Miracle-dz/UniFAR-FTUs huggingface dataset:
First Aid for Pool Chemical Exposure: A Narrative Review

Over 4500 visits to emergency departments related to pool chemical exposures occur annually in the United States, and it is likely that many more go unreported. Injury can occur due to sensitivity to standard chemical concentrations in pools (such as with opening one’s eyes underwater), accidental exposure to super-concentrated chemicals (such as malfunction of a pool chlorinator), or accidental inhalation of fumes while opening the storage container for chlorination tablets. Therefore, first aid care has the potential to significantly limit morbidity. A literature review was undertaken to determine the appropriate first aid for pool chemical exposures. This literature search revealed 25 pertinent articles, of which none were systematic reviews or studies directly related to the first aid treatment of pool chemical exposures. However, five articles were included as indirect evidence, and a hand search of references revealed five additional articles for inclusion. Treatment recommendations were extrapolated from the treatment of chemical exposures from other incidents. Symptoms of pool chemical exposure reflect irritation secondary to the caustic chemicals involved. Patients may report irritation of the skin, eyes, nose, or throat; cough; chest tightness; and difficulty breathing. Following any exposure to pool chemicals, the victim should be removed from the source, taken to an area with fresh air, and contaminated materials (e.g. clothing, contact lenses) should be removed. Irrigation of the exposed area should take place immediately with uncontaminated fresh water for at least 15 minutes. It is anticipated that an exposed person will be symptomatically improved by leaving the area of exposure, removing their contaminated clothing items, and irrigating the contaminated body parts. However, if symptoms do not resolve during that time or if symptoms are worsening, the victim should be evaluated by trained medical personnel.
Brain gamma-aminobutyric acid, but not glutamine and glutamate levels are lower in older adults with chronic musculoskeletal pain: considerations by sex and brain location

Younger controls had higher prefrontal and sensorimotor γ-aminobutyric acid, but not Glx, levels compared with older controls and older adults with chronic pain. Abstract Introduction and Objectives: GABAergic and glutamatergic neurotransmitter systems are central to the pathophysiology of chronic pain and are equally affected by aging processes. We measured levels of frontal gamma-aminobutyric acid (GABA) and the combined resonance of glutamate and glutamine (Glx) in vivo using proton magnetic resonance spectroscopy (1H-MRS) to elucidate age-specific and pain-specific associations with clinical and experimental pain in older adults. Methods: Younger (18–24, n = 24) and older (60–94, n = 41) individuals part of a larger study (Neuromodulatory Examination of Pain and Mobility Across the Lifespan [NEPAL]) underwent questionnaires, quantitative sensory testing, and 1H-MRS Mescher-Garwood point-resolved spectroscopy to measure GABA and Glx levels in prefrontal and sensorimotor brain regions. Results: Older participants had significantly lower sensorimotor, but not prefrontal, GABA and Glx levels, compared with younger controls (P's < 0.05). Younger controls had significantly higher prefrontal and sensorimotor GABA, but not Glx, levels compared with older controls and older adults with chronic pain (P's < 0.05). Older males with chronic pain had significantly lower prefrontal GABA compared with older and younger male controls (P's < 0.05). Prefrontal GABA, but not Glx, was significantly associated with self-reported and experimental pain measures (P's < 0.05). Our results are the first to focus exclusively on age and pain differences in GABA and Glx including younger and older controls to elucidate aging and pain contributions to brain GABAergic and glutamatergic processes. Conclusion: Evaluation of both the neuroinhibitory and neuroexcitatory mechanisms provide promising potential for improving both our understanding of the mechanisms of chronic pain in aging and opportunities for effective, individualized treatments.
Peptide-Based Vaccines for Hepatocellular Carcinoma: A Review of Recent Advances

