Miracle-dz/UniFAR-FTUs huggingface dataset:
Application of polymeric nanoparticles in immunotherapy

Purpose of reviewThe purpose of the present review is to underline the importance of nanoparticulate carriers, such as polymeric nanoparticles, in the future development of safe and effective formulation in the field of immunotherapy against infectious diseases and cancer. Recent findingsPolymeric nanoparticles can modulate the immune response, that is, by targeting antigens to dendritic cells that possess a crucial role in initiating immune responses, and might be potentially useful in immunotherapy. SummaryIn the last decades, significant progress in research and clinics has been made to offer possible innovative therapeutics for the management of infectious diseases and cancer. Polymeric nanoparticles are particularly adept at facilitating immunotherapeutic approaches because they can be engineered to have different physical properties, encapsulated agents, and surface ligands. Moreover, these systems are administrable for all routes, are capable of being actively taken up by dendritic cells and have shown promising potential in systemic and mucosal immunotherapy. Here, some recent findings on these systems, in their potential applications for infectious and cancer immunotherapy, are reported.
ALTA PREVALENCIA DE IGG ANTI CITOMEGALOVIRUS EN 583 EMBARAZOS: HOSPITAL PADRE HURTADO *

RESUMENAntecedentes: Citomegalovirus (CMV) es la infeccion congenita mas frecuente, demostrado en el 1% de recien nacidos en paises desarrollados. Es la primera causa de sordera y alteraciones del desarrollo neuro-logico infantil. Recientes estudios han demostrado que la seropositividad no evita una reinfeccion materna ni la enfermedad congenita, por lo que la caracterizacion de la seroprevalencia permite saber si la infeccion congenita proviene mayoritariamente de primoinfeccion o de reinfeccion. Objetivos: Conocer la seropre-valencia al parto en 583 mujeres beneﬁciarias del Hospital Padre Hurtado durante mayo y junio del 2006. Metodos: Estudio prospectivo, observacional, en que se estudio la presencia de IgG anti CMV en sangre materna al parto. Resultados: Se obtuvo una seroprevalencia de 95%, sin casos de infeccion sintomatica al nacer. Conclusion: La seroprevalencia es elevada, lo que sugiere que la reinfeccion seria la forma principal de infeccion congenita. Un estudio en recien nacidos con cultivos virales o PCR permitiria conocer la tasa de infeccion congenita real, y no un estudio basado en seroconversion pues omitiria todos los casos que reinfeccion, que serian mayoritarios.PALABRAS CLAVE: Citomegalovirus congenito, tamizaje, serologia, prevalenciaSUMMARYBackground: Cytomegalovirus is the most frequent congenital infection, affecting 1% of the population in developed countries, and the leading cause of deafness and brain development abnormalities in children. Recent studies have demonstrated that seropositivity do not avoid reinfection and congenital disease. Ob-jective: To study the seroprevalence in 583 pregnant women at delivery at Padre Hurtado Hospital, during 2006. Methods: Prospective, observational study, in which maternal blood at delivery was studied for the presence of anti CMV IgG. Results: There was 95% seroprevalence, without any case of symptomatic infec-tion. Conclusion: The high prevalence supports that most of the cases of congenital disease would occur in seropositive women, supporting that reinfection is the main way of neonatal compromise. This supports that a study with direct detection in liveborns would be suitable to reveal the impact of cytomegalovirus in our population and not that of seroconversion. KEY WORDS: Congenital cytomegalovirus, screening, serology, prevalence
Community College Pathways: Improving the U.S. Physician Workforce Pipeline

