Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison of Nd:YAG Laser and Combined Intense Pulsed Light and Radiofrequency in the Treatment of Hypertrophic Scars

Introduction Hypertrophic scars are fibroproliferative disorders, seen after burn, trauma, and/or surgery. We aimed to compare the clinical and histopathological results of 1064-nm Nd:YAG laser and combined intense pulsed light and radiofrequency in the treatment of hypertrophic scars. Methods Fifty patients with hypertrophic scars were included in this prospective, randomized study. Twenty-five patients were treated with Nd:YAG laser and 25 patients with combined intense pulsed light and radiofrequency (E-light). The scars were evaluated at baseline, during and at 3 months after the final treatment session using the Vancouver scar scale. Biopsy specimens from scars were obtained before, during, and 3 months after the final treatment session and were stained with hematoxylin and eosin stain, Masson's trichrome stain, and immunostaining procedures for collagen I, collagen III, and TGF-β1. Results Significant improvements in the total Vancouver scar scale scores before and after the treatment in both groups (P < 0.001); however, a significant difference between both groups (P < 0.001), regarding the E-light, which showed better response than Nd:YAG laser. Hematoxylin and eosin and Masson's trichrome staining showed arrangement and thinning of collagen bundles and reduction in collagen density by in both groups, but the collagen bundles thinning and parallelism were more obvious in the E-light group. Significant decrease in the concentration of collagen I, collagen III, and TGF-β1 in the E-light group as compared with the laser group (P = 0.005, P = 0.003 and P < 0.001, respectively). Conclusions Both modalities were successful in the treatment of hypertrophic scars; however, a significant improvement in the clinical and histopathological findings was detected with the E-light method.
PROFILE OF HCV GENOTYPES AND HIV-SUBTYPES AMONG HIV-COINFECTED PATIENTS IN SOUTHERN BRAZIL.

BACKGROUND Hepatitis B and C virus (HBV and HCV) are the two most common infections among human immunodeficiency virus (HIV)-infected patients. OBJECTIVE To identify the frequency of HIV subtypes and HCV genotypes in HIV-coinfected patients. METHODS A cross-sectional and retrospective study was carried out into two reference centers in Southern Brazil between January 1, 2002 and June 30, 2016. The Abbott Real Time HCV Genotype II system was used for routine diagnostics to determine the HCV genotype based on dual-target real-time PCR. Proviral HIV-1 RNA was extracted from serum samples and fragments of the pol gene were generated by PCR. The HIV-1 PT and RT gene sequences were submitted to Maximum Likelihood Phylogenetic analysis by collecting reference sequences from the HIV-1 group M subtype of the Los Alamos database. RESULTS During the study period, 3340 patients with HIV were diagnosed at both referral centers, of which 4.97% (166/3340) had HBV and/or HCV coinfection. Seroprevalence of HIV-HBV, HIV-HCV and HIV-HBV-HCV was 37.4%, 58.4%, and 4.2%, respectively. HIV-HCV-coinfected patients had a lower median nadir CD4+ T-cell count when compared to HIV-HBV-coinfected patients (P=0.01). Among those coinfected with HCV, HCV-1 (HCV-1) and HCV-3 (HCV-3) genotypes were the most prevalent, being detected in 73.8% and 21.4%, respectively. Among the HCV-1 coinfected patients, 79.3% and 20.1% had subtypes 1a and 1b, respectively. HIV subtype B was the most prevalent in HIV-coinfected patients. There was no significant difference regarding nadir CD4+ T-cell count and HIV viral load when compared to coinfected with HCV-1 with HCV-3, as well as those co-infected with HCV-1a with HCV-1b. CONCLUSION In the present study, a higher frequency of subtype B of HIV and HCV-1 were found in HIV-coinfected patients. Further larger-scale and long-term studies are needed to better understand the effect of HCV genotypes in HIV-infected patients.
On the machinability and properties of Ti–6Al–4V biomaterial with n-HAp powder–mixed ED machining

