Miracle-dz/UniFAR-FTUs huggingface dataset:
Glutamine on critical-ill patients: a systematic review and meta-analysis.

BACKGROUND To conduct a meta-analysis of the effect of glutamine supplements on prognosis in adult critical-ill patients. METHODS We searched the Web of Science, Cochrane library, PubMed, the Wanfang Database, and the China National Knowledge Infrastructure (CNKI)/CBMdisc database. The primary outcome was hospital mortality, or if not reported, 28-day/6-month/intensive care unit (ICU) mortality. The secondary outcomes were duration of mechanical ventilation (MV), length of stay (LOS) in the ICU, LOS in the hospital, and nosocomial infections. RESULTS In 599 related articles, 47 randomized controlled trials, including 6,198 patients, met all the inclusion criteria. Hospital mortality was not significantly different between the glutamine group and the control group. Length of MV was significantly higher in the control group than that of the glutamine group. In a subgroup analysis of severely burned patients, hospital mortality had the same trend. In other subgroups, there was no significant difference between the two groups. CONCLUSIONS We suggest that supplemental glutamine need not be routinely added to the diet of criticalill patients to reduce hospital mortality, with the exception of the diet of severely burned patients.
Measuring addiction to internet gaming among Indian medical students: Development and preliminary psychometric properties of a new scale

Background: Internet gaming disorder (IGD) is emerging as an important source of behavioral addiction in young people globally. Objective: The aim of this study was to assess addiction to internet gaming in medical students using a self designed research instrument. Materials and Methods: We conducted a cross-sectional study and enrolled 264 male and 160 female MBBS students (n = 424) in Delhi, India. The study instruments included: a 2-item Internet gaming screening questionnaire (IGSQ), a 14-item self-designed Internet gaming addiction scale (IGAS) to measure addiction-like behavior associated with multiplayer Internet gaming, and the Pittsburgh Sleep Quality Index to measure sleep quality. Results: After preliminary screening, 91 male and 6 female participants were found to be multiplayer Internet gamers, and were further assessed using the 14-item IGAS. The Cronbach's alpha of the IGAS was 0.879. Principal component analysis revealed a three-component IGAS structure based on eigenvalue cutoff (>1), loading score >0.4, and inspection of the scree-plot that explained 66.71% of the total variance. The IGAS score and the average weekly gaming time of the participants showed a moderate positive correlation (r = 0.45, P < 0.001). Only 17 (4.0%) participants reported agreement/strong agreement across ≥5 domains of addiction. The mean (standard deviation) IGAS score was significantly higher in the participants reporting poor sleep quality (PQSI > 6) (P = 0.047). Conclusion: IGD has low prevalence among medical students, and the problem is negligible among female students. The 14-item IGAS, in conjunction with the 2-item IGSQ, are reliable and valid tools for the assessment of IGD.
CAR‐T TREK through the lymphoma universe, to boldly go where no other therapy has gone before

Chimeric antigen receptor (CAR) T cells (CART) therapies have changed and continue to change the treatment paradigms for B‐cell malignancies because they can achieve durable complete remission in patients in whom multiple lines of treatment have failed. These unprecedented results have led to the widespread use of anti‐CD19 CART therapy for patients with relapsed and refractory aggressive large B‐cell lymphomas. While long‐term follow‐up data show that about one‐third of patients achieve prolonged complete remission and are potentially cured, the majority of patients either do not respond to CD19 CART therapy or eventually relapse after CD19 CART therapy. These results are, on the one hand, driving intense research into identifying mechanisms of relapse and, on the other hand, inspiring the development of novel strategies to overcome resistance. This review summarizes current clinical outcomes of CART immunotherapy in B‐cell non‐Hodgkin lymphomas, describes the most up‐to‐date understanding of mechanisms of relapse and discusses novel strategies to address resistance to CART therapy. We are indeed at the beginning of a scientific trek to explore the mechanisms of resistance, seek out new, more effective treatment approaches based on these discoveries and to boldly go where no other therapy has gone before!
Novel Borrelia genotypes in bats from the Macaregua Cave, Colombia

