Miracle-dz/UniFAR-FTUs huggingface dataset:
Change in corneal endothelial cell density after phacoemulsification in patients with type II diabetes mellitus

Objective: To compare the mean change in Corneal Endothelial cell Density (CED), from baseline (pre-operative value), two months after phacoemulsification cataract surgery between type II diabetic patients and non-diabetic patients. Methods: This prospective stratified controlled study was conducted at PNS Shifa Hospital, Karachi. 80 eyes of 72 type II diabetic patients and 80 eyes of 77 non diabetic controls, having Nuclear Opalescence (NO) grades 2 and 3 on slit lamp examination underwent phacoemulsification surgery. CED was measured in cells/mm2, of concerned eye of each subject preoperatively and 2 months post operatively using specular microscope. The difference in mean CED change between the two groups after surgery was analyzed. Results: Mean age of study population was 61.41± 6.76 years. Out of study population, 92 (57.5%) were males and 68 (42.5%) were females. There was a statistically significant difference between both groups in terms of mean post-operative CED, mean change in CED and mean frequency change in CED (p <0.05). There was no statistically significant difference between both groups in age, gender, laterality of eyes and mean pre-operative CED, (p >0.05). Difference of pre-operative CED from post-operative CED in each group was statistically significant. Conclusion: There is a significant difference between diabetic population and normal population in terms of corneal endothelial loss after uneventful phacoemulsification cataract surgery.
Antitumor effect of kurarinone and underlying mechanism in small cell lung carcinoma cells

Background Kurarinone, a prenylated ﬂavonone isolated from the roots of Sophora ﬂavescens, is known to be cytotoxic against many human cancer cells but not human small cell lung carcinoma (SCLC) yet. Also, the exact molecular mechanism of kurarinone for induction cytotoxicity remains unknown. Material and methods We investigated the effects of kurarinone on cell proliferation, apoptosis, and migration in H1688 SCLC cells. Cell viability was determined by the MTT assay. Apoptotic indices such as cell cycle, mitochondrial membrane potential, cytochrome c release, caspase activity, and death receptors were evaluated by flow cytometry. Transwell migration and invasion assays were also included. Results Our results indicated that kurarinone significantly decreased H1688 cell viability and induced the accumulation of sub-G1 fractions by activating caspase-3, -9, and PARP cleavage accompanied by the elevated release of cytochrome c and mitochondrial dysfunction in H1688 cells. Additionally, kurarinone promoted Fas and TRAIL receptor-1 and -2 expression via the caspase-8/Bid pathway, suggesting that kurarinone triggered apoptosis via the mitochondria-mediated and receptor-mediated apoptotic pathways. We also observed that kurarinone repressed migration and invasion capabilities of SCLC cells by suppressing the expression of epithelial-mesenchymal transition-related proteins and matrix metalloproteinases. Conclusion Our findings provided evidence that kurarinone can induce apoptosis in SCLC cells via multiple mechanisms and delayed the cell migration and invasion of SCLC cells.
Effectiveness of four oral antifungal drugs (fluconazole, griseofulvin, itraconazole, terbinafine) in current epidemic of altered dermatophytosis in India: A randomized pragmatic trial

Background: Dermatophyte infections have undergone unprecedented changes in India in recent past. Clinical trials comparing effectiveness of 4 main oral antifungal drugs are not available. We tested effectiveness of oral fluconazole, griseofulvin, itraconazole and terbinafine in chronic and chronic-relapsing tinea corporis, tinea cruris and tinea faciei. Methods: Two hundred microscopy confirmed patients were allocated to 4 groups, fluconazole (5mg/kg/day), griseofulvin (10 mg/kg/day), itraconazole (5mg/kg/day), and terbinafine (7.5mg/kg/day), by concealed block randomization and treated for 8 weeks or cure. Effectiveness was calculated based on intention to treat analysis. Results: At 4 weeks, 4, 1, 2, and 4 patients were cured with fluconazole, griseofulvin, itraconazole and terbinafine, respectively (P=0.417). At 8 weeks, 21 (42%), 7 (14%), 33 (66%) and 14 (28%) patients were cured, respectively (P=0.000); itraconazole was superior to fluconazole, griseofulvin and terbinafine (P[≤]0.016). Relapse rates after 4 and 8 weeks of cure in different groups were similar. Numbers-needed-to-treat (NNT) (versus griseofulvin), calculated based on cure rates at 8 weeks, for itraconazole, fluconazole, and terbinafine were 2, 4 and 8, respectively. Conclusion: In view of cure rates and NNT, itraconazole is the most effective drug, followed by fluconazole (daily), terbinafine and then griseofulvin, in chronic and chronic-relapsing dermatophytosis in India.
‘My desire to play was stronger than my fear of re-injury’: athlete perspectives of psychological readiness to return to soccer following anterior cruciate ligament reconstruction surgery