Nano-hydroxyapatite powder was used in electric discharge machining to modify the surface of Ti–6Al–4V medical alloy. Herein, electric discharge machining was performed, with and without powder-mixed flushing for evaluation of the material erosion rate and surface roughness. In addition to dielectric type, several process parameters including current, pulse-on duration, pulse-off duration, and electrode hole diameter were considered. The experiments were planned by Taguchi design technique and conducted to analyze the material erosion rate and surface roughness. After machining, scanning electron microscope, energy-dispersive X-ray spectrometry, and X-ray diffraction techniques were used to evaluate the surfaces of the samples. Furthermore, wear and corrosion tests were also carried out on the Ti alloy with modified surfaces. The influential factors were identified based on analysis of variance results. Current and dielectric type were the significant factors, both for the material erosion rate and surface roughness. The scanning electron microscope images of Ti–6Al–4V samples highlighted that the process parameters exhibited a vital influence on the topology and microstructure of machined surface. Furthermore, energy-dispersive X-ray spectrometry and X-ray diffraction analyses confirmed the presence of hydroxyapatite on Ti alloy surface after machining. Moreover, the results of wear and corrosion tests revealed lower wear and corrosion rates of the surface-treated workpiece with nano-hydroxyapatite.
Free Serratus Fascia Flap for Reconstruction of Soft Tissue Defects Involving the Distal Upper and Lower Extremity

Background Free fascial flaps are widely used for the reconstruction of defects located on the distal extremities as they provide thin yet durable soft tissue coverage. The serratus anterior fascia flap stands out from other fascial flap alternatives as it has optimal anatomical properties that can provide ideal coverage in a wide range of reconstructive challenges. The purpose of this study was to present our experience with the serratus anterior fascia flap in a variety of complex soft tissue defects. Methods A retrospective review was conducted on patients who underwent reconstruction with the free serratus anterior fascia flap for complex soft tissue defects involving the distal extremities. Results Complex soft tissue defects of 13 patients were reconstructed using the free serratus fascia flap. No major postoperative complications such as flap loss, dehiscence, infection, or hematoma were encountered in any of the patients. All of the patients demonstrated durable and harmonious long-term flap coverage that facilitated movement without any signs of scar contractures and tendon adhesions at the site of reconstruction. Conclusions The serratus anterior fascia flap demonstrates versatility and stability for the closure of complex distal extremity defects. It creates thin yet durable coverage that facilitates underlying tendon gliding while providing harmony with the natural contours of these anatomic areas and has low donor site morbidity, making it a primary choice in the reconstruction complex soft tissue defects involving the hands and feet.
Guidelines and Essential Elements for Prebriefing.

STATEMENT Simulationists have reported essential elements that need to be included during prebriefing to establish best practices in simulation and support learner success in simulation. However, there is a gap in the literature; there is a need for synthesis of these reported elements.This article reports the current established prebriefing standards and guidelines. It compiles all the elements that are recommended into one document to facilitate educator training. An infographic is included to serve as a cognitive aid and a checklist for facilitators to use in practice. Finally, this article discusses additional areas of inquiry and research that needs to be completed in relation to prebriefing.
A Brief Look at Urgent Care Visits for Migraine: The Care Received and Ideas to Guide Migraine Care in this Proliferating Medical Setting

There has been a rise in urgent care centers throughout the country over the past 10 years, leading to an increase in patients accessing medical care in these locations. These centers advertise an alternative to the Emergency Department (ED) for the evaluation and treatment of urgent medical conditions. The goal of this analysis was to examine the use of urgent care visits for migraine within 2 urgent care centers within a large academic medical system in New York City. We examined the trends in management and treatment of migraine in these urgent care settings, as well as prescriptions and instructions given to this patient population upon discharge. We paid particular attention to whether the medications administered and prescribed on discharge were those recommended by American Headache Society migraine management guidelines.
Pre-screening Textual Based Evaluation for the Diagnosed Female Breast Cancer (WBC)

