Miracle-dz/UniFAR-FTUs huggingface dataset:
How Long is It Safe to Wait for Breast Surgery After Completion of Neoadjuvant Chemotherapy?

Purpose This study aimed to evaluate the impact of surgical time on postoperative complications and survival outcomes in breast cancer patients after neoadjuvant chemotherapy (NAC). Patients and Methods We retrospectively reviewed breast cancer patients treated at Breast Disease Center of the Affiliated Hospital of Qingdao University, from January 2013 to December 2018. The eligibility criteria were female patients with histologically confirmed primary stage II–III breast cancer and initially treated with NAC, who were <75 years old, and patients for whom medical records were available. The patients with severe comorbidities of other organs, with previous histories of other malignancies or breast cancer, and with distant metastasis or contralateral breast cancer, were excluded. Eligible patients were divided into three groups based on time to surgery (TTS): (A) ≤21 days; (B) between 21 and 28 days; and (C) >28 days. We collected medical records and followed up patients. Results Totally 422 patients were enrolled. The median TTS was 26 days. Among these patients, 119 (28.2%) were in Group A, 152 (36.0%) were in Group B, and 151 (35.8%) were in Group C. Eighty-two (19.4%) patients achieved pathologic complete response (pCR). Survival analysis showed that DFS (P=0.012) and OS (P=0.015) were significantly different among three groups. In multivariate analysis, DFS (HR=2.333, P=0.001) and OS (HR=2.783, P=0.030) were significantly worse when TTS >28 days. Postoperative complications occurred in 96 (22.7%) patients. The incidence of total postoperative complications in the three groups was statistically different (P=0.001) and Group A had worse performance. Multivariate analysis showed that age >50 years old (P=0.004) and TTS ≤21 days (P<0.001) were independent parameters for total postoperative complications. Conclusion Postoperative complications and survival outcomes in breast cancer patients seemed to be influenced by TTS after the NAC. The benefits were remarkable in patients undergoing surgery between 21 and 28 days.
Non-invasive multimodal imaging of Diabetic Retinopathy: A survey on treatment methods and Nanotheranostics

Diabetes Retinopathy (DR) is one of the most prominent microvascular complications of diabetes. It is one of the pre-eminent causes for vision impairment followed by blindness among the working-age population worldwide. The de facto cause for DR remains challenging, despite several efforts made to unveil the mechanism underlying the pathology of DR. There is quite less availability of the low cost pre-emptive theranostic imaging tools in terms of in-depth resolution, due to the multiple factors involved in the etiology of DR. This review work comprehensively explores the various reports and research works on all perspectives of diabetic retinopathy (DR), and its mechanism. It also discusses various advanced non-destructive imaging modalities, current, and future treatment approaches. Further, the application of various nanoparticle-based drug delivery strategies used for the treatment of DR are also discussed. In a nutshell, the present review work bolsters the pursuit of the development of an advanced non-invasive optical imaging modal with a nano-theranostic approach for the future diagnosis and treatment of DR and its associated ocular complications.
COVID-19 Communication Ecology: Visualizing Communication Resource Connections During a Public Health Emergency Using Network Analysis

The COVID-19 outbreak began in December 2019 and soon became a global pandemic, resulting in major public health consequences for countries across the world. As the COVID-19 outbreak evolved, individuals were challenged to understand the risk of COVID-19 and to identify ways to stay safe. This understanding was accomplished through COVID-19 communication ecologies that consist of interpersonal, organizational, and mediated communication resources. In the current study, we examine the U.S. COVID-19 communication ecology in September 2021. We introduce the communication ecology network (CEN) model, which posits that similar useful communication resources will cluster in a communication ecology, and we use network analysis for visualization of the ecology. Our results indicate a robust COVID-19 communication ecology. The most important communication resources in the ecology were partisan and organizational communication resources. We identify and discuss five clusters within the COVID-19 communication ecology and examine how use of each of these clusters is associated with belief in COVID-19 misinformation. Our use of network analysis illustrates benefits of this analytical approach to studying communication ecologies.
Influence of resin cement on color stability of ceramic veneers: in vitro study

