Miracle-dz/UniFAR-FTUs huggingface dataset:
A Meta-analysis of Preoperative Duplex Ultrasound Vessel Diameters for Successful Radiocephalic Fistula Placement

Background The Kidney Dialysis Outcomes Quality Initiative (K/DOQI) guidelines for vascular access recommend the use of radiocephalic wrist arteriovenous fistulas (RCAVFs) as the initial option for dialysis access. The survival rate of a successfully placed fistula is excellent. However, 10–24% of RCAVFs fail to reach functional status as the result of early thrombosis or maturation failure. Many authors have investigated the utility of preoperative vascular mapping by Duplex ultrasound to predict adequate vessel size for successful fistula placement. This meta-analysis is the first in which preoperative radial arterial (RAD) and cephalic venous diameters (CVD) required for favorable fistula outcomes are reviewed. Methods A literature search was performed by use of the MEDLINE electronic base for “arteriovenous, fistula, ultrasound, and hemodialysis. ” The analysis yielded 166 studies, of which 20 studies included preoperative duplex data. Meta-analysis was performed by applying the statistical test of comparing two proportions, assuming equal variances. Results A total of 433 patients were duplexed for preoperative evaluation of the RAD and 386 for CVD. The total number of subjects ranged from 21 to 91, mean age 58.7 years. The subjects were 55.5% male, 39.0% with diabetes mellitus. Meta-analysis yielded 2.0 mm for RAD and 2.0 mm for CVD as designated cutoff vessel diameters. Our study showed the mean fistula success rate was significantly different between RAD >2.0 mm (59%) and RAD >2.0 mm (40%). The mean fistula success rate was also significantly different between CVD > 2.0 mm (71%) and >2.0 mm (29%). Successful fistula placement was defined as a functional fistula at least 4–6 weeks after creation. Conclusion On the basis of our study, the use of Duplex ultrasound is important in determining preoperative vessel diameter size, and subsequent functional success rate of fistula placement.
Effective Classroom Management: A Study In Three Public Junior High Schools

This classroom management study of nine teacher participants at three public junior high schools in Muaro Jambi Regency aimed to investigate participant teachers’ implementation, efforts and hindering factors of effective classroom management. A qualitative case study approach was employed to gather the data of the study. Data were collected through interviews by using purposive sampling technique in selecting study participants. The findings showed that the effectiveness of classroom management was measured by the standards set by the teacher and student participation. Effective classroom management is achieved if two substantive elements of behavioral management and environmental management are carried out properly. The efforts made by the teachers included the use of verbal and non-verbal language, building personal relationships with students, developing relationships through social media, and changing class layouts. Furthermore, Physical environmental conditions, socio-emotional conditions, and misuse of multimedia technology were factors that inhibit the effectiveness of classroom management in this study.
Low Prevalence of Occult Hepatitis B Infection Among Blood Donors in Beirut, Lebanon: Reconsider the Deferral Strategy of Anti-HBc Positive Blood Donors

Background: Hepatitis B virus (HBV) infection remains one of the major infectious threats to human health. Since the implementation of highly sensitive HBV nucleic acid testing, occult HBV infection (OBI) has been detected. Occult HBV infection is characterized by a positive HBV DNA test with undetectable HBsAg (Hepatits B surface antigen). The prevalence of OBI varies significantly between geographic areas, genotypes, and population depending on the sensitivity of the detection assays used. Objectives: This project aimed at determining the prevalence of OBI in blood donors from a major blood donor center in Beirut, Lebanon through testing for 4 HBV markers (HBsAg, anti-HBs, anti-HBc and HBV DNA). Methods: A total of 7437 blood donors were first tested for anti-HBc marker between August 2013 and March 2015; samples positive for anti-HBc were tested for other serological markers and HBV genome. DNA was extracted from 500 μL of plasma and tested for HBV DNA using Artus HBV TM PCR Kit assay. All anti-HBc positive samples were tested by nested PCR, targeting the S gene. Results: This study revealed a 4.6% prevalence of anti-HBc positive blood donors (341/7437). Among anti-HBc positive blood donors, 21 were HBsAg positive (6.2%) and 75% were positive for anti-HBs. The occurrence of occult hepatitis B virus in healthy seropositive blood donors during a 20 month period was very low; only 1 Syrian blood donor (n = 1/341, 0.3%) was HBsAg negative, HBV DNA-positive with anti-HBs level > 1000 mIU/mL. Conclusions: Our study indicates that HBV DNA is present in a small percentage of HBsAg negative, anti-HBc reactive units. Lebanon has developed its own blood screening strategy, which is to screen for anti-HBc in addition to HBsAg. This is based on HBV prevalence and cost-effectiveness of testing methods. The disadvantage of not implementing nucleic acid testing (NAT) is missing rare blood units from donors in the window period.
The linkage among academic performance, learning strategies and self-efficacy of Japanese university students: a mixed-method approach

