Miracle-dz/UniFAR-FTUs huggingface dataset:
Antepartum Depression and Associated Factors Among Pregnant Women Attending ANC Clinics in Gurage Zone Public Health Institutions, SNNPR, Ethiopia, 2019

Background Antepartum depression is a form of clinical depression that can be caused by the stress and worry that pregnancy can bring a more severe level. It can be triggered by an unplanned pregnancy, a history of substance abuse, and low economic status. Antepartum depression is critical and has an intergenerational impact on children in the developing world and it can have negative effects on fetal development. Therefore, this study aimed to assess its magnitude and associated factors among pregnant women attending antenatal clinics in Gurage zone public health institutions, SNNPR, Ethiopia, 2019. Methods Intuition-based cross-sectional study was employed in Gurage zone public health institutions from February 14 to April 14/2019. A systematic random sampling technique was used. The data were collected and then entered into EpiData and processed by SPSS version 24.0 for analysis. P values <0.05 with 95% confidence level were used to declare statistical significance. Results In this study, a total of 343 pregnant mothers were participated by making a response rate of 96%. The magnitude of antepartum depression among pregnant women was 27.6% (95% CI: 22.4–33.2). The multivariable analysis showed that respondents who had unplanned pregnancy [AOR=2.11 (95% CI: 1.05–4.44)], having complications during their previous labor and delivery [AOR=4.42 (95% CI: 2.06–9.48)], previous history of child hospitalization [AOR=3.34 (95% CI: 1.48–7.51)], and satisfaction in their marriage [AOR=3.9 (95% CI: 1.15–13.21)] were associated with antepartum depression. Conclusion In this study, about one in four women during pregnancy develop antepartum depression. Unplanned pregnancy, complications during labor and delivery of the last baby, women having a history of child hospitalization, and maternal satisfaction with marriage were statistically associated factors with APD. To prevent further consequences, all concerned bodies need to take action by making targeted intervention and early screening of all pregnant mothers for depression.
Association of CETP Gene Variants with Atherogenic Dyslipidemia Among Thai Patients Treated with Statin

Objective Patients treated with statins for dyslipidemia may still have a residual risk of atherosclerotic cardiovascular disease (ASCVD). To determine whether genetic variants in the cholesteryl ester transport protein (CETP), rs3764261 (C>A), rs708272 (G>A), and rs12149545 (G>A) affect ASCVD risk, we studied the association of these variants with dyslipidemia in statin-treated patients. Patients and Methods We included 299 adult Thai patients treated with a statin (95 men and 204 women). Genotyping was performed by conducting a TaqMan real-time polymerase chain reaction-based analysis. We used logistic regression models adjusted for potential confounders of age, body mass index, blood pressure, insulin resistance, and statin dosage to analyze the association between CETP variants and atherogenic lipoprotein patterns. Results CETP polymorphisms of rs3764261 and rs708272, but not rs12149545, were significantly associated with high-density lipoprotein cholesterol (HDL-C), apoA-I, triglycerides, very low-density lipoprotein (VLDL)-C, and large LDL (LDL1-C) levels as well as mean LDL particle size (all p < 0.020). However, no significant difference was observed in total cholesterol, LDL-C, or apoB levels by CETP variants. Regardless of sex, the combination of rs3764261 (CC genotype) and rs708272 (GG or GA genotypes) showed a stronger association with atherogenic dyslipidemia, including features of decreased HDL-C, elevated triglycerides, and LDL subclass pattern B (odds ratio [OR] = 2.99, 95% confidence interval [CI]: 1.78–5.02) compared with the single variant rs3764261 (OR = 2.11, 95% CI: 1.27–3.50) or rs708272 (OR = 2.12, 95% CI: 1.29–3.49). Conclusion The polymorphisms of CETP rs3764261 (CC genotype) and rs708272 (GG and GA genotypes) may have a higher susceptibility to atherogenic dyslipidemia. Testing for CETP rs3764261 and rs708272 may serve as a surrogate marker for lipid management in statin-treated patients, which may help individualize treatment for reducing the residual risk of ASCVD.
Prevalence of Workplace Bullying and Its Associated Factors among Workers in a Malaysian Public University Hospital: A Cross-Sectional Study