Abstract Primary liver cancer is the sixth most commonly diagnosed cancer and the third leading cause of cancer-related deaths worldwide. After surgery, up to 70% of patients experience relapses. The current first-line therapy for advanced cases of hepatocellular carcinoma (HCC) comprises sorafenib and lenvatinib administered as single-drug therapies. Regorafenib, cabozantinib, and ramucirumab are administered as second-line therapies. Recently, it has been reported that using the immune checkpoint inhibitors atezolizumab (anti-PDL1 antibody) and bevacizumab (anti-VEGF antibody) leads to longer overall survival of unresectable cases, when compared with the use of sorafenib. The role of cancer immunity against HCC has attracted the attention of clinicians. In this review, we describe our phase I/II clinical trials of peptide vaccines targeting GPC3 in HCC and discuss the potential of peptide vaccines targeting common cancer antigens that are highly expressed in HCC, such as WT-I, AFP, ROBO1, and FOXM1. Further, we introduce recent cancer vaccines targeting neoantigens, which have attracted attention in recent times, as well as present our preclinical studies, the results of which might aid to initiate a neoantigen vaccine clinical trial, which would be the first of its kind in Japan.
The J-Curve Association Between Blood Pressure and Mortality in Stroke Survivors

Purpose The optimal blood pressure (BP) targets in terms of mortality risk after stroke remain unclear. This study aimed to assess the relationship between BP and mortality in stroke survivors. Patients and Methods We included 1696 participants with self-reported history of stroke aged 18 years and older from the National Health and Nutrition Examination Survey (NHANES) 1999–2014 and NHANES III with public-use linked mortality files from 2015. Baseline systolic BP (SBP) and diastolic BP (DBP) levels were obtained by taking the average of 3 measures. Cox proportional hazard models and restricted cubic splines were conducted to explore the relationship between BP and all-cause mortality. Results During a median follow-up period of 5.6 years, 888 deaths occurred. After fully adjusting for confounding factors, SBP displayed a J-curve relationship (nadir 135 mm Hg), while DBP exhibited a reverse J-curve relationship (nadir 73 mm Hg) with the risk of all-cause mortality. However, the J-curve or reverse J-curve pattern between blood pressure and mortality appeared to be limited to individuals with an age >65 years, identifying a nadir of SBP/DBP of 142/73 mm Hg. The risk of mortality followed a linear relationship for SBP and DBP in stroke survivors aged ≤65 years, with risks increasing with higher SBP and lower DBP. Conclusion In this cross-sectional study that used national survey data, these data suggest a strong J-curve or reverse J-curve relationship between blood pressure and risk of all-cause mortality, whereas the pattern appears to be limited to individuals with an age >65 years, with a nadir at 142/73 mmHg. However, missing data on stroke type and stroke treatment limits the generalizability. Future prospective studies are needed to determine preferential blood pressure target in patients after stroke.
Impaired B Cell Apoptosis Results in Autoimmunity That Is Alleviated by Ablation of Btk

While apoptosis plays a role in B-cell self-tolerance, its significance in preventing autoimmunity remains unclear. Here, we report that dysregulated B cell apoptosis leads to delayed onset autoimmune phenotype in mice. Our longitudinal studies revealed that mice with B cell-specific deletion of pro-apoptotic Bim (BBimfl/fl ) have an expanded B cell compartment with a notable increase in transitional, antibody secreting and recently described double negative (DN) B cells. They develop greater hypergammaglobulinemia than mice lacking Bim in all cells and accumulate several autoantibodies characteristic of Systemic Lupus Erythematosus (SLE) and related Sjögren’s Syndrome (SS) including anti-nuclear, anti-Ro/SSA and anti-La/SSB at a level comparable to NODH2h4 autoimmune mouse model. Furthermore, lymphocytes infiltrated the tissues including submandibular glands and formed follicle-like structures populated with B cells, plasma cells and T follicular helper cells indicative of ongoing immune reaction. This autoimmunity was ameliorated upon deletion of Bruton’s tyrosine kinase (Btk) gene, which encodes a key B cell signaling protein. These studies suggest that Bim-mediated apoptosis suppresses and B cell tyrosine kinase signaling promotes B cell-mediated autoimmunity.
Osmotic Vesicle Collapse of Sealed Inside–Out Membrane Vesicles From Red Blood Cells

The preparation of plasma membrane vesicles from a large variety of cells has contributed a wealth of information on the identity and vectorial properties of membrane transporters and enzymes. Vesicles from red blood cell (RBC) membranes are generated in media of extremely low tonicity. For functional studies, it is required to suspend the vesicles in higher tonicity media in order to bring the concentrations of the substrates of transporters and enzymes under investigation within the physiological ranges. We investigated the effects of hypertonic transitions on the vesicle morphology using transmission electron microscopy. The results show that hypertonic transitions cause an irreversible osmotic collapse of sealed membrane vesicles. Awareness of the collapsed condition of vesicles during functional studies is critical for the proper interpretation of experimental results.
Sex Differences in HIV Testing among Older Adults in Sub-Saharan Africa: A Systematic Review

