Miracle-dz/UniFAR-FTUs huggingface dataset:
The Effect of Surfactant Accompanied by Ventolin on the Respiratory Distress Syndrome in Premature Newborns: A Clinical Trial Study

Background The respiratory distress syndrome (RDS) is one of the most common respiratory disorders in premature newborns. The aim of this study was to determine the effect of surfactant accompanied by Ventolin on the RDS in premature newborns. Materials and Methods The study was a double-blind randomized controlled trial that was conducted on 80 premature newborns with RDS in Imam Reza Hospital of Kermanshah, Iran, in 2018. The eligible newborns, using aÂ random number table, were divided into two groups of surfactant with Ventolin as intervention group (n=40) and surfactant with normal saline as control group (n=40). The data collection tool was a checklist, including the demographic characteristics (gender, birth weight, gestational age, etc.) and clinical variables (length of hospitalization, pneumothorax, need of Continuous Positive Airway Pressure (CPAP), mechanical ventilation, tachypneaÂ duration, RDS score, etc.). Data were analyzed using SPSS software (version 24.0). Results The results of the study showed that the two groups of intervention and control have significant statistical difference in terms of RDS score, tachypnea duration, duration of taking oxygen, start time of oral feeding, length of hospitalization, partial pressures of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), need of mechanical ventilation and pneumothorax, respiratory rate, heart rate, oxygen saturation and FIO2 after intervention (P 0.05). Conclusion The results of this study showed that administration surfactant accompanied by Ventolin can lead to decrease in RDS score, improve the respiration status, reduce start time of oral feeding and also reduce length of hospitalization.
AB0423 CHANGES IN DISEASE ACTIVITY, PAIN, GLOBAL HEALTH AND PHYSICAL FUNCTION AFTER SWITCHING FROM ORAL TO SUBCUTANEOUS METHOTREXATE: RESULTS OF THE SIX-MONTH OBSERVATIONAL PROSPECTIVE STUDY IN CROATIA

Background: In rheumatoid arthritis (RA) and psoriatic arthritis (PsA) methotrexate (MTX) is usually the first choice in the treatment strategy. Bioavailability of oral MTX reaches plateau in doses ≥15 mg weekly, and this is the reason of its lower clinical efficacy. Objectives: The objective of this observational longitudinal study was to evaluate the changes in disease activity, intensity of pain, global health, and physical function when switching from oral (P.O.) to subcutaneous (S.C.) MTX in patients with RA and peripheral form of PsA. Methods: Forty-eight consecutive patients (79.2% women) with established diagnosis of RA (77.1%) and peripheral PsA were enrolled from the outpatient clinics in six centres in Croatia. Median age was 61 (39-79) years, and the median of disease duration was 120 (3-528) months. Data were collected at baseline (T0) including retrospective data collection from the previous 3 months (on P.O. MTX), at day 90 (±10 days) (T1) and at day 180 (±10 days) (T2) for the previous periods, both of them during S.C. MTX treatment. Dose of MTX remained stable during the study. Domains of interest were Disease Activity Score on 28 joints measured using ESR (DAS28-ESR), level of pain, Patent’s Global Health Assessment (PtGHA) and Physician’s Global Health Assessment (PhGHA) were measured on horizontal 100 mm VAS, while physical function was measured by Health Assessment Questionnaire – Disability Index (HAQ-DI). Results: Out of 48 patients 41 patients were switched to S.C. MTX monotherapy and 7 to S.C. MTX in combination with another csDMARD. At T1 40 patients were on S.C. MTX monotherapy and 8 on S.C. MTX in combination with another DMARD, and at T2 39 patients were on S.C. MTX monotherapy, 4 on S.C. MTX in combination with another DMARD, 1 on another DMARD and 4 were lost to follow-up. DAS28 showed trend of decrease from 4.9 at baseline to 4.6 at T1 and 4.2 at T2. Analysis of transition of patients according to DAS28 EULAR criteria has shown that percentage of patients with low disease activity has raised from 4.3% at T0, to 21.7% at T1, and 24.3% at T2, while percentage of patients with high disease activity has declined from 38.3% at T0 to 21.7% at T1 and 13.5% at T2. Recommendation for prednisone therapy > 7.5 mg/QD had 12.5% patients at T0 and T1, and only 6.8% patients at T2. There was a significant decrease in adjusted mean values for level of pain (-1.46; 95%CI -1.55, -0.35), PtGHA (-1.12; 95%CI -1.50, -0.73) and PhGHA (-1.15; 95%CI -1.50, -0.80). HAQ-DI showed significant improvement during the 6-month follow-up (-0.25; 95%CI -0.32, -0.17). Conclusion: Patients who switched from P.O. to S.C. MTX showed improvement in all observed parameters: decrease of disease activity, reduction of pain, better global health, and physical function. Results of our study are in line with previously published literature data. Disclosure of Interests: None declared
Malignant Thyroid Lesions: A Histopathological Perspective

