Miracle-dz/UniFAR-FTUs huggingface dataset:
The effect of an educational intervention in early pregnancy with spouse's participation on optimal gestational weight gain in pregnancy: a randomized controlled trial

Gaining weight above the Institute of Medicine recommended range contributes to the development of obesity, which increases risk for diseases. We evaluated the effectiveness of an educational program with the spouse's participation on the optimal gestational weight gain (GWG) in pregnancy. We conducted a randomized controlled trial on 128 nulliparous women attending Najmieh Hospital-Antenatal Clinic based in Tehran-Iran. Participants randomly allocated into two groups of interventions and one control group. In group A, the women received education with their spouse's participation. In group B, the women received education without the participation of the spouses. In the control group, women received only routine prenatal care. Data were analysed by the ANOVA and Chi-square coefficient. The mean of the total GWG in the groups A and B was significantly lower than the control group (13.50 ± 3.85, 13.55 ± 3.20 and 15.53 ± 4.20 kg, respectively, P > 0.05). The rate of optimal GWG in groups A and B was 1.97 and 1.77 times of the control group, respectively (P < 0.05). The percentage of non-optimal GWG significantly decreased (P < 0.05). Groups A and B were not significantly different indicating no effect of spousal presence.
Metabolomics approach in the investigation of depression biomarkers in pharmacologically induced immune-related depression

Background The aim of this study was to identify previously unrecognised biological pathways and biomarkers that might expand the inflammatory hypothesis of depression. Methods Broad metabolomics analyses in plasma samples from 31 chronic hepatitis C-infected patients with and without immune-related depression were carried out using the Absolute IDQ p180 kit—a targeted metabolomics approach of combined direct flow injection and liquid chromatography that measures acylcarnitines, amino acids, biogenic amines, glycerophospholipids, sphingolipids, and sugars. Results The measurements showed that the average concentration of the branched-chain amino acid isoleucine was significantly lower in depressive HCV patients in comparison to non-depressive HCV patients [depression group: Median 51.35 (43.4–60.2 μmol/L) vs. Median 62.10 (38.4–81.7 μmol/L); U = -2.958; p = 0.002]. All other amino acids, acylcarnitines, biogenic amines, glycerophospholipids, sphingolipids, sugars, liver enzymes and thyroid levels showed no statistically significant differences. Conclusions The results of the present study suggest that the branched-chain amino acid isoleucine might play a role in the pathophysiology of immune-related major depression, which expands existing knowledge about inflammatory hypothesis of depression.
The Perception of Pregnancy and Parenthood Among Female Orthopaedic Surgery Residents.

INTRODUCTION Orthopaedic surgery has the lowest percentage of female residents of all surgical specialties. Female medical students may believe that the demands of the specialty, both during training and in clinical practice, may be less conducive to becoming a parent. The purpose of this study was to determine the perceptions of and experiences with pregnancy and parenthood among female orthopaedic surgery trainees. METHODS An anonymous 24-question online survey was distributed to all current female orthopaedic surgery trainees in the United States via the American Academy of Orthopaedic Surgeons Diversity Advisory Board. Survey questions included the demographics of the residents' programs, the parental status of the respondents, and their experiences with pregnancy and parenthood during training. RESULTS Of the respondents, 83.7% did not have children during residency and were not currently pregnant. Furthermore, 48.4% responded that they had deferred having children because they were in residency. One hundred and thirteen respondents (59.5%) reported that they experienced bias from co-residents about women having children during residency, whereas 94 (49.5%) reported such bias from attendings. CONCLUSION This study demonstrates that most female orthopaedic trainees do not have children during residency. Most respondents experienced bias from co-residents about women having children during residency, and nearly half experienced such bias from orthopaedic attendings. Combating bias about pregnancy during residency may help encourage more women to pursue a career in orthopaedics.
Immunohistochemical analysis of histone H3 acetylation in the trigeminal root entry zone in an animal model of trigeminal neuralgia.

