Miracle-dz/UniFAR-FTUs huggingface dataset:
Prognostic and predictive significance of tumor infiltrating lymphocytes for ductal carcinoma in situ

ABSTRACT This study aims to identify the density of TILs in ductal carcinoma in situ (DCIS) in terms of prognostic significance with recurrence and the benefit of whole breast irradiation (WBI). The clinicopathological data of DCIS patients from Jan 2009 to Dec 2016 who received breast-conserving surgery (BCS) were retrospectively reviewed. Cox regression analysis was used to confirm independent prognostic factors of ipsilateral breast tumor recurrence (IBTR). Kaplan–Meier method was utilized to analyze IBTR and values of WBI. Touching-tumor-infiltrating lymphocytes (TILs) were defined by TILs touching or within one lymphocyte cell thickness from the malignant ducts’ basement membrane. In total, 129 patients were enrolled in this analysis with 98 patients who received WBI. After a median follow-up of 53.0 months, there were 16 IBTR events with five invasive IBTRs. Univariate and multivariate analyses showed that touching-TILs >5 were an independent prognostic factor for higher IBTR (HR = 6.17, 95%CI 1.95–19.56, p < .01). The whole cohort was classified into two subgroups: dense group (>5 touching-TILs per duct) and sparse group (≤5 touching-TILs per duct). Dense touching-TILs were associated with unfavorable biologic characteristics. The 5-y rate of IBTR between dense and sparse group was 29.0% versus 4.5% (p < .01). For the sparse group, WBI significantly reduced the rate of 5-y-IBTR risk from 13.2% to 1.7% (p = .02), but there was no benefit of WBI in the dense group. Touching-TILs density was heterogeneous in patients with DCIS. Sparse touching-TILs were associated with better prognosis and benefit from WBI. Dense touching-TILs not only were associated with a higher risk of IBTR but also lack of benefit from WBI.
An experimental model of anti-PD-1 resistance exhibits activation of TGFß and Notch pathways and is sensitive to local mRNA immunotherapy

ABSTRACT Immune checkpoint blockade elicits durable anti-cancer responses in the clinic, however a large proportion of patients do not benefit from treatment. Several mechanisms of innate and acquired resistance to checkpoint blockade have been defined and include mutations of MHC I and IFNγ signaling pathways. However, such mutations occur in a low frequency of patients and additional mechanisms have yet to be elucidated. In an effort to better understand acquired resistance to checkpoint blockade, we generated a mouse tumor model exhibiting in vivo resistance to anti-PD-1 antibody treatment. MC38 tumors acquired resistance to PD-1 blockade following serial in vivo passaging. Lack of sensitivity to PD-1 blockade was not attributed to dysregulation of PD-L1 or β2M expression, as both were expressed at similar levels in parental and resistant cells. Similarly, IFNγ signaling and antigen processing and presentation pathways were functional in both parental and resistant cell lines. Unbiased gene expression analysis was used to further characterize potential resistance mechanisms. RNA-sequencing revealed substantial differences in global gene expression, with tumors resistant to anti-PD-1 displaying a marked reduction in expression of immune-related genes relative to parental MC38 tumors. Indeed, resistant tumors exhibited reduced immune infiltration across multiple cell types, including T and NK cells. Pathway analysis revealed activation of TGFβ and Notch signaling in anti-PD-1 resistant tumors, and activation of these pathways was associated with poorer survival in human cancer patients. While pharmacological inhibition of TGFβ and Notch in combination with PD-1 blockade decelerated tumor growth, a local mRNA-based immunotherapy potently induced regression of resistant tumors, resulting in complete tumor remission, and resensitized tumors to treatment with anti-PD-1. Overall, this study describes a novel anti-PD-1 resistant mouse tumor model and underscores the role of two well-defined signaling pathways in response to immune checkpoint blockade. Furthermore, our data highlights the potential of intratumoral mRNA therapy in overcoming acquired resistance to PD-1 blockade.
Giant Gastrointestinal Stromal Tumors of the Stomach Successfully Treated With Laparoscopic Resection: Case Report and Literature Review