Purpose To examine the association between participation in a community college (CC) pathway, medical school admission, and intentions to practice in underserved communities or work with minority populations. Method The authors performed cross-sectional analyses of the 2012 Association of American Medical Colleges matriculant and applicant files and the Matriculating Student Questionnaire to assess associations between student characteristics and participation in a CC pathway. They used logistic regression to estimate the association among CC pathway and acceptance to medical school, intention to practice in underserved areas, or intention to work with minority populations. Results There were 40,491 applicants and 17,518 matriculants to U.S. MD-granting schools; about one-third used a CC. A higher proportion of underrepresented minority (URM) matriculants used CC pathways compared with whites. Applicants who attended a CC after high school and before a four-year university (First-CC) had lower odds of acceptance into medical school (adjusted odds ratio [AOR] = 0.68; 95% CI 0.61–0.75; P < .05). Compared with medical students who never attended a CC, First-CC matriculants were more likely to have parents without a college education (304/895 [34%] versus 1,683/12,598 [13%], P < .001) and higher odds of intentions to practice in underserved communities (AOR = 1.26; 95% CI 1.04–1.53; P < .05), after adjusting for covariates. Conclusions There is both high representation of URM students and higher prevalence of intention to work with underserved communities among CC pathway participants. These findings may be of interest to those seeking to enhance diversity in the physician workforce.
Going Inter-Professional: Working Together for Health and Welfare

Ed Audrey Leathard Routledge, pounds sterling14.99, pp 244 ISBN 0 415 09286 8 For workers in primary care, working with other professionals raises many unanswered questions: How can members of different professions get on more effectively? To what extent can professionals work together without identifying themselves with the stereotypes associated with their professional group? Can doctors working in primary care stop speaking as though they have the master language? Can social scientists working in university departments stop asserting that general practitioner colleagues are second rate? Having trained initially in social science and then worked in hospitals and general practice, I have learnt to recognise …
The power of power laws and an interpretation of Lotkaian informetric systems as self-similar fractals

Power laws as defined in 1926 by A. Lotka are increasing in importance because they have been found valid in varied social networks including the Internet. In this article some unique properties of power laws are proven. They are shown to characterize functions with the scale-free property (also called self-similarity property) as well as functions with the product property. Power laws have other desirable properties that are not shared by exponential laws, as we indicate in this paper. Specifically, Naranan (1970) proves the validity of Lotka's law based on the exponential growth of articles in journals and of the number of journals. His argument is reproduced here and a discrete-time argument is also given, yielding the same law as that of Lotka. This argument makes it possible to interpret the information production process as a self-similar fractal and show the relation between Lotka's exponent and the (self-similar) fractal dimension of the system. Lotkaian informetric systems are self-similar fractals, a fact revealed by Mandelbrot (1977) in relation to nature, but is also true for random texts, which exemplify a very special type of informetric system.
Especial Skill Effect Across Age and Performance Level: The Nature and Degree of Generalization

ABSTRACT It has been claimed that an especial skill emerges after massive amounts of basketball practice. Despite this no direct evidence is available to support this claim. The authors aimed to shed light on this question. Thirty-seven male basketball players took part representing four groups: 2 groups of senior players, a cadet group, and a group of juniors. Players performed free throw shots from 7 distances including shots from the free throw line (15 ft). It was shown that an especial skill was present in senior players, but not in junior players who had only 3 years of playing experience. The authors present a descriptive model of especial skill and express it using the formalism of a hierarchical Bayesian model to fit the data and estimate the parameters. This model can account not only for the results, which indicate the presence and a substantial degree of generalizability of especial skill to nearby distances, but also for results of the original study on especial skill where it was proposed that specificity in practice leads to the emergence of the especial skill.
mTOR inhibition: the learning curve in kidney transplantation

All immunosuppressive medications require a learning curve that enables clinicians to improve the therapeutic index of agents. Mammalian target of rapamycin (mTOR) inhibitors are potentially a less nephrotoxic form of immunosuppression than calcineurin inhibitors (CNIs) that has been used in kidney transplant recipients for more than two decades. This drug class has a novel immunosuppressive action, probably mediated in part through inhibition of growth receptor signaling mechanisms. In addition, it has a unique drug toxicity, which is partially dose‐related. This medication class also possesses antiproliferative activity, which may be useful in‐post‐transplant patients with increased atherosclerotic and malignancy risks. mTOR inhibitors have been utilized for de novo immunosuppression with CNIs, corticosteroids, and antimetabolites. mTOR inhibitors also have been used as CNI‐sparing agents both early and late post‐transplant. Much debate remains over how to best utilize mTOR inhibition in kidney transplantation.
Effect of Exhaustive Incremental Treadmill Effort on Force Generation Repeatability in Biathletes

