Miracle-dz/UniFAR-FTUs huggingface dataset:
Maternal cardiac complications in women with cardiac disease in pregnancy

The aim of the present work is to identify the risk factors for maternal cardiac complications and for adverse neonatal outcome in women with heart disease in pregnancy. Prospective observational study was carried out at a tertiary referral hospital in South India. Data was collected from 144 women going through 146 pregnancies and delivered after 24 weeks of gestation, over a period of 7 years. Logistic regression analysis was done to identify the risk factors for maternal and the neonatal complications. Principal etiology of the lesion was Rheumatic in 67%, Congenital in 26% and peripartum cardiomyopathy in 5%. Maternal mortality was 2% (3 women) and maternal cardiac complications occurred in 27%. NYHA class III/IV at booking, pulmonary arterial hypertension and myocardial dysfunction were the risk factors for maternal cardiac complications during pregnancy. NYHA class III/IV, gestational age >20 weeks at booking and associated hypertension during present pregnancy were the risk factors for adverse neonatal outcome. RHD remains an important cause for maternal as well as perinatal mortality and morbidity in developing countries. NYHA class III/IV, myocardial dysfunction and pulmonary arterial hypertension are the risk factors for maternal cardiac complications.
Disordered eating behaviours, body image and social networking in a type 1 diabetes population

The purpose of this study was twofold: to examine predictors of disordered eating behaviours and body image dissatisfaction, including social networking, among type 1 diabetes population, and to qualitatively explore the relationship between type 1 diabetes management and body image. A convenience sample of 121 type 1 diabetes patients (F = 106; Mage = 36 ± 6.5) was collected via online questionnaires, of which 98 patients responded to two open-ended questions. Young age and negative body image explained 58.8 per cent of disordered eating variance, while body weight and social networking negatively contributed to poor body image (29.9%). Qualitative analysis revealed three themes: no control over body weight, limitation in clothing options and discomfort towards medical equipment.
Predicting program attendance and weight loss in obesity interventions: Do triggering events help?

Medical events that “trigger” motivation to lose weight may improve treatment outcomes compared to non-medical or no triggering events. However, previous findings include only long-term successful participants, not those initiating treatment. The current study compared those with medical triggering events or non-medical triggering events to no triggering events on attendance and weight loss during a weight management program. Medical-triggering-event participants lost 1.8 percent less weight (p = 0.03) than no-triggering-event participants. Non-medical-triggering-event participants attended 1.45 more sessions (p = 0.04) and were 1.83 times more likely to complete the program (p = 0.03) than no-triggering-event participants. These findings fail to support the benefit of medical triggering events when beginning treatment for obesity.
Moral distress experienced by non-Western nurses: An integrative review

Background: Moral distress has been identified as a significant issue in nursing practice for many decades. However, most studies have involved American nurses or Western medicine settings. Cultural differences between Western and non-Western countries might influence the experience of moral distress. Therefore, the literature regarding moral distress experiences among non-Western nurses is in need of review. Aim: The aim of this integrative review was to identify, describe, and synthesize previous primary studies on moral distress experienced by non-Western nurses. Review method: Whittemore and Knafl’s integrative review methodology was used to structure and conduct the review of the literature. Research context and data sources: Key relevant health databases included the Ovid MEDLINE, CINAHL, Web of Science, and Google Scholar databases. Two relevant journals, Nursing Ethics and Bioethics, were manually searched. Ethical consideration: We have considered and respected ethical conduct when performing a literature review, respecting authorship and referencing sources. Findings: A total of 17 primary studies published between 1999 and 2019 were appraised. There was an inconsistency with regard to moral distress levels and its relationship with demographic variables. The most commonly cited clinical causes of moral distress were providing futile care for end-of-life patients. Unit/team constraints (poor collaboration and communication, working with incompetent colleagues, witnessing practice errors, and professional hierarchy) and organizational constraints (limited resources, excessive administrative work, conflict within hospital policy, and perceived lack of support by administrators) were identified as moral distress’s stimulators. Negative impacts on nurses’ physical, psychological, and spiritual well-being were also reported. Conclusion: Further research is needed to investigate moral distress among other healthcare professions which may further build understanding. More importantly, interventions to address moral distress need to be developed and tested.
Keloid lesions show increased IL‐4/IL‐13 signaling and respond to Th2‐targeting dupilumab therapy

