Miracle-dz/UniFAR-FTUs huggingface dataset:
Chimney Technique and Single-Branched Stent Graft for the Left Subclavian Artery Preservation During Zone 2 Thoracic Endovascular Aortic Repair for Type B Acute Aortic Syndromes

Purpose: The purpose of this study was to evaluate the efficacy and safety of zone 2 thoracic endovascular aortic repair assisted by the chimney technique or single-branched stent graft for the preservation of the left subclavian artery, and summarize our single-center experience with the techniques. Materials and methods: From February 2017 to June 2020, 137 patients who underwent left subclavian artery revascularization during zone 2 thoracic endovascular aortic repair were enrolled. Patients had acute type B aortic dissection and penetrating aortic ulcer associated with intramural hematoma. The chimney technique was performed in 68 patients (group A), and single-branched stent graft was deployed in 69 patients (group B). All procedures were performed during the acute phase. Primary technical success, immediate postoperative endoleak, neurologic complications (stroke or spinal cord ischemia), 30-day mortality, 1-year technical success, all-cause mortality, patency of the left subclavian artery, and reintervention were analyzed. Comparing the occurrence of the Bird-Beak Configuration, defined as a gap between the aortic wall and the sent graft with stent protrusion into the aortic lumen more than 5 mm, was also performed. Results: Primary technique success was achieved in 66 and 67 patients in groups A and B, respectively. The incidence of immediate postoperative endoleak, neurologic complications (stroke or spinal cord ischemia), and 30-day mortality were 5.9%, 1.5%, and 4.4% in group A, and 2.9%, 2.9%, and 2.9% in group B, respectively. During follow-up, the 1-year technical success rate was similar in both groups. All-cause mortality was similar in both groups (3.1% in group A and 4.5% in group B). The patency of the left subclavian artery was not significantly different between the 2 groups with 2 and 3 occlusions in groups A and B, respectively. The rate of reintervention was higher in group B (3.1% vs 1.6%, p=0.536), with a non-significant difference. Bird-Beak Configuration was more prominent in group B with the incidence of 59.42%. Conclusions: Acting as minimally invasive alternatives, both techniques are feasible for left subclavian artery preservation during zone 2 thoracic endovascular aortic repair for type B acute aortic syndromes with encouraging mid-term outcomes. Long-term follow-up is required to confirm these findings.
Ulcerative injection site reaction after third COVID‐19 vaccine dose with mRNA‐1273

With the advent of vaccines COronaVIrus 2019 (COVID-19), associated local skin reactions reported. We herein report the case of a 67-year-old Caucasian woman who presented with a local ulcerative reaction to mRNA-1273 (Spikevax ® ; Moderna) vaccine about 1 month after the injection. The patient had her first two doses of BNT162b2 (Comirnaty ® ; Pfizer-BioNTech) vaccine, 7 and 6 months earlier. Previous vaccinations were not associated with remarkable injection site reactions. She was affected by chronic ischemic cardiopathy, hypothyroidism with multi-nodular goiter, hypertension, and Sjogren's disease and was taking doxazosin, clopidogrel, telmisartan, and rosuvastatin. Sjogren's disease was well-managed with the only use of topical oral (saliva substitutes) and ocular (artificial tear drops) therapy. A few days after the booster dose with mRNA-1273 vaccine, the patient noticed erythema and edema localized at the injection site (right arm) for which she was unsuccessfully treated by her general partitioner with Cefixime 400 mg daily for 5 days. Thirty days after the first clinical signs, she came to our department and the dermatological examination revealed two small ulcers covered by serous crusts at the site of inoculation surrounded by an eczematous area (Figure 1A). The patient com-plained of mild lesion-localized pain but denied any systemic symp-toms and no other dermatological lesions were observed. Routine tests (complete blood count, liver and renal function) were normal, C-reactive protein was slightly elevated (2 mg/dl; reference value <0.5 mg/dl). The histopathological exam revealed a superficial ulceration with epidermal reactive hyperplasia on the borders, vasodilata-tion, neoangiogenesis, fibroplasia, perivascular
C‐peptide determination in the diagnosis of type of diabetes and its management: A clinical perspective