The stomach is the most common site of gastrointestinal stromal tumors (GISTs), representing 60% to 70% of all GIST tumors of the gastrointestinal tract. Gastric GISTs are usually asymptomatic discovered incidentally during endoscopic or radiological investigations. A small percentage may present with melena, hematemesis, and anemia due to recurrent bleeding. We report a case of a giant gastric GIST presented with anemia, that successfully treated with laparoscopic resection.
The short‐run response of Saudi Arabia stock market to the outbreak of COVID‐19 pandemic: An event‐study methodology

Abstract This paper investigates the short‐term response of the Saudi stock market (Tadawul) to the COVID‐19 outbreak. Event study methodology applied to data derived from the 21 industry groups that constitute the Saudi stock market to calculate abnormal returns for the trading days after the announcement of the COVID‐19 in both China and Saudi Arabia. The results indicate that the estimated CARs for the industry groups and their sum on the event day were not statistically significant. Furthermore, the formal announcement of the first case of the COVID‐19 in China had a negative but not significant impact on the Saudi stock market. In contrast, in the first 9‐days event window, the announcement of the first confirmed case in Saudi Arabia had a negative and significant effect. Moreover, the most negatively affected industry groups were banks, consumer services, capital goods, transportation and commercial services, whereas telecommunication services and food and beverage were positively affected at the event window (+1, +9). In general, the Saudi stock market's response had become weaker in the event windows come after (+1, +9), and different industry groups were found to have different responses to the COVID‐19 outbreak.
Identity Leadership in a Crisis: A 5R Framework for Learning from Responses to COVID‐19

Abstract The COVID‐19 pandemic is the greatest global crisis of our lifetimes, and leadership has been critical to societies’ capacity to deal with it. Here effective leadership has brought people together, provided a clear perspective on what is happening and what response is needed, and mobilized the population to act in the most effective ways to bring the pandemic under control. Informed by a model of identity leadership (Haslam, Reicher & Platow, 2020), this review argues that leaders’ ability to do these things is grounded in their ability to represent and advance the shared interests of group members and to create and embed a sense of shared social identity among them (a sense of “us‐ness”). For leaders, then, this sense of us‐ness is the key resource that they need to marshal in order to harness the support and energy of citizens. The review discusses examples of the successes and failures of different leaders during the pandemic and organizes these around five policy priorities related to the 5Rs of identity leadership: readying, reflecting, representing, realizing, and reinforcing. These priorities and associated lessons are relevant not only to the management of COVID‐19 but to crisis management and leadership more generally.
Theoretical operational life study of the closed‐cycle transversely excited atmospheric CO2 laser

By using a comprehensive theoretical model that assumes a stable excitation discharge and homogeneous plasma chemical reactions in the discharge plasma, the laser output performance and the variations of the laser gas components during the sealed‐off operation of the high‐power, closed‐cycle transversely excited atmospheric CO2 laser have been investigated. The fractional CO2/N2, molecules decomposition, and the concentration of the various minor impurities accumulated in the laser gas mixture have been theoretically calculated as a function of shots and number of repetitive discharge pulses. According to the results, the gradual reduction of the laser output energy with the successive excitation pulses was mainly due to the depletion of the CO2 molecules and the reduction of the excitation efficiency; the excitation efficiency was decreased in consequence of the increased operational E/N (E is the discharge field strength, N is the total laser gas number density) caused by the accumulation of highly electronegative impurities such as O2 and O3. The nitrogen oxides were found to show little effect on the operational E/N in spite of their large electron attachment cross sections, because these molecules were much less accumulated in the laser gas mixture than O2 or O3. The theoretical model has clarified for the first time that a trace of water (H2O) vapor in the laser chamber effectively acts as a gaseous catalyst to enhance the CO2 reforming reaction in the discharge plasma. Furthermore, this CO2 reforming reaction by H2O, rather than the other backward reactions, predominantly determines the equilibrium CO2 decomposition level in the actual laser chamber. Finally, with regard to the ultraviolet (UV) preionization, it was theoretically shown that the UV absorption depth of the laser gas mixture steeply decreased as the CO2 decomposition increased owing to the contamination of strong UV absorbing species such as O2 and O3.
Characteristics and Risk Factors of Intraocular Lens Tilt and Decentration of Phacoemulsification After Pars Plana Vitrectomy

