Miracle-dz/UniFAR-FTUs huggingface dataset:
A dry bone study of thoracic spine pedicle transverse diameters in a Kenyan population

Background: The size of the pedicle screw utilized in spinal fixation is determined by the transverse diameter of the pedicle at the isthmus. This diameter has not been documented in dry bone specimens in an African population. Objective: To determine the outer transverse diameter of the thoracic pedicles at the isthmus using a vernier caliper in a Kenyan population, and compare this with published literature. Methods: One hundred thoracic spine cadaveric specimens were studied at the National Museums of Kenya. The diameters of both right and left pedicles at the isthmus of all the twelve thoracic vertebrae in each specimen were measured directly using a vernier caliper. The results were summarized with measures of central tendency and compared with results from previous studies using the student’s t -test. Results: The mean transverse diameter of the pedicle measured at the isthmus was: 7.2mm at T1, 5.3mm at T2, 4.3mm at T3, 3.7mm at T4, 3.7mm at T5, 4.0mm at T6, 4.4mm at T7, 4.3mm at T8, 5.0mm at T9, 5.9mm at T10, 7.4mm at T11 and 7.6mm at T12. The overall range was 1.3mm to 12.3mm. These measurements were much smaller than those of European and American studies; but were comparable to those in Indian studies. Conclusions: The trend in diameter between T1 and T12 within a specimen is like in previous studies. The variability in pedicle diameter between specimens is marked, denoting heterogeneity in the study population. Recommendations: The pedicle diameter variability precludes a recommendation of the appropriate pedicle screw diameter to be used in surgery. Further studies on the influence of demographic factors on pedicle transverse diameter are recommended. Keywords: Thoracic pedicle morphometry, Diameter
Decision-Making in Gunshot Muskuloskeletal Injuries: A Systematic Review

BACKGROUND: From January 2015 until January 2017, the treatment of patients with gunshot musculoskeletal injuries performed by the authors in an urban Trauma Hospital of Rio de Janeiro brought some controversies about surgical methods in Emergency Orthopedic Surgery. Therefore, data were revised in the literature to establish decision making in the primary management of these injuries. QUESTION/PURPOSE: What are the aspects of decision-making in primary management of gunshot musculoskeletal injuries about fracture initial stabilization, soft-tissue management and antibiotic therapy? MATERIAL AND METHODS/ RESULTS: The authors researched individually the combination of the terms “Fractures”, “muskuloskeletal injuries”, “Gunshot”, “Management”, “Treatment”, “Trauma” and “Orthopedic Surgery” in MEDLINE, PUBMED, SCIELO and LILACS. 231 articles were related to Orthopedics and Traumatology. After criteria had been set, 15 articles were selected and organized in TABLES. CONCLUSION: Gustillo grade I and II fractures treatment is based on debridement, immediate/early definitive internal fixation, and antibiotic therapy. Gustillo grade IIIA fractures can be treated with debridement and antibiotic therapy, reobservation of soft tissue conditions followed by definitive osteosynthesis. Gustillo grade IIIB and IIIC fractures of the long bones and joints can be treated with initial debridement and delayed internal fixation. More high level studies are necessary to determine if it is advantageous external fixation prior to definitive treatment of these fractures.
Post Intra-Alveolar Extraction Analgesia of Bupivacaine and Lidocaine: A Randomized Controlled Clinical Trial

Objective: We examined the etiology of hyperkeratosis of the oral mucosa, focusing on antioxidant actions and oxidative stress related to the accumulation of oxidized and damaged molecules. Materials and Methods: The subjects were non-smoking females with squamous cell hyperplasia, oral lichen planus, epithelial dysplasia, or squamous cell carcinoma. Proteins were extracted from hyperkeratosis tissue specimens. Carbonylated proteins, serving as oxidative stress markers, were detected by western blotting and identified by nano-liquid chromatography-tandem mass spectrometry. In addition, we performed immunohistochemical staining of oral mucosa tissue sections using an anti-hexanoyl-lysine (HEL) antibody. Results: Several carbonylated proteins from hyperkeratosis tissue of the oral mucosa were detected by western blot and identified asalpha-actinin-1 isoform a, tumor rejection antigen (gp96) 1, alpha-actinin 4, and neutral alphaglucosidase AB isoform 3 precursors. On immunohistochemical staining with the anti-HEL antibody, the prickle to basal cell layers in cornified lesions were positive. These results indicate the presence of local oxidative stressinduced changes in hyperkeratosis tissues and suggest a new approach for treating oral mucosal keratotic lesions.
Acute Posterior Multifocal Placoid Pigment Epitheliopathy Sharing Characteristic OCT Findings of Vogt-Koyanagi-Harada Disease