ABSTRACT The aims of this qualitative study were to understand how athletes (a) defined psychological readiness and (b) knew when they were ready to return to soccer following anterior cruciate ligament (ACL) reconstruction surgery. Data were collected from a group of 21 (male and female) athletes who had undergone ACL reconstruction surgery and returned to playing soccer. An open-ended, in-depth online survey was created to gather data on athlete understandings of psychological readiness, their experiences of overcoming psychological barriers when returning to sport, and any emotions or complications associated with their return to sport. Two main themes were uncovered in this study: ‘Having Confidence’ and ‘Love of the Game’. This research offers a greater understanding of how psychological readiness is defined from the perspective of soccer players, (particularly those returning to lower levels of competition, such as local and regional amateur clubs), than has been found in previous research.
Identification of signalling pathways involved in the oxidative stress response triggered by Low Temperature Plasma in prostate epithelial cells and the assessment of tumour-associated allelic expression in prostate cancer

Pairing of cancer genome and transcriptome data has revealed that heterozygous mutations aren’t always expressed in cells. The potential for point mutation or genomic rearrangement to alter tumour allelic expression has implications for understanding cellular heterogeneity and application of treatments. Mutation of SPOP, PTEN and IDH-1 was assessed in 51 primary prostate cancer cultures to establish allelic heterozygosity and ascertain whether oncogenic change to coding regions altered allelic expression. No mutations were detected in the three genes, although 18% of tested cultures had loss of heterozygosity in PTEN. The TMPRSS2-ERG fusion, present in half of all prostate cancers, is selectively expressed at an allelic level by cancer stem cells. Monoallelic expression didn’t correlate with TMPRSS2 promoter hypermethylation. Prostate cultures expressed fusion transcript, however epigenetic features of monoallelically expressed genes were not investigated in the epithelial subpopulations. Understanding of allelic chromatin states may inform treatment strategies that permit tumour suppressor expression or oncogenic protein repression. Inability to predict indolent or aggressive progression of organ-confined prostate cancers has created the problem of surgical overtreatment. Focal therapies targeting the tumour core are being met with increasing rates of recurrence, necessitating development of novel treatments. The anti-cancer properties of Low Temperature Plasma (LTP) are being explored in prostate models where it produces autophagy and necrosis through generation of reactive species. Initial gene expression response to LTP and the activation of upstream transcription factors were analysed. LTP activated Nrf2, AP-1 and Notch signalling in patient matched prostate normal and cancer cultures. The progenitor-containing cell fraction was more responsive to LTP than differentiated epithelial cells in both transcription of response genes and nuclear accumulation of active Notch1. When linked to cell-fate outcomes, these immediate molecular responses of prostate cancer to LTP could be used as hallmarks of resistance or treatment efficacy in patients.
Right Ventricular Function in Heart Failure Patients with Normal Left Ventricular Size: Analysis by Conventional Echocardiographic Parameters and Magnetic Resonance Imaging

Background: Hypokineticnon-dilatedcardiomyopathy(HNDC)isasubgroupof dilatedcardiomyopathy(DCM)spectrum,known by left ventricular (LV) systolic dysfunction despite normal LV size. Objectives: Inthisstudy,wearegoingtoevaluaterightventricular(RV)functioninthesepatientsasanimportantprognosticfactor in HF patients. Methods: 31 HNDC patients were enrolled in the study. RV function was evaluated by TTE using RV dysfunction score calculated as the summation of TAPSE, RV S’, RVMPI, and RVFAC scores. Ultimately, echocardiographic data were compared to right ventricular ejection fraction (RVEF) obtained from cardiac magnetic resonance imaging (CMR). Results: The prevalence of RV at dysfunction was estimated at 47.3%. Furthermore, we found a strong negative correlation between RV dysfunction score and CMR-RVEF. Conclusions: RV S’, RVFAC, and RVMPI would oﬀer an appropriate assessment of RV function in HNDC group. HNDC population exhibited RV dysfunction as prevalent as DCM patients reported in other
Suplementação energética para vacas de descarte de diferentes idades em terminação em pastagem cultivada de estação fria sob pastejo horário

