Miracle-dz/UniFAR-FTUs huggingface dataset:
Fentanyl related cases. The situation in Greece

Objective: Fentanyl is used as a pre-anesthetic medication and it is also prescribed for the management of chronic pain through the delivery method of transdermal patches. It is used or abused, as a recreational drug, worldwide. As a result, a significant number of fentanyl related deaths have been recorded in many countries, as well as in Greece. The aim of this paper is to present the current situation in Greece through the report of specific fentanyl related cases and to discuss the different aspects of fentanyl abuse. Methods: A gas chromatography-mass spectrometric method was developed, validated and applied for the determination of fentanyl in biological fluids during the investigation of fentanyl related cases. Results: Eight cases, lethal or not, have been recorded the last four years in Greece, where fentanyl blood concentration was found up to 22.7 ng/mL. Five of the cases concerned therapeutic use of fentanyl and three were related to abuse of the drug. Furthermore, six of these cases concerned fentanyl transdermal patches. Conclusions: The commercial success of transdermal fentanyl is impressive and ensures that the drug will remain in market for years to come. The litigation surrounding the use and abuse of fentanyl patches is a major concern today. Warning and information to users and practitioners about the possibility of adverse effects, even death, law enforcement action, prescribing regulations, and availability of rapid and accurate analytical methods for the determination of fentanyl in biological specimens, must be under deliberation.
Deep-Learning System Detects Neoplasia in Patients With Barrett's Esophagus With Higher Accuracy Than Endoscopists in a Multi-Step Training and Validation Study with Benchmarking.

BACKGROUND & AIMS We aimed to develop and validate a deep-learning computer-aided detection (CAD) system, suitable for use in real time in clinical practice, to improve endoscopic detection of early neoplasia in patients with Barrett's esophagus (BE). METHODS We developed a hybrid ResNet-UNet model CAD system using 5 independent endoscopy datasets. We performed pre-training using 494,364 labelled endoscopic images collected from all intestinal segments. Then, we used 1704 unique esophageal high-resolution images of rigorously confirmed early-stage neoplasia from patients with BE, and non-dysplastic BE, derived from 669 patients. System performance was assessed using datasets 4 and 5. Dataset 5 was also scored by 53 general endoscopists with a wide range of experience from 4 countries to benchmark CAD system performance. Coupled with histopathology findings, scoring of images that contained early-stage neoplasia in datasets 2-5 were delineated in detail for neoplasm position and extent by multiple experts whose evaluations served as the ground truth for segmentation. RESULTS The CAD system classified images as containing neoplasms or non-dysplastic BE with 89% accuracy, 90% sensitivity, and 88% specificity (dataset 4, 80 patients and images). In dataset 5 (80 patients and images) values for the CAD system vs those of the general endoscopists were 88% vs 73% accuracy, 93% vs 72% sensitivity, and 83% vs 74% specificity. The CAD system achieved higher accuracy than any of the individual 53 non-expert endoscopists, with comparable delineation performance. CAD delineations of the area of neoplasm overlapped with those from the BE experts in all detected neoplasia in datasets 4 and 5. The CAD system identified the optimal site for biopsy of detected neoplasia in 97% and 92% of cases (dataset 4 and 5 respectively). CONCLUSIONS We developed, validated, and benchmarked a deep-learning computer-aided system for primary detection of neoplasia in patients with BE. The system detected neoplasia with high accuracy and near-perfect delineation performance.
Antimicrobial Resistance of Acinetobacter spp. Isolated from Pus Specimens from AL-Shifa Hospital, Gaza, Palestine.