Bats have been implicated as reservoirs of relapsing fever group spirochaetes since the beginning of the last century. Recently, bat‐associated spirochaetes have been reported as human pathogens. In 1968, a spirochaete was detected in blood of the bat Natalus tumidirostris captured inside the Macaregua cave, Colombia. Data on this microorganism were never published again. The aim of this study was to evaluate the presence of Borrelia DNA in blood from bats of Macaregua cave. We performed molecular analyses using a genus‐specific real‐time PCR targeting the 16S rRNA to detect DNA of Borrelia in blood samples from 46 bats captured in the Macaregua cave. Positive samples were submitted to a battery of PCRs aiming to amply Borrelia 16S rRNA, flaB, glpQ, p66, ospC, clpA, clpX, nifS, pepX, pyrG, recG, rplB and uvrA genes. Seventeen samples were positive for Borrelia after real‐time PCR. With the exception of flaB gene, attempts to amplify further loci were unsuccessful. Nucleotide and amino acid divergences of four flaB haplotypes characterized from blood of Carollia perspicillata showed Borrelia burgdorferi sensu lato (Bbsl) as the most closely related group. A phylogenetic tree including 74 sequences of the genus confirmed this trend, since Borrelia genotypes detected in bats from Macaregua formed a monophyletic group basally positioned to Bbsl. Our results suggest that Borrelia genotypes characterized from bats roosting in the Macaregua cave might constitute a new taxon within the genus. This is the first molecular characterization of a Borrelia sp. in Colombia.
Conjunctival Ulcers in Behcet's Disease and Response to Colchicine

© 2020 Indian Dermatology Online Journal | Published by Wolters Kluwer Medknow Sir, A 14‐year‐old girl presented with painful orogenital ulcers of 4 months duration, associated with intermittent high‐grade fever. She developed pain and redness in left eye 2 weeks back and crops of painful nodular lesions over shins 4 days ago along with joint pains in ankle, wrist, and knee joints restricting her mobility significantly. Patient denied prior drug intake, sexual exposure, or personal or family history of tuberculosis.
Epidemiological Features of Aortic Stenosis in a French Nationwide Study: 10‐Year Trends and New Challenges

Background Aortic stenosis (AS) is one of the most common forms of valvular heart disease. Our aim was to estimate the burden of AS in the hospital in France, describe patient characteristics, and evaluate the mortality rate and temporal trends. Methods and Results All patients hospitalized for AS in France between 2006 and 2016 were identified from the national hospital discharge database. Patients’ sociodemographic, medical, and surgical characteristics and temporal trends were described. All AS‐related deaths between 2000 and 2014 were identified using death certificates. In 2016, 26 071 patients were hospitalized for AS: 56.5% were men with an average age of 77 years. The all‐cause mortality rate at 1 year postindex stay was 11%. The rate of patients hospitalized for AS increased by 59% between 2006 and 2016, reaching 38.7/100 000 person‐years in 2016. This increase was most pronounced in patients aged >75 years. The number of transcatheter aortic valve implantations increased following their introduction in 2010. In 2016, 44% of patients were treated with aortic valve surgery during the index hospital stay or following year (mean age, 71.5 years), and 34% were treated with transcatheter aortic valve implantation (mean age, 83.0 years). In 2014, 6186 deaths caused by AS were identified in death certificates: 41.6% were men with an average age of 87 years. The age‐standardized mortality rate increased by 5% between 2000 and 2014, reaching 8.5/100 000 person‐years in 2014. Conclusions The rate of patients hospitalized for AS increased in recent years in line with the higher life expectancy and introduction of transcatheter aortic valve implantation. Mortality increased more moderately.
Factors Affecting the Acceptance of Mobile Health by Medical Sciences Students: A Cross-Sectional Study