The experiment was conducted to evaluate the effect of energy supplementation on the performance of finishing cull cows under temporary grazing on triticale plus ryegrass. The energy supplement was ground sorghum in the levels of 0, . 3, . 6 and . 9% of the live weight. Forty Charolais cull cows were divided in age classes and randomly distributed on the supplementation levels. No interaction was observed between age of the cow and supplementation level. The increase of supplementation level did not affect the average daily weight gain (ADG), which was 1.483, 1.437, 1.476 and 1.510 kg for the levels from 0 to . 9%, respectively. The results showed that the pasture supplied the nutrients for the animals express the maximum potential for weight gain. The final body condition linearly increased as the supplementation level increased. The ADG was higher for the four year old cows (1.608 kg), linearly declining with the increase of age, reaching 1.333 kg for the cows above nine years old. Body condition showed a quadratic relation with age, improving up to seven/eight years and declining afterward.
Optimal duration of dual antiplatelet therapy after drug-eluting stent implantation: a network meta-analysis

: Objectives: There has been much debate regarding the optimal duration of Dual antiplatelet therapy (DAPT) cover after Drug eluting stent (DES) implantation. We aimed to assess the relative benefits between the shorter and longer durations of DAPT coverage. Methods: We performed a Network Meta-analysis (NMA) of all the randomized clinical trials (RCT) comparing different time durations of DAPT cover Results: We included 11 unique trials with a total of 33458 patients, the longest duration of follow up was 48 months while the shortest was 3 m. Network meta analysis results demonstrated that compared with 12 months, longer DAPT therapy of 30 months reduced the hazard ratio (HR) of stent thrombosis (HR: 0.29, 95% CrI = 0.17 to 0.49). There was no difference in mortality between short and longer durations of DAPT except for 30 vs 48 months (HR 0.48, 95% CrI 0.23 to 0.98). Compared with 12 months, longer DAPT therapy of 30 months reduced the risk of myocardial infarction (HR: 0.47, 95% CrI = 0.37 to 0.61). Results also demonstrated that compared with 12 months, a shorter term DAPT therapy reduced the risk of major bleeding (6 months: HR 0.53: 95% CrI = 0.29-0.98) while longer DAPT therapy increased major bleeding (30 months: HR: 1.61, 95% CrI = 1.21 - 2.15). As expected bleeding is less in the shorter duration regimens while the ischemic outcomes are better on the longer duration.
Serum gamma-glutamyl transferase level in acute stroke

Background: Stroke is the second leading cause of death worldwide, causing 6.2 million deaths in 2011. Serum Gamma-Glutamyl Transferase (GGT) has been conventionally considered as a marker of excessive alcohol intake and/or liver dysfunction. There are accumulating evidences suggesting association of raised serum GGT level in stroke. So, this study was conducted to determine the association between the serum GGT level and stroke in population without history of alcohol consumption.Methods: This cross-sectional comparative study was carried out at Department of General medicine, Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla from November 2016 to October 2018. 100 cases and 100 controls were included in this study. Cases were the patients admitted to Department of General Medicine, VIMSAR, Burla, presenting within 24 hours of first episode of stroke. Controls were the age (+/-5 years) and sex matched healthy attendants of the patients. Alcoholics or patients suffering from hepatitis, cirrhosis of liver, cholestasis or patients taking drugs like Phenytoin, Valproic acid, Carbamazepine etc or patients with past episode of stroke were excluded from this study. Serum GGT level of both cases and controls were measured and compared.Results: In stroke patients, the mean serum GGT level was 54.95 IU/L with standard deviation of 20.54. In controls, the mean serum GGT level was 32.14 IU/L with standard deviation of 5.07. The p-value was less than 0.0001 i.e. highly significant.Conclusions: Serum GGT level is significantly increased in stroke patients than healthy persons without stroke.
Bushehr University of Medical Sciences physicians: Role of individual, organizational and technical factors affecting knowledge sharing

