Miracle-dz/UniFAR-FTUs huggingface dataset:
Angiogenic regulatory influence of extracellular matrix deposited by resting state asthmatic and non‐asthmatic airway smooth muscle cells is similar

The extracellular matrix (ECM) is the tissue microenvironment that regulates the characteristics of stromal and systemic cells to control processes such as inflammation and angiogenesis. Despite ongoing anti‐inflammatory treatment, low levels of inflammation exist in the airways in asthma, which alters ECM deposition by airway smooth muscle (ASM) cells. The altered ECM causes aberrant behaviour of cells, such as endothelial cells, in the airway tissue. We therefore sought to characterize the composition and angiogenic potential of the ECM deposited by asthmatic and non‐asthmatic ASM. After 72 hours under non‐stimulated conditions, the ECM deposited by primary human asthmatic ASM cells was equal in total protein, collagen I, III and fibronectin content to that from non‐asthmatic ASM cells. Further, the matrices of non‐asthmatic and asthmatic ASM cells were equivalent in regulating the growth, activity, attachment and migration of primary human umbilical vein endothelial cells (HUVECs). Under basal conditions, asthmatic and non‐asthmatic ASM cells intrinsically deposit an ECM of equivalent composition and angiogenic potential. Previous findings indicate that dysregulation of the airway ECM is driven even by low levels of inflammatory provocation. This study suggests the need for more effective anti‐inflammatory therapies in asthma to maintain the airway ECM and regulate ECM‐mediated aberrant angiogenesis.
Considerations on activity assay discrepancies in factor VIII and factor IX products

New modified coagulation factor VIII (FVIII) and factor IX (FIX) products have been designed to improve the treatment of individuals with hemophilia A and B by increasing the interval between dosing. Although these FVIII and FIX molecules have been structurally modified to improve the circulation time, the changes have also influenced their behavior in functional assays in comparison with traditional plasma‐derived or recombinant coagulation factors. The assignment of potencies for these products can be problematic because discordance in factor activity values between the commonly used one‐stage clotting and chromogenic substrate assays is often observed. Discrepancies in potency assay values also exist when different assay kits and reagents are used in the same assay type. Ideally, all FVIII and FIX products should be calibrated against the World Health Organization (WHO) International Standards (IS) because the assignment of potencies in international units (IU) helps maintain treatment tradition and meaningful references for manufacturers, patients, and clinicians. The discrepant measurements, attributed to the modified structural and functional properties of these products, are manifested in their lack of commutability with the WHO IS for FVIII or FIX. Herein, we discuss the considerations upon which an assay is chosen for potency assignment and postadministration monitoring of a new factor product, which include the validity of the assay calibrated with the IS, the meaning of the potency values in IU, standards of care for patients, clinical relevance between the assigned potency value and recovery value from clinical laboratories, and patient safety.
Peritoneal Dialysis Use in Patients With Ascites: A Review.

Past few decades have seen steady increase in the prevalence of kidney failure (KF), needing kidney replacement therapy. Concomitantly, there has been progressive growth of heart failure and chronic liver disease, and many such patients develop ascites. Therefore, it is not uncommon to encounter patients with KF who concurrently have ascites. The presence of ascites adds many challenges in the management of KF. Poor hemodynamics make volume management difficult. Presence of coagulopathy, malnutrition and encephalopathy compounds the complexity of the management. Such patients do not tolerate hemodialysis well. However, several concerns have limited the use of peritoneal dialysis (PD), and hemodialysis remains the predominant dialysis modality in these patients. On the contrary, observational studies illustrate that PD provides hemodynamic stability and facilitates better volume management compared to hemodialysis. Moreover, PD obviates the need for therapeutic paracentesis by facilitating continuous drainage of ascites. PD potentially reduces hemorrhagic complications by avoiding routine anticoagulation use. Moreover, small studies suggest that outcomes such as peritonitis, and mechanical complications are comparable to that in KF-PD patients without ascites. PD does not affect transplant candidacy and these patients can successfully receive combined liver and kidney transplants. Hence, PD should be considered a viable dialysis option in KF patients with ascites.
Impact of duloxetine on succinylcholine‐induced postoperative myalgia after direct microlaryngoscopic surgeries: Randomized controlled double‐blind study