Impaired beta‐cell function is a recognized cornerstone of diabetes pathophysiology. Estimates of insulin secretory capacity are useful to inform clinical practice, helping to classify types of diabetes, complication risk stratification and to guide treatment decisions. Because C‐peptide secretion mirrors beta‐cell function, it has emerged as a valuable clinical biomarker, mainly in autoimmune diabetes and especially in adult‐onset diabetes. Nonetheless, the lack of robust evidence about the clinical utility of C‐peptide measurement in type 2 diabetes, where insulin resistance is a major confounder, limits its use in such cases. Furthermore, problems remain in the standardization of the assay for C‐peptide, raising concerns about comparability of measurements between different laboratories. To approach the heterogeneity and complexity of diabetes, reliable, simple and inexpensive clinical markers are required that can inform clinicians about probable pathophysiology and disease progression, and so enable personalization of management and therapy. This review summarizes the current evidence base about the potential value of C‐peptide in the management of the two most prevalent forms of diabetes (type 2 diabetes and autoimmune diabetes) to address how its measurement may assist daily clinical practice and to highlight current limitations and areas of uncertainties to be covered by future research.
The effects of medical students’ self-oriented perfectionism on academic procrastination: the mediating effect of fear of failure

Purpose Based on the logic that self-oriented perfectionism (SOP) is one of the most well-established predictors of academic procrastination (AP), we predicted that fear of failure (FF) would mediate the association between SOP and AP. The purpose of this study is to investigate the mediating effect of FF on the influence of SOP on AP in medical students. Methods A total of 156 undergraduate medical students completed a battery of questionnaires. This study is an analysis of cross-sectional data obtained through an offline survey. The self-report questionnaires assessed demographics and psychological scales, including the Multidimensional Perfectionism Scale, Performance Failure Appraisal Inventory, and Aitken Procrastination Inventory. The data were analyzed by descriptive statistics, correlations analysis, and multiple regression analyses using IBM SPSS ver. 22.0 (IBM Corp., Armonk, USA). Results SOP had a direct negative influence on AP (β=-0.420, p<0.001). Also, SOP had a significant indirect effect on AP through FF (β=0.0393; 95% confidence interval, 0.040–0.0936). These results indicated that the FF partially mediates the relationship between SOP and AP. Conclusion Although SOP among medical students might play an adaptive role to lessen AP, in cases FF gets higher, SOP could have opposing effects via the mediating effect of FF, leading to an actual increase in AP. Attempts to deal with the FF among medical students should be made for better academic achievements.
miRNAs are now starring in “No Time to Die: Overcoming the chemoresistance in cancer”

Cancer is a leading cause of death globally, with about 19.3 million new cases reported each year. Current therapies for cancer management include—chemotherapy, radiotherapy, and surgery. However, they are loaded with side effects and tend to cause toxicity in the patient's body posttreatment, ultimately hindering the response towards the treatment building up resistance. This is where noncoding RNAs such as miRNAs help provide us with a helping hand for taming the chemoresistance and providing potential holistic cancer management. MicroRNAs are promising targets for anticancer therapy as they perform critical regulatory roles in various signaling cascades related to cell proliferation, apoptosis, migration, and invasion. Combining miRNAs and anticancer drugs and devising a combination therapy has managed cancer well in various independent studies. This review aims to provide insights into how miRNAs play a mechanistic role in cancer development and progression and regulate drug resistance in various types of cancers. Furthermore, next‐generation novel therapies using miRNAs in combination with anticancer treatments in multiple cancers have been put forth and how they improve the efficacy of the treatments. Exemplary studies currently in the preclinical and clinical models have been summarized. Ultimately, we briefly talk through the challenges that come forward with it and minimize them.
Synthesis and characterization of single‐walled carbon nanotube: Cyto‐genotoxicity in Allium cepa root tips and molecular docking studies

