danish Parliament decided to increase retirement age. Unfortunately, elderly people working in a physically demanding environment may be rendered unable to retain the ability to adequately perform the physical requirements of their jobs, due to age-related decreases in physical performance. Therefore, increasing the retirement age may not necessarily lead to the goal of keeping everybody in the labor market for a longer time. To date, our knowledge about the variations in physical performance of the elderly workforce is limited. Objective In this cross-sectional study we seek to investigate the effects of aging on physical performance among elderly manual workers. Methods Approximately 100 Danish manual workers between 50 and 70 years of age will be recruited. The main measurement outcomes include: (1) inflammatory status from blood samples; (2) body composition; (3) lung function; (4) static and dynamic balance; (5) reaction time, precision, and movement variability during a hammering task; (6) handgrip strength, rate of force development, and force tracking; (7) estimated maximal rate of oxygen consumption; and (8) back mobility. Additionally, information regarding working conditions, physical activity levels, and health status will be assessed with a questionnaire. Results Data collection is expected to take place between autumn 2017 and spring 2018. Conclusions This study will increase the knowledge regarding variations in physical performance in the elderly workforce and may identify potential workplace hazards. Moreover, this study might shed light on the potentially problematic decision to increase retirement age for all Danish citizens.
DOTTORATO DI RICERCA IN FISICA

The interest for the outstanding properties of graphene nanostructures is continuously increasing in several fields, from fundamental research to technological applications. In this thesis different strategies are proposed to modulate the intrinsic properties of sub-nm graphene nanostructures. The introduction of organic functional groups, covalently bonded to the edges of graphene nanoflakes allows to tune their optical and electronic properties. Specifically, the controlled shift of electron affinity and ionization potential opens the possibility to design all-graphene nanojunctions (GNJs) with different gap alignments. Type-II GNJs, obtained through the interface of electron-withdrawing and –donating groups within the same ribbon, are characterized by a bright optical excitation with large oscillator strength and charge transfer character. In addition we have shown that edge adsorption of a transition-metal atom allows for spin-transport selectivity in quasi-1D antiferromagnetic graphene nanoribbons. The results provide insights into the fundamental properties of graphene nanostructures and show promising perspectives in view of graphene-based optoelectronics and spintronics.
Rescuing Israeli travellers: effects of substance abuse, mental health, geographic region of rescue, gender and age of rescuees

Background Research conducted on young Israeli travellers has pointed to high substance usage rates. For some drug-using backpackers, actual extraction and rescue from their trip abroad is necessary. This study represents a first attempt to explore the influence of geographic region in which rescue occurs, cause for rescue and gender and age differences among Israeli rescuees. Methods Sub-analysis of all logs of individual rescuees during a 5-year period from 2011 to 2016 ( N = 86) included 66 men and 20 women, with an average age of 27.83 (SD = 7.86). Results The findings demonstrate that Israelis are most frequently rescued from South and Southeast Asia (57%) followed by Europe (22%), South America (17%), North America (2.3%) and Africa (1.2%). India was the country with the highest rate of rescue incidents ( N = 36) followed by Thailand ( N = 8) and the Netherlands ( N = 5). The most common cause for rescue was substance abuse (87%). However, significant regional differences were found based on the variable of age ( F = 3.21, df = 3,50, P < 0.05). The youngest rescuees were evacuated from South America ( M = 24.20 years, SD = 3.8), while the oldest were from Europe ( M = 32.86 years, SD = 10.9). The most frequent mental diagnosis for rescuees was acute psychosis due to substance use disorder (81%) and bipolar disorder, manic subtype due to substance abuse (7%). Significant gender differences were found among rescuees diagnosed with bipolar disorder, manic type: 25% were female, while men only accounted for 1.5% ( χ 2 = 61.70, df = 24, P < 0.0001). Conclusions Region, age and gender of young travellers should be taken into consideration when thinking about induced acute psychosis caused by substance use. Policymakers need to consider prevention and harm reduction interventions relevant to this risk group.
Mediators of Outcome in Complicated Grief Treatment.

