Miracle-dz/UniFAR-FTUs huggingface dataset:
Concurrent Dexamethasone Limits the Clinical Benefit of Immune Checkpoint Blockade in Glioblastoma

Purpose: Dexamethasone, a uniquely potent corticosteroid, is frequently administered to patients with brain tumors to decrease tumor-associated edema, but limited data exist describing how dexamethasone affects the immune system systemically and intratumorally in patients with glioblastoma (GBM), particularly in the context of immunotherapy. Experimental Design: We evaluated the dose-dependent effects of dexamethasone when administered with programmed cell death 1 (PD-1) blockade and/or radiotherapy in immunocompetent C57BL/6 mice with syngeneic GL261 and CT-2A GBM tumors. Clinically, the effect of dexamethasone on survival was evaluated in 181 patients with isocitrate dehydrogenase (IDH) wild-type GBM treated with PD-(L)1 blockade, with adjustment for relevant prognostic factors. Results: Despite the inherent responsiveness of GL261 to immune checkpoint blockade, concurrent dexamethasone administration with anti–PD-1 therapy reduced survival in a dose-dependent manner. Concurrent dexamethasone also abrogated survival following anti–PD-1 therapy with or without radiotherapy in immune-resistant CT-2A models. Dexamethasone decreased T-lymphocyte numbers by increasing apoptosis, in addition to decreasing lymphocyte functional capacity. Myeloid and natural killer cell populations were also generally reduced by dexamethasone. Thus, dexamethasone appears to negatively affect both adaptive and innate immune responses. As a clinical correlate, a retrospective analysis of 181 consecutive patients with IDH wild-type GBM treated with PD-(L)1 blockade revealed poorer survival among those on baseline dexamethasone. Upon multivariable adjustment with relevant prognostic factors, baseline dexamethasone administration was the strongest predictor of poor survival [reference, no dexamethasone; <2 mg HR, 2.16; 95% confidence interval (CI), 1.30–3.68; P = 0.003 and ≥2 mg HR, 1.97; 95% CI, 1.23–3.16; P = 0.005]. Conclusions: Our preclinical and clinical data indicate that concurrent dexamethasone therapy may be detrimental to immunotherapeutic approaches for patients with GBM.
Precision Approaches in the Management of Colorectal Cancer: Current Evidence and Latest Advancements towards Individualizing the Treatment

Simple Summary Metastatic colorectal cancer (mCRC) represents a significant burden in cancer-related morbidity and mortality. The study of mCRC-related genetic alterations and the molecular landscape of the disease has been ongoing and continues to improve the efficacy of the available treatment options. Here, we review various molecular pathways that are involved in colorectal carcinogenesis with driving mutations that could be targeted for precision approaches in the treatment of mCRC. We summarize groundbreaking clinical trials that are shaping the evolving role of precision approaches in the practice guidelines and discuss the latest advancements in emerging new modalities, novel technologies, and future directions toward individualizing the managemet approaches to the treatment of colorectal cancer. Abstract The genetic and molecular underpinnings of metastatic colorectal cancer have been studied for decades, and the applicability of these findings in clinical decision making continues to evolve. Advancements in translating molecular studies have provided a basis for tailoring chemotherapeutic regimens in metastatic colorectal cancer (mCRC) treatment, which have informed multiple practice guidelines. Various genetic and molecular pathways have been identified as clinically significant in the pathogenesis of metastatic colorectal cancer. These include rat sarcoma (RAS), epithelial growth factor receptor (EGFR), vascular endothelial growth factor VEGF, microsatellite instability, mismatch repair, and v-raf murine sarcoma viral oncogene homolog b1 (BRAF) with established clinical implications. RAS mutations and deficiencies in the mismatch repair pathway guide decisions regarding the administration of anti-EGFR-based therapies and immunotherapy, respectively. Furthermore, there are several emerging pathways and therapeutic modalities that have not entered mainstream use in mCRC treatment and are ripe for further investigation. The well-established data in the arena of targeted therapies provide evidence-based support for the use or avoidance of various therapeutic regimens in mCRC treatment, while the emerging pathways and platforms offer a glimpse into the future of transforming a precision approach into a personalized treatment.
Mental health first aid by Australian tertiary staff: Application rates, modes, content, and outcomes