Abstract Statement of the problem Long-term success of ceramic veneers depends on the color stability of resin cement used for their cementation. Color change of cement may be seen through the ceramic and compromise esthetics. Purpose This study aimed to compare the color change of two resin cements and their visibility through the ceramic veneers after accelerated artificial aging. Materials and methods In this in vitro study, color change (ΔE) was measured in the following groups (n = 10) before and after accelerated artificial aging: group 1, IPS e.max press high translucent ceramic discs; groups 2, Variolink NLC resin cement discs; group 3, Choice 2 resin cement discs; groups 4, Variolink NLC discs bonded to e.max ceramic discs; group 5, Choice 2 disc bonded to e.max ceramic discs. Color change was measured using a spectrophotometer according to International Commission on Illumination Lab (CIELab). Data were analyzed using one-way ANOVA and Tukey’s post-hoc test. Results Group 2 showed the highest (ΔE = 10.4 ± 0.9) and group 1 the lowest (ΔE = 0.9 ± 0.4) color change. The color change of Variolink was significantly greater than Choice 2 either alone (p < .001) or through the ceramic discs (p < .004). The color change of both cements was lower through the ceramic veneer and this reduction was statistically significant (p < .001). Conclusion Noticeable color change may be expected in areas of cement exposure for both cements studied. Also, in case of using Variolink cement, the color change may be seen through the ceramic veneers.
Motor Neuron Disease in a Patient With Cervical Spondylotic Myelopathy: Too Much Bad Luck

Cervical spondylotic myelopathy (CSM) and amyotrophic lateral sclerosis (ALS) share some clinical findings. Hence, motor neuron disease (MND) should be considered in the differential diagnosis of patients presenting with signs and symptoms of CSM. This unique case demonstrates the coexistence of both conditions in the same patient. The author reports the case of a 74-year-old male who initially underwent posterior cervical decompression and instrumented fusion for cervical myelopathy. He demonstrated postoperative improvement followed subsequently by unexplained neurological deterioration. A repeat MRI showed adequate decompression of the cervical cord and persistence of T2 hyperintense signal in the spinal cord. Based on the presence of signs and symptoms of lower motor neuron disease, electromyography (EMG) was performed demonstrating findings of MND. The presence of MND in a patient with CSM is unique and can be difficult to diagnose based on overlapping symptoms. This case highlights the importance of EMG and the vigilance that spine surgeons need to display to identify ALS or other MND, despite the presence of ongoing cervical myelopathy. In cases where patients show discordant symptoms, further studies should be performed.
ISORROPIA II: a computationally efficient thermodynamic equilibrium model for K + –Ca 2+ –Mg 2+ –NH 4 + –Na + –SO 4 2− –NO 3 − –Cl − –H 2 O aerosols

This study presents ISORROPIA II, a thermo- dynamic equilibrium model for the K + -Ca 2+ -Mg 2+ -NH + - Na + -SO 2 -NO 3 -Cl -H2O aerosol system. A comprehen- sive evaluation of its performance is conducted against water uptake measurements for laboratory aerosol and predictions of the SCAPE2 thermodynamic module over a wide range of atmospherically relevant conditions. The two models agree well, to within 13% for aerosol water content and total PM mass, 16% for aerosol nitrate and 6% for aerosol chloride and ammonium. Largest discrepancies were found under condi- tions of low RH, primarily from differences in the treatment of water uptake and solid state composition. In terms of com- putational speed, ISORROPIA II was more than an order of magnitude faster than SCAPE2, with robust and rapid con- vergence under all conditions. The addition of crustal species does not slow down the thermodynamic calculations (com- pared to the older ISORROPIA code) because of optimiza- tions in the activity coefficient calculation algorithm. Based on its computational rigor and performance, ISORROPIA II appears to be a highly attractive alternative for use in large scale air quality and atmospheric transport models.
Effects of Fertilizer on Growth, Carbon and Nitrogen Responses of Foliage in a Red Pine Stand

