Miracle-dz/UniFAR-FTUs huggingface dataset:
Nasal vestibule and columella cancer: a therapeutic and reconstructive conundrum

Purpose of review Nasal vestibular cancers are rare entities among the head and neck cancers. The treatment options are varied. Although surgical treatment plays an important role, postablative defects are difficult to reconstruct. This review aims to discuss the current views in the management of these cancers and issues related to the reconstruction of the complex surgical defects. Recent findings Nasal vestibular cancers are a distinct rare entity of head and neck cancers. These cancers are staged using the AJCC-TNM system for nonmelanoma cutaneous cancers of head and neck or the Wang classification. Early lesions are best treated by either surgery or radiation giving excellent cure rates. Advanced stages tumours need combined treatment with surgery and adjuvant radiation therapy. Primary radiation therapy can be offered by external beam or interstitial brachytherapy. Surgical treatment varies from endonasal resections, Mohs’ chemosurgery to open excisions. Summary Even though the Wang system of classification is used by majority of reports due its clinical utility, it has a drawback of not taking into account the tumour size as done by the AJCC system. Brachytherapy has been reported to be offering excellent cure rates with low morbidity in early tumours. Surgical treatment is also effective in early lesions, but its role is more established in advanced lesions. Reconstruction of the surgical defects is often a challenge, to preserve functional integrity and cosmesis. Various techniques, including skin grafts, local flaps, free flaps and prosthetics, form part of the reconstructive armamentarium.
The global epidemic of thyroid cancer overdiagnosis illustrated using 18 months of consecutive nodule biopsy correlating clinical priority, ACR‐TIRADS and Bethesda scoring

Low thyroid cancer mortality worldwide has not been altered by decades of increasing radiological, pathological and surgical intervention for thyroid nodules. Ultrasound‐based risk stratification of thyroid nodules, such as TIRADS, has been introduced to reduce intervention for the ‘global epidemic’ of thyroid cancer ‘overdiagnosis’. This article illustrates the use of TIRADS at a New Zealand tertiary centre, during its introduction, with all nodules undergoing fine‐needle aspiration biopsy (FNAB) correlated with clinical referral priority and cytological Bethesda score. The correlation between TIRADS and Bethesda score was not significant but cytology had a strong association with clinical priority. Accuracy of TIRADS was poor though the risk of malignancy for TIRADS 5 nodules was 5.1 times those rated as TIRADS 3. After TIRADS was introduced, there was no significant trend in the proportion of malignant nodules diagnosed by FNAB. Despite an incomplete TIRADS programme, the ACR targets of malignancy rates were achieved. The number of patients, as well as the number of nodules per patient, referred for FNAB continues to rise. Changing papillary thyroid cancer nomenclature and other control measures by health policymakers, such as adjustments to payment systems, may be justified. Radiologists are wasting precious health resources that can be better deployed. The use of TIRADS is expensive and a symptom of health policy failure. Clear recommendations from professional societies to not report incidental small thyroid nodules may be a useful start. Whether TIRADS merits continuing use and promotion should be further investigated.
Effect of Yttrium-90 transarterial radioembolization in patients with non-surgical hepatocellular carcinoma: A systematic review and meta-analysis

Background Recently, the use of Yttrium-90 transarterial radioembolization in non-surgical hepatocellular carcinoma was suggested but the evidence supporting its use is unclear. Methods We searched Medline, Embase, Web of Science and Cochrane CENTRAL from inception up to April 14, 2020 for randomized controlled trials comparing Y90-TARE to standard of care in non-surgical HCC patients. Our primary outcome was overall survival (OS). Our secondary outcomes were progression-free survival, time to progression, disease control rate, grade ≥3 adverse events and rates of gastro-intestinal ulcers. Hazard ratios (HR) and risk ratios (RR) with random-effects model were used for our analyses. The risk of bias of the included studies was assessed using Cochrane’s RoB 2 tool. Results Of 1,604 citations identified, eight studies (1,439 patients) were included in our analysis. No improvement in overall survival were noted when Yttrium-90 transarterial radioembolization was compared to standard treatments (HR 0.99 [95% CI 0.81–1.21], 6 studies, I2 = 77.6%). However, Yttrium-90 transarterial radioembolization was associated with fewer grade ≥3 adverse events (RR 0.64 [95% CI 0.45–0.92], 7 studies, I2 = 66%). No difference was observed on other secondary outcomes. Discussion In non-surgical HCC patients, Yttrium-90 transarterial radioembolization was not associated with significant effect on survival, progression-free survival, time to progression, disease control rate and the incidence of gastro-intestinal ulcers but was however associated with significantly lower rates of grade ≥3 adverse events. Further randomized controlled trials are warranted to better delineate optimal treatment.
Prestimulus alpha power but not phase influences visual discrimination of long‐duration visual stimuli

