Miracle-dz/UniFAR-FTUs huggingface dataset:
Scar dermal transposition flap for depressed scars: A valuable technique for depressed scar management

Scar formation is a natural, physiological response to the healing of damaged tissue. However, abnormal or disturbed collagen synthesis can cause skin texture irregularities, such as depression. Scar treatments should improve both functional and aesthetic aspects of the scarred area to optimize patient satisfaction. Plastic surgeons use surgical, nonsurgical, and multimodal strategies to treat scars, which begin with an accurate understanding of the characteristics of the scar, as well as the patient’s needs. Depressed scars may occur when the injured tissue is replaced by scar tissue, which causes adhesion and tethering between the overlying skin and the underlying tissues, such as muscle or fascia. The main technique used to resolve depressed scars is to disrupt the connection between the skin and underlying tissue and to prevent re-adhesion [1,2]. However, many patients present with combined scar problems. In such cases, making an additional skin incision over a depression site is considered to be uneconomical. Therefore, we used de-epithelialized scar tissue of the widened scar portion as a transposition flap to fill under the depressed area for volume augmentation and to prevent re-adhesion. Dong Yeon Kim, Hyo Jeong Kwon, Suk-Ho Moon, Young Joon Jun, Jong Won Rhie, Deuk Young Oh
Evaluation of Copeptin level and Peradeniya Score as Predictors of Severity and Outcome in Acute Organophosphorus Pesticides Poisoned Patients Admitted to the Poison Control Center Ain Shams University Hospitals (A Prospective Study)

Background: Acute organophosphorus poisoning (AOPP) is one of the important causes of morbidity and mortality especially in developing countries. Exposure to organophosphorus (OP) compounds leads to inhibition of cholinesterase enzyme, resulting in overstimulation of muscarinic and nicotinic receptors. Hence, central, peripheral and autonomic manifestations may lead to death. The lack of valid scoring systems for classification of AOPP severity, render difficult outcome prediction and inaccurate potential complication incidence. There are emerging options for new biochemical markers in AOPP that may facilitate the prediction of severity and/ or outcome. Aim of the work: Evaluation and correlation of the role of serum Copeptin level and Peradeniya organophosphorus poisoning (POP) scale in predicting AOPP severity and outcome in 90 AOPP patients admitted to the Poison Control Center - Ain Shams University Hospitals (PCC-ASUHs). Subjects and Methods: A prospective cross sectional, hospital-based study carried out on 90 AOPP patients admitted to PCC- ASUHs. The diagnosis was verified by history of OP exposure, initial assessment of clinical manifestations and serum Pseudocholinestrase level measurement. Results: In the current study, according to POP scale 48% of the patients were mild, 42% were moderate and 10% were severe cases. Deaths were reported among 11% of the cases. Serum Copeptin level was positively associated with the severity and outcome, with cut off level ≥ 3.9 ng/ml for mortality prediction. POP score was directly proportional with hospital stay duration, serum Copeptin level and the outcome. Hospital disposition, mechanical ventilation and coma were positively associated with the degree of severity. Conclusion: Our study concluded that POP scale can be used as a reliable scoring system for AOPP classification of severity and early detector of hospital disposition either ICU or in- patient, hospital stay duration, total atropine dose, incidence of mechanical ventilation and mortality. Serum Copeptin level is positively associated with AOPP severity and had a role in outcome prediction. Recommendation: Early assessment of AOPP severity by POP score can facilitate categorization of the patient’s severity state and predict morbidity and mortality. Serum Copeptin level can be used as a tool for evaluation of severity and prognostic marker for the outcome of AOPP.
Biomechanical development and evaluation of a new framework for all-on-four rehabilitation