Background and Purpose Workplace bullying has been regarded as a serious phenomenon, particularly in health-care settings, due to its tendency to predispose health workers to serious psychological repercussions, job dissatisfaction, and turnover. Such consequences are costly to health systems and disruptive to the continuity of patient care. While global bullying literature in health settings grows, evidence on the magnitude of the problem from a Malaysian perspective is scarce. This study aimed to determine the prevalence of workplace bullying and its associated factors among health workers in a Malaysian public university hospital. Methods This cross-sectional study was conducted from October to December 2019 among 178 hospital workers at the Hospital Canselor Tuanku Muhriz in Kuala Lumpur, Malaysia. The study utilized a self-administered questionnaire that consisted of items on sociodemographics, work characteristics, sources of bullying, and the validated Malay version of the 23-item Negative Acts Questionnaire — revised to determine the prevalence of bullying. Descriptive and inferential statistics were analyzed using SPSS 22.0. Statistical significance was set at P<0.05. Results The prevalence of workplace bullying in this sample was 11.2%. Superiors or supervisors from other departments and colleagues were the main perpetrators. In the multivariate model, working for 10 years or less (aOR 4, 95% CI 1.3–12.3; P=0.014) and not being involved in patient care (aOR 5, 95% CI 2.5–10; P<0.001) were statistically significant attributes associated with workplace bullying. Conclusion Workplace bullying in the current study was strongly associated with occupational characteristics, particularly length of service and service orientation of the workers. Hospital directors and managers could undertake preventive measures to identify groups vulnerable to bullying and subsequently craft appropriate coping strategies and mentoring programs to curb bullying.
Hepatitis E virus re-infection accelerates hepatocellular carcinoma development and relapse in a patient with liver cirrhosis: A case report and review of literature

BACKGROUND Hepatitis E virus (HEV) superinfection is a suspected promoting factor for hepatocellular carcinoma (HCC) in patients with chronic hepatitis and cirrhosis. However, to date, very few cases of HEV-related HCC have been reported. Nevertheless, the role of HEV re-infection in cirrhotic liver without other chronic hepatitis infections has rarely been explored. CASE SUMMARY A 53-year-old male farmer was diagnosed with liver cirrhosis and splenomegaly in August 2016, accompanied with negative HEV-IgM and positive HEV-IgG. No evidence of hepatitis B virus or hepatitis C virus infection was found. Since then the patient was evaluated for liver function and viral parameters every 3 mo. In June 2017, the patient presented severe fatigue with whole body itching and was diagnosed with HCC. Afterwards this patient experienced quick HCC development, progression, relapse, and metastasis in the following 8 mo, and presented persistent dual positivity of HEV-IgM and HEV-IgG. This patient had a long history of smoking and alcohol consumption. CONCLUSION This unique case invokes the importance of HEV surveillance and treatment among cirrhotic patients, HCC cases, and blood donors.
Effects of nitrogen and sulfur deposition on CH4 and N2O fluxes in high-altitude peatland soil under different water tables in the Tibetan Plateau

Abstract The effects of nitrogen (N) and sulfur (S) deposition on methane (CH4) and nitrous oxide (N2O) emissions under low (10 cm below soil surface) and high (at soil surface) water tables were investigated in the laboratory. Undisturbed soil columns from the alpine peatland of the Tibetan Plateau were analyzed. CH4 emission was higher and N2O emission was lower at the high water table than those at the low water table regardless of nutrient application. Addition of N (NH4NO3 (ammonium nitrate), 5 g N m−2) decreased CH4 emission up to 57% and 50% at low and high water tables, respectively, but correspondingly increased N2O emission by 2.5 and 10.4 times. Addition of S (Na2SO4 (sodium sulfate), 2.5 g S m−2) decreased CH4 and N2O emission by 64% and 79% at the low water table, respectively, but had a slightly positive effect at the high water table. These results indicated that the responses of CH4 and N2O emissions to the S deposition depend on the water table condition in the high-altitude peatland.
Optical Coherence Tomography in Patients with Alzheimer’s Disease: What Can It Tell Us?