This study was to examine growth, carbon and nitrogen responses in foliage following forest fertilization in a red pine stand. Two types of fertilizer (N:P:K=113:150:37 kg ha -1 ; P:K=150:37 kg ha -1 ) were applied on late April 2011. Growth, carbon and nitrogen responses of foliage were monitored 3 times (July, September, November) after fertilization. Morphological growth responses (dry mass, leaf area, specific leaf area) with foliage age were not significantly (P > 0.05) affected by fertilizer application, while needle dry mass and leaf area of July were significantly lower in current-year-old than in one-year-old or two-year-old needles of September or November. Carbon concentration and content in foliage was little affected by fertilizer application compared with sampling month or needle age, while the NPK fertilizer produced high nitrogen concentration and content of foliage. The results indicate that nitrogen concentration and content in foliage may serve as an indicator of the nitrogen status by fertilization in a red pine stand.
Bubble Diffusion and the Motion of Point Defects near Surfaces. (Diffusion Theory for Discrete Media, Part IV†

The theory of diffusion of inert-gas bubbles in solids is important in a variety of fields, including reactor technology, ion bombardment, powder metallurgy, and the study of large defects. Bubble diffusion also provides a convenient frame of reference for discussing the motion near surfaces of point defects, i.e. of surface defects, vacancies, and vapourized atoms or molecules. It is shown that the bubble diffusion coefficient, Db, for a surface-diffusion mechanism is equal to (3/2 π a4) Ds, where a is the bubble radius in units of λ, the mean atomic spacing, and that this expression is independent of the surface-diffusion jump distance. The formation of vacancies at a surface should occur at a frequency given by Γfv = Dvol α/fpvλ2 per area λ2 of the surface, where αv is the vacancy condensation efficiency, f is the correlation factor, and pv (in units of λ) is the atom layer spacing next to the surface. With this assumption, Db for a volume-diffusion mechanism will be equal to (3/2 π a3f) Dvol. The frequency at which vapourized atoms or molecules are formed is shown to be given by a relation very similar to that for vacancy formation. The corresponding expression for Db, i.e. that for a vapourization-condensation mechanism, is of the form (3/4 π a3) (DgCg λ3), where Dg is the vapour diffusion coefficient and Cg is the equilibrium vapour concentration in atoms/cm3. Die Theorie der Diffusion von Edelgasblasen in Festkorpern ist fur eine Reihe von Anwendungsgebieten bedeutsam, einschlieslich Reaktortechnologie, Ionenbombardement, Pulver-Metallurgie und Untersuchung groser Defekte. Die Blasendiffusion stellt auch eine geeignete Methode zur Diskussion der Bewegung von Punktdefekten in der Nahe der Oberflache dar, d. h. Oberflachendefekte, Lucken und aufgedampfte Atome oder Molekule. Es wird gezeigt, das der Blasendiffusionskoeffizient Db fur einen Oberflachendiffusionsmechanismus gleich (3/2 π a4) Ds ist, wobei a der Blasenradius in Einheiten des mittleren Atomabstandes λ ist, und das dieser Ausdruck unabhangig ist von dem Sprungabstand der Oberflachendiffusion. Die Bildung von Lucken an der Oberflache sollte bei einer Frequenz erscheinen, die pro Flache λ2 der Oberflache durch γfv = Dvolαv/fpv λ2 gegeben ist, wobei αv die Kondensationsausbeute der Lucken, f der Korrelationsfaktor und pv (in Einheiten von λ) der zur Oberflache nachste Atomlagenabstand ist. Mit diesen Annahmen wird Db fur einen Volumendiffusionsmechanismus gleich (3/2 π a3f) Dvol. Die Frequenz, bei der verdampfte Atome oder Molekule gebildet werden, ist, wie gezeigt wird, durch eine Beziehung gegeben, die der fur die Luckenbildung sehr ahnlich ist. Der korrespondierende Ausdruck fur Db, d. h. der Ausdruck fur einen Verdampfungs-Kondensations-Mechanismus, ist von der Form (3/4 π a3) (DgCg λ3), wobei Dg der Diffusionskoeffizient des Dampfes und Cg die Gleichgewichtskonzentration des Dampfes in Atome/cm3 ist.
Influence of Severe Gastrointestinal Complications in Primary Gastrointestinal Diffuse Large B-Cell Lymphoma

