Miracle-dz/UniFAR-FTUs huggingface dataset:
Implementation and experimental validation of surface electromyogram and force model of Tibialis Anterior muscle for examining muscular factors

This study reports a surface electromyogram and force of contraction model. The objective was to investigate the effect of changes in the size, type and number of motor units in the Tibialis Anterior muscle to surface electromyogram and force of dorsiflexion. A computational model to simulate surface electromyogram and associated force of contraction by the Tibialis Anterior muscle was developed. This model was simulated for isometric dorsiflexion, and comparative experiments were conducted for validation. Repeated simulations were performed to investigate the different parameters and evaluate inter-experimental variability. An equivalence statistical test and the Bland–Altman method were used to observe the significance between the simulated and experimental data. Simulated and experimentally recorded data had high similarity for the three measures: maximal power of power spectral density (p < 0.0001), root mean square of surface electromyogram (p < 0.0001) and force recorded at the footplate (p < 0.03). Inter-subject variability in the experimental results was in-line with the variability in the repeated simulation results. This experimentally validated computational model for the surface electromyogram and force of the Tibialis Anterior muscle is significant as it allows the examination of three important muscular factors associated with ageing and disease: size, fibre type and number of motor units.
Safety and Efficacy of Fidaxomicin and Vancomycin in Children and Adolescents with Clostridioides (Clostridium) difficile Infection: A Phase 3, Multicenter, Randomized, Single-blind Clinical Trial (SUNSHINE)

Abstract Background Fidaxomicin, a narrow-spectrum antibiotic approved for Clostridioides (Clostridium) difficile infection (CDI) in adults, is associated with lower rates of recurrence than vancomycin; however, pediatric data are limited. This multicenter, investigator-blind, phase 3, parallel-group trial assessed the safety and efficacy of fidaxomicin in children. Methods Patients aged <18 years with confirmed CDI were randomized 2:1 to 10 days of treatment with fidaxomicin (suspension or tablets, twice daily) or vancomycin (suspension or tablets, 4 times daily). Safety assessments included treatment-emergent adverse events. The primary efficacy end point was confirmed clinical response (CCR), 2 days after the end of treatment (EOT). Secondary end points included global cure (GC; CCR without CDI recurrence) 30 days after EOT (end of study; EOS). Plasma and stool concentrations of fidaxomicin and its active metabolite OP-1118 were measured. Results Of 148 patients randomized, 142 were treated (30 <2 years old). The proportion of participants with treatment-emergent adverse events was similar with fidaxomicin (73.5%) and vancomycin (75.0%). Of 3 deaths in the fidaxomicin arm during the study, none were CDI or treatment related. The rate of CCR at 2 days after EOT was 77.6% (76 of 98 patients) with fidaxomicin and 70.5% (31 of 44) with vancomycin, whereas the rate of GC at EOS was significantly higher in participants receiving fidaxomicin (68.4% vs 50.0%; adjusted treatment difference, 18.8%; 95% confidence interval, 1.5%–35.3%). Systemic absorption of fidaxomicin and OP-1118 was minimal, and stool concentrations were high. Conclusions Compared with vancomycin, fidaxomicin was well tolerated and demonstrated significantly higher rates of GC in children and adolescents with CDI. Clinical Trials Registration NCT02218372
Perceptions and Experiences of Medical Assistance in Dying Among Illicit Substance Users and People Living in Poverty

Since medical assistance in dying (MAiD) became legal in Canada in 2016, there have been concerns about vulnerable people feeling pressured to end their lives. It is important to understand what people in marginalized communities know and feel about MAiD in order to help prevent any pressure to hasten death and to prevent any barriers to accessing assisted death. This qualitative study explored the perceptions and experiences of MAiD and other end-of-life care options with 46 people who were illicit substance users, living in poverty, or who worked with marginalized people in these communities. Six broad themes were identified: the importance of family, friends, and community; the effects of the opioid crisis; barriers to accessing end-of-life care services; support for MAiD; the difference between suicide and MAiD; and what constitutes a good death. Findings from this research may be used to help inform future legislation, professional guidelines, and standards of best practice.
Protocols for drug allergy desensitization in children

