Miracle-dz/UniFAR-FTUs huggingface dataset:
Oral Spirulina Platensis Attenuates Hyperglycemia and Exhibits Antinociceptive Effect in Streptozotocin-Induced Diabetic Neuropathy Rat Model

Introduction Diabetic neuropathy is a common consequence of diabetes. Hyperalgesia is one of the main symptoms of diabetic neuropathy. In response to noxious stimuli, streptozotocin (STZ)-induced diabetic rats show exaggerated hyperalgesic behavior, while Spirulina platensis has anti-inflammatory, antioxidant, and insulin-like effects. To assess the antinociceptive effect of oral Spirulina platensis (SP) powder on formalin-induced nociceptive responses in STZ-induced diabetic rats. Methods Sixty mature male albino rats were randomly allocated into six equal groups (10 in each group). Group 1 (control non-diabetic group) received 0.9% saline; group 2 was given oral pure SP powder-treated as a non-diabetic control group, group 3 was sodium salicylate-treated rats and used as a positive non-diabetic control group, group 4 managed as vehicle-treated diabetic rats, group 5 considered as SP-treated-diabetic group, and sodium salicylate-treated-diabetic rats used as a diabetic positive control group (group 6). STZ-diabetic rats were orally given SP in a dose of 500 mg kg/day for 1 month. The formalin test was implemented in two phases: the early phase in the first 10-min post-formalin injection, and the late phase was considered in the 15–60 min post-formalin injection time interval. Results Pain scores were increased in the diabetic groups during both phases of the experiment. Blood glucose was significantly reduced in diabetic rats that received oral SP, P < 0.01. Besides, SP-treated rats had lower pain scores during both phases of the experiment than untreated diabetic ones. However, in the sodium salicylate group, the pain score was reduced only during the second phase. An exaggerated nociceptive response occurred in diabetic rats after the formalin test. A significant antinociceptive effect appeared in SP-treated control and diabetic rats. Discussion The findings suggest that oral Spirulina platensis could have a potential therapeutic role for managing induced painful diabetic neuropathy in rats.
Role of IFN and Complements System: Innate Immunity in SARS-CoV-2

Abstract The critical role of the innate immune system has been confirmed in driving local and systemic inflammation and the cytokine release storm in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This dysregulated immune response is focused on interferon (IFN) and complement activation, which are crucial for the development of metabolic inflammation, local lung tissue damage, and systemic multi-organ failure. IFNs control viral infections by inducing expression of IFN-stimulated genes (ISGs) that restrict distinct steps of viral replication. Therefore, in this review article, we propose the mechanism of SARS-CoV-2-associated acute respiratory disease syndrome, and assess treatment options by considering IFNs and by targeting IFN-antagonist SARS-CoV-2 virulent gene products. Furthermore, we elaborate on the mechanism of the amplified complement-mediated inflammatory cytokine storm, and propose an antiviral and immunotherapeutic strategy against coronavirus disease 2019 (COVID-19).
Construction of Nomograms for Predicting Pathological Complete Response and Tumor Shrinkage Size in Breast Cancer

Purpose Pathological complete response (pCR) is the goal of neoadjuvant chemotherapy (NAC) for the HER2-positive and triple-negative subtypes of breast cancer and is related to survival benefit; however, luminal breast cancer is not sensitive to NAC, and the size of tumor shrinkage is a more meaningful clinical indicator for the luminal breast cancer subtype. We wanted to use a nomogram or formula to develop and implement a series of prediction models for pCR or tumor shrinkage size. Patients and Methods We developed a prediction model in a primary cohort consisting of 498 patients with invasive breast cancer, and the data were gathered from July 2016 to September 2018. The endpoint was pCR and tumor shrinkage size. In the primary cohort, the HER2-positive cohort, and the triple-negative cohort, multivariate logistic regression analysis was used to screen the significant clinical features and clinicopathological features to develop nomograms. In the luminal group, multivariate linear regression analysis was used to test the risk factors that affect tumor shrinkage size. The area under the receiver operating characteristic curve (AUC) and calibration curves were adopted to evaluate and analyze the discrimination and calibration ability of nomograms. Furthermore, we also performed internal validation and independent validation in the primary cohort. Results ER status, KI67 status, HER2 status, number of NAC cycles, and tumor size were independent predictive factors of pCR in the primary cohort. These indicators had good discrimination and calibration in the primary and validation cohorts (AUC: 0.873, 0.820). The nomogram for HER2-positive and triple-negative breast cancer (TNBC) had an AUC of 0.820 and 0.785, respectively. Both the HER2 positive and TNBC nomogram calibration curves indicated significant agreement. Moreover, the luminal subtype prediction model was Y (tumor shrinkage size) = −0.576 × (age at diagnosis) + 2.158 × (number of NAC cycles) + 0.233 × (pre-NAC tumor size) + 51.662. Conclusion Utilizing this predictive model will enable us to identify patients at high probability for pCR after NAC. Clinicians can stratify these patients and make individualized and personalized recommendations for therapy.
Chemo Suppressive and Curative Potential of Hypoestes forskalei Against Plasmodium berghei: Evidence for in vivo Antimalarial Activity