Succinylcholine is a preferred muscle relaxant for rapid sequence intubation. Postoperative myalgia (POM) is one of its commonest adverse effects with unknown pathogenesis. Various modalities were examined to reduce POM. We hypothesized that duloxetine may reduce the incidence and severity of fasciculation or succinylcholine‐induced POM in outpatient surgeries.
Effect of Proximal Dome and Distal Chevron Osteotomies on Plantar Pressures and Radiographic and Functional Outcomes in Hallux Valgus Surgery: A Retrospective Analysis.

BACKGROUND No detailed comparative studies have been performed regarding plantar pressure changes between proximal dome and distal chevron osteotomies. This study aimed to compare radiographic and plantar pressure changes after distal chevron and proximal dome osteotomies and to investigate the effect of radiographic and plantar pressure changes on clinical outcomes. METHODS This study included 26 and 22 patients who underwent distal chevron and proximal dome osteotomies, respectively. Visual analog scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) forefoot scores were used to evaluate pain and functional outcomes. Hallux valgus angle, intermetatarsal angle, talar-first metatarsal angle, and calcaneal inclination angle were measured in the evaluation of radiographic outcomes. Preoperative and postoperative plantar pressure changes were evaluated. RESULTS There were no statistically significant differences between the two groups in age, body mass index, or AOFAS forefoot and VAS scores. In the proximal dome group, the pressure measurement showed significant lateralization of the maximal anterior pressure point in the forefoot (P < .001). In addition, the postoperative calcaneal inclination angle was significantly lower (P = .004) and the talar-first metatarsal angle was significantly higher (P < .001) in the proximal dome group. Postoperative transfer metatarsalgia was observed in one patient (3.8%) in the distal chevron group and five (22.7%) in the proximal dome group (P < .05). CONCLUSIONS Proximal dome osteotomy led to more lateralization of the maximum anterior pressure point, decreased calcaneal inclination angle and first metatarsal elevation, and related higher transfer metatarsalgia.
Impacts of volcanic eruptions and early recovery in freshwater environments and organisms

Volcanic eruptions modify environments physically and chemically with serious consequences for the biota. In this review, we analysed 80 papers reporting the effects of volcanic eruptions in freshwater environments and on freshwater organisms. An increase in water turbidity is the most common reported physical effect while increases in concentrations of inorganic elements, many representing nutrients for primary producers, are the most common chemical effects. Bacterial growth is usually stimulated, while autotrophs can be either positively or negatively affected depending on the type of impact. A persistent effect reported in the biota is changes to the assemblage, which could generate further changes in terms of ecosystem functions. This analysis also identifies some information gaps, particularly involving the effects of eruptions on heterotrophic biofilms in streams and on invertebrates and fish in lakes. Most studies were carried out soon after the volcanic eruption, so it is difficult to assess the recovery of the ecosystems. Eruptions present unique opportunities for scientific discovery, although such studies are often hindered by a lack of pre‐eruption data, which would allow for a more comprehensive assessment of the effects.
Exosomale microRNA-21 Promotes Keloid Fibroblast Proliferation and Collagen Production by inhibiting Smad7.

In keloid fibroblasts, microRNA-21 (miR-21) enhances activation of the TGF-β-Smad-signaling pathway by downregulating Smad7 expression, thereby promoting keloid fibroblast proliferation and collagen production. However, it is unclear whether miR-21 performs the above-mentioned functions through exosomal transport. Here, we extracted exosomes from the culture supernatants of keloid and normal skin fibroblasts, and observed that exosomes from both cell types secreted exosomes; however, keloid fibroblasts secreted significantly more exosomal miR-21 than normal skin fibroblasts (P < 0.001). Interestingly, we also observed that exosomal miR-21 could enter target keloid fibroblasts. In addition, inhibiting exosomal miR-21 upregulated Smad7 protein expression and reduced Smad2 and Smad3 protein levels in target keloid fibroblasts. Furthermore, inhibiting exosomal miR-21 downregulated collagen I and collagen III expression in target keloid fibroblasts, increased the proportion of apoptotic cells, and reduced cell proliferation. Taken together, these results show that exosomal miR-21 promoted proliferation and collagen production in keloid fibroblasts by inhibiting Smad7. Thus, we identified regulatory roles for miR-21 in promoting keloid fibroblast proliferation and participating in keloid formation and development. These findings imply that miR-21 may serve as a novel target for controlling the development of keloids.
Inductively coupled nonthermal plasma synthesis of aluminum nanoparticles

