Miracle-dz/UniFAR-FTUs huggingface dataset:
Treatment of Proximal Femoral Fragility Fractures in Patients with COVID-19 During the SARS-CoV-2 Outbreak in Northern Italy

Background: From February 20 to April 2020, the coronavirus SARS (severe acute respiratory syndrome)-CoV-2 spread in northern Italy, drastically challenging the care capacities of the national health care system. Unprepared for this emergency, hospitals have quickly reformulated paths of assistance in an effort to guarantee treatment for infected patients. Orthopaedic departments have been focused on elderly traumatology, especially the treatment of femoral neck fractures in patients with coronavirus disease-2019 (COVID-19). The purpose of the present study was to evaluate the orthopaedic management strategy for femoral fragility fractures in COVID-19-positive patients with the hypothesis that operative treatment may contribute to the overall stability of the patient. Methods: Sixteen patients affected by proximal femoral fracture and a recent history of fever, shortness of breath, and desaturation were admitted to the emergency room. Thoracic computed tomography (CT) and oropharyngeal swabs confirmed that they were positive for COVID-19, requiring hospitalization and prophylaxis with low-molecular-weight heparin. Results: Three patients died before surgery because of severe respiratory insufficiency and multiple-organ-failure syndrome. Ten patients underwent surgery on the day after admission, whereas 3 patients had suspended their use of direct thrombin inhibitors and needed surgery to be delayed until the third day after admission. In all patients except 1, we noted an improvement in terms of O2 saturation and assisted respiration. In 9 patients, hemodynamic and respiratory stability was observed at an average of 7 days postoperatively. Four patients who underwent surgical treatment died of respiratory failure on the first day after surgery (1 patient), the third day after surgery (2 patients), or the seventh day after surgery (1 patient). Conclusions: We noted a stabilization of respiratory parameters in 12 COVID-19-positive patients who underwent surgery treatment of proximal femoral fractures. We believe that in elderly patients with COVID-19 who have proximal femoral fractures, surgery may contribute to the overall stability of the patient, seated mobilization, improvement in physiological ventilation, and general patient comfort in bed. Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Efficient and flexible representation of higher-dimensional cognitive variables with grid cells

We shed light on the potential of entorhinal grid cells to efficiently encode variables of dimension greater than two, while remaining faithful to empirical data on their low-dimensional structure. Our model constructs representations of high-dimensional inputs through a combination of low-dimensional random projections and “classical” low-dimensional hexagonal grid cell responses. Without reconfiguration of the recurrent circuit, the same system can flexibly encode multiple variables of different dimensions while maximizing the coding range (per dimension) by automatically trading-off dimension with an exponentially large coding range. It achieves high efficiency and flexibility by combining two powerful concepts, modularity and mixed selectivity, in what we call “mixed modular coding”. In contrast to previously proposed schemes, the model does not require the formation of higher-dimensional grid responses, a cell-inefficient and rigid mechanism. The firing fields observed in flying bats or climbing rats can be generated by neurons that combine activity from multiple grid modules, each representing higher-dimensional spaces according to our model. The idea expands our understanding of grid cells, suggesting that they could implement a general circuit that generates on-demand coding and memory states for variables in high-dimensional vector spaces.
Student generation and peer review of exam questions in the dental curriculum: enhancing student engagement and learning.

BACKGROUND Writing, sharing, answering, discussing and rating examination questions is a way to involve students in creating content and applying their knowledge. The PeerWise online question-setting platform facilitates student communities in this activity. This mixed-methods study asks the question: Does students' writing and answering examination questions enhance their engagement and learning of Neurology as a Life Science topic? METHODS Over a 2-year period, self-assembled groups of 3-4 students, submitted 1-2 multiple choice questions (MCQs) every 2 weeks into the PeerWise portal for review by their peers. Summative exam results were compared with previous year's control group. Data were also collected regarding student engagement (number of MCQs answered or submitted comments) are compared to summative assessment results at the end of semester. Post-intervention student satisfaction surveys were analysed qualitatively and quantitatively to assess the effectiveness of the exercise. RESULTS With 174 and 80 student participants in intervention and control groups, respectively, no statistical difference was found in the average marks between the cohorts. However, within intervention group, positive correlation (Spearman r = 0.272 - 0.333) was found between higher level of student engagement with PeerWise and higher exam result. Positive correlation remained persistent after completion of the PeerWise exercise. Student survey revealed greater engagement with subject content and qualitative thematic analysis was mapped to define various ways students engaged with the PeerWise activity. CONCLUSION Tasking students to regularly generate and review MCQs enhances engagement with the topic; and higher engagement with PeerWise correlating to higher exam scores.
Influence of Emission Sources and Tributaries on the Spatial and Temporal Patterns of Micropollutant Mixtures and Associated Effects in a Small River

