Miracle-dz/UniFAR-FTUs huggingface dataset:
Affective theory of mind in Parkinson’s disease: the effect of cognitive performance

Purpose Among other non-motor symptoms, theory of mind (ToM), the ability to recognize, understand and infer others’ mental states, beliefs, intents and wishes, has been shown to deteriorate during the course of Parkinson’s disease (PD). It has been speculated that ToM impairments could be related to cognitive deficits in PD. However, the current state of literature suggests that there is heterogeneity regarding the involvement of cognitive functioning in the relationship of PD and ToM. The study aimed to measure affective ToM abilities and cognitive performance in a sample of PD patients, to explore the link between affective ToM abilities and cognitive status, and to examine the impact of PD on affective ToM through the mediator effect of cognitive performance. Patients and methods Sixty-five patients diagnosed with idiopathic PD and 51 healthy controls matched for age, gender and educational level completed a visual affective ToM task (Reading the Mind in the Eyes – RMET), cognitive performance was evaluated with Montreal Cognitive Assessment, and psychiatric symptoms were measured with BPRS-E (Brief Psychiatric Rating Scale). Results Affective ToM abilities were preserved in early PD patients, declining as the disease progressed. Deficits in cognitive functioning predicted deficiencies in affective ToM. Although attention (AT), executive functions (EF) and visuospatial abilities (VSA) together mediated the relationship between PD and affective ToM, only VSA impairment had a specific negative impact on affective ToM. Moreover, 41% of the total effect of attention and executive functions on affective ToM was mediated by visuospatial skills. Conclusion Cognitive performance may have an impact on the relationship between PD and affective ToM through the involvement of VSA. The influence of AT and EF in this relationship appears to be also exerted by PD patients’ VSA.
The Critical Assessment of the Quality of Common Clinical Guidelines for Administering Chemotherapy Drugs by Using AGREE II Tool

Context: Administering chemotherapy drugs in patients with cancer is a complicated and risky process that may have the potential to harm patients and the healthcare team if not done safely. Objectives: This study aimed to evaluate the quality of current clinical guidelines for the administration of chemotherapy drugs by using the appraisal of guidelines for research & evaluation II (AGREE II) tool. Evidence Acquisition: After searching through authoritative databases and publishing clinical guidelines by institutions, the articles which were published between 2007 to August 2018 with selected keywords were reviewed and the clinical guidelines were evaluated independently by 5 experts using AGREE II tool based on the inclusion and exclusion criteria. The consensus between appraisers was examined using the ICC (intraclass correlation coefficient). Results: Among 51 clinical guidelines, 4 of them were matched with the inclusion criteria. All 4 clinical guidelines had a high level of quality, with a minimum score above 60% in their 5 domains. Domain 1(scope and purpose) obtained the highest score (95.27 %) and domain 3 (rigor of development) obtained the lowest score (84.89%). The degree of agreement between evaluators was very good (0.84 – 0.95). Conclusions: The overall quality of current clinical guidelines for administering chemotherapy drugs which were evaluated by AGREE II tool, is satisfactory. Therefore, their clinical implementation is recommended to the entire health care team and nurses working in oncology departments, in order to improve the safety of patients and the health care team, and also to prevent the complications of chemotherapy.
Laparoscopic Needle assisted Repair of Inguinal Hernia in Children in Manipal Teaching Hospital, Pokhara

Introduction: There are numerous minimally invasive surgical techniques for repair of congenital inguinal hernia (CIH) in children. We present a unique needle-assisted laparoscopic inguinal hernia repair using 20-gauge intravenous cannula. This study aims to evaluate the safety and feasibility of this technique. Methods: This prospective descriptive study was conducted in 50 patients; aged 1-13 years; from February 2018 to May 2019; either admitted with the diagnosis of CIH or detected incidentally when operated for some other surgical conditions. CIH was repaired using single supraumbilical port and 2-0 prolene suture passed through 20-gauge intravenous cannula. Statistical analysis was done using SPSS 20. Results: A total of 56 hernias were repaired in 50 patients out of which five cases were detected incidentally on patients undergoing laparoscopic appendectomy. The bilateral CIH was present in six cases. The mean operative time was 18.20 ± 4.57 minutes; 17.36 ± 3.83 minutes for unilateral hernia and 24.33 ± 5.20 minutes for bilateral hernia. There was no difference in operative time when compared between gender (p=0.26). The complications were recurrence in 1(1.78%) case, hematoma around deep ring in 2 (3.57%) cases and puncture site bleeding in 2 (3.57%) cases. There were 35 (70%) male and 15 (30%) female. The contralateral occult hernias were noted in 5 (10%) cases. Conclusions: Single port laparoscopic repair of inguinal hernia using a 20-gauge intravenous cannula with non-absorbable suture is a safe, effective and feasible in resource poor settings. The postoperative complications are minimal which is similar to past studies.
Wound healing activity of Plantago major extract on hyperglicaemic rat

