Miracle-dz/UniFAR-FTUs huggingface dataset:
Insights Into Breast Cancer in the East vs the West: A Review.

Importance During the past few decades, the incidence of breast cancer (BC) has been increasing rapidly in East Asia, and BC is currently the most common cancer in several countries. The rising incidence is likely related to changing lifestyle and environmental factors in addition to the increase in early diagnosis with BC awareness and screening. The understanding and management of BC are generally based on research and data from the West. However, emerging differences in BC epidemiology and tumor and host biology in Asian populations may be clinically relevant. Observations A higher proportion of premenopausal BCs occur in Asia, although this factor is possibly an age-cohort effect. Although the relative frequencies of different immunohistochemical subtypes of BC may be similar between the East and West, the higher prevalence of luminal B subtypes with more frequent mutations in TP53 may be confounded by disparities in early detection. In addition, Asian BCs appear to harbor a more immune-active microenvironment than BCs in the West. The spectra of germline mutations in BC predisposition genes and single-nucleotide polymorphisms contributing to BC risk vary with ethnicity as well. Differences in tolerability of certain cytotoxic and targeted agents used in BC treatment may be associated with pharmacogenomic factors, whereas the lower body mass of the average woman in East Asia may contribute to higher toxicities from drugs administered at fixed doses. Phenotypic characteristics, such as lower breast volume, may influence the type of surgery performed in East Asian women. On the other hand, increased breast density may affect the sensitivity of mammography in detecting BCs, limiting the benefits of screening mammography. Conclusions and Relevance Breast cancer has become a major health problem in Asia. The inclusion of more women from Asia in clinical trials and epidemiologic and translational studies may help unravel the interethnic heterogeneity of BCs and elucidate the complex interplay between environmental and intrinsic factors in its pathogenesis. These insights may help to refine prevention, diagnosis, and management strategies for BC in the setting of ethnic diversity.
Surgical site infections in elderly fragility hip fractures patients undergoing warfarin treatment.

OBJECTIVES Surgical site infection (SSI) is a devastating complication of proximal femoral fracture surgery, related with increased morbidity and mortality. As warfarin treatment has been described as a risk factor for SSI, we aimed to compare patient and SSI characteristics in warfarin and non-anticoagulated patients. DESIGN Retrospective cohort study. SETTING Level-1 trauma center. PATIENTS Individuals aged 65 and older with fragility hip fractures. INTERVENTION Patients were divided into 2 cohorts: warfarin treated (n=85) or non-anticoagulated (n=771). Demographics, in-hospital characteristics, laboratory data, prior hospitalizations, recent antibiotic use, and one-year incidence of SSIs and their characteristics were gathered. MAIN OUTCOME MEASUREMENTS Post-operative SSIs. RESULTS Twelve patients (14.1%) from the warfarin group and 21 patients (2.7%) from the noncoagulated group had SSI (p.<0.001). Both groups were comparable in terms of demographics and Charlson's comorbidity score. Warfarin treated patients had reduced white blood and neutrophils counts (10.1±3.2 vs. 11.6±4.0 and 8.1±3.2 vs. 9.6±3.9 for both comparisons respectively, p.<0.001 for both). They were more likely to be admitted to a geriatric than to orthopedics ward and were delayed to theater (58.5±44.5 vs. 30.6±27.4 hours, p<0.001). Following surgery there was no difference in blood transfusions required, in-hospital complications, or time to infection. Rates of prior hospitalizations, antibiotic use or type of bacteria did not differ. CONCLUSION Warfarin treatment in fragility hip fracture surgery is correlated with an increased risk for SSI, regardless of in-hospital complications, and hospitalizations prior to surgery or to the infection itself. LEVEL OF EVIDENCE III.
A peek into cancer-associated fibroblasts: origins, functions and translational impact