Received: 15 April 2019 Accepted: 27 June 2019 The existing virtual assistants (VAs) for medical services cannot output satisfactory results on Chinese language processing (CLP). This paper attempts to design a VA that identifies the seriousness and improves the awareness of breast cancer (BC) based on inputs of Chinese texts. Our VA was developed based on the neural network called long short-term memory (LSTM), integrating two N-gram models, namely, bigram and trigram. The integrated models are critical to text-based Chinese word segmentation (CWS). The sequence-to-sequence learning was introduced to covert the CWS into a framework of sequence classification. The proposed VA was compared with several state-of-the-art methods through an experiment. The results show that our method achieved a high accuracy (94%~97%) in identifying the high-frequency characters. The research findings are helpful to the BC identification of Chinese women.
Age Assessment of Youth and Young Adults Using Magnetic Resonance Imaging of the Knee: A Deep Learning Approach

Background Bone age assessment (BAA) is an important tool for diagnosis and in determining the time of treatment in a number of pediatric clinical scenarios, as well as in legal settings where it is used to estimate the chronological age of an individual where valid documents are lacking. Traditional methods for BAA suffer from drawbacks, such as exposing juveniles to radiation, intra- and interrater variability, and the time spent on the assessment. The employment of automated methods such as deep learning and the use of magnetic resonance imaging (MRI) can address these drawbacks and improve the assessment of age. Objective The aim of this paper is to propose an automated approach for age assessment of youth and young adults in the age range when the length growth ceases and growth zones are closed (14-21 years of age) by employing deep learning using MRI of the knee. Methods This study carried out MRI examinations of the knee of 402 volunteer subjects—221 males (55.0%) and 181 (45.0%) females—aged 14-21 years. The method comprised two convolutional neural network (CNN) models: the first one selected the most informative images of an MRI sequence, concerning age-assessment purposes; these were then used in the second module, which was responsible for the age estimation. Different CNN architectures were tested, both training from scratch and employing transfer learning. Results The CNN architecture that provided the best results was GoogLeNet pretrained on the ImageNet database. The proposed method was able to assess the age of male subjects in the range of 14-20.5 years, with a mean absolute error (MAE) of 0.793 years, and of female subjects in the range of 14-19.5 years, with an MAE of 0.988 years. Regarding the classification of minors—with the threshold of 18 years of age—an accuracy of 98.1% for male subjects and 95.0% for female subjects was achieved. Conclusions The proposed method was able to assess the age of youth and young adults from 14 to 20.5 years of age for male subjects and 14 to 19.5 years of age for female subjects in a fully automated manner, without the use of ionizing radiation, addressing the drawbacks of traditional methods.
Bile acids inhibit cholinergic constriction in proximal and peripheral airways from humans and rodents.

Duodenogastroesophageal reflux (DGER) is associated with chronic lung disease. Bile acids (BAs) are established markers of DGER aspiration and are important risk factors for reduced post-transplant lung allograft survival by disrupting the organ-specific innate immunity facilitating airway infection and allograft failure. However, it is unknown whether BAs also affect airway reactivity. We investigated the acute effects of 13 BAs detected in post-lung transplant surveillance bronchial washings (BW) on airway contraction. We exposed precision-cut slices from human and mouse lungs to BAs and monitored dynamic changes in cross-sectional luminal area of peripheral airways using video phase-contrast microscopy. We also used guinea-pig tracheal rings in organ baths to study BA effects in proximal airway contraction induced by electrical field stimulation. We found that most secondary BAs at low micromolar concentrations strongly and reversibly relaxed smooth muscle and inhibited peripheral airway constriction induced by acetylcholine but not by non-cholinergic bronchoconstrictors. Similarly, secondary BAs strongly inhibited cholinergic constrictions in tracheal rings. In contrast, TC-G 1005, a specific agonist of the BA receptor TGR5, did not cause airway relaxation, and Tgr5 deletion in knockout mice did not affect BA-induced relaxation, suggesting that this receptor is not involved. BAs inhibited acetylcholine-induced inositol phosphate synthesis in human airway smooth muscle cells overexpressing the muscarinic M3 receptor. Our results demonstrate that select BAs that are found in BW of patients with lung transplantation can affect airway reactivity by inhibiting the cholinergic contractile responses of the proximal and peripheral airways, possibly by acting as antagonists of M3 muscarinic receptors.
Charles Porter Ellington (1952–2019)

[][1] Charlie and The Flapper, the latter making its first public appearance at the Royal Society Soirees in 1991. These events are full-dress affairs; it can just be seen that the flapper is wearing a bow tie. Photo credit: R.J.W. By the mid-1970s, the study of insect flight
De Novo Genotypic Heterogeneity in the UL56 Region in Cytomegalovirus-infected Tissues: Implications for Primary Letermovir Resistance.