ABSTRACT Previous research investigating the dynamics among the three inter-connecting variables of students’ learning (i.e. learning strategies, academic performances and self-efficacy) was focused largely on Western countries. The present study attempted use a mixed approach to extend this line of research to an East Asian country. First, we randomly recruited 390 Japanese university students as participants by completing two learning inventories (LASSI and MSLQ), to investigate the interrelationships among the three variables of students’ learning processes. Second, we followed up by interviewing 37 students from the same pool of participants, to complement the quantitative data. Convergent evidence generally supported that (a) there were important differences between the learning strategies used by the Japanese students with different levels of academic performance and (b) self-efficacy had equal status with the learning strategies in predicting the students’ academic performances.
MIER3 suppresses the progression of non-small cell lung cancer by inhibiting Wnt/β-Catenin pathway and histone acetyltransferase activity

Background The mesoderm induction early response 1, family member 3 (MIER3) gene has been recognized as potentially being associated with cancer. However, in relation to the development of non-small cell lung cancer (NSCLC), the expression pattern and the role of MIER3 are yet to be reported. The aim of this research was to investigate the rate of expression of MIER3 in NSCLC cells and tissues and to investigate the role of MIER3 in NSCLC. Methods Seventeen patients received NSCLC tissues and corresponding healthy tissues. MTT assay was used to determine cell proliferation. For detecting mRNA and protein expression, we used both quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot method. To measure cell apoptosis and cell cycle distribution, we applied the flow cytometry technique. We used a wound-healing assay and a Transwell invasion assay to study cell migration and invasion. Results In comparison with adjacent normal tissues, the expression of MIER3 was down-regulated in NSCLC tissues. In addition, the level of MIER3 in NSCLC cell lines was also lower than in pulmonary epithelial cell BEAS-2B. Moreover, when MIER3 was overexpressed, cell proliferation, migration, and invasion were significantly inhibited, apoptosis increased, and cell cycle arrest was induced in A549 and H460 cells. MIER3 overexpression also suppressed tumor growth in NSCLC xenograft mouse models. Furthermore, our study demonstrated that MIER3 down-regulated the Wnt/β-catenin signaling pathway in NSCLC cells. More importantly, MIER3 decreased the activity of histone acetyltransferase (HAT) p300, which may have contributed to its regulation on β-catenin and tumorigenesis. Conclusions The data suggests MIER3 takes on the tumor-suppressor role in the progression of NSCLC and, therefore, could prove to be a valuable clinical marker in the prognosis of the disease.
Mottled Hypopigmentation from Laser Toning in the Treatment of Melasma: A Catastrophic or Manageable Complication?

