Miracle-dz/UniFAR-FTUs huggingface dataset:
Medical emergencies in dental hygienists’ practice

Abstract Dental hygienists in Poland work in various settings, including public health care institutions, private dental practices, dental clinics, kindergartens, and schools. They can often face medical emergencies, whose rate is increasing owing to comorbidities and aging of dental patients’ populations. The aim of the study was to assess the prevalence of medical emergencies in dental hygienists’ practice in Poland and the hygienists’ preparedness and attitudes toward emergencies. A 10-question authors’ own questionnaire was filled in by 613 dental hygienist. It referred to their cardiopulmonary resuscitation training, availability of emergency medical equipment in the workplace, the prevalence of medical emergencies including the need for an emergency medical service (EMS) call, and the management of cardiac arrest. Overall, 613 dental hygienists working in Poland participated in the study; 38.99% had taken part in basic life support (BLS) training within the previous 12 months and 35.89% within 2 to 5 years; 15.17% had experienced at least 1 emergency situation requiring an EMS call within the previous 12 months. Vasovagal syncope was the most common medical emergency (15.97%), followed by moderate anaphylactic reaction (13.87%), seizures (8.81%), hyperventilation crisis (7.50%), and hypoglycemia (7.34%). The most common medical emergency in dental hygienists’ practice in Poland is syncope followed by mild anaphylactic reaction. Most of the dental hygienist had participated in a BLS course within the previous 5 years; however, 20% of them have never participated since graduation. Dental hygienists should participate in BLS courses every 2 years to keep the cardiopulmonary resuscitation skills and stay up-to-date with current guidelines. An important part of the study participants declare the lack of availability in their workplaces of life-saving equipment, including self-expanding bag resuscitator, oropharyngeal, and supraglottic airway device and oxygen source. Medical emergency equipment as recommended in the international guidelines should be available in every practice.
Retrospective evaluation of the efficacy and safety of rivaroxaban in patients with cancer-associated venous thromboembolism

Abstrct The purpose of this study was to evaluate the efficacy and safety of rivaroxaban for the treatment of cancer-associated venous thromboembolism (VTE). We performed a retrospective chart review of cancer patients with a pulmonary embolism, deep vein thrombosis, or both. Our analysis included all patients who received rivaroxaban from March 2013 to June 2016 at the Hemato-Oncology Division at the Pusan National University Hospital in Korea. Preliminary results identified 123 patients with a history of cancer that were treated with rivaroxaban. The average duration of rivaroxaban therapy was 95.25 days. While 35 patients had resolved VTE after the initiation of rivaroxaban, only one patient had it recur on rivaroxaban treatment. Major bleeding was observed in 6 (4.9%) patients and minor bleeding in 12 (9.8%) patients. The majority of bleeding events occurred spontaneously and most incidences of bleeding could be treated conservatively. Recurrence and major bleeding events on rivaroxaban were relatively low despite the fact that many patients had metastatic disease. Among 52 patient deaths (42.3%), none were due to VTE or bleeding complications; the cause of death in the majority of cases was cancer progression. Rivaroxaban is effective and safe for the treatment of cancer-associated VTE.
Clozapine and tardive dyskinesia in patients with schizophrenia: A systematic review

Background: It is commonly recommended that a switch to clozapine be implemented in the face of tardive dyskinesia, even if current treatment involves another “atypical” agent. However, reports do indicate clozapine carries a liability for tardive dyskinesia. Aims: This review sought to evaluate clozapine in relation to tardive dyskinesia in the context of available evidence. Methods: Medline, Embase, and PsycINFO databases were searched for studies published in English, using the keywords: clozapine AND tardive dyskinesia OR TD. References from major review articles were searched for additional relevant publications. Studies were included if they investigated: tardive dyskinesia in clozapine-treated patients diagnosed with schizophrenia spectrum disorders, and reported on two or more assessments of tardive dyskinesia severity measured by the Abnormal Involuntary Movement Scale; or clozapine’s tardive dyskinesia liability. Results: In total, 513 unique citations were identified and 29 reports met the inclusion criteria. Thirteen studies suggest clozapine reduces dyskinetic symptoms over time (n=905 clozapine-treated participants); however, the minimum required dose and effect of withdrawal requires further investigation. The majority of reports which address clozapine’s liability for tardive dyskinesia are case studies (11 of 14 reports, 79%), and clozapine was only the first-line treatment in one of the remaining three studies reporting treatment-emergent dyskinetic symptoms with clozapine in 12% of patients. No significant between-drug differences were identified comparing clozapine’s risk to other atypical antipsychotics. Conclusions: Research to date supports switching to clozapine for the purpose of reducing tardive dyskinesia risk and/or treating existing tardive dyskinesia, but prospective randomized controlled trials are necessary if we are to substantiate existing recommendations.
TUNEL assay: Establishing a sperm DNA fragmentation cut‐off value for Egyptian infertile men

