Miracle-dz/UniFAR-FTUs huggingface dataset:
Secondary Malignancies: The Cost of Progress

Background With advances in treatment of cancer, patients who survive their first malignancy are at risk of developing additional malignancies. Data on the risks of secondary malignancies after treatment of some of the more common cancers are lacking. Methods Our prospectively maintained database was queried from 1996 to 2016 to identify patients with breast cancer, colorectal cancer, melanoma, sarcoma, gastric, and pancreatic adenocarcinoma who developed additional malignancies. Predisposing clinical factors were included in our analysis. Results We identified 756 patients diagnosed with a solid malignancy who developed a second malignancy, of which 606 (80.1%) had one of the most common treated cancers. 59.5% of patients were women. 810 additional malignancies were identified in the 606 patients with breast and colon cancer being the most common secondary malignancies. Of these 606 patients, 460 (76%) patients had two malignancies; 145 (23.9%) had 3 or more malignancies. 15.2% of patients were diagnosed under the age of 40.63 years. 8.3% patients had a known genetic mutation, with BReast CAncer gene, and Lynch mutations being the most common. Conclusion Advances in cancer treatment have led to higher cure rates. These patients should continue surveillance and undergo screening as they may be at risk of developing additional malignancies.
Association between Geriatric Nutritional Risk Index and Mortality in Older Trauma Patients in the Intensive Care Unit

The geriatric nutritional risk index (GNRI) is a simple and efficient tool to assess the nutritional status of patients with malignancies or after surgery. Because trauma patients constitute a specific population that generally acquires accidental and acute injury, this study aimed to identify the association between the GNRI at admission and mortality outcomes of older trauma patients in the intensive care unit (ICU). Methods: The study population included 700 older trauma patients admitted to the ICU between 1 January 2009 and 31 December 2019. The collected data included age, sex, body mass index (BMI), albumin level at admission, preexisting comorbidities, injury severity score (ISS), and in-hospital mortality. Multivariate logistic regression analysis was conducted to identify the independent effects of univariate predictive variables resulting in mortality in our study population. The study population was categorized into four nutritional risk groups: a major-risk group (GNRI < 82; n = 128), moderate-risk group (GNRI 82 to <92; n = 191), low-risk group (GNRI 92–98; n = 136), and no-risk group (GNRI > 98; n = 245). Results: There was no significant difference in sex predominance, age, and BMI between the mortality (n = 125) and survival (n = 575) groups. The GNRI was significantly lower in the mortality group than in the survival group (89.8 ± 12.9 vs. 94.2 ± 12.0, p < 0.001). Multivariate logistic regression analysis showed that the GNRI (odds ratio—OR, 0.97; 95% confidence interval (CI) 0.95–0.99; p = 0.001), preexisting end-stage renal disease (OR, 3.6; 95% CI, 1.70–7.67; p = 0.001), and ISS (OR, 1.1; 95% CI, 1.05–1.10; p < 0.001) were significant independent risk factors for mortality. Compared to the patients in group of GNRI > 98, those patients in group of GNRI < 82 presented a significantly higher mortality rate (26.6% vs. 13.1%; p < 0.001) and length of stay in hospital (26.5 days vs. 20.9 days; p = 0.016). Conclusions: This study demonstrated that GNRI is a significant independent risk factor and a promising simple screening tool to identify the subjects with malnutrition associated with higher risk for mortality in those ICU elderly trauma patients.
Dielectric relaxation phenomena in superparaelectric and ferroelectric ceramic thin films and the relevance with respect to high density DRAM and FRAM applications

Dielectric relaxation has been observed for a wide variety of materials. Especially for dielectric thin films a typical Curie - von Schweidler relaxation has been observed by many groups in the literature. Although some possible reasons for these relaxation phenomena have been discussed, a comprehensive understanding of the physical origins involved could not be obtained by now. The purpose of this contribution is to present a wide range of experimental results collected on Pb(Zr,Ti)O 3 (PZT) thin films. Results are compared to investigations on (Ba,Sr)TiO 3 and SrTiO 3 films.
Hepatoprotective effect of Ginkgo biloba extract against methotrexate-induced hepatotoxicity via targeting STAT3/miRNA-21 axis

