Miracle-dz/UniFAR-FTUs huggingface dataset:
Factors affecting professional ethics development in students: A qualitative study

Background: Ethics development is one of the most important aspects of professional practice in health sciences students. Understanding factors affecting ethics development can enhance clinical and professional performance in students. Objective: This study was conducted to explore students’ perceptions about factors affecting professional ethics development. Research design: This study is a conventional content analysis. Data were collected through 20 semi-structured interviews and two focus group interviews (12 students) during 2017–2018. Data were analyzed concurrently with data gathering, using the conventional content analysis approach of Graneheim and Lundman. Participants and research context: In total, 8 students of nursing, 5 medical students, 4 students of anesthesia and 3 operating room students in individual interviews, and 12 students in two focus group interviews from one university in the south of Iran were selected through purposive sampling. Ethical considerations: The research was approved by the Ethics Committee of one university in the south of Iran. Findings: The findings revealed two themes: personal and background factors. Personal factors consisted of the two categories of individual motivation and tendencies and interpersonal interactions. Background factors consisted of the two categories of role and function of teachers and environmental agents. Discussion and conclusions: According to the findings, both background and individual factors affect development of professional ethics in students. Understanding these factors along with reinforcement of educational planning in this field can improve healthcare services.
In Vitro Epiretinal Membrane Model and Antibody Permeability: Relationship With Anti-VEGF Resistance in Diabetic Macular Edema.

Purpose Diabetic macular edema (DME) is characterized by an accumulation of fluid in the macula due to diabetic retinopathy. Currently, anti-VEGF drugs are the standard treatment worldwide for DME. This study aimed to assess whether the existence of epiretinal membrane (ERM) affects anti-VEGF efficacy, due to reduced permeability of the antibody through the ERM. Methods We retrospectively examined clinical data of DME patients who underwent anti-VEGF treatment and evaluated whether clinical differences existed between DME eyes with ERM and those without ERM. We then created an in vitro ERM model using MIO-M1, ARPE-19, and NTI-4 cells on Transwell membranes and evaluated antibody permeability through this in vitro ERM model using fluorescently labeled antibodies. Results Central retinal thickness (CRT) change between before and 1 month after first anti-VEGF treatment, as well as final CRT and final visual acuity 12 months after first anti-VEGF treatment, significantly differed between DME eyes with ERM and those without ERM. The in vitro ERM model led to production of collagen I in a manner similar to that of human ERM specimens. Fluorescence intensity of the lower chamber of the in vitro ERM model was significantly reduced in a dose-dependent manner. Conclusions Clinical data analysis indicated that the existence of ERM in DME eyes lowered the efficacy of anti-VEGF treatment. Reduced antibody permeability through the in vitro ERM model suggested ERM presence was associated with resistance to anti-VEGF treatment in DME eyes with ERM.
Management of radial scars/complex sclerosing lesions of the breast diagnosed on vacuum‐assisted large‐core biopsy: is surgery always necessary?

The diagnosis of radial scars/complex sclerosing lesions (RSs/CSLs) onpercutaneous biopsy carries a risk of histological underestimation. Consequently, surgical excision is often performed in order to exclude a possible associated malignancy. The aim of this study was to assess the rate of ‘upgrade to carcinoma’ upon subsequent surgical excision of RS/CSL cases diagnosed on vacuum‐assisted large‐core biopsy (VALCB). We also analysed the risk factors for upgrade in order to determine a subset of patients who could avoid surgery and benefit from conservative management with clinical and imaging follow‐up.
Intravascular innate immune cells reprogrammed via intravenous nanoparticles to promote functional recovery after spinal cord injury