OBJECTIVEThe trigeminal root entry zone (TREZ) is a transitional zone between the central nervous system (CNS) and peripheral nervous system (PNS), adjacent to the brainstem. Microvascular compression of the TREZ has been considered to be the primary etiology in most cases of trigeminal neuralgia (TN), but whether epigenetic regulation is involved in the pathogenesis of TN is still unclear. Therefore, this study was designed to investigate the epigenetic regulation of histone H3 acetylation in the TREZ in an animal model of TN.METHODSAn animal model of TN was established, and adult male Sprague-Dawley rats were randomly assigned to a TN group with trigeminal nerve root compression, sham operation group, TN+HDACi group (TN plus selective histone deacetylase inhibitor injection into the TREZ), or TN+Veh group (TN plus vehicle injection into the TREZ). To measure the length of the central portion of the TREZ from the junction of the trigeminal nerve root entering the pons to the interface of the dome-shaped CNS-PNS transitional zone, immunofluorescent staining of glia and glial nuclei was performed using glial fibrillary acidic protein (GFAP) antibody and DAPI, respectively. To investigate the acetylation of histone H3 within the TREZ in a TN animal model group and a sham operation group, localization of histone H3K9, H3K18, and H3K27 acetylation was examined via immunohistochemical staining methods.RESULTSMeasurements of the CNS-PNS transitional zone in the TREZ revealed that the average length from the junction of the trigeminal nerve root connecting the pons to the glial fringe of the TREZ in the TN group was longer than that in the sham operation group (p < 0.05) and that the interface gradually migrated distally. Cells that stained positive for acetylated histone H3K9, H3K18, and H3K27 were distributed around both sides of the border of the CNS-PNS junction in the TREZ. The ratio of immunoreactive H3K9-, H3K18- and H3K27-positive cells in the TN group was obviously higher than that in the sham operation group on postoperative days 7, 14, 21, and 28 (p < 0.05). CONCLUSIONSThese results suggested that chronic compression of the trigeminal nerve root may be involved in the pathogenesis of TN in an animal model by influencing the plasticity of the CNS-PNS transitional zone and the level of histone acetylation in the TREZ.
A Pilot Analysis of Morphometric Assessment of Itraconazole Brands Using Dermoscopy and its Relevance in the Current Scenario

Background: Itraconazole (ITZ) is widely used for cutaneous and systemic mycoses. Its bioavailability is inconsistent and shows interindividual variations. The quality of ITZ pellets is an important factor determining its absorption profile and thereby the therapeutic effect. Analysis of morphometric characteristics is a surrogate method to determine the same. Pellet number and size are the most important parameters in this regard. Aim: We aimed to delineate few low-cost brands, the assessed variables of which fell within the formulated criteria. Materials and Methods: In all, 22 (100 mg) formulations of ITZ were included. The pellet number was calculated manually and pellet size was determined using a dermoscope with an inbuilt measurement tool. Furthermore, size variation with respect to the innovator US Food and Drug Administration (FDA)-approved brand was determined. Results: There is a large variation in pellet number and average pellet size among different brands. Pellet number ranged from 121 to 820 and average size from 959 to 1845 μm. Few brands had dummy pellets and loose powder within the capsule. Two brands within the price range of less than Rs. 20 per capsule fulfilled the three formulated criteria: of a good pellet count, small pellet size, and low size variation. Two other brands also satisfied these criteria but were priced between Rs. 20 and 30 per capsule. The innovator US FDA-approved brand had the highest number of pellets and minimum size variation but is the costliest of all assessed brands. Limitations of the Study: We cannot comment on inter-batch variation as ours was a one-point assessment. Advanced techniques such as scanning electron microscopy and drug release profile, which would have given further useful information on pellet quality, were beyond our scope. Conclusion: There is marked variation in the assessed characteristics of ITZ formulations. These morphometric characteristics may have a significant bearing on the quality of ITZ. And thus analysis of these can help clinicians make an informed decision in choosing an ITZ formulation to achieve optimal efficacy.
Structure of HIV‐1 reverse transcriptase/d4TTP complex: Novel DNA cross‐linking site and pH‐dependent conformational changes