Abstract The usage of the chemotherapeutic agent methotrexate (MTX) was associated with hepatotoxicity that minimized its clinical use. The Ginkgo biloba extract (GBE) was used before to alleviate the MTX-induced liver injury through its antioxidant activity. This work was carried out to elucidate other molecular hepatoprotective mechanisms of GBE via examining the IL-6/STAT3 pathway in addition to the miRNA-21 expression in hepatic tissue. Sprague Dawley rats were allocated into four groups: normal control (NC); Ginkgo biloba extract control (GBEC); methotrexate (MTX); and Ginkgo biloba extract and methotrexate (GBE + MTX) group. GBE was administered orally 60 mg/kg/day for 10 days while MTX was intraperitoneally injected with 20 mg/kg on day 5. After the experiment, the serum was separated for liver enzyme determination while liver tissues were collected for biochemical and histopathological examinations. MTX induced marked elevation in the liver enzymes, hepatic IL-6, and HGF mRNA expressions, phospho-STAT3/STAT3 ratio, and miRNA-21 hepatic expression when compared with the NC group. Liver injury was observed histopathologically after MTX. The GBE administration reversed these biochemical alterations and improved liver histopathology. The hepatoprotective mechanism of GBE against MTX-induced hepatotoxicity via the modulation of the IL-6/STAT3 signaling pathway and the downregulation of the miRNA-21 hepatic expression was reported for the first time.
Ferroelectric poly(vinylidene fluoride) thin films on Si substrate with the β phase promoted by hydrated magnesium nitrate

Solution derived poly(vinylidene fluoride) (PVDF) homopolymer thin films on silicon substrates with the addition of hydrated salt [Mg(NO3)2⋅6H2O] were systematically investigated. β phase dominant ferroelectric PVDF thin films with a remnant polarization of 77 mC∕m2 were achieved by optimizing the concentration of Mg(NO3)2⋅6H2O and the processing condition. Our experimental results and theoretical analysis indicated that the hydrogen bonds between water in the hydrated salt and the PVDF molecules result in the interchain registration of the all-trans conformation, and the hydrated salt acts as the nucleation agent and promotes the crystallization of the β phase. The obtained effective d33 was −14.5 pm∕V, tested with a laser scanning vibrometer, without taking into account the substrate clamping effect. The numerical simulation, after considering the elastic constrain of the substrate, determined that the corresponding actual d33 is −30.8 pm∕V, which is comparable to that of uniaxially stretched piezoelect.
Classification of retinal images based on convolutional neural network

Automatic detection of maculopathy disease is a very important step to achieve high‐accuracy results for the early discovery of the disease to help ophthalmologists to treat patients. Manual detection of diabetic maculopathy needs much effort and time from ophthalmologists. Detection of exudates from retinal images is applied for the maculopathy disease diagnosis. The first proposed framework in this paper for retinal image classification begins with fuzzy preprocessing in order to improve the original image to enhance the contrast between the objects and the background. After that, image segmentation is performed through binarization of the image to extract both blood vessels and the optic disc and then remove them from the original image. A gradient process is performed on the retinal image after this removal process for discrimination between normal and abnormal cases. Histogram of the gradients is estimated, and consequently the cumulative histogram of gradients is obtained and compared with a threshold cumulative histogram at certain bins. To determine the threshold cumulative histogram, cumulative histograms of images with exudates and images without exudates are obtained and averaged for each type, and the threshold cumulative histogram is set as the average of both cumulative histograms. Certain histogram bins are selected and thresholded according to the estimated threshold cumulative histogram, and the results are used for retinal image classification. In the second framework in this paper, a Convolutional Neural Network (CNN) is utilized to classify normal and abnormal cases.
Usage of peptidases by SARS‐CoV‐2 and several human coronaviruses as receptors: A mysterious story