A 17-year-old male presented with acute bilateral paracentral scotomata and blurred vision. Funduscopic examination showed bilateral macular serous retinal detachment and yellow-white placoid lesions at the level of retinal pigment epithelium. OCT study showed typical VKH disease findings with marked choroidal thickening and macular serous retinal detachment partly with subretinal septa in both eyes. FA demonstrated hypofluorescence at the placoid lesions in the early phase and hyperfluorescence in the late phase. Laboratory investigation showed negative result for HLA-DR4 serotype and the patient's cerebrospinal fluid test values were within normal range. We made the diagnosis of APMPPE from these results. At 2-month follow-up without the use of corticosteroids, OCT reexamination showed complete amelioration of subretinal fluid in both eyes. Patchy pigmentary lesions also resolved clinically with partial chorioretinal scars. The results in this case suggested OCT findings in APMPPE patients could be similar to characteristic features usually found in acute VKH disease. We recommend comprehensive assessments such as FA, cerebral spinal fluid analysis, and HLA typing which help in leading proper diagnosis.
Relationships between sleep patterns and metabolic profile in patients maintained on antipsychotics: a cross-sectional comparative study

Background Disturbances in sleep duration and quality have been associated with obesity and other metabolic changes. Patients with mental disorders (MD) are known to have more sleep problems, and antipsychotics (AP), used in the treatment of these patients, can also cause weight gain. This study aimed to compare the self-reported sleep patterns between psychiatric patients (on or off AP) and controls. We also evaluated the associations between the clinical and metabolic profiles with short or long sleep duration. Methods A total of 339 subjects was recruited: Mentally ill patients maintained on AP for at least six months (MD+AP, n=112), patients not taking AP for at least the last six months before enrollment (MD/noAP, n=101), and non-psychiatry controls (HC, n=126). Multinomial regression analysis was applied to find the predictors of irregular sleep duration in this sample. Results More mentally ill patients (MD+AP and MD/noAP) reported a sleep duration of >8 hrs than HC. Patients from MD/noAP showed more insomnia than HC. Sleep disturbances were significantly more frequent in MD+AP than HC. Participants who reported sleeping >8 hrs had higher body mass index and waist circumference than those who slept <7 hrs. Conclusion Female gender, central obesity and being mentally ill were independently associated with long sleep duration (>8h) in the population of Qatar.
Hematopoietic Stem Cell Transplantation in Primary Immunodeficiency Diseases: Current Status and Future Perspectives

Primary immunodeficiencies (PID) are disorders that for the most part result from mutations in genes involved in immune host defense and immunoregulation. These conditions are characterized by various combinations of recurrent infections, autoimmunity, lymphoproliferation, inflammatory manifestations, atopy, and malignancy. Most PID are due to genetic defects that are intrinsic to hematopoietic cells. Therefore, replacement of mutant cells by healthy donor hematopoietic stem cells (HSC) represents a rational therapeutic approach. Full or partial ablation of the recipient's marrow with chemotherapy is often used to allow stable engraftment of donor-derived HSCs, and serotherapy may be added to the conditioning regimen to reduce the risks of graft rejection and graft versus host disease (GVHD). Initially, hematopoietic stem cell transplantation (HSCT) was attempted in patients with severe combined immunodeficiency (SCID) as the only available curative treatment. It was a challenging procedure, associated with elevated rates of morbidity and mortality. Overtime, outcome of HSCT for PID has significantly improved due to availability of high-resolution HLA typing, increased use of alternative donors and new stem cell sources, development of less toxic, reduced-intensity conditioning (RIC) regimens, and cellular engineering techniques for graft manipulation. Early identification of infants affected by SCID, prior to infectious complication, through newborn screening (NBS) programs and prompt genetic diagnosis with Next Generation Sequencing (NGS) techniques, have also ameliorated the outcome of HSCT. In addition, HSCT has been applied to treat a broader range of PID, including disorders of immune dysregulation. Yet, the broad spectrum of clinical and immunological phenotypes associated with PID makes it difficult to define a universal transplant regimen. As such, integration of knowledge between immunologists and transplant specialists is necessary for the development of innovative transplant protocols and to monitor their results during follow-up. Despite the improved outcome observed after HSCT, patients with severe forms of PID still face significant challenges of short and long-term transplant-related complications. To address this issue, novel HSCT strategies are being implemented aiming to improve both survival and long-term quality of life. This article will discuss the current status and latest developments in HSCT for PID, and present data regarding approach and outcome of HSCT in recently described PID, including disorders associated with immune dysregulation.
Oridonin overcomes the gemcitabine resistant PANC-1/Gem cells by regulating GST pi and LRP/1 ERK/JNK signalling