Occipital oscillations in the alpha band are closely related to visual perception and attention. In multiple studies, increased alpha power has been shown to reduce detection rates of hard‐to‐detect visual stimuli. Recent studies explain this finding by a shift in perceptual bias. Moreover, the phase of alpha oscillations prior to stimulus onset appears to be critical for the detection of visual stimuli. This is explained by a shift in cortical excitability over the course of each alpha cycle. However, prior studies often used short presentation times of visual stimuli at the perceptual threshold. Here, we use longer presentation times to elucidate whether the same mechanisms hold for the perception of salient but challenging visual stimuli presented for up to 1,500 ms. To this end, we presented participants with hard to distinguish but salient upright or tilted Gaussian gratings in a two‐alternative forced choice task, while recording occipital electroencephalographic activity. Previous reports link alpha power to stimulus detection hit rates, and we found that low prestimulus power at the individual alpha frequency relates to higher perceptual accuracy. Contrary to recent findings, we neither found an influence of alpha power on criterion, nor an influence of alpha phase on perception or response speed. We argue that longer presentation times might attenuate a possible response bias, and increased excitability might sharpen the discrimination ability, thereby leading to increased perceptual accuracy and unaffected response criterion.
Cohort profile: the Dutch famine birth cohort (DFBC)— a prospective birth cohort study in the Netherlands

Purpose The Dutch famine birth cohort study was set up to investigate the effects of acute maternal undernutrition of the 1944–1945 Dutch famine during the specific stages of gestation on later health, with a particular focus on chronic cardiovascular and metabolic diseases, ageing and mental health. Participants The Dutch famine birth cohort consists of 2414 singletons born alive and at term in the Wilhelmina Gasthuis in Amsterdam around the time of the Dutch famine (1943–1947) whose birth records have been kept. The cohort has been traced and studied since 1994, when the first data collection started. The cohort has been interviewed and physically examined in several waves of data collection since that time, allowing repeated measures of a wide range of phenotypic information as well as the collection of biological samples (blood, urine, buccal swabs), functional testing (of heart, lungs, kidney, HPA axis) and imaging of the brain (MRI) and vasculature (ultrasound). Additionally, genetic and epigenetic information was collected. Through linkage with registries, mortality and morbidity information of the entire cohort has been obtained. Findings to date Prenatal famine exposure had lasting consequences for health in later life. The effects of famine depended on its timing during the gestation and the organs and tissues developing at that time, with most effects after exposure to famine in early gestation. The effects of famine were widespread and affected the structure and function of many organs and tissues, resulted in altered behaviour and increased risks of chronic degenerative diseases and increased mortality. The effects of famine were independent of size at birth, which suggests that programming may occur without altering size at birth. Future plans As the cohort ages, we will be assessing the effects of prenatal undernutrition on (brain) ageing, cognitive decline and dementia, as well as overall morbidity and mortality. Registration The Dutch famine birth cohort is not linked to a clinical trial.
COVID-19 pandemic impact on sleep habits, chronotype and health-related quality of life among high school students: a longitudinal study.