Stavudine (d4T, 2′,3′‐didehydro‐2′,3′‐dideoxythymidine) was one of the first chain‐terminating nucleoside analogs used to treat HIV infection. We present the first structure of the active, triphosphate form of d4T (d4TTP) bound to a catalytic complex of HIV‐1 RT/dsDNA template‐primer. We also present a new strategy for disulfide (S–S) chemical cross‐linking between N6 of a modified adenine at the second overhang base to I63C in the fingers subdomain of RT. The cross‐link site is upstream of the duplex‐binding region of RT, however, the structure is very similar to published RT structures with cross‐linking to Q258C in the thumb, which suggests that cross‐linking at either site does not appreciably perturb the RT/DNA structures. RT has a catalytic maximum at pH 7.5. We determined the X‐ray structures of the I63C‐RT/dsDNA/d4TTP cross‐linked complexes at pH 7, 7.5, 8, 8.5, 9, and 9.5. We found small (~0.5 Å), pH‐dependent motions of the fingers subdomain that folds in to form the dNTP‐binding pocket. We propose that the pH‐activity profile of RT relates to this motion of the fingers. Due to side effects of neuropathy and lipodystrophy, use of d4T has been stopped in most countries, however, chemical modification of d4T might lead to the development of a new class of nucleoside analogs targeting RNA and DNA polymerases.
Pre‐operative fasting in adults and children: clinical practice and guidelines

It is widely recognised that prolonged fasting for elective surgery in both children and adults serves no purpose, adversely affects patient well‐being and can be detrimental. Although advised fasting times for solids remain unchanged, there is good evidence to support a 1‐h fast for children, with no increase in risk of pulmonary aspiration. In adults, a major focus has been the introduction of carbohydrate loading before anaesthesia, so that patients arrive for surgery not only hydrated but also in a more normal metabolic state. The latter attenuates some of the physiological responses to surgery, such as insulin resistance. As in children, there is no increase in risk of pulmonary aspiration. Further data are required to guide best practice in patients with diabetes.
Cefixime-associated acute generalized exanthematous pustulosis: Rare cases in India

BACKGROUND: Cefixime is a widely used third-generation cephalosporin schedule H1 drug, which is prescribed for the treatment of otitis media, respiratory tract infections, and uncomplicated urinary tract infections and is effective against infections caused by Enterobacteriaceae and Haemophilus influenzae species in India. The National Coordination Centre (NCC)-Pharmacovigilance Programme of India (PvPI), Indian Pharmacopoeia Commission (IPC), has received rare individual case safety reports (ICSRs) for acute generalized exanthematous pustulosis (AGEP) associated with the use of cefixime. MATERIALS AND METHODS: IPC, NCC-PvPI also acts as a national collaborating center for pharmacovigilance activities under the aegis of Ministry of Health and Family Welfare, Government of India; moreover, it is a member country in global pharmacovigilance system, World Health Organization-Uppsala Monitoring Centre, Sweden. There are more than 250 government/corporate medical colleges and hospitals acting as regional adverse drug reaction monitoring centers, actively functioning under PvPI. Furthermore, various stakeholders including consumers and pharmaceutical industries also play a significant contribution. NCC-PvPI receives spontaneous ICSRs from various stakeholders. RESULTS: NCC-PvPI, IPC has received a total of four spontaneous ICSRs for cefixime-induced AGEP. After clinical evaluation of reported ICSRs, a strong causal relationship was established between AGEP and cefixime and was supported by published literature and histopathological examination of skin. Based on the statistics with positive information component (IC025 Value: 0.17) and proportionality relative risk (PRR:3.4), PvPI considered cefixime-associated AGEP may be a potential signal. CONCLUSION: Hence, initially, AEGP is considered by PvPI as drug safety alert in July 2016. Therefore, to enhance the safety of population in rational usage of medication, as a result, there is a need for physicians and health-care professionals to sensitize about serious adverse reaction while prescribing the cefixime as signal in India.
Hot beverages and oesophageal cancer risk in western Kenya: Findings from the ESCCAPE case–control study