ABSTRACT Introduction: When a drug hypersensitivity reaction is proven, desensitization protocols allow the reintroduction of the molecule in patients for whom such therapy is essential. Through drug desensitization (DDS), a temporary immune tolerance is maintained for the single course of a specific therapy. In pediatrics, indications for such a procedure include children with chronic diseases, severe infectious diseases and/or malignancies, who have a proven drug hypersensitivity. Areas covered: We ran a search on PubMed and Web of Science for papers on DDS and on DDS in children. Most protocols and recommendations on DDS focus on adults and have been adapted for children. The best candidates for desensitization are children with a history of immediate, IgE-mediated drug allergy, but this therapy may be applied also in nonallergic hypersensitivities and in non-immediate reactions. Most protocols in literature focus on antibiotics, especially beta-lactams, on chemotherapeutic agents, and on monoclonal antibodies. Expert opinion: Pediatric allergists should cooperate with specialists in infectious diseases and onco-hematology to provide DDS to children in need. Standardized protocols and international guidelines are still needed to optimize such treatment and to implement it in clinical daily practice.
A Tool for Rapid Identification of Potential Herbal Medicine—Drug Interactions

C P J / R P C • S E P T E M B E R / O C T O B E R 2 0 0 9 • V O L 1 4 2 , N O 5 Introduction Herbal products have recently been regulated in Canada in the class of natural health products (NHPs), which also includes vitamins, minerals and homeopathic remedies. Although generally regarded as safe by the public, there is growing evidence that herbal medicines can have clinically significant adverse effects and interactions with each other as well as with other medications. A formidable challenge for the field of herbal medicine pharmacovigilance is the under-reporting of suspected adverse drug reactions associated with herbal products. In North America, NHPs are commonly available for sale in pharmacies as well as at other retail outlets. The purpose of this paper is to describe a quick reference tool for identifying potential interactions between herbal and conventional pharmaceutical medications (see tool accompanying this issue of CPJ or go to www.cpjournal.ca); the tool was developed as part of a larger study, known as Pharmacy SONAR (Study Of Natural health product Adverse Reactions), investigating the feasibility of an active surveillance program for collecting NHP adverse event information in community pharmacies. This tool is not meant to replace access to high-quality databases or texts providing evidence-based information about natural health products including herbs — it is intended as a counselling aid to enhance the rapid identification of potentially harmful herbal medicine–drug combinations and to help the pharmacist identify when further information is needed to provide patient-specific advice.
Looking horizontally at disseminated superficial actinic porokeratosis: Correlations between in‐vivo reflectance confocal microscopy and histopathology

Dear Editor, Disseminated superficial actinic porokeratosis (DSAP) is the most common form of porokeratosis with a complex pathogenesis. According to the most recent theories, genetic factors, ultraviolet light, trauma, immunosuppression, and infectious agents may indeed cooperate in disease pathogenesis and progression.1 On histopathology, all porokeratosis subtypes are characterized by the presence of the “cornoid lamella. ” It is an important
Organizational Culture and Professionalism: An Assessment of the Professional Culture of the U. S. Army Senior Level Officer Corps

The theory of organizational culture maintains that individual behavior within an organization is not solely controlled by the formal regulations and structures of authority as supported by structural theorists. Instead, the theory postulates that cultural norms, values, beliefs, and assumptions provide unconscious guidance and direction, and consequently, the subsequent behavior of organizational members. If you want to be able to comprehend the current behavior of an organization as well as to reasonably anticipate its future actions then you must be able to understand the deep basic underlying assumptions that comprise the abstract concept of organizational culture (Schein, 1999). Organizational culture can be found at every level of an organization, and since organizational members are multicultural entities understanding an organization’s culture is significant “because the beliefs, values, and behavior of individuals are often understood only in the context of people’s cultural identities” (Schein, 1999, p. 14). Consequently, the long-term strategic decisions made by the senior leaders of an organization are influenced by their multicultural background, but especially by the organization in which they have spent the bulk of their life, such as members of professional organizations like doctors, lawyers, and military officers. Professional organizations exist in a competitive environment where their social jurisdiction and legitimacy can only be supported or perpetuated as long as they maintain their expertise over an area of abstract knowledge that society perceives as important (Freidson, 1970, 1986; Abbott, 1988; Burk, 2002). Since organizational culture is hypothesized to have a considerable impact on organizational behavior and
Experimental modeling of the acute toxicity and cytogenotoxic fate of composite mixtures of chromate, copper and arsenate oxides associated with CCA preservative using Clarias gariepinus (Burchell 1822)