Background The emergence of drug resistance together with the global burden of malaria triggers the necessity for the searching of new antimalarial agents. This study, therefore, was initiated to investigate the in vivo antimalarial activity of Hypoestes forskalei in mice based on the strong supported evidence from the ethnobotanical claims and the in vitro anti-plasmodial activity of the plant. Methods The 4-day suppressive (crude extract and fractions) and the Rane’s (n-butanol fraction) tests were used to evaluate the antimalarial activity of the plant. A cold maceration technique with 80% methanol was used for the crude extraction of the plant. The crude extract was then fractionated using solvents of different polarity (chloroform, n-butanol, and water). Results All the test doses of the crude extract as well as the fractions reduced parasitemia and prolonged mean survival time significantly (P<0.001) as compared to their negative control groups. Maximum parasitemia suppression effect (56%) was observed at the highest dose (600 mg/kg) of the crude extract during the 4-day suppressive test. Likewise, the n-butanol, chloroform, and aqueous fractions showed a percentage suppression of about 50, 38, and 19, respectively, at the dose of 600 mg/kg. Therefore, the n-butanol fraction showed the highest parasitemia suppression followed by the chloroform fraction and then the aqueous fraction. Moreover, the n-butanol fraction showed a significant curative effect (P<0.001) in Rane’s test with a percentage suppression of about 49 at a dose of 600 mg/kg. Conclusion The study has revealed that the plant has a promising antimalarial activity, the activity being more in the crude extract than the fractions. The highest antimalarial activity of the n-butanol fraction suggests that non-polar and medium polar principles could be responsible for the observed activity.
Benefits of Cochlear Implantation in Middle-Aged and Older Adults

Introduction Nowadays cochlear implantation (CI) is the treatment of choice in adults in case conventional hearing devices fail. Besides speech perception, an improvement in quality of life and in cognitive performance has been reported. Thereby, the study focused on the impact of age. Participants and Methods Thirty middle-aged (MA) between 50 and 64 years and 41 older subjects (OA) aged 65 and older with bilateral severe hearing loss performed a comprehensive computer-based neurocognitive test battery (ALAcog) pre- and 12 months post-implantation. Besides, monosyllabic speech perception in quiet (Freiburg monosyllabic speech test), health-related quality of life (HR-QoL, Nijmegen Cochlear Implant Questionnaire) and depressive symptoms (GDS-15) have been assessed. Results Both age groups significantly improved in all three categories after 12 months. No differences were evaluated between MA and OA regarding speech perception and HR-QoL pre- and post-operatively. In contrast, cognitive performance differed between the age groups: pre-operatively OA performed worse in most neurocognitive subdomains like working memory (p=0.04), inhibition (p=0.004), processing speed (p=0.003) and mental flexibility (p=0.01), post-operatively MA outperformed OA only in inhibition (p=0.01). Age only slightly influenced cognitive performance in MA, whereas in OA age per se tremendously impacted on working memory (p=0.04), inhibition (p=0.02), memory (p=0.04) and mental flexibility (p=0.01). Educational level also affected processing speed, mental flexibility (p=0.01) and working memory (p=0.01). This was more pronounced in OA. In both age groups, hearing status had a strong effect on attentional tasks (p=0.01). In MA, depressive symptoms were more influential on cognitive functioning and on HR-QoL than in OA. Improvement in quality of life (p=0.0002) and working memory (p=0.001) was greater for those with a higher pre-operative depression score. Conclusion Speech perception and HR-QoL improved in hearing impaired, independently of age. Pre-operative differences in cognitive performance between OA and MA clearly attenuated 12 months after CI. Impact of comorbidities differed between age groups.
Caspase Recruitment Domain-Containing Protein 9 Expression is a Novel Prognostic Factor for Lung Adenocarcinoma