OBJECTIVE In this study, we examined the mechanisms of action of complicated grief treatment (CGT), an efficacious psychotherapy for complicated grief. METHOD We explored 3 putative mediators (guilt/self-blame related to the deceased, negative thoughts about the future, and avoidance) among treatment completers assigned to either CGT (n = 35) or interpersonal psychotherapy (n = 34) in a previously reported randomized controlled trial. Antidepressant use was examined as a moderator of mediation effects. RESULTS A reduction in guilt/self-blame, negative thoughts about the future, and avoidance behavior each mediated the relationship between treatment group and complicated grief outcomes. Reduction in avoidance emerged as an independent mediator after controlling for all mediators. CONCLUSION Reducing avoidance of situations and emotions connected to the loss seems to be a key mechanism of change in CGT. Revising counterfactual thinking around troubling aspects of the death may also play a role in facilitating effective adaptation to loss.
Neuroscience and Biobehavioral Reviews the Spatial Orienting Paradigm: How to Design and Interpret Spatial Attention Experiments

This paper is conceived as a guide that will describe the very well known Spatial Orienting paradigm, used to explore attentional processes in healthy individuals as well as in people suffering from psychiatric disorders and brain-damaged patients. The paradigm was developed in the late 1970s, and since then, it has been used in thousands of attentional studies. In this review, we attempt to describe, the paradigm for the naïf reader, and explain in detail when is it used, which variables are usually manipulated, how to interpret its results, and how can it be adapted to different populations and methodologies. The main goal of this review is to provide a practical guide to researchers who have never used the paradigm that will help them design their experiments, as a function of their theoretical and experimental needs. We also focus on how to adapt the paradigm to different technologies (such as event-related potentials, functional resonance imaging, or transcranial magnetic stimulation), and to different populations by presenting an example of its use in brain-damaged patients.
The role of patient perception of crowding in the determination of real-time patient satisfaction at Emergency Department

Objective To evaluate the associations between real-time overall patient satisfaction and Emergency Department (ED) crowding as determined by patient percepton and crowding estimation tool score in a high-volume ED. Design A prospective observational study. Setting A tertiary acute hospital ED and a Level 1 trauma center. Participants ED patients. Intervention(s) Crowding status was measured by two crowding tools [National Emergency Department Overcrowding Scale (NEDOCS) and Severely overcrowded-Overcrowded-Not overcrowded Estimation Tool (SONET)] and patient perception of crowding surveys administered at discharge. Main outcome measure(s) ED crowding and patient real-time satisfaction. Results From 29 November 2015 through 11 January 2016, we enrolled 1345 participants. We observed considerable agreement between the NEDOCS and SONET assessment of ED crowding (bias = 0.22; 95% limits of agreement (LOAs): -1.67, 2.12). However, agreement was more variable between patient perceptions of ED crowding with NEDOCS (bias = 0.62; 95% LOA: -5.85, 7.09) and SONET (bias = 0.40; 95% LOA: -5.81, 6.61). Compared to not overcrowded, there were overall inverse associations between ED overcrowding and patient satisfaction (Patient perception OR = 0.49, 95% confidence limit (CL): 0.38, 0.63; NEDOCS OR = 0.78, 95% CL: 0.65, 0.95; SONET OR = 0.82, 95% CL: 0.69, 0.98). Conclusions While heterogeneity exists in the degree of agreement between objective and patient perceived assessments of ED crowding, in our study we observed that higher degrees of ED crowding at admission might be associated with lower real-time patient satisfaction.
Supporting Lung Cancer Patients With an Interactive Patient Portal: Feasibility Study

Background MyAVL is an interactive portal for cancer patients that aims to support lung cancer patients. Objective We aimed to evaluate the feasibility and usability of the patient portal and generate preliminary evidence on its impact. Methods Lung cancer patients currently or recently treated with curative intent could use MyAVL noncommittally for 4 months. Feasibility, usability, and preliminary impact (ie, patient activation, quality of life, and physical activity) were studied by means of questionnaires, a focus group, and analysis of user log data. Results We included 37 of 123 eligible patients (mean age 59.6 years). The majority of responses (82%) were positive about using MyAVL, 69% saw it as a valuable addition to care, and 56% perceived increased control over their health. No positive effects could be substantiated on the impact measures. Conclusions MyAVL appears to be a feasible and user-friendly, multifunctional eHealth program for a selected group of lung cancer patients. However, it needs further improvements to positively impact patient outcomes.
Coaxial extrusion bioprinting of 3D microfibrous constructs with cell-favorable gelatin methacryloyl microenvironments