Metallic nanoparticles of aluminum (Al), a nontoxic and earth-abundant element, are relevant to plasmonic and energetic applications. However, monodisperse Al nanoparticles are difficult to synthesize using all gas-phase approaches, especially in the 10 to 20 nm size range; yet, many applications require particles of this size due to their enhanced properties. Here, an inductive nonthermal plasma reactor fed with aluminum trichloride (AlCl3) and Ar is used to synthesize single-crystal aluminum nanoparticles. The particles can be produced with or without hydrogen. Several reactor conditions such as AlCl3 vapor concentration, flow rates, and power are found to strongly influence particle properties such as the oxide shell thickness, particle mono-dispersity, and particle size. Significant quantities of Ar relative to AlCl3, short residence times of 10 s of ms, and pressures in excess of 4.7 Torr are required to form Al particles with geometric mean sizes of 10–20 nm and geometric standard deviations as low as 1.3. While the Al nanoparticles are covered with 2–4 nm thick oxide shells, the best synthesis conditions yield particle sizes determined by electron microscopy that are comparable to crystallite sizes determined from x-ray diffraction.
What are the ethical dilemmas in the decision making processes of nursing people given Electroconvulsive therapy? A critical realist review of qualitative evidence.

INTRODUCTION Electroconvulsive therapy (ECT) has a complex and contentious place in psychiatric care. Mental health nurses (MHNs) are of obligated to be part of this practice despite ethical concerns. AIM To consider the ethical dilemmas and decision-making processes facing MHNs involved in the administration of ECT. METHOD A critical realist review of the literature surrounding ethical considerations and ECT was undertaken using thematic analysis. FINDINGS Four key themes emerged: the MHN as an advocate and conflict in their role, issues surrounding consent, questionable efficacy and unknown method of action, side effects, and legal issues and clinical guidelines. DISCUSSION Using a critical-realist framework for understanding, the decision-making process and ethical considerations are viewed as part of the empirical and actual parts of reality, while the potential for other, unseen causal powers to be at play is acknowledged. IMPLICATIONS FOR PRACTICE MHNs need to ensure they have an adequate ethical underpinning to their practice to enable them to navigate contentious areas of practice such as ECT to practice effectively and preserve safety. This may require moving beyond the traditional bio-medical model of ethics. Developing an appreciation of unseen causal factors is also an essential part of MHNs' developing professional competency. RELEVANCE STATEMENT MHNs are involved in the care of people receiving ECT. Due to the contentious nature of ECT treatment and the complex ethical issues, they may be placed in situations which are professionally tricky to navigate. MHNs may need to broaden their ethical framework beyond the biomedical model and to improve their understanding of unseen causal factors at play to meet their professional obligations in relation to practicing effectively and preserving safety.
Phytochemical Profile and Antioxidant Activity of the Aerial Part Extracts from Matthiola incana subsp. rupestris and subsp. pulchella (Brassicaceae) Endemic to Sicily

