Miracle-dz/UniFAR-FTUs huggingface dataset:
Treatment of COVID-19 Patients with Prolonged Post-Symptomatic Viral Shedding with Leflunomide -- a Single-Center, Randomized, Controlled Clinical Trial

Abstract Objective To evaluate the efficacy and safety of leflunomide, an approved dihydroorotate dehydrogenase inhibitor, to treat COVID-19 patients with prolonged post-symptomatic viral shedding. Methods We conducted a prospective, randomized, controlled, open-label trial involving hospitalized adult COVID-19 patients with prolonged PCR positivity. Patients were randomly assigned to receive either leflunomide (50 mg, q12h, three consecutive times, orally; then 20 mg, once daily for 8 days), in addition to nebulized interferon alpha 2a (IFN α-2a, 3 million IU each time, twice daily for 10 days), or nebulized IFN α-2a alone for 10 days. The primary end point was the duration of viral shedding. Results A total of 50 COVID-19 patients with prolonged PCR positivity were randomized into 2 groups; 26 were assigned to the leflunomide group, and 24 were assigned to the interferon alone group. Treatment with leflunomide was not associated with a difference from the interferon alone group in the duration of viral shedding (hazard ratio for negative RT-PCR, 0.70; 95% confidence interval, 0.391-1.256; P=0.186). In addition, the patients given leflunomide did not have a substantially shorter length of hospital stay than patients treated with interferon alone, with median (IQRs) durations of 29.0 (19.3-47.3) days and 33.0 (29.3-42.8) days, respectively, P=0.170. Two leflunomide recipients were unable to complete the full 10-day course of administration due to adverse events. Conclusions In COVID-19 patients with prolonged PCR positivity, no benefit in terms of the duration of viral shedding was observed with the combined treatment of leflunomide and IFN α-2a beyond IFN α-2a alone.
Chronological Age Assessment in Young Individuals Using Bone Age Assessment Staging and Nonradiological Aspects: Machine Learning Multifactorial Approach

Background Bone age assessment (BAA) is used in numerous pediatric clinical settings as well as in legal settings when entities need an estimate of chronological age (CA) when valid documents are lacking. The latter case presents itself as critical as the law is harsher for adults and granted rights along with imputability changes drastically if the individual is a minor. Traditional BAA methods have drawbacks such as exposure of minors to radiation, they do not consider factors that might affect the bone age, and they mostly focus on a single region. Given the critical scenarios in which BAA can affect the lives of young individuals, it is important to focus on the drawbacks of the traditional methods and investigate the potential of estimating CA through BAA. Objective This study aims to investigate CA estimation through BAA in young individuals aged 14-21 years with machine learning methods, addressing the drawbacks of research using magnetic resonance imaging (MRI), assessment of multiple regions of interest, and other factors that may affect the bone age. Methods MRI examinations of the radius, distal tibia, proximal tibia, distal femur, and calcaneus were performed on 465 men and 473 women (aged 14-21 years). Measures of weight and height were taken from the subjects, and a questionnaire was given for additional information (self-assessed Tanner Scale, physical activity level, parents' origin, and type of residence during upbringing). Two pediatric radiologists independently assessed the MRI images to evaluate their stage of bone development (blinded to age, gender, and each other). All the gathered information was used in training machine learning models for CA estimation and minor versus adult classification (threshold of 18 years). Different machine learning methods were investigated. Results The minor versus adult classification produced accuracies of 0.90 and 0.84 for male and female subjects, respectively, with high recalls for the classification of minors. The CA estimation for the 8 age groups (aged 14-21 years) achieved mean absolute errors of 0.95 years and 1.24 years for male and female subjects, respectively. However, for the latter, a lower error occurred only for the ages of 14 and 15 years. Conclusions This study investigates CA estimation through BAA using machine learning methods in 2 ways: minor versus adult classification and CA estimation in 8 age groups (aged 14-21 years), while addressing the drawbacks in the research on BAA. The first achieved good results; however, for the second case, the BAA was not precise enough for the classification.
Sinonasal mucosal melanoma: a 10-year experience of 36 cases in China