Background: Chemotherapy remains a primary treatment method for advanced pancreatic cancer. However, chemotherapy resistance can influence the therapeutic effect of pancreatic cancer. The resistance mechanism of chemotherapeutic agents such as gemcitabine, which is an agent typically used to treat pancreatic cancer, is complicated and can be influenced by genes and the environment. Oridonin is a tetracyclic diterpenoid compound extracted from the traditional Chinese herb Rabdosia labtea. Oridonin may overcome drug resistance in pancreatic cancer, but researching pancreatic cancer drug resistance of chemotherapy by oridonin is not completely understood. Purpose: The present study aimed to assess the impact of oridonin on multidrug resistance proteins, apoptosis-associated proteins and energy metabolism in gemcitabine-resistant PANC-1 (PANC-1/Gem) pancreatic cancer cells. Methods: Gemcitabine resistance in PANC-1/Gem cells was induced using a concentration gradient of gemcitabine. Cell Counting Kit-8 assays were used to detect the impact of gemcitabine and oridonin on the proliferation of PANC-1 and PANC-1/Gem cells. Western blot analysis and immunofluorescence were used to detect the expression of multidrug resistance proteins, apoptosis-associated proteins and low-density lipoprotein receptor protein 1 (LRP1) proteins in PANC-1/Gem cells. The effects of gemcitabine and oridonin on PANC-1/Gem cells apoptosis were detected using flow cytometry. Animal xenograft tumor assays were used to detect the effect of gemcitabine and oridonin on pancreatic cancer in vivo. Furthermore, the ATP Assay kit was used to determine the effects of gemcitabine and oridonin on ATP levels in PANC-1/Gem cells. Immunofluorescence assays were used to detect the effects of gemcitabine and oridonin on the expression of low-density lipoprotein receptor protein 1 (LRP1) in PANC-1/Gem cells. In addition, LRP1 expression was knocked down in PANC-1/Gem cells via lentiviral vector-mediated RNA silencing. Clone formation assays and Western blot analysis were used to detect the effect of LRP1 knockdown on the proliferation of PANC-1/Gem cells. Results: The present results demonstrate that oridonin overcomes PANC-1/Gem cells gemcitabine reistance by regulating GST pi and LRP1/ERK/JNK signaling. Conclusion: In conclusion, the present study indicated that oridonin could overcome gemcitabine resistance in PANC-1/Gem cells by regulating GST pi and LRP1/ ERK/JNK signaling, inducing cell apoptosis. Therefore, oridonin with gemcitabine may be a promising preoperative treatment for patients who suffer from pancreatic cancer.
The efficacy of internet-based cognitive behavior therapy on blood pressure for comorbid hypertension and insomnia

Objective To evaluate the effectiveness of internet-based cognitive behavior therapy (CBT-I) on blood pressure in patients with hypertension comorbid with insomnia. Methods One hundred and six patients met the JNC-8 diagnostic criteria for hypertension and DSM-5 diagnostic criteria for insomnia were selected, and randomly assigned to CBT-I group (n=53) and regular treatment group (n=53). All the patients accepted relevant treatment for 8 consecutive weeks. Changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), the sleep parameters and the anxiety and depression levels were observed between baseline and 8 weeks of follow-up. Results Compared with pre-treatment, SBP and DBP decreased significantly in both CBT-I group and regular treatment group (P<0.01), the decrease was more significant in CBT-I group than in regular treatment group (P<0.01). The sleep latency, sleep efficiency, bed time and rating anxiety scale were improved more significantly in CBT-I group than in regular treatment group (44.49±22.75min vs. 55.50±34.96min; 72.31%±9.15% vs. 57.70%±11.53%; 302.65±43.76min vs. 262.70±50.64min and 17.14±6.45 vs. 21.02±6.64, respectively), the differences were of statistical significance (P<0.05). In addition, no significant difference was found in the level of depression between CBT-I group and regular treatment group. Conclusion CBT-I can effectively shorten sleep latency, improve sleep efficiency, extend bed time and improve anxiety, meanwhile effectively lower the blood pressure of patients with hypertension comorbid with insomnia by optimizing sleep quality. DOI: 10.11855/j.issn. 0577-7402.2017. 04.11
Diagnostic and Predictive Value of Some Tumor Markers in the Diagnosis and Follow Up of Patients with Hepatocellular Carcinoma

