Miracle-dz/UniFAR-FTUs huggingface dataset:
Patterns and predictors of complementary and alternative medicine use in people presenting with the non-communicable disease in an urban health facility, North India

Background: The rising burden of non-communicable diseases (NCDs) is a threat to India. Increasingly, individuals interested in improving their health and making healthy lifestyle changes are turning to complementary and alternative medicine (CAM) as a health-care option. Design and Methods: The objective of this study was to determine the prevalence, pattern, and predictor of alternative medicine use among NCDs patients undergoing allopathic treatment in an urban health centre. The study design was a hospital-based crosssectional study, which was done in a government hospital, Srinagar, Pauri District, Uttarakhand, India among adult males and females aged above 20 years. The patients having NCDs were systematically sampled. Result: Among 233 studied patients 57.1% were males. The mean age of the patients was 55.8 years (SD 13.5). Of the total studied patients 46.8% were diagnosed with DM, and 43.8% of HTN. Nearly one-fifth of the patients were known to have a CVD or COPD. A total of 49.8% of the studied NCD patients reported use of both allopathic and alternative medicine treatment and nearly 3.4% of the studied NCD patients in the last one year to seek exclusive alternative medicine treatment. The overall use of exclusive alternative medicine was low that is 3.7%, 1.0%, and 5% in diabetes, hypertension, and chronic lung disease patients, respectively. The most common form of alternative medicine used by studied patients was medicinal herbs/biological-based medicine (MB) (62.9%). Among MB commonly used were a bitter gourd, aloe vera, and others. 29.8% of the patients used Indian/Ayurveda medicine in total. Conclusions: The use of exclusive alternative medicine is low in adult patients with NCD. However, medical pluralism is prevalent. A better understanding of practices especially that focuses on alternative medicine needs a qualitative study, which was beyond the scope of this study. Significance for public health Alternative medicine provision for non communicable disease patients remains largely informal or unregulated. Though integrated into conventional health care frameworks it is largely fragmented. A better understanding of the pattern of alternative medicine use amongst non communicable disease patients will help dispel prevalent misconceptions concerning alternative medicine. It will assist conventional practitioners to critically evaluate their own prescribing habits.
Progression-free survival at 24 months as a predictor of survival outcomes after CHOP treatment in patients with peripheral T-cell lymphoma: a single-center validation study in a Japanese population

Abstract Peripheral T-cell lymphoma (PTCL) is a group of aggressive lymphomas commonly treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). Progression-free survival at 24 months (PFS24) constitutes a survival predictor for some lymphomas but has not been examined in Asian populations. We retrospectively investigated whether PFS24 was predictive of survival outcomes after CHOP treatment in 73 Japanese patients with PTCL. Patients without PFS24 had shorter median subsequent overall survival (OS) (20.2 vs. 121.0 months, p < 0.001) and shorter median subsequent progression-free survival (5.0 vs. 17.1 months, p = 0.03). Patients without PFS24 had worse overall (62.5% vs. 100%) and complete response rates (45.8% vs. 96.0%) (both p < 0.001). PFS24 absence (hazard ratio: 3.34, p = 0.004) and poor performance status (hazard ratio: 3.17, p = 0.04) were independently predictive of shorter OS. These findings suggest that PFS24 is predictive of survival after CHOP treatment in Japanese patients with PTCL.
Dietary Phytochemicals as a Potential Source for Targeting Cancer Stem Cells

Abstract The tumor microenvironment is composed of various types of cells that lead to tumor heterogeneity. In the middle of these populations, cancer stem cells play a vital role in the initiation and progression of cancer cells and are capable of self-renewal and differentiation processes. These cancer stem cells are resistant to conventional therapy such as chemotherapy and radiotherapy. To eradicate the cancer stem cells in the tumor environment, various natural product has been found in recent years. In this review, we have selected some of the natural products based on anticancer potential including targeting cancer cells and cancer stem cells. Further, this review explains the molecular mechanism of action of these natural products in various cancer stem cells. Therefore, targeting a multi-drug resistant cancer stem cell by natural products is a novel method to reduce drug resistance and adverse effect during conventional therapy.
Home sleep apnea testing of adults with chronic heart failure.