Oesophageal squamous cell carcinoma (ESCC) has markedly high incidence rates in Kenya and much of East Africa, with a dire prognosis and poorly understood aetiology. Consumption of hot beverages—a probable carcinogen to humans—is associated with increased ESCC risk in other settings and is habitually practiced in Kenya. We conducted a case–control study in Eldoret, western Kenya between August 2013 and March 2018. Cases were patients with endoscopically confirmed oesophageal cancer whose histology did not rule out ESCC. Age and sex‐matched controls were hospital visitors and hospital out and in‐patients excluding those with digestive diseases. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for self‐reported drinking temperatures; consumption frequency; mouth burning frequency and hot porridge consumption using logistic regression models adjusted for potential confounders. Drinking temperature association with tumour sub‐location was also investigated. The study included 430 cases and 440 controls. Drinkers of ‘very hot’ and ‘hot’ beverages (>95% tea) had a 3.7 (95% CI: 2.1–6.5) and 1.4‐fold (1.0–2.0) ESCC risk, respectively compared to ‘warm’ drinkers. This trend was consistent in males, females, never and ever alcohol/tobacco and was stronger over than under age 50 years. The tumour sub‐location distribution (upper/middle/lower oesophagus) did not differ by reported drinking temperature. Our study is the first comprehensive investigation in this setting to‐date to observe a link between hot beverage consumption and ESCC in East Africa. These findings provide further evidence for the role of this potentially modifiable risk factor in ESCC aetiology.
The Challenges of Improving Treatments for Depression.

In the past few decades substantial progress has been made in the research and development of treatments for major depression. Many different types of medications and psychotherapy are currently available and rigorous studies have shown that antidepressants are more effective than placebo,1 and several types of psychotherapies are more effective than waiting list or other controls.2 These findings suggest that many patients with depression can be successfully treated. Based on these significant and positive effects, many of these treatments are included in treatment guidelines and are widely used in clinical practice. However, not all patients with depression recover with available treatments and several important challenges need to be resolved to improve existing treatments and to increase the number of patients who benefit from them.
Mechanisms involved in inflammatory pulmonary fibrosis induced by lunar dust simulant in rats

Lunar dust is one of the biggest risk factors in the future manned exploration mission. Much is not known about the pulmonary toxicity of lunar dust. The aim of this study was to evaluate the lung inflammation and oxidative stress induced by subacute exposure to lunar dust stimulant (LDS) in rats. Wistar rats were intratracheally administered LDS, twice a week for 3 weeks. Inflammatory cell counting and cytokine assays using bronchoalveolar lavage fluid (BALF) were performed. Lung tissues were processed for histopathological examination and immunohistochemical staining. Biomarkers of oxidative stress and genes and proteins related to inflammation and fibrosis in lung tissue were also determined. The neutrophil count in the BALF of LDS‐exposed groups was higher than that in controls (P < .05). LDS caused a significant increase in some of biochemical indicators and proinflammatory factors levels in BALF compared with control group. The normal balance between oxidation and antioxidation was broken by LDS. Pathological characteristics of lung tissue and immunohistochemical results for α‐smooth muscle actin (α‐SMA) indicated that inflammatory response was an extremely important passage to pulmonary fibrosis. Real‐time PCR analysis showed elevated levels of nitric oxide synthase (NOS) and nicotinamide adenine dinucleotide phosphate oxidase (NOX) mRNA in the lungs (P < .05). Western blotting results were consistent with immunohistochemistry and qPCR results. These results indicate that inhalation of lunar dust may cause inflammatory pulmonary fibrosis. NOX4 may be a key potential therapeutic target for inflammatory injury and fibrosis in the lung.
Disease Pattern among Sexually Transmitted Infection Clinic Attendees: A Hospital-Based Study

