Miracle-dz/UniFAR-FTUs huggingface dataset:
Fibrinogen–Albumin Ratio Index (FARI) as a Certain Prognostic Biomarker in Pretreated Patients with Immunotherapy

Purpose Immunotherapy has become the standard treatment for advanced tumors so that many biomarkers play parts in predicting prognosis and clinical outcome. Use of FARI is increasing, but there are no studies on its use prior to immunotherapy. Patients and Methods A retrospective study prior to immunotherapies in advanced carcinoma used FARI and other biomarkers as clinical parameters from which to analyse data from January 2014 to November 2020. Data were presented in GraphPad Prism 7 and X-Tile and analyzed using IBM SPSS. Results A total of 146 patients were enrolled in our study. FARI (with an optimal cut-off value of 11.1%) was divided into a high group, in connection with shorter OS mainly in patients with bone metastasis (120m vs 11.5m, 95% Cl: 12.17–23.83, SE: 2.974, p=0.03), and a low group with a longer PFS (11.0m vs 5.0m, 95% Cl: 3.303–12.697, SE: 2.397, p=0.03) in NSCLC but a shorter PFS (3.5m vs 5.5m, 95% Cl: 3.757–6.243, SE: 0.634, p=0.01) in liver metastasis. FARI was not determined as an independent predictor of OS in patients undergoing medical therapies (>11.1% vs ≤11.1%, HR: 1.296, 95% Cl: 0.687–2.032, p=0.314). ECOG (HR: 2.892, 95% Cl: 1.911–4.378, p<0.001) can be an independent predictor for PFS and OS in advanced carcinoma. Conclusion Our findings highlight certain potential values for predicting prognosis but no outstanding biomarkers prior to immunotherapy according to FARI.
Dementia Enlightened?! A Systematic Literature Review of the Influence of Indoor Environmental Light on the Health of Older Persons with Dementia in Long-Term Care Facilities

Abstract Light therapy for older persons with dementia is often administered with light boxes, even though indoor ambient light may more comfortably support the diverse lighting needs of this population. Our objective is to investigate the influence of indoor daylight and lighting on the health of older adults with dementia living in long-term care facilities. A systematic literature search was performed within PubMed, CINAHL, PsycINFO, Web of Science and Scopus databases. The included articles (n=37) were published from 1991 to 2020. These articles researched the influence of existing and changed indoor light conditions on health and resulted in seven categories of health outcomes. Although no conclusive evidence was found to support the ability of indoor light to decrease challenging behaviors or improve circadian rhythms, findings of two studies indicate that exposure to (very) cool light of moderate intensity diminished agitation. Promising effects of indoor light were to reduce depressive symptoms and facilitate spatial orientation. Furthermore, there were indications that indoor light improved one’s quality of life. Despite interventions with dynamic lighting having yielded little evidence of its efficacy, its potential has been insufficiently researched among this study population. This review provides a clear and comprehensive description of the impact of diverse indoor light conditions on the health of older adults with dementia living in long-term care facilities. Variation was seen in terms of research methods, (the description of) light conditions, and participants’ characteristics (types and severity of dementia), thus confounding the reliability of the findings. The authors recommend further research to corroborate the beneficial effects of indoor light on depression and to clarify its role in supporting everyday activities of this population. An implication for practice in long-term care facilities is raising the awareness of the increased lighting needs of aged residents.
Platelets: The Emerging Clinical Diagnostics and Therapy Selection of Cancer Liquid Biopsies