Coronaviruses recognize a variety of host receptors to infect many humans and animals. Newly emerged severe acute respiratory syndrome coronavirus2 (SARS‐CoV‐2) recognizes angiotensin‐converting enzyme 2 (ACE2) to gain entry into different cells. Interestingly, besides SARS‐CoV2, four other human coronaviruses (HCoVs) use three different ectopeptidases (ACE2, dipeptidyl peptidase 4, and aminopeptidase N) as receptors independent of their common peptidase activity. This issue has led to the important question “why do several HCoVs rely on peptidases as their receptors? ” In this paper, we discussed to answer this question. Mostly, it seems that the use of peptidases by HCoVs may be more related to their widespread presence on target cells and also viruses prefer to take advantage of molecules with relatively low affinity for their natural ligands through evolving a stronger binding affinity to the surface receptors for entry and endocytosis. Meanwhile evolutionary conservation of these receptors may allow HCoVs to switch between different host species. Finally, the choice of peptidases by HCoVs may reflect the “trial and error” nature of evolution. In conclusion, substantial efforts are needed to get a strong picture of this fascinating question and poorly explored area. Detailed understanding of the entry mechanisms offers opportunities for the development of refined strategies to stop viruses.
Microbiome of the Healthy External Auditory Canal.

OBJECTIVE To investigate the microbiota of the healthy external auditory canal (EAC) culture-independently and to evaluate the usefulness of the swabbing method in collecting EAC microbiota samples. STUDY DESIGN Cohort study. PATIENTS Fifty healthy asymptomatic working-age volunteers. INTERVENTION Samples were harvested with DNA-free swabs from the volunteers' EACs. MAIN OUTCOME MEASURES Amplicon sequencing of the 16S rRNA gene was used to characterize the microbial communities in the samples. RESULTS The swabbing method is feasible for EAC microbiota sample collection. The analyzed 41 samples came from 27 female and 14 male subjects; 4 samples were excluded due to recent antimicrobial treatment and 5 because of low sequence count or suspected contaminant microbes. The four most frequent amplicon sequence variants in the microbiota data were Staphylococcus auricularis, Propionibacterium acnes, Alloiococcus otitis, and Turicella otitidis. Typically, the dominant amplicon sequence variant in a sample was one of the most frequent bacteria, but there were also subjects where the dominant species was not among the most frequent ones. The genus Alloiococcus was least common in females who reported cleaning their ears. Subjects with a high relative abundance of Alloiococcus typically had a low abundance of Staphylococcus, which may be a sign of the two being competing members of the microbial community. CONCLUSIONS The most common bacteria in the microbiome of the healthy EAC were Staphylococcus auricularis, Propionibacterium acnes, Alloiococcus otitis, and Turicella otitidis. The EAC microbiota seems more diverse and individualized than previously thought. Also, ear cleaning habits seem to alter the EAC microbiome.
Malignant pleural neoplasm with both differentiation of epithelioid mesothelioma and squamous‐cell carcinoma, a rare phenomena

Malignant mesothelioma, a neoplasm arising within the serosal surfaces, has been linked closely to asbestos exposure. We present a case of 72‐year‐old male with a 27 year work‐related history of asbestos exposure who presented with dyspnea. Chest computed tomography scan showed a large, right pleural effusion with compressive right lung atelectasis. Biopsies, subsequent pleurectomy and lung wedge resections revealed epithelioid malignant mesothelioma with associated focal non‐keratinizing squamous‐cell carcinoma, supported by extensive immunohistochemical stains and molecular studies. The patient was treated with 6 cycles of carboplatin/pemetrexed, showing no new metastases. Seven months post‐treatment, the patient presented with progressive dyspnea and large pleural effusions. Bilateral pleural fluid was collected and showed malignant epithelioid cells, morphologically similar to the patient's pleural neoplastic cells. However, the tumor was positive for squamous cells markers and showed BAP1 loss, while negative for mesothelial markers. The findings support the diagnosis of squamous‐cell carcinoma and were consistent with the patient's previously diagnosed pleural neoplastic origin. A malignant mesothelioma associated with squamous‐cell carcinoma is a rare phenonmenon. To our knowledge, only two case reports are available in current literature. This unique case shows a single pleura tumor differentiating as both malignant mesothelioma and squamous‐cell carcinoma. Squamous‐cell carcinoma is the predominating malignancy seen within the bilateral pleural effusions, a potential pitfall for cytology specimen diagnosis.
Power, policy and abortion care in Uganda