Mental health problems are a growing challenge in tertiary institutions warranting psycho‐educational intervention programmes such as mental health first aid (MHFA) that provide training to identify and support affected individuals. The present study assesses the impact of MHFA interventions on tertiary students and staff. Specifically, we examine (1) MHFA application rates and the types of mental health issues encountered, (2) how MHFA was provided, (3) application of the MHFA action plan, and (4) perceived outcomes of MHFA.
The Anatomy of the Frontal Process of the Maxilla in the Medial Wall of the Lacrimal Drainage System in East Asians

Purpose: To investigate the anatomical structure characteristics of the frontal process of the maxilla in the medial wall of the lacrimal drainage system for endoscopic dacryocystorhinostomy based on the cone-beam computed tomography images. Methods: One hundred eight sides of orbits were retrospectively evaluated in this study. The angulation and thickness of the frontal process of the maxilla in the medial wall of the lacrimal drainage system were measured and compared at 2 different levels: lacrimal sac level and nasolacrimal duct level. The vertical height between the 2 measurement levels was also measured. Data were compared between males and females. Results: The average angulation and thickness of the frontal process of the maxilla were found significantly larger at the lacrimal sac level than at the nasolacrimal duct level (83.1 ± 11.3° vs. 61.7 ± 10.9° and 2.7 ± 0.9 mm vs. 1.1 ± 0.4 mm) (p < 0.001). The vertical height between the 2 levels was significantly higher in males than in females (8.6 ± 1.8 mm vs. 7.8 ± 1.7 mm) (p = 0.015). Conclusions: We found the angulation and thickness of the frontal process of the maxilla in the medial wall of the lacrimal drainage system decreased from the upper to the lower level. Starting the osteotomy during endoscopic dacryocystorhinostomy might be easier and safer at the midpoint level of the maxillary line. Starting osteotomy in endoscopic dacryocystorhinostomy at the midpoint level of the maxillary line is easier as the frontal process of the maxilla at this level is angled more towards the coronal plane and thinner.
Automated Diagnosis of Various Gastrointestinal Lesions Using a Deep Learning–Based Classification and Retrieval Framework With a Large Endoscopic Database: Model Development and Validation

Background The early diagnosis of various gastrointestinal diseases can lead to effective treatment and reduce the risk of many life-threatening conditions. Unfortunately, various small gastrointestinal lesions are undetectable during early-stage examination by medical experts. In previous studies, various deep learning–based computer-aided diagnosis tools have been used to make a significant contribution to the effective diagnosis and treatment of gastrointestinal diseases. However, most of these methods were designed to detect a limited number of gastrointestinal diseases, such as polyps, tumors, or cancers, in a specific part of the human gastrointestinal tract. Objective This study aimed to develop a comprehensive computer-aided diagnosis tool to assist medical experts in diagnosing various types of gastrointestinal diseases. Methods Our proposed framework comprises a deep learning–based classification network followed by a retrieval method. In the first step, the classification network predicts the disease type for the current medical condition. Then, the retrieval part of the framework shows the relevant cases (endoscopic images) from the previous database. These past cases help the medical expert validate the current computer prediction subjectively, which ultimately results in better diagnosis and treatment. Results All the experiments were performed using 2 endoscopic data sets with a total of 52,471 frames and 37 different classes. The optimal performances obtained by our proposed method in accuracy, F1 score, mean average precision, and mean average recall were 96.19%, 96.99%, 98.18%, and 95.86%, respectively. The overall performance of our proposed diagnostic framework substantially outperformed state-of-the-art methods. Conclusions This study provides a comprehensive computer-aided diagnosis framework for identifying various types of gastrointestinal diseases. The results show the superiority of our proposed method over various other recent methods and illustrate its potential for clinical diagnosis and treatment. Our proposed network can be applicable to other classification domains in medical imaging, such as computed tomography scans, magnetic resonance imaging, and ultrasound sequences.
Sensitivity of polyphagous (Plodia interpunctella) and stenophagous (Ephestia kuehniella) storage moths to residual insecticides: effect of formulation and larval age

