Miracle-dz/UniFAR-FTUs huggingface dataset:
Safety and efficacy of azathioprine in immune thrombocytopenia.

BACKGROUND Immune thrombocytopenia (ITP) is a benign hematological disorder characterized by low platelet counts in peripheral blood and spectrum of various bleeding manifestations. Azathioprine is one of the effective, readily available, and affordable immunosupressants available for ITP management in developing countries. We aimed to study the efficacy and long-term safety profile of our patients with ITP who were treated with azathioprine. METHOD This was a retrospective, single-center study conducted at a tertiary care hospital in Northern India. The patients who had received at least one line of therapy before receiving azathioprine were included in this study. All patients received oral azathioprine at a dose of 1 mg/kg/day (50 mg or 100 mg tablet formulations were used), which was increased up to 2 mg/kg/day depending upon the response and adverse effects. RESULT Sixty-three patients were analyzed. Their median age was 28 years (range 15-68); 29/63 patients (46.03%) were females. The median duration from diagnosis to azathioprine initiation was 539 days (323 days-980.5 days). The patients included in the study had received a median of 3 (range 1-6) prior lines of therapies; 38/63 patients (60.32%) had received ≥3 prior therapies. Six patients (9.5%) had relapsed after splenectomy, and 16 patients (25.4%) had relapsed after receiving rituximab. The mean baseline platelet count was 10000/μL. The median time to response was 95 days (90 days-not reached) and the cumulative overall response rate (complete and partial response) at day 90 was 38.1%. Only one patient achieved complete response with azathioprine in our study. The cumulative rate of relapse at five years was 21.2%. Twenty-six patients stopped azathioprine after achieving some response (CR/PR) with Azathioprine for a median duration of 1067.5 days (range: 236 days-2465 days). They were followed up for a median of 870 days (range: 392 days-1928 days), and twelve of them relapsed. Twenty-six patients (26/63, 41.27%) reported one or more adverse events while on azathioprine. Leucopenia was the most frequent adverse event, followed by anemia and hepatobiliary laboratory abnormalities. Serious adverse events (grade ≥3 CTCAEv4) were noted in three patients (4.7%). One patient succumbed to severe sepsis multiorgan dysfunction while being on treatment. CONCLUSION We conclude that azathioprine has a good response rate in chronic ITP patients. It is well-tolerated with minimal and manageable side effects.
Correlation of the Corvis Biomechanical Factor with tomographic parameters in keratoconus

The Corvis Biomechanical Factor CBiF, a modification of the linear term of the CBI, is highly associated with KC severity as defined by corneal tomography. Purpose: To investigate the relationship between corneal biomechanics and keratoconus (KC) severity as described by tomographic parameters. Setting: University-based German ophthalmology department. Design: Retrospective cross-sectional study. Methods: A total of 448 KC corneas of the Homburg Keratoconus Center and 112 healthy corneas (448+112 patients) were examined by Pentacam high-resolution and Corneal Visualization Scheimpflug Technology (Pentacam HR and Corvis ST). The KC population included a wide spectrum of disease severity based on Belin's ABCD classification. Linear regression analysis was performed between the linear term of the Corvis Biomechanical Index (CBI) (CBI beta) and the tomographic values anterior radius of curvature (ARC), posterior radius of curvature (PRC), and thinnest corneal thickness (TCT). A linear transformation of the CBI beta was performed to provide an intuitive scaling, which was referred to as the Corvis Biomechanical Factor (CBiF = −0.24294226 × CBI beta + 6.02). This scaling adjusted the CBI beta to the same scale as posterior corneal curvature (PRC). Results: There was a high correlation of the CBI beta and its modification, the CBiF, with TCT (Pearson, r = −0.775), ARC (r = −0.835), and PRC (r = −0.839) in the KC population (P < .001). In the control corneas, the correlation between the CBI beta and ARC was weak (r = −0.216, P = .022), not significant (PRC, r = −0.146, P = .125), or moderate (TCT, r = −0.628, P < .001). Conclusions: The linear term of the CBI was highly associated with KC severity as defined by corneal tomography. The CBiF represents a new scale based on biomechanical characteristics in KC, which could serve as a basis for a biomechanical KC classification in the future.
Emergence of equine-like G3 strains as the dominant rotavirus among children under five with diarrhea in Sabah, Malaysia during 2018–2019