ABSTRACT. The authors examined how force generation repeatability changes as the result of incremental maximal test to volitional exhaustion by well-trained (VO2/kg [mL·kg−1·min−1] 62.55 ± 5.27) individuals. 13 young biathletes (18.9 ± 1.7 years) performed isometric maximum voluntary contraction (IMVC) and submaximal targeted (98N) pushes against the force transducers by arms: elbow extension (EE), elbow flexion (EF) and legs: knee extensions (KE) in pre- and posttest conditions after incremental exhaustive test performed on treadmill. IMVC did not differ significantly between pre and posttest conditions for upper and statistically decrease in lower extremities measurements (p <.01). The mean force of 10 submaximal targeted force productions (Fmean; N) is similar for pre- and posttest measurements. Standard deviation of Fmean (Fsd; N) and coefficient variation (CV;%) decrease statistically in elbows flexion p <. 02 but not extension. The reduction of force repetition accuracy in left knee extension was noticed (p <.01). The fatigue induced by incremental running test decreases a magnitude of force production variability in specifically trained muscle groups in biathletes.
Liver transplantation and conventional surgery for advanced hepatocellular carcinoma

This study intended to discuss the roles of hepatic resection (HR) and liver transplantation (LT) in patients with advanced hepatocellular carcinoma (HCC) through our experience and literature review. For large HCC > 10 cm, HR is regarded as the treatment of choice when hepatic function is preserved. Considering frequent extrahepatic recurrence and acceptable outcome after curative HR, LT has not been recommended. For multiple HCCs, HR has been attempted in different preferences worldwide. HR can offer acceptable survival outcome for patients with small oligo‐nodular HCCs and well‐preserved liver function. Recurrence pattern lowers the applicability of salvage LT, thus primary LT is suggested. For HCC patients with major portal vein tumor thrombus, HR with thrombus removal can be performed, in contrast LT is contraindicated. For HCC with bile duct tumor thrombus, aggressive en bloc resection can lead to prolongation of survival. There is no consensus on transplantability of HCC with bile duct tumor thrombus, but complete resection may provide survival gain after LT. In conclusion, HR and LT have complementary roles, thus they should be associated to rather than being opposed. Multi‐modality treatment strategy especially, for patients with advanced HCC, provides new fields of investigation for diverse indications of HR and LT.
Postural Mechanisms to Control Body Displacements in the Performance of Lateral Gaze Shifts

ABSTRACT Medialateral postural control mechanisms (bodyweight distribution and center of pressure location) have been studied in static conditions. Our objective was to determine how these mechanisms are adjusted to perform voluntary movements, in our case 80° lateral gaze shifts at 0.125 Hz and 0.25 Hz. In healthy, young adults, we expected body marker (neck, lower back) and center of pressure displacements to be significantly greater in gaze shift conditions than in the stationary gaze condition. To explain these changes in center of pressure displacement, the amplitude contribution of both mechanisms was expected to increase significantly. All these results were found accordingly. Unexpectedly, the active contribution of the bodyweight distribution mechanism was negatively related to body marker displacements in the gaze shift conditions (ns in stationary condition). Moreover, changes in the contribution of the mechanisms were statistically weaker in effect size than changes in body displacement. However, the participants were not unstable because they performed the visual tasks as requested. We propose that the strength of medialateral postural control mechanisms may not only be strengthened to control challenging ML stance conditions but also slightly weakened to allow the performance of adequate body motions in ongoing tasks.
Time Pressure and Attention Allocation Effect on Upper Limb Motion Steadiness