Early detection of hepatocellular carcinoma (HCC) is essential for successful treatment. Although the role of alpha fetoprotein (AFP) in the diagnosis of advanced HCC is well recognized, at least one third of small HCCs and 15–20% of advanced HCC will be missed unless another diagnostic tool is used. Thus, new serologic markers with sufficient sensitivity and specificity are required. In the present study, we aimed at evaluating the diagnostic and prognostic role of AFP, protein induced by vitamin K absence or antagonist(P1VKA-II), vascular endothelial growth factor (VEGF), sialic acid, alpha-L-fucosidase (AFU) and transforming growth factor-beta 1 (TGF-β1) in the diagnosis and follow up of Egyptian patients with hepatocellular carcinoma in an attempt to find a tumor marker with a reasonable sensitivity and specificity for diagnosis of HCC and monitoring patients after therapy. The study was conducted on 4 selected groups of patients and a control group. Group I included 10 patients with liver cirrhosis. Group II consisted of 10 patients with benign hepatic focal lesions. Group III included 10 HCC patients without distant metastasis and group IV included 10 HCC patients presenting with metastasis. Ten apparently healthy age and sex matched subjects were also included and served as control group. AFP, sialic acid, alpha-L-fucosidase (AFU), VEGF, PIVKA-II and TGFβ1 were determined in the blood of five studied groups. The sensitivity and specificity of the tumor markers were calculated and compared. Significant differences in the median blood levels of AFP, PIVKA-II, VEGF, sialic acid, TGFβ1 and alpha-Lfucosidase activity (AFU) were found on comparing the HCC groups (with and without metastasis) with the other groups. The median blood levels of PIVKAII, αfetoprotein level, sialic acid and AFU activity were lower in the HCC group without metastasis compared to that with metastasis (p<0.001). On the other hand, the median serum VEGF level was higher in the HCC group without metastasis compared to that of the HCC group with distant metastasis(p<0.001). Serum TGFβ1 level did not vary significantly between both groups (with and without metastasis) (p>0.05). There were significant lower median blood levels of all parameters in HCC patients without metastasis after ablation therapy compared to pretreatment levels. Combined determination of serological markers could be used as a highly valuable tool for screening and diagnosis of HCC as combination of these markers improved their sensitivity and specificity. They could also be used as prognostic markers decreasing the need for more invasive procedures. Bull. Egypt. Soc. Physiol. Sci. 29 (2) 2009 Abdel-Aleem et al.
Energy System Development in the Weight Room: Incorporating Prescribed Rest Periods for NCAA Men's Basketball Players

TRAINING PROGRAMSOFTEN VARY SETS AND REPS TO ACHIEVE DIFFERENT TRAINING GOALS. REST IS NOT OFTEN PROGRAMMEDWITHIN AN ANNUAL TRAINING CYCLE BUT CAN BE PRESCRIBED IN RESISTANCE TRAINING SESSIONS TO FURTHER DEVELOP ENERGY SYSTEMS DEMANDED BY SPORT. SPECIFICALLY, BASKETBALL INCLUDES INTERMITTENT PERIODS OF MODERATE TO HIGH INTENSITY, DERIVING MOST OF ITS ENERGY FROM THE ADENOSINE TRIPHOSPHATEPHOSPHOCREATINE AND ANAEROBIC GLYCOLYTIC SYSTEMS. BY IDENTIFYING SPECIFIC WORK:REST RATIOS INBASKETBALL, STRENGTH COACHES CAN PRESCRIBE LOGICAL REST PERIODS WITHIN A WEIGHT TRAINING SESSION. NOT ONLY WILL THIS ENHANCE OVERALL ENERGY SYSTEM DEVELOPMENT, BUT WILL ALSO PROVIDE MORE STRUCTURE TO STRENGTH TRAINING ROUTINES.
ASAP3 is a downstream target of HIF-1α and is critical for progression of lung adenocarcinoma