Significance Inflammatory responses, such as those following spinal cord injury (SCI), lead to extensive tissue damage that impairs function. Here, we present nanoparticles that target circulating immune cells acutely, with nanoparticles reprogramming the immune cell response. The polymeric nanoparticles are formed without an active pharmaceutical ingredient that can have off-target effects, and internalization redirects some immune cells to the spleen, with modest numbers at the SCI. Following intravenous delivery, immune cell infiltration is reduced, correlating with decreased tissue degeneration. Furthermore, the SCI develops into a permissive microenvironment characterized by proregenerative immune cell phenotypes, expression of regeneration associated genes, increased axons and myelination, and a substantially improved functional recovery. These nanoparticles may be applied to numerous inflammatory diseases. Traumatic primary spinal cord injury (SCI) results in paralysis below the level of injury and is associated with infiltration of hematogenous innate immune cells into the injured cord. Methylprednisolone has been applied to reduce inflammation following SCI, yet was discontinued due to an unfavorable risk-benefit ratio associated with off-target effects. In this study, i.v. administered poly(lactide-coglycolide) nanoparticles were internalized by circulating monocytes and neutrophils, reprogramming these cells based on their physicochemical properties and not by an active pharmaceutical ingredient, to exhibit altered biodistribution, gene expression, and function. Approximately 80% of nanoparticle-positive immune cells were observed within the injury, and, additionally, the overall accumulation of innate immune cells at the injury was reduced 4-fold, coinciding with down-regulated expression of proinflammatory factors and increased expression of antiinflammatory and proregenerative genes. Furthermore, nanoparticle administration induced macrophage polarization toward proregenerative phenotypes at the injury and markedly reduced both fibrotic and gliotic scarring 3-fold. Moreover, nanoparticle administration with the implanted multichannel bridge led to increased numbers of regenerating axons, increased myelination with about 40% of axons myelinated, and an enhanced locomotor function (score of 6 versus 3 for control group). These data demonstrate that nanoparticles provide a platform that limits acute inflammation and tissue destruction, at a favorable risk-benefit ratio, leading to a proregenerative microenvironment that supports regeneration and functional recovery. These particles may have applications to trauma and potentially other inflammatory diseases.
Incidence of radionecrosis in single-fraction radiosurgery compared with fractionated radiotherapy in the treatment of brain metastasis.

Introduction Radiation-induced brain necrosis ["radionecrosis" (rn)] is a relatively uncommon but potentially severe adverse effect of stereotactic radiosurgery (srs) for brain metastasis. Although dose, volume, and hypofractionation have been suggested to affect rn rates, patient and treatment variability in this population make it difficult to clearly delineate the risk. We set out to establish the effect of fractionation on rn rates by reviewing patients receiving simultaneous multi-fraction and single-fraction treatment at our centre. Methods Patients receiving simultaneous (within 1 month) 1-fraction (ssrs) and 3-fraction (fsrs) radiosurgery treatments during 2012-2015 were identified in our institution's database. Serial post-srs magnetic resonance imaging (mri) was reviewed to determine rn and local recurrence. The effect of maximum dose, volume, whole-brain radiotherapy (wbrt), and fractionation on rn development was assessed using logistic regression for paired data. Results are reported using odds ratios (ors) and corresponding 95% confidence intervals (cis). Results Of 90 patients identified, 22 had at least a 6-month mri follow-up. Median follow-up was 320 days. The most common primary tumour type was non-small-cell lung cancer, followed by breast and rectal cancer. Radionecrosis developed in 16 patients [21 of 62 lesions (34%), with 4 being symptomatic (20%)]. Of the 21 lesions in which rn developed, 11 received 3 fractions, and 10 received 1 fraction. The or for the association between the incidence of rn and maximum dose was 1.0 (95% ci: 0.9 to 1.1); for fractionation it was 1.0 (95% ci: 0.3 to 3.6); for previous wbrt, it was 0.4 (95% ci: 0.2 to 1.2); and for a 10-unit increase in volume, it was 3.1 (95% ci: 1.0 to 9.6). Local recurrence developed in 8 patients (12%), 6 of whom belonged to the ssrs group. Conclusions Our results indicate that patients receiving srs for multiple brain metastases experience a higher rate of rn than is reported in the literature and poorer survival despite having equivalent local control. Maximum dose did not appear to be associated with rn risk in our cohort, but volume was significantly associated with rn risk. Although fractionated treatment did not directly lower the rate of rn in this population, it might have played a role in reducing the magnitude of the rn risk in large-volume lesions. Further investigation will help to delineate optimal dose and fractionation so as to minimize rn while maintaining local control in this group.
White matter volume and white/gray matter ratio in mammalian species as a consequence of the universal scaling of cortical folding