Herein, single‐walled carbon nanotubes (SWCNTs) were synthesized by the thermal chemical vapor deposition (CVD) method, and characterized by scanning electron microscopy (SEM), energy‐dispersive X‐ray spectroscopy (EDX), transmission electron microscopy (TEM), Raman spectroscopy, dynamic light scattering (DLS), and thermo‐gravimetric analysis (TGA). The results indicated that obtained nanotubes were SWCNTs with high crystallinity and their average diameter was 10.15 ± 3 nm. Allium cepa ana–telophase and comet assays on the root meristem were employed to evaluate the cytotoxic and genotoxic effects of SWCNTs by examining mitotic phases, mitotic index (MI), chromosomal aberrations (CAs), and DNA damage. A. cepa root tip cells were exposed to SWCNTs at concentrations of 12.5, 25, 50, and 100 μg/ml for 4 h. Distilled water and methyl methanesulfonate (MMS, 10 μg/ml) were used as the negative and positive control groups, respectively. It was observed that MIs decreased statistically significantly for all applied doses. Besides, CAs such as chromosome laggards, disturbed anaphase–telophase, stickiness and bridges and also DNA damage increased in the presence of SWCNTs in a concentration‐dependent manner. In the molecular docking study, the SWCNT were found to be a strong DNA major groove binder showing an energetically very favorable binding free energy of −21.27 kcal/mol. Furthermore, the SWCNT interacted effectively with the nucleotides on both strands of DNA primarily via hydrophobic π and electrostatic interactions. As a result, cytotoxic and genotoxic effects of SWCNTs in A. cepa root meristematic cells which is a reliable system for assessment of nanoparticle toxicology were demonstrated in this study.
Evaluating Measures of Externalizing Personality Pathology Traits in Black and White American Adolescents in a Program for at-Risk Youths

Abstract Adolescent personality assessment measures can aid in the identification of traits that are associated with various types of maladjustment. Externalizing personality pathology traits (e.g., antisocial, borderline, and narcissistic personality disorder features) are particularly relevant for many problematic outcomes, yet measures that assess these traits have not been validated extensively in diverse samples. The present study aimed to examine the properties of measures of externalizing personality pathology traits in a sample of White (n = 184) and Black (n = 99) adolescents participating in a residential program for at-risk youth. The fit of the proposed structure for these measures was tested in the sample as a whole and in each racial group separately. Associations between these measures and the count of disciplinary infractions received while in the program were also tested. Measures were found to have less than optimal fit in this sample, especially among Black adolescents. Suggestions for future research and clinical use of these measures are discussed.
Sex-specific reference values for the crown heights of permanent anterior teeth and canines for assessing tooth wear

Abstract Objective We propose sex-specific reference values for the clinical crown height of anterior teeth and canines. Material and methods In this cross-sectional study, 1426 teeth were analysed from 169 undergraduate and postgraduate dental students (83 women and 86 men, median age 22 years). Teeth with worn or totally restored incisal edges, or gingival inflammation were excluded. Age, gender and body height were recorded and the degree of tooth wear was scored according to the quantification module of the Tooth Wear Evaluation System. The clinical crown heights of all anterior teeth and canines were measured from the gingival margin to the incisal edge with a digital calliper. Reference values for tooth groups were obtained at the percentiles 10, and expressed by sex if there was a significant difference between men and women. Results Mean crown heights were bigger in men than in women for each tooth group (p = .028). Clinical crown heights showed sexual dimorphism at the 10th percentiles for all tooth groups except for mandibular anterior teeth. Conclusions For assessing tooth wear, the sex-specific reference values for the clinical crown height of young adults Caucasoids range from 7.5 mm to 9.0 mm in women and from 7.5 mm to 9.5 in men.
Improvement in feed efficiency and reduction in nutrient loading from rainbow trout farms: the role of selective breeding

