Miracle-dz/UniFAR-FTUs huggingface dataset:
Serum HPV16 E7 Oncoprotein Is a Recurrence Marker of Oropharyngeal Squamous Cell Carcinomas

Simple Summary Classical markers alone, such as HPV DNA, p16 and HPV mRNA expression, are not enough to stratify HPV-positive head and neck squamous cell carcinoma (HNSCC) patients, but when combined with serological markers, the latter are strong indicators of prognosis in oropharyngeal squamous cell carcinoma (OPSCC) patients. Specifically, HPV16 E7 oncoprotein in serum at the time of diagnosis, correlates with disease recurrence and patient overall survival. To our knowledge, this is the first study to investigate HPV E7 oncoprotein in patient serum. The E7 oncoprotein detection in serum at the time of diagnosis may be useful as a non-invasive procedure for HPV-positive OPSCC patient stratification and follow-up, helping to identify patients at risk for tumor recurrence and metastasis during follow-up, and ultimately, providing a tool for clinicians to identify patients for de-escalation treatment or those to be kept under close surveillance. Abstract Despite improved prognosis for many HPV-positive head and neck squamous cell carcinomas (HNSCCs), some cases are still marked by recurrence and metastasis. Our study aimed to identify novel biomarkers for patient stratification. Classical HPV markers: HPV-DNA, p16 and HPV mRNA expression were studied in HNSCC (n = 67) and controls (n = 58) by qPCR. Subsequently, ELISA tests were used for HPV16 L1 antibody and HPV16 E7 oncoprotein detection in serum at diagnosis and follow-up. All markers were correlated to relapse-free survival (RFS) and overall survival (OS). HPV-DNA was found in HNSCCs (29.85%), HPV16-DNA in 95% of cases, HPV16 E7 mRNA was revealed in 93.75%. p16 was overexpressed in 75% of HPV-positive HNSCC compared to negative samples and controls (p < 0.001). Classical markers correlated with improved OS (p < 0.05). Serological studies showed similar proportions of HPV16 L1 antibodies in all HNSCCs (p > 0.05). Serum E7 oncoprotein was present in 30% HPV-positive patients at diagnosis (p > 0.05) and correlated to HNSCC HPV16 E7 mRNA (p < 0.01), whereas it was associated to worse RFS and OS, especially for oropharyngeal squamous cell carcinoma (OPSCC) (p < 0.01). Detection of circulating HPV16 E7 oncoprotein at diagnosis may be useful for stratifying and monitoring HPV-positive HNSCC patients for worse prognosis, providing clinicians a tool for selecting patients for treatment de-escalation.
REPRODUCIBILITY OF S2-ALAR ILIAC SCREW MORPHOMETRIC ANALYSIS

ABSTRACT Objective: To evaluate the reproducibility of a S2-alar iliac (S2AI) screw parameters measurement method by inter and intraobserver reliability. Methods: Cross-sectional study, considering computed tomography exams. Morphometric analysis was performed by multiplanar reconstructions. Screw length, diameter and trajectory angles were the studied variables. To analyze the measurements reproducibility, intraclass correlation coefficient (ICC) was used. Results: Interobserver reliability was classified as strong for screw shortest length (ICC: 0.742) and diameter (ICC: 0.699). Interobserver reliability was classified as moderate for screw longest length (ICC: 0.553) and for screw trajectory angles in the axial plane for the longest (ICC: 0.478) and for the shortest lengths (ICC: 0.591). Intraobserver reliability was interpreted as excellent for screw shortest (ICC: 0.932) and longest lengths (ICC: 0.962) and diameter (ICC: 0.770) and screw trajectory angles in the axial plane for the screw longest (ICC: 0.773) and shortest lengths (ICC: 0.862). There were weak interobserver and strong intraobserver reliabilities for trajectory angle in sagittal plane, but no statistical significance was found. Conclusion: Inter and intraobserver reliability of S2AI screw morphometric parameters were interpreted from moderate to excellent in almost all studied variables, except for the screw trajectory angle in the sagittal plane measurement. Level of Evidence IV, Diagnostic Studies - Investigating a Diagnostic Test.
Human Radiosensitivity and Radiosusceptibility: What Are the Differences?