Concurrent occurrence of chromium (Cr), copper (Cu) and arsenic (As) from chromated copper arsenate (CCA) wood preservative in aquatic ecosystems demands that their joint-actions in eliciting toxic effects be assessed for adequate understanding of the health risk they may pose to biota. Clarias gariepinus was exposed to As2O3 , CrO3 and CuO and their composite mixtures (1:1 and 1:1:1) at various concentrations (0 – 600 mg/L) for 96-h to determine the acute toxicity using OECD (1992) protocol. C. gariepinus was then exposed to sub-lethal concentrations corresponding to 6.25, 12.5, 25.0, 50.0 and 100% of the 96-h LC50 for 7 days to assess the cytogenotoxic effects using piscine micronucleus (MN) test. The 96-h LC50 showed that the metals/metalloid demonstrated differential interactions in a concentration dependent pattern. The 96-h LC50 showed that Cr was the most toxic while Cu and As:Cu were indeterminate (Cr > Cr:Cu > As:Cr > As > As:Cr:Cu > Cu = As:Cu indeterminate). Isobologram and synergistic ratio (SR) models predicted antagonistic interaction between Cu:Cr and As:Cr and synergism between As:Cu in the causation of morbidity and mortality of C. gariepinus. Interaction factor model predicted antagonism as common interactive mechanism among the metal/metalloid mixtures in the induction of MN and abnormal nuclear erythrocytes in C. gariepinus. Predicted interactions among the three metals/ metalloid were largely antagonism and synergism towards the induction of acute toxicity and cytogenotoxicity. The models employed herein may be useful in establishing environmental safe limits for mixtures of metals/metalloids against the induction of acute toxicity and DNA damage in lower aquatic vertebrates.
Disparities in Donor Human Milk Supplementation Among Well Newborns

Background: Donor human milk supplementation for healthy newborns has increased. Racial-ethnic disparities in supplementation have been described in the neonatal intensive care unit but not in the well newborn setting. Research aim: The aim of this study was to identify maternal characteristics associated with donor human milk versus formula supplementation in the well newborn unit. Methods: This retrospective cohort study includes dyads of well newborns and their mothers (N = 678) who breastfed and supplemented with formula (n = 372) or donor human milk (n = 306) during the birth hospitalization at a single hospital in the midwestern United States. Maternal characteristics and infant feeding type were extracted from medical records. Chi-square and logistic regression were used to examine associations between maternal characteristics and feeding type. Results: Nonwhite women were less likely to use donor human milk. Compared to non-Hispanic white women, the largest disparity was with Hispanic (adjusted odds ratio [OR] = 0.28, 95% CI [0.12, 0.65]), then non-Hispanic black (adjusted OR = 0.32, 95% CI [0.13, 0.76]) and Asian women (adjusted OR = 0.34, 95% CI [0.16, 0.74]). Lower donor human milk use was associated with primary language other than English and public versus private insurance. Conclusion: The goal of improving public health through breastfeeding promotion may be inhibited without targeting donor human milk programs to these groups. Identifying the drivers of these disparities is necessary to inform person-centered interventions that address the needs of women with diverse backgrounds.
Sampling Methods for Luminescence Dating of Subsurface Deposits from Cores