Keloids are benign growths representing a disrupted wound healing process involving abnormal collagen proliferation. Keloids are most prevalent in African American (AA)1 and Asian populations,2 and greatly impact quality of life.3 Keloids show high recurrence rates and current therapies (intralesional steroids, bleomycin, surgical excision, etc.) have limited efficacy;4 thus, presenting a high unmet need for better treatments.
Reliability and construct validity of the stepping-forward affordance perception test for fall risk assessment in community-dwelling older adults

Thus far, few studies have examined the estimation and actual performance of locomotor ability in older adults. To our knowledge, there are no studies examining the relationship between stepping-forward estimation versus ability and fall occurrence. The aim of this study was to develop and assess the reliability and validity of a new test for fall risk assessment in community-dwelling older adults. In total, 347 participants (73.1 ± 6.2 years; 266 women) were assessed for their perception of maximum distance for the stepping-forward and action boundary. The test was developed following the existing literature and expert opinions. The task showed strong internal consistency. Intraclass correlation ranged from 0.99 to 1 for intrarater agreement and from 0.83 to 0.97 for interrater agreement. Multivariate binary regression analysis models revealed an area under the curve (AUC) of 0.665 (95% CI: 0.608–0.723) for fallers and 0.728 (95% CI: 0.655–0.797) for recurrent fallers. The stepping-forward affordance perception test (SF-APT) was demonstrated to be accurate, reliable and valid for fall risk assessment. The results showed that a large estimated stepping-forward associated with an underestimated absolute error works as a protective mechanism for fallers and recurrent fallers in community-dwelling older adults. SF-APT is safe, quick, easy to administer, well accepted and reproducible for application in community or clinical settings by either clinical or nonclinical care professionals.
Short Disease Duration Is Associated With Increased Risk of Treatment Failure in Biologic-Treated Patients With Ulcerative Colitis.

BACKGROUND Longer disease duration is associated with inferior response to biologic therapy in Crohn's disease. However, the effect of disease duration on response to biologic therapy in ulcerative colitis (UC) has not been well studied. METHODS In a single-center retrospective cohort study of outpatients with UC starting a biologic agent, we evaluated treatment response by disease duration. The primary outcome was treatment failure (composite outcome of inflammatory bowel disease [IBD]-related surgery/hospitalization or treatment modification including dose escalation, treatment discontinuation, or addition of corticosteroids); secondary outcomes were risk of IBD-related surgery/hospitalization and endoscopic remission. We conducted multivariate Cox proportional hazard analyses to evaluate the independent impact of disease duration on clinical outcomes. RESULTS We included 160 biologic-treated UC patients (73% biologic-naïve) with a median age (interquartile range) of 36 (26-52) years and disease duration (range) of 4.5 (1-9) years. After adjusting for immunosuppressive medications, albumin, and body mass index, each 1-year increase in disease duration was associated with a 5% lower risk of treatment failure (adjusted hazard ratio, 0.95; 95% confidence interval [CI], 0.91-0.99) and a 9% higher risk of achieving endoscopic remission (adjusted odds ratio, 1.09; 95% CI, 1.01-1.18). This association of short disease duration with treatment failure was observed only in biologic-naïve patients, but not biologic-experienced patients. No significant association was seen between disease duration and risk of surgery or hospitalization. CONCLUSION Shorter disease duration is independently associated with increased risk of treatment failure in biologic-treated patients with UC. Requirement of biologic therapy early in the course of disease may be a negative prognostic marker in patients with UC.
Respiratory function and cognitive profile in amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is increasingly recognized as a multisystem disorder with 30%–50% of patients exhibiting cognitive impairment. The pathophysiological mechanisms of cognitive dysfunction are probably multifactorial although hypoventilation secondary to respiratory dysfunction may contribute to cognitive decline. The current study aimed to identify the relationship between respiratory function in ALS patients and the presence and degree of cognitive impairment.
Different tissue thermodynamics between the 40 W and 20 W radiofrequency power settings under the same ablation index/lesion size index

The ablation index (AI) and lesion size index (LSI) are novel markers for predicting the ablation lesion quality, however, collateral damage is still a concern. This study aimed to compare the lesion characteristics and tissue temperature profiles between 20 W (20 Ws) and 40 W (40 Ws) ablation settings under the same AI and LSI.
Microstructural and physiological responses to cadmium stress under different nitrogen levels in Populus cathayana females and males.