Abstract Unsafe abortion practices remain the major contributor to maternal death in Uganda, impeding the achievement of universal health coverage and quality of maternal health care. Using an ethnographic design and critical discourse analysis, we explored the operations of power in setting maternal healthcare priorities, as evident at the 2018 Reproductive, Maternal, Neonatal, Child and Adolescents Health Conference. Observational data were collected of the policy-making activities, processes and events and key informant interviews were conducted with 27 participants. We describe how neoliberal and state governance through the structure and organization of policy-making, epistemic governance and universal concepts of ‘high-impact’ interventions, results-based financing, cost-effectiveness and accountability converge to suppress the articulation of local conditions associated with unsafe and risky abortion. By defining maternity along the continuum of birth and emphasizing birthing women, priority-setting was directed towards interventions promoting women’s normative role as mothers while suppressing unmet abortion care needs. Finally, discursive and communicative materials controlled how women of reproductive age in Uganda managed reproduction.
Correction of Post-Cleft Lip Nostril Floor Stenosis: Para-Alar Flap Combined With Lip Revision

Post-cheiloplasty nostril floor stenosis is a scarcely reported secondary deformity. The aim of the current study was to assess the outcome of para-alar flap for management of nostril floor stenosis post-unilateral cleft lip repair. This is a retrospective case series study reviewing consecutive patients presenting with nostril floor stenosis following repair of unilateral cleft lip who were managed by the inferiorly based para-alar flap and lip revision. Differential nostril width was measured preoperative, immediate, and late postoperative. We reported 8 patients (3 boys and 5 girls) with an average age of 9.8 years (range: 4.5-19). Satisfactory results with good nostril symmetry measures were achieved, and no restenosis has been observed during the follow-up periods. The donor site scars were negligible. There was no reported partial or total flap loss. Para-alar flap was found to be an effective reconstructive option for patients with nostril floor stenosis post-unilateral cleft lip repair and can be combined safely with cleft lip revision.
A Computed Tomographic Analysis of Spheno-Occipital Synchondrosis Ossification for Age Estimation in a Sample of Egyptians

Abstract The aim of the present work was to create statistically quantified age estimation standards based on spheno-occipital synchondrosis (SOS) fusion state as visualized in computed tomography in Egyptians. The study included 208 Egyptians between the ages of 5 and 30 years (117 male and 90 female participants). Spheno-occipital synchondrosis was visualized in a midsagittal view in a neutral head position. Degree of ossification of SOS was assessed using a 4-stage system. Interobserver agreement and intraobserver agreement were almost perfect with Cohen κ values of 0.863 and 0.983, respectively. The mean ages of complete fusion (stage 3) were 20.36 ± 3.11 and 20.94 ± 4.06 years in male and female participants, respectively. Nonfusion (stage 0) was observed up to 15 and 13 years in male and female participants, respectively. Complete fusion occurred as early as 15 and 13 years in male and female participants, respectively. All subjects with nonfused SOS were minors (<18 years). A total of 87.9% of male participants and 85.3% of female participants with completely fused SOS were legally adults (≥18 years). Significant regression models were formulated to predict age from SOS fusion stage (adjusted R2 = 0.779 for male participants and 0.780 for female participants). Regression models predicted that male and female participants 18 years or older with 96.30% and 95.59% accuracy, respectively.
Pharmacotherapy of attention deficit/hyperactivity disorder in individuals with autism spectrum disorder: A systematic review of the literature