Purpose Caspase recruitment domain-containing protein 9 (CARD9) is expressed at high levels in bone marrow cells and has a crucial role in innate immunity. Current studies indicate that CARD9 also plays a key role in tumor progression, but there are few reports on the role of CARD9 in lung cancer. The aim of this study was to clarify the role of CARD9 in lung adenocarcinoma. Patients and Methods Lung adenocarcinoma tumor samples from 74 patients who underwent complete resection at Kobe University Hospital from January 2014 to December 2014 were analyzed by immunohistochemistry. The role of CARD9 in cancer cells was analyzed using lung cancer cell lines treated with CARD9 siRNA. Results High expression of CARD9 was observed in 32.4% of tumors, and compared to low expression of CARD9, high expression was associated with poorer overall survival (P = 0.0365). Univariate and multivariate analyses showed that high expression of CARD9 was an independent prognostic factor. Knockdown of CARD9 in lung adenocarcinoma cells inhibited proliferation but did not increase apoptosis. In addition, CARD9 activated the NF-κB pathway in a lung adenocarcinoma cell line. Conclusion CARD9 was shown to be an independent prognostic factor of poor outcome for lung cancer and may represent a molecular target for treatment.
The Evaluation of Electrocardiography Parameters Changes in Breath‐Holding Children Compared to Controls

Background Breath-holding spells (BHS) are brief periods when young children stop breathing for up to 1 minute and are widely recognized types of non-epileptic severe occasions in early stages of childhood. This study aimed to evaluate QTd and QTc changes in children with breath-holding spells compared with healthy children. Materials and Methods This case-control study was conducted to evaluate ECG parameters' changes in 90 children with breath-holding spells compared to 90 healthy children, who were included as controls, without any breath - holding in pediatric neurology clinic of Ali Asghar Hospital of Medical Sciences, University of Zahedan (ZaUMS), Iran, in 2018. Electrocardiography measures were measured from 12-lead surface electrocardiograms of the patients and the control group. Data were analyzed using SPSS software version 18.0. Results In the study there were 46 (51.1%), and 35(38.9%) females in controls and Breath Holding patients, respectively. QT max (p=0.002), S in V1 (p <0.001), R in V5 (p <0.001), R in aVL (p <0.001), S in V3 (p=0.002), LV mass (p <0.001), QTd (p <0.001), QTc max (p <0.001), and QTcd (p <0.001) were different in patients compared to controls, significantly (p <0.05). QTd (p <0.001), QTc max (p=0.03), and QTcd (p <0.001) were higher in pallid attacks, significantly. QT max (p=0.039), and QT min (p=0.039) were different in boys and girls so that QT max and QT min were higher in girls. Conclusion From the present study it can be concluded that QT, QTc, QTd and QTcd were higher in BHS. QTd, QTc max and QTcd were higher in pallid and QT max and QT min were higher in girls. However, in spite of what is reported in some studies, we suggest that obtaining ECG parameters is necessary to assess rhythm abnormality in children with BHS.
Variation in Growth and Water Uptake of Atriplex halimus and Atriplex nummularia Plants in Relation to Water Deficit

The variation in water deficit stress tolerance in terms of biomass production and water uptake of Mediterranean saltbush (A. halimus) and Australian saltbush (A. nummularia) was investigated in this study. One-year-old seedlings of the two species were grown in containers in the field at the University of Jordan, Jubeiha station. Plants were subjected to four water levels (100%, 75%, 50% and 25% ETo). Plants were sampled at three dates; June, September and December, for leaves, stems and roots dry weight and for leaves area and root length measurement and for water uptake and use efficiency (WUE) estimation. Reducing water level below 75% ETo reduced biomass production, leaves area (LA), and root length density (RLD). On the other hand, reducing water level increased WUE and root-to-shoot ratio. Biomass production was reduced mostly by 69% in response to stress (25% ETo). Root growth was also affected by water stress; where root dry weight (RDW), and RLD were reduced by values ranging 25%-72% compared to the 100% ETo. Atriplex nummularia had higher biomass, RL, RLD, RDW, and LA, than A. halimus. Water use efficiency was increased with increasing water deficit. This increase was higher at June (92%) as compared to September and December samplings. Atriplex halimus had a higher WUE than A. nummularia especially at high stress (25% ET).
FOLFIRINOX in borderline resectable and locally advanced unresectable pancreatic adenocarcinoma