Abstract Due to the inherent molecular heterogeneity of metastatic tumours and the dynamic evolution ability of tumour genomes, tumour tissues obtained through biopsy and other methods cannot capture all of the features of tumour genomes. A new diagnostic concept called “liquid biopsy” has received widespread attention in recent years. Liquid biopsy has changed the clinical practice of oncology and is widely used to guide targeted drug utilization, monitor disease progression and track drug resistance. The latest research subject in liquid biopsy is platelets. Platelets originate from multifunctional haematopoietic stem cells in the bone marrow haematopoietic system. They are small cells from the cytoplasm of bone marrow megakaryocytes. Their main physiological functions are to participate in the processes of physiological haemostasis and coagulation. Tumour cells transfer biomolecules (such as RNA) to platelets through direct contact and release of exosomes, which changes the platelet precursor RNA. Under the stimulation of tumour cells and the tumour microenvironment, platelet precursor mRNA is spliced into mature RNA and converted into functional protein to respond to external stimuli, forming tumour-educated platelets (TEPs). The detection of TEPs in the peripheral blood of patients is expected to be used in clinical tumour diagnosis. This emerging liquid biopsy method can replace and supplement the current tumour detection methods. Further research on the role of platelets in tumour diagnosis will help provide a novel theoretical basis for clinical tumour diagnosis.
Survival Time to Development of Hypertension and Its Predictors among a Cohort of Diabetic Patients in Health Facilities of Gurage Zone: A Retrospective Follow-Up Study

Background It is expected that around 50% of individuals with diabetes mellitus will develop hypertension in the course of medical follow-up. However, with strict medical follow-up and adherence to medical advice the incidence of hypertension can be highly reduced and the time to occurrence can be delayed. Therefore, this paper aimed to measure the time to development of hypertension and identify its predictors among a 10-year cohort of diabetic patients who have medical follow-up in health facilities of Gurage Zone. Methods An institution-based retrospective cohort study was conducted in diabetic follow-up clinics of Gurage Zone by reviewing 540 consecutively selected records among the records enrolled from January 1, 2010 to December 31, 2019. The outcome variable was incidence rate and survival time to the occurrences of hypertension (a systolic blood pressure at or above 140 mmHg and/or a diastolic blood pressure at or above 90 mm Hg and known hypertensive cases taken from adults’ age ≥18 years) among admitted diabetic patients (fasting blood sugar ≥126 mg/dL or random blood sugar ≥200 mg/dL). Data were collected using a standardized checklist by trained professionals by reviewing records of all clients ever enrolled. Data were cleaned and entered by Epi info version 7 and analyzed by STATA. A Cox-proportional hazard regression model was built to identify predictors of development of hypertension. Results A total of 540 clients were followed for different periods with a median follow-up period of 2.3 years which gives 3,200 person-years of observation. Two hundred and seventy-six (51.1%) participants were males and the mean age of was 52.2 (+11.7) years. Three hundred (55.6%) participants were urban dwellers. The overall incidence density rate (IDR) of hypertension in the cohort was 48.6 cases per 1,000 persons-year. Older ages adjusted hazard ratio (AHR)=4.0 (95% CI=2.26–7.82), body mass index (BMI) >25 kg/m2 AHR=2.3 (95% CI=1.06–3.68), Type II diabetes mellitus (DM) AHR=2.0 (95% CI=1.16–3.04), presence of comorbidity AHR=2.9 (95% CI=1.74–4.58), and poor drug adherence AHR=2.5 (95% CI=1.45–4.65) predicted the development of hypertension. Conclusion The risk of occurrences of hypertension among diabetic patients was high at the early periods and the risk was less at the late diabetic periods and the incidence density rate of hypertension among diabetic patients was high. In addition, age, BMI, type of DM, comorbidity, and drug adherence were independent predictors of occurrences of hypertension. Therefore, intervention to further reduce its occurrence has to focus on drug adherence and prevention of infection.
Factors Affecting Future Caries Occurrence Among Preschoolers in Northern Guangdong: A Longitudinal Study