As part of a project aimed at investigating the Matthiola taxa endemic to Sicily (Italy), this study focused on Matthiola incana, an edible species used in the traditional medicine of various countries. Herein, the characterization of phenolic and volatile compounds, the antioxidant capacity in vitro (1,1‐diphenyl‐2‐picrylhydrazil (DPPH), reducing power and Fe2+ chelating activity assays) and the toxicity test (Artemia salina lethality bioassay) of the hydroalcoholic extracts from the aerial parts of M. incana subsp. rupestris from Mt. Pellegrino (Palermo) and Mt. Erice (Trapani), and of M. incana subsp. pulchella are reported. The results are compared with those previously shown for M. incana subsp. incana, to achieve a comprehensive overview of the three subspecies. The HPLC‐PDA/ESI‐MS and SPME‐GC/MS analyses led to the identification of 13 phenolics and 54 volatile compounds. Differences in the qualitative‐quantitative profile of these phytochemicals have been highlighted between the M. incana subspecies. The antioxidant tests showed different activity for the extracts, which were found to possess better chelating properties. At last, none of the tested extracts displayed toxicity against brine shrimp larvae. These findings enrich the knowledge on the Matthiola taxa growing wild in Sicily, both from the strictly systematic point of view and for the possible applications as sources bioactive compounds that can be used in the nutraceutical field.
A randomized comparative evaluation of local infiltration analgesia, extended nerve blocks, and conventional analgesia in pain management after total knee arthroplasty

Objectives The aim of this study was to analyze the postoperative effects of extended nerve blocks and local infiltration analgesia (LIA) on postoperative pain control, muscle weakness, and blood loss after total knee arthroplasty (TKA). Patients and methods Between February 24th 2020 and July 10th 2020, a total of 161 patients (55 males, 106 females; median age: 69.0 years [IQR 63.0-75.0], range, 41 to 81 years) who underwent primary TKA were randomly allocated into three parallel groups according to their concomitant procedure in a double-blind fashion: (i) those to whom nerve blockade was performed after competition of surgery under the duration of spinal anesthesia (n=50); (ii) those to whom LIA was performed during surgery (n=52), and (iii) control group (n=59). The content of LIA was 10-10 mL of 20 mg lidocaine with 0.01 mg adrenalin and 100 mg ropivacaine, 1 mL (30 mg) ketorolac, and 5 mL (500 mg) tranexamic acid was diluted by 50 mL 0.9% NaCl under aseptic conditions. Outcome parameters were the evaluation of pain until the evening of first postoperative day (24 to 36 h), mobilization, and blood loss within the first three postoperative days. Results The pain was maximal between 4 and 8 h postoperatively, when the effect of the spinal anesthetic drugs disappeared. During this critical period, tolerable pain (Numerical Rating Scale, NRS ≤3) was observed in 52%, 42%, and 19% of nerve blockade in LIA and control groups, respectively. None of the patients complained of high-intensity pain (NRS >8) in the LIA group, which was a significant difference from the block and control groups (10% and 14%, p<0.008, respectively). There was no significant muscle weakness associated with the use of this extended block. The decrease in hemoglobin level was significantly lower in the LIA group than in the control and block groups (odds ratio [OR]: 0.379, 95% confidence interval [CI]: 0.165-0.874 for nerve blockade vs. LIA, OR: 1.189, 95% CI: 0.491-2.880 for nerve blockade vs. control, OR: 0.319, 95% CI: 0.140-0.727, respectively). The common language effect size for pain in each referred interval in each group and for decrease of hemoglobin between the first and third postoperative days fell between 0.507 and 0.680. Conclusion This study demonstrates that LIA technique offers a fast and safe treatment option for pain relief after TKA. No clinically relevant muscle weakness was observed among groups according to field block applications. Significant advantages were also achieved in blood loss.
Predictors of severity and mortality among patients hospitalized with COVID-19 in Rhode Island