Rotavirus infection is a dilemma for developing countries, including Malaysia. Although commercial rotavirus vaccines are available, these are not included in Malaysia’s national immunization program. A scarcity of data about rotavirus genotype distribution could be partially to blame for this policy decision, because there are no data for rotavirus genotype distribution in Malaysia over the past 20 years. From January 2018 to March 2019, we conducted a study to elucidate the rotavirus burden and genotype distribution in the Kota Kinabalu and Kunak districts of the state of Sabah. Stool specimens were collected from children under 5 years of age, and rotavirus antigen in these samples was detected using commercially available kit. Electropherotypes were determined by polyacrylamide gel electrophoresis of genomic RNA. G and P genotypes were determined by RT-PCR using type specific primers. The nucleotide sequence of the amplicons was determined by Sanger sequencing and phylogenetic analysis was performed by neighbor-joining method. Rotavirus was identified in 43 (15.1%) children with watery diarrhea. The male:female ratio (1.9:1) of the rotavirus-infected children clearly showed that it affected predominantly boys, and children 12–23 months of age. The genotypes identified were G3P[8] (74% n = 31), followed by G1P[8] (14% n = 6), G12P[6](7% n = 3), G8P[8](3% n = 1), and GxP[8] (3% n = 1). The predominant rotavirus circulating among the children was the equine-like G3P[8] (59.5% n = 25) with a short electropherotype. Eleven electropherotypes were identified among 34 strains, indicating substantial diversity among the circulating strains. The circulating genotypes were also phylogenetically diverse and related to strains from several different countries. The antigenic epitopes present on VP7 and VP4 of Sabahan G3 and equine-like G3 differed considerably from that of the RotaTeq vaccine strain. Our results also indicate that considerable genetic exchange is occurring in Sabahan strains. Sabah is home to a number of different ethnic groups, some of which culturally are in close contact with animals, which might contribute to the evolution of diverse rotavirus strains. Sabah is also a popular tourist destination, and a large number of tourists from different countries possibly contributes to the diversity of circulating rotavirus genotypes. Considering all these factors which are contributing rotavirus genotype diversity, continuous surveillance of rotavirus strains is of utmost importance to monitor the pre- and post-vaccination efficacy of rotavirus vaccines in Sabah.
An update of targeted therapeutic options for primary Sjögren syndrome: current status and future development

ABSTRACT Introduction: Primary Sjögren syndrome (pSS) is a systemic autoimmune disease that may affect 3 in 1,000 people within the general population. The therapeutic scenario is complex, and no therapy has proved to be able to modify the natural course of the disease, nor to prevent the most severe systemic complications. Areas covered: Recently, the EULAR 2020 Recommendations for pSS have underlined the low level of evidence supporting efficacious therapeutic approaches, lacking a definition of specific treatment targets and being far from the ‘disease modification’ concept that is frequently used in other diseases. Herein, the authors review the status of current targeted therapies and provide the reader with their expert opinion. Expert opinion: The progress in discovering novel treatments for pSS seem to be focused on searching new biological therapies as highly-selective drugs that can be effective without the adverse effects related to the wide, nonspecific immunosuppression induced by the drugs currently used. Most likely, the more disruptive therapeutic approach in pSS that could be seen in a few years is the use of combination strategies targeting different etiopathogenic pathways.
Psychological predictors of chemotherapy‐induced nausea in women with breast cancer: Expectancies and perceived susceptibility