Purpose This study aimed to investigate the new development of caries among preschoolers in northern Guangdong and to assess caries-related factors to distinguish groups with different caries risk levels. Methods Baseline data were recorded for participants from September to November 2019, and participants were reexamined from September to November 2020. A longitudinal observation of 11,973 preschoolers was conducted. The simplified debris index (DI-S) and decayed-missing-filled tooth (dmft) index values were obtained for each participant. Results Factors associated with whether caries would occur in the future and one-year increase in dmft (Δdmft) included baseline dmft, baseline DI-S, and baseline age. The risk ratio (RR) of caries occurrence and the number of teeth with new-onset caries were 4.482 (95% confidence interval, 4.056–4.957) and 2.945 (2.742–3.165) in the participants with baseline dmft ≥3, which were higher than those with baseline dmft =1 or 2. In the baseline caries-free group, whether caries would occur in the future was related to the baseline DI-S (95% confidence interval, 0.022–0.062). The caries incidence of maxillary central incisors (27.9%) was the highest among teeth of preschoolers without caries at baseline, whereas the caries incidence of mandibular first deciduous molars (42.7%) was the highest among teeth of preschoolers with caries at baseline. Conclusion Baseline dmft is a good predictor of future caries. Children with baseline caries-free status, baseline dmft >0, and baseline dmft ≥3 should be treated with preventive interventions of different intensities and frequencies. The occurrence of future caries in baseline caries-free participants is related to oral hygiene status. Measures to prevent caries on smooth surfaces, such as topical fluoridation, should be applied to all preschoolers. Preschoolers with caries at baseline may be given priority for pit and fissure sealing.
Nature of some features in Raman spectra of hydroxyapatite‐containing materials

A very broad vibrational band ranging from 1000 up to 4000 cm−1 and two relatively sharp bands at 5000 and 5027 cm−1 are found in the Raman scattering spectrum of hydroxyapatite-containing films obtained by gas detonation spray method. We developed a theoretical model that interprets the broad band as a result of strong interaction between the high-frequency hydrogen bond vibrations and lattice phonons. Both sharp bands around 5000 cm−1 are assigned to the overtones of v-OH vibrations. Copyright © 2016 John Wiley & Sons, Ltd.
Association Between Vitamin D and Zinc Levels With Alopecia Areata Phenotypes at a Tertiary Care Center

Objectives Alopecia areata (AA) is a common immune-mediated hair disorder that presents in different clinical patterns. This study aims to find the association between vitamin D and zinc levels with AA phenotypes, to determine the common comorbidities in AA patients, and to assess the influence of age, gender, and body mass index (BMI) on AA phenotypes. Methods This is a cross-sectional study conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Data were collected through retrospective chart review of the electronic medical record system (BestCare) and by utilizing a structured data collection sheet. Results A total of 177 patients were clinically diagnosed with AA with a mean age of 28.37 ± 12.68 years. The mean vitamin D level was 49.14 ± 29.09 nmol/L. Zinc levels were reported in only 22 patients, among which, only one patient had deficient levels. The mean zinc level was 9.8 ± 1.5 µmol/L. Patchy alopecia areata (60.45%) was the most common phenotype followed by universalis (9%) and totalis (7%). Hypothyroidism (11.8%) was the most prevalent comorbidity followed by atopic diseases (10.7%), then both diabetes and mood disorders (6.2%). Conclusion Deficient serum vitamin D levels were present in 62.7% of patients with AA. Nevertheless, no statistically significant relation was detected between vitamin D status and patterns of alopecia areata (P=0.108). A limited number of our sample had records of zinc levels with a mean serum of 9.8 ± 1.5 µmol/L and only one patient was found to be deficient.
First detection of Gongylonema species in Geotrupes mutator in Europe

Abstract The detection of three Gongylonema sp. infective larvae in two specimens of the dung beetle Geotrupes mutator (Marsham, 1802) from western Spain is reported here for the first time in Europe. Scanning electron microscopy confirmed that the analyzed specimens belong to the genus Gongylonema, but it was not possible to determine the species identity by the lack of morphological information in the literature and because many of the phenotypic characteristics had not yet fully developed at this juvenile stage. Nevertheless, a phylogenetic analysis using amplified cox1 nucleotide sequences has revealed that the studied larvae could be clearly discriminated (< 89% identity) from all the other Gongylonema cox1 sequences available in public genetic databases. While our results are limited by the scarcity of genetic information available for this genus, the possibility that the analyzed specimens might correspond to a new species should not be ruled out, and more studies are needed. The results provided in this report indicate that G. mutator is involved in the transmission cycle of Gongylonema sp. to vertebrates in Europe.
Relationship of Substance P with the Degree of Atopic Dermatitis Severity