Male factor infertility is responsible for half of all infertility cases. Conventional semen analysis is inadequate to evaluate male fertility. Sperm DNA fragmentation (SDF) test can be done by: direct methods such as Terminal deoxynucleotidyl transferase dUTP Nick‐End Labeling (TUNEL) and Comet assay, or indirect like Sperm Chromatin Structure Assay (SCSA) and Sperm Chromatin Dispersion (SCD). TUNEL assay measures both single‐ and double‐strand breaks and is technically less demanding, while SCSA tests for the susceptibility for nuclear DNA denaturation and samples should be sent to the reference lab. Studies showed that a single cut‐off value does not fit all. Therefore, this study aimed at establishing a cut‐off value to discriminate between fertile and infertile Egyptian men. We enrolled 354 infertile men and 40 proven fertile volunteers.TUNEL assay was performed using Apo‐Direct kit and bench top flow cytometer.The calculated SDF cut‐off value was 20.3% with a sensitivity of 96.6% and specificity of 87.5%, and the overall accuracy of the test was 95.7%. Sperm DNA fragmentation Test using TUNEL assay is valuable tool for male infertility evaluation, and it assists in offering the best treatment options based on it's results.
Presurgical simulation for neuroendoscopic procedures: Virtual study of the integrity of neurological pathways using diffusion tensor imaging tractography

Background: White matter (WM) transgression is an unexplored concept in neuroendoscopy. Diffusion tensor image (DTI) tractography could be implemented as a planning and postoperative evaluation tool in functional disconnection procedures (FDPs), which are, currently, the subject of technological innovations. We intend to prove the usefulness of this planning method focused on the assessment of WM injury that is suitable for planning FDPs. Methods: Ten cranial magnetic resonance studies (20 sides) without pathological findings were processed. Fascicles were defined by two regions of interest (ROIs) using the fiber assignment method by the continuous tracking approach. Using three-dimensional (3D) simulation and DTI tractography, we created an 8-mm virtual endoscope and an uninjured inferior fronto-occipital fasciculus (IFOF) from two ROIs. The injured tract was generated using a third ROI built from the 3D model of the intersection of the oriented trajectory of the endoscope with the fascicle. Data and images were quantitatively and qualitatively analyzed. Results: The average percentage of the injured fibers was 32.0% (range: 12.4%–70%). The average intersected volume was 1.1 cm3 (range: 0.3–2.3 cm3). Qualitative analysis showed the inferior medial quadrant of the inferior fronto-occipital fasciculus (IFOF) as the most frequently injured region. No hemispherical asymmetry was found (P > 0.5). Conclusion: DTI tractography is a useful surgical planning tool that could be implemented in several endoscopic procedures. Together with a functional atlas, the presented technique provides a noninvasive method to assess the potential sequelae and thus to optimize the surgical route. The suggested method could be implemented to analyze pathological WM fascicles and to assess the surgical results of FDP such as hemispherotomy or amygdalohippocampectomy. More studies are needed to overcome the limitations of the tractography based information and to develop more anatomically and functionally reliable planning systems.
Thiol–Gelatin–Norbornene Bioink for Laser‐Based High‐Definition Bioprinting