STUDY OBJECTIVES To evaluate home sleep apnea testing (HSAT) using a type 3 portable monitor (PM) to help diagnose sleep disordered breathing (SDB) and identify respiratory events including obstructive sleep apnea (OSA), central sleep apnea (CSA) and Cheyne-Stokes respiration (CSR) in adults with stable CHF. METHODS Eighty-four adults with CHF (86.9% males, age [mean±SD] 58.7±16.3 years, body mass index 29.4±13.0 kg/m², left ventricular ejection fraction 40.3±11.5%) performed unattended HSAT followed by an in-laboratory PSG with simultaneous portable monitor (PM) recording. RESULTS The apnea-hypopnea index (AHI) was 22.0±17.0 events/hour on HSAT, 26.8±20.5 events/hour on in-laboratory PM, and 23.8±21.3 events/hour on PSG (p=0.373). Bland-Altman analysis of AHI on HSAT versus PSG showed a mean difference (95% confidence interval) of -2.4 (-4.9, 0.1) events/hour and limits of agreement (±2 SDs) of -24.1 to 19.2 events/hour. HSAT underestimated AHI to a greater extent at higher AHI (rho=-0.358, P<0.001). Similar levels of agreement on HSAT versus PSG were observed when comparing obstructive apnea index (OAI), central apnea index (CAI) and percentage of time in CSR pattern. Using an AHI ≥5 events/hour to diagnose SDB, HSAT had 86.7% sensitivity, 76.5% specificity, 92.9% positive predictive value and 61.9% negative predictive value compared to PSG. Detection of CSR on HSAT had 94.6% sensitivity, 91.1% specificity, 88.6% positive predictive value and 97.6% negative predictive value compared to PSG. CONCLUSIONS HSAT with a type 3 portable monitor can help to diagnose SDB and identify OSA, CSA and CSR events in adults with CHF.
Characteristics and outcomes of patients with COVID-19 admitted to hospital and intensive care in the first phase of the pandemic in Canada: a national cohort study

Background: Clinical data on patients admitted to hospital with coronavirus disease 2019 (COVID-19) provide clinicians and public health officials with information to guide practice and policy. The aims of this study were to describe patients with COVID-19 admitted to hospital and intensive care, and to investigate predictors of outcome to characterize severe acute respiratory infection. Methods: This observational cohort study used Canadian data from 32 selected hospitals included in a global multisite cohort between Jan. 24 and July 7, 2020. Adult and pediatric patients with a confirmed diagnosis of COVID-19 who received care in an intensive care unit (ICU) and a sampling of up to the first 60 patients receiving care on hospital wards were included. We performed descriptive analyses of characteristics, interventions and outcomes. The primary analyses examined in-hospital mortality, with secondary analyses of the length of hospital and ICU stay. Results: Between January and July 2020, among 811 patients admitted to hospital with a diagnosis of COVID-19, the median age was 64 (interquartile range [IQR] 53–75) years, 495 (61.0%) were men, 46 (5.7%) were health care workers, 9 (1.1%) were pregnant, 26 (3.2%) were younger than 18 years and 9 (1.1%) were younger than 5 years. The median time from symptom onset to hospital admission was 7 (IQR 3–10) days. The most common symptoms on admission were fever, shortness of breath, cough and malaise. Diabetes, hypertension and cardiac, kidney and respiratory disease were the most common comorbidities. Among all patients, 328 received care in an ICU, admitted a median of 0 (IQR 0–1) days after hospital admission. Critically ill patients received treatment with invasive mechanical ventilation (88.8%), renal replacement therapy (14.9%) and extracorporeal membrane oxygenation (4.0%); 26.2% died. Among those receiving mechanical ventilation, 31.2% died. Age was an influential predictor of mortality (odds ratio per additional year of life 1.06, 95% confidence interval 1.03–1.09). Interpretation: Patients admitted to hospital with COVID-19 commonly had fever, respiratory symptoms and comorbid conditions. Increasing age was associated with the development of critical illness and death; however, most critically ill patients in Canada, including those requiring mechanical ventilation, survived and were discharged from hospital.
Effects of liver transplantation on sexual function and quality of life