Introduction: Thyroid cancer incidence is increasing globally. This increase has been attributed to improvement in diagnostic methods. This study has as its aim the analysis of the pattern of thyroid gland malignancies seen at the Jos University Teaching Hospital, Jos, Nigeria, between January 2008 and December 2018. Methodology: A descriptive retrospective study of consecutive cases of thyroid specimens analyzed at our center was done. Data was obtained from the Histopathology Department Records. The diagnosis of each case was confirmed by reviewing archival slides. Results: There were 70 cases of thyroid carcinomas during the period of the study. The histological types of thyroid cancers seen were: follicular carcinoma, papillary carcinoma, medullary carcinoma and anaplastic carcinoma, respectively accounting for 36(51.4%), 23(32.9%), 4(5.7%) and 7(8.6%) cases. There was only 1 case of follicular carcinoma in 2012, and non between 2013 and 2018. The male to female ratio was 1: 3.1. The mean age of thyroid carcinoma was 42.7 years, with an age range of 13-80 years. Conclusion: The histological pattern of thyroid cancers has changed over the last two decades in our environment with the erstwhile predominant follicular carcinoma receding to near disappearance. The papillary carcinoma histotype is currently overwhelmingly the commonest type diagnosed. The former is relatively commonly seen in the older age group, in a sharp contrast with the later. The female gender remains the most afflicted group.
Program development of human papillomavirus education program for health officials in the Achham district of Nepal

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections in the world. Cervical cancer, caused almost exclusively by HPV infection, is the most common cancer among women in Nepal, despite being only the fourth most common female cancer globally and the tenth most common female cancer in more developed regions. Nepal intends to address this by initiating a national HPV vaccination program. However, there are low levels of awareness and understanding of HPV, its vaccine, and cervical cancer are present among the general population, medical and nursing students, and likely among local government healthcare officials. Medical professionals are among the most trusted sources for parents when deciding upon vaccination, so capacity building for HPV in the healthcare system is a matter of public health importance. The education program proposed in this paper, to be managed by the Nepal Fertility Care Center, will provide of cervical cancer and HPV training to the healthcare staff in the district of Achham. Through this program, the district healthcare system will be prepared for the increased screenings, vaccinations, and community engagement that will be required for the HPV vaccination campaign. This would facilitate a reduction of rates of HPV and ultimately cervical cancer in the district.
Protein Kinase G Is Involved in Acute but Not in Long-Term Regulation of Renin Secretion