ABSTRACT In malignant tumors, cancer cells adapt to grow within their host tissue. As a cancer progresses, an accompanying host stromal response evolves within and around the nascent tumor. Among the host stromal constituents associated with the tumor are cancer-associated fibroblasts, a highly abundant and heterogeneous population of cells of mesenchymal lineage. Although it is known that fibroblasts are present from the tumor's inception to the end-stage metastatic spread, their precise functional role in cancer is not fully understood. It has been suggested that cancer-associated fibroblasts play a key role in modulating the behavior of cancer cells, in part by promoting tumor growth, but evolving data also argue for their antitumor actions. Taken together, this suggests a putative bimodal function for cancer-associated fibroblasts in oncogenesis. As illustrated in this Review and its accompanying poster, cancer-associated fibroblasts are a dynamic component of the tumor microenvironment that orchestrates the interplay between the cancer cells and the host stromal response. Understanding the complexity of the relationship between cancer cells and cancer-associated fibroblasts could offer insights into the regulation of tumor progression and control of cancer. Summary: Cancer-associated fibroblasts constitute a functionally heterogeneous mesenchymal cell population in the tumor microenvironment. This ‘At a glance’ article reviews their origin and their pro- and antitumor properties.
Automated Measurement of Tear Meniscus Height with the Kowa DR-1α Tear Interferometer in Both Healthy Subjects and Dry Eye Patients.

Purpose To develop and assess a method for quantitation of lower tear meniscus height (TMH) with the Kowa DR-1α tear interferometer. Methods Sixty-nine eyes of 49 men and 20 women (36 healthy volunteers, 33 patients with aqueous-deficient dry eye [ADDE]; mean age ± SD, 50.0 ± 14.0 years) were enrolled. TMH of each subject was measured by two observers both with DR-1α and newly developed software and with anterior-segment swept-source optical coherence tomography (SS-OCT). Intraoperator repeatability and interoperator and intersession reproducibility of measurements were assessed based on the within-subject SD (Sw), coefficient of variation (CV), and intraclass correlation coefficient (ICC). Agreement between the two devices was assessed by regression and Bland-Altman analysis. Results The CV for system repeatability of DR-1α was <2.0%. The CV for intraoperator repeatability and interoperator and intersession reproducibility for DR-1α measurements was ≤9.6%, ≤4.5%, and ≤4.4% in healthy subjects, respectively, and ≤16.8%, ≤9.8%, and ≤10.3% in ADDE patients. All corresponding ICC values were ≥0.87 in healthy subjects and ≥0.48 in ADDE patients. Bland-Altman plots indicated a high level of agreement between the two devices. Schirmer test value was significantly correlated with interferometric TMH in both healthy subjects (β = 0.59, P < 0.001) and ADDE patients (β = 0.47, P = 0.017). Conclusions Tear interferometry allows measurement of TMH as reliably as does SS-OCT. DR-1α may inform not only the diagnosis of dry eye disease but also identification of disease subtype.
REDD1/Autophagy Pathway Is Associated with Neutrophil-Driven IL-1β Inflammatory Response in Active Ulcerative Colitis

Infiltration of neutrophils into colonic mucosa has been associated with the severity of ulcerative colitis (UC). We investigated the effect of disease microenvironment on the release of neutrophil extracellular traps (NETs) as well as the involved mechanisms in NETosis and whether certain NET proteins are correlated with disease phenotype. Peripheral blood neutrophils, sera, and colonic tissue were collected from treatment-naive and mesalazine-treated patients with active UC, treatment-naive patients with active Crohn’s disease, patients suffering from infectious colitis, or healthy individuals (controls). Analysis of colonic biopsy specimens and peripheral blood neutrophils for the presence of NET-related markers using immunofluorescence confocal microscopy, ELISA, immunoblotting, flow cytometry, and quantitative PCR were performed. In vitro cell and tissue culture systems were further deployed. The local inflammatory response in colon in UC, but not Crohn’s disease, is characterized by the presence of NETs carrying bioactive IL-1β and thrombogenic tissue factor. The inflammatory environment of UC is able to induce neutrophil activation, IL-1β expression, and NET release, as shown both ex vivo and in vitro. REDD1 expression, as a mediator linking inflammation, autophagy, and NET release, was also specifically associated with the inflammatory response of UC. We show that neutrophil expression of REDD1 in colon tissue and the presence of IL-1β in neutrophils/NETs provide candidate biomarkers for the differential diagnosis of inflammatory colitis and possible targets for the treatment of UC, suggesting that UC shares common features with autoinflammatory disorders.
Quantification of staphylococcal enterotoxin type A in cow milk by using a stable isotope-labelled peptide via liquid chromatography–tandem mass spectrometry