ةزغب ءافشلا ىفشتسم نم ديدصلا تانيع نم رتكابوتينيسلاا تلازعل تاداضملا ةمواقم ، نيطسلف سلاا ايريتكب ربتعت نم ديازتم ددع نع ةلوئسم رتكابوتيني تاباهتللاا تايفشتسملا يف ةيزاهتنلاا . بستكاو ت ةيويحلا تاداضملا ةمواقم ىلع اهتردق للاخ نم ةعساو ةرهش . ةيويحلا تاداضملا ةمواقم تاسارد ربتعت ةدعاسمل ملاعلا نادلب لك يف ةحلم ةرورض ءابطلأا ةيرظنلا تاجلاعلا فصو يف نييلحملا . ـ ف مت هذـه ي تاحسم ىلع ديدصلا تانيع عمج ةساردلا وأ ةزـغب ءافشـلا ىفشتسم نم ىضرم نم نقاحملا ةطساوب . ةيريتكبلا طاسولأا ىلع تعرز تانيعلا ) يكنوكاملا راجاو مدلا راجا . ( تـكلتما يتلا تلازعلا ضارتفا مت ىلع زيديسكولاا صحف ةبلاسو زوكولجلا ريمخت مدع ةفص اهنأ رتكابوتينيسا . ع مت هـعومجم ام لز 152 ل تلازـعلل ةـيلاع ةـمواقم ةيساسـحلا صـحف جئاـتن ترـهظأو رتكابوتينيسلاا نم ةلزع نـم لـك Cephalosporins ) cephalexine, 98%, cefuroxime, 98.2% cefotaxime, 93.2%, ceftazidime, 87.5%, ceftriaxone, (93.3% cefaclor, 97.4%) لقأ بسن ةساردلا ترهظأ امنيب ملا نم دض ةمواق aminoglycosides (amikacin, 68.3% and gentamicin, 81.3%) . داضـملا وه جئاتنلا ترهظا امك ةيلاعف رثكلأا doxycycline ةمواقم ةبسن لقأب ) 22.1 % ( . ةـساردلا هذـه جئاتن ثـحبلاو تايفشتسملا يف ةباصلاا رطاخم ليلقتل ةيلمع تاوطخب مايقلا بجيو راذنإ ةباثمب ربتعت نأ بجي ةليدب تاداضم نع . ةيحاتفم تاملك : ةيويحلا تداضملا ةمواقم ، رتكابوتينيسا .
The difference in risk of chronic pulmonary disease morbidity and mortality between former elite athletes and ordinary men in Finland

Abstract The impact of a history of competitive sports on later smoking behaviour and occurrence of chronic pulmonary diseases is poorly known. We investigated how a history of elite level sports predicted later pulmonary disease morbidity and mortality. Chronic pulmonary disease incidence was assessed from national hospital and cause-of-death registers from 1970 to 2015 among Finnish male former elite athletes (n = 2078) and matched controls (n = 1453) alive in 1970 (mean age 45.0 years). Hazard ratios (HRs) were calculated by Cox proportional hazards model. In 1985, cohort members reported on their smoking habits, engagement in physical activity/sports and physician-diagnosed chronic diseases. The risk of any chronic pulmonary disease or death was lower among former athletes than controls (age-adjusted HR 0.61; 95% CI 0.46–0.83). The risk was significantly lower among endurance (HR 0.54), mixed (HR 0.61), and power sports athletes (HR 0.66) compared to controls. The age- and smoking pack-year-adjusted HRs of incident diseases from the time of the 1985 questionnaire until the end of follow-up in former athletes was 0.58 (95% CI 0.37–0.93) compared to controls. In 1985 athletes smoked less and their cumulative smoking quantity was lower than that of controls. Former athletes were more physically active and self-reported less physician-diagnosed emphysema. The risk of any chronic pulmonary disease was lower among former athletes than controls even after considering smoking status and cumulative smoking quantity. Ability to compete at the highest level of sports in young adulthood associated with a reduced risk of pulmonary disease in later life.
Postoperative neurocognitive disorders.

PURPOSE OF REVIEW Alterations in cognitive functions are common in the perioperative course. Although often unnoticed by physicians, these alterations might have distinct long-term consequences for the patient with regard to everyday functioning, self-dependency, and quality of life. In recent years, however, perioperative cognition has gained increased interest, both by clinicians and scientists, and knowledge of the preventive measures of postoperative cognitive decline has become mandatory for anesthetists and surgeons. RECENT FINDINGS This review offers a brief overview of the current state of knowledge concerning perioperative changes in cognition, including its pathophysiology and prevention strategies. SUMMARY Postoperative neurocognitive disorders are frequent complications, especially in elderly patients, with postoperative delirium being its most pronounced and acute postoperative form, predisposing the patient for long-term cognitive impairment. The incidence of postoperative cognitive decline can be reduced by implementing preventive measures during perioperative patient care as recommended by national and international guidelines.
Circulating Extracellular Vesicles in Normotension Restrain Vasodilation in Resistance Arteries.

