Miracle-dz/UniFAR-FTUs huggingface dataset:
Albuminuria, not only a cardiovascular/renal risk marker, but also a target for treatment?

Albuminuria, not only a cardiovascular/renal risk marker, but also a target for treatment? Albuminuria has been identified as a marker for predicting both cardiovascular and renal risk. From normal to overt proteinuria levels, albuminuria shows a continuous marked increase in risk. This is independent of other well-known cardiovascular and renal risk markers and factors, such as blood pressure, cholesterol, smoking, overweight, and others. The predictive power is not only present in already diseased populations with either nondiabetic or diabetic renal disease, but also in hypertensive and even in otherwise healthy populations. New antihypertensive intervention strategies, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II (Ang II) receptor-antagonists are claimed to have cardioprotective and renoprotective benefits that go beyond blood pressure control. Interestingly, these new therapeutic classes share the ability to lower urinary albumin excretion by an average of 40%, a characteristic that is not observed with the other antihypertensive drug classes. This short-term–induced antiproteinuric effect appears to predict the long-term cardiovascular and renal protection: the more albuminuria is lowered, the more that individual (or group) is protected. These data suggest that albumin is not only a risk marker for cardiovascular and or renal disease, but it may also be a useful target for therapy. Monitoring of albuminuria should be daily practice in subjects at risk for cardiovascular and renal disease. In addition to new clinical trials that prove that albumin can be targeted to obtain cardiovascular protection, guidelines should be made to help the physician in deciding how to measure albumin in the urine, what are normal levels, how to target "abnormal" levels, and how low we should go.
Augmenting Clinical Outcome Measures of Gait and Balance with a Single Inertial Sensor in Age-Ranged Healthy Adults

Gait and balance impairments are linked with reduced mobility and increased risk of falling. Wearable sensing technologies, such as inertial measurement units (IMUs), may augment clinical assessments by providing continuous, high-resolution data. This study tested and validated the utility of a single IMU to quantify gait and balance features during routine clinical outcome tests, and evaluated changes in sensor-derived measurements with age, sex, height, and weight. Age-ranged, healthy individuals (N = 49, 20–70 years) wore a lower back IMU during the 10 m walk test (10MWT), Timed Up and Go (TUG), and Berg Balance Scale (BBS). Spatiotemporal gait parameters computed from the sensor data were validated against gold standard measures, demonstrating excellent agreement for stance time, step time, gait velocity, and step count (intraclass correlation (ICC) > 0.90). There was good agreement for swing time (ICC = 0.78) and moderate agreement for step length (ICC = 0.68). A total of 184 features were calculated from the acceleration and angular velocity signals across these tests, 36 of which had significant correlations with age. This approach was also demonstrated for an individual with stroke, providing higher resolution information about balance, gait, and mobility than the clinical test scores alone. Leveraging mobility data from wireless, wearable sensors can help clinicians and patients more objectively pinpoint impairments, track progression, and set personalized goals during and after rehabilitation.
New directions in diagnosis and treatment of canine acute pancreatitis

Acute pancreatitis is an important disease in companion animal medicine, and diagnostic methodology available to veterinary practitioners is often limited. Evidence based principles for the management of this common disease are also lacking. This thesis explores the current diagnostics of canine pancreatitis and management of this condition, reviewing the literature across both the veterinary and human medical fields. Assessment of the specificity of canine pancreatic-specific lipase (cPL) was made in a post-mortem study and calculated to be 82-92%, with a correlating sensitivity of 45-55%. A multi-centre study of dogs presenting with clinical signs consistent with acute pancreatitis to assess a new laboratory test, serum canine pancreatic elastase-1 (cPE-1) was also performed. This test had a sensitivity ranging from 66-79%, with a specificity of 92%. The sensitivity of both laboratory tests was greater in dogs with severe disease. To assess potential treatment options, a clinical severity score was established, with gut health, respiratory complications, cardiac complications, and blood pressure determining the final score. Retrospectively, plasma administration did not appear to be associated with treatment success, but this conclusion was limited by the retrospective nature of the study and small numbers of dogs. Out of the other factors, fasting for 3 or more days was the one most significantly associated with mortality. To begin assessment of nutritional modalities, pancreatic responses in healthy dogs to varying dietary fat composition (ranging from 4%DW to 16% DW) was assessed, with no statistical difference determined. On the basis of this, a pilot study of 10 dogs with severe pancreatitis was undertaken, with 5 dogs fed enterally and another 5 dogs were given total parenteral nutrition (TPN). No differences in mortality or days of hospitalisation between the two were found, but there were significantly less episodes of vomiting or regurgitation in the dogs given food (p < 0.001). There were also more severe complications (4/5) in the TPN group compared to the enteral feeding group (2/5). In all, this thesis supports the new premise of enteral feeding of dogs with acute pancreatitis early in the course of disease, determines the sensitivity and specificity of two diagnostic tests and has established an objective marker of disease severity.
Twenty‐five years of diabetes distress research