Background: Despite the scarcity of data based on randomized trials, FOLFIRINOX is widely used in the management of borderline resectable pancreatic cancer (BRPC) and locally advanced unresectable pancreatic cancer (LAPC). We investigated the clinical outcomes of neoadjuvant FOLFIRINOX in patients with BRPC and LAPC. Methods: This single-center retrospective analysis included a total of 199 consecutive patients with BRPC or LAPC who received conventional or modified FOLFIRINOX between February 2013 and January 2017. An independent radiologist reviewed all baseline computed tomography or magnetic resonance imaging scans were reviewed for vascular invasion status. Results: With median follow-up duration of 40.3 months [95% confidence interval (CI), 36.7–43.8] in surviving patients, median progression-free survival (PFS) and overall survival (OS) were 10.6 (95% CI, 9.5–11.7) and 18.1 (95% CI, 16.0–20.3) months, respectively. The 1-year PFS rate was 66.0% (95% CI, 65.3–66.7%), and the 2-year OS rate was 37.2% (95% CI, 36.5–37.9%). PFS and OS did not differ between BRPC and LAPC groups [median PFS, 11.1 months (95% CI, 8.8–13.5) versus 10.1 months (95% CI, 8.4–11.8), p = 0.47; median OS, 18.4 months (95% CI, 16.1–20.8) versus 17.1 months (95% CI, 13.2–20.9), p = 0.50]. Curative-intent conversion surgery (R0/R1) was performed in 63 patients (31.7%). C•A 19-9 response, objective tumor response to FOLFIRINOX, and conversion surgery were independent prognostic factors for OS. Conclusion: FOLFIRINOX was effective for management of BRPC and LAPC. Given the potential for cure, a significant proportion of patients can undergo conversion curative-intent surgery following FOLFIRINOX.
A Real-World Study of Dexamethasone Implant in Treatment-Naïve Patients with Diabetic Macular Edema: Efficacy and Correlation Between Inflammatory Biomarkers and Treatment Outcome

Purpose There has been an increasing clinical interest in specific retinal parameters as non-invasive biomarkers of retinal inflammation in diabetic macular edema (DME) that have been shown to have prognostic value, such as hyperreflective retinal fields (HRFs) and subfoveal neuroretinal detachment (SND). Methods We conducted a prospective, non-comparative study of treatment-naïve patients with DME to evaluate the efficacy of a Pro Re Nata (PRN) regimen of intravitreal dexamethasone implant 0.7 mg (DexI, Ozurdex™). After administration, patients underwent subsequent injections according to PRN criteria in case of edema relapse, but not earlier than 4 months after the previous treatment. Patients were evaluated at baseline, within 15 days of injection, and every month thereafter. During all visits, best-corrected visual acuity (BCVA) was recorded; central retinal thickness (CRT), type of edema, presence of SND, and presence and number of HRFs were evaluated using swept-source optical coherence tomography (SS-OCT) 3D. Treatment outcome was defined as changes in BCVA, CRT, SND and HRFs at 12 (T12) and 24 (T24) months compared with baseline (T0). Results The study enrolled 24 eyes of 18 patients. The mean duration of follow-up was 18±6.6 months; for all eyes, T12 data were available, while follow-up reached T24 for 12 eyes. BCVA improved significantly and CRT decreased significantly during treatment; the edema was no longer detectable in 13/24 eyes at T12 and 8/12 eyes at T24. No patient presented SND at T12 and T24, and the mean number of HRFs decreased significantly during treatment. Results with CRT and HRFs correlated with BCVA at 12 and 24 months. No significant adverse events were observed. Conclusion In patients with DME, the intravitreal dexamethasone implant was effective and safe in improving both functional and tomographic parameters. This result is consistent with improvement in biomarkers of inflammation.
Factors Affecting Menstrual Hygiene Management Practice Among School Adolescents in Ambo, Western Ethiopia, 2018: A Cross-Sectional Mixed-Method Study