Introduction Atopic dermatitis (AD) is a chronic inflammatory skin disease that starts during childhood with a varied course. Itching or incessant itching in severe cases, sleep disturbance, and infection-prone skin are the typical symptoms of this disease. Substance P is postulated to have an important role in AD. Increasing levels of substance P in AD induce the release of IFN-γ, IL-4, tumor necrosis factor-α (TNF-α), and IL-10 from peripheral blood mononuclear leukocytes, inducing an itching response. Methods This study is a cross-sectional study that aims to analyze the relationship between serum substance P levels and AD severity in children using Score of AD (SCORAD), and to determine the mean serum substance P levels and severity of AD in patients with AD. This study also aims to find out the correlation of substance P levels with the SCORAD values. Results Forty-six children (29 males; 17 females) with a mean age of 10.35 years (standard deviation (SD) = 4.01) were diagnosed with AD. The SCORAD index assessment was conducted to analyze AD (mean value, 23.15; SD = 9.42), and mild AD obtained the highest degree. The level of substance P was also examined (mean value, 300.88; SD = 127.55). Discussion This study did not find a significant relationship between substance P levels and AD severity (p-value = 0.880), and there was no significant correlation between substance P levels and SCORAD values (p-value = 0.233; r = −0.179). The limitations of this study include a small number of cases, no control group, and we only found two cases of severe AD. To generalize the results, further studies with wide range population and AD severity might be done in the future.
An Update on Immune Checkpoint Therapy for the Treatment of Lynch Syndrome

Abstract During the recent years, immune checkpoint-based therapy has proven highly effective in microsatellite instable (MSI) solid tumors irrespective of organ site. MSI tumors are associated with a defective mismatch repair (MMR) system and a highly immune-infiltrative tumor microenvironment—both characteristics of Lynch syndrome. Lynch syndrome is a multi-tumor syndrome that not only confers a high risk of colorectal and endometrial cancer but also cancer in, eg the upper urinary tract, ovaries, and small bowel. Since the genetic predisposition for Lynch syndrome are pathogenic variants in one of the four MMR genes, MLH1, MSH2, MSH6 or PMS2, most of the Lynch syndrome cancers show MMR deficiency, MSI, and activation of the immune response system. Hence, Lynch syndrome cancer patients may be optimal candidates for immune checkpoint-based therapies. However, molecular differences have been described between sporadic MSI tumors (developed due to MLH1 promoter hypermethylation) and Lynch syndrome tumors, which may result in different treatment responses. Furthermore, the response profile of the rare Lynch syndrome cases may be masked by the more frequent cases of sporadic MSI tumors in large clinical trials. With this review, we systematically collected response data on Lynch syndrome patients treated with FDA- and EMA-approved immune checkpoint-based drugs (pembrolizumab, atezolizumab, durvalumab, avelumab, ipilimumab, and nivolumab) to elucidate the objective response rate and progression-free survival of cancer in Lynch syndrome patients. Herein, we report Lynch syndrome-related objective response rates between 46 and 71% for colorectal cancer and 14–100% for noncolorectal cancer in unselected cohorts as well as an overview of the Lynch syndrome case reports. To date, no difference in the response rates has been reported between Lynch syndrome and sporadic MSI cancer patients.
Treating Advanced Unresectable or Metastatic HER2-Positive Breast Cancer: A Spotlight on Tucatinib

Abstract The management of HER2 positive breast cancer has been transformed by the development of targeted therapies. Dual blockade with the monoclonal antibodies, trastuzumab and pertuzumab, added to first-line taxane chemotherapy and second-line therapy with the antibody–drug conjugate, T-DM1, are internationally agreed standards of care for advanced HER2 positive breast cancer, where available. However, until recently, options for patients for third-line therapy and beyond were of modest efficacy or limited by toxicity. In 2019, the results of trials of two exciting new agents for this space were presented. A third-generation HER2 tyrosine kinase inhibitor, tucatinib, combines the efficacy of the second-generation drug, neratinib, with a more manageable toxicity profile and has become a new standard of care after T-DM1, in combination with capecitabine and trastuzumab. The antibody–drug conjugate, trastuzumab deruxtecan, demonstrated remarkable efficacy in heavily pre-treated patients and received accelerated approval in the United States, whilst confirmatory Phase 3 trials are completed. This review will discuss the available data for the post-T-DM1 setting, focusing on tyrosine kinase inhibitors including tucatinib.
Subcutaneous Interferon Beta Therapy in Multiple Sclerosis Patients – Characterization of Injection Site Reactions and Flu-Like Symptoms in a Daily Practice Setting – Results from the Non-Interventional Study PERFECT