Background: Sexually transmitted infections (STIs) have a definite role in the facilitation of HIV infection, which, in turn, also increases susceptibility to other STIs. Further, the social stigma and secrecy surrounding STIs create difficulty in estimating its true incidence and prevalence. Objective: The objective of this study was to know the pattern of diseases including different clinical presentations and final diagnosis among the STI clinic attendees. Materials and Methods: This study was a hospital-based study; a predesigned and pretested schedule was used to collect data from 140 patients after obtaining their consent. The study was carried out between January 1, 2016, and December 31, 2016. Statistical Analysis: Analysis was done using tabulation and proportion. Results and Observation: Genital ulcer (31.43%) was the most common clinical presentation among the attendees. Primary syphilis was the most common (17.14%) STI detected among the participants followed by herpes genitalis (16.43%). The most common mixed infection was primary syphilis with chancroid (36.36%) followed by herpes genitalis with primary syphilis (18.18%). Conclusion: Ulcerative STIs singly or in combination are more frequent than the non-ulcerative STIs. Further studies with large sample sizes are needed to obtain a more vivid picture.
Quantitative Variations with pH of Actin Depolymerizing Factor/Cofilin’s Multiple Actions on Actin Filaments

Actin depolymerizing factor (ADF)/cofilin is the main protein family promoting the disassembly of actin filaments, which is essential for numerous cellular functions. ADF/cofilin proteins disassemble actin filaments through different reactions, as they bind to their sides, sever them, and promote the depolymerization of the resulting ADF/cofilin-saturated filaments. Moreover, the efficiency of ADF/cofilin is known to be very sensitive to pH. ADF/cofilin thus illustrates two challenges in actin biochemistry: separating the different regulatory actions of a single protein and characterizing them as a function of specific biochemical conditions. Here, we investigate the different reactions of ADF/cofilin on actin filaments, at four different pH values ranging from 6.6 to 7.8, using single-filament microfluidics techniques. We show that decreasing the pH decreases the effective filament severing rate by increasing the rate at which filaments become saturated by ADF/cofilin, thereby reducing the number of ADF/cofilin domain boundaries, where severing can occur. The severing rate per domain boundary, however, remains unchanged at different pH values. The ADF/cofilin-decorated filaments (“cofilactin” filaments) depolymerize from both ends. We show here that, at physiological pH (7.0–7.4), the pointed end depolymerization of cofilactin filaments is barely faster than that of bare filaments. In contrast, cofilactin barbed ends undergo an “unstoppable” depolymerization (depolymerizing for minutes despite the presence of free actin monomers and capping protein in solution), throughout our pH range. We thus show that, at physiological pH, the main contribution of ADF/cofilin to filament depolymerization is at the barbed end.
Comparisons of Ray-Tracing and parabolic equation Methods for the Large-Scale Complex electromagnetic Environment simulations

It is important for the wireless communication field to conduct research on large-scale complex electromagnetic environment (CEME) simulation. There exist many models for computing CEME simulation, including empirical models, half-empirical or half-deterministic models and deterministic models. Most of these models cannot obtain satisfactory results due to the limitation of the capacity of computers. The ray tracing (RT) and parabolic equation (PE) methods are very suitable for large-scale CEME simulation. Based on the introduction of RT and PE, qualitative comparisons of the two methods are analyzed in view of algorithm theory, the category of the model, solution to the model and the application field, and then four specific indices are focused on to analyze the computational complexity, accuracy, speed and parallelism in details. The numerical experiments are presented by the three-dimensional (3D) RT method employing the software of Wireless InSite (WI) and a quasi-3DPE method using the sliced method. Although both RT and PE methods can achieve high speedup using coarse-grained parallel computing, the experimental results indicate that the PE method can obtain a higher speed than the RT method, and the two methods can acquire an approximate precision. A hybrid procedure using both RT and PE methods can obtain a better result for solving CEME problems.
Sustained 52‐week efficacy and safety of triple therapy with dapagliflozin plus saxagliptin versus dual therapy with sitagliptin added to metformin in patients with uncontrolled type 2 diabetes

To compare the efficacy and safety of an intensification strategy of early triple combination therapy with dapagliflozin (DAPA) plus saxagliptin (SAXA) to a dual therapy strategy with sitagliptin (SITA) in patients with type 2 diabetes who are inadequately controlled with metformin (MET) monotherapy.