Background Sinonasal mucosal melanoma (SNMM) is a rare tumor with a poor prognosis. This study aimed to assess the clinical and imaging features, progression, treatment, and possible prognostic factors of SNMM. Methods Thirty-six patients with SNMM were retrospectively reviewed in the Department of Otolaryngology & Head and Neck Surgery of Xinhua Hospital from January 2008 to December 2017. Results The age of the first diagnosis was 67.4±10.8 years; the most common clinical symptoms included epistaxis, nasal obstruction, headache, and facial pain. Most tumors originated in the nasal cavity (63.9%) and at stage IV (77.8%). Melanin in melanoma showed typical signal intensity on magnetic resonance imaging (MRI), T1WI had high signal while T2WI had low signal. 41.6% of patients had the typical MRI findings. Treatment included surgery, surgery with radiotherapy, and radiotherapy only. The follow-up time ranged from 4 to 96 months, with a median time of 22 months, 1-, 3-, and 5-year OS is 80.6%, 36.1%, and 13.9%, respectively. The 3-year OS was better in cases in the T3 stage than the T4 stage (P=0.02). However, tumors that originated from the paranasal sinus had a poorer prognosis than the nasal cavity (P=0.04). The cases receiving postoperative radiotherapy showed poorer prognosis (P=0.02). Other factors were not found to be associated with prognosis, including gender, age, lymph node metastasis, distant metastasis, computed tomography (CT) enhancement, and typical MRI findings. Conclusions The SNMM was a devastating tumor with poor outcomes; most cases were diagnosed at late stages, which may account for poor prognosis. Tumors with melanin feature MRI findings do not have a better prognosis. The treatment of postoperative radiotherapy is still controversial.
A Survey on Feedlot Performance of Purebred and Crossbred European Young Bulls and Heifers Managed Under Intensive Conditions in Veneto, Northeast Italy

This study, based on a nearly 10-year collection of performance data of young bulls and beef heifers, aimed to benchmark production traits of specialized fattening herds of northern Italy and to compare the performance of stock calves belonging to several European genetic types (GT). Data originated from 2806 batches (a group of stock calves homogeneous for GT, origin, finishing herd, fattening period, and diets), and concerned 188,891 animals of 10 GT herded in 44 farms of the Veneto region. For each batch, average body weight (BW) at arrival and at sale, duration of the fattening period, losses due to injury or death, purchase and sell price were collected, and average daily gain (ADG) and net sale gain (NSG) per head, per day of fattening, and per kg of BW gain were computed. Charolais and Limousine young bulls accounted for nearly 50% and 20%, respectively, of all animals, and over 90% of calves originated from France. Average BW at arrival and at slaughter approximated 370 and 650 kg, respectively, and ADG approached 1.30 kg/d, but variation due to GT was large (P<0.01). Charolais young bulls were the heaviest at slaughter and showed the greatest ADG, whereas Irish crosses produced the highest NSG per head and per day of fattening. Year affected all traits (P<0.01), but his magnitude was limited for BW at purchase or sale and for ADG, and slightly larger for NSG, even if this last trait did not evidence any long period congruent trend.
Cultural Competency Among Pediatric Registered Nurses in Saudi Arabia: A Cross-Sectional Design

Introduction Saudi Arabia’s culturally diverse population is growing rapidly. The need for cultural competence is greatest in pediatric units where nurses provide care to children in collaboration with their parents. Method Nonprobability sampling of 394 nurses and cross-sectional descriptive design was used to investigate nurses’ cultural competence, and to examine the relationships between the variables and participants’ demographic data in pediatric units across five hospitals in Riyadh, Saudi Arabia, by asking nurses to complete a self-report questionnaire. Results The results suggest a high degree of cultural competency. Participants’ scores indicated high levels of perceived cultural awareness, sensitivity, and cultural competence behavior for performance. Discussion This study supports the 3-D Puzzle Model of culturally congruent care for cultural competence, which assumes that cultural competence is deeply influenced by one’s experiences. The findings revealed a high level of cultural competence despite a lack of information with respect to patient views.
Estimation of the Lysine Requirement of Broiler Chicks for Maximum Body Gain and Feed Efficiency