Impaired wound healing in diabetic patients is a serious complication that can lead to amputation and even death. Proper diabetic wound management is needed to improve the quality of life of diabetic patients. Plantago major (plantain) has been used empirically for wound healing. This study was conducted to determine the activity of ethanol extract of plantain on wound healing in hyperglycemic rats. A total of 30 hyperglicaemic male rats (Wistar) were divided into 6 groups (K1-K6), and subsequently treated with gel of ethanol extract of plantain leaves 5% and 10%, gel of ethanol extract of plantain roots 5% and 10 %, gel base, and bioplacenton®, respectively. Drugs were applied topically on animals’ wounds created on the dorsal part (length of 2 cm, a depth of 5 mm), once a day during 21 days. Wound healing activity was evaluated based on the percentage of wound closure and wound healing time. The results showed that the gel of ethanol extract of plantain leaves and roots at the concentration of 5% and 10% were able to increase the percentage of wound closure and accelerate wound healing time (p < 0.05) compared to the negative control. It can be concluded that the ethanol extract of plantain leaves and roots have wound healing activity on hyperglycemic rats.
Questionnaire study of use of emergency contraception among teenagers

Aim of the study is to get the information and frequency of emergency contraception use, as well as sexual activity, among teenagers in ages 15 to 18 in Skopje. Material and Methods: Study design included questioning 638 teenagers, females, at the ages between 15 and 18 years, in four secondary schools in the area of Skopje in 2010. The authors used the anonyme questioning for real responses obtaining. The results were analysed with descriptuve and analytical epidemiologicall method. Results: The paper presents the results for girls in secondary schools from the cohort 1995 (mean age of 15,8 yrs., range 15,3-16,2) and 1994 (mean age of 16,6 and range 16,3-17,4), as well as for girls in upper secondary schools from the cohort 1993 (mean age 17,9 with range 17,5-18,8 yrs.Only 33% of the 15-16 years olds and 27,5% of the 17-18 years olds didn’t know what emergency contraception is. The proportion of girls who had used emergency contraception increased with age from 2,1% to 15,1%. Two thirds of all girls who had used emergency contraception had used it only once. In secondary schools 7,3% of 15 year olds (cohort 1995) and 16,8% of 16 year olds (cohort 1994) had sexual intercourse, while among 17 – 18 year olds (cohort 1993) this percent was 41,5%. Information about the usage of contraception and consultations with gynecologist about that have had only 57 (8,9%) from the girls that were included in the survey and most of them searched for the information on the internet. Conclusions: Emergency contraception is a part of primary health care in local health centers and family planning clinics in many European countries (Finland, Denmark, Sweden, Norway). Sexual education in schools includes adequate informationing and consulting of teenagers about the sexual problems including emergency contraception. In our country the sexual education is not imposed inthe schools and consultations with gynecologist about using contraceptive methods confirmed only low percentage of the girls in age from 15 to 18 years. Keywords: teenagers, education, emergency contraception, sexual intercourse.
HLA Class I-Specific Effects in AML with Mutated Nucleophosmin