Background Menstruation is still regarded as something unclean in many parts of Ethiopia. Despite the challenges related to menstrual hygiene management, it has been routinely overlooked in the school setting. The existing evidence on menstrual hygiene management lacks objective measurement approaches. Therefore, the aim of this study was to assess factors affecting menstrual hygiene management practice among school adolescents in Ambo, Western Ethiopia. Methods An institutional-based mixed-method cross-sectional study was conducted from 1 to 30 March 2018 with 364 high school females. A systematic random sampling and purposive sampling technique were used to select study participants. We used a self-administered questionnaire, observational checklists, and focus group discussion. Data were analyzed using SPSS statistical software and thematic analysis. Multiple logistic regression analyses were done. With 95% CI, P< 0.05 was considered the level of significance. Results The prevalence of unsafe menstrual hygiene management practice was 53.6%, and it was affected by factors including age of the females [AOR: 0.16 (0.045, 0.57), P=0.005], frequency of discussing menses [AOR: 0.30, 95% CI: 0.13, 0.71, P-value = 0.006], and source of information about menses [AOR: 3.75, 95% CI: 1.75, 8.00) P= 0.001]. Lack of information about how to manage menses safely and lack of sufficient WASH facility were also identified. Conclusion High prevalence of unsafe menstrual hygiene management in the study area implies that urgent measures are needed from the concerned body. The school environments were not female friendly for managing their menses safely highlighting that the water, sanitation, and hygiene facilities in the schools need urgent solutions.
Patient Dignity in Iranian Clinical Care Settings as Perceived by Physicians, Caregivers, and Patients

Introduction All over the world, healthcare team members are recommended to respect patients’ human dignity. However, the dignity of hospitalized patients is not preserved in many cases. Due to the abstract, complex, and cultural nature of the concept of human dignity, further studies are required to precisely determine the different aspects of this concept. Purpose The aim of the present study was to explore the experiences and perceptions of physicians, nurses, family caregivers, and hospitalized patients with regard to patient dignity in Iranian clinical setting. Materials and Methods This is a qualitative, exploratory study in which physicians, nurses, family caregivers, and patients were recruited from 2 educational hospitals located in an urban area in Iran from April 2016 to February 2017 using the purposive sampling method (n = 24). Data were collected through individual interviews and subsequently analyzed using conventional content analysis in the software MAXQDA 2007, VERBIO`. Results Three major themes emerged from analyses of the data obtained from the interviews: a peaceful environment, respect, and comprehensive support. Conclusion From the participants’ point of view, in order for their dignity to be preserved, patients need to be hospitalized in a peaceful environment in which they are treated with empathy, they receive comprehensive support, and the care settings are managed properly. Furthermore, it is important to respect patient’s values and beliefs, to provide unbiased care and treatment, and to maintain patient’s autonomy in order to maintain hospitalized patients’ dignity.
Digital Image Analysis of CD8+ and CD3+ Tumor-Infiltrating Lymphocytes in Tongue Squamous Cell Carcinoma

Purpose The presence of CD8+ tumor-infiltrating lymphocytes (TILs) has been reported to be associated with treatment outcomes in many types of solid tumors. However, the results vary due to the various methods of visual estimation and subjective interpretation. The current study is the first to use digital image analyses to evaluate the density of CD8+/CD3+ TILs in tongue squamous cell carcinoma (TSCC). Patients and Methods From 2005 to 2015, a cohort of 258 TSCC patients were consecutively enrolled in this study. After immunohistochemistry on representative sections, the density of CD8+/CD3+ TILs at tumor invasive margins was evaluated by digital image analysis. The subjects were stratified by the median values of CD3+ cell density, CD8+ cell density, CD8/CD3, and scores (0, 1, and 2) to demonstrate the association with various clinicopathological manifestations. Results Low CD8+ TIL counts were associated with advanced tumor stages (p=0.034), and low CD8/CD3 ratios were associated with perineural invasion (p=0.043). Both parameters were also associated with increased tumor depths (p=0.034 and 0.004, respectively). Univariate analyses revealed that advanced tumor stages, perineural invasion, extranodal extension, tumor depth, lower CD8 counts, and lower scores (score 0 vs 2) were associated with poorer overall survival, and multivariate analysis further indicated that extranodal extension and low scores (score 0 vs 2) were both independent factors for overall survival (p < 0.0001 and p = 0.0369, respectively). Conclusion The use of digital image analysis to assess CD8+ TILs at the invasive margins provides an objective indicator of prognoses including overall survival.