ABSTRACT This descriptive study aimed to determine patients’ sexual dysfunction and quality of life before and after liver transplantation. The study was conducted with 64 patients who underwent liver transplantation at a university hospital between January 2015 and 2017. The patients were aged 18 or over, able to answer relevant questions and volunteered to participate in the study. The population of the study included patients who underwent liver transplantation on the specified dates and agreed to participate in the study. Descriptive Characteristics Form, Short Form-36 (SF-36), Female Sexual Function Index (FSFI) and International Index of Erectile Function (IIEF) were used for data collection. A significant increase was found in all subscale scores of males on the IIEF scale after transplantation (p = 0.000). The total FSFI score of the females was 24.27 ± 18.60 before transplantation and 29.62 ± 25.19 after transplantation. The results were not statistically significant (p = 0.072). After transplantation, a highly significant increase was observed in the Physical Component Summary and Mental Component Summary subscale scores of the SF-36 both in males and females (p = 0.000). An increase was observed in the sexual functions of males and females after transplantation. A statistically significant increase was found in the mean scores of both males and females on the quality of life after transplantation (p = 0.000). This study concluded that sexual functions of male (p < 0.05) and female (p > 0.05) patients improved after transplantation.
Prevalence and risk factors for thyroid cancer in patients with multinodular goitre

Abstract Background Rates of thyroid cancer in patients with multinodular goitre (MNG) vary widely, from 3 per cent in older studies to 35 per cent in more recent studies. The purpose of the present study was to evaluate the prevalence of thyroid cancer in patients operated on for MNG, and to determine risk factors for incidental thyroid malignancy. Methods A prospectively developed database of all patients who underwent thyroidectomy for a benign MNG at the high-volume endocrine surgery unit of a tertiary referral university hospital was interrogated. Results A total of 3233 patients were analysed, separated into three groups according to their functional thyroid status (hypothyroid, hyperthyroid or euthyroid). There were 2788 women (86.2 per cent); the mean patient age was 56.4 years and mean preoperative disease duration was 106.2 months. Incidental thyroid cancer was identified in 1026 patients (31.7 per cent), of which 917 (89.4 per cent) were papillary cancers. Multivariable regression analysis identified functional thyroid status, younger age, male sex, smaller adenoma size, smaller thyroid glands, Hashimoto’s thyroiditis and chronic non-specific thyroiditis as independent risk factors for thyroid cancer. Conclusion MNG was associated with a considerable rate of incidental thyroid cancer, which has been underestimated. A variety of factors should be taken into account when considering the malignant potential of a presumed benign MNG.
Recombinant protein subunit SARS-CoV-2 vaccines formulated with CoVaccine HT adjuvant induce broad, Th1 biased, humoral and cellular immune responses in mice

The speed at which several COVID-19 vaccines went from conception to receiving FDA and EMA approval for emergency use is an achievement unrivaled in the history of vaccine development. Mass vaccination efforts using the highly effective vaccines are currently underway to generate sufficient herd immunity and reduce transmission of the SARS-CoV-2 virus. Despite the most advanced vaccine technology, global recipient coverage, especially in resource-poor areas remains a challenge as genetic drift in naïve population pockets threatens overall vaccine efficacy. In this study, we described the production of insect-cell expressed SARS-CoV-2 spike protein ectodomain and examined its immunogenicity in mice. We demonstrated that, when formulated with CoVaccine HT™adjuvant, an oil-in-water nanoemulsion compatible with lyophilization, our vaccine candidates elicit a broad-spectrum IgG response, high neutralizing antibody titers, and a robust, antigen-specific IFN-γ secreting response from immune splenocytes in outbred mice. Our findings lay the foundation for the development of a dry-thermostabilized vaccine that is deployable without refrigeration.
A single-plasmid approach for genome editing coupled with long-term lineage analysis in chick embryos