STUDY OBJECTIVES The COVID-19 pandemic has challenged the population of affected areas in multiple dimensions. Adolescents have been especially affected with school closure and home confinement. The impact of the pandemic on sleep habits and quality of sleep and quality of life among adolescents have not been adequately characterized. We hypothesized that the COVID-19 pandemic induced an evening shift of the daily rhythm among adolescents and adversely affected sleep quality and quality of life of high school students. METHODS Students were questioned about their usual bed and wake-up times and answered the Pittsburg Sleep Quality Index Questionnaire (PSQI), the Epworth Sleepiness Scale (ESS), the Morning-Eveningness Questionnaire (MEQ) and the World Health Organization Quality of Life Questionnaire (WHOQOL) before and during the pandemic. RESULTS Ninety-four students (64% females, aged 15+1 years) participated in both phases of the study. Students delayed bed and wake-up times in 1.5[0.5-2.0] and 2.0[1.5-2.5]h, respectively. Chronotype (MEQ) shifted towards eveningness during the pandemic. Sleep duration increased and quality of sleep (PSQI) improved only among those students with shorter sleep duration before the pandemic. During the pandemic, the physical and psychological domains of WHOQOL worsened but the environmental domain improved as compared to the study before the pandemic. CONCLUSIONS High school students delayed bed and wake-up times and shifted chronotype towards eveningness during the COVID-19 pandemic. The worsening of the physical and psychological WHOQOL domains and improvement of the environmental domain highlights the conflicting experiences that high school students are facing during the COVID-19 pandemic.
Identify Complex Imaging Genetic Patterns via Fusion Self-Expressive Network Analysis

In the brain imaging genetic studies, it is a challenging task to estimate the association between quantitative traits (QTs) extracted from neuroimaging data and genetic markers such as single-nucleotide polymorphisms (SNPs). Most of the existing association studies are based on the extensions of sparse canonical correlation analysis (SCCA) for the identification of complex bi-multivariate associations, which can take the specific structure and group information into consideration. However, they often take the original data as input without considering its underlying complex multi-subspace structure, which will deteriorate the performance of the following integrative analysis. Accordingly, in this paper, the self-expressive property is exploited for the reconstruction of the original data before the association analysis, which can well describe the similarity structure. Specifically, we first apply the within-class similarity information to construct self-expressive networks by sparse representation. Then, we use the fusion method to iteratively fuse the self-expressive networks from multi-modality brain phenotypes into one network. Finally, we calculate the imaging genetic association based on the fused self-expressive network. We conduct the experiments on both single-modality and multi-modality phenotype data. Related experimental results validate that our method can not only better estimate the potential association between genetic markers and quantitative traits but also identify consistent multi-modality imaging genetic biomarkers to guide the interpretation of Alzheimer’s disease.
Perspectives of Trial Staff on the Barriers to Recruitment in a Digital Intervention for Psychosis and How to Work Around Them: Qualitative Study Within a Trial

Background Recruitment processes for clinical trials of digital interventions for psychosis are seldom described in detail in the literature. Although trial staff have expertise in describing barriers to and facilitators of recruitment, a specific focus on understanding recruitment from the point of view of trial staff is rare, and because trial staff are responsible for meeting recruitment targets, a lack of research on their point of view is a key limitation. Objective The primary aim of this study was to understand recruitment from the point of view of trial staff and discover what they consider important. Methods We applied pluralistic ethnographic methods, including analysis of trial documents, observation, and focus groups, and explored the recruitment processes of the EMPOWER (Early Signs Monitoring to Prevent Relapse in Psychosis and Promote Well-being, Engagement, and Recovery) feasibility trial, which is a digital app–based intervention for people diagnosed with schizophrenia. Results Recruitment barriers were categorized into 2 main themes: service characteristics (lack of time available for mental health staff to support recruitment, staff turnover, patient turnover [within Australia only], management styles of community mental health teams, and physical environment) and clinician expectations (filtering effects and resistance to research participation). Trial staff negotiated these barriers through strategies such as emotional labor (trial staff managing feelings and expressions to successfully recruit participants) and trying to build relationships with clinical staff working within community mental health teams. Conclusions Researchers in clinical trials for digital psychosis interventions face numerous recruitment barriers and do their best to work flexibly and to negotiate these barriers and meet recruitment targets. The recruitment process appeared to be enhanced by trial staff supporting each other throughout the recruitment stage of the trial.
DNA-templated silver nanoclusters as an efficient catalyst for reduction of nitrobenzene derivatives: a systematic study