Background We have recently identified a skewed distribution of class I human leukocyte antigens (HLA) among patients with AML and mutated nucleophosmin gene (NPMc+ AML). A lower frequency of several HLA allelic groups in the NPMc+ AML patient cohort was in good correlation with the results of theoretical predictions for high-affinity immunopeptides derived from NPM1, suggesting that an anti-NPM1 immune response could prevent leukemia development in patients with a suitable HLA class I type. Aim We here present more detailed analysis of HLA-specific features, in a much larger cohort (N = 357) of AML patients with NPM1 mutation (type A/D) from several centers in the Czech Republic, Germany and Poland. Results Most importantly, we confirmed the lower incidence of B´40 and C´07 allelic groups in NPMc+ AML compared to the normal values. The moderate decrease of A´02 allelic group frequency became statistically significant in this larger patient cohort (see Table). On the other hand, no difference in HLA class II frequencies was found compared to the normal distribution. Furthemore, patients with B´07 allelic group had a significantly better prognosis, but only in the absence of Flt-3-ITD mutations (p = 0.049, see Figure). HLA typing was performed by molecular methods in a subgroup of patients (N = 73), allowing for discrimination between C´07 alleles. In this subgroup, C*07:01, but not C*07:02/04 expression was associated with better overall survival (p = 0.036), in agreement with theoretical predictions. Conclusion Our results support the hypothesis that anti-NPM1 immune response reduces AML development and contributes to a better outcome of NPMc+ AML patients with suitable HLA class I type (including at least A´02, B´07, B´40 and C*07:01). Furthermore, NPMc+ immunogenicity is caused rather by its aberrant localization than by the generation of a unique aminoacid sequence. Disclosures Schetelig:Sanofi: Honoraria. Thiede:AgenDix: Employment, Other: Ownership.
Prognostic significance of lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization and radiofrequency ablation

Background Hepatocellular carcinoma (HCC) ranks fifth among malignancies globally. Previous studies have shown that systemic inflammatory response, platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) are associated with poor prognosis of various types of cancer. Materials and methods Radiofrequency ablation (RFA) was performed using an internal cooling electrode with a 2- or 3-cm exposed tip. The LMR was calculated as the ratio of lymphocytes to monocytes. In order to explore the influence of pretreatment with PLR and LMR on survival of HCC patients undergoing transcatheter arterial chemoembolization (TACE) and RFA, 204 cases with HCC which accepted RFA and TACE were retrospectively analyzed and assigned into 2 groups based on optimal cutoff values for LMR (low: ≤2.13 or high: >2.13) and PLR (low: ≤95.65 or high: >95.65). Results Patients with a lower PLR had a longer overall survival (OS) compared to those with a higher PLR (median OS, 20 versus 13 months), and patients with a higher LMR had a longer OS than those with a lower LMR (OS, 22 versus 10 months). Multivariate logistic regression analysis was performed using Cox proportional hazards regression analysis for multiple prognostic factors and identified PLR and LMR as prognostic factors for OS of HCC cases. Conclusion We conclude that PLR and LMR, whose detection is generally available and affordable, may be novel noninvasive circulating markers to potentially assist doctors assess the prognosis of patients.
Outcomes and dynamic changes of the mitral valve after surgical repair of mitral regurgitation in patients with an atrial septal defect

Purpose: We purposed to determine the outcomes of surgical mitral valve repair in patients with atrial septal defect (ASD) and mitral regurgitation (MR) and determine factors associated with good outcomes. Methods: Sixty-one patients after operation for ASD and MR were enrolled. Mitral valve annular diameter, lengths of mitral leaflets, and motion angles of both leaflets were measured on echocardiographic images. Results: The severity of MR and mitral valve prolapse improved after surgery from 2.3± 0.7 to 1.7±0.9 and from 41.8% to 16.4%, respectively. In patients with postoperative MR grade <3, angles of both leaflets on systole and motion angles of the posterior leaflet were changed. Operation at an earlier age (28.0±18.9 years vs. 60.3±10.1 years) and chordae repair (70.2% vs. 25.0%) were performed more frequently in patients with postoperative MR grade <3. More MAZE operations were performed in patients with postoperative MR grade ≥3 (21.3% vs. 87.5%). Conclusion: Operation age, MAZE operation, and chordae repair affected postoperative MR. Not only prolapse, but also the angles of both leaflets on systole and the motion angle of PML were significantly improved in patients with postoperative MR grade <3.
Estimating the incidence rate of hepatitis B and C in East Azerbaijan, Islamic Republic of Iran.