Abstract Introduction For complete rehabilitation of fully edentulous mandibles, the option for immediate loading determines the use of temporary prostheses that splint the installed implants. Although temporary prostheses with reinforcement provide rehabilitations with biomechanical benefits, the non-adoption of this recommendation coexists in different studies on immediate restorations. Objective This study evaluates a type of prosthesis to restore jaws by the all-on-four concept. Material and method: The mechanical behavior of prostheses with the modified framework was evaluated in vitro, under a cantilever mechanical unilateral bending test. Two representative groups were included in the all-on-four concept, with a G1 test group (n = 10) containing modified frameworks and a G2 control group (n = 10) that included full acrylic prostheses. The samples were submitted to thermal cycling with 500 cycles (5° ± 2 °C for 30 s, and 55° ± 2° for 30 s) and to the mechanical bending test on the cantilever. Result The Mann-Whitney test revealed a significant difference between G1 and G2 (p <0.001). In the descriptive evaluation, G1 averaged 830.50 N until the initial resin fracture, while the control group presented a mean of 403.58N. The maximum resistance until complete fracture was recorded in G1, with a mean of 903.03N, while in G2, a mean of 435.20N was recorded. The linear vertical component of the flexion was 0.68 mm and 0.39 mm until the initial fracture of the bar, respectively for G1 and G2. Conclusion The modified framework for the all-on-four protocol determined better mechanical performance when compared to the same full acrylic prosthesis model.
COST ANALYSIS OF EMERGENCY VISITS DUE TO DRUG RELATED PROBLEMS

Objective: To identify patients coming to Emergency Medicine Department (EMD) with drug related problems, classify the DRPs and calculate the direct cost spent for treating them. Methods: This was a prospective observational study conducted in emergency medicine department. The patients coming to EMD with DRPs were classified according to Cipolle’s classification and the direct medical and non-medical costs were calculated. Results: A total of around 107 patients identified with DRPs of which 99 patients were included in the study. In this study, 51% of the cases were due to ADR and 35% due to non-adherence and rest of the cases were due to overdose (10%), drug interaction (3%) and sub therapeutic dose (1%). Major portion for treatment was spent for direct medical cost in which cost for laboratory investigations have contributed the most, INR 10,93,992 (42%) followed by Health care professional cost INR 55,6814 (21%), Pharmacy cost INR 4,00,524.6 (15%), Admission cost INR 3,80,400 (15%). The direct non-medical cost includes cost for diet and travel which was found to be INR 1,68,443 and INR 71,947 respectively. Conclusion: The drug related problems adds a significant economic burden on the patients which can be reduced by imparting knowledge about the proper use of medicines and by improving collaborative efforts of the patients, physicians, pharmacists and caregivers.
Ultra-high-resolution assessment of lesion extension after cryoballoon ablation for pulmonary vein isolation

Introduction Unrecognized incomplete pulmonary vein (PV) isolation during the index procedure, can be a major cause of clinical recurrences of atrial fibrillation (AF) after cryoballoon (CB) ablation. We aimed to characterize the extension of the lesions produced by CB ablation and to assess the value of using an ultra-high resolution electroanatomic mapping (UHDM) system to detect incomplete CB lesions. Materials and methods Twenty-nine consecutive patients from the CHARISMA registry undergoing AF ablation at four Italian centers were prospectively evaluated. The Rhythmia™ mapping system and the Orion™ (Boston Scientific) mapping catheter were used to systematically map the left atrium and PVs before and after cryoablation. Results A total of 116 PVs were targeted and isolated. Quantitative assessment of the lesions revealed a significant reduction of the antral surface area of the PV, resulting in an ablated area of 5.7 ± 0.7 cm2 and 5.1 ± 0.8 cm2 for the left PV pair and right PV pair, respectively (p = 0.0068). The mean posterior wall (PW) area was 22.9 ± 2 cm2 and, following PV isolation, 44.8 ± 6% of the PW area was ablated. After CB ablation, complete isolation of each PV was documented by the POLARMap™ catheter in all patients. By contrast, confirmatory UHDM and the Lumipoint™ tool unveiled PV signals in 1 out of 114 of the PVs (0.9%). Over 30-day follow-up, no major procedure-related adverse events were reported. After a mean follow-up of 333 days, 89.7% of patients were free from arrhythmia recurrence. Conclusion The lesion extension achieved by the new CB ablation system involved the PV antrum, with less than 50% of the PW remaining untouched. The new system, with short tip and circular mapping catheter, failed to achieve PV isolation in only 0.9% of all PVs treated. Clinical trial registration [http://clinicaltrials.gov/], identifier [NCT03793998].
Cardiovascular effects associated with chimeric antigen receptor T cell therapy in cancer patients: A meta-analysis