Organic micropollutants of anthropogenic origin in river waters may impair aquatic ecosystem health and drinking water quality. To evaluate micropollutant fate and turnover on a catchment scale, information on input source characteristics as well as spatial and temporal variability is required. The influence of tributaries from agricultural and urban areas and the input of wastewater were investigated by grab and Lagrangian sampling under base flow conditions within a 7.7‐km‐long stretch of the Ammer River (southwest Germany) using target screening for 83 organic micropollutants and 4 in vitro bioassays with environmentally relevant modes of action. In total, 9 pesticides and transformation products, 13 pharmaceuticals, and 6 industrial and household chemicals were detected. Further, aryl hydrocarbon receptor induction, peroxisome proliferator–activated receptor activity, estrogenicity, and oxidative stress response were measured in the river. The vast majority of the compounds and mixture effects were introduced by the effluent of a wastewater‐treatment plant, which contributed 50% of the total flow rate of the river on the sampling day. The tributaries contributed little to the overall load of organic micropollutants and mixture effects because of their relatively low discharge but showed a different chemical and toxicological pattern from the Ammer River, though a comparison to effect‐based trigger values pointed toward unacceptable surface water quality in the main stem and in some of the tributaries. Chemical analysis and in vitro bioassays covered different windows of analyte properties but reflected the same picture. Environ Toxicol Chem 2020;39:1382–1391. © 2020 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.
A Silk Fibroin Based Hydration Accelerator for Root Canal Filling Materials

Mineral trioxide aggregate (MTA) is widely used in various dental endodontic applications such as root-end filling, furcal perforation repair, and vital pulp therapy. In spite of many attempts to improve handling properties and reduce the discoloration of MTA, the ideal root canal filling material has yet to be fully developed. The objective of this study was to investigate the setting time, mechanical properties, and biocompatibility of MTA set by a silk fibroin solution. A 5 wt% silk fibroin (SF) solution (a novel hydration accelerant) was used to set SavDen® MTA and ProRoot® white MTA (WMTA). Changes in setting time, diametral tensile strength (DTS), material crystallization, in vitro cell viability, and cell morphology were assessed by Vicat needle measurement, a universal testing machine, scanning electron microscopy (SEM), and WST-1 assay, respectively. The initial setting time of ProRoot® MTA and SavDen® MTA experienced a drastic decrease of 83.9% and 42.1% when deionized water was replaced by 5 wt% SF solution as the liquid phase. The DTS of SavDen® MTA showed a significant increase after set by the SF solution in 24 h. A human osteoblast-like cell (MG-63)-based WST-1 assay revealed that both ProRoot® MTA and SavDen® MTA hydrated using SF solution did not significantly differ (p > 0.05) in cell viability. MG-63 cells with pseudopodia attachments and nuclear protrusions represent a healthier and more adherent status on the surface of MTA when set with SF solution. The results suggest that the 5 wt% SF solution may be used as an alternative hydration accelerant for MTA in endodontic applications.
Demersal and epibenthic assemblages of trawlable grounds in the northern Alboran Sea (western Mediterranean)