The term ‘diabetes distress’ first entered the psychosocial research vernacular in 1995, and refers to ‘the negative emotional or affective experience resulting from the challenge of living with the demands of diabetes’. At first the proponents of the concept were hesitant in advocating that diabetes distress was a major barrier to individuals’ self‐care and management of diabetes. Since then, a burgeoning body of evidence, now including several systematic reviews of intervention studies, suggests that diabetes distress, in both type 1 and type 2 diabetes, across ages and in all countries and cultures where it has been studied, is common and can be a barrier to optimal emotional well‐being, self‐care and management of diabetes. As a consequence, monitoring diabetes distress as part of routine clinical care is part of many national guidelines. The present narrative review summarizes this research and related literature, to postulate the aetiology of diabetes distress, and thus how it may be prevented. The current evidence base for the management of diabetes distress is summarized, and the next steps in the prevention and management of diabetes distress identified.
Is food addiction a predictor of treatment outcome among patients with eating disorder?

OBJECTIVES The study aimed to examine whether food addiction (FA) was associated with greater severity in both binge eating disorders (BED) and bulimia nervosa and, therefore, to determine if FA was predictive of treatment outcome. METHOD Seventy-one adult patients with bulimia nervosa and BED (42 and 29, respectively) participated in the study. FA was assessed by means of the Yale Food Addiction Scale. RESULTS The results confirmed a high prevalence of FA in patients with binge disorders (around 87%) and also its association with a greater severity of the disorder (i.e., related to an increased eating psychopathology and greater frequency of binge eating episodes). Although FA did not appear as a predictor of treatment outcome in general terms, when the diagnostic subtypes were considered separately, FA was associated with poor prognosis in the BED group. In this vein, FA appeared as a mediator in the relationship between ED severity and treatment outcome. DISCUSSIONS Our findings suggest that FA may act as an indicator of ED severity, and it would be a predictor of treatment outcome in BED but not in BN.
Multidimensional or essentially unidimensional? A multi-faceted factor-analytic approach for assessing the dimensionality of tests and items.

BACKGROUND Factor-analysis based dimensional assessment of psychometric measures is a key step in the development of tests. However, current practices for deciding between a multiple-correlated or essentially unidimensional solution are clearly improvable. METHOD A series of recent studies are reviewed, and an approach is proposed that combines multiple sources of information, which is expected to be used to make an informed judgement about the most appropriate dimensionality for the measure being studied. It uses both internal and external sources of information, and focuses on the properties of the scores derived from each of the solutions compared. RESULTS The proposal is applied to a re-analysis of a measure of symptoms of psychological distress. The results show that a clear and informed judgement about the most appropriate dimensionality of the measure in the target population can be obtained. DISCUSSION The proposal is useful and can be put into practice by using user-friendly, non-commercial software. We hope that this availability will result in good practice in the future.
Perinatal mortality at Kathmandu Model Hospital.