Background This study assessed the clinical characteristics of gastrointestinal bleeding (GIB), obstruction (GIO), and perforation (GIP) in patients with primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL) and the influence on long-term survival. Methods A retrospective analysis was performed of 148 patients with PGI-DLBCL admitted to Peking University First Hospital from August 1994 to May 2018. The clinical characteristics of GIB, GIO, and GIP before and after chemotherapy were recorded. The associated overall survival and progression-free survival were analyzed. Results Among 148 patients, 56.8% had gastrointestinal complications (GICs), including GIB, GIO, GIP, and multiple complications, and 22.6% of them occurred after chemotherapy, mostly during the first 4 cycles. The most common clinical manifestations of patients with GICs were abdominal pain or discomfort (79.8%), hematemesis or melena (22.6%), and abnormal bowel habits (17.9%). Patients with Eastern Cooperative Oncology Group (ECOG) score ≥2, tumor mass ≥10 cm, or intestinal involvement had significantly higher risk of severe GICs as initial manifestations. Among 130 patients who received chemotherapy, B symptoms, tumor mass ≥10 cm, and Lugano stage (IIE, IV) strongly correlated with GICs after chemotherapy (P < 0.05). Rituximab did not increase the risk of GICs. GICs which occurred before or after chemotherapy reduced the objective response rate at the end of chemotherapy. The prognosis of patients was significantly worsened by GIP, GIB, or multiple complications after chemotherapy (P < 0.05). GIB at presentation or GIO before or after chemotherapy had no prognostic value (both P > 0.05). Conclusion GICs adversely affect the quality of life, prolong the length of hospitalization, and shorten the long-term survival of patients with PGI-DLBCL.
(2R,6R)-Hydroxynorketamine Alleviates Electroconvulsive Shock-Induced Learning Impairment by Inhibiting Autophagy

Purpose Learning impairment after electroconvulsive therapy (ECT) is common. Ketamine, an anesthetic used for ECT, has been demonstrated to attenuate cognitive impairment after ECT. However, the mechanism by which ketamine occurs in this case is still unknown. We aimed to explore the role of ketamine metabolite (2R,6R)-hydroxynorketamine [(2R,6R)-HNK] in the protection against learning impairment and investigate whether autophagy is involved in the protective effect. Materials and Methods A rat depression model received electroconvulsive shock (ECS; simulated ECT in animal models) daily for 3 days. The Morris water maze was used to assess the spatial learning function of the rats. Western blotting was used to detect the expression of Beclin-1, light chain (LC)3-II/LC3-I, p62, mammalian target of rapamycin (mTOR), and p-mTOR in the hippocampus. Results The escape latency for the maze in the ECS group was significantly longer than that in the sham ECS group (P=0.042). Meanwhile, the escape latency in the (2R,6R)-HNK+ECS group was significantly shorter than that in the ECS group (P=0.005). The LC3-II/LC3-I ratio and Beclin-1 expression level significantly increased, and the p62 expression level significantly decreased in the ECS group, compared with those in the sham ECS group (all P<0.001). The (2R,6R)-HNK+ECS group showed lower LC3-II/LC3-I ratio (P<0.001) and Beclin-1 expression level (P<0.001) and higher p62 (P<0.001) and p-mTOR expression levels (P=0.048) than did the ECS group. After small-molecule enhancer of rapamycin 28 (SMER28) administration, the role of (2R,6R)-HNK in protecting against learning impairment and inhibiting autophagy was abrogated, showing no difference in the escape latency; the difference in the LC3-II/LC3-I ratio and p62 expression level between the SMER28+(2R,6R)-HNK+ECS and ECS groups was not as significant as that between the (2R,6R)-HNK+ECS and ECS groups (P<0.05–0.01 vs P<0.001). Conclusion (2R,6R)-HNK yields cognitive protection by suppressing autophagy through the mTOR signaling pathway in the ECS-treated rat hippocampus.
Development and Psychometric Testing of the Japanese Version of the Fremantle Neck Awareness Questionnaire: A Cross-Sectional Study