Study of subsurface deposits often requires coring or drilling to obtain samples for sedimentologic and geochemical analysis. Geochronology is a critical piece of information for stratigraphic correlation and rate calculations. Increasingly, luminescence dating is applied to sediment cores to obtain depositional ages. This paper provides examples and discussion of guidelines for sampling sediment core for luminescence dating. Preferred protocols are dependent on the extraction method, sedimentology, core integrity, and storage conditions. The methods discussed include subsampling of sediment in opaque core-liners, cores without liners, previously open (split) cores, bucket auger samples, and cuttings, under red lighting conditions. Two important factors for luminescence sampling of sediment core relate to the integrity of the natural luminescence signal and the representation of the dose rate environment. The equivalent dose sample should remain light-safe such that the burial dose is not reset (zeroed) by light exposure. The sediment sampled for dose rate analyses must accurately represent all units within at least 15 cm above and below the equivalent dose sample. Where lithologic changes occur, units should be sampled individually for dose rate determination. Sediment core extraction methods vary from portable, hand-operated devices to large truck- or vessel-mounted drill rigs. We provide recommendations for luminescence sampling approaches from subsurface coring technologies and downhole samplers that span shallow to deep sample depths.
Evaluation of photobiomodulation effects on pain, edema, paresthesia, and bone regeneration after surgically assisted rapid maxillary expansion

Abstract Background: Surgically assisted rapid maxillary expansion (SARME) generates an uncomfortable postoperative period accompanied by pain, edema, and paresthesia. There are few studies on the effect of photobiomodulation (PBM) after SARME and it was not possible to find studies on the efficacy of light emitted by diode (LED) after this type of intervention. The main objective of the study will be to evaluate the efficacy of PBM with LED in the control of pain, facial edema, paresthesia, and bone repair after SARME. Methods: A randomized, double-blind, placebo-controlled clinical trial involving 72 participants aged from 18 to 45 years, who search the Department of Buccomaxillofacial Surgery and Traumatology of Mandaqui Hospital Complex, will be conducted. Immediately after surgeries, the participant will be inserted into the placebo or LED group. In the LED group, the participants will receive PBM with an extraoral device (660 and 850 nm with 6 J per point) and an intraoral device (660 nm with 2 J per point) and in the control group the person in charge of the application will simulate the irradiation with the devices kept off. The applications will be in the immediate postoperative period, 1, 2, 7, 14, 30, 60, 90, and 120 days after the end of the surgeries, when the evaluations will also be performed. Facial measurements, extra and intraoral sensitivity, pain and bone repair will be evaluated. Secondarily, data regarding the occurrence of headache; otalgia; nausea; bruising; nasolacrimation; epistaxis; dysphagia; systemic and superficial temperature in the operated region; use of analgesics and anti-inflammatories; anxiety and impact of oral health on the participants’ quality of life will be computed. Discussion: Since PBM has shown positive effects on postoperative complications of other types of oral surgery and also has a positive effect on bone repair after maxillary disjunction, surgically assisted or not, it seems clear the need to evaluate its performance regarding pain, edema, and paresthesia after these surgeries. Trial registration: This protocol was registered in Clinical Trials platform (https://clinicaltrials.gov/) with the number NCT03814525, first published and last updated on January 24, 2019.
Polyethyleneimine Hybrid Thin Shell Hollow Mesoporous Silica Nanoparticles as Vaccine Self-Adjuvants for Cancer Immunotherapy.

Conventional adjuvants (e.g., aluminum) are insufficient to trigger cell-mediate immunity, which plays crucial role in triggering specific immunity against cancer. Therefore, developing appropriate adjuvants for cancer vaccines is a central way to stimulate antitumor immune response. Hollow mesoporous silica nanoparticles (HMSNs) have been proven to stimulate Th1 antitumor immunity in vivo and promote immunological memory in the formulation of novel cancer vaccines. Yet, immune response rates of existing HMSNs for anti-cancer immunity still remain low. Here, we demonstrate the generation of polyethyleneimine (PEI)-incorporated thin shell HMSNs (THMSNs) through a facile PEI-etching strategy for cancer immunotherapy. Interestingly, incorporation of PEI and thin shell hollow structures of THMSNs not only improve the antigen-loading efficacy, sustained drug release profiles, but also enhance the phagocytosis efficiency by dendritic cells (DCs), enabled DCs maturation and Th1 immunity, and sustained immunological memory, resulting in the enhancement of the adjuvant effect of THMSNs. Moreover, THMSNs vaccines without significant side effects can significantly reduce the potentiality of tumor growth and metastasis in tumor challenge and re-challenge models, respectively. THMSNs are considered to be promising vehicles and excellent adjuvants for the formulation of cancer vaccines for immune therapy.
Chitosan as a Wound Dressing Starting Material: Antimicrobial Properties and Mode of Action