Melasma is a common acquired pigmentary disorder and difficult to treat with a high rate of recurrence. Conventional methods in the treatment of melasma have drawbacks and limitations. The so-called “laser toning” treatment, which uses a collimated low-fluence 1,064 nm Q-switched neodymium-doped yttrium aluminum garnet laser, was introduced a few years ago for the treatment of melasma. Laser toning has attracted much popularity and attention, and has become a crucial method for treatment of melasma. Laser toning is now a mainstay for treatment and management of melasma, however some dermatologists have excessive concerns about the risk of hypopigmentation. This inordinate fear may have originated from a few studies which insisted that laser toning therapy has a high risk of hypopigmentation and should be considered as a second-line treatment, not a first-line treatment for melasma. In the current study, we suggest that hypopigmentation after laser toning is a preventable and controllable complication based on our clinical experiences and reviews of various literatures.
Clinical profile of patients undergoing coronary angiography with special reference to complications of coronary angiography

Background: Cardiovascular Diseases (CVD’s) remain the biggest cause of death worldwide. Recent trends suggest that disease incidence has escalated and has started affecting younger age group also. Incidence of CVD’s has been on increasing trend not only in urban areas but in rural areas also. Aim of this research is to study clinical profile and complications in patients undergoing coronary angiography. Methods: 100 patients admitted in hospital who were planned for coronary angiography were selected. All routine investigations, Hba1c if patient is known diabetic, Serology, ECG, CXR were done at the time of admission. General physical and local examinations were performed at the end of procedure, after 12, 48 and 72 hours of coronary angiography. Results: Acute Myocardial Infarction (AMI) is the commonest indication for CAG in this study group. Out of 100 patients who underwent CAG, complications occurred in 29 individuals. Only 3 types of complications- Haematoma, Anaphylactoid reactions and Contrast Induced Nephropathy (CIN) are observed in this study. Conclusions: Hypertension, obesity, family history of IHD in first degree relatives and DM are important risk factors for IHD. Most common complication of CAG is haematoma. Females patients are more predisposed for all complications DM, HTN, advanced age and CHF are independent risk factors for developing CIN.
Handwashing: Clean Hands Save Lives

Abstract Handwashing is one of the most important ways to prevent the spread of illness. The five steps that need to be completed every time handwashing occurs are: wet, lather, scrub, rinse, dry. Using these tips will improve the likelihood of fighting germs and reducing the spread of illness. The Centers for Disease Control has launched a new campaign titled “Life is Better with Clean Hands” as an initiative to spread the word about the importance of handwashing, and can be found at . Through this campaign and other publications, the CDC hopes to see a reduction in spread of illness.
Success Factors in Community-Based Nutrition Programmes

Community-based nutrition programmes (CBNPs) generally include such activities as growth monitoring, breastfeeding promotion, nutrition education, promotion of better weaning practices, and sometimes micronutrient programmes and deworming. Defining success in these programmes involves the attainment of objectives related to process, outcome, and sustainability (financial and functional), all of which are influenced by sociopolitical, technical, and financial factors. Four well-known programmes generally acknowledged as successful are used to illustrate the combination of contextual (sociopolitical), programmatic (technical), and financial factors that ensure success in CBNPs. the more technical programmes are more instructive and replicable, given the difficulty in creating conducive sociopolitical factors. However, the evidence demonstrates that with careful design and phased implementation of different components, nutrition activities can enhance positive sociopolitical factors, thereby creating a positive context for nutrition programmes and for capacity building for the broader challenge of social development.
The microRNA miR-516a-3p regulates the Wnt pathway by targeting extracellular sulfatase 1 in human scirrhous gastric cancers: Anti-metastatic therapy via miRNA-based medicine