Extracellular vesicles (EVs) have been described as novel biomarkers and bioactivators in vascular dysfunction in hypertension. However, the mechanism(s) by which EVs affect vascular function is unknown. To examine the effects of EVs on endothelial-dependent vasodilation (acetylcholine), we isolated circulating EVs from platelet-poor plasma using a low centrifugation speed (17 000g) and mesenteric resistance arteries from 12-week-old normotensive WKYs (Wistar-Kyoto rats) and SHRs (spontaneously hypertensive rats). Arteries were cannulated on a pressure myograph, and EVs were added to the vessel lumen and circulating bath. We found that circulating EVs from normotensive WKY reduced vasodilation of normotensive WKY arteries but had no effect on hypertensive SHR arteries. In contrast, EVs from hypertensive SHR failed to reduce vasodilation of arteries from both WKY and SHR. The restraining effect on vasodilation by EVs from normotensive WKY may be mediated by inhibition of eNOS (endothelial NO synthase), as addition of L-nitro-arginine methyl ester did not provide any additive effect. Moreover, circulating EVs from normotensive 6-week-old SHR-an age where SHRs have not yet developed hypertension-had similar restraining effect on vasodilation. In addition, delipidation of EVs did not alter the restraining effect of EVs from WKY but did restore the restraining effect of EVs from SHR. Finally, EVs from normotensive humans also restrained vasodilation of normotensive mouse arteries-an effect not observed in EVs from hypertensive humans. Taken together, our data support a vasoactive role of EVs that is altered in hypertension.
Further investigations on the PHAEOTHAMNIOPHYCEAE using a multigene phylogeny, with descriptions of five new species

We examined 12 strains representing eight species classified in the algal class Phaeothamniophyceae (Heterokontophyta). Based upon a five‐gene molecular phylogeny (nuclear‐encoded SSU rRNA and plastid‐encoded psaA, psbA, psbC, and rbcL) and light microscopic observations, we describe five new species: Phaeoschizochlamys santosii sp. nov., Phaeoschizochlamys siveri sp. nov., Phaeothamnion wetherbeei sp. nov., Stichogloea dopii sp. nov. and Stichogloea fawleyi sp. nov. The Phaeothamniophyceae, as delimited here, form a natural group that is sister to the Aurearenophyceae. Molecular phylogenetic analyses proved more reliable than morphological characters for distinguishing species. Evolutionary trends with the SI clade of the heterokont algae are discussed.
Poor performance of the 'child Reading the Mind in the Eyes Test' correlates with poorer social-emotional functioning in children with attention-deﬁcit/hyperactivity disorder.

The performance of the 'child Reading the Mind in the Eyes Test' (cRMET), a measure of Theory of Mind (ToM), was assessed in children with attention-deficit/hyperactivity disorder (ADHD) with relation to social-emotional functioning and ADHD severity. The impact of a single dose of methylphenidate on cRMET performance was evaluated. A group of 25 children aged 7-17 years diagnosed with ADHD were assessed at baseline by cRMET, the Strengths and Difficulties Questionnaire (SDQ) and the ADHD-rating scale. cRMET assessment was repeated after administration of a single dose of methylphenidate. Significant correlation was found between the age of the participant and baseline cRMET levels (r = 0.56; P = 0.0037). Significant correlation was found between poorer cRMET performance and worse socioemotional functioning, as reflected by higher baseline SDQ scores (r = -0.39, P = 0.048). No significant correlations were found at baseline between cRMET scores and ADHD severity. No significant improvement in cRMET was detected following administration of a single methylphenidate dose. Poor baseline ToM functioning is associated with lower social-emotional functioning. The ToM functioning improves with age in children with ADHD, but is not affected by a single methylphenidate administration.
Microscopic Characterization of GRP1 PH Domain Interaction with Anionic Membranes