Purpose The purpose of this study was to investigate the characteristics and risk factors of intraocular lens (IOL) tilt and decentration of phacoemulsification after pars plana vitrectomy (PPV) using swept-source optical coherence tomography (SS-OCT). Methods One hundred four eyes with prior PPV and 104 eyes without PPV undergoing uneventful cataract surgery were enrolled in this study. IOL tilt and decentration were measured by SS-OCT (CASIA2) 3 months postoperatively. Results The mean IOL tilt and decentration were greater in the PPV group (5.36 ± 2.50 degrees and 0.27 ± 0.17 mm, respectively) than in the non-PPV group (4.54 ± 1.46 degrees, P = 0.005; 0.19 ± 0.12 mm, P < 0.001, respectively). Multiple logistic regression showed that silicone oil (SO) tamponade (odds ratio [OR] = 5.659, P = 0.021) and hydrophilic IOL (OR = 5.309, P = 0.022) were associated with IOL tilt over 7 degrees, and diabetes mellitus (DM; OR = 5.544, P = 0.033) was associated with IOL decentration over 0.4 mm. Duration of SO tamponade was positively correlated with IOL tilt (P = 0.014) and decentration (P < 0.001). The internal total higher-order aberration, coma, trefoil, and secondary astigmatism in the PPV group were higher than in the non-PPV group, and positively correlated with IOL tilt (P < 0.05). Conclusions Patients with prior vitrectomy had greater IOL tilt and decentration than the non-PPV group. Longer duration of SO tamponade, hydrophilic IOL, as well as DM were the risk factors of greater IOL tilt and decentration in patients with prior PPV. Translational Relevance Optically sophisticated designed IOLs should be used cautiously in vitrectomized eyes.
A little shot of humility: Intellectual humility predicts vaccination attitudes and intention to vaccinate against COVID‐19

Abstract Vaccinations remain a critical, albeit surprisingly controversial, health behavior, especially with the promise of widely available COVID‐19 vaccine. Intellectual humility, a virtue characterized by nonjudgmental recognition of one's own intellectual fallibility, may counter rigidity associated with anti‐vaccination attitudes and help promote vaccine‐related behaviors. This study investigated whether intellectual humility is related to anti‐vaccination attitudes and intentions to vaccinate against COVID‐19, and whether intellectual humility can predict unique variance in these outcomes beyond participant demographic and personal factors. Participants (N = 351, 57.23% male, mean age = 37.41 years, SD = 11.51) completed a multidimensional measure for intellectual humility, the anti‐vaccination attitudes (VAX) scale, and a two‐item COVID‐19 vaccination intention scale. Bivariate correlations demonstrated that intellectual humility was negatively related with anti‐vaccination attitudes overall, r(349) = −. 46, p < . 001, and positively related to intentions to vaccinate against COVID‐19, r(349) = . 20, p < . 001. Hierarchical multiple regression revealed that intellectual humility predicted all four types anti‐vaccination attitudes, overall anti‐vaccination attitudes, and COVID‐19 vaccination intentions above and beyond demographic and personal factors (i.e., sex, race/ethnicity, age, education, socioeconomic status, and political orientation), ΔR 2 between . 08 and . 18, ps < . 001. These results bolster intellectual humility as a malleable psychological factor to consider in efforts to combat anti‐vaccination attitudes and promote COVID‐19 vaccination uptake.
Moving from “Do Not Resuscitate” Orders to Standardized Resuscitation Plans and Shared-Decision Making in Hospital Inpatients

Not for Cardiopulmonary Resuscitation (No-CPR) orders, or the local equivalent, help prevent futile or unwanted cardiopulmonary resuscitation. The importance of unambiguous and readily available documentation at the time of arrest seems self-evident, as does the need to establish a patient’s treatment preferences prior to any clinical deterioration. Despite this, the frequency and quality of No-CPR orders remains highly variable, while discussions with the patient about their treatment preferences are undervalued, occur late in the disease process, or are overlooked entirely. This review explores the evolution of hospital patient No-CPR/Do Not Resuscitate decisions over the past 60 years. A process based on standardized resuscitation plans has been shown to increase the frequency and clarity of documentation, reduce stigma attached to the documentation of a No-CPR order, and support the delivery of medically appropriate and desired care for the hospital patient.
Electronic absorption spectroscopy and colour of chromium-doped solids