Abstract The world's literature on the lysine requirement of starting chickens (0-3 wk) was reviewed and 16 response data sets were chosen for analyses based on completeness of the description of the experimental conditions and the period studied. Data was pooled from different research reports to compare responses and get estimates of the requirement for dietary lysine for broiler chicks up to 21 days of age. The nonlinear mathematical models “ascending line with plateau” (ALP) and “ascending quadratic with plateau” (AQP) were fitted to estimate the lysine requirement. The AQP model may be more realistic and adequate than the ALP model for the prediction of the lysine requirement theoretically, but the statistical fits of the two models were very similar. The predicted lysine requirements for broiler chicks from 0 to 3 wk of age using the ALP model were 1.04±0.02% for gain and 1.10±0.05% for feed efficiency. Using the AQP model the requirements were 1.21±0.06% for gain and 1.32±0.10% for feed efficiency.
Long-term survival of heterotopic allografts of the amoebocyte-producing organ in Biomphalaria glabrata (Mollusca: Pulmonata)

Afin d'examiner le devenir des allogreffes chez les mollusques, la paroi du pericarde arterien de B. g. , organe hematopoietique produisant des amœbocytes, a ete greffee et examinee histologiquement. Le but final etant de determiner le role de cet organe dans la resistance aux trematodes parasites
Comparison of emergency cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters in patients with placenta accreta spectrum

Abstract Objective The objective of the study was to compare outcomes of women with placenta accreta spectrum(PAS) who underwent emergency cesarean hysterectomy with and without prophylactic intravascular balloon catheters. Methods Sixty-three cases who had emergency hysterectomy related to PAS disorders were retrospectively analyzed. Subjects with prophylactic intravascular balloon catheter placement plus hysterectomy were compared with those who had hysterectomy alone. The cases were divided into three groups: infrarenal aortic artery balloon occlusion (IAABC) group (who had IAABC plus hysterectomy, n = 31), internal iliac artery balloon occlusion (IIABOC) group (who had IIABOC plus hysterectomy, n = 17), and hysterectomy alone group (control group n = 15). Results Outcome measures were not significantly different between the IIABOC group and the control group. IAABC plus hysterectomy resulted in a better outcome than hysterectomy alone, with less amount of estimated blood loss (EBL) during cesarean section (2000 vs 3000 ml, p = .011) and 24 h after cesarean section (2010 vs 4520 ml, p = .004), less operation time(90 vs 106 min, p = .01), and a lower rate of major blood loss(42 vs 93%, p = .029). IAABC plus hysterectomy resulted in better outcomes than IIABOC plus hysterectomy, with less amount of EBL during cesarean section (2000 vs 3000 ml, p = .005) and 24 h after cesarean section (2010 vs 3000 ml, p = .035), a lower rate of major blood loss(42 vs 100%, p < .001), less operation time (90 vs 100 min, p = .038), and less fetus radiation dose（1.9 mGy vs 22.4 mGy, p < . 001). Conclusions IAABC was more effective in emergency cesarean hysterectomy related to PAS disorders.
Ramsay Hunt syndrome affecting the vagus nerve with epiglottic ulcers as the first manifestation: a case report

Ramsay Hunt syndrome involving the vagus nerve is very rare. We herein describe a 53-year-old man who developed severe pharyngeal pain after alcohol intoxication. Antibiotic treatment was ineffective. Laryngoscopy showed an ulcer on the right side of the epiglottis. As the condition progressed, the patient developed hoarseness. He then gradually developed multiple herpes lesions on the right side of the head, face, and neck along with right peripheral facial paralysis. Corticosteroid, analgesic, antiviral, and nutritional nerve therapy resulted in disappearance of the herpes lesions, epiglottis ulcer, pharyngeal pain, and right head and face pain. The facial paralysis slightly improved, but the hoarseness did not improve. The patient was discharged with an unsatisfactory outcome, and he attempted treatment with acupuncture. After 6 months, the right facial paralysis and hoarseness disappeared. Our case emphasizes the importance of early diagnosis and treatment of atypical Ramsay Hunt syndrome as well as timely communication, enhancement of trust, and reduction of disputes between doctors and patients.
Pain, sensitization and physical performances in patients with chronic painful knee osteoarthritis or chronic pain following total knee arthroplasty: An explorative study