Background In order for healthcare systems to prepare for future waves of COVID-19, an in-depth understanding of clinical predictors is essential for efficient triage of hospitalized patients. Methods We performed a retrospective cohort study of 259 patients admitted to our hospitals in Rhode Island to examine differences in baseline characteristics (demographics and comorbidities) as well as presenting symptoms, signs, labs, and imaging findings that predicted disease progression and in-hospital mortality. Results Patients with severe COVID-19 were more likely to be older (p = 0.02), Black (47.2% vs. 32.0%, p = 0.04), admitted from a nursing facility (33.0% vs. 17.9%, p = 0.006), have diabetes (53.9% vs. 30.4%, p<0.001), or have COPD (15.4% vs. 6.6%, p = 0.02). In multivariate regression, Black race (adjusted odds ratio [aOR] 2.0, 95% confidence interval [CI]: 1.1–3.9) and diabetes (aOR 2.2, 95%CI: 1.3–3.9) were independent predictors of severe disease, while older age (aOR 1.04, 95% CI: 1.01–1.07), admission from a nursing facility (aOR 2.7, 95% CI 1.1–6.7), and hematological co-morbidities predicted mortality (aOR 3.4, 95% CI 1.1–10.0). In the first 24 hours, respiratory symptoms (aOR 7.0, 95% CI: 1.4–34.1), hypoxia (aOR 19.9, 95% CI: 2.6–152.5), and hypotension (aOR 2.7, 95% CI) predicted progression to severe disease, while tachypnea (aOR 8.7, 95% CI: 1.1–71.7) and hypotension (aOR 9.0, 95% CI: 3.1–26.1) were associated with increased in-hospital mortality. Conclusions Certain patient characteristics and clinical features can help clinicians with early identification and triage of high-risk patients during subsequent waves of COVID-19.
Systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio levels are associated with keratoconus

Purpose: The aim of this study was to assess the systemic immune-inflammation index (SII) levels, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in patients with keratoconus (KC). Methods: A total of 42 patients with KC (KC group) and 42 age- and sex-matched healthy subjects (control group) were included into this cross sectional study. Complete blood count parameters were assayed. SII, NLR, red cell distribution width (RDW), and PLR values were calculated. The SII value was calculated as follows: platelet count × (neutrophil/lymphocyte). Results: SII, NLR, RDW, and PLR values were significantly higher in KC group compared to control group [709 ± 236 vs. 418 ± 117 (P < 0.001), 2.5 ± 0.8 vs. 1.76 ± 0.3 (P < 0.001), 14.3 ± 1.6% vs. 12.9 ± 0.54% (P < 0.001), and 143 ± 36 vs. 106 ± 23 (P < 0.001), respectively]. Using the receiver operating characteristics (ROC) curve analysis to predict KC, the highest area under the curve (AUC) was determined SII (0.846 for SII, 0.778 for NLR, and 0.796 for PLR). Conclusion: SII, NLR, RDW, and PLR levels were significantly increased in patients with KC. This study supports the idea that several inflammatory pathways may play important role in the pathogenesis of this disorder. SII may be much better marker than NLR and PLR for predicting the inflammatory status of the disease.
Impact of the use of digital devices on eyes during the lockdown period of COVID-19 pandemic

Purpose: The purpose of this study is to observe pattern of digital device use and the various ocular, visual and systemic symptoms associated with them during the lockdown period of the novel coronavirus disease (COVID-19) pandemic. Methods: Two hundred and thirty-three volunteers were included in web-based open e-survey. The survey was designed on the 'Survey Monkey' website and distributed through social media platform. The information was collected regarding hours and numbers of digital devices along with numbers of digital activities carried out during the pandemic. A pretested symptom questionnaire was also included regarding ocular, visual and systemic symptoms before and during lockdown. The statistical analysis was carried out using Statistical Package of Social Science software. Results: During the pandemic, most of the respondents were engaged in more than two digital activities (73.81%) over more than two digital devices (48.50%) for more than six days (65.66%). Maximum respondents were mobile users (97.85%) spending major time on social media (89.70%). Symptoms including watering eyes (P = 0.000), dry eyes (P = 0.000), shoulder pain (P = 0.020), back pain (P = 0.003) and headache (P = 0.043) showed positive correlation with hours of digital device use per day during lockdown, while itching eyes (P = 0.036) and pain behind eyes (P = 0.025) were the major symptoms in those engaged in a greater number of digital activities. Moreover, red eyes (P = 0.040) were more prominent in respondents using multiple devices for a greater number of hours. Conclusion: A big jump in digital activities on multiple digital devices was seen during lockdown which are more prone to ocular symptoms. Acceleration of ocular and systemic symptoms was particular with rise in time spending on digital devices.