Significance The white matter of the cerebral cortex contains all axons that support long-range cortical connectivity and increases faster in volume than the gray matter, which contains the connected cortical neuronal cell bodies. We show that the ratio between volumes of white and gray matter scales universally according to the same factors that account for the degree to which the cortex folds, that is, the combination of cortical surface area and thickness. We postulate that the relative white matter volume is determined as the developing cortex settles in the most energetically favorable folded conformation, regardless of its number of neurons. Because the white matter of the cerebral cortex contains axons that connect distant neurons in the cortical gray matter, the relationship between the volumes of the 2 cortical compartments is key for information transmission in the brain. It has been suggested that the volume of the white matter scales universally as a function of the volume of the gray matter across mammalian species, as would be expected if a global principle of wiring minimization applied. Using a systematic analysis across several mammalian clades, here we show that the volume of the white matter does not scale universally with the volume of the gray matter across mammals and is not optimized for wiring minimization. Instead, the ratio between volumes of gray and white matter is universally predicted by the same equation that predicts the degree of folding of the cerebral cortex, given the clade-specific scaling of cortical thickness, such that the volume of the gray matter (or the ratio of gray to total cortical volumes) divided by the square root of cortical thickness is a universal function of total cortical volume, regardless of the number of cortical neurons. Thus, the very mechanism that we propose to generate cortical folding also results in compactness of the white matter to a predictable degree across a wide variety of mammalian species.
A look into the future? Patients' and health care staff's perception and evaluation of genetic information and the right not to know

The progress of medical genetics leads to a significant increase in genetic knowledge and a vast expansion of genetic diagnostics. However, it is still unknown how these changes will be integrated into medical practice and how they will change patients' and healthy persons' perception and evaluation of genetic diagnoses and genetic knowledge. Therefore, we carried out a comprehensive questionnaire survey with more than 500 patients, clients seeking genetic counseling, health care staff, and healthy persons (N = 523). The questionnaire survey covered detailed questions on the value of genetic diagnoses for the different groups of study participants, the right to know or not to know genetic diagnoses, possible differences between genetic and other medical diagnoses, and the practical use and implications of genetic knowledge with a special focus on hereditary neuropsychiatric diseases. A huge majority of the participants (90.7%) stated to have a right to learn every aspect of her or his genetic make‐up. Similarly, study participants showed high interest (81.8%) in incidental health care findings—independent of whether the diseases are treatable or not. One can derive from the data outcome that study participants did not follow the implications of a “genetic exceptionalism” and often considered genetic findings as equivalent in relation to other medical diagnoses.
Immunochemical and physical quantitation of grass and olive pollen allergens and correlation with asthma admitions in Cáceres, Spain.

BACKGROUND AND OBJECTIVE The association between pollen counts and allergen levels in the air is controversial. Objective: The aim of the study was to quantify total and major allergen levels of Phleum pratense and Olea europaea, and to analyze their correlation with grass and olive pollen counts and the number of asthmatic crisis attended in the Hospital Complex of Cáceres, Spain. MATERIAL AND METHODS A volumetric air sampler and a Burkard spore-trap were used for pollen and aeroallergen collection during April-June 2011. Filters were extracted and major allergens were quantified by ELISA. RESULTS May was the main grass pollination period, showing a maximum peak of 1,362 grass pollen grains/m3 (May 13th). The main pollination period of olive was April 30th-May 20th, showing a maximum peak of 851 olive pollen grains/m3 (May 11th). Moderate correlation between grass pollen counts or Phleum total allergen levels and asthma exacerbations were observed, which increased when a 3-day offset was introduced. Significant association between asthma exacerbations and levels of olive total allergens or olive pollen grains was observed when a 1-day offset was introduced. The maximum correlation (moderate-high) was observed 4 days and 6 days away from the maximum olive pollen peak and the maximum Ole e 1 peak level, respectively. CONCLUSIONS This study reveals a significant correlation between grass and olive pollination and the increase of the number of visits to the emergency room due to asthma crisis. The aerobiological pattern of allergen levels in the air is comparable to the pollen counts during the grass and olive pollination periods.
Could Greater Time Spent Displaying Waking Inactivity in the Home Environment Be a Marker for a Depression-Like State in the Domestic Dog?