Nitrobenzene compounds are highly toxic pollutants with good stability, and they have a major negative impact on both human health and the ecological environment. Herein, it was found for the first time that fluorescent DNA-silver nanoclusters (DNA-AgNCs) can catalyze the reduction of toxic and harmful nitro compounds into less toxic amino compounds with excellent tolerance to high temperature and organic solvents. In this study, the reduction of p-nitrophenol (4-NP) as a model was systematically investigated, followed by expending the substrate to disclose the versatility of this reaction. This report not only expanded the conditions for utilizing catalytic reduction conditions of DNA-AgNCs as an efficient catalyst in the control of hazardous chemicals but also widened the substrate range of DNA-AgNCs reduction, providing a new angle for the application of noble metal nanoclusters.
The effect of diagnostic hysteroscopy performed before fresh and frozen-thawed embryo transfer in IVF cycles on reproductive outcomes

Objective: Hysteroscopy is frequently performed in infertile women and thought to improve pregnancy rates. The data obtained from studies investigating the effect of hysteroscopy in in-vitro fertilization (IVF) cycles is variable. We aimed to evaluate the effect of hysteroscopy on pregnancy outcomes of fresh and frozen-thawed embryo transfers (FET) performed during IVF cycles. Material and Methods: The data of the 765 patients, who had IVF treatment between January 2015 and July 2017 in an infertility center, were retrospectively analyzed. Of those, 586 (76.6%) patients underwent fresh embryo transfer, while 179 (23.4%) patients underwent FET. Hysteroscopy performed by a single experienced surgeon was scheduled two months before transfer. Hysteroscopy was performed in 101/586 (17.2%) in those undergoing fresh embryo transfer and 44/179 (24.6%) patients in the FET group. Pregnancy outcomes of the groups were compared respectively within their own group. Results: The mean age was similar in patients in the fresh and FET groups (p=0.365, respectively). There was no difference in the number of transferred embryos between the groups (p=0.218). In the fresh embryo group there were 246 pregnancies, of which 44 had undergone diagnostic hysteroscopy while 202 had not, (p=0.516) and 79 pregnancies in the FET group, of which 20 had undergone diagnostic hysteroscopy while 59 had not (p=0.711). There was no statistical difference according to pregnancy rate between the groups (p=0.538). Conclusion: Performing diagnostic hysteroscopy before fresh or FET does not improve the pregnancy rates.
Reactions Involving Iron in Mediating Catechol Oxidation in Model Wine

Studies in wine and model systems have established that iron is an essential catalyst that mediates the reaction of polyphenols with oxygen. This investigation examined how this metal exerts its action. When wine is protected from air, iron exists in its reduced ferrous state, Fe(II), which is rapidly oxidized to the ferric state, Fe(III), on exposure to oxygen. This rapid transformation is observed when Fe(II) is added to model wine saturated with aerial oxygen, but the reaction slows to a very slow rate before completion due to the inhibitory action of Fe(III). 4-Methylcatechol was found not to be oxidized by Fe(III) or as Fe(II) was reacting with oxygen. It was apparent, therefore, that the catechol did not react with intermediate oxygen radicals. Consequently, it is proposed that hydroperoxyl radicals are not produced in wine conditions and a revised mechanism for the reaction of Fe(II) with oxygen to produce hydrogen peroxide is proposed. However, sulfite addition, which is known to promote catechol oxidation, resulted in rapid Fe(III) reduction and attainment of an Fe(III)/Fe(II) redox equilibrium. Benzenesulfinic acid, which does not react with oxygen, produced the same effect and it is proposed that nucleophiles, which react rapidly with quinones, allow the oxidation of catechols to proceed. Examination of the Fenton reaction showed that the reaction of Fe(II) with hydrogen peroxide was rapid and resulted in the uptake of oxygen. A comparison of the rates of Fe(II) oxidation and Fe(III) reduction in the presence of different ligands showed a dependence on reduction potentials.
Validation of LensHooke® X1 PRO and Computer-Assisted Semen Analyzer Compared with Laboratory-Based Manual Semen Analysis