The individual response to ionizing radiation (IR) raises a number of medical, scientific, and societal issues. While the term “radiosensitivity” was used by the pioneers at the beginning of the 20st century to describe only the radiation-induced adverse tissue reactions related to cell death, a confusion emerged in the literature from the 1930s, as “radiosensitivity” was indifferently used to describe the toxic, cancerous, or aging effect of IR. In parallel, the predisposition to radiation-induced adverse tissue reactions (radiosensitivity), notably observed after radiotherapy appears to be caused by different mechanisms than those linked to predisposition to radiation-induced cancer (radiosusceptibility). This review aims to document these differences in order to better estimate the different radiation-induced risks. It reveals that there are very few syndromes associated with the loss of biological functions involved directly in DNA damage recognition and repair as their role is absolutely necessary for cell viability. By contrast, some cytoplasmic proteins whose functions are independent of genome surveillance may also act as phosphorylation substrates of the ATM protein to regulate the molecular response to IR. The role of the ATM protein may help classify the genetic syndromes associated with radiosensitivity and/or radiosusceptibility.
Study of clinical features of patients with COVID-19 hospitalized in an educational hospital in Iran

BACKGROUND: The outbreak of new pathogens or the resurgence of pathogens that have already spread is a serious challenge to public health. Coronavirus is a pathogen that seems to invade the human respiratory system in the first place. Coronaviruses form a large family and are so called because of the presence of crown like cristae on their surface. MATERIALS AND METHODS: This is a cross-sectional, descriptive study conducted to assess the status of patients with COVID-19 who were hospitalized in an educational hospital. For this purpose, 142 patients hospitalized in this hospital were followed up 2 weeks after discharge and were inquired about the symptoms they had upon admission to the hospital, the number of hospitalization days, the history of underlying disease, and so on. Descriptive data analysis was done with the SPSS software version 22. RESULTS: The findings of this research showed that overweight or obese people (about 66%) is more likely to contract the disease. It also seems that older people (37.3% older than 60 years old) and those with a history of diseases (69.6%) such as diabetes, high blood pressure, or heart disease are more prone to COVID-19. The most common symptoms of COVID-19 patients included fever (64.5%), shortness of breath (67.4%), and dry cough (50.4%). CONCLUSION: it seems that high risk group (obese people, old people, and people with a history of disease) is more likely to be infect with coronavirus so they should more careful than others. Another important issue is that policy-makers must play an active role in public awareness of dangers of COVID-19 and ways to prevent it.
Learning with lockdown: Utility of whatsApp status-based multiple-choice question discussion on COVID-19 among medical students and teaching faculty

BACKGROUND: Following the COVID-19 pandemic, the Government of India announced lockdown from March 25, 2020, which included measures such as social distancing, canceling mass gatherings, and closure of schools and colleges. Since the present generation of students spends a lot of time on social media, especially WhatsApp, the utility of the same to discuss the various public health domains of COVID-19 through multiple-choice questions (MCQs) was explored. MATERIALS AND METHODS: This longitudinal study was conducted among 154 participants (undergraduates, interns, postgraduates, and teaching faculty) for 3 months. MCQs on COVID-19 were disseminated through WhatsApp status of the investigator, and feedback regarding the same was taken at the end of 3 months. The activity log was maintained, and the information was downloaded as a comma-separated value (CSV) file and exported to MS Excel. Descriptive statistics were applied. The location of the participants was entered into the Microsoft Excel sheet and converted into CSV file. The Geographical data were analyzed in the Quantum Geographical information System (QGIS). RESULTS: Among the 154 study participants, 48% were undergraduates, 10.4% were interns, 30.6% were postgraduates, and 11% were teaching faculty. Eighty-nine percent of the participants felt that WhatsApp can be used as a platform for discussing MCQs. 89%, 93%, and 89.6% of the participants felt that the exercise improved their analytical skills, helped in self-directed learning, and improved collaborative learning, respectively. CONCLUSIONS: Majority of the participants responded that WhatsApp can be used as a platform to discuss MCQs and that the exercise helped in collaborative and self-directed learning.
Predictors of cognitive emotion regulation strategies: Iranian nurses