Background: The use of mobile health has a pivotal role in the prevention and treatment of many diseases. This study aimed at determining the affecting factors in acceptance of mobile health by using a modified acceptance model, among medical sciences students in the south-west of Iran. Materials and Methods: This cross-sectional, analytical study was conducted in 2017. The research population included all the students of Lorestan University of Medical Sciences (LUMS). The 352 of students selected as the samples of study through a stratified sampling method. Data gathering was done through a valid and reliable questionnaire. The data was analyzed using Linear Structural Relations (LISREL) and Statistical Package for the Social Sciences (SPSS) software. Results: The findings showed that perceived usefulness (t7, 38= 2.16, p = 0.03), performance expectancy (t7, 70= 3.18, p = 0.01), facilitating conditions (t10, 61= 4.17, p < 0.001), and attitude to use (t7, 14= 5.49, p < 0.001) were effective in the behavior intention of mobile health. Moreover, the results showed that the behavior intention of mobile health applications (t10, 77= 8.10, p < 0.001) is effective on its user behavior. Conclusions: The results of our study showed that perceived usefulness, performance expectancy, facilitating conditions, and attitude to use of technology were the affecting factors in the acceptance of mobile health by the students. It is suggested that the policymakers and authorities comprehensively consider these important factors when introducing new technologies.
The Effect of Cognitive Behavioural Group Therapy on the Workplace and Decisional Procrastination of Midwives: A Randomized Controlled Trial

Background: Procrastination in the general population is a prevalent phenomenon. Procrastination in midwives, who are responsible for health care services, can have serious consequences and reduce health care productivity. Cognitive Behavioral Group Therapy (CBGT) is believed to reduce procrastination, but few studies have investigated its effectiveness. The aim of the present study was to determine the effect of CBGT on the workplace and decisional procrastination of midwives. Materials and Methods: This randomized, controlled trial was conducted on 47 participants who were eligible to participate in the study. The participants were randomly assigned to the CBGT (n = 24) and control (n = 23) groups. The intervention group received 7 sessions of CBGT and the control group received no intervention. Decisional and workplace procrastination were assessed at the pre-treatment, post-treatment, and 2-month follow-up phases. Repeated measures Analysis of Variance (ANOVA) and Analysis of Covariance (ANCOVA) were used for data analysis. Results: At the posttest and follow-up phases, workplace procrastination (Post-test: F1,40= 11.78, p = 0.001; Follow-up: F1,40= 11.12, p = 0.002), soldiering (Post-test: F1,40= 13.77, p = 0.001; Follow-up: F1,40= 4.15, p = 0.049), cyberslacking (Post-test: F1,40= 4.20, p = 0.047; Follow-up: F1,40= 13.34, p = 0.001), and decisional procrastination (Post-test: F1,40= 6.66, p = 0.014; Follow-up: F1,40= 6.12, p = 0.018) significantly decreased in the CBGT group compared to the control group. CBGT explained 23% of the changes in the total workplace procrastination score and 22% of the changes in the component of soldiering (p < 0.05). Conclusions: CBGT significantly reduced workplace and decisional procrastination in midwives.
Role of FNAC in Extramammary Tumors Metastatic to the Breast

Background: Metastasis to the breast of an extra-mammary origin is very rare. FNAC plays an important role in differentiating non-mammary breast metastasis from primary malignancy. This study aimed to analyze the cytomorphological criteria and its pitfalls in differentiating metastatic lesion of the breast from primary malignancy. Methodology: Retrospective analysis of 891 FNACs of the breast was performed for a time span of 3 years. A total of 12 cases were diagnosed on FNAC as secondary neoplasms to the breast. Clinical and radiological data, along with Pap and MGG stained smears of each case were examined and correlated with the histopathology of the primary tumor. Statistical analysis was carried out. All cases of primary breast malignancies were excluded from our study. Results: In 10 out of 12 cases, primary malignancies were identified as Plasma cell myeloma (one case), B-acute lymphoblastic leukemia (two cases), acute myeloid leukemia (one case); chronic myeloid leukemia (one case), Burkitt's lymphoma of the ovary (one case), Diffuse large B-cell lymphoma (one case), esophageal squamous cell carcinoma (one case), spindle cell sarcoma (one case) and squamous cell carcinoma of the cervix (one case). The remaining two cases in our study were misdiagnosed on cytology as metastasis and turned out to be breast primaries on histopathology. Conclusion: Our case series highlights the importance of FNAC to differentiate secondary lesions from primary breast malignancy and thus helps to avoid unnecessary surgery to the patient. It emphasizes on the need to keep in mind the possibility of metastatic breast neoplasms in the presence of unusual cytological features on FNAC.
rMEA: An R package to assess nonverbal synchronization in motion energy analysis time-series