Bioinks with shear-thinning/rapid solidification properties and strong mechanics are usually needed for the bioprinting of three-dimensional (3D) cell-laden constructs. As such, it remains challenging to generate soft constructs from bioinks at low concentrations that are favorable for cellular activities. Herein, we report a strategy to fabricate cell-laden constructs with tunable 3D microenvironments achieved by bioprinting of gelatin methacryloyl (GelMA)/alginate core/sheath microfibers, where the alginate sheath serves as a template to support and confine the GelMA pre-hydrogel in the core during the extrusion process, allowing for subsequent UV crosslinking. This novel strategy minimizes the bioprinting requirements for the core bioink, and facilitates the fabrication of cell-laden GelMA constructs at low concentrations. We first showed the capability of generating various alginate hollow microfibrous constructs using a coaxial nozzle setup, and verified the diffusibility and perfusability of the bioprinted hollow structures that are important for the tissue engineering applications. More importantly, the hollow alginate microfibers were then used as templates for generating cell-laden GelMA constructs with soft microenvironments, by using GelMA pre-hydrogel as the bioink for the core phase during bioprinting. As such, GelMA constructs at extremely low concentrations (<2.0%) could be extruded to effectively support cellular activities including proliferation and spreading for various cell types. We believe that our strategy is likely to provide broad opportunities in bioprinting of 3D constructs with cell-favorable microenvironments for applications in tissue engineering and pharmaceutical screening.
Internet Use and Access, Behavior, Cyberbullying, and Grooming: Results of an Investigative Whole City Survey of Adolescents

Background According to the Digital Agenda for Europe, the way children use the Internet and mobile technologies has changed dramatically in the past years. Objective The aims of this study were to: (1) breakdown the modalities of access and use of the Internet by teenagers to assess risks and risky behaviors; and (2) provide scientific data to evaluate and counsel safe use of the Internet and new technologies by teenagers. Methods The study was conducted under the program “Strategies for a Better Internet for Children” started in May 2012 by the European Commission. It represents the main result of the project launched by Telecom Italia, “Anche io ho qualcosa da dire” (I too have something to say), thanks to which many contributions were collected and used to develop a survey. The questionnaire was structured in 45 questions, covering three macro areas of interest. It was approved by the Department Board at University of Magna Graecia’s School of Medicine. After authorization from the regional high school authority, it was administered to all 1534 students (aged 13-19 years) in the city of Catanzaro, Italy. Results The data was broken down into three main groups: (1) describing education and access to the Internet; (2) methods of use and social networking; and (3) perception and evaluation of risk and risky behaviors. Among noteworthy results in the first group, we can mention that the average age of first contact with information technologies was around 9 years. Moreover, 78.87% (1210/1534) of the interviewed students reported having access to a smartphone or a tablet. Among the results of the second group, we found that the most used social networks were Facebook (85.78%, 1316/1534), YouTube (61.14%, 938/1534), and Google+ (51.56%, 791/1534). About 71.31% (1094/1534) of the interviewed teenagers use their name and surname on social networks, and 40.09% (615/1534) of them knew all their Facebook contacts personally. Among the results of the third group, we found that 7.69% (118/1534) of the interviewed teenagers have uploaded pictures or movies of which they felt ashamed; 27.05% (415/1534) have received invitations from people they met on the Internet to meet in real life; and 8.67% (133/1534) have accepted such invitations. Conclusions The results offer a breakdown of the teenagers’ use of the Internet, focusing on how teenagers learn to use and access it while taking into account factors such as parental coaching, schooling, or self-education. It describes how they approach and interact with social networks and how they perceive risks and risky behaviors on the Internet. Information technology must be seen as an instrument and not as a hindrance. For this to happen, parental guidance, schooling, and medical counseling are needed for a sound development of the child in this critical stage.
A 5‐Gbps USB3.0 transmitter and receiver linear equalizer