ABSTRACT Following ironic process theory (IPT), the authors aimed at investigating how attentional allocation affects participants’ upper limb motion steadiness under low and high levels of mental load. A secondary purpose was to examine the validity of skin conductance level in measuring perception of pressure. The study consisted of 1 within-participant factor (i.e., phase: baseline, test) and 4 between-participant factors (i.e., gender: male, female; mental load: fake time constraints, no time constraints; attention: positive, suppressive; order: baseline→→→test, test→→baseline). Eighty college students (40 men and 40 women, Mage = 20.20 years, SDage = 1.52 years) participated in the study. Gender-stratified random assignment was employed in a 2 × 2 × 2 × 2 × 2 mixed experimental design. The findings generally support IPT but its predictions on motor performance under mental load may not be entirely accurate. Unlike men, women's performance was not susceptible to manipulations of mental load and attention allocation. The validity of skin conductance readings as an index of pressure perception was called into question.
Comparison of surgical methods in liver transplantation: retrohepatic caval resection with venovenous bypass (VVB) versus piggyback (PB) with VVB versus PB without VVB

Use of piggyback technique (PB) and elimination of venovenous bypass (VVB) have been advocated in adult liver transplantation (LT). However, individual contribution of these two modifications on clinical outcomes has not been fully investigated. We performed a retrospective review of 426 LTs within a 3‐year period, when three different surgical techniques were employed per the surgeons’ preference: retrohepatic caval resection with VVB (RCR + VVB) in 104 patients, PB with VVB (PB + VVB) in 148, and PB without VVB (PB‐Only) in 174. The primary outcomes were intraoperative blood transfusion and the patient and graft survivals. Demographic profiles were similar, except younger recipient age in RCR + VVB and fewer number of grafts with cold ischemic time over 16 h in PB‐Only. PB‐Only required lesser intraoperative red blood cells (P = 0.006), fresh frozen plasma (P = 0.005), and cell saver return (P = 0.007); had less incidence of acute renal failure (P = 0.001), better patient survival (P = 0.039), and graft survival (P = 0.003). The benefits of PB + VVB were only found in shortened total surgical time (P = 0.0001) and warm ischemic time (P = 0.0001), and less incidence of acute renal failure (P = 0.001) than RCR + VVB. PB‐Only method seemed to provide the best clinical outcome. The benefit of PB was not fully achieved when it was used with VVB.
Latência do potencial evocado auditivo P300 em idosos

Auditory cortical disorders in the elderly can be assessed by the P300. The lack of contemporary reference values of P300 latency in healthy elderly motivated this study. AIM: To estimate the effect of age on P300 latency in a group of elderly. METHODS: We studied 62 elderly patients with pure tone thresholds up to 40 dB HL at the frequencies of 1000 and 2000 Hz, divided into groups according to age (60-64, 65-69 and 70-74 years). Were assessed by the P300 latency in response to the rare stimulus of 2000 Hz and 1000 Hz frequencies, both in the intensity of 80 dB HL. STUDY DESIGN: clinical, cross-sectional observational individual compared prospective. RESULTS: The latency in Group 60 was 337.26 ms (SD 11.31) in Group 65 was 351.86 ms (SD 29.05) and in Group 70 it was 370.19 ms (SD 23.40). The linear regression of the values of P300 latency showed an increase of 2.85 ms per year of age. The statistical analysis showed that the results were significant. CONCLUSION: The P300 latency increases with age at a rate of 2.85 ms per year between the ages of 60 and 74 years.
Course Offerings in the Fourth Year of Medical School: How U.S. Medical Schools Are Preparing Students for Internship

