Miracle-dz/UniFAR-FTUs huggingface dataset:
Orofacial muscles activity in children with swallowing dysfunction and removable functional appliances

Swallowing dysfunction is a frequent disorder among children and refers to an altered tongue posture and abnormal tongue movement during swallowing. Removable functional appliance is one of the treatments applied by dentistry to correct this disorder. The aim of this study was to evaluate any differences on orofacial muscles activity in children with swallowing dysfunction with and without removable functional appliances. 68 children were eligible for the study and divided into the orthodontic group (OG) and the no-orthodontic group (NO-OG). Both groups performed a dental occlusion-class evaluation, a swallowing function test and a myoscan analysis in order to measure perioral forces (i.e. tongue extension force, lip pressure, masseter contraction force). Our results showed a significant difference (P=0.02) between OG and NO-OG for the tongue extension force, whereas no significant differences (P>0.05) were found for the other parameters. Our findings suggest that children with swallowing dysfunction and removable functional appliance show orofacial muscles activity within the range of reference values (except for the lip pressure). However, we hypothesize that orthodontic treatment can achieve more effective results with integration of myofunctional therapy.
Clinical consequences of poor adherence to lipid-lowering therapy in patients with cardiovascular disease: can we do better?

There is high-quality evidence demonstrating that early initiation of statin use following an acute coronary syndrome (ACS) and persistent use thereafter reduces the risk of major adverse cardiovascular events (MACE) including mortality. However, despite the overwhelming evidence, adherence remains suboptimal and the medications frequently discontinued.1 Here we discuss the data on lipid-lowering therapy among patients with cardiovascular disease and discuss some potential interventions that address the gap. Among those with established atherosclerotic cardiovascular disease (ASCVD), poor statin adherence has been reported to be 47.2% in real-world registry data.2 Discontinuation rates have been reported ranging from 14%3 to 26.5%4 at 12 months in both large multicentre randomised clinical trial (RCT) data and national registries, with long-term discontinuation being 51% after 7 years in a large-scale RCT involving 39 countries.3 In a systematic review including 28 studies (5 nested case–control and 22 cohort studies), adherence to statin use in patients at high risk of ASCVD and those with established ASCVD was associated with a reduction in subsequent cardiovascular events (OR 1.22–5.26) and improved survival (OR 1.79–5.00). 5 The US National Cardiovascular data Registry’s PINNACLE database (data collected at the point of care at cardiology practices) was used in a large study that showed that in 1 029 633 adults with known ASCVD, 27.9% did not receive any lipid-lowering medication.6 Similarly, other registries demonstrate high proportions of patients not receiving lipid-lowering therapy within the first year following an ACS in Australia7 and New Zealand8—22% and 25% respectively. Prescription of statins at the time of discharge after ACS is associated with continued use,7 and a range of data demonstrates significant gaps in use of lipid-lowering drugs among patients with cardiovascular disease. In the CONCORDANCE trial, failure to discharge patients on guideline-recommended therapies was 10 …
Higher education challenges to teaching practices: perspectives drawn from a multidisciplinary peer observation of teaching program

Teachers in higher education are now, all over the world, challenged to shift their practices towards a new paradigm focused on students and their learning. However such appeals rarely take into account that changes may proceed from current didactic practices and relate with teachers‟ awareness about his/her own performance. The peer review model of peer observation of teaching is seen as an important opportunity to improve teaching practices, an opportunity that can be fostered within a multidisciplinary peer observation scheme. Aiming to go deeper on the role of current practices and teachers‟ awareness about their performance to improve teaching practices in higher education, some research data collected during a multi-disciplinary peer observation of teaching program are presented and discussed. It can be concluded that multidisciplinary collaboration can be a path for mutual enrichment, not only by recognizing among the other ways of doing those that can be transposed into our field, but also by recognizing weaknesses and strengths in ourselves.
Surgery in patients with small cell lung cancer: A period propensity score matching analysis of the Seer database, 2010-2015