The main purpose of sharing knowledge is to provide the necessary ground for realization of knowledge management, and then, a transformation of organization knowledge into an effective organizational source. The purpose of this study was to determine the role of individual and organizational technical and cultural factors affecting knowledge sharing among physicians of BUMS, in 2017. This is a descriptive-analytical survey where a self-administered questionnaire is used as a research tool. The research population is constituted of 30 general practitioners, 124 specialists and sub-specialist, and 30 fellowships. Sampling is performed by proportional stratified random method. The results are analyzed SPSS software, version 19. The findings of this study indicated that, in respective order, individual factors, with mean value of 3.54, and cultural factors, with mean value of 3.47, have the highest and lowest effect on knowledge sharing of physicians of BUMS in 2017. In the meanwhile, credit gain index in the organization with mean value of 3.88, and the loss of individual power with mean value of 2.88 have the highest and the lowest impact on knowledge sharing of this group, respectively. According to the findings of this study and positive attitude of physicians of BUMS toward knowledge sharing and its role in obtaining academic authority, it is worthwhile for health and medical educators to pay more attention to this issue and ask medical informants and librarians’ help to promote knowledge sharing. This article assessed the role of knowledge sharing among BUMS’ physicians which is based on their viewpoints and the role of medical informants in 2017, whose data have been collected using a quantitative and descriptive-analytic method. Key words: Medical informants, knowledge sharing, knowledge management, cultural factors, academic authority, BUMS.
Magnetically controlled protein nanocontainers as a drug depot for the hemostatic agent

Purpose Currently, there is a number of successfully implemented local hemostatic agents for external bleedings in forms of wound dressings and other topical materials. However, little has been done in the field of intravenous hemostatic agents. Here, we propose a new procedure to fabricate biocompatible protein nanocontainers (NCs) for intravenous injection allowing magneto-controllable delivery and short-term release of the hemostatic agent ε-aminocaproic acid (EACA). Methods The nanocontainers were synthesized by the desolvation method from bovine serum albumin (BSA) using methanol without any further crosslinking. Polyethylene glycol (PEG) was used both as a stabilization agent and for size control. Characterization of nanocontainers was performed by the transmission and scanning electron microscopy, dynamic light scattering, X-ray diffraction, and FTIR spectroscopy. Cytotoxicity was estimated using MTT assay. The dopant release from nanocontainers was measured spectrophotometrically using rhodamine B as a model molecule. The specific hemostatic activity was assessed by analyzing clot lysis and formation curve (CloFAL). Moreover, the ability for magneto targeting was estimated using the original flow setup made of a syringe pump and silicon contours. Results Fabricated nanocontainers had an average size of 186±24 nm and were constructed from building blocks–nanoparticles with average size ranged from 10 to 20 nm. PEG shell was also observed around nanocontainers with thickness 5–10 nm. NCs were proved to be completely non-cytotoxic even at concentrations up to 8 mg BSA/mL. Uptake capacity was near 36% while release within the first day was 17%. The analysis of the CloFAL curve showed the ability of NCs to inhibit the clot lysis successfully, and the ability of magneto targeting was confirmed under flow conditions. Conclusion The ability of synthesized NCs to deliver and release the therapeutic drug, as well as to accumulate at the desired site under the action of the magnetic field was proved experimentally.
Relationship Between Obstructive Sleep Apnoea and AF

With the growing obesity epidemic, the global burden of AF and obstructive sleep apnoea (OSA) is increasing at an alarming rate. Obesity, age, male gender, alcohol consumption, smoking and heart failure are common risk factors for both AF and OSA and they are independently associated with adverse cardiovascular outcomes. Weak evidence from observational studies link OSA to the development of AF. Hypoxia/hypercapnia, systemic inflammation and autonomic nervous system modulation are biological mechanisms that link OSA to AF. Patients with OSA have a poor response to catheter ablation of AF and often suffer recurrences. Observational data shows that continuous positive airway pressure is associated with a reduction in AF burden and a better response to catheter ablation of AF. However, prospective randomised studies are needed to confirm the usefulness of continuous positive airway pressure in the treatment of AF in patients with OSA.
Prediction of Late Breast Cancer-Specific Mortality in Recurrence-Free Breast Cancer Survivors Treated for Five Years with Tamoxifen