Abstract Resource efficiency, the ratio of inputs to outputs, is essential for both the economic and environmental performance of any sector of food production. This study quantified the advancement in the feed conversion ratio (FCR) and reduction in nutrient loading from rainbow trout farming in Finland and the degree to which genetic improvements made by a national breeding program have contributed to this advancement. The study combined two datasets. One included annual records on farm-level performance of commercial rainbow trout farms from 1980 onwards, and the other included individuals across eight generations of the national breeding program. The data from the commercial farms showed that from 1980 onwards, the farm-level feed conversion ratio improved by 53.4%, and the specific nitrogen and phosphorus loading from the farms decreased by over 70%. Hence, to produce 1 kg of fish today, only half of the feed is needed compared to the 1980s. The first generation of the breeding program was established in 1992. The FCR was not directly selected for, and hence, the genetic improvement in the FCR is a correlated genetic change in response to the selection for growth and body composition. Since 1992, the estimated genetic improvement in the FCR has been 1.74% per generation, resulting in a cumulative genetic improvement of 11.6% in eight generations. Genetic improvement in the FCR is estimated to be 32.6% of the total improvement in the FCR observed at farms, implying that genetic improvement is a significant contributor to resource efficiency. The use of genetically improved rainbow trout, instead of the base population of fish, reduces feed costs by 18.3% and total production costs by 7.8% at commercial farms (by −0.266€ per kg of ungutted fish). For phosphorus and nitrogen, it can be assumed that the use of fish material with an improved FCR also leads to 18.3% less nitrogen and phosphorus flowing into an aquatic environment. Such improvements in resource efficiency are win–wins for both industry and the environment—the same amount of seafood can be produced with significantly reduced amounts of raw materials and reduced environmental impact.
Proof of an optimized salicylic acid paste-based treatment concept of ulcerative M2-stage digital dermatitis lesions in 21 dairy cows

The efficacy of salicylic acid paste (SA) in the treatment of ulcerative bovine digital dermatitis (BDD) was assessed by combining clinical and histopathological analyses with molecular biological techniques. The latter were conducted in a blinded manner to reach maximum objectivity. Prior to treatment, M2-stage BDD lesions (n = 26, diagnosed in 21 dairy cows) exhibited ulceration, with severe perivascular, chronic, lymphoplasmacytic dermatitis and extensive keratinolysis being noted in most cases. Pretreatment biopsy samples (n = 12) followed by povidone-iodine ointment under bandage for one week before administration of SA paste were tested positive for Treponema spp. by blinded PCR and fluorescent in situ hybridization (FISH). Subsequent treatment consisted of application of SA and bandaging at weekly intervals until lesions had completely resolved. The treatment duration ranged between 2 and 4 weeks. Complete healing was achieved in 100% of cases, with 2/21 animals requiring a second round of treatment upon disease reoccurrence. Importantly, only 3/26 biopsies taken from previously affected sites still tested positive by Treponema PCR, and in another biopsy, the outermost layers of the stratum corneum scored weakly positive by Treponema-specific FISH. None of these Treponema DNA-positive biopsies showed signs of ulceration. One case exhibited focal keratinolysis. Positive PCR or FISH in these cases may have arisen from DNA traces of dead bacteria or environmental contamination during biopsy harvesting. To our knowledge, this is the first study on blinded molecular biological monitoring of the therapeutic efficacy of SA with respect to treponemal infection, and on complete BDD M2-stage remission in all animals achieved by SA treatment according to an optimized protocol. Although the etiology of BDD is considered as multifactorial, our data further support the concept that treponemes have a decisive role in BDD pathogenesis.
Characterizing the Level of Inquiry in the Undergraduate Laboratory.

Acommon goal for science educators is to engage students in inquiry; however, many factors complicate the completion of such a task. A primary problem encountered by faculty facing this challenge is that the word “inquiry” is used ubiquitously throughout education literature, both as a style of teaching and as a method for conducting research (Flick 1995). This dualistic perspective can generate cognitive dissonance for faculty. How much direction is necessary? To what extent does the learner develop his or her own procedures and methods? How is student learning assessed? Are there different types or varying degrees of inquiry? We found such discrepancies in chemistry and were prompted to delve further into other science disciplines (Fay et al. 2007). Given the emphasis on inquiry in the National Science Education Standards (NRC 2000), we probed the K–12 literature, uncovering a myriad of usages for the word “inquiry. ” In this paper, we propose a quantitative rubric designed to characterize the level of inquiry in laboratory activities and laboratory curricula. We do not wish to answer the question, “What is inquiry? ” but rather, provide a tool for identifying its varying degrees of student independence. RESEARCH AND TEACHING
Sustainability Dimensions of the Mediterranean Diet: A Systematic Review of the Indicators used and Its Results.