Twenty-one chromium-containing compounds and solid solutions belonging to ten structural types were obtained by either solid-state reactions or the Pechini method and studied from the point of view of the relationship between structure, composition and colour. Formation of single-phase products was assured by heating on several high-temperature stages and monitoring phase transformations by X-ray diffraction. Electronic absorption spectra and colour coordinates of the samples were obtained and analysed paying special attention to the dependence of the colour on the structural characteristics and the presence of chromium in oxidation states other than Cr(III).
Assessing the Social Influences, Self-Esteem, and Stress of High School Students Who Vape

Adolescent vaping is rapidly rising in Canada, and e-cigarettes have become the most widely used tobacco product among high school students; 29% of students in grades 10 to 12 reported e-cigarette use in 2019. Vaping among adolescents is a problem because the long-term health consequences of e-cigarettes remain unknown, large numbers of teens are becoming addicted to the harmful drug nicotine, and vaping has been shown to increase risk of initiation of combustible tobacco product use. To address the gaps in the current understanding of adolescent e-cigarette use, this study aims to examine the role of social peer and family influence, self-esteem, and stress on teen vaping. Seventy-nine students in grades 10 to 12 at an independent, co-ed high school in Toronto, Ontario completed an online survey about factors that influence them to vape, and about their perceived self-esteem and stress. Survey data was analyzed using Chi-Square tests and T-tests. Common motivations for vaping included stress relief (70%) and peer influence (60%). Family history of smoking or vaping and the ability to vape indoors also influenced vaping habits. Notably, e-cigarette users reported higher stress levels than non-users, but self-esteem levels were comparable. Our findings suggest that high school vaping prevention strategies should focus on stress reduction and encourage healthy coping strategies. Similar research studies should be conducted in other high schools, and future research should further explore the correlation between stress and adolescent vaping.
Catastrophic impact of Covid‐19 on the global stock markets and economic activities

Abstract This paper intends to know the influence of COVID‐19 on the stock markets and economic activities across the world. To achieve the purpose, daily panel data of 12 selective countries covering four continents from January to April 2020 have been collected. The impact on stock markets has been measured by applying the event study method, while the panel vector autoregressive model has been applied to measure the impact on economic activities. The stock index of each country, purchasing managers’ index, COVID‐19 variables, namely the number of lockdown days, restriction in internal movement, restriction in international travel, fiscal measure, and confirmed cases have been used. The study observes the serious negative impact of the pandemic on stock market returns. European stock markets are the worst sufferer compared to others. All pandemic variables have a negative impact on stock markets; moreover, lockdown days and restriction on movement have a negative impact on economic activities. This study considers such countries which significantly represent the world economy and are a serious victim of COVID‐19 pandemic. The outcome‐based recommendations will help governments, regulatory authority, and policymakers to combat the crisis in different dimensions.
Outcome of Root Canal Treatment of Necrotic Teeth with Apical Periodontitis Filled with a Bioceramic-Based Sealer

Introduction Apical periodontitis is among the most common pathologies in endodontics. The treatment of apical periodontitis has always been an important occupation in the modern practice of endodontics, and the failure has been associated with nonhermetic root canal filling. With that in mind, bioceramic-based sealers have been incorporated into endodontic practice. The purpose of this study was to evaluate the outcome of nonsurgical root canal treatment (RCT), using a single-cone and Bioroot RCS filling of necrotic teeth with apical periodontitis. Materials and Methods This follow-up study included patients treated in the department of Restorative Dentistry and Endodontics in the Dental Clinic of Monastir, from January 2018 to December 2019. The study intended to include all adult patients presenting a symptomatic or asymptomatic apical periodontitis. Once the diagnosis was performed, the patients were divided into two groups: a one-session treatment group and a two-session treatment group. All cases were obtured with BioRoot using a single-cone technique with a minimum of a 6-month recall. At 6-month follow-ups, teeth were classified as healed, healing (success), or not healed (failure), based on clinical and radiographic findings. Results Twelve patients met the inclusion criteria, six patients per group. Seven patients returned for follow-ups. At 6-month follow-ups, the overall success rate was 100%, with 57.1% determined to be “healed” and 42.8% determined to be “healing. ” All the PAI scores decreased compared to the baseline situation. Conclusion The results obtained showed the contribution of BioRoot RCS in the healing of periapical lesions. Accordingly, bioceramic-based sealers seem to optimize the prognosis of root canal treatments.
Variation in Non-external and External Causes of Death in Peru in Relation to the COVID-19 Lockdown