Background Despite being sexually active and engaging in risky sexual behaviours similar to young adults, older adults (50 years or older) are less likely to receive HIV testing, and disaggregated data are still scarce about HIV prevention and treatment in this vulnerable population in sub-Saharan Africa (SSA). This systematic review is aimed at examining sex differences in HIV testing and counseling (HTC) among older adults in SSA. Methods A systematic search of four databases, namely, MEDLINE (Ovid), EMBASE (Ovid), Web of Science, and Global Health, was conducted from 2000 to January 2020. The primary outcome of interest for this study was gender differences in HTC among older adults in SSA. Observational studies including cross-sectional, retrospective, and prospective cohort studies were included. Eligible studies must have reported sex differences in HIV testing uptake in a standard HTC service among older adults in SSA. Results From the database search, 4143 articles were identified. Five studies were ultimately included in the final review. Of the 1189 participants, 606 (51.1%) and 580 (48.9%) were female and male, respectively. The review findings suggested that both men and women preferred HTC providers that are the same sex as them with women additionally preferring a provider who is also of a similar age. Men and women differed in their pathways to getting tested for HIV. The review documented mixed results with regard to the associations between sex of older adults and uptake of HTC. Older adult HTC uptake data are limited in scope and coverage in sub-Saharan Africa. Conclusion This review revealed shortage of evidence to evaluate optimum HTC utilization among older adults. Few studies examined sex differences in HIV testing among older adults in the region. There is a need for stakeholders working in the area of HIV prevention and treatment to focus on older adult health utilization evidence organization, disaggregated by age and sex. Hence, high-quality research designs are needed on the topic in order to generate good quality evidence for targeted interventions to improve HTC among older adults in sub-Saharan Africa.
Digital Implementation of Oscillatory Neural Network for Image Recognition Applications

Computing paradigm based on von Neuman architectures cannot keep up with the ever-increasing data growth (also called “data deluge gap”). This has resulted in investigating novel computing paradigms and design approaches at all levels from materials to system-level implementations and applications. An alternative computing approach based on artificial neural networks uses oscillators to compute or Oscillatory Neural Networks (ONNs). ONNs can perform computations efficiently and can be used to build a more extensive neuromorphic system. Here, we address a fundamental problem: can we efficiently perform artificial intelligence applications with ONNs? We present a digital ONN implementation to show a proof-of-concept of the ONN approach of “computing-in-phase” for pattern recognition applications. To the best of our knowledge, this is the first attempt to implement an FPGA-based fully-digital ONN. We report ONN accuracy, training, inference, memory capacity, operating frequency, hardware resources based on simulations and implementations of 5 × 3 and 10 × 6 ONNs. We present the digital ONN implementation on FPGA for pattern recognition applications such as performing digits recognition from a camera stream. We discuss practical challenges and future directions in implementing digital ONN.
Magnetic-Guided Axillary UltraSound (MagUS) Sentinel Lymph Node Biopsy and Mapping in Patients with Early Breast Cancer. A Phase 2, Single-Arm Prospective Clinical Trial