The aim of this study was to assess clinical pain, pain sensitization and physical performances to profile patients with chronic painful knee osteoarthritis (OA) or pain after total knee arthroplasty (TKA). Examining the interactions between pain mechanisms and physical performances would enable us to investigate the underlying explanatory relationships between these parameters.
3D radiomics predicts EGFR mutation, exon-19 deletion and exon-21 L858R mutation in lung adenocarcinoma

Background To establish a radiomic approach to identify epidermal growth factor receptor (EGFR) mutation status in lung adenocarcinoma patients based on CT images, and to distinguish exon-19 deletion and exon-21 L858R mutation. Methods Two hundred sixty-three patients who underwent pre-surgical contrast-enhanced CT and molecular testing were included, and randomly divided into the training (80%) and test (20%) cohort. Tumor images were three-dimensionally segmented to extract 1,672 radiomic features. Clinical features (age, gender, and smoking history) were added to build classification models together with radiomic features. Subsequently, the top-10 most relevant features were used to establish classifiers. For the classifying tasks including EGFR mutation, exon-19 deletion, and exon-21 L858R mutation, four logistic regression models were established for each task. Results The training and test cohort consisted of 210 and 53 patients, respectively. Among the established models, the highest accuracy and sensitivity among the four models were 75.5% (61.7–86.2%) and 92.9% (76.5–99.1%) to classify EGFR mutation, respectively. The highest specificity values were 86.7% (69.3–96.2%) and 70.4% (49.8–86.3%) to classify exon-19 deletion and exon-21 L858R mutation, respectively. Conclusions CT radiomics can sensitively identify the presence of EGFR mutation, and increase the certainty of distinguishing exon-19 deletion and exon-21 L858R mutation in lung adenocarcinoma patients. CT radiomics may become a helpful non-invasive biomarker to select EGFR mutation patients for invasive sampling.
The inorganic nitrogen nutrition of phytoplankton in the southern Benguela: new production, phytoplankton size and implications for pelagic foodwebs

Available information on direct measures of nitrate and ammonium assimilation by phytoplankton populations in the southern Benguela over the past 10 years has been synthesized into a convenient framework for comparison with other major coastal upwelling ecosystems. Based on a recent model, the southern Benguela and Peruvian upwelling systems are characterized by the highest potential for new production of the four systems analysed. Realization of this production potential is determined by biological and physical factors. The effects of ammonium and phytoplankton size on the f-ratio (and new production) have been considered. The proportion of ammonium in the inorganic nitrogen pool suppresses the f-ratio in a manner similar to that described for a number of other coastal regions. Related to the effect of ammonium and its supply by microbial processes is the partitioning of nitrogen resources among different size-classes of phytoplankton. Netplankton are characterized by higher f-ratios than both nanoplankt.
A systematic revision of the Australian ploiarioline thread-legged assassin bugs (Hemiptera: Reduviidae: Emesinae)

The Australian members of the emesine tribe Ploiaiolini (Hemiptera: Heteroptera: Reduviidae) are revised. A key, as well as diagnoses and figures, are presented for all 16 Australian species. Seven new species are described. Four species previously not recorded from Australia are included in the continent’s fauna. Emesopsis is expanded to include species in which the basal cell of the forewing is absent.
Headache and rhinosinusitis: A review

Purpose of review To explain our current understanding of headache attributed to rhinosinusitis, an often inappropriately diagnosed secondary headache. Recent findings Recent studies have shown that headache attributed to rhinosinusitis is often over-diagnosed in patients who actually have primary headache disorders, most commonly migraine. Failure to recognize and treat rhinosinusitis, however, can have devastating consequences. Abnormalities of the sinuses may also be treatable by surgical means, which may provide headache relief in appropriately selected patients. Summary It is important for the practicing physician to understand how rhinosinusitis fits into the differential diagnosis of headache, both to avoid overdiagnosis in patients with primary headache, and to avoid underdiagnosis in patients with serious sinus disease.
microRNA strand selection: Unwinding the rules