ABSTRACT In this study, the staphylococcal enterotoxin type A (SEA) contaminant was quantified in cow milk by liquid chromatography–tandem mass spectrometry (LC–MS/MS) with the use of a stable isotope-labelled peptide of SEA as an internal standard. SEA was cleaned up in a two-step process that included pH control and trichloroacetic acid (TCA) precipitation. The pH control phase eliminated other proteins. TCA precipitation cleaned up SEA without special equipment. An appropriate enzyme-to-protein ratio maximised tryptic digestion. A desalting process guaranteed the stable retention of SEA-digested peptides. The coverage of amino-acid sequences (>10%) clearly identified the toxin’s presence. SEA was accurately quantified using LC-MS/MS based on a multiple-reaction monitoring mode. The developed method was validated based on spiked recovery tests at 50 and 100 µg kg−1 conducted with two samples collected on a daily basis for five days based on Japanese validation guidelines. The new method exhibited good accuracy which ranged from 80% to 82%. The relative standard deviations of repeatability were 13–14% and the relative standard deviations of within-laboratory reproducibility were 13–18%. These standard deviations satisfied the criteria of the Japanese validation guidelines. The quantification limit was estimated to be 10 µg kg−1.
Hepatitis C virus treatment by direct-acting antivirals in successfully treated hepatocellular carcinoma and possible mutual impact

Background and aims Treatment of hepatitis C virus (HCV) after successfully treated hepatocellular carcinoma (HCC) becomes possible with the introduction of direct-acting antivirals because of their favorable efficacy, safety, and short period of treatment. Few data are available on the results of treatment using different direct-acting antiviral regimens in successfully treated HCC and a lot of debate about its role in tumor recurrence. Methods Sixty-two HCV-related HCC patients were enrolled in the study after successfully treated HCC; the studied population included either Child–Pugh ‘A’ or ‘B7’. The patients were subcategorized to receive one of the following regimens: group 1: sofosbuvir (SOF)+ribavirin (RBV) for 24 weeks, group 2: SOF+simeprevir for 12 weeks, group 3: SOF+daclatasvir for 24 weeks, and group 4: SOF+daclatasvir+RBV for 12 weeks. The overall median follow-up period is 12 months after treatment initiation. Results All treatment regimens were tolerable for all patients, with no reported major adverse events during treatment. The overall sustained virologic response rate was 64.5%, with the highest result in group 4 and the lowest result in group 1; 87.5 and 26.7%, respectively. HCC recurrence was observed in 42% of patients; 80.7% of these patients developed recurrence within 6 months of treatment initiation. Conclusion Treatment of HCV in successfully treated HCC is feasible, with the best results achieved using multiple direct-acting antivirals and RBV; a high rate of HCC recurrence was observed, especially within the first 6 months of treatment initiation (ClinicalTrials.gov no: NCT02771405).
Economic Model Predictive Control and Applications for Diesel Generators

When developing control systems for diesel generators, tuning of the controller’s parameters to achieve acceptable performance is a significant challenge, particularly while satisfying input, emission, and safety constraints in the face of unknown system disturbances. Robust economic model predictive control (EMPC) can simplify this process by directly addressing the generator’s objectives, while systematically handling constraints in a robust way. This paper details how robust EMPC can be implemented as the control solution for diesel generators. To illustrate the process, two distinct generator applications are considered. The first application is a power tracking diesel generator, operating under emissions constraints. Such an application is found in series hybrid electric vehicles. The second application concerns diesel generators onboard submarines. In this application, engine speed and exhaust temperatures must be kept constant, despite significant system disturbances. An experimental study highlights the effectiveness of the EMPC as a solution for both applications.
Cues to Stress Assignment in Reading Aloud