A USB3.0 compatible transmitter and the linear equalizer of the corresponding receiver are presented in this paper. The architecture and circuit design techniques used to meet the strict requirements of the overall link design are explored. Output voltage amplitude and de‐emphasis levels are programmable, whereas the output impedance is calibrated to 50Ω. A programmable receiver equalizer is also presented with its main purpose being to compensate for the channel losses; this is employed together with a DC offset compensation scheme. The 6.25‐GHz equalizer provides a 10 dB overall gain equalization and 5.5‐dB peaking at the maximum gain setting. Designed using a mature and well established 65 nm complementary metal oxide semiconductor process, the layout area is 400 µm × 210 µm for the transmitter core, and 140 µm × 70 µm for the equalizer core. The power consumption is 55 and 4 mW, respectively, from a 1.2 V supply at a data rate of 5 Gbps. The target application for such high‐speed blocks is to implement the critical part of the physical layer that defines the signaling technology of SuperSpeed USB3 PHY. However, identical iterations of the circuitry discussed can be used for similar high‐speed applications like the PCI express (PCIe). Copyright © 2014 John Wiley & Sons, Ltd.
Comparison of the local pulmonary distribution of nanoparticles administered intratracheally to rats via gavage needle or microsprayer delivery devices

Intratracheal administration methods are used to conduct toxicological assessments of inhaled nanoparticles (NPs), and gavage needles or microsprayers are common intratracheal delivery devices. The NP suspension is delivered in a liquid state via gavage needle and as a liquid aerosol via microsprayer. The differences in local pulmonary NP distribution (called the microdistribution) arising from the different states of the NP suspension cause differential pulmonary responses; however, this has yet to be investigated. Herein, using microbeam X‐ray fluorescence microscopy, we quantitatively evaluated the TiO2 pulmonary microdistribution (per mesh: 100 μm × 100 μm) in lung sections from rats administered an intratracheal dose of TiO2 NPs (6 mg kg−1) via gavage needle or microsprayer. The results revealed that: (i) using a microsprayer appears to reduce the variations in TiO2 content (ng mesh−1) among rats (e.g., coefficients of variation, n = 3, microsprayer vs gavage needle: 13% vs 30%, for the entire lungs); (ii) TiO2 appears to be deposited less in the right middle lobes than in the rest of the lung lobes, irrespective of the chosen intratracheal delivery device; and (iii) similar TiO2 contents (ng mesh−1) and frequencies are deposited in the lung lobes of rats administered TiO2 NPs via gavage needle or microsprayer. This suggests that the physical state of the administered NP suspension does not markedly alter TiO2 pulmonary microdistribution. The results of this investigation are important for the standardization of intratracheal administration methods. Copyright © 2016 John Wiley & Sons, Ltd.
Upregulation of Glutaredoxin-1 Activates Microglia and Promotes Neurodegeneration: Implications for Parkinson's Disease.

AIMS Neuroinflammation and redox dysfunction are recognized factors in Parkinson's disease (PD) pathogenesis, and diabetes is implicated as a potentially predisposing condition. Remarkably, upregulation of glutaredoxin-1 (Grx1) is implicated in regulation of inflammatory responses in various disease contexts, including diabetes. In this study, we investigated the potential impact of Grx1 upregulation in the central nervous system on dopaminergic (DA) viability. RESULTS Increased GLRX copy number in PD patients was associated with earlier PD onset, and Grx1 levels correlated with levels of proinflammatory tumor necrosis factor-alpha (TNF-α) in mouse and human brain samples, prompting mechanistic in vitro studies. Grx1 content/activity in microglia was upregulated by lipopolysaccharide (LPS), or TNF-α, treatment. Adenoviral overexpression of Grx1, matching the extent of induction by LPS, increased microglial activation; Grx1 silencing diminished activation. Selective inhibitors/probes of nuclear factor κB (NF-κB) activation revealed glrx1 induction to be mediated by the Nurr1/NF-κB axis. Upregulation of Grx1 in microglia corresponded to increased death of neuronal cells in coculture. With a mouse diabetes model of diet-induced insulin resistance, we found upregulation of Grx1 in brain was associated with DA loss (decreased tyrosine hydroxylase [TH]; diminished TH-positive striatal axonal terminals); these effects were not seen with Grx1-knockout mice. INNOVATION Our results indicate that Grx1 upregulation promotes neuroinflammation and consequent neuronal cell death in vitro, and synergizes with proinflammatory insults to promote DA loss in vivo. Our findings also suggest a genetic link between elevated Grx1 and PD development. CONCLUSION In vitro and in vivo data suggest Grx1 upregulation promotes neurotoxic neuroinflammation, potentially contributing to PD. Antioxid. Redox Signal. 25, 967-982.