Abstract Introduction. Motion Energy Analysis (MEA) is a procedure that allows to automatically assess the amount of persons’ movement from video recordings. Recent studies used MEA to investigate nonverbal synchrony, i.e., the occurrence of simultaneous movement, suggesting the existence of an association with relationship quality. In patient-therapist dyads, synchrony predicted therapeutic alliance, empathy, as well as treatment outcome. Package description . The article presents rMEA, an open-source R package that allows to import, filter, and visualize dyadic time-series of nonverbal behaviour generated by other MEA software. The package includes a fast, state-of-the-art, moving window cross-correlation algorithm with lag analysis, which provides a user-friendly interface for the assessment of nonverbal synchrony. Through the analysis of a motivating example (40 psychotherapy intake interviews split between dropouts and good cases) the article provides an in-depth description of the package main functions and a tutorial for a typical analysis in this field, requiring only the most basic knowledge of the R language and environment. The rich visualization capabilities of the software provide powerful tools for the various steps involved in the diagnostics, analysis, interpretation and publication of these data. Conclusions. Overall, the paper aims to empower psychotherapy researchers and other interaction scientists to investigate nonverbal synchrony in their own dyads.
Enteral immunonutrition versus enteral nutrition for patients undergoing esophagectomy: a randomized controlled trial.

BACKGROUND In recent years, immunonutrition has been introduced and proposed to have a positive modulatory effect on inflammatory and immune responses and gut function for surgical patients, especially for patients undergoing gastrointestinal cancer resection. We conducted this parallel-group, randomized and double-blind clinical controlled trial to investigate the efficacy of perioperative enteral immunonutrition (EIN) on clinical and immunological outcomes of patients undergoing esophageal resection. METHODS A randomized, parallel-group, double-blind, clinical trial was conducted between December 1, 2017 and March 1, 2018. This study enrolled 120 patients with esophageal cancer. And 112 patients were divided into two groups randomly: EIN group and enteral nutrition (EN) group. The EIN contained extra immunonutritional substrates, including a consistent combination of arginine, RNA and the omega-3 fatty acids compared with EN. Immune indicators were measured at preoperative day 7, postoperative day (POD) 1, 3, 7 and post-discharge day (PDD) 30. RESULTS There were 56 participants randomized to each group. Finally, 53 patients in EIN and 50 patients in EN were analyzed. Immune indicator was the primary outcome in this study. EIN yielded a significantly lower rate of CD8/CD3 (%) at POD 3 compared with EN group (P=0.005). The rate of CD4/CD8 (%) in EIN group was higher than that in EN group at POD3 (P=0.004). The serum levels of IgM at POD 3 and 7 were significantly higher in EN group compared with EIN group (P=0.025 and P=0.009, respectively). The rate of NK (%) and the serum level of IgA were significantly higher in EIN group compared with EN group at PDD 30 (P=0.022 and P=0.041, respectively). No significant differences were found in 2-year progressionfree survival and overall survival. CONCLUSIONS Immunonutrition is a safe and feasible nutritional treatment, which has a positive modulatory impact on immune responses after esophagectomy. Although no significant difference was found in clinical and survival outcomes between EIN and EN groups, immunonutrition could still have a positive effect on immunological function of patients undergoing esophagectomy.
Fractionation, chemical and toxicological characterization of tobacco smoke components