Surgery as a therapeutic modality for non-small cell lung cancer is widely accepted in clinical practice. However, the role of surgery for small cell lung cancer (SCLC) remains controversial. Therefore, in the present study a period propensity score matching analysis using the Surveillance, Epidemiology and End Results (SEER) Registry database was performed to investigate the role of surgery on survival in patients with SCLC. Patients with SCLC between January 2010 and December 2015 were identified from the SEER database, and individual data for each case regarding general clinical characteristics, surgery of primary site (SPS), cause-specific death classification and survival time were retrieved. Differences of cause-specific survival (CSS) between subgroups were estimated by the log-rank test. Cox regression analysis was used to evaluate the effects of multiple variables on CSS, and differences between the incidences of cause-specific death were examined using a χ2 test. A total of 1,707 records met the inclusion criteria and were retrieved for analysis. There were significant differences of CSS in the clinicopathological features of N (P=0.01), Stage (P<0.01) and Surgery (P<0.01) when comparing non-surgery with surgery, and in N (P<0.001), Stage (P=0.006) and Surgery (P=0.049) when comparing sublobectomy with lobectomy or bilobectomy (lobe/s). Patients who did not receive surgery (P<0.001) or who received sublobectomy (P=0.03) had an increased risk of mortality when compared with patients who received surgery and lobe/s. The findings of the present study indicate that surgery should be taken into consideration when an initial treatment strategy is made in patients for patients with SCLC at clinical stage I–IIA (T1-2,N0,M0), regardless of whether they are >50 years of age, their sex, histology and grade. The results suggest that certain patients with SCLC with stage IIB (N1) can also benefit from lobe/s, although further investigation is required. In addition, lobe/s is preferable to sublobectomy when surgery is performed. However, the present study was unable to comprehensively analyze the efficacy of pneumonectomy for SCLC.
Impact of Hydrostatic Pressure Variations Caused by Height Differences in Supine and Prone Positions on Fractional Flow Reserve Values in the Coronary Circulation

Objectives To examine the influence of hydrostatic pressure on fractional flow reserve (FFR) in vivo. Background Systematic differences in FFR values have been observed previously in the left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA). It has been suggested that as the hydrostatic pressure variations caused by the height differences between the catheter tip (mean aortic pressure (Pa)) and pressure-wire sensor (mean distal intracoronary pressure (Pd)) are small, intracoronary pressure need not be corrected. Methods Resting Pd/Pa and FFR values in 23 patients (27 lesions) were measured and compared in supine and prone positions. These values were corrected by hydrostatic pressure influenced by height levels and compared. Height differences between Pa and Pd were calculated using coronary computed tomography angiographies. Results In LAD, resting Pd/Pa and FFR values were significantly higher in the prone position than in the supine position (0.97 ± 0.05 vs 0.89 ± 0.04, P < 0.001 (resting Pd/Pa); 0.81 ± 0.09 vs 0.72 ± 0.07, P < 0.001 (FFR)). Conversely, in LCX and RCA, these values were significantly lower in the prone position (LCX: 0.93 ± 0.03 vs 0.98 ± 0.03, P < 0.001 (resting Pd/Pa); 0.84 ± 0.05 vs 0.89 ± 0.04, P < 0.001 (FFR); RCA: 0.91 ± 0.04 vs 0.98 ± 0.03, P=0.005 (resting Pd/Pa); 0.78 ± 0.07 vs 0.84 ± 0.07, P=0.019 (FFR)). FFR values corrected by hydrostatic pressure showed good correlations in the supine and prone positions (R2 = 0.948 in LAD; R2 = 0.942 in LCX; R2 = 0.928 in RCA). Conclusions Hydrostatic pressure variations due to height levels influence intracoronary pressure measurements and largely affect resting Pd/Pa and FFR, which might have caused systematic differences in FFR values between the anterior and posterior coronary territories.
Risk taking behaviors in relation to Attention Deficit and Hyperactivity Disorder in Iranian male workers: a latent class analysis