Simple Summary Stressed pet dogs, such as when deprived of their owners or after the loss of a social companion, can become inactive and unresponsive. Dogs in this condition are commonly referred to as being “depressed”, but this remains an untested hypothesis. One hallmark of human clinical depression is anhedonia—a reduction in the experience of pleasure. Here we tested the hypothesis that shelter dogs that spend greater time inactive “awake but motionless” (ABM) in their home-pen would also show signs of anhedonia, as tested by reduced responses to a treat filled KongTM. We also explored whether dogs being rated by experts as disinterested in the KongTM would spend greater time ABM (experts did not know the dogs’ actual inactivity levels). Fifty-seven dogs from 7 shelters were tested in total. Dogs relinquished by their owners spent more time ABM than strays or legal cases, and one association was found between the ABM and the dogs’ response to the filled KongTM, which was in the opposite direction that expected, so does not support the hypothesis that waking inactivity indicates a depression-like state in dogs. Dogs rated by experts as “depressed” and “bored” when exposed to the KongTM, however, spent greater time ABM; we discuss whether ABM could tentatively indicate “boredom” in dogs. Abstract Dogs exposed to aversive events can become inactive and unresponsive and are commonly referred to as being “depressed”, but this association remains to be tested. We investigated whether shelter dogs spending greater time inactive “awake but motionless” (ABM) in their home-pen show anhedonia (the core reduction of pleasure reported in depression), as tested by reduced interest in, and consumption of, palatable food (KongTM test). We also explored whether dogs being qualitatively perceived by experts as disinterested in the food would spend greater time ABM (experts blind to actual inactivity levels). Following sample size estimations and qualitative behaviour analysis (n = 14 pilot dogs), forty-three dogs (6 shelters, 22F:21M) were included in the main study. Dogs relinquished by their owners spent more time ABM than strays or legal cases (F = 8.09, p = 0.032). One significant positive association was found between the KongTM measure for average length of KongTM bout and ABM, when length of stay in the shelter was accounted for as a confounder (F = 3.66, p = 0.035). Time spent ABM also correlated with scores for “depressed” and “bored” in the qualitative results, indirectly suggesting that experts associate greater waking inactivity with negative emotional states. The hypothesis that ABM reflects a depression-like syndrome is not supported; we discuss how results might tentatively support a “boredom-like” state and further research directions.
Measurement Invariance and Sex and Age Differences of the Big Five Inventory–2: Evidence From the Russian Version

The Big Five Inventory–2 (BFI-2) is a recently published 60-item questionnaire that measures personality traits within the five-factor model framework. An important aspect of the BFI-2 is that it measures the traits at both the domain and facet levels and also controls acquiescence bias via the balanced number of true- and false-keyed items across the domains and facets. The current research evaluates factorial measurement invariance of a Russian version of the BFI-2 across sex and age within samples of 1,024 university students (Study 1) and 1,029 Internet users (Study 2). Across these samples, men scored lower on the domains of negative emotionality and agreeableness and slightly higher on extraversion. Sex differences were also obtained on various facets. In the Internet sample, age correlated modestly with several Big Five domains in accordance with the well-documented maturity principle. The newly developed Russian version of BFI-2 showed good reliability and validity across both samples. Moreover, random intercept exploratory factor analyses showed that the BFI-2 displayed a hierarchical five-domain-15-facet structure that demonstrated strict measurement invariance across sex and age.
Sequence‐dependent nucleosome nanoscale structure characterized by atomic force microscopy