microRNAs (miRNAs) play a central role in the regulation of gene expression by targeting specific mRNAs for degradation or translational repression. Each miRNA is post‐transcriptionally processed into a duplex comprising two strands. One of the two miRNA strands is selectively loaded into an Argonaute protein to form the miRNA‐Induced Silencing Complex (miRISC) in a process referred to as miRNA strand selection. The other strand is ejected from the complex and is subject to degradation. The target gene specificity of miRISC is determined by sequence complementarity between the Argonaute‐loaded miRNA strand and target mRNA. Each strand of the miRNA duplex has the capacity to be loaded into miRISC and possesses a unique seed sequence. Therefore, miRNA strand selection plays a defining role in dictating the specificity of miRISC toward its targets and provides a mechanism to alter gene expression in a switch‐like fashion. Aberrant strand selection can lead to altered gene regulation by miRISC and is observed in several human diseases including cancer. Previous and emerging data shape the rules governing miRNA strand selection and shed light on how these rules can be circumvented in various physiological and pathological contexts.
EGFR circulating tumour DNA testing: identification of predictors of ctDNA detection and implications for survival outcomes

Background EGFR T790M testing is the standard of care for activating EGFR mutation (EGFRm) non-small cell lung cancer (NSCLC) progressing on 1st/2nd generation TKIs to select patients for osimertinib. Despite sensitive assays, detection of circulating tumour deoxyribonucleic acid (ctDNA) is variable and influenced by clinical factors. The number and location of sites of progressive disease at time of testing were reviewed to explore the effect on EGFR ctDNA detection. The prognostic value of EGFR ctDNA detection on survival outcomes was assessed. Methods Following extraction of cell-free DNA from plasma using the QIAamp Circulating Nucleic Acid Kit, custom droplet digital polymerase chair reaction (ddPCR) assays were used to assess EGFR ctDNA using the Bio-Rad QX200 system. The ddPCR assay has a limit of detection of ≤0.15% variant allele fraction. Baseline characteristics and imaging reports at time of EGFR ctDNA testing were reviewed retrospectively for a 1 year period. Results The study included 177 patients who had an EGFR ctDNA test. Liver (aOR 3.13) or bone (aOR 2.76) progression or 3–5 sites of progression (aOR 2.22) were predictive of EGFR ctDNA detection. The median OS from first ctDNA test after multiple testing iterations was 12.3 m undetectable EGFR ctDNA, 7.6 m for original EGFR mutation only and 24.1 m with T790M (P=0.001). Conclusions Patients with liver or bone progression and 3–5 progressing sites are more likely to have informative EGFR ctDNA testing. Detection of EGFR ctDNA is a negative prognostic indicator in the absence of a T790M resistance mutation, potentially reflecting the disease burden in the absence of targeted therapy options.
Expression of survivin and p53 genes in patients with alopecia areata: A case–control study

Alopecia areata is a common non‐scarring hair loss disorder. It has been generally recognised as a loss of immune privilege leading to an autoimmune attack upon anagen hair follicles. Survivin is one of the apoptosis inhibitor proteins, responsible for apoptosis suppression and cell cycle regulation. Survivin expression has been demonstrated in the matrix and outer root sheath keratinocytes of anagen hair follicles. Survivin overexpression was shown in several autoimmune diseases, and it was postulated that it contributes to the survival of self‐reactive T and B cells. P53 is a tumour suppressor gene that was suggested to repress autoimmunity via induction of T regulatory cells. Survivin gene expression is transcriptionally suppressed by wild‐type p53.
Temporal Arteritis Revealing Antineutrophil Cytoplasmic Antibody–Associated Vasculitides: A Case–Control Study

Temporal arteritis (TA) is a typical manifestation of giant cell arteritis (GCA). Antineutrophil cytoplasmic antibody (ANCA)–associated vasculitides (AAVs) are rarely revealed by TA manifestations, leading to a risk of misdiagnosis of GCA and inappropriate treatments. This study was undertaken to describe the clinical, biologic, and histologic presentations and outcomes in cases of TA revealing AAV (TA‐AAV) compared to controls with classic GCA.