Background Risk taking behaviors are a serious risk to the health and safety of workers. The aims of this study were to identify the subgroups of workers on the basis of risk taking behaviors and assess the independent role of ADHD on the membership of participants in each latent class. Methods This cross sectional study was performed on 2434 workers. The sample was selected through random cluster sampling from Kaveh Industrial City. All workers completed five sets of checklists and questionnaires. Data analysis was performed using chi-square, Fisher’s exact test, and latent class analysis. Results Four latent classes were identified; namely, 1) very low risk (65.6%), 2) low risk (27.8%), moderate risk (4.1%) and, high risk (2.5%). After adjusting for other studied covariates, having ADHD significantly increased the odds of membership in moderate risk class (OR=3.42, 95% CI: 2.21 −5.29) and high risk class (OR=3.10, 95% CI: 1.80 −5.34) compared to very low risk class. Also, having anxiety increased the odds of membership in latent class 2 (OR=1.28, 95% CI: 1.02–1.62), 3(OR=2.15, 95% CI: 1.51–3.10) and 4 (OR=2.06, 95% CI: 1.32–3.22) in comparison to class 1. Among all participants, 187 (7.7%) had ADHD and among studied variables, ADHD has the strongest role in the membership of subjects in different classes. Conclusion Results from the present study indicate that 6.6% of the workers fell under moderate or high risk class. Focusing on the treatment of ADHD with considering other comorbid factors such as anxiety may be helpful in designing and executing effective programs to reduce risk taking behaviors among workers.
The Therapeutic Effect of Lactobacillus reuteri in Acute Diarrhea in Infants and Toddlers

4) . 최근에는 Lactobacillus reuteri가 급성설사 및 로타바이러스 장염에 효과적인 것으로 보고되고 있다 5, 6) . L. reuteri는 비교적 최근에 발견된 Lactobacillus종으로 일 차적으로 인간모유에서 분리되었으며 인간과 동물의 위장관에서 가장 흔히 발견되는 Lactobacillus종이다 7, 8) . 기존의 유산균은 주로 젖산과 초산같은 유기산에 의하여 유해균을 억제하는데 L. reuteri는 젖산과 초산을 생성하는 것 이외에 광범위한 항균범 위를 보이면서 항균력이 강한 저분자 항균물질인 Reuterin을 생 성한다 9, 10) . 식품으로 사용하기 좋은 저분자량의 광범위한 항균 물질로 그람 양성, 음성세균, 효모, 진균, 기생충, 바이러스 전반 에 대한 항균효과가 있다 7, 11, 12) . L. reuteri는 대장염 쥐모델에 영유아의 급성 설사에서 Lactobacillus reuteri의 치료 효과
Sprint Interval Training, a novel exercise modality to improve exercise tolerance in COPD and sedentary healthy adults and the role of microcirculation

1 Foreword . 2 Introduction . 5 Aerobic Exercise Performance and Health Status . 5 Maximum Aerobic Power. 5 Work Economy . 9 Lactate Threshold . 10 Chronic Obstructive Pulmonary Disease. 10 Treatment . 12 Physiological Consequences of COPD . 12 Exercise and COPD . 14 Effects of SIT in Healthy Populations . 16 Effects on Cardiac Output . 17 Effects on A-VO2 Difference . 17 How SIT could impact COPD patients . 18 Methods. 20 Design . 20 Subjects . 20 Test Procedures and Materials . 21 Day 1 . 21 Day 2 . 22 Day 3 . 23 Near Infra-red Spectroscopy . 23 NIRS Variables . 24 Training interventions. 25 Statistical analysis . 26 Results . 27 Participants . 27 TTE and Wingate . 27 VO2peak and Work Economy Tests . 29 NIRS . 29 Discussion . 30 Wingate . 31 Training Induced Improvements in TTE . 31 NIRS . 33 VO2peak . 35 Conclusion . 37 Acknowledgments . 38 Appendix . 39 References . 43
Shexiang Baoxin Pill, a Formulated Chinese Herbal Mixture, Induces Neuronal Differentiation of PC12 Cells: A Signaling Triggered by Activation of Protein Kinase A

Background: Shexiang Baoxin Pill (SBP) is a well-known composite formula of traditional Chinese medicine (TCM), which is commonly used today in treating cardiovascular diseases. SBP consists of seven materials thereof, including Moschus, extract of Ginseng Radix et Rhizoma, Bovis Calculus Artifactus, Cinnamomi Cortex, Styrax, Bufonis Venenum, and Borneolum Syntheticum. Here, we are investigating the potential roles of SBP in inducing neuron differentiation, i.e., seeking possible application in neurodegenerative diseases. Methods: Water and ethanol extracts of SBP, denoted as SBPwater and SBPEtOH, respectively, as well as its individual herbal materials, were standardized and applied onto cultured rat pheochromocytoma PC12 cells. The potential effect of SBP extracts in neuronal differentiation was suggested by following parameters: (i) induction of neurite outgrowth of PC12 cells, (ii) increase of neurofilament expression, and (iii) activation of transcription of neurofilament. Results: The treatments of SBPwater and SBPEtOH, or extracts from individual herbal materials, with or without low concentration of nerve growth factor (NGF), could potentiate the differentiation of cultured PC12 cells. The differentiation was indicated by increase of neurite outgrowth, as well as expression of neurofilaments. In addition, application of H89, a protein kinase A (PKA) inhibitor, suppressed the SBP-induced neurofilament expressions, as well as the phosphorylation of cAMP-responsive element binding protein (CREB) in cultures. Conclusion: SBP is proposed to possess trophic activity in modulating neuronal differentiation of PC12 cells, and this induction is shown to be mediated partly by a cAMP-PKA signaling pathway. These results indicate the neurite-promoting SBP could be useful in developing potential drug in treating or preventing neurodegenerative diseases.
A survey exploring knowledge and beliefs about electronic cigarettes between health care providers and the general population in Egypt