Background The World Health Organization (WHO) has aimed for a 30% reduction in hepatitis B (HBV) and hepatitis C (HCV) incidence by 2020. To achieve this goal, it is important to have updated information about trends in the hepatitis incidence rate. However, there is a lack of up-to-date data from East Azerbaijan province in the Islamic Republic of Iran. Aims This study aimed to estimate the HBV and HCV incidence rate from 2011 to 2016 in East Azerbaijan, Islamic Republic of Iran. Methods Hepatitis data and population data were obtained respectively from the national notifiable disease surveillance system and the national Iranian census for 2016. For quantifying the rate of changes in incidence rate from baseline, the average annual rate of reduction (AARR) was calculated. For this, the linear regression model was used for estimating the beta coefficient. SPSS V25 was used for statistical analysis. Results Over the 6-year period, 3119 hepatitis cases in East Azerbaijan province were reported, of which 94.7% were hepatitis B. The majority of the affected individuals were 25-44 years old. HBV incidence was reduced by 12.71% annually between 2011 and 2016. However, the number of HCV patients increased during 2014-2016, and HCV incidence rate increased insignificantly (β = 0.109, P = 0.39). Conclusion There is a significant downward trend of HBV in East Azerbaijan due to mass vaccination programmes. In the case of HCV, when considering the availability of effective treatment regimens in addition to education and prevention programmes, policy-makers should focus on HCV screening and diagnosis, especially in the 25-44 age group.
Potential prognostic value of PD-L1 and FOXP3 as predictors of relapse in breast cancer

Background: Expression of PD-L1 detected by immunohistochemistry can represent a new hope for cancer management. The role of PD L1 in breast cancer is still unclear. Similarly, is the role of tumor-infiltrating FOXP3 +ve regulatory T (Treg) cells where literature data are conflicting. Our study aimed to evaluate the immunohistochemical expression of PD L1 and FOXP3 in breast cancer, correlate them with clinicopathological parameters as well as evaluating their relation.Methods: This is a retrospective study carried out on 136 breast cancer specimens. Only cases with proved pathological diagnosis of infiltrating duct carcinoma of no special type (NST) were included. Tissue microarray blocks were constructed and immunostained with the polyclonal antibody for PDL1 and monoclonal antibody for FOXP3.Results: Statistically significant correlation was found between high FOXP3 and nearly all adverse prognostic factors including; grade III tumors (p = .003), basal-like subtype(p = .001), high Ki67(p = .001), negative ER status(p = .001), negative PR(p = .028), HER2 expression(p = .04), advanced stage (p = .001), and LN metastases(p = .001). For PDL1, only statistically significant correlation with high Ki67 (p = .018) and advanced stage(p = .03) was found. A statistically significant positive correlation was found between PD L1 and FOXP3(p= .001). No statistically significant correlation was found between both PDL1 and FOXP3 in relation to disease-free survival (DFS) (p = .054). PDL1, age (≥ 50 years), nodal metastases were significant predictors of relapse in breast cancer.Conclusion: The current study supports PDL1 as a predictor of relapse in breast cancer. Additionally, it highlights the synergistic role between PDL1 and FOXP3 in breast cancer microenvironment. Each can be considered as a poor prognostic marker in breast cancer. This raises a concern about the benefit of breast cancer patients from blocking of PDL1 pathway.
A study to assess the prevalence of iodine deficiency disorders in Betul district, Madhya Pradesh, India

Background: Iodine deficiency disorders (IDD) constitute the single largest cause of preventable neurological damage worldwide. Majority of consequences of IDD are invisible and irreversible but at the same time these are preventable. The study was conducted to assess the prevalence of goiter in school children aged 6-12 years, to estimate the urinary iodine excretion and to assess the level of iodine concentration in salt samples obtained from households of selected school children.Methods: Population proportionate to size sampling. Sample size was 90 primary school-going children of age 6-12 years in each selected village, total 2700 from 30 villages/wards in Betul district, Madhya Pradesh, India.Results: The prevalence of goiter among the 6-12 years children was found to be 32.06%. Females had higher prevalence compared to males. Of the 540 salt samples, 370 (68.4%) had iodine concentration ≥15 ppm at household level.Conclusions: IDD is a mild public health problem in Betul district.
Implications of elevated cardiac troponin in patients presenting with acute pulmonary embolism: an observational study.