Total number of 410 deliveries were performed at Kathmandu Model Hospital (KMH) during 33 months (April 96 -Dec 98 ). Among 410 deliveries 107 (26.09%) cases were done by Lower Segment Caesarean Section (LSCS), 54 cases (13.37%) by forceps delivery, 188 (45.85%) cases normal vaginal delivery with epigiotomy and 61 (14.87%) normal vaginal delivery with or without tear. During this period, 6 twin delivery cases were observed. There were 14 cases of perinatal deaths (still birth -10 and neonatal-death - 4). Hence, perinatal mortality rate during this peroid in this hospital was 34.15. Perinatal mortality was mostly due to severe prematurity, birth asphyxia, ante-partum haemorrhage (APH), intrauterine growth retardation (IUGR), congenital abnormalities and sepsis. KEY WORDS: Neonatal death, Still birth, Perinatal mortality, Antepartum haemorrhage (APH), Sepsis.
Current Smoking is Associated with Decreased Expression of miR-335-5p in Parenchymal Lung Fibroblasts

Cigarette smoking causes lung inflammation and tissue damage. Lung fibroblasts play a major role in tissue repair. Previous studies have reported smoking-associated changes in fibroblast responses and methylation patterns. Our aim was to identify the effect of current smoking on miRNA expression in primary lung fibroblasts. Small RNA sequencing was performed on lung fibroblasts from nine current and six ex-smokers with normal lung function. MiR-335-5p and miR-335-3p were significantly downregulated in lung fibroblasts from current compared to ex-smokers (false discovery rate (FDR) <0.05). Differential miR-335-5p expression was validated with RT-qPCR (p-value = 0.01). The results were validated in lung tissue from current and ex-smokers and in bronchial biopsies from non-diseased smokers and never-smokers (p-value <0.05). The methylation pattern of the miR-335 host gene, determined by methylation-specific qPCR, did not differ between current and ex-smokers. To obtain insights into the genes regulated by miR-335-5p in fibroblasts, we overlapped all proven miR-335-5p targets with our previously published miRNA targetome data in lung fibroblasts. This revealed Rb1, CARF, and SGK3 as likely targets of miR-335-5p in lung fibroblasts. Our study indicates that miR-335-5p downregulation due to current smoking may affect its function in lung fibroblasts by targeting Rb1, CARF and SGK3.
Development and introduction of a communication skills module for postgraduate students of ophthalmology

Purpose: Effective communication lies at the heart of a patient--doctor relationship. Communication skills (CS) teaching and assessment is not a part of the postgraduate (PG) curriculum. Lack of effective CS in current PG students' results in patient distrust and dissatisfaction, conflicts, and compromised healthcare. The regulatory authorities of medical education have recognized the need to inculcate soft skills among medical graduates, one of which is CS. The purpose of this study was to assess the need for teaching CS to ophthalmology PG students and develop and introduce a module for the same. Methods: In this prospective, interventional study done at the ophthalmology department of a tertiary hospital, a validated 8 day CS workshop was conducted for 60 PG students through interactive lectures, observations, video sessions, and role plays. Feedbacks were obtained through narratives, validated Google survey, reflections and verbal method and analyzed. Results: In the needs assessment done on 27 departmental faculties, 20 faculties found poor communication to be a major reason for patient complaints. All faculties agreed that CS should be taught to medical students. Statistically significant improvement in CS awareness was noted among students after the workshop. Lack of CS training, work burden, and language were identified as main barriers to effective communication. All the students were satisfied with the workshop and wanted it to be conducted regularly. Conclusion: This study establishes that CS training is essential to improve patient satisfaction and patient-doctor relationships. Barriers to effective CS could be identified, for which possible solutions could be found.
Treatment of acute bacterial exacerbations of chronic bronchitis