Pyralid moths, Ephestia kuehniella and Plodia interpunctella, are prevalent stored product pests. The insecticides are the main tool to control these moths in the stores. The data describing the response of these moths to insecticides are scarce. The lethal effect of the organophosphate, pyrethroid, and halogenated‐pyrrole on moths larvae were compared in laboratory test. The hypothesis was that the very polyphagous P. interpunctella would have generally higher insecticide tolerance than that of the stenophagous E. kuehniella. Different insecticide concentrations were applied onto the inner surface of glass tube vials. Ten larvae of 14 or 21 d old of E. kuehniella and 7 or 14 d old of P. interpunctella were used by treatment. The larval mortality was checked after 24 h of exposure. The mortality was significantly influenced by age of larvae and the groups of chemicals. No differences among the efficacies of the tested formulations with identical active compounds were found, except significant different mortality of E. kuehniella on deltamethrin formulations. A comparison of analytical standards showed that P. interpunctella was less susceptible to the active ingredient pirimiphos‐methyl than E. kuehniella, while E. kuehniella was less susceptible to deltamethrin than P. interpunctella. No differences between the two species were observed for chlorfenapyr. We therefore rejected the hypothesis that polyphagy/stenophagy can be a general predictor of insecticide tolerance in the two tested storage moths. The most important finding for effective use was that the young larvae of both species were more susceptible to tested insecticides than older larvae.
Preliminary observations regarding the expectations, acceptability and satisfaction of whole body MRI in self- referring asymptomatic subjects.

OBJECTIVE To evaluate the satisfaction of asymptomatic subjects who self- referring Whole-Body Magnetic Resonance Imaging (WB-MRI) for early cancer diagnosis. METHODS Subjects completed a pre- examination questionnaire, while waiting for WB-MRI examination, recording demographics, expected discomfort, perceived knowledge and usefulness of the procedure and health risk perceptions, as well as a post-examination questionnaire, measuring discomfort experienced, acceptability and satisfaction with WB-MRI. We examined which factors influenced discomfort and satisfaction associated with WB-MRI. RESULTS 65 asymptomatic subjects (median age 51; 29 females) completed the questionnaire. Before WB-MRI, 29% of subjects expected discomfort of some form with claustrophobia (27.7%) and exam duration (24.6%) being the most common concerns. Experienced discomfort due to shortness of breath was significantly lower than expected. This difference was significantly associated with the personal risk perception to get a disease (p = 0.01) and educational level (p = 0.002). More specifically, higher level of perceived personal risk of getting a disease and lower level of education were associated with higher expected than experienced discomfort. Similarly, experiencing less claustrophobia than expected was significantly associated with gender (p = 0.005) and more pronounced amongst females. A majority (83%) of subjects expressed high levels of satisfaction with WB-MRI for early cancer diagnosis and judged it more acceptable than other diagnostic exams. CONCLUSIONS Asymptomatic subjects self-referring to WB-MRI for early cancer diagnosis showed high levels of satisfaction and acceptability with the examination. Nevertheless, a relevant proportion of participants reported some form of discomfort. Interestingly, participants with higher perceived personal risk to get a disease, lower education and females showed to expect higher discomfort than experienced. ADVANCES IN KNOWLEDGE Scope exists for measures to assess expected feelings and develop personalized interventions to reduce the stress anticipated by individuals deciding to undergo WB-MRI for early cancer diagnosis.
Probing the drug delivery strategies in ischemic stroke therapy