Simple Summary Superparamagnetic iron oxide nanoparticles (SPIO) have been shown to identify sentinel lymph nodes (SLNs) in patients with breast cancer. This study investigated whether a minimally invasive approach with MRI-LG after SPIO injection in the breast followed by a magnetic guided axillary ultrasound and core biopsy of the SLN (MagUS) could accurately stage the axilla. The study included not only patients planned for primary surgery but also patients with recurrent cancer after previous surgery, but also patients scheduled for neoadjuvant treatment (NAT). The latter underwent minimally invasive SLNB prior to treatment and had their SLN clipped; surgery in the axilla was performed after NAT. In 79 included patients, MagUS detected all patients with macrometastasis and performed comparably with surgical sentinel lymph node dissection (SLND). It also allowed for marking of the SLN in patients planned for PST and enabled tailored decision making in breast cancer recurrence. Abstract Lymph Node Dissection (SLND) is standard of care for diagnosing sentinel lymph node (SLN) status in patients with early breast cancer. Study aim was to determine whether the combination of Superparamagnetic iron oxide nanoparticles (SPIO) MRI-lymphography (MRI-LG) and a Magnetic-guided Axillary UltraSound (MagUS) with biopsy can allow for minimally invasive, axillary evaluation to de-escalate surgery. Patients were injected with 2 mL of SPIO and underwent MRI-LG for SN mapping. Thereafter MagUS and core needle biopsy (CNB) were performed. Patients planned for neoadjuvant treatment, the SLN was clipped and SLND was performed after neoadjuvant with the addition of isotope. During surgery, SLNs were controlled for signs of previous biopsy or clip. The primary endpoint was MagUS SLN detection rate, defined as successful SLN detection of at least one SLN of those retrieved in SLND. In 79 patients, 48 underwent upfront surgery, 12 received neoadjuvant and 19 had recurrent cancer. MagUS traced the SLN in all upfront and neoadjuvant cases, detecting all patients with macrometastases (n = 10). MagUS missed only one micrometastasis, outperforming baseline axillary ultrasound AUS (AUC: 0.950 vs. 0.508, p < 0.001) and showing no discordance to SLND (p = 1.000). MagUS provides the niche for minimally invasive axillary mapping that can reduce diagnostic surgery.
Physicochemical characterization of two bulk fill composites at different depths

Objectives This study analyzed the physical-chemical behavior of 2 bulk fill resin composites (BFCs; Filtek Bulk Fill [FBF], and Tetric-N-Ceram Bulk Fill [TBF]) used in 2- and 4-mm increments and compared them with a conventional resin composite (Filtek Z250). Materials and Methods Flexural strength and elastic modulus were evaluated by using a 3-point bending test. Knoop hardness was measured at depth areas 0–1, 1–2, 2–3, and 3–4 mm. The translucency parameter was measured using an optical spectrophotometer. Real-time polymerization kinetics was analyzed using Fourier transform infrared spectroscopy. Results Flexural strength was similar among the materials, while TBF showed lower elastic modulus (Z250: 6.6 ± 1.3, FBF: 6.4 ± 0.9, TBF: 4.3 ± 1.3). The hardness of Z250 was similar only between 0–1 mm and 1–2 mm. Both BFCs had similar hardness until 2–3 mm, and showed significant decreases at 3–4 mm (FBF: 33.45 ± 1.95 at 0–1 mm to 23.19 ± 4.32 at 3–4 mm, TBF: 23.17 ± 2.51 at 0–1 mm to 15.11 ± 1.94 at 3–4 mm). The BFCs showed higher translucency than Z250. The polymerization kinetics of all the materials were similar at 2-mm increments. At 4-mm, only TBF had a similar degree of conversion compared with 2 mm. Conclusions The BFCs tested had similar performance compared to the conventional composite when used in up to 2-mm increments. When the increment was thicker, the BFCs were properly polymerized only up to 3 mm.
Evaluation of APOE ɛ2/ɛ3/ɛ4 Alleles in a Cohort of Individuals Affected by Developmental Topographical Disorientation

The three common alleles of the APOE gene, ɛ2/ɛ3/ɛ4, have been linked to human spatial orientation. We investigated the genetic role of APOE in developmental topographical disorientation (DTD), a lifelong condition that results in topographical disorientation. We genotyped the APOE ɛ2/ɛ3/ɛ4 alleles in a cohort of 20 unrelated DTD probands, and found allele frequencies not statistically different from the those seen in the population as a whole. Therefore, we found no evidence that DTD occurs preferentially on a genetic background containing any particular APOE allele, making it unlikely that these APOE alleles are contributing to the development of DTD.
Measures of Bilingual Cognition – From Infancy to Adolescence