The composition and abundance of megabenthic fauna caught by the commercial trawl fleet in the Alboran Sea were studied. A total of 28 hauls were carried out at depths ranging from 50 to 640 m. As a result of a hierarchical classification analysis four assemblages were detected: (1) the outer shelf group (50-150 m), characterised by Octopus vulgaris and Cepola macrophthalma ; (2) the upper slope group (151-350 m), characterised by Micromesistius poutassou , with Plesionika heterocarpus and Parapenaeus longirostris as secondary species; (3) the middle slope group (351-640 m), characterised by M. poutassou, Nephrops norvegicus and Caelorhincus caelorhincus , and (4) the small seamount Seco de los Olivos (310-360 m), characterised by M. poutassou, Helicolenus dactylopterus and Gadiculus argenteus , together with Chlorophthalmus agassizi, Stichopus regalis and Palinurus mauritanicus . The results also revealed significantly higher abundances in the Seco de los Olivos seamount, probably related to a higher food availability caused by strong localised currents and upwellings that enhanced primary production. Although depth proved to be the main structuring factor, others such as sediment type and food availability also appeared to be important. Differences between shelf and slope assemblages could be in part related to a greater dependence on benthic resources in the former and a higher use of planktonic resources in the latter.
Targeting mitochondrial oxidative stress with MitoQ reduces NET formation and kidney disease in lupus-prone MRL-lpr mice

Objectives Recent investigations in humans and mouse models with lupus have revealed evidence of mitochondrial dysfunction and production of mitochondrial reactive oxygen species (mROS) in T cells and neutrophils. This can provoke numerous cellular changes including oxidation of nucleic acids, proteins, lipids and even induction of cell death. We have previously observed that in T cells from patients with lupus, the increased mROS is capable of provoking oligomerisation of mitochondrial antiviral stimulator (MAVS) and production of type I interferon (IFN-I). mROS in SLE neutrophils also promotes the formation of neutrophil extracellular traps (NETs), which are increased in lupus and implicated in renal damage. As a result, in addition to traditional immunosuppression, more comprehensive treatments for lupus may also include non-immune therapy, such as antioxidants. Methods Lupus-prone MRL-lpr mice were treated from weaning for 11 weeks with the mitochondria-targeted antioxidant, MitoQ (200 µM) in drinking water. Mice were then assessed for ROS production in neutrophils, NET formation, MAVS oligomerisation, serum IFN-I, autoantibody production and renal function. Results MitoQ-treated mice manifested reduced neutrophil ROS and NET formation, decreased MAVS oligomerisation and serum IFN-I, and reduced immune complex formation in kidneys, despite no change in serum autoantibody . Conclusions These findings reveal the potential utility of targeting mROS in addition to traditional immunosuppressive therapy for lupus.
Predictive value of integrated 18F-FDG PET/MRI in the early response to nivolumab in patients with previously treated non-small cell lung cancer

Background The early response to treatment with immune-checkpoint inhibitors is difficult to evaluate. We determined whether changes in integrated [18F]-fluoro-2-deoxy-D-glucose positron emission tomography/MRI (18F-FDG PET/MRI) parameters after the first 2 weeks of antiprogrammed death-1 antibody nivolumab therapy could predict the response of patients with non-small cell lung cancer (NSCLC). Methods Twenty-five patients with previously treated NSCLC were enrolled prospectively and underwent 18F-FDG PET/MRI before and at 2 weeks after nivolumab therapy. Changes in maximal standardized uptake value, total lesion glycolysis (ΔTLG) and apparent diffusion coefficient (ΔADC) between the two scans were calculated and evaluated for their associations with the clinical response to therapy. Results The disease control rate was 64%. Patients with non-progressive disease (non-PD) had significantly decreased TLG, increased ADCmean (ie, negative ΔADCmean) and lower ΔTLG+ΔADCmean than patients with PD. Among the parameters tested, receiver operating characteristic curve analysis revealed that a cut-off value of 16.5 for ΔTLG+ΔADCmean had the highest accuracy (92%) for distinguishing between patients with non-PD and PD. A ΔTLG+ΔADCmean value <16.5 was significantly associated with longer median progression-free survival (9.0 vs 1.8 months, p<0.00001) and overall survival (23.6 vs 4.7 months, p=0.0001) compared with ΔTLG+ΔADCmean value ≥16.5. A multivariate Cox model revealed that ≥16.5 ΔTLG+ΔADCmean was an independent predictor of shorter progression-free survival (HR 37.7) and overall survival (HR 9.29). Conclusions A combination of ΔTLG and ΔADCmean measured by integrated 18F-FDG PET/MRI may have value as a predictor of the response and survival of patients with NSCLC following nivolumab therapy. Trial registration number UMIN 000020707.
Consumers’ awareness, attitude and associated factors towards self-medication in Hail, Saudi Arabia