ABSTRACT An important strategy for establishing mechanisms of gene function during development is through mutation of individual genes and analysis of subsequent effects on cell behavior. Here, we present a single-plasmid approach for genome editing in chick embryos to study experimentally perturbed cells in an otherwise normal embryonic environment. To achieve this, we have engineered a plasmid that encodes Cas9 protein, gene-specific guide RNA (gRNA), and a fluorescent marker within the same construct. Using transfection- and electroporation-based approaches, we show that this construct can be used to perturb gene function in early embryos as well as human cell lines. Importantly, insertion of this cistronic construct into replication-incompetent avian retroviruses allowed us to couple gene knockouts with long-term lineage analysis. We demonstrate the application of our newly engineered constructs and viruses by perturbing β-catenin in vitro and Sox10, Pax6 and Pax7 in the neural crest, retina, and neural tube and segmental plate in vivo, respectively. Together, this approach enables genes of interest to be knocked out in identifiable cells in living embryos and can be broadly applied to numerous genes in different embryonic tissues.
Longitudinal Multi-omics and Microbiome Meta-analysis Identify an Asymptomatic Gingival State That Links Gingivitis, Periodontitis, and Aging

A significant portion of world population still fails to brush teeth daily. As a result, the majority of the global adult population is afflicted with chronic gingivitis, and if it is left untreated, some of them will eventually suffer from periodontitis. ABSTRACT Most adults experience episodes of gingivitis, which can progress to the irreversible, chronic state of periodontitis, yet roles of plaque in gingivitis onset and progression to periodontitis remain elusive. Here, we longitudinally profiled the plaque metagenome, the plaque metabolome, and salivary cytokines in 40 adults who transited from naturally occurring gingivitis (NG) to healthy gingivae (baseline) and then to experimental gingivitis (EG). During EG, rapid and consistent alterations in plaque microbiota, metabolites, and salivary cytokines emerged as early as 24 to 72 h after oral-hygiene pause, defining an asymptomatic suboptimal health (SoH) stage of the gingivae. SoH features a swift, full activation of 11 salivary cytokines but a steep synergetic decrease of plaque-derived betaine and Rothia spp. , suggesting an anti-gum inflammation mechanism by health-promoting symbionts. Global, cross-cohort meta-analysis revealed, at SoH, a greatly elevated microbiome-based periodontitis index driven by its convergence of both taxonomical and functional profiles toward the periodontitis microbiome. Finally, post-SoH gingivitis development accelerates oral microbiota aging by over 1 year within 28 days, with Rothia spp. depletion and Porphyromonas gingivalis elevation as hallmarks. Thus, the microbiome-defined, transient gum SoH stage is a crucial link among gingivitis, periodontitis, and aging. IMPORTANCE A significant portion of world population still fails to brush teeth daily. As a result, the majority of the global adult population is afflicted with chronic gingivitis, and if it is left untreated, some of them will eventually suffer from periodontitis. Here, we identified periodontitis-like microbiome dysbiosis in an asymptomatic SoH stage as early as 24 to 72 h after oral-hygiene pause. SoH features a swift, full activation of multiple salivary cytokines but a steep synergetic decrease of plaque-derived betaine and Rothia spp. The microbial ecology during early gingivitis is highly similar to that in periodontitis under both taxonomical and functional contexts. Unexpectedly, exposures to gingivitis can accelerate over 10-fold the normal rate of oral microbiota aging. Our findings underscore the importance of intervening at the SoH stage of gingivitis via proper oral-hygiene practices on a daily basis, so as to maintain a periodontitis-preventive plaque and ensure the healthy aging of the oral ecosystem.
Organ‐on‐chip of the cervical epithelial layer: A platform to study normal and pathological cellular remodeling of the cervix