Pharmacological inhibition of the renin–angiotensin–aldosterone system (RAAS) is, in combination with diuretics, the first-choice treatment for hypertension, although 10–20% of patients do not respond adequately. Next to the RAAS, the nitric oxide/cGMP/protein kinase G (PKG) system is the second fundamental blood pressure regulator. Whether both systems influence each other is not well-studied. It has been shown that nitric oxide (NO) supports renin recruitment via activation of soluble guanylate cyclase (sGC) and subsequent generation of cGMP. Whether this leads to an ensuing activation of PKGs in this context is not known. PKGIα, as well as PKGII, is expressed in renin-producing cells. Hence, we analyzed whether these enzymes play a role regarding renin synthesis, secretion, or recruitment. We generated renin-cell-specific PKGI-knockout mice and either stimulated or inhibited the renin system in these mice by salt diets. To exclude the possibility that one kinase isoform can compensate the lack of the other, we also studied double-knockout animals with a conditional knockout of PKGI in juxtaglomerular cells (JG cells) and a ubiquitous knockout of PKGII. We analyzed blood pressure, renin mRNA and renal renin protein content as well as plasma renin concentration. Furthermore, we stimulated the cGMP system in these mice using BAY 41-8543, an sGC stimulator, and examined renin regulation either after acute administration or after 7 days (application once daily). We did not reveal any striking differences regarding long-term renin regulation in the studied mouse models. Yet, when we studied the acute effect of BAY 41-8543 on renin secretion in isolated perfused kidneys as well as in living animals, we found that the administration of the substance led to a significant increase in plasma renin concentration in control animals. This effect was completely abolished in double-knockout animals. However, after 7 days of once daily application, we did not detect a persistent increase in renin mRNA or protein in any studied genotype. Therefore, we conclude that in mice, cGMP and PKG are involved in the acute regulation of renin release but have no influence on long-term renin adjustment.
Minimum message length encoding, evolutionary trees and multiple-alignment

A method of Bayesian inference known as minimum message length encoding is applied to the inference of an evolutionary-tree and to multiple-alignment for k>or=2 strings. It allows the posterior odds-ratio of two competing hypotheses, for example two trees, to be calculated. A tree that is a good hypothesis forms the basis of a short message describing the strings. The mutation process is modelled by a finite-state machine. It is seen that tree inference and multiple-alignment are intimately connected. <<ETX>>
TTB Protects Astrocytes Against Oxygen-Glucose Deprivation/Reoxygenation-Induced Injury via Activation of Nrf2/HO-1 Signaling Pathway

Neonatal hypoxic/ischemic encephalopathy (NHIE) is a severe condition that leads to death or neurological disability in newborns. The underlying pathological mechanisms are unclear, and developing the target neuroprotective strategies are urgent. 2,7,2′-trihydroxy-4,4′7′-trimethoxy-1,1′-biphenanthrene (TTB) is a natural product isolated from Cremastra appendiculata (D. Don) Makino and Liparis nervosa (Thunb.) Lindl. TTB has demonstrated potent cytotoxic activity against stomach (HGC-27) and colon (HT-29) cancer cell lines. However, none of the studies have addressed the effects of TTB in NHIE. In the present study, an oxygen-glucose deprivation/reoxygenation (OGD/R)-induced astrocyte injury model was established to investigate the effect of TTB and its potential mechanisms. Our results showed that TTB alleviated the OGD/R-induced reactive oxygen species increase and the intracellular antioxidant capacity of superoxide dismutase activity decrease. Moreover, TTB potentially prolonged the activation state of the nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) pathway and maintained the protection against oxidative stress in OGD/R-induced astrocytes by inducing the nuclear translocation and up-regulation of Nrf2 along with the enhanced expression of the downstream target gene HO-1. Furthermore, TTB treatment diminished the accumulation of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) expression induced by OGD/R. We also found TTB-treated astrocytes reversed the inhibition of OGD/R on neurite growth of neurons by the astrocyte-neuron coculture system. In conclusion, TTB inhibited the OGD/R-induced astrocyte oxidative stress at least partially through the inhibition of HIF-1α and VEGF via the Nrf2/HO-1 signaling pathway.
Facebook-photovoice interface: Empowering non-native pre-service English language teachers

Jessie Grace U. Rubrico, UCSI University Fatimah Hashim, University of Malaya Engaging non-native pre-service English teachers who are still learning the language themselves requires two tasks: facilitating their language teaching skills and scaffolding their language learning. This action research interfaced Facebook and Photovoice technologies in order to empower participants to be proactive in their language learning and teaching skills. Using pedagogy of empowerment and collaboration, the researchers tracked the participants’ impressions regarding the interface’s role in strategizing their language learning and teaching skills enhancement. Data for this study are the participants’ midand post-semester feedback, reflection papers, and engagement matrix from the class Facebook page. Results suggest that the instructional design of blending technology (i.e., Facebook and Photovoice), pedagogy of empowerment, and collaboration was effective in empowering participants to take responsibility for their own learning, thereby improving their language learning and teaching skills.
Associations of hypertension Diabetes Smoking History and SNPs with Responses to Aflibercept Treatment for tAMD and PCV