The mechanism and function of cancer metastasis-associated microRNAs (miRNAs) have not been completely examined. Using a miRNA array, we previously determined that a significantly decreased level of miR-516a-3p was closely associated with the peritoneal dissemination of scirrhous gastric cancers. We previously established HSC-58 cells from a scirrhous gastric cancer patient, and we further isolated metastatic cells (58As9) from ascites in nude mice upon repeated orthotopic transplantation of HSC-58. In our previous report (Takei Y, et al. Cancer Res, 2011), we showed that the miR-516a-3p expression was significantly low and the peritoneal dissemination was significantly high in 58As9 compared with HSC-58. To augment the decreased expression of miR-516a-3p in 58As9 cells, we successfully prepared a cell line (58As9-miR-516a-3p) that stably overexpressed the miRNA. In the present study, we showed that orthotopic transplantation of 58As9-miR-516a-3p into nude mice resulted in significantly decreased primary tumor growth, ascites, and peritoneal dissemination. Moreover, the transplanted nude mice showed long survival time, probably due to the small amount of ascitic fluids pooled. The miRNA directly targeted sulfatase 1, which works to remove a sulfate group from heparan sulfate proteoglycans on the cell surface, and promotes the release of membrane-bound Wnt ligands into medium. Significantly increased concentrations of Wnt3a, Wnt5a, and nuclear-accumulated b-catenin were observed in 58As9 cells, and in 58As9-miR-516a-3p, all of the levels were attenuated. Anti-metastatic therapy via injection of the miR-516a-3p expression vector/atelocollagen mixture into 58As9 orthotopic tumors in nude mice resulted in significantly prolonged survival along with the inhibition of ascites and peritoneal dissemination. Our findings thus indicate that the miR-516a-3p-sulfatase 1-Wnt b-catenin route can be targeted to block the peritoneal dissemination of scirrhous gastric cancers.
Tactical departures and strategic arrivals: Divergent effects of climate and weather on caribou spring migrations

The Arctic has been warming rapidly, affecting ecological processes across the region. Caribou and reindeer ( Rangifer tarandus ) is a keystone Arctic species undergoing declines in many parts of its range, but de ﬁ nitive links between climate and populations remain elusive. The conspicuous and dramatic mass migration of many caribou populations, during which nearly all pregnant females move from wintering ranges to calving grounds shortly before giving birth, may be an important link between climate and caribou populations. The drivers of migration, however, are similarly mysterious. It is unknown, for example, whether caribou respond to immediate phenological cues, anticipate conditions on calving grounds, or are driven by lagged effects related to physical condition. To investigate the drivers of migration, we analyzed movement data from over 1000 individual caribou from seven major herds, spanning 3000 km across Alaska, Yukon, Northwest Territories (NWT), and Nunavut in Canada, from 1995 to 2017. We developed a hierarchical model to estimate migration departure and arrival times, and analyzed these variables against global climate indices and local weather conditions, exploring immediate and lagged effects, as well as snowmelt timing and vegetation indices. We discovered a continent-wide synchrony in spring migration departure times, driven mainly by large-scale, ocean-driven climate indices (Paci ﬁ c Decadal Oscillation, Arctic Oscillation, and North Atlantic Oscillation). However, we also found that the speed of migration was highly plastic with later migration departure times followed by shorter migration durations. This plasticity made arrival timing independent of departure timing and its respective drivers. Rather, arrival timing depended strongly on weather conditions from the previous summer: cooler and windier summers generally led to earlier arrival at calving grounds the following year. We suggest that maternal body condition, mainly in ﬂ uenced by conditions that limit insect harassment, is a major factor for earlier spring migration arrival timing, and therefore earlier calving and higher survival rates. We place these results in the context of mechanistic links between climate and caribou population dynamics. Long-term and large-scale observations of migratory animals can provide insights into the mechanisms by which long-distance, collective migrants may adapt to dynamic and unpredictable environments.
Infezione da Clostridium difficile nel paziente geriatrico Clostridium difficile infection in the elderly

C lostridium difficile is a Gram-positive anaerobic spore-forming bacterium, known to be the causative agent of pseudomembranous colitis. With increasing life expectancy in Western countries, the geriatric patient is well recognized as a high risk host for C. difficile infection (CDI). Advanced age, age-related changes of the intestinal flora, immunosenescence, presence of comorbidities, frequent hospitalizations and high exposure to antibiotics are some of the risk factors for CDI in this patient population. Prompt recognition of the clinical picture with a rapid and accurate diagnosis are necessary to reduce complications and mortality in this group of patients. This review provides an update on the currently available literature regarding the epidemiology and clinical management of C. difficile in the elderly.
Challenging Deficit Syndrome Of Schizophrenia By Norepinephrine Reuptake Inhibitor: A Controlled Clinical Trial