Abstract Ischemic stroke, which is caused by a sudden clot in the blood vessels, may cause severe brain tissue damage and has become a leading cause of death globally. Currently, thrombolysis is the gold standard primary treatment of ischemic stroke in clinics. However, the short therapeutic window of opportunity limits thrombolysis utility. Secondary cerebral damage caused by stroke is also an urgent problem. In this review, we discuss the present methods of treating ischemic stroke in clinics and their limitations. Various new drug delivery strategies targeting ischemic stroke lesions have also been summarized, including pharmaceutical methods, diagnostic approaches and other routes. These strategies could change the pharmacokinetic behavior, improve targeted delivery or minimize side effects. A better understanding of the novel approaches utilized to facilitate drug delivery in ischemic stroke would improve outcomes.
Improving sleep disturbances in obesity by nutritional strategies: review of current evidence and practical guide

Abstract Over the past decades, there has been an increase in overweight and obesity worldwide rates in both in adult and children. In parallel, it has been reported a worsening of sleep duration and quality. Some studies have shown an association between obesity and sleep disturbances (SD) vice versa, subjects with obesity have a greater risk of SD. As well as SD influences diet, also food choices have been shown to influence various sleep-related variables, such as duration and quality. For this reason, nutrition could represent an important tool not only to lose weight but also to improve sleep in patients with obesity and sleep disturbances. Thus, the aim of this review is to provide an overview of the studies that assessed the association between obesity and SD and vice versa, highlighting possible nutritional advices as a tool to improve sleep in patients with obesity and sleep disturbances.
Cytotoxic activity of butanolic extract from Sambucus nigra L. flowers in natura and vehiculated in micelles in bladder cancer cells and fibroblasts

Abstract Bladder cancer has a high incidence and recurrence rate among patients worldwide. This study aimed to evaluate the cytotoxic activity of fractions of Sambucus nigra L. flower extracts on bladder carcinoma cells (T24 cells) and human fibroblast cells (MRC-5). The butanolic fraction (F-BuOH) was characterized by UPLC-DAD-MS/MS and nine flavonoids were identified. Rutin was the major compound. The cytotoxic activity of this fraction was observed in the T24 cells but not in MRC-5 cells, indicating selectivity. F-BuOH was incorporated in micellar solutions of Pluronic® F127 and cytotoxic effect for T24 cells was observed again. In vitro assay demonstrated a controlled release of the fraction from the micelles. The results obtained showed that flavonoids are the possible responsible for cytotoxic activity in bladder carcinoma cells. In addition, micellar solutions act together to increase the action of the butanolic fraction. Graphical Abstract
Clostridioides difficile infection and antibiotic prescription rates in the community: Explaining the gender gap

Abstract In this cross-sectional population-based study, women had significantly higher crude incidence rates of both community-associated Clostridioides difficile infection (CA-CDI) and ambulatory antibiotic prescriptions compared to men in South Carolina in 2015. After adjustments for antibiotic prescription rates, there was no difference in the incidence rates of CA-CDI between the genders.
Large-Scale and Localized Laser Crystallization of Optically Thick Amorphous Silicon Films by Near-IR Femtosecond Pulses

Amorphous silicon (α-Si) film present an inexpensive and promising material for optoelectronic and nanophotonic applications. Its basic optical and optoelectronic properties are known to be improved via phase transition from amorphous to polycrystalline phase. Infrared femtosecond laser radiation can be considered to be a promising nondestructive and facile way to drive uniform in-depth and lateral crystallization of α-Si films that are typically opaque in UV-visible spectral range. However, so far only a few studies reported on use of near-IR radiation for laser-induced crystallization of α-Si providing less information regarding optical properties of the resultant polycrystalline Si films demonstrating rather high surface roughness. The present work demonstrates efficient and gentle single-pass crystallization of α-Si films induced by their direct irradiation with near-IR femtosecond laser pulses coming at sub-MHz repetition rate. Comprehensive analysis of morphology and composition of laser-annealed films by atomic-force microscopy, optical, micro-Raman and energy-dispersive X-ray spectroscopy, as well as numerical modeling of optical spectra, confirmed efficient crystallization of α-Si and high-quality of the obtained films. Moreover, we highlight localized laser-induced crystallization of α-Si as a promising way for optical information encryption, anti-counterfeiting and fabrication of micro-optical elements.
Splenectomy in Jamaican children with sickle cell disease: Outcome of selective blood transfusion