Purpose: To determine the correlation between therapeutic effects of IVA treatment on typical AMD (tAMD), and polypoidal choroidal vasculopathy (PCV) and the history of hypertension, diabetes mellitus, smoking history and single nucleotide polymorphisms (SNPs). Methods: Prospective, interventional study. Subjects were assigned to 125 untreated patients with exudative AMD (tAMD: 58 patients, PCV: 67 patients, male: 91:34, mean age 73.4 years). Among the tAMD patients, there were 28 bimonthly injections 30 who received pro re nata (PRN) injections after three monthly injections. Among the PCV patients, 33 were treated with bimonthly injections and 34 received PRN injections after three monthly injections. Therapeutic effects were evaluated by best-corrected visual acuity (BCVA), central retinal thickness (CRT), subfoveal choroidal thickness (CCT), and exudative change after 3 months and 1 year from initial treatment, and also the history of hypertension, diabetes mellitus, smoking and five SNPs (rs10490924, rs800292, rs699947, rs1061170, rs13278062). Results: Improvements of BCVA, CRT were observed in all groups at 1 year after initial treatment. The one-yearchange in CRT showed significant improvement in nonsmokers than smokers in tAMD. The one-year change in CRT indicated a significant improvement in non-diabetic patients in PCV. There was more exudation at both 3 months and 1 year who had smoking history in tAMD. With respect to the rs1061170 mutation of tAMD, in the case with TT type, significant residual exudation was noted at both 3 and 12 months.Conclusions: The history of smoking and diabetes could be influence to IVA treatment for AMD.
The Effect of Preventive Guideline Program about Genital Tract Infection on Adolescent Female's Knowledge and Practice at Assuit City

Good health behavior safeguards the health of adolescent females by reducing their vulnerability to reproductive tract infections. Objective: Assess the adolescent female students’ knowledge and practice regarding prevention of genital tract infection, and assess the effectiveness of the program on students’ knowledge and practice regarding prevention of genital tract infection. Setting: This study conducted in randomly three secondary schools that represent the different districts of Assiut city in Egypt. Subjects: A total of 124 secondary female's students were selected. Tools: A structured interview schedule was designed to assess socio-demographic data and students' health knowledge and practices at pre- and post-intervention. Results: The mean age of participants’ students was 16.7±1.2 years. The study revealed an improvement of knowledge regarding personal health practice toward genital tract hygiene among adolescents. Also the students reported significant improvements in the perineal hygiene practices. There was a positive correlation between students' knowledge and their practices. Conclusion: The post-intervention assessment revealed an obvious improvement of knowledge and practice among the studied students. Recommendations: Appropriate educational strategies as simple illustration, brochures and booklets should be available for students to increase their awareness about the healthy practices regarding genital tract and use reproductive health service.
Effects of Perioperative Hyperglycemia in Patients With Diabetes Compared to Patients Without Diabetes: A Retrospective Study of Treatment and Outcomes

The main goal of this project was to examine the differences in perioperative hyperglycemia treatment received by patients with a diagnosis of diabetes mellitus (DM) and patients without a diagnosis of diabetes (NDM); and how these treatment differences can affect the length of hospital stay. Studies have revealed that, when comparing DM and NDM patients with the same degree of perioperative hyperglycemia, NDM patients suffer worse outcomes. It has been suggested in previous research that this may be because NDM patients receive treatment that does not measure up to the standard of care treatment that DM patients receive. In this project, we study these standard of care discrepancies between DM and NDM patients, in order to examine the difference in postoperative hospital length of stay (LOS). We conducted a retrospective cohort study, using a subset of data comprised of inpatients who underwent a broad spectrum of surgery types at Nebraska Medicine over a period of twenty months. All patients in the study experienced perioperative hyperglycemia. Roughly half of them were DM patients and roughly half were NDM patients. We performed bivariate regression analysis on all available covariates in the data set in order to find candidates for final linear and logistic regression models. We also performed a time-to-event survival analysis to see if different lengths of stay among the two groups of patients were explained by possible differences in time lags between hyperglycemia trigger and insulin administration. We aimed to find whether aspects of glucose control practices were associated with hyperglycemic NDM patients experiencing longer LOS than DM patients. This information may bolster existing study conclusions and better assist us in understanding barriers to glucose control measures in NDM patients.
Targeted genotyping of circulating tumor DNA for classical Hodgkin lymphoma monitoring: a prospective study