Citation: Jafarabad Azizi R (2019) Challenging Deficit Syn- drome of Schizophrenia by Norepinephrine Reuptake Inhibitor: A Controlled Clinical Trial. J Alcohol Drug Depend Subst Abus 5: 010. Abstract Objective: Despite advances made in treating the positive symp- toms of schizophrenia, treatment of negative symptoms remains an unmet therapeutic need. Reboxetine is a norepinephrine reuptake inhibitor (NRI) . Objective of this study was to evaluate its effect on the negative symptoms of schizophrenia. Method: In a twelve-week randomized placebo-controlled trial, re- boxetine was compared with placebo, as an add-on medication to haloperidol (5 mg), for treatment of 50 patients meeting diagnosis of schizophrenia. In this respect, Scale for Assessment of Negative Symptoms was used as the primary outcome measure. Treatment efficacy was analyzed by t test, Split-plot (Mixed) and repeated – measures analysis of variance (ANOVA). Result: The primary finding of this trial was a significant reduction in mean total scores of SANS in the reboxetine group, in comparison with the placebo group, at the end of the 12th week (P <0.0001). As well, in the experiment group, all of the sub-scales of SANS demonstrated considerable improvement. A trivial escalation in mean total scores of SAPS also was evident in the later group. Effect Size (ES) analysis too at the end of the trial, pointed to a large improvement with reboxetine. Conclusion: Reboxetine, as adjuvant to haloperidol, may cause a favorable outcome on behalf of improvement of deficit symptoms of schizophrenia.
Early Levothyroxine Treatment on Maternal Subclinical Hypothyroidism Improves Spatial Learning of Offspring in Rats

Maternal hypothyroidism has adverse effects on neural development in the offspring. The present study aimed to investigate whether maternal subclinical hypothyroidism impairs spatial learning in the offspring, as well as the efficacy and optimal time of levothyroxine (L‐T4) treatment in pregnancy. Female adult Wistar rats were randomly divided into six groups (n = 10 per group): control, hypothyroid (H), subclinical hypothyroid (SCH) and SCH treated with L‐T4, starting from the tenth, thirteenth and seventeenth gestational day (GD10, GD13 and GD17), respectively, to restore normal thyroid hormone levels. Spatial learning was assessed on progenies by a water maze test, a field excitatory postsynaptic potential (fEPSP) recording, and an long‐term potentiation induction assay. Protein levels of early growth response protein 1 (Egr1), activity‐regulated cytoskeleton‐associated protein (Arc), Ras‐proximate‐1 (Rap1), p‐extracellular signal‐regulated kinase (p‐ERK) and brain‐derived neurotrophic factor (BDNF) were determined by western blotting. Progenies from the SCH and H groups demonstrated significantly longer mean latency in the water maze test and a lower amplification percentage of the amplitude and slope of the fEPSPs compared to offspring of the control group. L‐T4 treatment for the GD10 and GD13 groups significantly shortened mean latency and increased the amplification percentage of the amplitude and slope of the fEPSPs of the progeny of rats with subclinical hypothyroidism. However, L‐T4 treatment for the GD17 group showed only minimal effects on spatial learning in the offspring. Progenies of SCH and H groups had lower levels of Egr1, Arc, p‐ERK and BDNF but higher levels of Rap1 compared to those of the controls. L‐T4 treatment ameliorated these protein expression changes in the progeny of rats with subclinical hypothyroidism. Maternal subclinical hypothyroidism impaired spatial learning in the offspring; L‐T4 treatment in early pregnancy recovered this adverse effect, and the optimal time of treatment should start from early pregnancy (GD10 and GD13).
Anesthesia management in a giant congenital undifferentiated orbital teratoma: A challenging, rare entity

28 The Indian Anaesthetists’ Forum | Volume 18 | Issue 1 | January-June 2017 Blind nasal technique is usually adopted to secure airway in this situation. [3,4] We could manage difficult intubation with flexible FOL. Patency of single nostril due to deviated nasal septum precluded simultaneous use of flexible FOL and nasopharyngeal airway. The flexible FOL, though handy due to shorter length (30 cm), is devoid of channels for oxygenation and suction-like bronchoscope. Hence, oxygen supplementation was given orally during fiberoptic intubation, using a 3 mm ETT.