Purpose The purpose of this study was to assess the prevalence of injection site reactions (ISR) and flu-like symptoms (FLS) during treatment with subcutaneous (SC) interferon (IFN) beta therapies and to document measures to mitigate and prevent ISR and FLS. Patients and Methods The cross-sectional post-authorization safety study PERFECT was conducted from 11/2017 to 7/2019 in neurology practices in Germany. Adult patients with relapsing-remitting multiple sclerosis (MS) receiving SC IFN beta for ≥3 months were eligible. The primary endpoints were patient-reported prevalence of ISR and FLS. Additional endpoints reported by patients, MS nurses, and neurologists included type, frequency, duration, time of occurrence, and management of ISR and FLS. Results In total, 603 patients (median age 45 years [range 36–53], 74% female) were included in the analysis. Time since MS diagnosis was >5 years in most patients. The majority had received none (64%) or 1 (22%) prior therapy. Current MS therapy in 36%, 32%, and 30% of patients was IFN beta-1b, IFN beta-1a, and peginterferon beta-1a, respectively. ISR and FLS under current therapy were reported by 84% and 68% of patients, respectively. ISR developed within 5 days after injection (84%) and lasted for 2–14 days (53%) in most patients. The most frequent patient-reported symptom was erythema (39%). ISR resolved or abated with systemic treatments or topical ointments. Most frequent preventive measures included alternating injection sites (58%). Occurrence of ISR rarely resulted in treatment interruption (5%). FLS occurred predominantly up to 6 h after injection (40%) and lasted <12 h (26%). The most frequent patient-reported symptoms were fatigue (15%) and aching limbs (15%). Assessments by physicians and MS nurses differed from patient-reported results. Conclusion Although ISR were experienced by the majority of patients, they rarely resulted in treatment interruption. In this real-world setting, ISR and FLS management was in line with published expert recommendations.
Surgical Treatment for Patent Ductus Arteriosus: Our Experience of 12 Years

Introduction Patent ductus arteriosus (PDA) is a congenital heart disease that, if left untreated, can lead to pulmonary hypertension, congestive heart failure, and death. Here, we aimed to assess postoperative cardiac hemodynamic changes and surgical techniques, as well as early and late postoperative findings in surgically treated PDA patients. Materials and methods We retrospectively analyzed the data belonging to 126 patients whose PDA was surgically closed in our clinic from January 2001 to December 2012. With echocardiography being a standard in diagnosis and follow-up, angiography and computed tomography were also used in the presence of pulmonary hypertension and congenital heart disease, when needed. Postoperative data were compared between isolated PDA patients and those with congenital cardiac deformities. Results Evaluating the patients' pulmonary artery pressure (PAP), pulmonary hypertension was detected in 121 patients (96.0%). Preoperative PAP was significantly higher in PDA patients with congenital heart disease compared to the isolated PDA group (p<0.05). PAP decreased significantly in postoperative follow-up in both groups (p<0.05). However, this decrease was faster in the isolated PDA group than in patients with congenital heart disease and right-left shunt accompanying PDA (p<0.05). Regarding the correlation between ductus diameters and preoperative PAP, we found that as ductus diameter increased, PAP increased significantly (p<0.05). Conclusions In PDA patients, closing the ductus is necessary to prevent pulmonary and cardiac complications. Surgical closure remains one of the most effective methods for this, although there is little difference between surgical treatment methods in terms of mortality.
PROCEEDINGS OF THE ASSOCIATION OF CLINICAL BIOCHEMISTS

Dr. B. A. Callingham (London University) discussed the Determination of Catecholamines in Biological Materials, considering mainly the assay of adrenaline, noradrenaline and dopamine. He gave a brief description of some of the more commonly used biological preparations, the rat blood pressure and rabbit aorta as screening tests for urine and Vogt's method for blood plasma, noting the limitations of these methods, particularly for the differential estimation of the catecholamines.