The pleckstrin homology (PH) domain of general receptor for phosphoionositides 1 (GRP1‐PHD) binds specifically to phosphatidylinositol (3,4,5)‐triphosphate (PIP3), and acts as a second messenger. Using an extensive array of molecular dynamics (MD) simulations employing highly mobile membrane mimetic (HMMM) model as well as complementary full membrane simulations, we capture differentiable binding and dynamics of GRP1‐PHD in the presence of membranes containing PC, PS, and PIP3 lipids in varying compositions. While GRP1‐PHD forms only transient interactions with pure PC membranes, incorporation of anionic lipids resulted in stable membrane‐bound configurations. We report the first observation of two distinct PIP3 binding modes on GRP1‐PHD, involving PIP3 interactions at a “canonical” and at an “alternate” site, suggesting the possibility of simultaneous binding of multiple anionic lipids. The full membrane simulations confirmed the stability of the membrane bound pose of GRP1‐PHD as captured from our HMMM membrane binding simulations. By performing additional steered membrane unbinding simulations and calculating nonequilibrium work associated with the process, as well as metadynamics simulations, on the protein bound to full membranes, allowing for more quantitative examination of the binding strength of the GRP1‐PHD to the membrane, we demonstrate that along with the bound PIP3, surrounding anionic PS lipids increase the energetic cost of unbinding of GRP1‐PHD from the canonical mode, causing them to dissociate more slowly than the alternate mode. Our results demonstrate that concurrent binding of multiple anionic lipids by GRP1‐PHD contributes to its membrane affinity, which in turn control its signaling activity. © 2019 Wiley Periodicals, Inc.
Pain processing in the isolated spinal cord: Adaptive nociceptive modifications

Pain Processing in the Isolated Spinal Cord: Adaptive Nociceptive Modifications. (May 2011) Denise Alejandra Puga, B.A., New Mexico State University; M.S., Texas A&M University Chair of Advisory Committee: Dr. James W. Grau We utilize a simple instrumental (response-outcome) learning task to measure spinal plasticity in the isolated spinal cord. Peripheral uncontrollable nociceptive input has been shown to disrupt spinal instrumental learning and induce enhance tactile reactivity. In contrast, 1.5mA of continuous shock has been found to induce antinociception and protect spinal plasticity from the detrimental consequences of uncontrollable stimulation. The experiments of this dissertation examined the link between the beneficial effects of continuous stimulation and antinociception. The results replicated previous work examining the protective and antinociceptive effect of 1.5mA of continuous shock (Experiments 1-2). Novel to this research was the inclusion of a lower (0.5mA) intensity continuous stimulation. Results revealed that 0.5mA of continuous shock induced a comparable antinociception to that seen with 1.5mA of continuous shock (Experiment 1). At this lower intensity, however, continuous shock was unable to protect the isolated spinal cord from the detrimental effect of intermittent stimulation (Experiment 2). Further examination revealed that co-
Implementation of HIV Interventions Into Faith-Based Organizations: Models and Methodological Considerations.

BACKGROUND Implementation of evidence-based interventions aimed at reducing and treating HIV can have a wider spread if funneled through faith-based organizations. However, there is a paucity of frameworks or process models aimed at providing the best practices to implement HIV interventions into faith-based community organizations. SETTING Implementation framework and process model for African American faith settings. RESULTS Presented here is a systems multilevel implementation framework and implementation process model for integrating HIV interventions into faith-based organizations. We conclude with presentation of key methodological considerations and recommendations and discuss strategies for moving implementation science forward in faith-based organizations. CONCLUSION Because of their key role in the African American community, faith-based settings must be engaged in implementing evidence-based HIV interventions. Through use of a multilevel systems framework and process model, the methods and approaches of implementation science can be leveraged to encourage the spread of HIV interventions in the African American community.
Deep Learning for Lesion Detection, Progression, and Prediction of Musculoskeletal Disease

Deep learning is one of the most exciting new areas in medical imaging. This review article provides a summary of the current clinical applications of deep learning for lesion detection, progression, and prediction of musculoskeletal disease on radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine. Deep‐learning methods have shown success for estimating pediatric bone age, detecting fractures, and assessing the severity of osteoarthritis on radiographs. In particular, the high diagnostic performance of deep‐learning approaches for estimating pediatric bone age and detecting fractures suggests that the new technology may soon become available for use in clinical practice. Recent studies have also documented the feasibility of using deep‐learning methods for identifying a wide variety of pathologic abnormalities on CT and MRI including internal derangement, metastatic disease, infection, fractures, and joint degeneration. However, the detection of musculoskeletal disease on CT and especially MRI is challenging, as it often requires analyzing complex abnormalities on multiple slices of image datasets with different tissue contrasts. Thus, additional technical development is needed to create deep‐learning methods for reliable and repeatable interpretation of musculoskeletal CT and MRI examinations. Furthermore, the diagnostic performance of all deep‐learning methods for detecting and characterizing musculoskeletal disease must be evaluated in prospective studies using large image datasets acquired at different institutions with different imaging parameters and different imaging hardware before they can be implemented in clinical practice.
Comparison of Clinical Outcomes following Intramedullary Fixation of Tibia Fractures Caused by Blunt Trauma and Civilian Gunshot Wounds: a Retrospective Review.