We reviewed the post-operative morbidity and mortality of open splenectomy undertaken in conjunction with selective blood transfusion in Jamaican children with sickle cell disease. Data were collected on 150 splenectomies performed between November 1994 and October 2017. Selective blood transfusion involved raising haemoglobin levels to approximately 100 g/L in patients with admission haemoglobin ≥10 g/L below steady state. There was no mortality. Mean post-operative stay was 3.2 days with a median of three days. Total morbidity was 19/150 cases (12.7%), with acute chest syndrome accounting for 11/19 (57.9%). Among the non-transfused, acute chest syndrome occurred in 10/117 cases (8.5%), while among transfused, acute chest syndrome occurred in 1/33 cases (2.9%). We recommend this selective blood transfusion protocol for patients with sickle cell disease to surgeons who undertake splenectomies in settings where blood bank reserves are perennially low.
Effect of Acetaminophen (APAP) on Physiological Indicators in Lactuca sativa

This study analyzes the effects of acetaminophen (APAP) as a contaminant on physiological characteristics of lettuce plants (Lactuca sativa L.). Experiments were provided in an experimental greenhouse with semi-controlled conditions. The effect of different amounts of contaminant was evaluated by using regression analysis. Plants were grown in five concentrations of APAP: 0 µM, 5 µM, 50 µM, 500 µM, and 5 mM for 14 days in two variants, acute and chronic. The obtained results show that the monitored parameters were demonstrably influenced by the experimental variant. Plants are more sensitive to chronic contamination compared to acute. Significant (p < 0.05) deviation in photosynthesis and fluorescence was observed compared to the control in different variants. The highest doses of APAP reduced the intensity of photosynthesis by a maximum of more than 31% compared to the control. A reduction of 18% was observed for the fluorescence parameters. Pronounced correlation was described between chlorophyll fluorescence parameters and yield mainly under APAP conditions. The amount of chlorophyll was influenced by exposure to APAP.
Clinicians, cooks, and cashiers: Examining health equity and the COVID-19 risks to essential workers

In Spring/Summer 2020, most individuals living in the United States experienced several months of social distancing and stay-at-home orders because of the coronavirus (COVID-19) pandemic. Clinicians, restaurant cooks, cashiers, transit operators, and other essential workers (EWs), however, continued to work outside the home during this time in order to keep others alive and maintain a functioning society. In the United States, EWs are often low-income persons of color who are more likely to face socioeconomic vulnerabilities, systemic racism, and health inequities. To assess the various impacts of COVID-19 on EWs, an online survey was distributed to a representative sample of individuals residing in six states during May/June 2020. The sample included 990 individuals who identified as EWs and 736 nonessential workers (NWs). We assessed differences between EW and NW respondents according to three categories related to health equity and social determinants of health: (1) demographics (e.g. race/ethnicity); (2) COVID-19 exposure risk pathways (e.g. ability to social distance); and (3) COVID-19 risk perceptions (e.g. perceived risk of contracting COVID-19). EWs were more likely to be Black or Hispanic than NWs and also had lower incomes and education levels on average. Unsurprisingly, EWs were substantially more likely to report working outside the home and less likely to report social distancing and wearing masks indoors as compared to NWs. EWs also perceived a slightly greater risk of contracting COVID-19. These findings, which we discuss in the context of persistent structural inequalities, systemic racism, and health inequities within the United States, highlight ways in which COVID-19 exacerbates existing socioeconomic vulnerabilities faced by EWs.