Abstract Objective Chemotherapy‐induced nausea is challenging to predict and treat. Research indicates that pretreatment psychological variables including patients' perceptions of their susceptibility to nausea, expectancies of treatment‐related nausea and nausea history (i.e., motion sickness, morning sickness and baseline levels of nausea) may aid in predicting nausea severity during chemotherapy. However, this research is dated and limited in quantity. We investigated whether psychological variables could improve prediction of nausea severity to inform interventions targeting chemotherapy‐induced nausea. Methods In this secondary analysis, a subgroup of women receiving chemotherapy (for the first time) for breast cancer completed pretreatment measures: perceived nausea susceptibility, nausea expectancies, nausea history and baseline nausea. They rated subsequent nausea severity across 4‐days, during treatment and posttreatment in a self‐report diary. Structural Equation Modelling was used to explore associations. Results Across the women (N = 481), perceived nausea susceptibility predicted subsequent nausea severity (β = 0.16), but nausea expectancies did not (β = 0.05). Nausea history variables demonstrated small‐moderate associations with perceived susceptibility (β = 0.21–0.32) and negligible‐small associations with nausea expectancies (β = 0.07–0.14). Conclusion Perceived nausea susceptibility appears to capture patients' nausea history, to a degree, and is related to nausea severity during treatment. This is an important variable to include in pretreatment prediction of patients at risk of severe nausea.
Ultrastructural characterization of the intestine of the Eurasian common moorhen using scanning electron microscopy and light microscopy

The present investigation focused on the morphological features of the intestine of Eurasian common moorhen by the aid of scanning electron microscopy and histological, morphometric, and statistical examinations. The intestinal villi were varied in shape along the intestinal tract; the duodenal villi were elongated and twisted, the jejunal villi were tongue‐like, the ileal villi were cuboidal, and the cecal villi were tongue‐like and finger‐like at the base and body of the cecum. While at the apex of the cecum, it appeared as corrugated longitudinal folds and the rectal villi appeared as columns. The microvilli were present as projections on the surface of villi of the small intestine and the base of the cecum. While at the body and the apex of the cecum, the microvilli appeared as threads and as brush hairs on the rectal villi. The duodenal, jejunal, ileal, cecal, and rectal villi were lined by simple columnar epithelium with goblet cells. The submucosal layer of small intestine consisted of connective tissue fibers along the intestinal tract, but it was absent at the base of the cecum. The tunica musculosa consisted of single longitudinal layer of smooth muscle fibers in the duodenum and rectum. While in the jejunum, ileum, and cecum, it was composed of single circular layer of smooth muscle fibers. The thickness of the tunics differed among the intestinal parts.
Effects of General Anesthesia Combined with Epidural Anesthesia on Cognitive Dysfunction and Inflammatory Markers of Patients after Surgery for Esophageal Cancer: A Randomised Controlled Trial.

OBJECTIVE To evaluate the impact of general anesthesia (GA) combined with epidural anesthesia (GAEA) on postoperative cognitive dysfunction (POCD) and inflammatory markers in patients with esophageal cancer (EC). Study Design: A randomised controlled trial. PLACE AND DURATION OF STUDY Department of Anesthesiology, Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan Province, China, from August 2019 to April 2020. METHODOLOGY SPSS was used to randomly divide 142 cases into two groups, namely: the GA (n=71) and GAEA (n=71) categories. 128 candidates were used in this study. Cognitive function and the levels of interleukin 6 (IL-6), interleukin 8 (IL-8), and tumor necrosis markers α (TNF-α) in serum were evaluated at baseline, 1, 3 and 7 days after operation by Montreal Cognitive Assessment (MoCA) and enzyme-linked immunosorbent assay (ELISA), respectively. Pearson correlation analysis was used to assess the interrelationships between MoCA score and inflammatory markers levels. RESULTS Compared to the GA group (n=64), the GAEA category (n=64) showed significantly higher MoCA score on 1 day and 3 days postoperatively (all p <0.05). IL-6, IL-8 and TNF-α in the GA group were significantly increased on 1, 3 and 7 days after surgery (all p <0.05). Pearson correlation analysis indicated that the three inflammatory markers were inversely correlated with cognitive function score (all p <0.05). The postoperative adverse events between the two groups were comparable (all p >0.05). CONCLUSION Combining general and epidural anesthesia may reduce the incidence of POCD in patients undergoing esophagectomy by suppressing inflammatory response. Key Words: General anesthesia, Epidural anesthesia, Esophageal cancer, Postoperative cognitive dysfunction, Inflammatory markers.
Adrenergic receptor behaviors of mesenchymal stem cells obtained from different tissue sources and the effect of the receptor blockade on differentiation