Two‐photon polymerization (2PP) is a lithography‐based 3D printing method allowing the fabrication of 3D structures with sub‐micrometer resolution. This work focuses on the characterization of gelatin–norbornene (Gel–NB) bioinks which enables the embedding of cells via 2PP. The high reactivity of the thiol‐ene system allows 2PP processing of cell‐containing materials at remarkably high scanning speeds (1000 mm s−1) placing this technology in the domain of bioprinting. Atomic force microscopy results demonstrate that the indentation moduli of the produced hydrogel constructs can be adjusted in the 0.2–0.7 kPa range by controlling the 2PP processing parameters. Using this approach gradient 3D constructs are produced and the morphology of the embedded cells is observed in the course of 3 weeks. Furthermore, it is possible to tune the enzymatic degradation of the crosslinked bioink by varying the applied laser power. The 3D printed Gel–NB hydrogel constructs show exceptional biocompatibility, supported cell adhesion, and migration. Furthermore, cells maintain their proliferation capacity demonstrated by Ki‐67 immunostaining. Moreover, the results demonstrate that direct embedding of cells provides uniform distribution and high cell loading independently of the pore size of the scaffold. The investigated photosensitive bioink enables high‐definition bioprinting of well‐defined constructs for long‐term cell culture studies.
Target Analysis and Retrospective Screening of Multiple Mycotoxins in Pet Food Using UHPLC-Q-Orbitrap HRMS

A comprehensive strategy combining a quantitative method for 28 mycotoxins and a post-target screening for other 245 fungal and bacterial metabolites in dry pet food samples were developed using an acetonitrile-based extraction and an ultrahigh-performance liquid chromatography coupled to high-resolution mass spectrometry (UHPLC-Q-Orbitrap HRMS) method. The proposed method showed satisfactory validation results according to Commission Decision 2002/657/EC. Average recoveries from 72 to 108% were obtained for all studied mycotoxins, and the intra-/inter-day precision were below 9 and 14%, respectively. Results showed mycotoxin contamination in 99% of pet food samples (n = 89) at concentrations of up to hundreds µg/kg, with emerging Fusarium mycotoxins being the most commonly detected mycotoxins. All positive samples showed co-occurrence of mycotoxins with the simultaneous presence of up to 16 analytes per sample. In the retrospective screening, up to 54 fungal metabolites were tentatively identified being cyclopiazonic acid, paspalitrem A, fusaric acid, and macrosporin, the most commonly detected analytes.
Association of Subclinical Thyroid Dysfunction with Chronic Kidney Disease: A Systematic Review and Meta-analysis

ABSTRACT Background: The association of subclinical thyroid dysfunction (SCTD) with chronic kidney disease (CKD) among community population remains inconclusive. Our aim was to evaluate the association between SCTD and the risk of CKD by conducting a meta-analysis. Methods: Multiple databases were searched to identify studies on the association between SCTD and risk of CKD, up to October 2018. Relevant information for analysis was extracted. A random-effects model was used to calculate the pooled risk estimate. Results: Eight articles were included in this meta-analysis, with three cohort and five cross-sectional studies. The pooled odds ratio (OR) of subclinical hypothyroidism for CKD was 1.37 (95% CI: 1.13–1.67, P = .000, n = 8) in a multivariable-adjusted model. A significant association was observed in subgroup younger than 70 years (OR = 1.40, 95% CI: 1.09–1.79, P = .000, n = 6), but not in subgroup older than 70 years (OR = 1.28, 95% CI: 0.89–1.83, P = .186, n = 2). For subclinical hyperthyroidism, the summary OR was 1.16 (95%CI: 0.97–1.39, P = .115, n = 5) and subgroup analyses by age and study design did not alter the results significantly. Conclusions: Our findings demonstrated that subclinical hypothyroidism was significantly associated with a higher risk of CKD independent of some conventional risk factors among community population and age might have modifying effects on the association.
MRI Assessment of Cerebral Small Vessel Disease in Patients with Spontaneous Intracerebral Hemorrhage

Purpose Cerebral small vessel disease (SVD) is known to be associated with ischemic stroke, intracerebral hemorrhage (ICH), and cognitive impairment. In this retrospective observational study, we explored SVD markers on MRI relevant to spontaneous ICH. Materials and Methods The ICH group consisted of 150 consecutive patients with a first primary parenchymal ICH, and the control group consisted of 271 age- and sex-matched individuals who underwent brain MRI in a health care center. We compared cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), enlarged perivascular space (EPVS), and lacunae in the ICH and control groups. Results A total of 1278 CMB lesions were identified in 121 of the 150 patients in the ICH group (80.6%), while 77 CMB lesions were found in 32 of the 271 individuals in the control group (11.8%). WMH and EPVS were more severe and lacunae were more frequent in the ICH patients than in the control group. When receiver operating characteristic (ROC) curves were plotted, number of CMBs most significantly predicted ICH. All imaging markers were significantly associated with ICH in every age group. The location of CMBs coincided with the location of ICH, and ICH volume correlated with CMB count. Conclusion All MRI markers for SVD were worse in ICH patients than in healthy controls, and these markers were prominent even in young ICH patients. Lacunae, WMH, EPVS, and CMB should be considered as factors related with spontaneous ICH.
Synergistic effects of fermented soybean meal and mannan-oligosaccharide on growth performance, digestive functions, and hepatic gene expression in broiler chickens

