In recent years, there has been a surge in the publication of clinical trial reports, making it challenging to conduct systematic reviews. Automatically extracting Population, Intervention, Comparator, and Outcome (PICO) from clinical trial studies can alleviate the traditionally time-consuming process of manually scrutinizing systematic reviews. Existing approaches of PICO frame extraction involves supervised approach that relies on the existence of manually annotated data points in the form of BIO label tagging. Recent approaches, such as In-Context Learning (ICL), which has been shown to be effective for a number of downstream NLP tasks, require the use of labeled examples. In this work, we adopt ICL strategy by employing the pretrained knowledge of Large Language Models (LLMs), gathered during the pretraining phase of an LLM, to automatically extract the PICO-related terminologies from clinical trial documents in unsupervised set up to bypass the availability of large number of annotated data instances. Additionally, to showcase the highest effectiveness of LLM in oracle scenario where large number of annotated samples are available, we adopt the instruction tuning strategy by employing Low Rank Adaptation (LORA) to conduct the training of gigantic model in low resource environment for the PICO frame extraction task. More specifically, both of the proposed frameworks utilize AlpaCare as base LLM which employs both few-shot in-context learning and instruction tuning techniques to extract PICO-related terms from the clinical trial reports. We applied these approaches to the widely used coarse-grained datasets such as EBM-NLP, EBM-COMET and fine-grained datasets such as EBM-NLPrev and EBM-NLPh. Our empirical results show that our proposed ICL-based framework produces comparable results on all the version of EBM-NLP datasets and the proposed instruction tuned version of our framework produces state-of-the-art results on all the different EBM-NLP datasets. Our project is available at https://github.com/shrimonmuke0202/AlpaPICO.git.

BACKGROUND: Cerebrospinal fluid (CSF) is commonly analyzed in South American camelids with suspected neurologic disease because of ease of collection and characteristic findings associated with certain diseases.
OBJECTIVE: To assess CSF findings associated with short-term survival or non-survival in South American camelids in which neurologic disease was a differential diagnosis based on history and physical examination.
METHODS: Twenty-one llamas and 33 alpacas that underwent CSF analysis at the University of Missouri Veterinary Health Center.
METHODS: Retrospective study. Medical records of camelids that underwent CSF analysis between January 2005 and September 2021 were studied. Short-term survival was defined as survival to discharge from the Veterinary Health Center. A Fisher\'s exact test was used to compare species, CSF results, and survival.
RESULTS: Odds of survival were 3.9 times higher in camelids with a total nucleated cell count (TNCC) <3 cells/μL (P = .04). No significant association was found between survival and total protein concentration (TPC; P = .15) or percentage of eosinophils (P = 1.0). No significant correlation was found between species and increased TNCC (P = .63), TPC (P = .55), or percentage of eosinophils (P = .30). Among camelids diagnosed with Paralephostrongylus tenuis infestation, odds of survival were 4.95 times higher in alpacas (P = .05).
CONCLUSIONS: Cerebrospinal fluid TNCC ≥3 cells/μL is associated with decreased odds of short-term survival in South American camelids.

Camelid pathology submissions to veterinary diagnostic laboratories are on the rise given the increasing popularity and population of llamas and alpacas especially in the western United States. When compared to other animals, the field of camelid neoplasia has a relative paucity of cases reported in the literature. The Colorado State University Veterinary Diagnostic Laboratories (CSU-VDL) has had a steady increase in the numbers of camelid pathology submissions allowing for a robust review of diagnoses of neoplasia in new world camelids. Here we present a retrospective analysis of camelid neoplastic and proliferative lesions diagnosed at the CSU-VDL from 1995 to 2020, followed by an extensive literature review. Results show increasing incidence of camelid neoplasia reported in the literature, therefore becoming a common diagnosis in llamas and alpacas. Proliferative and neoplastic lesions were diagnosed in 8.8% of new world camelid submissions to CSU-VDL with the most common tumors being lymphomas, squamous cell carcinomas, fibromas, and adenocarcinomas. Risk factors are female sex and increased age except in the case of lymphoma, which tends to occur in younger camelids. Lymphomas, melanomas, and adenocarcinomas (especially of gastrointestinal tract) carry an increased risk of multiple-organ system involvement often with widespread metastases. Conditions described in camelids for the first time include osteosarcoma, cutaneous hemangiosarcoma, myxosarcoma, pilomatricoma, ovarian theca cell tumor, congenital nevus with malignant transformation, and various other neoplasia. This article will provide an operational guide for camelid neoplasia to further assist veterinary laboratory diagnosticians, researchers, and practicing veterinarians in the field of camelid medicine and pathology.