DNA sequence plays an important role in the assembly of nucleosomes, and DNA motifs with high specificity to nucleosomes have been identified. At the same time, important questions such as how the DNA sequence changes DNA wrapping and how the DNA sequence contributes to the interaction between the nucleosomes remain unclear. Here, we addressed these questions by comparing nanoscale properties of nucleosomes assembled on the highest nucleosome positioning sequence, the 601 motif, and essentially random DNA sequences. We used atomic force microscopy to measure the nucleosome positions and the DNA wrapping. The studies showed that nucleosomes assemble on the nonspecific sequence without any preference for position on DNA, but they wrap the same DNA length as DNA of the same length with the 601 sequence. Experiments with longer DNA containing the 601 motif along with nonspecific DNA, capable of forming dinucleosomes, revealed that dinucleosomes assembled on hybrid sequences show a preference for positioning near each other, with one always assembling on the 601 motif. These findings point to the interaction between the nucleosomes and suggest that internucleosomal interactions may play a large role in nucleosome positioning. —Stormberg, T. , Stumme‐Diers, M. , Lyubchenko, Y. L. Sequence‐dependent nucleosome nanoscale structure characterized by atomic force microscopy. FASEB J. 33, 10916–10923 (2019). www.fasebj. org
Induction Therapy in Elderly Kidney Transplant Recipients With Low Immunological Risk

Supplemental Digital Content is available in the text. Background. In nonimmunized patients, similar rejection rates are observed for patients who have undergone thymoglobulin (antithymocyte globulins [ATG]) or basiliximab (BSX) therapy. While ATG may improve delayed graft function, it may also be associated with higher infection rates and malignancy risk. We compared survival and clinical outcomes in elderly recipients with low immunological risk according to their induction therapy. Methods. We conducted a multicentric study on nonimmunized patients ≥65 years of age receiving a first kidney transplant between 2010 and 2017. The principal outcome was patient and graft survival. Secondary outcomes were cumulative probabilities of infection, first acute rejection episode, malignancy, de novo donor specific antibody, posttransplant diabetes (PTD), cardiac complications, estimated glomerular filtration rate, and occurrence of delayed graft function. Cox, logistic, or linear statistical models were used depending on the outcome studied, and models were weighted on the propensity scores. Results. Two hundred and four patients were included in the BSX group and 179 in the ATG group with the average age of 71.0 and 70.5 years, respectively. Patient and graft survival at 3 years posttransplantation were 74% (95% CI, 65%-84%) and 68% (95% CI, 60%-78%) in ATG and BSX group, respectively, without significant difference. Occurrence of PTD was significatively higher in BSX group (23% versus 15%, P = 0.04) due to higher trough levels of Tacrolimus on month 3 (9.48 versus 7.30 ng/mL, P = 0.023). There was no difference in other evaluated outcomes. Conclusions. In elderly recipients, ATG does not lead to poorer outcomes compared with BSX and could permit lower trough levels of Tacrolimus, thus reducing occurrence of PTD.
Hitchhiking of Viral Genomes on Cellular Chromosomes.

Persistent viral infections require a host cell reservoir that maintains functional copies of the viral genome. To this end, several DNA viruses maintain their genomes as extrachromosomal DNA minichromosomes in actively dividing cells. These viruses typically encode a viral protein that binds specifically to viral DNA genomes and tethers them to host mitotic chromosomes, thus enabling the viral genomes to hitchhike or piggyback into daughter cells. Viruses that use this tethering mechanism include papillomaviruses and the gammaherpesviruses Epstein-Barr virus and Kaposi's sarcoma-associated herpesvirus. This review describes the advantages and consequences of persistent extrachromosomal viral genome replication. Expected final online publication date for the Annual Review of Virology Volume 6 is September 30, 2019. Please see http://www.annualreviews. org/page/journal/pubdates for revised estimates.