Tobacco smoke is an extremely complex aerosol composed of thousands of constituents distributed amongst the particulate and vapor phases. Toxicological effects have been linked to compounds present in both of these phases. Many biologically active compounds have been identified within tobacco smoke; however, there is a lack of studies correlating specific in vitro or in vivo biological responses to components within whole tobacco smoke. The goal of this research was to develop reliable and robust smoke fractionation methods using analytical separation and detection techniques in combination with in vitro toxicological assays. In a previous study by our collaborators, toxicological assessment of the particulate phase combustion products of twelve individual tobacco components revealed that the combustion products of chlorogenic acid were the most cytotoxic using the in vitro micronucleus test. Therefore, a preparative liquid chromatography method was developed in this work to fractionate the combustion products of chlorogenic acid to assess the bioactivity of these fractions and to identify the compounds responsible for the toxicity observed. The sub-fraction responsible for the most cytotoxic response comprised catechol, which was identified by liquid chromatography/time-of-flight mass spectrometry. Emerging studies have highlighted the toxicological significance of whole tobacco smoke and specifically the vapor phase, which shifted our focus to whole smoke analyses. The Borgwaldt RM20S smoking machine in combination with British American
Intravenously delivered multilineage-differentiating stress enduring cells dampen excessive glutamate metabolism and microglial activation in experimental perinatal hypoxic ischemic encephalopathy

Perinatal hypoxic ischemic encephalopathy (HIE) results in serious neurological dysfunction and mortality. Clinical trials of multilineage-differentiating stress enduring cells (Muse cells) have commenced in stroke using intravenous delivery of donor-derived Muse cells. Here, we investigated the therapeutic effects of human Muse cells in an HIE model. Seven-day-old rats underwent ligation of the left carotid artery then were exposed to 8% oxygen for 60 min, and 72 hours later intravenously transplanted with 1 × 104 of human-Muse and -non-Muse cells, collected from bone marrow-mesenchymal stem cells as stage-specific embryonic antigen-3 (SSEA-3)+ and −, respectively, or saline (vehicle) without immunosuppression. Human-specific probe revealed Muse cells distributed mainly to the injured brain at 2 and 4 weeks, and expressed neuronal and glial markers until 6 months. In contrast, non-Muse cells lodged in the lung at 2 weeks, but undetectable by 4 weeks. Magnetic resonance spectroscopy and positron emission tomography demonstrated that Muse cells dampened excitotoxic brain glutamatergic metabolites and suppressed microglial activation. Muse cell-treated group exhibited significant improvements in motor and cognitive functions at 4 weeks and 5 months. Intravenously transplanted Muse cells afforded functional benefits in experimental HIE possibly via regulation of glutamate metabolism and reduction of microglial activation.
Fenofibrate attenuates ischemia reperfusion‐induced acute kidney injury and associated liver dysfunction in rats

Ischemia/reperfusion (I/R) is one of the common reasons for acute kidney injury (AKI) and we need to develop effective therapies for treating AKI. We investigated the role of fenofibrate against I/R‐induced AKI and associated hepatic dysfunction in rats. In male wistar albino rats, renal pedicle occlusion for 40 min and 24 h reperfusion resulted in AKI. I/R‐induced AKI was demonstrated by measuring serum creatinine, creatinine clearance, urea, uric acid, potassium, fractional excretion of sodium and urinary microproteins. Oxidative stress in rat kidneys was quantified by assaying superoxide anion generation, thiobarbituric acid reactive substances, and reduced glutathione levels. AKI‐induced hepatic damage was quantified by assaying serum aminotransferases, alkaline phosphatase and bilirubin levels. Moreover, serum cholesterol, high density lipoprotein and triglycerides were quantified. Hematoxylin–eosin staining of renal and hepatic tissues was done and the kidney and liver injury scores were determined. Immunohistology of endothelial nitric oxide synthase (eNOS) was done in rat kidneys. Fenofibrate was administered for 1 week before subjecting rats to AKI. In separate group, the nitric oxide synthase inhibitor, L‐nitroarginine methyl ester (L‐NAME) was administered prior to fenofibrate treatment. In I/R group, significant alteration in the serum/urine parameters indicated AKI and hepatic dysfunction along with marked increase in kidney and liver injury scores. Treatment with fenofibrate attenuated AKI and associated hepatic dysfunction. Moreover, I/R‐induced decrease in renal eNOS expression was abrogated by fenofibrate. Pre‐treatment with L‐NAME abolished fenofibrate mediated reno‐ and hepato‐protective effects. In conclusion, fenofibrate attenuates I/R‐induced AKI and associated hepatic dysfunction putatively through modulation of eNOS expression.