Introduction: Lockdowns are designed to slow COVID-19 transmission, but they may have unanticipated relationships with other aspects of public health. Assessing the overall pattern in population health as a country implements and relaxes a lockdown is relevant, as these patterns may not necessarily be symmetric. We aimed to estimate the changing trends in cause-specific mortality in relation to the 2020 COVID-19 related lockdowns in Peru. Methods: Based on data from the Peruvian National Death Information System (SINADEF), we calculated death rates per 10 million population to assess the trends in mortality rates for non-external and external causes of death (suicides, traffic accidents, and homicides). We compared these trends to 2018-2019, before, during, and after the lockdown, stratified by sex, and adjusted by Peruvian macro-region (Lima & Callao (capital region), Coast, Highland, and Jungle). Results: Non-external deaths presented a distinctive pattern among macro-regions, with an early surge in the Jungle and a later increase in the Highland. External deaths dropped during the lockdown, however, suicides and homicides returned to previous levels in the post-lockdown period. Deaths due to traffic accidents dropped during the lockdown and returned to pre-pandemic levels by December 2020. Conclusions: We found a sudden drop in external causes of death, with suicides and homicides returning to previous levels after the lifting of the lockdown. Non-external deaths showed a differential pattern by macro-region. A close monitoring of these trends could help identify early spikes among these causes of death and take action to prevent a further increase in mortality indirectly affected by the pandemic.
Identification of the Lignan Nortrachelogenin in Knot and Branch Heartwood of Scots Pine (Pinus sylvestris L.)

By Rainer Ekman1, Stefan Willfær1, Rainer Sjæholm2, Markku Reunanen1, Jukka Måki3, Reko Lehtilå3 and Christer Eckerman1 1 Process Chemistry Group, Laboratory of Forest Products Chemistry, âbo Akademi University, Turku/âbo, Finland 2 Process Chemistry Group, Department of Organic Chemistry, âbo Akademi University, Turku/âbo, Finland 3 Department of Organic Chemistry, âbo Akademi University, Turku/âbo, Finland
Disparities in antenatal care service utilization among food secure and food insecure women in Gombora District, Hadiya zone, south Ethiopia

Introduction little is known about antenatal care (ANC) utilization difference among food secure and food insecure household pregnant women and factors contributing to inequities in antenatal care use in developing country including Ethiopia. To determine the disparities in the utilization of antenatal care that exists between pregnant women in food secure and food insecure household women. Methods a community based comparative cross-sectional study was conducted in Gombora District, Hadiya zone, southern Ethiopia. Data were collected from February 25th to March 25th, 2015, using a pre-tested structured questionnaire. Pregnant women were selected by a simple random sampling method. The data were entered using EpiData 3.1 and exported to SPSS version 21 for analysis. Multivariate logistic regression analysis was done to compare antenatal care utilization among food secure and insecure household women at 95% confidence interval (CI). Statistical tests were done at a level of significance of p<0.05. Results two hundred sixty-seven (34.5%) of the respondents received at least one antenatal care visit on current pregnancy. Forty-nine-point one percent of food secure and 23.3% of food insecure household women utilized ANC from health professionals. Factors associated with antenatal care utilization included being from a food secure household (adjusted odds ratio [aOR]= 2.54; 95%CI: 1.79-3.59), having attained secondary or higher education (aOR=3.76; 95%CI: 2.32-6.1), good level of knowledge of antenatal care (aOR= 2.42; 95%CI 1.34-4.33) and being from a wealthy household (aOR=2.10; 95% CI: 1.34-3.28). Conclusion: this study showed a significant variation in the use of ANC in food secure and food insecure household pregnant women. Interventions to improve ANC utilization should prioritize women from poor socio-economic and low educational background.