Although an increasing attention has been paid on the relationships between heavy metal and nitrogen availability, the mechanism underlying adaptation to Cd stress in dioecious plants has been largely overlooked. This study examined Cd accumulation, translocation and allocation among tissues and cellular compartments in Populus cathayana females and males. Both leaf Cd accumulation and root-to-shoot Cd translocation were significantly greater in females than in males under a normal N supply, but they were reduced in females and enhanced in males under N deficiency. The genes related to Cd uptake and translocation, HMA2, YSL2 and ZIP2, were strongly induced by Cd stress in female roots and in males under a normal N supply. Cd largely accumulated in the leaf blades of females and in the leaf veins of males under a normal N supply, while the contrary was true under N deficiency. Furthermore, Cd was mainly distributed in the leaf epidermis and spongy tissues of males, and in the leaf palisade tissues of females. N deficiency increased Cd allocation to the spongy tissues of female leaves and to the palisade tissues of males. In roots, Cd was preferentially distributed to the epidermis and cortices in both sexes, and also to the vascular tissues of females under a normal N supply but not under N deficiency. These results suggested that males possess better Cd tolerance compared to females, even under N deficiency, which is associated with their reduced root-to-shoot Cd translocation, specific Cd distribution in organic and/or cellular compartments, and enhanced antioxidation and ion homeostasis. Our study also provides new insights into engineering woody plants for phytoremediation.
Isolation and characterization of the first Slovenian human triple‐negative breast cancer cell line

1Faculty of Medicine, Institute of Biomedical Sciences and Department of Pharmacology, University of Maribor, Maribor, Slovenia 2Department of pathology, General Hospital Graz II, Location West, Graz, Austria 3Faculty of Medicine, Center of Human Molecular Genetics and Pharmacogenomics, University of Maribor, Maribor, Slovenia 4Faculty of Chemistry & Chemical Engineering, University of Maribor, Maribor, Slovenia 5Department of Pathology, University Medical Centre Maribor, Maribor, Slovenia 6Faculty of Medicine, Department of Gynaecology and Obstetrics, University of Maribor, Maribor, Slovenia 7Department of Gynaecology and Perinatology, University Medical Centre Maribor, Maribor, Slovenia
Alzheimer Disease Pathology-Associated Polymorphism in a Complex Variable Number of Tandem Repeat Region Within the MUC6 Gene, Near the AP2A2 Gene

Abstract We found evidence of late-onset Alzheimer disease (LOAD)-associated genetic polymorphism within an exon of Mucin 6 (MUC6) and immediately downstream from another gene: Adaptor Related Protein Complex 2 Subunit Alpha 2 (AP2A2). PCR analyses on genomic DNA samples confirmed that the size of the MUC6 variable number tandem repeat (VNTR) region was highly polymorphic. In a cohort of autopsied subjects with quantitative digital pathology data (n = 119), the size of the polymorphic region was associated with the severity of pTau pathology in neocortex. In a separate replication cohort of autopsied subjects (n = 173), more pTau pathology was again observed in subjects with longer VNTR regions (p = 0.031). Unlike MUC6, AP2A2 is highly expressed in human brain. AP2A2 expression was lower in a subset analysis of brain samples from persons with longer versus shorter VNTR regions (p = 0.014 normalizing with AP2B1 expression). Double-label immunofluorescence studies showed that AP2A2 protein often colocalized with neurofibrillary tangles in LOAD but was not colocalized with pTau proteinopathy in progressive supranuclear palsy, or with TDP-43 proteinopathy. In summary, polymorphism in a repeat-rich region near AP2A2 was associated with neocortical pTau proteinopathy (because of the unique repeats, prior genome-wide association studies were probably unable to detect this association), and AP2A2 was often colocalized with neurofibrillary tangles in LOAD.
Role of zinc and copper ions in the pathogenetic mechanisms of traumatic brain injury and Alzheimer’s disease