Background Although numerous studies confirmed the marked efficacy of chimeric antigen receptor T cells (CAR-T cells) in many hematologic malignancies, severe cardiovascular toxicities remain to be a major obstacle when incorporating this technology. Furthermore, previous individual investigations regarding the cardiovascular toxicities of CAR-T cell therapy also reported controversial conclusions. Therefore, a meta-analysis was performed to further evaluate the impacts of CAR-T cell therapy on cardiovascular toxicities. Methods The PubMed, Embase, Web of Science, and ClinicalTrials.gov databases were searched for eligible studies up to April 2022. All analyses were carried out using the R 4.1. 0 software. Results Eventually, 25 related studies consisting of 2,059 patients were enrolled in the current meta-analysis. We discovered that the pooled incidence rate of the all-cause mortality rate was 14.1% and that the pooled incidence rates of overall cardiovascular (CV) events and CV events with cytokine release syndrome (CRS) grade ≥ 2 were 25.6% and 14.2%, respectively. The pooled incidence of hypotension was 28.6%. Further analysis showed that the incidence rates of arrhythmias, cardiovascular dysfunction, heart failure (HF), CV deaths, acute coronary syndrome (ACS), cardiomyopathy, cardiac arrest, and other CV events were 19.2%, 8.0%, 5.3%, 1.8%, 2.5%, 2.9%, 1.3%, and 1.9%, respectively. Conclusion Cancer patients treated with CAR-T cell therapy were at risk for cardiovascular toxicities, of which the most common cardiovascular events were arrhythmias, cardiovascular dysfunction, and heart failure. These findings would contribute to achieving more rational and individualized use of CAR-T cells in clinical treatment.
Non-replicative antibiotic resistance-free DNA vaccine encoding S and N proteins induces full protection in mice against SARS-CoV-2

SARS-CoV-2 vaccines currently in use have contributed to controlling the COVID-19 pandemic. Notwithstanding, the high mutation rate, fundamentally in the spike glycoprotein (S), is causing the emergence of new variants. Solely utilizing this antigen is a drawback that may reduce the efficacy of these vaccines. Herein we present a DNA vaccine candidate that contains the genes encoding the S and the nucleocapsid (N) proteins implemented into the non-replicative mammalian expression plasmid vector, pPAL. This plasmid lacks antibiotic resistance genes and contains an alternative selectable marker for production. The S gene sequence was modified to avoid furin cleavage (Sfs). Potent humoral and cellular immune responses were observed in C57BL/6J mice vaccinated with pPAL-Sfs + pPAL-N following a prime/boost regimen by the intramuscular route applying in vivo electroporation. The immunogen fully protected K18-hACE2 mice against a lethal dose (105 PFU) of SARS-CoV-2. Viral replication was completely controlled in the lungs, brain, and heart of vaccinated mice. Therefore, pPAL-Sfs + pPAL-N is a promising DNA vaccine candidate for protection from COVID-19.
Early Assessment of Molecular Progression and Response by Whole-genome Circulating Tumor DNA in Advanced Solid Tumors

Treatment response assessment for patients with advanced solid tumors is complex and existing methods require greater precision. Current guidelines rely on imaging, which has known limitations, including the time required to show a deterministic change in target lesions. Serial changes in whole-genome (WG) circulating tumor DNA (ctDNA) were used to assess response or resistance to treatment early in the treatment course. Ninety-six patients with advanced cancer were prospectively enrolled (91 analyzed and 5 excluded), and blood was collected before and after initiation of a new, systemic treatment. Plasma cell–free DNA libraries were prepared for either WG or WG bisulfite sequencing. Longitudinal changes in the fraction of ctDNA were quantified to retrospectively identify molecular progression (MP) or major molecular response (MMR). Study endpoints were concordance with first follow-up imaging (FFUI) and stratification of progression-free survival (PFS) and overall survival (OS). Patients with MP (n = 13) had significantly shorter PFS (median 62 days vs. 310 days) and OS (255 days vs. not reached). Sensitivity for MP to identify clinical progression was 54% and specificity was 100%. MP calls were from samples taken a median of 28 days into treatment and 39 days before FFUI. Patients with MMR (n = 27) had significantly longer PFS and OS compared with those with neither call (n = 51). These results demonstrated that ctDNA changes early after treatment initiation inform response to treatment and correlate with long-term clinical outcomes. Once validated, molecular response assessment can enable early treatment change minimizing side effects and costs associated with additional cycles of ineffective treatment.
Clinical utilization of shear wave dispersion imaging in diffuse liver disease