Background Electronic cigarettes are increasing in popularity, and they are easily accessible in a variety of locations. Despite increasing its popularity, little is known about its overall health effects. Physicians have rated the most trustful source of information about it and play also a role in disseminating information about it. Thus, this study identified the difference in knowledge and beliefs about electronic cigarettes between health care providers and the general population in Egypt. Methods A cross-sectional study using the self-administered questionnaire in the Arabic language was conducted between December 2018 and March 2019 in the Chest Department in Ain Shams University Hospital in Egypt. Study population (n=610) was divided into health care providers (n=260) and general population (n=350). Result A total of 593 respondents participated in this study and returned filled questionnaire with total response rate=97.2%, only 8.8% of all participates were smokers, none of the study population reported using electronic cigarettes, despite that, 79.3% of the participants have heard of electronic cigarettes, media advertisements were the main source of getting to know it and there was a statistically significant difference between both groups regarding most beliefs and attitudes toward electronic cigarettes. Conclusion There was high awareness about electronic cigarettes in Egypt and more negative attitude about it among health care providers than the general population, but still educational programs and guidelines for health care providers are needed to raise more the awareness which will aid in counseling general population appropriately.
The possible ameliorative role of mesenchymal stem cells and curcumin on the lung in experimentally induced type I diabetes: Histological and immunohistochemical study

Background: Type 1 diabetes mellitus affects lungs due to poor glycemic control. Improvement in both lung function andarchitecture in experimentally-induced lung injury that received exogenous AMSCs by different mechanisms was found.Curcumin has a potent antioxidant and antifibrotic function.Objective: The current study was designed to elucidate the possible ameliorative role of mesenchymal stem cells and curcuminon the lung in experimentally induced type I diabetes by histological and immunohistochemical study.Materials and Methods:Twenty six adult albino rats were divided into five groups: donor, control group, curcumin group andadipose derived mesenchymal stem cell (AMSCs) group. Group II (diabetic group) received a single dose STZ 50 mg/kg/day,group III received STZ and powdered diet supplemented with 0.05% curcumin, group IV received STZ and 1x106 of culturedand labelled rat AMSCs. Lung sections were subjected to histological, morphometric, biochemical and statistical studies.Results: Diabetes induced histological changes in lung in the form of inflammatory changes in bronchiole, a sig increase inthe thickness of interalveolar septa, thickness of the vessels wall, area % of collagen and count CD105+ve cells. Sig decreasein antioxidant activity and sig increase in oxidant enzymes. Sig increase in L-hydroxyproline(L-hyp) level as well STAT andSMAD genes. Administration of curcumin and AMSCs improved sig the previous changes.Conclusion: Diabetes induced lung injuries in rats that was ameliorated by by curcumin, but AMSCs have more pronouncedeffect than curcumin therapy.
Neonatal septicemia: bacteriological profile in a tertiary level hospital in South India