Abstract In this study, it was aimed to analyze behavioral changes of adrenergic receptors (ARs) in first three passages and osteogenic/adipogenic differentiation of mesenchymal stem cells (MSCs) derived from placenta fetal membrane (FM) and bone marrow (BM). It was also aimed to evaluate effects of receptor blockade on differentiation. We obtained first three passages of MSCs from placenta and BM samples. For cell identification, the cells were analyzed by flow cytometry using CD34, CD45 and CD3, CD105 antibodies in each passage. The effects of propranolol and phenoxybenzamine at incremental doses were analyzed by MTT. In addition, cell cultures were separately maintained with the blockers or without after second passage. After each passage and differentiation, α1A, α1B, α2A, α2B, β1, β2, β3 AR-mRNA expressions analyzed by RT-qPCR technique. BMP6 and PPARG mRNA expressions only after differentiation and passage 3 were analyzed. A microscopic examination was also performed. Our results showed that AR expression behaviors were different in MSCs obtained from different tissue sources. In particular, α1A-AR and α2A-AR were expressed with considerably high coefficients in differentiation under blocker effect in BM-derived MSCs. No such coefficients were observed in any group of placental MSCs. In addition, it was found that the blockers stimulated adipogenesis in BM-derived MSCs during osteogenic differentiation. MSCs exhibit protein expressions that vary according to source of tissue and differentiation. Given that MSCs from different sources are used for repair and modulation, our study makes implications of this variable expression intriguing in the clinical practice.
Awareness of and reactions to health and environmental harms of red meat among parents in the United States

Abstract Objective: Evidence of the health and environmental harms of red meat is growing, yet little is known about which harms may be most impactful to include in meat reduction messages. This study examined which harms consumers are most aware of and which most discourage them from wanting to eat red meat. Design: Within-subjects randomised experiment. Participants responded to questions about their awareness of, and perceived discouragement in response to, eight health and eight environmental harms of red meat presented in random order. Discouragement was assessed on a 1-to-5 Likert-type scale. Setting: Online survey. Participants: 544 US parents. Results: A minority of participants reported awareness that red meat contributes to health harms (ranging from 8 % awareness for prostate cancer to 28 % for heart disease) or environmental harms (ranging from 13 % for water shortages and deforestation to 22 % for climate change). Among specific harms, heart disease elicited the most discouragement (mean = 2·82 out of 5), followed by early death (mean = 2·79) and plants and animals going extinct (mean = 2·75), though most harms elicited similar discouragement (range of means, 2·60–2·82). In multivariable analyses, participants who were younger, identified as Black, identified as politically liberal, had higher general perceptions that red meat is bad for health and had higher usual red meat consumption reported being more discouraged from wanting to eat red meat in response to health and environmental harms (all P < 0·05). Conclusions: Messages about a variety of health and environmental harms of red meat could inform consumers and motivate reductions in red meat consumption.
Associations between home renovation and asthma, allergic rhinitis, and eczema among preschool children in Wuhan, China

ABSTRACT To investigate the potential associations between household renovation and allergic diseases among preschool children in Wuhan, we conducted a large cross-sectional questionnaire survey among 9455 preschool children aged 3–6 years in Wuhan during November to December 2019. Data on demographics, health status, and home decoration conditions were analysed based on a questionnaire. Compared with tiles/stone/cement floor covering, the use of composite floor significantly increased the risk of diagnosed rhinitis and eczema among children (rhinitis: AOR, 95% CI: 1.36, 1.06–1.73; eczema: AOR, 95% CI: 1.47, 1.17–1.85). Household renovation had significant associations with diagnosed eczema (within 1 year before pregnancy: AOR, 95% CI: 1.34, 1.20–1.50; during pregnancy: AOR, 95% CI: 1.25, 1.08–1.44). This study suggests that use of artificial synthetic materials in home renovation during early childhood and pregnancy may be potential risk factors for childhood asthma, allergic rhinitis, and eczema.
Resistance Training and High-intensity Interval Training Improve Cardiometabolic Health in High Risk Older Adults: A Systematic Review and Meta-anaylsis