An extensive literature exists regarding the effect of bilingualism on cognition in developing populations. However, the term ‘cognition’ is vague and applies to a large number of different abilities. We reviewed 60 publications examining cognition in simultaneous bilingual children to understand what aspects of cognition have been studied in this population and what tasks have been used, in addition to qualitatively assessing the results of bilingual/monolingual comparisons. Executive function was the most frequently assessed cognitive ability across all age groups, paralleling the adult bilingual literature, with memory flexibility and theory of mind also emerging as common targets within infant and preschool age groups. Results are discussed in light of developmental trajectories and assessment methodologies currently available for the cognitive abilities represented in this literature.
Quality Assessment for PCR-based Minimal Residual Disease in Lymphoma: 10 Years of Cross-laboratory Standardization Process Within the Fondazione Italiana Linfomi MRD Network

1Department of Molecular Biotechnologies and health sciences, Hematology Division, University of Torino, Italy 2Hematology, Department of Translational and Precision Medicine, Sapienza University of Roma, Italy 3Gimema Foundation, Rome, Italy 4Division of Hematology, Department of Clinical and Experimental Medicine, Santa Chiara Hospital, Pisa, Italy 5Hematopathology section, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Italy 6Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico, I.R. C.C. S. , Aviano, Italy 7Second Medical Department, University Hospital Schleswig-Holstein, Kiel, Germany 8Laboratoire d’immunologie biologique, hôpital Henri-Mondor, Créteil Cedex, France 9Division of Hematology, Servicio de Hematología, Hospital Universitario de Salamanca, Spain 10Division of Hematology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy 11SC Ematologia and Infrastruttura Ricerca Formazione Innovazione, Az Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy 12Hematology U, “AOU Città della Salute e della Scienza di Torino,” Italy Supplemental digital content is available for this article. Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. HemaSphere (2021) 5:10(e639). http://dx.doi. org/10.1097/HS9.0000000000000639. Received: 12 April 2021 / Accepted: 5 August 2021 Quality Assessment for PCR-based Minimal Residual Disease in Lymphoma: 10 Years of Cross-laboratory Standardization Process Within the Fondazione Italiana Linfomi MRD Network
Elemene Nanoemulsion Inhibits Metastasis of Breast Cancer by ROS Scavenging

Introduction Elemene (C15H24) is a sesquiterpene compound extracted from the rhizome of Curcuma herbs. In the past decades, the anti-tumor activity of elemene has been observed in vitro and in some clinical practices. However, pharmacological mechanisms of elemene are not demonstrated adequately, which may lead to improper clinical applications. This study aimed to investigate the anti-tumor effect of elemene nanoemulsion in the mouse model of triple-negative breast cancer (TNBC) and reveal the underlying mechanisms. Methods The ESR measurement and quantum mechanics simulation were used to characterize the antioxidant ability of elemene nanoemulsion. The murine breast cancer cell line 4T1 cells were inoculated subcutaneously into the left fourth mammary fat pad of BalB/c mice to establish a TNBC mice model. The H&E staining, immunohistochemical staining, DHE staining and Western blot were employed to evaluate the therapeutic effects of the elemene nanoemulsion on the TNBC mice. Results It was shown that the elemene nanoemulsion prolonged the survival of the triple-negative breast cancer-bearing mice and inhibited the metastasis to lung and liver while did not induce significant cytotoxicity to the tumor cells. Mechanistic studies demonstrated that the elemene nanoemulsion effectively scavenged the reactive oxygen species (ROS) in vitro and in vivo, which decreased the stabilization of hypoxia-inducible factor-1α (HIF-1α) and consequently reduced angiogenesis in the tumor microenvironment as well as decreased the level of NLRP3 inflammasomes and IL-1β production. In addition, the elemene nanoemulsion downregulated the level of IL-1β in the RAW264.7 cells in exposure with LPS. Conclusion In conclusion, due to the ROS scavenging ability, elemene nanoemulsion effectively inhibited the metastasis of the breast cancer cells to lung and liver and consequently prolonged the survival of TNBC mice.
Overview of the modeling of complex biological systems and its role in neurosurgery

Biological systems are complex with distinct characteristics such as nonlinearity, adaptability, and self-organization. Biomedical research has helped in advancing our understanding of certain components the human biology but failed to illustrate the behavior of the biological systems within. This failure can be attributed to the use of the linear approach, which reduces the system to its components then study each component in isolation. This approach assumes that the behavior of complex systems is the result of the sum of the function of its components. The complex systems approach requires the identification of the components of the system and their interactions with each other and with the environment. Within neurosurgery, this approach has the potential to advance our understanding of the human nervous system and its subsystems.