Fighting bacterial resistance is one of the concerns in modern days, as antibiotics remain the main resource of bacterial control. Data shows that for every antibiotic developed, there is a microorganism that becomes resistant to it. Natural polymers, as the source of antibacterial agents, offer a new way to fight bacterial infection. The advantage over conventional synthetic antibiotics is that natural antimicrobial agents are biocompatible, non-toxic, and inexpensive. Chitosan is one of the natural polymers that represent a very promising source for the development of antimicrobial agents. In addition, chitosan is biodegradable, non-toxic, and most importantly, promotes wound healing, features that makes it suitable as a starting material for wound dressings. This paper reviews the antimicrobial properties of chitosan and describes the mechanisms of action toward microbial cells as well as the interactions with mammalian cells in terms of wound healing process. Finally, the applications of chitosan as a wound-dressing material are discussed along with the current status of chitosan-based wound dressings existing on the market.
Early Amniocentesis

Traditional practice in British obstetrics dictates that all mothers at risk of bearing a fetus with chromosomal abnormalities are offered in-utero diagnostic techniques in the first half of pregnancy. In the past, these mothers included those with a past, personal or family history of chromosomal abnormality and those aged over 35 years. However, 70% of Down's syndrome babies are born to mothers under 35 and the introduction of biochemical screening (1) has allowed mothers previously thought to be at low risk to be offered in-utero diagnosis. At present these biochemcial markers are diagnosed from maternal blood samples taken at approximately 16 weeks gestation so it is to be hoped that in the near future biochemical screening and hence diagnostic detection can be offered in the first trimester. The choice of technique for first trimester diagnosis of fetal abnormalities has been the subject of much editorial comment (2-8) and the shortcomings of traditional amniocentesis and chorionic villus sampling have led several centres to evaluate first trimester amniocentesis (9-15).
A New Serum Biomarker Set to Detect Mild Cognitive Impairment and Alzheimer’s Disease by Peptidome Technology

Background: Because dementia is an emerging problem in the world, biochemical markers of cerebrospinal fluid (CSF) and radio-isotopic analyses are helpful for diagnosing Alzheimer’s disease (AD). Although blood sample is more feasible and plausible than CSF or radiological biomarkers for screening potential AD, measurements of serum amyloid- β (Aβ), plasma tau, and serum antibodies for Aβ1 - 42 are not yet well established. Objective: We aimed to identify a new serum biomarker to detect mild cognitive impairment (MCI) and AD in comparison to cognitively healthy control by a new peptidome technology. Methods: With only 1. 5μl of serum, we examined a new target plate “BLOTCHIP®” plus a matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/MS) to discriminate control (n = 100), MCI (n = 60), and AD (n = 99). In some subjects, cognitive Mini-Mental State Examination (MMSE) were compared to positron emission tomography (PET) with Pittsburgh compound B (PiB) and the serum probability of dementia (SPD). The mother proteins of candidate serum peptides were examined in autopsied AD brains. Results: Apart from Aβ or tau, the present study discovered a new diagnostic 4-peptides-set biomarker for discriminating control, MCI, and AD with 87% of sensitivity and 65% of specificity between control and AD (***p < 0.001). MMSE score was well correlated to brain Aβ deposition and to SPD of AD. The mother proteins of the four peptides were upregulated for coagulation, complement, and plasticity (three proteins), and was downregulated for anti-inflammation (one protein) in AD brains. Conclusion: The present serum biomarker set provides a new, rapid, non-invasive, highly quantitative and low-cost clinical application for dementia screening, and also suggests an alternative pathomechanism of AD for neuroinflammation and neurovascular unit damage.