Purpose The extension of endocrine therapy beyond 5 years for recurrence-free survivors of breast cancer improves survival; however, the issue on how to clinically identify appropriate candidates remains controversial. This study aimed to identify prognostic factors for breast-cancer-specific mortality in patients who have had 5 years of tamoxifen treatment and categorize subgroups based on the risk of death using combinations of these prognostic factors to assist in the clinical decision to perform further endocrine therapy. Methods In total, 3,158 patients with breast cancer were enrolled. Breast cancer-specific survival rates after 5 years of tamoxifen treatment were calculated, and associated prognostic factors were analyzed using a Cox proportional-hazards model. Results An age extreme at diagnosis (i.e., < 40 or ≥ 60 years), tumor size > 2 cm, and positive lymphovascular invasion were robust independent prognostic factors for late breast cancer-specific death in tamoxifen-treated patients (hazard ratio [HR] = 2.162, 1.739, and 1.993; p = 0.001, 0.047, and 0.011, respectively). Lymph node metastasis and progesterone receptor negativity had borderline significance in this regard (HR = 1.741 and 1.638, p = 0.099 and 0.061). The study patients were classified into four groups according to the number of prognostic indicators, i.e., low, intermediate, high, and extremely high risk. The additional 5- and 10-year cumulative risks of breast cancer-specific death were 0.8% and 1.5% in the low-risk group, 0.9% and 3.9% in the intermediate-risk group, 1.3% and 7.3% in the high-risk group, and 4.8% and 13.8% in the extremely high-risk group, respectively. Conclusion This new risk stratification system for late mortality in breast cancer can be used to identify the right candidates for extended endocrine therapy after 5 years of tamoxifen treatment.
The Difference of Angiopoietin-2 Levels between Dengue Hemorrhagic Fever Patients with Shock and without Shock

BACKGROUND: Dengue infection is one of the problems in the national health sector in Indonesia because the incidence and mortality in Indonesia due to dengue infection is still very high. In 2005 Indonesia became the highest contributor to dengue infection in Southeast Asia (53%) with 95.270 people and 1.298 deaths. AIM: This study aims to analyse differences in angiopoietin-2 levels in dengue hemorrhagic fever (DHF) with and without shock. METHODS: This study was a consecutive sampling design with the research subject was obtained based on the order of admission to the hospital — the serum Angiopoietin-2 levels using the ELISA method. The statistical test used is the independent t-test. The value of p < 0.05 was said to be statistically significant. RESULT: The result showed that the mean of Angiopoietin-2 levels in DHF patients with shock was higher than in DHF (p < 0.05). CONCLUSION: This study concluded that there was a difference in the average level of Angiopoietin-2 among DHF patients with shock compared to without shock.
Marked influence of adiposity on laboratory biomarkers in a healthy cohort of children and adolescents.

BACKGROUND The prevalence of pediatric obesity is increasing worldwide and strongly associates with metabolic abnormalities, including inflammation, insulin resistance and dyslipidemia. This study assessed the influence of three measures of adiposity on levels of routinely assessed biochemical markers in apparently healthy children and adolescents. METHODS The influence of adiposity on 35 biochemical markers were examined in the CALIPER (Canadian Laboratory Initiative on Pediatric Reference Intervals) cohort of healthy children and adolescents by comparing serum biomarker levels between subjects with a normal weight, overweight, and obese BMI. The cohort was comprised of 1,332 subjects ages 5.1-19.0 years with BMI ranging from 13.4-65.0 kg/m2. The association between each biochemical marker and BMI, WC and WHtR z-scores was assessed, while adjusting for age and sex. Reference intervals were established for all biochemical markers before and after removing overweight/obese subjects. RESULTS In children and adolescents, levels of 13 routinely assessed biochemical markers, including ALT, apoB, C3, C4, ChE, hsCRP, GGT, haptoglobin, HDL-C, iron, transferrin, triglycerides, and uric acid, were significantly differed between BMI categories. BMI, WC, and/or WHtR significantly associated with serum concentration of 24 of the 35 markers examined, after adjusting for age and sex. CONCLUSIONS Excess adiposity significantly influences circulating levels of routinely assessed laboratory markers, most notably liver enzymes, lipids/lipoproteins, inflammatory markers and uric acid, in children and adolescents. While it is unknown whether altered biochemical marker levels in subjects with overweight/obesity reflect health or indolent disease, clinicians should be aware of the effect of weight status on several laboratory tests.