The concern about sustainability is growing and the Mediterranean Diet has been extensively identified as a promising model, with benefits for human and environmental health. This systematic review aims to identify and describe the indicators which have been used to evaluate the sustainability of the Mediterranean Diet and the results from their application. A methodology using PRISMA guidelines was followed, and searches performed in Web of Science, PubMed, Scopus, and GreenFile. A total of 32 studies assessing the sustainability of the Mediterranean Diet were identified. Twenty-five of these studies quantified the environmental impact, seven studies evaluated the nutritional quality, and twelve studies assessed the daily cost of this dietary pattern. A total of 33 distinct indicators were identified, of which ten were used to assess the environmental dimension (mainly Carbon, Water, and Ecological Footprint), eight were used to assess the nutritional dimension (mainly Health score and Nutritional Rich Food Index), one was used to assess the economic dimension (dietary cost) and, eight used combined indicators. The remaining six indicators for the assessment of sociocultural dimension were only identified in one study but were not measured. The Mediterranean Diet had a lower environmental impact than Western diets and showed a Carbon Footprint between 0.9 and 6.88 kg CO2/d per capita, a Water Footprint between 600 and 5280 m3/ d per capita, and an Ecological Footprint between 2.8 and 53.42 m2/ d per capita. Regarding the nutritional dimension, the Mediterranean Diet had a high nutritional quality and obtained 122 points on the Health Score and ranged between 12.95 and 90.6 points on the Nutrient Rich Food Index. The cost of Mediterranean Diet is similar to other diets and varied between 3.33 and 14.42€/ d per capita. These findings show that no uniformity in assessing the MDiet's sustainability exists.
The Effect of Person Misfit on Classification Decisions

The effect of person misfit to an item response theory model on a mastery/nonmastery decision was investigated. Furthermore, it was investigated whether the classification precision can be improved by identifying misfitting respondents using person-fit statistics. A simulation study was conducted to investigate the probability of a correct classification using different cutoff points, estimation methods, person-fit statistics, model violations, test lengths, and sample sizes. The effect of the presence of misfitting item score patterns on the item parameter estimates was also taken into account. Results showed that the effect of the presence of misfitting item score patterns on the classification of nonaberrant simulees was generally small (i.e., the classification precision for these simulees did not go down). Furthermore, for simulees classified as nonaberrant using a person-fit statistic, the classification decisions were comparable with the classification decisions for actual nonaberrant simulees. These results were comparable across different person-fit statistics and estimation methods.
Effects of a Meaning-Centered Spiritual Care Training Program for Hospice Palliative Care Teams in South Korea

Background Spiritual care is an essential part and a core component of quality palliative care, as identified by the World Health Organization. However, spiritual care training for hospice palliative care teams (HPCTs) is infrequent. Objective The aim of this study was to investigate the effects of a meaning-centered spiritual care training program for HPCTs (McSCTP-HPCT). Methods This study used a nonrandomized controlled design. The McSCTP-HPCT comprised 5 modules. The participants were HPCTs working in 15 national hospice institutions and were allocated to either the experimental group (n = 33) or the control group (n = 27) based on the participating institutions’ preference. Three outcome variables were tested: spiritual care competency, spiritual care therapeutics, and compassion fatigue. Data were analyzed using descriptive statistics, χ2 test, 1-way analysis of variance, and repeated-measures analysis of variance. Results There was a significant difference in the interaction between measurement time and group assignment in spiritual care competency (P = .002) and spiritual care therapeutics (P = .038), whereas no significant difference was found for compassion fatigue (P = .716). Conclusion The McSCTP-HPCT conducted in this study shows effectiveness in increasing the spiritual care competency and spiritual care therapeutics of HPCTs and may support the importance of spiritual care training. Implications for Practice The McSCTP-HPCTs adds to the scientific evidence on spiritual care and has the capacity to improve the quality of care for patients with a life-threatening illness.