Abstract The disruption of homeostasis of zinc (Zn2+) and copper (Cu2+) ions in the central nervous system is involved in the pathogenesis of many neurodegenerative diseases, such as amyotrophic lateral sclerosis, Wilson’s, Creutzfeldt-Jakob, Parkinson’s, and Alzheimer’s diseases (AD), and traumatic brain injury (TBI). The last two pathological conditions of the brain are the most common; moreover, it is possible that TBI is a risk factor for the development of AD. Disruptions of Zn2+ and Cu2+ homeostasis play an important role in the mechanisms of pathogenesis of both TBI and AD. This review attempts to summarize and systematize the currently available research data on this issue. The neurocytotoxicity of Cu2+ and Zn2+, the synergism of the toxic effect of calcium and Zn2+ ions on the mitochondria of neurons, and the interaction of Zn2+ and Cu2+ with β-amyloid (Abeta) and tau protein are considered.
Strong TH1-biased CD4 T cell responses are associated with diminished SIV vaccine efficacy

Vaccine-induced IFNγ+ CD4 T cells migrate to and persist in mucosal tissue and negatively associate with protection against SIV. Troublesome T cells Many HIV vaccines aim to generate robust T cell responses, but two new studies show that this is not always straightforward. Chamcha et al. analyzed data from several nonhuman primate vaccine studies with SIV/SHIV challenges and discovered that achieving a certain threshold of vaccine-induced IFNγ+ CD4 T cells lowered vaccine efficacy, possibly by providing target cells for the virus. Kallas et al. vaccinated people with HIV Gag/Pol alone or with Env to see whether antigenic competition could interfere with CD4 T cell responses; lower responses to Gag/Pol were detected when Env was also administered, indicating that including multiple antigens in a vaccine may preclude maximal T cell responses. Together, these studies highlight how we must tread carefully on the path to an effective HIV vaccine. Activated CD4 T cells are a major target of HIV infection. Results from the STEP HIV vaccine trial highlighted a potential role for total activated CD4 T cells in promoting HIV acquisition. However, the influence of vaccine insert-specific CD4 T cell responses on HIV acquisition is not known. Here, using the data obtained from four macaque studies, we show that the DNA prime/modified vaccinia Ankara boost vaccine induced interferon γ (IFNγ+) CD4 T cells [T helper 1 (TH1) cells] rapidly migrate to multiple tissues including colon, cervix, and vaginal mucosa. These mucosal TH1 cells persisted at higher frequencies and expressed higher density of CCR5, a viral coreceptor, compared to cells in blood. After intravaginal or intrarectal simian immunodeficiency virus (SIV)/simian-human immunodeficiency virus (SHIV) challenges, strong vaccine protection was evident only in animals that had lower frequencies of vaccine-specific TH1 cells but not in animals that had higher frequencies of TH1 cells, despite comparable vaccine-induced humoral and CD8 T cell immunity in both groups. An RNA transcriptome signature in blood at 7 days after priming immunization from one study was associated with induction of fewer TH1-type CD4 cells and enhanced protection. These results demonstrate that high and persisting frequencies of HIV vaccine–induced TH1-biased CD4 T cells in the intestinal and genital mucosa can mitigate beneficial effects of protective antibodies and CD8 T cells, highlighting a critical role of priming immunization and vaccine adjuvants in modulating HIV vaccine efficacy.
CRISPR-Cas influences the acquisition of antibiotic resistance in Klebsiella pneumoniae