Background: Early onset bacterial sepsis remains a major cause of neonatal morbidity and death. The choice of antibiotic for an infant with sepsis depends on the predominant bacterial pathogens and the antibiotic susceptibility profiles for the microorganisms causing disease in a particular geographic region. The purpose of this study was to analyze the bacteriological profile and antibiotic sensitivity pattern of neonatal septicemia in our neonatal unit.Methods: A descriptive cross sectional study carried was out at the NICU of a tertiary level hospital in South India for a period of one year.Results: Clinically suspected septicemia comprised 18.14% of total NICU admissions. Organism was isolated by blood culture in 14.9% of cases. The most common organisms causing septicemia were Coagulase negative Staphylococci, Klebsiella and Staphylococcus aureus. Gram positive isolates were most sensitive to Vancomycin (100%) while the gram negative isolates were most sensitive to Amikacin. Resistance to Crystalline Penicillin, Ampicillin and 3rd generation cephalosporins was high.Conclusions: The most common organism isolated in septicemia was Coagulase negative staphylococcus in our NICU. Gram positive isolates were most sensitive to Vancomycin (100%) while the gram negative isolates were most sensitive to Amikacin. High resistance to commonly used antibiotics is worrisome. There should be a constant surveillance of the common microbes and their sensitivity pattern in each NICU and the antibiotic protocols should be periodically reviewed. Rational use of antibiotics and preventive measures like hand washing is the need of the hour.
Audit of MRI protocol, referral pattern and appropriateness of clinical indications for lumbar spine MRI use for adult low back pain: A single-centre study in Ghana

A guideline for MRI request is nonexistent in Ghana. This study is to evaluate the local lumbar spine MRI protocol, clinical indications, referral sources, imaging findings and the appropriateness of the request using the Appropriateness Criteria (AC) of the American College of Radiology (ACR) for MRI of Lower Back Pain (LBP) patients. Using a Ghanaian tertiary hospital’s MRI centre, we evaluated the local MRI protocol used for lumbar spine imaging, reviewed the referral sources of adult patients (18 years and above) within a six-month period. The age, gender, clinical indication, imaging findings and the appropriateness of lumbar spine MRI for low back pain (LBP) was descriptively analyzed using Excel 2013. A total of 242 patients (females 140, males 102) underwent MRI for LBP within a six-month period. The existing MRI protocol was justified. Using the AC of ACR, about 39% of MRI requests were “usually appropriate”, 36% “may be appropriate”, and 25% were “usually not appropriate”. Most referrals were from the OPD (58%). Most common indication was LBP/sciatica (52.1%); the most common imaging finding was degenerative changes (65.0%). The local MRI protocol for LBP was justified. Judicious request for MRI is very necessary to avoid wastefulness. MRI centers must prioritize requests coming from Orthopedic Specialists and not the OPD. The main imaging finding was degenerative bone disease which plain radiography can diagnose. This study may serve as a reference for local lumbar spine MRI practice, and inform local practice.
Diagnostic accuracy of composite autonomic symptom scale 31 (COMPASS-31) in early detection of autonomic dysfunction in type 2 diabetes mellitus

Purpose Diabetic autonomic neuropathy (DAN) is a common and disabling complication of diabetes, with cardiac autonomic neuropathy (CAN) being a major cause of mortality and morbidity. Standard autonomic function tests (AFT) are cumbersome and time consuming to conduct in OPD setting. Objective To evaluate the diagnostic accuracy of composite autonomic symptom scale 31 (COMPASS-31) as a screening test for DAN. Patients and methods A cross-sectional study which enrolled 60 type 2 diabetes individuals was conducted at a tertiary care center. Autonomic functions were evaluated by COMPASS-31 questionnaire as well as by standard Ewing's battery of tests; short-term heart rate variability; sympathetic skin response along with nerve conduction studies. Results Thirty males and 24 females completed the study. Forty-nine (89%) participants had CAN, of which, 9 (17%) had definite CAN. Peripheral neuropathy was present in 20 (37%). COMPASS-31 scores showed no difference between “No CAN” and “Early CAN”. “Definite CAN” individuals differed significantly from “No and Early CAN” on COMPASS-31 scores and its gastrointestinal sub-domain. Receiver operating characteristic between “Definite CAN” and “No and Early CAN” showed fair accuracy with AUC of 0.731 (95% CI 0.561–0.901), sensitivity 77.8%, specificity 71.7% at a cut-off of 28.67 of COMPASS-31 score. Gastrointestinal sub-domain, at a cut-off score of 5.8, had 77.8% sensitivity, 60% specificity, and AUC was 0.748 (95% CI 0.603–0.894). Conclusion COMPASS-31, a self-administered tool, requiring less time, qualifies as an acceptable screening tool, especially for definite CAN. However, individuals scoring low on COMPASS-31 are still required to be evaluated by Ewing’s battery to differentiate between “Early CAN” and “No CAN”.