Research seeking to uncover the mechanisms by which we read aloud has focused almost exclusively on monosyllabic items presented in isolation. Consequently, important challenges that arise when considering polysyllabic word reading, such as stress assignment, have been ignored, while little is known about how important sentence-level stress cues, such as syntax and rhythm, may influence word reading aloud processes. The present study seeks to fill these gaps in the literature by (a) documenting the individual influences of major sublexical cues that readers use to assign stress in single-word reading in English and (b) determining how these cues may interact with contextual stress factors in sentence reading. In Experiments 1, 2, and 3 we investigated the effects of prefixation, orthographic weight (i.e., number of letters in a syllable), and vowel length on stress assignment by asking participants to read aloud carefully-constructed nonwords that varied on the presence of these cues. Results revealed individual effects of all three cues on the assignment of second-syllable stress. In Experiment 4, we tested the effects of these cues on stress assignment in the context of sentence reading. Results showed that sublexical cues influenced stress assignment over and above higher-level syntactic and rhythmic cues. We consider these findings in the framework of extant rule-based, distributed-connectionist, and Bayesian approaches to stress assignment in reading aloud, and we discuss their applications to understanding reading development and acquired and developmental reading disorders.
Chronic Exposure to Water-Pipe Smoke Induces Alveolar Enlargement, DNA Damage and Impairment of Lung Function

Background/Aim: Epidemiological evidence indicates that water-pipe smoking (WPS) adversely affects the respiratory system. However, the mechanisms underlying its effects are not well understood. Recent experimental studies reported the occurrence of lung inflammation and oxidative stress following acute and subacute exposure to WPS. Here, we wanted to verify the extent of inflammation and oxidative stress in mice chronically-exposed to WPS and to evaluate, for the first time, its effect on alveolar injury and DNA damage and their association with impairment of lung function. Methods: Mice were nose-only exposed to mainstream WPS (30 min/day; 5 days/week for 6 consecutive months). Control mice were exposed using the same protocol to atmospheric air only. At the end of the exposure period, several respiratory parameters were assessed. Results: In bronchoalveolar lavage fluid, WPS increased neutrophil and lymphocyte numbers, lactate dehydrogenase, myeloperoxidase and matrix metallopeptidase 9 activities, as well as several proinflammatory cytokines. In lung tissue, lipid peroxidation, reactive oxygen species, superoxide dismutase activity and reduced glutathione were all increased by WPS exposure. Along with oxidative stress, WPS exposure significantly increased lung DNA damage index. Histologically the lungs of WPS-exposed mice had foci of mixed inflammatory cells infiltration in the interalveolar interstitium which consisted of neutrophils, lymphocytes and macrophages. Interestingly, we found dilated alveolar spaces and alveolar ducts with damaged interalveolar septae, and impairment of lung function following WPS exposure. Conclusion: We show the persistence of lung inflammation and oxidative stress in mice chronically-exposed to WPS and demonstrate, for the first time, the occurrence of DNA damage and enlargement of alveolar spaces and ducts associated with impairment of lung function. Our findings provide novel mechanistic elucidation for the long-term effects of WPS on the respiratory system.
Thrombolysis related symptomatic intracranial hemorrhage in estimated versus measured body weight

Background and aim In acute ischemic stroke, under- or overestimation of body weight can lead to dosing errors of recombinant tissue plasminogen activator with consequent reduced efficacy or increased risk of hemorrhagic complications. Measurement of body weight is more accurate than estimation of body weight but potentially leads to longer door-to-needle times. Our aim was to assess if weight modality (estimation of body weight versus measurement of body weight) is associated with (i) symptomatic intracranial hemorrhage rate, (ii) clinical outcome, and (iii) door-to-needle times. Methods Consecutive patients treated with intravenous thrombolysis between 2009 and 2016 from 14 hospitals were included. Baseline characteristics and outcome parameters were retrieved from medical records. We defined symptomatic intracranial hemorrhage according to the European Cooperative Acute Stroke Study (ECASS)-III definition and clinical outcome was assessed with the modified Rankin Scale. The association of weight modality and outcome parameters was estimated with regression analyses. Results A total of 4801 patients were included. Five hospitals used measurement of body weight (n = 1753), six hospitals used estimation of body weight (n = 2325), and three hospitals (n = 723) changed from estimation of body weight to measurement of body weight during the study period. In 2048 of the patients (43%), measurement of body weight was used and in 2753 (57%), estimation of body weight. In the measurement of body weight group, an inbuilt weighing bed was used in 1094 patients (53%) and a patient lift scale in 954 patients (47%). In the estimation of body weight group, policy regarding estimation was similar. Estimation of body weight was not associated with increased symptomatic intracranial hemorrhage risk (adjusted odds ratio = 1.16; 95% confidence interval 0.83–1.62) or favorable outcome (adjusted odds ratio = 0.99; 95% confidence interval 0.82–1.21), but it was significantly associated with longer door-to-needle times compared to measurement of body weight using an inbuilt weighing bed (adjusted B = 3.57; 95% confidence interval 1.33–5.80) and shorter door-to-needle times compared to measurement of body weight using a patient lift scale (−3.96; 95% confidence interval −6.38 to −1.53). Conclusion We did not find evidence that weight modality (estimation of body weight versus measurement of body weight) to determine recombinant tissue plasminogen activator dose in intravenous thrombolysis eligible patients is associated with symptomatic intracranial hemorrhage or clinical outcome. We did find that estimation of body weight leads to longer door-to-needle times compared to measurement of body weight using an inbuilt weighing bed and to shorter door-to-needle times compared to measurement of body weight using a patient lift scale.
Mass Gatherings and Diarrheal Disease Transmission among Rural Communities in Coastal Ecuador.