Purpose To compare two automated semen quality analysis systems (LensHooke® X1 PRO [X1 PRO]) and IVOS CASA) for accuracy, precision and agreement with laboratory-based manual semen analysis (MSA). Materials and Methods Semen samples (n=31) were obtained from normozoospermic healthy male volunteers and infertile men with a minimum abstinence period between 2–3 days. After complete liquefaction, 101 seminal aliquots were prepared and tested according to WHO 5th Edition (2010) guidelines. The results obtained by X1 PRO and IVOS CASA were compared with that of MSA. Additionally, 10 samples were used to evaluate the intra- and inter-rater agreement for X1 PRO and MSA. Results The semen parameters (sperm concentration, total, and progressive motility) showed strong correlation and agreement for both automated semen analyzers and MSA (Spearman's rank correlation ≥0.92, p<0.0001). X1 PRO and IVOS CASA were able to differentiate samples with abnormal concentration with a positive predictive value (PPV) of 100%. Furthermore, the PPV for X1 PRO (86.5%) was higher than that for IVOS CASA (71.7%) in differentiating samples with abnormal motility. The X1 PRO device showed a high PPV (97.7%) in identifying normal sperm forms compared to MSA. Semen parameters evaluated showed a high inter-rater (kappa >0.91) and intra-rater (kappa >0.92) agreement for X1 PRO compared with MSA. Conclusions Both automated semen analyzers demonstrated a high level of concordance and their performance was comparable with MSA analysis. Furthermore, high-levels of inter-and intra-rater reliability for semen analysis indicate that the new X1 PRO can be used in a clinical laboratory to offer accurate and quick test results.
Effects of Brewer's Spent Grain on the Quality and Dietary Fibre Content of Cookies

Dried and ground brewer's spent grain (BSG) was blended with soft wheat flour at levels of 5-25%. BSG preparations of fine (<212 μm), medium (212-425 μm) and coarse (425-850 μm) particle sizes were used in the production of wire-cut cookies. The protein content decreased and the dietary fibre content (acid detergent fibre, neutral detergent fibre and total dietary fibre) increased, as the particle size of the BSG samples increased. The results indicated that BSG preparations with high dietary fibre content have potential as a source of dietary fibre. The effects of BSG on the quality and dietary fibre content of cookies have been investigated. Total dietary fibre (TDF) contents of the cookies supplemented with different particle size BSG increased significantly (p<0.05) as the addition level increased. Cookies prepared with BSG of medium and coarse particle sizes resulted in better properties in terms of Spread Ratio, Hunter color values and overall sensory score as compared to those made with BSG of fine particle size. Cookies made with medium and coarse particle size BSG gave better cookie properties up to the 15% addition and deteriorated significantly above this level (p<0.05).
Osteotomy and iliac bone graft for the treatment of malunion caused by failed mandibular fracture reduction

This report describes osteotomy and iliac bone graft for malunion caused by failed mandibular fracture reduction. A 27-year-old man was referred 3 months after a motor vehicle accident. At another hospital, two operations had been performed for symphyseal fracture using two resorbable plates. Malocclusion was noted, and panoramic radiography and computed tomography revealed a misaligned dental arch, with a 9.37-mm gap between the central and the lateral incisor of the left mandible. A wafer was made from the patient’s dental model, and a maxillary arch bar was applied. Through a lower gingivolabial incision, osteotomy was performed between the malunited symphyseal fracture segments. Both segments were reduced to their original position using the wafer and fixed with titanium miniplates via intermaxillary fixation (IMF). The intersegmental gap was filled with cancellous bone from the iliac crest. The gingival defect was covered with a mucosal transposition flap from the gingivolabial sulcus. IMF and the wafer were maintained for 5 and 9 weeks, respectively. At postoperative week 13, the screws were removed from the mandible and satisfactory occlusion was noted. His mouth opening improved from 2.5 to 3 finger breadths (40 mm). This case demonstrates the need for sufficient IMF when using resorbable plates.