Shear wave (SW) dispersion imaging is a newly developed imaging technology for assessing the dispersion slope of SWs, which is related to tissue viscosity in diffuse liver disease. Our preclinical and preliminary clinical studies have shown that SW speed is more useful than dispersion slope for predicting the degree of fibrosis and that dispersion slope is more useful than SW speed for predicting the degree of necroinflammation. Thus, dispersion slope, which reflects viscosity, may provide additional pathophysiological insight into diffuse liver disease.
Generation of high affinity ICAM-1-specific nanobodies and evaluation of their suitability for allergy treatment

The nasal cavity is an important site of allergen entry. Hence, it represents an organ where trans-epithelial allergen penetration and subsequent IgE-mediated allergic inflammation can potentially be inhibited. Intercellular adhesion molecule 1 (ICAM-1) is highly expressed on the surface of respiratory epithelial cells in allergic patients. It was identified as a promising target to immobilize antibody conjugates bispecific for ICAM-1 and allergens and thereby block allergen entry. We have previously characterized a nanobody specific for the major birch pollen allergen Bet v 1 and here we report the generation and characterization of ICAM-1-specific nanobodies. Nanobodies were obtained from a camel immunized with ICAM-1 and a high affinity binder was selected after phage display (Nb44). Nb44 was expressed as recombinant protein containing HA- and His-tags in Escherichia coli (E.coli) and purified via affinity chromatography. SDS-PAGE and Western blot revealed a single band at approximately 20 kDa. Nb44 bound to recombinant ICAM-1 in ELISA, and to ICAM-1 expressed on the human bronchial epithelial cell line 16HBE14o- as determined by flow cytometry. Experiments conducted at 4°C and at 37°C, to mimic physiological conditions, yielded similar percentages (97.2 ± 1.2% and 96.7 ± 1.5% out of total live cells). To confirm and visualize binding, we performed immunofluorescence microscopy. While Texas Red Dextran was rapidly internalized Nb44 remained localized on the cell surface. Additionally, we determined the strength of Nb44 and ICAM-1 interaction using surface plasmon resonance (SPR). Nb44 bound ICAM-1 with high affinity (10-10 M) and had slow off-rates (10-4 s-1). In conclusion, our results showed that the selected ICAM-1-specific nanobody bound ICAM-1 with high affinity and was not internalized. Thus, it could be further used to engineer heterodimers with allergen-specific nanobodies in order to develop topical treatments of pollen allergy.
Intestinal microbiota and melatonin in the treatment of secondary injury and complications after spinal cord injury

Spinal cord injury (SCI) is a central nervous system (CNS) disease that can cause sensory and motor impairment below the level of injury. Currently, the treatment scheme for SCI mainly focuses on secondary injury and complications. Recent studies have shown that SCI leads to an imbalance of intestinal microbiota and the imbalance is also associated with complications after SCI, possibly through the microbial-brain-gut axis. Melatonin is secreted in many parts of the body including pineal gland and gut, effectively protecting the spinal cord from secondary damage. The secretion of melatonin is affected by circadian rhythms, known as the dark light cycle, and SCI would also cause dysregulation of melatonin secretion. In addition, melatonin is closely related to the intestinal microbiota, which protects the barrier function of the gut through its antioxidant and anti-inflammatory effects, and increases the abundance of intestinal microbiota by influencing the metabolism of the intestinal microbiota. Furthermore, the intestinal microbiota can influence melatonin formation by regulating tryptophan and serotonin metabolism. This paper summarizes and reviews the knowledge on the relationship among intestinal microbiota, melatonin, and SCI in recent years, to provide new theories and ideas for clinical research related to SCI treatment.
Lumbar spinal stenosis associated with progression of locomotive syndrome and lower extremity muscle weakness