Damage to the cervical epithelial layer due to infection and inflammation is associated with preterm birth. However, the individual and/or collective roles of cervical epithelial layers in maintaining cervical integrity remain unclear during infection/inflammation. To determine the intercellular interactions, we developed an organ‐on‐chip of the cervical epithelial layer (CE‐OOC) composed of two co‐culture chambers connected by microchannels, recapitulating the ectocervical and endocervical epithelial layers. Further, we tested the interactions between cells from each distinct region and their contributions in maintaining cervical integrity in response to LPS and TNFα stimulations. The co‐culture of ectocervical and endocervical cells facilitated cellular migration of both epithelial cells inside the microchannels. Compared to untreated controls, both LPS and TNFα increased apoptosis, necrosis, and senescence as well as increased pro‐inflammatory cytokine productions by cervical epithelial cells. In summary, the CE‐OOC established an in vitro model that can recapitulate the ectocervical and the endocervical epithelial regions of the cervix. The established CE‐OOC may become a powerful tool in obstetrics and gynecology research such as in studying cervical remodeling during pregnancy and parturition and the dynamics of cervical epithelial cells in benign and malignant pathology in the cervix.
Endovascular arteriovenous fistulas— are they the answer we haven’t been looking for?

ABSTRACT Introduction Surgically created arteriovenous fistulas are the accepted gold standard for the establishment of hemodialysis access in patients requiring dialysis. However, primary and maturation failures may limit their usage. Recent advances in endovascular technology have resulted in the creation of devices for endovascular arteriovenous fistula formation. These devices may offer an additional or alternative approach to fistula formation in patients with end-stage kidney disease. Areas covered This review describes the limitations of surgical arteriovenous fistulas and the endovascular devices currently available. The review covers initial trial data and subsequent studies examining their use. Expert opinion Early results achieved with endovascular fistula formation are encouraging. Current limitations of this technology include anatomic suitability and a high rate of re-interventions required to establish maturity. Greater uptake of the technology will also require a review of long-term outcomes in larger patient cohorts.
Using Machine Learning Technologies in Pressure Injury Management: Systematic Review

Background Pressure injury (PI) is a common and preventable problem, yet it is a challenge for at least two reasons. First, the nurse shortage is a worldwide phenomenon. Second, the majority of nurses have insufficient PI-related knowledge. Machine learning (ML) technologies can contribute to lessening the burden on medical staff by improving the prognosis and diagnostic accuracy of PI. To the best of our knowledge, there is no existing systematic review that evaluates how the current ML technologies are being used in PI management. Objective The objective of this review was to synthesize and evaluate the literature regarding the use of ML technologies in PI management, and identify their strengths and weaknesses, as well as to identify improvement opportunities for future research and practice. Methods We conducted an extensive search on PubMed, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, China National Knowledge Infrastructure (CNKI), the Wanfang database, the VIP database, and the China Biomedical Literature Database (CBM) to identify relevant articles. Searches were performed in June 2020. Two independent investigators conducted study selection, data extraction, and quality appraisal. Risk of bias was assessed using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). Results A total of 32 articles met the inclusion criteria. Twelve of those articles (38%) reported using ML technologies to develop predictive models to identify risk factors, 11 (34%) reported using them in posture detection and recognition, and 9 (28%) reported using them in image analysis for tissue classification and measurement of PI wounds. These articles presented various algorithms and measured outcomes. The overall risk of bias was judged as high. Conclusions There is an array of emerging ML technologies being used in PI management, and their results in the laboratory show great promise. Future research should apply these technologies on a large scale with clinical data to further verify and improve their effectiveness, as well as to improve the methodological quality.