Background: Controversies persist regarding the optimal management of patients with acute exacerbations of chronic bronchitis (AECB). Objective: To evaluate the available evidence on relevant issues, namely the need for administering antimicrobials in patients with AECB, the identification of the subgroup of patients with AECB needing antibiotics, the antimicrobial regimen of choice and its optimal duration, the existence of new agents, and the value of non-antimicrobial regimens for AECB. Methods: Data from various sources of evidence, including recent relevant meta-analyses, were appraised. Conclusion: Administration of antimicrobial agents, combined with bronchodilators and systemic corticosteroids, is warranted in approximately half of AECBs (i.e., in bacterial exacerbations) to achieve a survival benefit. Simple clinical parameters, mainly sputum purulence, and biomarkers, such as procalcitonin, are useful in identifying patients requiring antibiotics. Advanced antibiotics (quinolones, macrolides, or amoxicillin/clavulanic acid) are more effective than ‘old’ antibiotics in AECB; regimens of short duration (for 5 days) are preferred. There is no difference between several classes of advanced antibiotics regarding their short-term effectiveness; however, quinolones are associated with better long-term outcomes than macrolides. Newer quinolones and new formulations of macrolides enrich clinicians' armamentarium against AECB.
Awareness, current use of electronic cigarettes and associated smoking factors in Zhejiang Chinese adolescents

Objectives The present study aims at examining the prevalence of awareness and current use of electronic cigarettes (e-cigarettes) among middle and high school students from Zhejiang, China. Smoking-related factors associated with e-cigarettes use will also be explored. Methods This cross-sectional study was based on 2017 Zhejiang Youth Risk Behavior Survey. A total of 24,157 adolescents were recruited and relevant data of e-cigarettes and smoking-related factors were collected via a self-reported questionnaire. Logistic regression models were used to examine the association between e-cigarettes current use and the smoking-related factors. Odds ratios (ORs) and their 95% confidence intervals (CIs) were reported. Results Overall, 70.61% of middle and high school students reported hearing of e-cigarettes, while only 2.15% reported using e-cigarettes in the past month. Among smoking-related factors, cigarette smoking (ever and current), use of other tobacco products, second hand smoke exposure and previous attempts to quit smoking were significantly associated with higher current e-cigarettes use in adolescents. Conclusions These results presented high awareness of e-cigarettes while relatively low use in Chinese adolescents. Smoking-related factors were significantly associated with increased e-cigarettes use.
Cyclodextrin-Elicited Bryophyllum Suspension Cultured Cells: Enhancement of the Production of Bioactive Compounds

The rates of production of secondary metabolites obtained by employing conventional plant breeding may be low for practical purposes. Thus, innovative approaches for increasing their rates of production are being developed. Here, we propose the use of elicited plant suspension cultured cells (PSCC) with cyclodextrins (CDs) as an alternative method for the production of bioactive compounds from Bryophyllum species. For this purpose, we analyzed the effects of methyl–β–cyclodextrin and 2–hydroxypropyl–β–cyclodextrin on cell culture growth and on the intra- and extracellular production of phenols and flavonoids. Results clearly show that CDs enhance the biosynthesis of polyphenols by PSCC favoring their accumulation outside the cells. CDs shift the homeostatic equilibrium by complexing extracellular phenolics, causing stress in cells that respond by increasing the production of intracellular phenolics. We also analyzed the radical scavenging activity of the culture medium extracts against 2,2–diphenyl–1–pycrilhydrazyl (DPPH) radical, which increased with respect to the control samples (no added CDs). Our results suggest that both the increase in the production of polyphenols and their radical scavenging activity are a consequence of their inclusion in the CD cavities. Overall, based on our findings, CDs can be employed as hosts for increasing the production of polyphenols from Bryophyllum species.
Xenon lamps used for fruit surface sterilization can increase the content of total flavonols in leaves of Lactuca sativa L. without any negative effect on net photosynthesis