Purpose The purpose of this study was to evaluate the association between the early stages of lumbar spinal stenosis (LSS) and the risk of locomotive syndrome, as well as its effect upon muscle strength of the back, upper extremities, and lower extremities. Patients and methods LSS was diagnosed with a self-administered, self-reported history questionnaire. Participants (n=113) who agreed to be tested by the diagnostic support tool for LSS underwent three risk tests for locomotive syndrome: a stand-up test, a two-step test, and a 25-question Geriatric Locomotive Function Scale (GLFS-25), as well as measurements of the strength of their grip, back extensor, hip flexor, and knee extensor muscles. Results Twenty-three participants were diagnosed with LSS by the questionnaire. Results of the stand-up test in the LSS group were significantly worse than those in the no-LSS group (P=0.003). The results of the two-step test and the total score on the GLFS-25 in the LSS group were significantly worse than those in the no-LSS group (P=0.002 and P<0.0001, respectively). The stages of locomotive syndrome assessed by the stand-up test, two-step test, and the GLFS-25 were significantly worse in the LSS group than in the no-LSS group (P=0.0004, P=0.0007, and P<0.0001, respectively). Hip flexor and knee extensor strength, but not grip and back extensor strength, in the LSS group were significantly lower than that in the no-LSS group. Conclusions LSS diagnosed using the self-reported support tool worsened the stage of locomotive syndrome in older people. Furthermore, participants with LSS had significant lower extremity weakness.
Event-related potential and lexical decision task in dyslexic adults: Lexical and lateralization effects

Developmental dyslexia is a specific learning disorder that presents cognitive and neurobiological impairments related to different patterns of brain activation throughout development, continuing in adulthood. Lexical decision tasks, together with electroencephalography (EEG) measures that have great temporal precision, allow the capture of cognitive processes during the task, and can assist in the understanding of altered brain activation processes in adult dyslexics. High-density EEG allows the use of temporal analyses through event-related potentials (ERPs). The aim of this study was to compare and measure the pattern of ERPs in adults with developmental dyslexia and good readers, and to characterize and compare reading patterns between groups. Twenty university adults diagnosed with developmental dyslexia and 23 healthy adult readers paired with dyslexics participated in the study. The groups were assessed in tests of intelligence, phonological awareness, reading, and writing, as well as through the lexical decision test (LDT). During LDT, ERPs were recorded using a 128-channel EEG device. The ERPs P100 occipital, N170 occipito-temporal, N400 centro-parietal, and LPC centro-parietal were analyzed. The results showed a different cognitive profile between the groups in the reading, phonological awareness, and writing tests but not in the intelligence test. In addition, the brain activation pattern of the ERPs was different between the groups in terms of hemispheric lateralization, with higher amplitude of N170 in the dyslexia group in the right hemisphere and opposite pattern in the control group and specificities in relation to the items of the LDT, as the N400 were more negative in the Dyslexia group for words, while in the control group, this ERP was more pronounced in the pseudowords. These results are important for understanding different brain patterns in developmental dyslexia and can better guide future interventions according to the changes found in the profile.
Predictive role of the neutrophil: lymphocyte ratio in acute kidney injury associated with off-pump coronary artery bypass grafting

Objectives This study aims to investigate whether the ratios of cell types in peripheral blood could be used as reliable predictors of off-pump coronary artery bypass grafting (CABG)-associated acute kidney injury (AKI). Materials and methods We retrospectively reviewed patients (n = 420) undergoing off-pump CABG from January 1, 2021 to January 1, 2022 in Qilu Hospital of Shandong University. We used logistic regression analysis to identify the potential predictors of off-pump CABG-associated AKI and construct a predictive model. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive ability of predictors and prediction models. Results The prevalence of AKI associated with off-pump CABG was 20.95%. Patients in the AKI group had significantly higher ratios of peripheral blood cells on postoperative day (POD)1 than patients in the non-AKI group (P < 0.01). The area under the ROC curve (AUC) of the neutrophil:lymphocyte ratio (NLR) on POD1 for predicting off-pump CABG-associated AKI was 0.780 and the cutoff value was 20.07. Patients with high NLR on POD1 had a poor short-term prognosis. The AUC of the predictive model constructed by logistic regression analysis was 0.882. The sensitivity was 68.2% and the specificity was 93.1%. Conclusion The NLR on POD1 was a reliable predictive biomarker of off-pump CABG-associated AKI. And we successfully construct a prediction model, which contribute to the early recognition and management of off-pump CABG-associated AKI.