BACKGROUND: Nurses have a challenging job and encounter more stressful situations. In response to these situations, they demonstrate adaptive or maladaptive cognitive emotion regulation strategies (CERS). As there is a lack of literature regarding the factors predicting the selection of CERS, the present study aimed to investigate the role of age, sex, marital status, working experience, type of ward, and education level in predicting these strategies in Iranian nurses. MATERIALS AND METHODS: A descriptive correlational study was conducted to examine predictive factors’ emotion regulation strategies used by 193 nurses who worked at six hospitals under the supervision of Qazvin University of Medical Sciences in 2018. The study population were selected by stratified random sampling method. Data were collected by two questionnaires, one demographic questionnaire and the other was Cognitive Emotion Regulation Questionnaire conducted by Garnefski (α = 0.8). Data analysis was performed using correlation and multiple linear regression. RESULTS: The results showed that there is a significant relationship between the “type of ward” and “age” with adaptive and maladaptive strategies. In the multiple linear regression model, two variables of age (P = 0.03) and type of ward (P = 0.04) were able to predict 23% of variance CERS. CONCLUSIONS: Based on the results of this study, health-care providers and hospital managers should pay attention to factors related to adaptive and maladaptive CERS.
Profile and antibiotic-resistance pattern of bacteria isolated from endotracheal secretions of mechanically ventilated patients at a tertiary care hospital

BACKGROUND: Critically ill patients on mechanical-ventilation are always at a higher risk of acquiring ventilator-associated respiratory infections. The current study was intended to determine the antibiotic-resistance pattern of bacteria recovered from the endotracheal (ET) specimens of ventilated patients. MATERIALS AND METHODS: This was a single-centered, retrospective study carried out in a 400-bed tertiary care hospital in Oman. The data of profile and antibiotic resistance pattern of bacterial isolates recovered from ET aspirates of ventilated patients during the period from January 2017 to August 2019 were retrieved from hospital database. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 22 (IBM, Armonk, New York, USA). Descriptive statistics were applied to find the frequencies and percentages. Charts and tables were constructed. RESULTS: In total, 201 bacterial isolates recovered from ET secretions of 154 ventilated patients were studied. The rate of isolation was predominant among males (65.6%) and in elderly people (50%). Gram-negative bacilli (GNB) were predominantly (88.6%) isolated. Acinetobacter baumannii (31.3%) was the most common isolate and 86% of them were multidrug-resistant strains. Klebsiella pneumoniae (23.9%) and Pseudomonas aeruginosa (22.9%) were the other common GNB, whereas Staphylococcus aureus was the most frequently isolated Gram-positive bacteria. Gentamicin showed good in vitro activity against S. aureus and all the GNB except A. baumannii reflecting good choice for empirical therapy. CONCLUSION: Gram-negative bacteria were the predominant isolates in ET secretions of ventilated patients. There was an alarmingly high rate of antimicrobial resistance among GNB. A rational use of antibiotics, regular monitoring of antibiotic resistance and use of right combination of drugs, in addition to refining of existing infection control practices are critical to control the emergence of drug-resistant strains.
Post-Discharge Complications of Dental Treatment in General Anesthesia Performed in a Day-Care Service

Objective To review the frequency and management of post-discharge complications in patients who underwent dental treatment in general anesthesia (GA) in a day-care surgery setting and identify the factors that increase the risk for these complications. Material and methods Anonymous questionnaire was sent to parents/caregivers of patients who underwent full mouth restoration in GA at our institution between 1st January 2017 and 31st July 2019. Demographic and clinical data of patients as well as the data about the occurrence and management of complications were collected. Results Sixty-six parents/caregivers (30.5%) responded to the questionnaire. Most frequent complications were drowsiness and pain in 40(60.6%) patients. Complications were managed by parents or caregivers with conservative measures at home in 57(91.9%) cases. Phone consultation with dentist was required in 5(8.1%) cases. One patient (1.6%) was readmitted. Younger age and diagnosis were associated with increased risk for drowsiness. Conclusion Post discharge complications of dental treatment in GA in a day-care service are common and they can be managed by parent/caregiver with conservative measures at home. The rate of readmission is low. Dental treatment in GA in a day-care service is a safe procedure that can be performed with acceptable risk in carefully selected patients.
Protective Effect of Autologous Arteriovenous Fistulae Against Oxidative Stress in Hemodialyzed Patients