This study investigated the effects of fermented soybean meal (FSBM) with or without mannan-oligosaccharide (MOS) prebiotic on growth performance, digestive functions, and hepatic IGF-1 gene expression of broiler chicken. A total of 480 day-old male broiler chickens were fed with 4 experimental diets for 6 wk. Experimental diets included corn-soybean meal diet (CON); corn-soybean meal diet + MOS prebiotic [0.2%, ActiveMOS; Biorigin, Brazile]; corn-FSBM diet [soybean meal (SBM) was totally replaced by FSBM]; and corn-FSBM + MOS prebiotic (MIX). Replacing dietary SBM with FSBM with or without MOS improved body weight gain and feed efficiency for the total grow-out period. However, the addition of MOS to the FSBM diet exhibited a greater body weight gain than other experimental diets. Villus height and villus height to crypt depth of the duodenum and jejunum were increased by feeding FSBM, MOS, and MIX diets. The ileal crude protein and energy digestibilities, as well as the activities of intestinal amylase and protease, and pancreatic protease, were improved by replacing SBM with FSBM, with or without MOS. The concentration of plasma 3-methylhistidine was reduced by FSBM and MOS, and synergistically by their combination. The MOS and FSBM diets upregulated the hepatic IGF-1 gene expression. However, there was an evident synergistic effect of FSBM supplemented with MOS in the upregulation of the hepatic IGF-1 gene expression. The outcomes of the current study indicate the FSBM and MOS had the potential to improve growth performance, hepatic IGF-1 expression, and intestinal morphology of broilers. Overall, the fermented products could be considered as functional feed that exhibits probiotic effects and the synergistic effects of prebiotics added to the fermented feeds may further improve the growth performance and gut health and functionality in broiler chicken.
SOCS1-Derived Peptide Administered by Eye Drops Prevents Retinal Neuroinflammation and Vascular Leakage in Experimental Diabetes

Current treatments for diabetic retinopathy (DR) target late stages when vision has already been significantly affected. Accumulating evidence suggests that neuroinflammation plays a major role in the pathogenesis of DR, resulting in the disruption of the blood-retinal barrier. Suppressors of cytokine signaling (SOCS) are cytokine-inducible proteins that function as a negative feedback loop regulating cytokine responses. On this basis, the aim of the present study was to evaluate the effect of a SOCS1-derived peptide administered by eye drops (2 weeks) on retinal neuroinflammation and early microvascular abnormalities in a db/db mouse model. In brief, we found that SOCS1-derived peptide significantly reduced glial activation and neural apoptosis induced by diabetes, as well as retinal levels of proinflammatory cytokines. Moreover, a significant improvement of electroretinogram parameters was observed, thus revealing a clear impact of the histological findings on global retinal function. Finally, SOCS1-derived peptide prevented the disruption of the blood-retinal barrier. Overall, our results suggest that topical administration of SOCS1-derived peptide is effective in preventing retinal neuroinflammation and early microvascular impairment. These findings could open up a new strategy for the treatment of early stages of DR.
Evaluating Tissue Contrast and Detecting White Matter Injury in the Infant Brain: A Comparison Study of Synthetic Phase-Sensitive Inversion Recovery