Objectives To determine the factors motivating the consumers towards self-medication, the intended indications and the consumers’ perceptions about complications that may arise due to its use. Design Cross-sectional community based prospective study Place and duration of study Community pharmacies located at various locations of Hail, Saudi Arabia from January 2019 to March 2019. Methods The subjects of this cross-sectional study were people visiting community pharmacies for self-medication. Data on 663 participants was collected through a validated questionnaire prepared on the basis of WHO guidelines for the regulatory assessment of medicinal products for use in self-medication. Two trained data collectors visited the randomly selected community pharmacies, approached and interviewed the consumers purchasing medicines without prescriptions. Data was entered in SPSS and analyzed using descriptive and inferential analyses (alpha level = 0.05). Results Out of 663 respondents, 68.6% were university graduates; and 33.9% were healthcare professionals. Consumers preferred self-medication mainly for headache (85.8%), cold and sore throat (80.8%), cough (75.7%) and fever (71.8%) with the justification that these illnesses were minor (90.2%), time saving (82.2%), convenient (74.7%), quicker relief (66.1%), and economical (61.2%). Occupation was significantly associated with the reasons for preferring self-medication (p<0.001). Similarly, age, gender and education were also significantly associated with most of the reasons for opting self-medication. People were quite aware about harmful consequences of self-medication. Multivariate logistic regression analysis showed that the respondents with lower education (AOR = 2.404 [95% CI: 1.579–3.661]), non-healthcare professionals (AOR = 1.712 [95% CI: 1.143–2.565]) and higher monthly income (AOR = 0.376 [95% CI: 0.236–0.599]) preferred self-medication (p <0.001, p = 0.009, p <0.001) respectively. Conclusion Self-medication was prevalent among young university graduate males for minor ailments mainly due to convenience and time saving. Despite people beliefs about the harmful consequences of self-medication, its use was omnipresent particularly among the respondents with lower education, non-healthcare professionals and people with higher monthly income.
Chemical modifications of vicilins interfere with chitin-binding affinity and toxicity to Callosobruchus maculatus (Coleoptera: Chrysomelidae) insect: a combined in vitro and in silico analysis.

Vicilins are related to cowpea seed resistance towards Callosobruchus maculatus due to their ability to bind to chitinous structures lining larval midgut. However, this binding mechanism is not fully understood. Here, we identified chitin binding sites and investigated how in vitro and in silico chemical modifications interfere with vicilin chitin-binding and insect toxicity. In vitro assays showed that unmodified vicilin strongly binds to chitin matrices, mainly with acetylated-chitin. Chemical modifications of specific amino acids (tryptophan, lysine, tyrosine), as well as glutaraldehyde crosslinking, decreased evaluated parameters. n silicoI analyses identified at least one chitin-binding site in vicilin monomer - the region between Arg208 and Lys216, which bears the sequence REGIRELMK and forms an alpha-helix, exposed in the 3D-structure. In silico modifications of Lys223 (acetylated at its terminal nitrogen) and Trp316 (iodinated to 7-iodine-L-tryptophan or oxidized to β-oxy-indolylalanine) decreased vicilin chitin-binding affinity. Glucose, sucrose and N-acetylglucosamine also interfered with vicilin chitin-binding affinity.
Cannabis Use among Dual Electronic and Combustible Cigarette Smokers: Relations with Pain and Hazardous Drinking