BACKGROUND Letermovir, an inhibitor of UL56-encoded cytomegalovirus (CMV)-terminase, shows prophylactic effects with low-grade adverse events in hematopoietic stem cell transplant recipients. Despite few case reports on acquired letermovir resistance, the frequency of de novo amino acid (A.A.) changes encoded by UL56 in CMV-infected tissues is unclear. METHODS We analyzed CMV UL56 sequences between the conserved region IV and variable region I in 175 formalin-fixed, paraffin-embedded tissues obtained from 147 patients showing positive CMV immunochemical staining between November 2012 and October 2016. Nucleotides 552-1330 of the open reading frame of UL56 were amplified with five primers and sequenced by a dideoxy fluorescence-based cycle. RESULTS Six (3.4%) tissues from four (2.7%) patients harbored A.A. substitutions. There were no known potent resistant mutations. However, we found C325Y in two tissues from one patient, along with other mutations. Four novel A.A. changes, which have not been observed in previous in-vitro experiments, were identified (T244I, S301T, G312V, and M434I). Most (9 of 11, 81.8%) of the A.A. changes occurred between the codons 301 and 325 present between the conserved regions V and VI. CONCLUSION The treatment difficulties associated with letermovir resistance in a clinical setting need to be verified prior to its widespread use.
The Effect of Botulinum Toxin Injection into the Common Extensor Tendon in Patients with Chronic Lateral Epicondylitis: A Randomized Trial.

BACKGROUND Botulinum toxin (BTX) is widely used for pain control in various musculoskeletal disorders. OBJECTIVES We evaluated the analgesic effect of botulinum toxin type A (BTX-A) in chronic lateral epicondylitis and compared the effect between 10 and 50 IU of BTX-A. METHODS Sixty subjects with chronic lateral epicondylitis were included and underwent a BTX-A injection in the common extensor tendon. The subjects were randomly allocated into two groups: the small-dose group (SD group; 30 subjects, 10 IU) and large-dose group (LD group; 30 subjects, 50 IU). Treatment outcomes were evaluated by measuring the pain level using the numeric rating scale (NRS) and measuring grip strength before and one, two, three, four, five, and six months after treatment. RESULTS Subjects in both groups showed a significant decrease in NRS scores at all evaluation time points after treatment. The reduction in NRS scores was significantly greater in the LD group at one, two, three, and four months after treatment. Six months after treatment, 19 subjects (63.3%) in the SD group and 21 (70%) in the LD group reported successful pain relief (pain relief ≥50%). The rate of successful pain relief was not significantly different between the two groups. Grip strength was more increased in the LD group at one, two, three, four, and six months after treatment. CONCLUSIONS BTX-A injection into the common extensor tendon can be a good treatment option for chronic lateral epicondylitis. The 50-IU BTX-A injection achieved a better outcome than the 10-IU injection.
Characterization of Terpene Synthase from Tea Green Leafhopper Being Involved in Formation of Geraniol in Tea (Camellia sinensis) Leaves and Potential Effect of Geraniol on Insect-Derived Endobacteria

When insects attack plants, insect-derived elicitors and mechanical damage induce the formation and emission of plant volatiles that have important ecological functions and flavor properties. These events have mainly been studied in model plants, rather than crop plants. Our study showed that tea green leafhopper (Empoasca (Matsumurasca) onukii Matsuda), a major pest infesting tea attack significantly induced the emission of geraniol from tea leaves, but did not affect the crude enzyme activity of geraniol synthase in tea leaves. An enzyme extract of E. (M.) onukii specifically produced geraniol from geraniol diphosphate. Furthermore, a terpene synthase (EoTPS) was isolated from E. (M.) onukii. This terpene synthase was able to convert geraniol diphosphate to geraniol in vitro. In addition, geraniol had in vitro ability to inhibit the growth of Acinetobacter johnsonii that is endobacterial isolated from E. (M.) onukii. This information illustrates that elicitors from piercing-sucking insects can induce the formation of volatiles from crop plants and advances our understanding of the roles of plant volatiles in the interaction among crops-insects-microorganisms.
Histological and molecular diversity and heterogeneity of precancerous lesions associated with inflammatory bowel diseases