The relevance of circulating tumor DNA (ctDNA) analysis as a liquid biopsy and minimal residual disease tool in the management of classical Hodgkin lymphoma (cHL) patients was demonstrated in retrospective settings and remains to be confirmed in a prospective setting. We developed a targeted Next-Generation sequencing (NGS) panel for fast analysis (AmpliSeq® technology) of nine commonly mutated genes in biopies and ctDNA of cHL patients. We then conducted a prospective trial to assess ctDNA follow-up at diagnosis and after two cycles (C2) of chemotherapy. Sixty cHL patients treated by first line conventional chemotherapy (BEACOPPescalated [21.3%], ABVD/ABVD-like [73.5%] and other regimens [5.2%, for elderly patients]) were assessed in this noninterventional study. The median age of the patients was 33.5 years (range: 20-86). Variants were identified in 42 (70%) patients. Mutations of NFKBIE, TNFAIP3, STAT6, PTPN1, B2M, XPO1, ITPKB, GNA13 and SOCS1 were found in 13.3%, 31.7%, 23.3%, 5%, 33.3%, 10%, 23.3%, 13.3% and 50% of patients, respectively. ctDNA concentration and genotype were correlated with clinical characteristics and presentation. Regarding early therapeutic response, 45 patients (83%, not available [NA] =6) had a negative positron emission tomography (PET) after C2 (Deauville Score 1-3). The mean of DeltaSUVmax after C2 was -78.8%. ctDNA after C2 was analysed in 54 patients (90%). ctDNA became rapidly undetectable in all cases after C2. Variant detection in ctDNA is suitable to depict the genetic features of cHL at diagnosis and may help to assess early treatment response, in association with PET. Clinical Trial reference: NCT02815137.
Incurable Childhood Blindness in India: A Review

Visual impairment in childhood is a great socio-economic burden not only to the family and society but also to the nation. Early detection and prompt intervention for some of the treatable aetiologies can substantially reduce this burden. Previously thought ‘incurable’ aetiologies can also be taken care of by agile screening and newer diagnostic technologies, but it is important to first gauge the magnitude of this menace. In the west, we have conclusive data due to rigorous community screening and vigilant school programmes but in India only a few concrete studies are available. To address this problem, we are working in a tertiary hospital of North India with the aim of reviewing available data and suggesting possible strategic recommendations concerning the control of childhood blindness in India. In this review article, we discuss the available data based upon recent studies conducted in India and suggest the solutions for the control of the same.
Efficacy and Safety of Bisphosphonates for Postmenopausal Women: A Systematic Review and Network Meta-analysis

ii ACKNOWLEDGEMENTS . iii TABLE OF CONTENTS . iv LIST OF TABLES . ix LIST OF FIGURES . xi CHAPTER 1: INTRODUCTION . 1 1.1 RATIONALE . 1 1.2 THESIS OBJECTIVES . 2 1.3 CHAPTER OUTLINE . 3 CHAPTER 2: BACKGROUND . 4 2.1 POSTMENOPAUSAL OSTEOPOROSIS . 4 2.2 FRAGILITY FRACTURES . 5 2.3 DIAGNOSTIC CRITERIA . 6 2.4 BISPHOSPHONATES FOR POSTMENOPAUSAL OSTEOPOROSIS . 7 2.5 EFFICACY OF BISPHOSPHONATES . 10 2.6 SAFETY CONCERNS AND LONG-TERM TREATMENT . 12 2.7 RATIONALE FOR CONDUCTING A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS . 13 CHAPTER 3: SYSTEMATIC REVIEW AND META-ANALYSIS OF ALENDRONATE . 16 3.