BACKGROUND AND PURPOSE: Synthetic MR imaging enables the acquisition of phase-sensitive inversion recovery images. The aim of this study was to compare the image quality of synthetic phase-sensitive inversion recovery with that of other sequences in infants. MATERIALS AND METHODS: Brain MR imaging with 3D T1-weighted fast-spoiled gradient recalled, synthetic T1WI, and synthetic phase-sensitive inversion recovery of 91 infants was compared. Contrast between unmyelinated WM and myelinated WM and between unmyelinated WM and cortical GM was calculated. Qualitative evaluation of image quality and myelination degree was performed. In infants with punctate white matter injuries, the number of lesions was compared. RESULTS: The contrast between unmyelinated WM and myelinated WM was higher in synthetic phase-sensitive inversion recovery compared with fast-spoiled gradient recalled or synthetic T1WI (P < .001). Compared with synthetic T1WI, synthetic phase-sensitive inversion recovery showed higher gray-white matter differentiation (P < .001) and myelination degree in the cerebellar peduncle (P < .001). The number of detected punctate white matter injuries decreased with synthetic phase-sensitive inversion recovery compared with fast-spoiled gradient recalled sequences (1.2 ± 3.2 versus 3.4 ± 3.6, P = .001). CONCLUSIONS: Synthetic phase-sensitive inversion recovery has the potential to improve tissue contrast and image quality in the brain MR imaging of infants. However, we have to be aware that synthetic phase-sensitive inversion recovery has limited value when assessing punctate white matter injuries compared with 3D fast-spoiled gradient recalled imaging.
The Impact of Coronary Artery Disease and Statins on Survival After Liver Transplantation

Cardiovascular disease (CVD) is a major contributor to longterm mortality after liver transplantation (LT) necessitating aggressive modification of CVD risk. However, it is unclear how coronary artery disease (CAD) and the development of dyslipidemia following LT impacts clinical outcomes and how management of these factors may impact survival. Patients undergoing LT at Virginia Commonwealth University from January 2007 to January 2017 were included (n = 495). CAD and risk factors in all potential liver transplantation recipients (LTRs) over the age of 50 years were evaluated via coronary angiography. The impact of pre‐LT CAD after transplantation was evaluated via a survival analysis. Additionally, factors associated with new‐onset dyslipidemia, statin use, and mortality were assessed using multiple logistic regression or Cox proportional hazards models. The mean age of the cohort was 55.3 ± 9.3 years at the time of LT, and median follow‐up was 4.5 years. CAD was noted in 129 (26.1%) patients during the pre‐LT evaluation. The presence or severity of pre‐LT CAD did not impact post‐LT survival. Dyslipidemia was present in 96 patients at LT, and 157 patients developed new‐onset dyslipidemia after LT. Statins were underused as only 45.7% of patients with known CAD were on therapy. In patients with new‐onset dyslipidemia, statin therapy was initiated in 111 (71.1%), and median time to initiation of statin therapy was 2.5 years. Statin use conferred survival benefit (hazard ratio, 0.25; 95% confidence interval, 0.12‐0.49) and was well tolerated with only 12% of patients developing an adverse event requiring the cessation of therapy. In conclusion, pre‐LT CAD did not impact survival after LT, potentially suggesting a role of accelerated atherosclerosis that may not be captured on pre‐LT testing. Although statin therapy confers survival benefit, it is underused in LTRs.
Assessment of Polymorphism of the VDR Gene and Serum Vitamin D Values in Gestational Diabetes Mellitus

Abstract Objective To evaluate the relationship between vitamin D receptor (VDR) gene polymorphism (FokI [rs10735810]) and serum vitamin D concentration in gestational diabetes mellitus (GDM). Methods A prospective case-control study that recruited healthy pregnant women (control group) (n = 78) and women with GDM (GDM group) (n = 79), with no other comorbidities. Peripheral blood samples were collected in the 3rd trimester of gestation, and all of the pregnant women were followed-up until the end of the pregnancy and the postpartum period. Serum vitamin D concentrations were measured by high-performance liquid chromatography (HPLC). For genomic polymorphism analysis, the genomic DNA was extracted by the dodecyltrimethylammonium bromide/cetyltrimethylammonium bromide (DTAB/CTAB) method, and genotyping was performed by the polymerase chain reaction – restriction fragment length polymorphism (PCR-RFLP) technique, using the restriction enzyme FokI. The Student-t, Mann-Whitney, chi-squared, and Fischer exact tests were used for the analysis of the results. Results There was no significant difference between the pregnant women in the control and GDM groups regarding serum vitamin D levels (17.60 ± 8.89 ng/mL versus 23.60 ± 10.68 ng/mL; p = 0.1). Also, no significant difference was detected between the FokI genotypic frequency when the 2 groups were compared with each other (p = 0.41). Conclusion There was no association between the FokI polymorphism and the development of GDM, nor was there any change in serum vitamin D levels in patients with GDM.