Introduction: Oxidative stress (OS) is ubiquitous in chronic kidney disease (CKD) and is exacerbated by hemodialysis (HD). OS is also associated with anemia, malnutrition, and cardiovascular (CV) disease and is an independent predictor of mortality and morbidity in patients undergoing HD. HD vascular access (VA) types are strongly correlated with CKD patient outcomes. Prolonged use of central venous catheters (CVC) for HD and arteriovenous grafts (AVG) promotes inflammation and OS. However, the effects of the VA type on OS have been poorly studied in HD patients. This study investigated OS prevalence in an HD population to determine the relationship between the VA type and HD. Methods: The oxidative stress index (OSI) was used to assess the HD patients’ OS status. OSI summarizes information derived from the reactive oxygen metabolites (d-ROMs) fast test and the plasma antioxidant test (PAT) in a single value, using the hydrogen peroxide concentration (for d-ROMs) and ascorbic acid (for PAT) as reference standards. The OSI was created to indicate how far the OS status deviates from normal (i.e., fully compensated oxidative balance). An index increase may be from an increase or decrease in peroxide or antioxidant concentrations. Patients undergoing chronic HD were evaluated by dividing the cases according to the OSI status: normal (N-OSI), borderline (BL-OSI), high (H-OSI), and very high (VH-OSI). Patients with clinical evidence of active infections were excluded. Results: In total, 129 patients were included; 86.8% used high-flux dialyzers, 13.2% used hemodiafiltration (HDF), and 24.5% were diabetic. An altered OSI was observed in 86 of 129 patients (66.7%). An increased OSI correlated with a significant increase in d-ROMs (r = 0.420) and PAT (r = 0.710). There were no differences between sex, diabetes status, age, dialysis vintage, or dialysis modalities. d-ROMs were inversely correlated with hemoglobin levels (r = −0.209). The iron dose by month correlated with the OSI (r = 0.189) and was significantly lower in the N-OSI group. N- and BL-OSI patients had a significantly higher rate of autologous arteriovenous fistula (AVF) compared to the other groups, and VH-OSI patients had a higher rate of permanent tunneled CVC. Conclusion: Most HD patients had more OS, indicated by the OSI scores. In chronic HD patients, AVF had a protective effect against imbalanced peroxidation-antioxidation.
Detection of coronavirus-2 by real-time reverse transcription polymerase chain reaction in conjunctival swabs from patients with severe form of Coronavirus disease 2019 in São Paulo, Brazil

OBJECTIVES: To test conjunctival swabs from patients with laboratory-confirmed severe forms of coronavirus disease 2019 (COVID-19) for the presence of SARS-CoV-2 on real-time reverse-transcription polymerase chain reaction (rRT-PCR). METHODS: Fifty conjunctival swabs were collected from 50 in-patients with laboratory-confirmed severe forms of COVID-19 at the largest teaching hospital and referral center in Brazil (HCFMUSP, São Paulo, SP). The samples were tested for SARS-CoV-2 on rRT-PCR with the primers and probes described in the CDC protocol which amplify the region of the nucleocapsid N gene (2019_nCoV_N1 and 2019_nCoV_N2) of SARS-CoV-2 RNA and compared with naso/oropharyngeal swabs collected within 24 hours of the conjunctival swabs. RESULTS: Five conjunctival samples (10%) tested positive (amplification of the N1 and N2 primer/probe sets) while two conjunctival samples (4%) yielded inconclusive results (amplification of the N1 primer/probe set only). The naso/oropharyngeal swabs were positive for SARS-CoV-2 on rRT-PCR in 34 patients (68%), negative in 14 (28%) and inconclusive in 2 (4%). The 5 patients with positive conjunctival swabs had positive (n=2), negative (n=2) or inconclusive (n=1) naso/oropharyngeal swabs on rRT-PCR. Patients with negative or inconclusive naso/oropharyngeal swabs had the diagnosis of COVID-19 confirmed by previous positive rRT-PCR results or by serology. CONCLUSION: This is the first study to present conjunctival swab rRT-PCR results for SARS-CoV-2 in a Brazilian population. In our sample of 50 patients with severe forms of COVID-19, 10% had positive conjunctival swabs, most of which were correlated with positive naso/oropharyngeal rRT-PCR results.
Age-standardized mortality rate and predictors of mortality among COVID-19 patients in Iran