Background: ASAP3 was first identified as a protein that promotes cell proliferation in hepatocellular carcinoma and later reported to be an Arf6-specific Arf GTPase-activating protein that regulates cell migration associated with cancer cell invasion. Materials and methods: Patients and tissue samples were from Hubei Cancer Hospital, human lung adenocarcinoma cell lines were obtained from the cell bank of the Chinese Academy of Science, nude mice (BALB/c nu/nu) were obtained from Shanghai SLAC Laboratory Animal Co. Ltd. Our methods contained immunohistochemistry, Western blotting, reverse-transcription polymerase chain reaction (RT-PCR), immunofluorescence staining, stable transfection of lung adenocarcinoma cells, chromatin immunoprecipitation (CHIP) and luciferase assay, wound healing and cell migration assay. Results: In this study, we show that ASAP3 overexpression promotes migration and invasiveness in human lung adenocarcinoma cells and accelerates tumor progression in a xenograft mouse model. In patient tumor samples, ASAP3 overexpression was significantly associated with lymph node metastasis and reduced overall survival. We also show that ASAP3 expression is induced under hypoxic conditions through hypoxia-inducible factor 1α (HIF-1α), which binds directly to HER1 or/and HER2 (hypoxia response element) in the ASAP3 promoter. ASAP3 overexpression counteracts the inhibition of lung adenocarcinoma progression caused by HIF-1α knockdown both in vitro and in vivo. Conclusion: Our results identify ASAP3 as a downstream target of HIF-1α that is critical for metastatic progression in lung adenocarcinoma.
The Effect of Traditional Music Therapy on Blood Pressure Among Elderly with Hypertension: A Literature Review

Background: Elderly as one of vulnerable population has experienced several risk of cardiovascular system disturbance such as hypertension. Hypertension be non communicable disease most suffered elderly in some countries. Objective: This literature review aimed at describing the effect of traditional music therapy on blood pressure among elderly with hypertension. Method: This study carried out from databases such as EBSCOhost, Scopus, Pubmed, ProQuest, Science Direct and Sage with limited years of an article published in the last ten years (2008-2018). Result: Fifteen most relevant articles were extracted in this study and found that traditional music therapy provide a positive effect to decrease blood pressure’s elderly with hypertension and this finding explained clearly with Roy’s Adaptation Model. Conclusion: Traditional music therapy provides a positive effect in lowering blood pressure’s elderly with hypertension. This therapy can be given as single intervention or collaboration with other non pharmacological therapy such as calisthenics, breathing exercises, muscle relaxation, lifestyle modifications and walking-based exercise.
CLINICAL AND HEMATOLOGICAL EFFECTS OF HYDROXYUREA THERAPY IN MANAGEMENT OF SICKLE CELL ANEMIA

Background: The most predominant form of haemoglobinopathy worldwide is sickle cell disease. The greatest burden of the disease lies in sub-Saharan Africa and Asia5. Objective: To evaluate the effectiveness of HU therapy in sickle cell disease as measured by decrease in crises rate, hospital admissions, days of hospitalization and number of blood transfusions. Methods: the study was conducted on 79 children of 1-16 year age. Out of which in only 75 patients Hydroxyurea therapy was started as they were found to be eligible. 16% of the patients responded to 15 mg/kg/ day of HU, 50.66% responded to 20 mg/kg/ day, 29.33% to 25 mg/kg/ day and only 4% needed a dose escalation to 30 mg/kg/ day for the response. Results: Our study showed a significant reduction in the VOC rate from 243 episodes to 46 episodes (p value <0.001), the number of ACS reduced from 37 episodes to 5 episodes (p value <0.001), also there is a significant decline in the rates of hemolytic crises from 63 episodes to 10 episodes per year, Significant increase in the HbF levels from 15.87±5.50% to 21.77. ±4.06% (p value <0.001). There was a definite and significant reduction in the number of hospitalization days from 7.76±4.76 to 3.79±2.29 days and in the number of admissions per year dropped significantly from 4.80 ± 1.41 to 1.42± 0.61 per year. Conclusion: Hydroxyurea reduced the frequency of painful crises and diminished the number of hospitalization, transfusion, and episodes of acute chest syndrome17. Keywords: Haemoglobin (Hb), Hydroxyurea (HU), Mean Corpuscular Volume (MCV), Pletelet Counts, Sickle Cell Disease (SCD), White Blood Cells (WBC).
Knowledge mining: An approach using comparison of data cleansing tools

Abstract Data Cleaning is a process to improve the quality of the data by adding few factors like removing missing values from the database, removing delicacy, correcting inconsistent data, data acquit ion and noisy data etc. we have also discussed how to remove missing data and various problems which arise due to the date formats as different systems have different set of date formats in which date is stored.