Multi-membrane spanning proteins, such as G protein-coupled receptors (GPCRs) and ion channels, are extremely difficult to purify as native proteins. Consequently, the generation of antibodies that recognize the native conformation can be challenging. By combining genetic immunization, phage display, and biopanning, we identified a panel of monovalent antibodies (nanobodies) targeting the vasoactive intestinal peptide receptor 1 (VPAC1) receptor. The nine unique nanobodies that were classified into four different families based on their CDR3 amino acid sequence and length, were highly specific for the human receptor and bind VPAC1 with moderate affinity. They all recognize a similar epitope localized in the extracellular N-terminal domain of the receptor and distinct from the orthosteric binding site. In agreement with binding studies, which showed that the nanobodies did not interfere with VIP binding, all nanobodies were devoid of any functional properties. However, we observed that the binding of two nanobodies was slightly increased in the presence of VPAC1 agonists [vasoactive intestinal polypeptide (VIP) and pituitary adenylate cyclase-activating polypeptide-27 (PACAP-27)], but decreased in the presence of VPAC1 antagonist. As no evidence of allosteric activity was seen in VIP binding studies nor in functional assays, it is, therefore, possible that the two nanobodies may behave as very weak allosteric modulators of VPAC1, detectable only in some sensitive settings, but not in others. We demonstrated that the fluorescently labeled nanobodies detect VPAC1 on the surface of human leukocytes as efficiently as a reference mouse monoclonal antibody. We also developed a protocol allowing efficient detection of VPAC1 by immunohistochemistry in paraffin-embedded human gastrointestinal tissue sections. Thus, these nanobodies constitute new original tools to further investigate the role of VPAC1 in physiological and pathological conditions.

OBJECTIVE: The number of South American Camelids (New World Camelids) housed in Germany has increased in the recent years. While these species were formerly kept solely in zoological gardens, ever more private and commercial livestock is being established. Compared to indigenous livestock animals, they bear some distinctive differences, particularly in terms of digestive tract anatomy and physiology. Therefore, it is of considerable interest for veterinarians working with South American Camelids to obtain knowledge about the distinguishing features of these animals and the typical diseases affecting them in Germany.
METHODS: For this purpose, the necropsy reports, including the anamnestic data, and their diagnostic usefulness, from 1995 to 2012 were studied retrospectively.
RESULTS: Du- ring this period, a total of 233 New World Camelids were examined (195 alpacas and 38 llamas). Anamnestic data of diagnostic usefulness regarding the cause of disease were only submitted in a limited number of cases, because most of the animals died without specific symptoms. The following were the most frequent pathological findings: enteritis (n = 91), gastritis (n = 76), cachexia (n = 73), pneumonia (n = 30), stomatitis (n = 27), azotaemia (n = 22) and anaemia (n = 9). An endoparasitosis occurred in 107 cases and was considered the predominant cause of enteritis.
CONCLUSIONS: As with indigenous ruminants, llamas and alpacas primarily suffered from diseases of the digestive and respiratory tracts. Other organ systems were affected to a lesser extent.
CONCLUSIONS: Even in cases with severe alterations in the affected organs, South American Camelids do not show or show too late diagnostically indicative clinical symptoms. Therefore, a detailed clinical examination of these animals is important.