Abstract Progressive resistance training (PRT) and high-intensity interval training (HIIT) improve cardiometabolic health in older adults. Whether combination PRT+HIIT (COMB) provides similar or additional benefit is less clear. This systematic review with meta-analysis of controlled trials examined effects of PRT, HIIT and COMB compared to non-exercise control in older adults with high cardiometabolic risk. Databases were searched until January 2021, with study quality assessed using the PEDro scale. Risk factor data was extracted and analysed using RevMan V.5. 3. We analysed 422 participants from nine studies (7 PRT, n=149, 1 HIIT, n=10, 1 COMB, n=60; control n=203; mean age 68.1±1.4 years). Compared to control, exercise improved body mass index (mean difference (MD) −0.33 [−0.47, −0.20], p≤0.0001), body fat% (standardised mean difference (SMD) −0.71 [−1.34, −0.08], p=0.03), aerobic capacity (SMD 0.41 [0.05, 0.78], p=0.03), low-density lipoprotein (SMD −0.27 [−0.52, −0.01], p=0.04), and blood glucose (SMD −0.31 [−0.58, −0.05], p=0.02). Therefore, PRT, HIIT and COMB can improve cardiometabolic health in older adults with cardiometabolic risk. Further research is warranted, particularly in HIIT and COMB, to identify the optimal exercise prescription, if any, for improving older adults cardiometabolic health. (PROSPERO: CRD42019128527).
VOLATILE COMPOUNDS ANALYSIS OF DACIA SAUSAGE, A TRADITIONAL ROMANIAN DRY-CURED SAUSAGE

Three batches of Dacia sausage were produced as follows: one without starter culture and two with a mix of starter cultures. Volatiles were extracted by a purgeand-trap method and analyzed by gas chromatographic/mass spectrometry. Approximately 43 compounds were identified. The substances identified belong to: aldehydes, alcohols, ketones, hydrocarbons, esters, acids, furans. Results indicated that the most abundant class of chemical substances in flavor at the end of the ripening process was esters, followed by aldehydes, hydrocarbures and terpenes. This could only indicate the high microbial esterification activity that took place in the batches. It was possible to differentiate between the three sausages applying a discriminant analysis.
The effects of clinical and angiographic aspects of coronary artery disease on the cardiac autonomic function: a single-center prospective cohort study.

BACKGROUND Autonomic malfunction is linked to elevated cardiovascular morbidity and mortality. Various patient characteristics can alter the cardiac autonomic function therefore, using a prospective observational study, we aimed to assess the effects of different clinical and angiographic factors of coronary artery disease (CAD) patients on the cardiac autonomic function evaluated by heart rate variability (HRV) measurement. METHODS AND PATIENTS 100 patients undergoing coronary angiography when clinically indicated were enrolled. A short-term 5-minute HRV measurement was performed by CheckMyheart™ handheld HRV device manufactured by DailyCare BioMedical Inc, Taiwan. HRV data were fed to CheckMyheart™ 5-min HRV analysis software and interpreted based on the standard methods for HRV measurement as discussed in the Task Force of the European Society of Cardiology (ESC) and The North American Society of Pacing and Electrophysiology (NAPSE). Coronary angiography was done with an emphasis on SYNTAX (SX) score calculation. RESULTS The mean age of the recruited patients was 56.89±10.75 years with 85% of them were males and the mean SX score 13.11±8.52. Multivariate regression analysis of the different patient clinical and angiographic characteristics affecting HRV showed that CAD type either single or multi-vessel and SX score were the major independent variables affecting HRV in patients with CAD. CONCLUSION The complexity of CAD measured by SX score was the main independent predictor affecting the cardiac autonomic function estimated by HRV measurement.
Holmium laser enucleation of the prostate: A truly size‐independent method?

To evaluate the impact of prostate size on functional outcomes and perioperative morbidity, we analyzed patients undergoing holmium laser enucleation of the prostate (HoLEP) for lower urinary tract symptoms (LUTS). As LUTS secondary to benign prostatic obstruction (BPO) are a chronic progressive disease, prevalence and prostate size increase with age. HoLEP is a size‐independent method for surgical treatment of LUTS/BPO and can be offered in medication‐refractory patients with durable long‐term results and reduced perioperative morbidity.