Aims Inflammatory bowel disease (IBD)-associated precancerous lesions may be adenomatous or non-adenomatous with various histomorphologies. We aim to validate the newly proposed classification, to explore the neoplastic nature of the non-adenomatous lesions and to elucidate the molecular mechanisms underlying the different histomorphologies. Methods 44 background precursor lesions identified in 53 cases of surgically resected IBD-associated colorectal and ileal carcinomas were reviewed for the histomorphological features (classified into adenomatous, mucinous, sessile serrated adenoma (SSA)-like, traditional serrated adenoma-like, differentiated, eosinophilic and serrated not otherwise specified (NOS)) and analysed for a key panel of colonic cancer-related molecular markers. Results Approximately 60% of the lesions were adenomatous, of which some had mixed serrated, mucinous or eosinophilic changes. The remaining non-adenomatous lesions, including all other types except SSA-like type, mostly showed mixed features and focal adenomatous dysplasia. KRAS mutation and p53 mutant-type expression were found in about half cases across all types, while PIK3CA mutation only in some of adenomatous and eosinophilic lesions and MLH1/PMS2 loss in a subset of adenomatous, mucinous and eosinophilic but not in differentiated and serrated lesions. SAT-B2 or PTEN loss and IMP3 overexpression were seen in a small subset of lesions. No BRAF, NRAS or EGFR gene mutation was detected in any type. Certain molecular-morphological correlations were demonstrated; however, no single or combined molecular alteration(s) was specific to any particular morphological type. Conclusions IBD-associated precancerous lesions are heterogeneous both histologically and molecularly. True colitis-associated adenomatous lesions are unlikely conventional adenomas. Non-adenomatous lesions without frank cytologic dysplasia should also be regarded as neoplastic.
Theory and predictions for the development of morphology and syntax: A Universal Grammar + statistics approach

Abstract The key aim of this special issue is to make developmental theory proposals concrete enough to evaluate with empirical data. With this in mind, I discuss proposals from the “Universal Grammar + statistics” (UG+stats) perspective for learning several morphology and syntax phenomena. I briefly review why UG has traditionally been part of many developmental theories of language, as well as common statistical learning approaches that are part of UG+stats proposals. I then discuss each morphology or syntax phenomenon in turn, giving an overview of relevant UG+stats proposals for that phenomenon, specific predictions made by each proposal, and what we currently know about how those predictions hold up. I conclude by briefly discussing where we seem to be when it comes to how well UG+stats proposals help us understand the development of morphology and syntax knowledge.
Exposure to Indoor Ferromagnetic Particulate Matter Monitored by Strawberry Plants and the Occurrence of Acute Respiratory Events in Adults

Exposure assessment of air pollution in epidemiologic research remains a challenge. Previous studies showed that magnetic monitoring of strawberry leaves, based on Saturation Isothermal Remnant Magnetization (SIRM), is a valid tool for estimating the concentration of ambient particulate matter (PM). This study uses this assessment method for the first time in epidemiologic research to quantify indoor exposure to PM. In a nested case control study, we evaluated the association between ‘waking up by cough’ and indoor air pollution measured by SIRM of dust deposition on leaves of strawberry plants located in the bedroom in the general adult population. A multiple logistic regression was used to estimate the association between ‘waking up by cough’ and exposure to ferromagnetic particles of PM controlling for age, gender and smoking status. A cut-off of 10 µA was decided to define exposure status (high versus low). Using logistic regression, a crude odds ratio (OR) of 1.80 (95% CI: 0.90–3.60) for ‘waking up by cough’ was found. This association remained approximately the same after controlling for age, gender and smoking status (adjusted OR: 1.76; 95% CI: 0.60–5.30). We found an association between exposure to ferromagnetic particles and ‘waking up by cough’ in adults; however, it was not statistically significant. This environmental exposure assessment method could be a valuable alternative for expensive personal exposure measurement devices.