Mass gatherings exacerbate infectious disease risks by creating crowded, high-contact conditions, and straining the capacity of local infrastructure. While mass gatherings have been extensively studied in the context of epidemic disease transmission, the role of gatherings in incidence of high-burden, endemic infections has not been previously studied. Here, we examine diarrheal incidence among seventeen communities in Esmeraldas, Ecuador, in relation to recurrent gatherings characterized using ethnographic data collected during and after the epidemiological surveillance period (2004-2007). Using distributed lag generalized estimating equations, adjusted for seasonality, trend, and heavy rainfall events, we found significant increases in diarrhea risk in host villages, peaking two weeks after an event's conclusion (incidence rate ratio (IRR): 1.21, confidence interval (CI), adjusted for false discovery rate ≤ 0.05: 1.02, 1.43). Stratified analysis revealed heightened risks associated with events where crowding and travel were most likely (2-week lag IRR 1.51; CI, adjusted for false discovery rate ≤ 0.05: 1.09, 2.10). Our findings suggest that community-scale mass gatherings may play an important role in endemic diarrheal disease transmission and could be an important focus for interventions to improve community health in low resource settings.
Comparison of Patients with Acute Myocardial Infarction According to Age

Introduction: By development of the medicine, control of the risk factors for acute myocardial infarction (AMI), became the foundation of cardiology. Aim: To investigate the association of the age with presence of risk factors in patients with acute myocardial infarction. Methods: The study had a prospective, comparative and descriptive character, and it was done on a sample of 80 patients (n=80; 55 male and 25 female) Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Center University of Sarajevo from January 2016 to August 2018. All patients were hospitalized under the diagnosis of myocardial infarction and were divided into two main groups, which were divided into two subgroups according to age. Group A, group of patients under 45 years of age at the moment of diagnosis of AMI (n = 40; men = 29; women = 11) was divided into group A1 (n = 20; patients aged 25-35 years) and group A2 (n = 20; patients aged between 35-45 years). Group B, patients older than 45 years at the time of diagnosis of AMI (n = 40; men = 26, women = 14) was divided into group B1 (n = 20; patients aged between 45-55 years) and group B2 (n = 20; patients aged 55-65 years of age). Results: According to gender distribution, there is a significantly higher incidence of hypertension in male patients aged 25-35 years and between 35-45 years (p = 0.01; p = 0.01). Increased cholesterol values were significantly more common in men aged 25-35 years (p = 0.0121). Increased triglyceride values were significantly more common in men aged 25-35 years, in comparison to female respondents of the same age (86.67% vs. 13.33%, p = 0.0001). There was a significant significance between the two groups in the occurrence of anteroseptal (p = 0.04) and in the diaphragmatic myocardial infarction (p = 0.01), while in other infarction localities no significant significance was observed. Conclusion: Male sex is a predisposing risk factor for the development of a cardiovascular incident in the younger age. The post infarction ejection fraction of the left ventricle was significantly reduced in younger patients. The potential for prevention should be of paramount importance. The localization of the incident itself, and the involvement of a certain blood, represents, regardless of all the research, still a fact that is hard to stratify and directly correlated with a certain risk factor.