Purpose Contemporary theories of pain suggest that how the body is perceived is central to the emergence of pain. The Fremantle Back Awareness Questionnaire (FreBAQ) was developed to assess body-perception specific to the back in people with chronic low back pain. However, there is no comprehensive measure to quantify self-perception of the painful area in Japanese people with neck pain. This study aimed to develop a Japanese version of a self-perception questionnaire specific to the neck and evaluate the validity and reliability of the scale using Rasch analysis. Materials and Methods The Fremantle Neck Awareness Questionnaire (FreNAQ-J) was developed by modifying the FreBAQ-J. One hundred people with chronic neck pain and fifty-six matched healthy controls completed the questionnaire. Rasch analysis was used to evaluate targeting, category order, unidimensionality, person fit, internal consistency, differential item functioning, and differential test functioning in the neck pain population. Validity was investigated by examining the relationship between the FreNAQ-J and clinical status. Results People with chronic neck pain endorsed FreNAQ-J items with greater frequency than healthy controls. FreNAQ-J did not reject the null hypothesis of fitting the Rasch model, had acceptable internal consistency and good test–retest reliability. Summed FreNAQ-J scores were significantly correlated with pain intensity, disability, pain-related catastrophizing and fear of movement. Conclusion The individual items of the FreNAQ-J can be validly summed to provide a score of self-perception. The FreNAQ-J is the first scale developed for comprehensively evaluating disturbed body perception in Japanese patients with chronic neck pain.
Multivariate Analysis of COVID-19 for Countries with Limited and Scarce Data: Examples from Nepal

This paper aims to understand the dynamics of the spread of COVID-19 for Nepal. It is carried out with the help of multivariate statistics techniques. Direct relationships among variables are obvious, as they are easily seen and measured. But, hidden variables and their interrelationships also have a significant effect on the spread of a pandemic. Multinomial logistic regression, odds ratio, linear mixed-effect models, and principal component analysis are used here to analyze these hidden variables and their interrelationships. Also, such studies are very important for countries with limited and scarce data. These countries do not have a backbone of good-quality official records. Understanding the spread of a disease in a developing country also helps in management and eradication of that disease. The multivariate daily data of new cases, deaths, recovered, total cases, total deaths, total recovered, and total infected (isolated) are used here. The daily incidence of new cases is also modeled here using nonlinear regression. Two best nonlinear models are discussed here. ARIMA models are used for analyzing and forecasting the progression of the variables for two months into the future. The impact of government restriction in the form of strict lockdown 1, partially relaxed lockdown 1, completely relaxed lockdown 1, and strict lockdown 2 is minutely analyzed. These controls were exercised to curtail the spread of the pandemic. The role of these controls in curbing the spread of the pandemic is also studied here. The results obtained from this study can be applied to other countries of South Asia and Africa.
Improved Antibiotic Prescribing Practices for Respiratory Infections Through Use of Computerized Order Sets and Educational Sessions in Pediatric Clinics

Abstract Background Computerized clinical decision support systems (CDSS) have shown promising effectiveness in improving outpatient antibiotic prescribing. Methods We developed an intervention in the form of EPIC (Verona, WI, USA) order sets comprised of outpatient treatment pathways for 3 pediatric bacterial acute respiratory infections (ARIs) coupled with educational sessions. Four pediatric clinics were randomized into intervention and control arms over pre- and postimplementation study periods. In the intervention clinics, education was provided in between the 2 study periods and EPIC order sets became available at the beginning of the postimplementation period. The primary end point was the percentage of first-line antibiotic prescribing, and the secondary end points included antibiotic duration and antibiotic prescription modification within 14 days. Results A total of 2690 antibiotic prescriptions were included. During the pre-implementation phase, there was no difference in first-line antibiotic prescribing (74.9% vs 77.7%; P = .211) or antibiotic duration (9.69 ± 0.96 days vs 9.63 ± 1.07 days; P > .999) between the study arms. Following implementation, the intervention clinics had a higher percentage of first-line antibiotic prescribing (83.1% vs 77.7%; P = .024) and shorter antibiotic duration (9.28 ± 1.56 days vs 9.79 ± 0.75 days; P < .001) compared with the control clinics. The percentage of modified antibiotics was small in all clinics (1.1%–1.6%) and did not differ before and after the intervention (for all statistical comparisons, P ≤ .354). Conclusions A computerized CDSS involving treatment pathways in the form of order sets coupled with educational sessions was associated with a higher percentage of first-line antibiotic prescribing and shorter antibiotic duration for the outpatient treatment of pediatric bacterial ARIs.