One (1P), two (2P), three (3P) or four (4P) pulses of light supplied by a xenon lamp, were applied to young lettuce plants grown in pots. The lamp used in the trial was similar to those used for fruit surface sterilization. Total flavonols were measured in leaves using the Dualex method. In a first trial conducted in greenhouse conditions, 6 days after the pulsed light (PL) treatment, flavonols were increased by 312% and 525% in the 3P and 4P treatments, respectively, in comparison to the those in the untreated control. Changes in the chlorophyll fluorescence parameters suggest that the PL treatment may induce limited and transient damage to the photosynthetic machinery and that the damage increases with the increasing number of pulses. The performance parameters were not significantly affected by PL and recovered fully by 6 days after the treatments. The 1P and the 2P treatments 6 days after the treatment showed a 28.6% and a 32.5% increase, respectively, in net photosynthetic assimilation, when compared to that of the control. However, 8 days after the treatment, there was no longer a difference between the treatments and the control in net photosynthetic assimilation. Eight days after the light treatment, the 3P treatment showed a 38.4% increase in maximal net photosynthetic assimilation over that of the control, which is an indication of positive long-term adaptation of photosynthetic capacity. As a whole, our observations suggest that PL could be used on field or greenhouse crops to increase their phytochemical content. No long-lasting or strong negative effects on photosynthesis were associated with PL within the range of doses we tested; some observations even suggest that certain treatments could result in an additional positive effect. This conclusion is supported by a second trial conducted in phytotrons. More studies are required to better understand the roles of the different wavelengths supplied by PL and their interactions.
A retrospective study of patients with blood culture-confirmed typhoid fever in Fiji during 2014–2015: epidemiology, clinical features, treatment and outcome

Abstract Background Typhoid fever is endemic in Fiji. We sought to describe the epidemiology, clinical features and case fatality risk of blood culture-confirmed typhoid fever from January 2014 through December 2015. Methods Blood culture-positive patients were identified from a typhoid surveillance line list. A standardised case investigation form was used to record data from patients’ medical records. Results Of 542 patients, 518 (95.6%) were indigenous Fijians (iTaukei) and 285 (52.6%) were male. The median (IQR) age was 25 (16–38) y. Mean (SD) time from the onset of illness to admission was 11.1 (6.9) d. Of 365 patients with clinical information, 346 (96.9%) had fever, 239 (66.9%) diarrhoea, 113 (33.5%) vomiting, and 72 (30.2%) abdominal pain. There were 40 (11.0%) patients with complications, including 17 (4.7%) with shock, and 11 (3.0%) with hepatitis. Nine patients died for a case fatality risk of 1.7%. Of the 544 Salmonella Typhi isolates tested, none were resistant to first line antimicrobials; 3(0.8%) were resistant to ciprofloxacin and 5(1.4%) to nalidixic acid. Conclusions In Fiji, most blood culture-confirmed typhoid fever cases were in young adults. Common clinical manifestations were fever and gastrointestinal symptoms. Further studies are required to elucidate the factors associated with complications and death.
Evaluation of Osseous Morphology of the Hip Using Zero Echo Time Magnetic Resonance Imaging

Background: Femoroacetabular impingement syndrome (FAIS) is a common disorder of the hip resulting in groin pain and ultimately osteoarthritis. Radiologic assessment of FAI morphologies, which may present with overlapping radiologic features of hip dysplasia, often requires the use of computed tomography (CT) for evaluation of osseous abnormality, owing to the difficulty of direct visualization of cortical and subchondral bone with conventional magnetic resonance imaging (MRI). The use of a zero echo time (ZTE) MRI pulse sequence may obviate the need for CT by rendering bone directly from MRI. Purpose/Hypothesis: The purpose was to explore the application of ZTE MRI to the assessment of osseous FAI and dysplasia morphologies of the hip. It was hypothesized that angular measurements from ZTE images would show significant agreement with measurements obtained from CT images. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Thirty-eight hips from 23 patients were imaged with ZTE MRI and CT. Clinically relevant angular measurements of hip morphology were made in both modalities and compared to assess agreement. Measurements included coronal and sagittal center-edge angles, femoral neck-shaft angle, acetabular version (at 1-, 2-, and 3-o’clock positions), Tönnis angle, alpha angle, and modified-beta angle. Interrater agreement was assessed for a subset of 10 hips by 2 raters. Intermodal agreement was assessed on the complete cohort and a single rater. Results: Interrater agreement was demonstrated in both CT and ZTE, with intraclass correlation coefficient values ranging from 0.636 to 0.990 for ZTE and 0.747 to 0.983 for CT, indicating “good” to “excellent” agreement. Intermodal agreement was also shown to be significant, with intraclass correlation coefficients ranging from 0.618 to 0.904. Conclusion: Significant agreement of angular measurements for hip morphology exists between ZTE MRI and CT imaging. ZTE MRI may be an effective method to quantitatively evaluate osseous hip morphology.