BACKGROUND: To have a thorough understanding of epidemic surveillance, it is essential to broaden our knowledge of death tolls worldwide. This study aimed to determine the age-standardized mortality rate (ASMR) and predictors of mortality among coronavirus disease 2019 (COVID-19) patients. MATERIALS AND METHODS: In this cross-sectional design, all COVID-19 patients with a positive polymerase chain reaction test in the population covered by Arak University of Medical Sciences (AUMS) were entered to the study. Data collection was conducted by phone interview. The study variables comprised age, sex, coronary heart diseases, diabetes, and some symptoms at admission. The adjusted odds ratio (OR) and 95% confidence intervals (CIs) were obtained by logistic regression. The direct method was applied to calculate ASMR (per 100,000) of COVID-19. The analysis was applied by STATA software 12.0. RESULTS: A total of 208 cases of COVID-19 (out of 3050 total infected cases) were dead and 2500 cases were recovered. The mean age of dead patients was 70 years. The COVID-19 fatality rate in the population equaled 6.8%; in those patients who were 70 years old or more, however, the case fatality rate was 16.4%. The ASMR of COVID-19 was 12.9 (CI 95%: 11.2, 14.8). The odds of COVID-19-related death in the age over 60 were 10.87 (CI 95%: 6.30, 18.75) times than lower 45 years old. Moreover, it was observed that COVID-19 significantly increased the odds of COVID-19-related death in diabetes patients (OR = 1.45, CI 95%: 1.02, 2.06, P = 0.036). CONCLUSION: The ASMR of COVID-19 was relatively higher in males than females. In general, the COVID-19 fatality rate was relatively high. We found that older age and diabetes can have impact on the death of COVID-19, but the headache was found to have a negative association with the COVID-19-related death.
Fibroblast Activation Protein Expressing Mesenchymal Cells Promote Glioblastoma Angiogenesis

Simple Summary The perivascular niche in glioblastoma is crucial for maintaining a tumour- permissive microenvironment. In various extracranial cancers, mesenchymal cells that express fibroblast activation protein (FAP) are an important stromal component and a potential therapeutic target. In this study, we examine their functions in the glioblastoma microenvironment where their role is so far largely unexplored. Glioblastoma-associated FAP+ mesenchymal cells are localised around activated endothelial cells and their presence positively correlates with vascular density. They represent a subpopulation of stromal, non-tumorigenic cells which mostly lack the chromosomal aberrations characteristic of glioma cells. By soluble factors they induce angiogenic sprouting, chemotaxis of endothelial cells, contribute to destabilisation of blood vessels, and increase the migration and growth of glioma cells. Taken together, we identified a subpopulation of FAP+ mesenchymal cells in the perivascular niche in glioblastoma that may contribute to tumour progression by promoting angiogenesis and supporting dissemination of transformed cells into the surrounding tissue. Abstract Fibroblast activation protein (FAP) is a membrane-bound protease that is upregulated in a wide range of tumours and viewed as a marker of tumour-promoting stroma. Previously, we demonstrated increased FAP expression in glioblastomas and described its localisation in cancer and stromal cells. In this study, we show that FAP+ stromal cells are mostly localised in the vicinity of activated CD105+ endothelial cells and their quantity positively correlates with glioblastoma vascularisation. FAP+ mesenchymal cells derived from human glioblastomas are non-tumorigenic and mostly lack the cytogenetic aberrations characteristic of glioblastomas. Conditioned media from these cells induce angiogenic sprouting and chemotaxis of endothelial cells and promote migration and growth of glioma cells. In a chorioallantoic membrane assay, co-application of FAP+ mesenchymal cells with glioma cells was associated with enhanced abnormal angiogenesis, as evidenced by an increased number of erythrocytes in vessel-like structures and higher occurrence of haemorrhages. FAP+ mesenchymal cells express proangiogenic factors, but in comparison to normal pericytes exhibit decreased levels of antiangiogenic molecules and an increased Angiopoietin 2/1 ratio. Our results show that FAP+ mesenchymal cells promote angiogenesis and glioma cell migration and growth by paracrine communication and in this manner, they may thus contribute to glioblastoma progression.