In the US Carbapenem resistance in Klebsiella pneumoniae (Kp) is primarily attributed to the presence of the genes blaKPC-2 and blaKPC-3, which are transmitted via plasmids. Carbapenem-resistant Kp (CR-Kp) infections are associated with hospital outbreaks. They are difficult to treat, and associated with high mortality rates prompting studies of how resistance is obtained. In this study, we determined the presence of CRISPR-Cas in 304 clinical Kp strains. The CRISPR-Cas system has been found to prevent the spread of plasmids and bacteriophages, and therefore limits the horizontal gene transfer mediated by these mobile genetic elements. Here, we hypothesized that only those Kp strains that lack CRISPR-Cas can acquire CR plasmids, while those strains that have CRISPR-Cas are protected from gaining these plasmids and thus maintain sensitivity to antimicrobials. Our results show that CRISPR-Cas is absent in most clinical Kp strains including the clinically important ST258 clone. ST258 strains that continue to be sensitive to carbapenems also lack CRISPR-Cas. Interestingly, CRISPR-Cas positive strains, all non-ST258, exhibit lower resistance rates to antimicrobials than CRISPR-Cas negative strains. Importantly, we demonstrate that the presence of CRISPR-Cas appears to inhibit the acquisition of blaKPC plasmids in 7 Kp strains. Furthermore, we show that strains that are unable to acquire blaKPC plasmids contain CRISPR spacer sequences highly identical to those found in previously published multidrug-resistance-containing plasmids. Lastly, to our knowledge this is the first paper demonstrating that resistance to blaKPC plasmid invasion in a CRISPR-containing Kp strain can be reversed by deleting the CRISPR-cas cassette.
microRNA‐139‐5p confers sensitivity to antiepileptic drugs in refractory epilepsy by inhibition of MRP1

Drug resistance is an intractable issue urgently needed to be overcome for improving efficiency of antiepileptic drugs in treating refractory epilepsy. microRNAs (miRNAs) have been proved as key regulators and therapeutic targets in epilepsy. Accordingly, the aim of the present study was to identify a novel differentially expressed miRNA which could improve the efficiency of antiepileptic drugs during the treatment of refractory epilepsy.
Factors influencing anaemia among girls of school going age (6-18 years) from the slums of Ahmedabad City.

Research question: What is the prevalence of anaemia among school going girls and its relationship with various socio-demographic variables? Objective: To assess the magnitude of anaemia in school going pre-adolescent and adolescent girls along with associated demographic variables. Study design: Cross-sectional. Setting: 15 randomly selected urban slums of north zone of Ahmedabad city. Participants: 1295 randomly selected girls in the age group of 6-18 years. Study variables: Hemoglobin level age body mass index parents education parents occupation socio-economic status consumption of tea/coffee green leafy vegetables lemon/sour fruits knowledge about anaemia and status of menstruation. Statistical analysis: Multiple regression analysis chi-square test. Results: Prevalence of anaemia (Hb<l 2 gm/dl) was 81.8% (n=1153) and had significant association with variables such as occupation of father habit of post meal consumption of tea/coffee consumption of green leafy vegetables and body mass index. Conclusion: Prevalence of anaemia necessitates pragmatic intervention to improve the dietary intake nutritional supplement of iron and folic acid (IFA) tablets. (authors)
Beyond graduation: The trajectories of graduates in

Higher Education (HE) is in a state of transformation, with the economic recession leading to an even greater emphasis on graduate outcomes. Despite a proliferation of literature relating to under-represented groups ‘getting ready for’, ‘getting into’ and ‘staying in’ HE, less attention has been devoted to how they ‘get on’, post graduation, particularly in the long term. Existing UK research suggests that graduate opportunities are influenced by pre-entry characteristics, institution attended and subject studied. However it is noted that the majority of studies focus on first destinations (six months after graduation). This reflects the first six months after graduation and single outcomes. As a result this ESRC-funded study investigated graduates' long term trajectories up to four years after graduation. The mixed methods study focused on graduates from three different types of degree awarding institutions in North Wales and on three specific subjects – chosen for contrast and convenience. Half of the sample self identified as being non-traditional students. The study revealed that those graduates who defined themselves as being non-traditional students were more likely to have multiple outcomes or be in temporary employment, to have disrupted trajectories and lack social networks. This has serious implications for wider issues of social justice within education.