Aim: To assess the empirical evidence for the treatment of attention deficit/hyperactivity disorder (ADHD) in populations with autism spectrum disorder (ASD). Methods: A systemic PubMed, PsychINFO, Embase, and Medline database search of peer-reviewed literature was conducted. Included in the review were controlled trials published in English with sample sizes ⩾10 participants examining the safety and efficacy of anti-ADHD medication in ASD populations. Data was extracted on relevant variables of study design, demographics, associated psychopathology, medication dose, efficacy, and tolerability. Results: Nine controlled trials met the inclusion and exclusion criteria: five with methylphenidate, three with atomoxetine, and one with guanfacine. Sample sizes ranged from 10 to 128 with 430 children participating across all the trials. In all the trials, treatment response was significantly superior to placebo. However, almost all trials assessed only hyperactivity, and most included only participants with intellectual disability with high levels of irritability. None of the trials distinguished agitation from hyperactivity. The response on hyperactivity for methylphenidate and atomoxetine was less than that observed in the neurotypical population; however, the response for guanfacine surpassed results observed in neurotypical populations. Treatment-emergent mood lability (i.e. mood dysregulation and mood-related adverse events) was frequently associated with methylphenidate and guanfacine treatments. Worse treatment outcomes were associated with individuals with lower intellectual capability compared with those with higher IQs. Conclusions: here is a scarcity of controlled trials examining ADHD treatments in ASD populations, particularly in intellectually capable individuals with ASD and in adults. Response to ADHD medications in ASD were adversely moderated by the presence of intellectual disability and mood lability.
Disentangling the Respective Contribution of Task Selection and Task Execution to Self-Directed Cognitive Control Development.

Task selection and task execution are key constructs in cognitive control development. Yet, little is known about how separable they are and how each contributes to task switching performance. Here, 60 4- to 5-year olds, 60 7- to 8-year olds, and 60 10- to 11-year olds children completed the double registration procedure, which dissociates these two processes. Task selection yielded both mixing and switch costs, especially in younger children, and task execution mostly yielded switch costs at all ages, suggesting that task selection is costlier than task execution. Moreover, both task selection and execution varied with task self-directedness (i.e., to what extent the task is driven by external aids) demands. Whereas task selection and task execution are dissociated regarding performance costs, they nevertheless both contribute to self-directed control.
Gpr37l1/prosaposin receptor regulates Ptch1 trafficking, Shh production, and cell proliferation in cerebellar primary astrocytes

Mammalian cerebellar astrocytes critically regulate the differentiation and maturation of neuronal Purkinje cells and granule precursors. The G protein‐coupled receptor 37‐like 1 (Gpr37l1) is expressed by Bergmann astrocytes and interacts with patched 1 (Ptch1) at peri‐ciliary membranes. Cerebellar primary astrocyte cultures from wild‐type and Gpr37l1 null mutant mouse pups were established and studied. Primary cilia were produced by cultures of both genotypes, as well as Ptch1 and smoothened (Smo) components of the sonic hedgehog (Shh) mitogenic pathway. Compared to wild‐type cells, Gpr37l1−/− astrocytes displayed striking increases in proliferative activity, Ptch1 protein expression and internalization, intracellular cholesterol content, ciliary localization of Smo, as well as a marked production of active Shh. Similar effects were reproduced by treating wild‐type astrocytes with a putative prosaptide ligand of Gpr37l1. These findings indicate that Gpr37l1–Ptch1 interactions specifically regulate Ptch1 internalization and trafficking, with consequent stimulation of Shh production and activation of proliferative signaling.
An Ultrahigh Sensitive Paper-Based Pressure Sensor with Intelligent Thermotherapy for Skin-Integrated Electronics

Porous microstructure pressure sensors that are highly sensitive, reliable, low-cost, and environment-friendly have aroused wide attention in intelligent biomedical diagnostics, human–machine interactions, and soft robots. Here, an all-tissue-based piezoresistive pressure sensor with ultrahigh sensitivity and reliability based on the bottom interdigitated tissue electrode and the top bridge of a microporous tissue/carbon nanotube composite was proposed. Such pressure sensors exhibited ultrahigh sensitivity (≈1911.4 kPa−1), fast response time (<5 ms), low fatigue of over 2000 loading/unloading cycles, and robust environmental degradability. These enabled sensors can not only monitor the critical physiological signals of the human body but also realize electrothermal conversion at a specific voltage, which enhances the possibility of creating wearable thermotherapy electronics for protecting against rheumatoid arthritis and cervical spondylosis. Furthermore, the sensor successfully transmitted wireless signals to smartphones via Bluetooth, indicating its potential as reliable skin-integrated electronics. This work provides a highly feasible strategy for promoting high-performance wearable thermotherapy electronics for the next-generation artificial skin.