The fourth year of medical school remains controversial, despite efforts to reform it. A committee from the Clerkship Directors in Internal Medicine and the Association of Program Directors in Internal Medicine examined transitions from medical school to internship with the goal of better academic advising for students. In 2013 and 2014, the committee examined published literature and the Web sites of 136 Liaison Committee on Medical Education–accredited schools for information on current course offerings for the fourth year of medical school. The authors summarized temporal trends and outcomes when available. Subinternships were required by 122 (90%) of the 136 schools and allow students to experience the intern’s role. Capstone courses are increasingly used to fill curricular gaps. Revisiting basic sciences in fourth-year rotations helps to reinforce concepts from earlier years. Many schools require rotations in specific settings, like emergency departments, intensive care units, or ambulatory clinics. A growing number of schools require participation in research, including during the fourth year. Students traditionally take fourth-year clinical electives to improve skills, both within their chosen specialties and in other disciplines. Some students work with underserved populations or seek experiences that will be henceforth unavailable, whereas others use electives to “audition” at desired residency sites. Fourth-year requirements vary considerably among medical schools, reflecting different missions and varied student needs. Few objective outcomes data exist to guide students’ choices. Nevertheless, both medical students and educators value the fourth year of medical school and feel it can fill diverse functions in preparing for residency.
Evaluating the User Experience of Exercising Reaching Motions With a Robot That Predicts Desired Movement Difficulty

ABSTRACT The notion of an optimal difficulty during practice has been articulated in many areas of cognitive psychology: flow theory, the challenge point framework, and desirable difficulties. Delivering exercises at a participant's desired difficulty has the potential to improve both motor learning and users' engagement in therapy. Motivation and engagement are among the contributing factors to the success of exercise programs. The authors previously demonstrated that error amplification can be used to introduce levels of challenge into a robotic reaching task, and that machine-learning algorithms can dynamically adjust difficulty to the desired level with 85% accuracy. Building on these findings, we present the results of a proof-of-concept study investigating the impacts of practicing under desirable difficulty conditions. A control condition with a predefined random order for difficulty levels was deemed more suitable for this study (compared to constant or continuously increasing difficulty). By practicing the task at their desirable difficulties, participants in the experimental group perceived their performance at a significantly higher level and reported lower required effort to complete the task, in comparison to a control group. Moreover, based on self-reports, participants in the experimental group were willing, on average, to continue the training session for 4.6 more training blocks (∼45 min) compared to the control group's average. This study demonstrates the efficiency of delivering the exercises at the user's desired difficulty level to improve the user's engagement in exercise tasks. Future work will focus on clinical feasibility of this approach in increasing stroke survivors' engagement in their therapy programs.
In Vivo Confocal Microscopy Analysis of Corneal Microstructural Changes in Neurosurgically-Induced Neurotrophic Keratitis

Purpose: To investigate the changes of the corneal microstructure of neurosurgically-induced neurotrophic keratitis patients compared to normal human corneas using in vivo confocal microscope (IVCM). Methods: Ten eyes in the normal control group and 11 eyes in the neurosurgically-induced neurotrophic keratitis patient group were included in the present study. After corneal sensitivity tests were performed, thickness of each layer and number of endothelial cells and stromal keratocytes in the cornea were assessed using IVCM. Morphological characteristics of the corneal nerves were measured by ImageJ software. Results: After analysis of corneal thickness layer by layer, the Bowman’s layer was significantly reduced in the neurosurgically-induced neurotrophic keratitis patient group compared with the normal control group ( p = 0.016) and the portion of Bowman’s layer was significantly reduced in the neurosurgically-induced neurotrophic keratitis patient group compared with the control group ( p = 0.024). The nerve fiber length per square-millimeter became significantly shorter compared to the normal control group ( p = 0.042). The nerve fiber length per square millimeter showed significant correlations with the number of fibers, number of beading, branching patterns, and nerve tortuosity ( p = 0.002, 0.002, 0.013 and 0.034, respectively). The number of endothelial cells and stromal keratocytes, the number of nerve fibers and beading, and the pattern of branching and nerve tortuosity showed no significant differences between the normal and neurosurgically-induced neurotrophic keratitis patient groups. Conclusions: Our results showed that decreased thickness of Bowman’s layer may be related to the decreased corneal nerve dis-tribution, secondary to the dysfunction of trigeminal nerve branch innervating the cornea. The microstructural changes of Bowman’s layer can help diagnose the disease and evaluate the current status in neurosurgically-induced neurotrophic keratitis patients.