OBJECTIVE To assess the outcomes of patients who sustained blunt trauma tibia fractures compared to tibia fractures from civilian gunshot injuries when treated with intramedullary fixation. DESIGN Retrospective chart review SETTING:: Level I trauma centerPatients/Participants: Two hundred and seven patients underwent intramedullary nailing for 211 tibia fractures. METHODS A retrospective review of tibia fracture(s) treated with intramedullary fixation with comparison of closed, open and gunshot wound (GSW) fracture outcomes. MAIN OUTCOME MEASUREMENTS Outcomes included infection and nonunion. RESULTS The infection rate in closed and GSW tibia fractures was significantly lower compared to the infection rate of open fractures (1% v. 9% v. 20%; p=0.00005). Significantly lower rates of nonunion in closed fractures compared to open fractures and GSW fractures were appreciated (8% v. 20% v. 30%; p=0.003). There was no difference in infection or nonunion between GSW fractures with small wounds, no exposed bone, and minimal comminution and closed injuries (p=0.24, p=0.60). Conversely there was a significantly higher nonunion rate in GSW fractures with large wounds, exposed tibia and comminution compared to blunt injuries (p=0.0014). CONCLUSIONS This study suggests that tibia fractures from civilian GSWs are heterogeneous injuries and outcomes are dependent on the extent of soft tissue injury, bone exposure and bone loss. There are comparable infection rates in all fractures due to civilian GSWs and closed fractures, which are lower than high-grade open fractures. Tibia GSW fractures with exposed bone and comminution have higher complication rates and should be treated accordingly. LEVEL OF EVIDENCE Diagnostic Level III.
Event-, Time- and Activity-Based Prospective Memory in Children with ADHD

ABSTRACT We examined prospective memory (PM) function in children with attention deficit hyperactivity disorder (ADHD). A group of 28 children with ADHD and 28 typically developing children completed event-, time- and activity-based PM tasks and attention tests. ADHD children had impaired attention but intact PM performance. Both groups performed best in activity-based PM tasks, followed by event-based PM tasks, and performed worst in time-based PM tasks. ADHD children had lower ongoing task performance in the event-based PM task. The findings indicate that children with ADHD may have an intact PM, but this may be at the cost of ongoing task performance.
Tick paralysis in dogs and cats in Australia: treatment and prevention deliverables from 100 years of research.

This review of tick paralysis caused by Ixodes holocyclus in Australia addresses the question: What are the key discoveries that have enabled effective treatment and prevention of tick paralysis in dogs and cats? Critical examination of 100 years of literature reveals that arguably only three achievements have advanced treatment and prevention of tick paralysis in animals. First, the most significant treatment advance was the commercial availability of tick antiserum in the 1930s. Hyperimmune serum currently remains the only specific anti-paralysis tick therapy available to veterinarians in Australia. Second, advances in veterinary critical care have increased survival rates of the most severely affected dogs and cats. Critical care advancements have been enabled through specialised veterinary hospitals that can provide appropriate care 24 h a day, and advanced training of veterinarians, veterinary nurses and technicians. Third, perhaps that biggest advance of all in the last 100 years of research has been the commercial availability of the isooxazoline class of acaricidal preventatives in Australia specifically for I. holocyclus. This highly effective class of preventatives offers long duration of action, low cost, spot-on or oral formulations and a low rate of adverse reactions. Animal owners and veterinarians now have the most useful tool of all - a reliable preventative. This review reveals the key events in research over the last 100 years and the tortuous pathway to delivering better treatment and preventative options for this enigmatic Australian parasite.
Roflumilast is effective in reducing COPD related exacerbations and improving CAT score

We present a case of a 85-year-old man who suffered from several chronic obstructive pulmonary disease (COPD) related exacerbations and hospitalizations. Traditional therapy, which also included intramuscular steroid therapy, did not help and caused several drug related adverse events. After yet another exacerbation followed by hospitalization at the intensive care unit, it was decided to start roflumilast treatment. In the year after beginning treatment, the patient did not experience any more exacerbations and his lung function also improved, as recorded by the COPD assessment test (CAT) score and improved forced expiratory volume in the first second (FEV1) value. In this patient roflumilast seems to be effective in reducing exacerbations, an important goal to be achieved in COPD patients.