Background To evaluate the implications of elevated cardiac troponin (cTn) in patients presenting with pulmonary embolism (PE). Methods We conducted a retrospective analysis for patients with PE between 2011 and 2015 with an average of 3 years follow-up. Patients were categorized into two groups based on the cTn status on admission (negative vs. positive) and RV/LV ratio (≤1.2 vs. >1.2). PE diagnosis was made by computed tomography pulmonary angiography (CTPA) examinations. Results Among 220 patients with PE, 52.7% had positive cTn and 31.7% had RV dysfunction. Protein S and C deficiency were significantly higher in patients with negative cTn. Patients with positive cTn were more likely to have high-risk simplified pulmonary embolism severity index (sPESI), RV dilation, RV/LV ratio >1.2, severe inferior vena cava reflux and high Qanadli score (QS >18 points). Thrombolytic therapy was used in 15 patients; 9 (60%) of them had elevated troponin. Combined cTn and sPESI had higher sensitivity, negative predictive value and negative likelihood ratio to predict in-hospital mortality. Overall 30-day and 3 years morality were 10.0% and 22.3%; that were significantly higher in patients with positive troponin. Cox regression analysis showed that mortality increased 2.5 times with positive cTn after adjusting for age, sex, and RV dysfunction (adjusted HR 2.5; 95% CI: 1.25-5.01), P=0.009. Conclusions Elevated cTn is independent predictor of short and long-term mortality. The predictive power of cTn increases when combined with the clinical probability score. Further, larger prospective studies are needed to confirm the findings of the present study.
Dauricine suppresses the growth of pancreatic cancer in vivo by modulating the Hedgehog signaling pathway

Pancreatic cancer is a highly malignant cancer associated with high expression levels of sonic hedgehog signaling molecule (Shh), patched 1 (Ptch1), smoothened frizzled class receptor (Smo) and glioma-associated oncogene family zinc finger 1 (Gli1) in the hedgehog (Hh) signaling pathway. Inhibition of the Hh signaling pathway is a potential therapeutic target for pancreatic cancer. The aim of the present study was to investigate the effects of dauricine in a pancreatic cancer BxPC-3 ×enograft animal model and examine the underlying molecular mechanisms through Hh signaling pathway. High-and low-dose dauricine treatment significantly suppressed tumor growth with no concomitant effect on the spleen index. In addition, dauricine induced apoptosis and cell cycle arrest in pancreatic cancer BxPC-3 cells. The inhibitory effects of dauricine on pancreatic cancer may be mediated by the suppression of the Hh signaling pathway, as indicated by the decreases in the gene and protein expression levels of Shh, Ptch1, Smo and Gli1. The effects of dauricine were similar to those of 5-fluorouracil. Dauricine, a naturally occurring alkaloid, may be a potential anticancer agent for the treatment of pancreatic cancer.
A prospective comparative study of detection of colonic polyposis by magnetic resonance colonography versus conventional colonoscopy

Background: Colorectal cancer mostly arises from adenomatous polyp and the transition time to convert into carcinoma is around ten years. As the progress to adenocarcinoma is a slow process so, early detection and endoscope resection is claimed to be effective in decreasing incidence and mortality by colorectal cancer. MR colonography is a non-invasive method for evaluating entire colon. It can detect precancerous lesion, cancer and staging. It is non-invasive tool for screening. Acceptability of the patient is better for MR colonography.Methods: Present study is a prospective comparative evaluation of magnetic resonance colonography verses colonoscopy conducted in the Department of Radiology, Konaseema Institute of Medical Science, and other establishments from August 2015 to January 2018. The sample size was calculated to be 112. Specificity, sensitivity and predictive value were calculated by medical statistical software.Results: For all size of tumours, sensitivity was 85.71%, specificity was 92.85%, positive predictive value was 92.30%, negative predictive value was 86.66% and accuracy was 94.34%. The positive predictive value was 90.00% negative predictive value was 92.68% and accuracy was 92.16%. For 1 mm to 4 mm size of polyp the sensitive was 28.57%, specificity was 92.31%, positive predictive value was 66.67%, negative predictive value was 70.59% and accuracy was 70%. Conclusions: In present study we have found that there was male predominance in patient and gastrointestinal bleeding was common clinical presentation. We have also observed that all size of poly MR colonography as having sensitivity and specificity around 90% but MR colonography is highly sensitive and specific for polyp size above 8mm but it is less sensitive for size below 4 mm.