Abstract Background: E-cigarette use is on the rise and many adult e-cigarette users also smoke combustible cigarettes. Past work suggests that dual use (i.e. use of both electronic and combustible cigarettes) is associated with greater rates of cannabis use, yet little is known about the nature of cannabis use among dual users. Objectives: The current study examined 414 adult dual users (48.3% female, Mage = 35.1 years), half of whom endorsed current (past month) cannabis use. Results: Results indicated that cannabis users reported more severe pain, greater pain interference, and more hazardous drinking. In addition, cannabis use was robustly related to hazardous drinking after statistically controlling for demographic and pain-related variables. Cannabis use was also associated with hazardous drinking indirectly via pain interference at greater levels of pain severity. Conclusions/Importance: These results highlight several clinical correlates of cannabis use among adult dual users, and also suggest that pain may play an important role in hazardous drinking among these individuals.
Cutaneous Melanoma – A Review of Systemic Therapies

This decade has brought significantly improved out-comes for patients with advanced melanoma with immunotherapies and targeted treatments offering utility in a variety of settings. In 2020, we can hope for durable long-term responses, and complete remission in a subset of patients with metastatic disease. In the adjuvant setting, approximately 50% improvements in recurrence-free survival are seen both with targeted and immunotherapies. Early data from neoadjuvant immunotherapy clinical trials are very promising. However, responses to treatment are heterogeneous and not always durable; further advances are required, and several emerging strategies are of particular interest. We review the systemic treatment of melanoma, discussing the treatment of unresectable stage III–IV and recurrent disease, outlining curative treatment of cutaneous melanoma in the adjuvant setting and briefly discussing neoadjuvant systemic therapies for advanced melanoma.
The Role of Executive and General Cognitive Functioning in the Attention Problems of Very and Extremely Preterm Adults.

OBJECTIVE To determine whether the attention problems in adults born very preterm/very low birth weight (VP/VLBW; <32 weeks' gestation/<1500 g) or extremely preterm (EP; <26 weeks' gestation) are associated with specific executive or general cognitive deficits. METHOD Cohorts of VP/VLBW (the Bavarian Longitudinal Study [BLS]) and EP (the EPICure Study) participants were followed from birth to early adulthood, each also following a respective control group. Adult attention deficit hyperactivity disorder (ADHD) symptoms were assessed via self-report in both cohorts and additionally by parent report in the BLS. Participants in both cohorts also had their attention span rated by trained observers. Performed separately in each cohort, hierarchical regression analyses were used to assess whether the association between preterm birth status and attention problems remained after accounting for executive functioning (inhibitory control and working memory) in adulthood, childhood intelligence score (IQ), or sex. RESULTS In the discovery cohort of the BLS, significant differences were found between VP/VLBW adults and controls for parent-rated inattention (p < 0.001). However, for self-reported measures of ADHD, no significant differences were found in the BLS or in the EPICure replication cohort. In both cohorts, observer-rated attention spans were lower for VP/VLBW and EP participants in comparison to their respective control groups (p < 0.001). In final models for the BLS, inhibitory control and childhood IQ were significantly associated with parent-rated inattention symptoms (p < 0.006), whereas working memory and childhood IQ were significantly associated with observer-rated attention span (p < 0.001). The effect of childhood IQ on observer-rated attention span was replicated in EPICure. CONCLUSION VP/VLBW and EP adults are at increased risk of observer-rated attention problems. These problems were predominantly associated with poorer general cognitive ability in early childhood and somewhat with adult executive functioning.
Influences of Multicenter Bonding and Interstitial Elements on Twinned γ-TiAl Crystal

The bonding properties of the twin boundary in polysynthetic twinned γ-TiAl crystal and the effect of interstitial alloy elements on it are investigated by first principles. Among the three different kinds of interface relationships in the γ/γ interface, the proportion of true twin boundaries is the highest because it has the lowest interfacial energy, the reason for which is discussed by local energy and three-center bond. The presence of the interstitial atoms C, N, H, and O induces the competition for domination between their affinity to host atoms and three-center bonds, which eventually influences the values of unstable stacking fault energy (USFE) and intrinsic stacking fault energy (ISFE). The relative importance of different bonding with different alloy elements is clarified based on the analysis of local energy combined with Electron Localization Function (ELF) and Quantum Theory of Atoms in Molecules (QTAIM) schemes.