Purpose Although Alzheimer’s disease (AD) is a leading cause of dementia worldwide, its clinical diagnosis remains a challenge. Optical coherence tomography (OCT) and OCT with angiography (OCTA) are non-invasive ophthalmic imaging tools with the potential to detect retinal structural and microvascular changes in patients with AD, which may serve as biomarkers for the disease. In this systematic review, we evaluate whether certain OCT and OCTA parameters are significantly associated with AD and mild cognitive impairment (MCI). Methods PubMed database was searched using a combination of MeSH terms to identify studies for review. Studies were organized by participant diagnostic groups, type of imaging modality, and OCT/OCTA parameters of interest. Participant demographic data was also collected and baseline descriptive statistics were calculated for the included studies. Results Seventy-one studies were included for review, representing a total of 6757 patients (2350 AD, 793 MCI, 2902 healthy controls (HC), and 841 others with a range of other neurodegenerative diagnoses). The mean baseline ages were 72.78±3.69, 71.52±2.88, 70.55±3.85 years for AD, MCI and HC groups, respectively. The majority of studies noted significant structural and functional decline in AD patients when compared to HC. Although analysis of MCI groups yielded more mixed results, a similar pattern of decline was often noted amongst patients with MCI relative to HC. OCT and OCTA measurements were also shown to correlate with established measures of AD such as neuropsychological testing or neuroimaging. Conclusion OCT and OCTA show great potential as non-invasive technologies for the diagnosis of AD. However, further research is needed to determine whether there are AD-specific patterns of structural or microvascular change in the retina and optic nerve that distinguish AD from other neurodegenerative diseases. Development of sensitive and specific OCT/OCTA parameters will be necessary before they can be used to detect AD in clinical settings.
‘Senior Nursing Students and Interns’ Concerns and Willingness to Treat Patients with COVID-19: A Strategy to Expand National Nursing Workforce during the COVID-19 Pandemic

Background The coronavirus disease of 2019 (COVID-19) pandemic has challenged the existing healthcare delivery systems worldwide and overwhelmed the globally short healthcare workforce, particularly nurses. Nurses are recognized as front-line responders to the COVID-19 pandemic and are crucial healthcare members to win the fight against the evolving COVID-19. Considering the long-lasting shortage of national nurses, and turnover of the current nursing workforce, it is essential to consider unconventional strategies aiming at expanding the national nursing workforce in order to embrace the impact of COVID-19. Objective This study aimed to measure senior nursing students and intern’s willingness to treat patients with COVID-19. Further, this study investigated their feelings, knowledge, and concerns regarding treating patients with COVID-19. Methods This quantitative, cross-sectional study utilized self-reported survey gathered from a convenience sample of 178 senior nursing students and interns. A 7-item scale was used to measure the participants’ willingness to treat patients with COVID-19. The data were collected between March 2020 and April 2020. Results Out of 178 participants, 50.56% were at Level 8, 89.33% were single, and 53.37% had a very satisfactory grade point average. The highest proportion of the respondents (38.20%) felt neutral about treating patient with COVID-19, while 53.93% had good knowledge about COVID-19. The perceived willingness to treat of participants had an overall mean score of 20.19, which indicated neutral willingness to treat patients with COVID-19. Participants’ feelings about treating patients with COVID-19 predicted their willingness to treat patients with COVID-19 (P<0.001). Conclusion/Recommendation There is a clear need for educational and training programs both in clinical practice and academia for the improvement among nursing students and interns who reported paucity of knowledge about COVID-19. Furthermore, hospital institutions should provide additional incentives or hazard protections to maintain and even increase the number of staff at the frontline who are willing to care for patients amid the deadly pandemic of COVID-19.
Association Between Single Nucleotide Polymorphisms in CDKAL1 and HHEX and Type 2 Diabetes in Chinese Population

Purpose Type 2 diabetes mellitus (T2DM) has a high global prevalence, and the interaction of environmental factors and genetic factors may contribute to the risk of T2DM. We aimed to investigate the association between T2DM and the single nucleotide polymorphisms (SNPs) in genes (CDKAL1 and HHEX) associated with insulin secretion. Subjects and Methods T2DM (n=1,169) and nondiabetic (NDM) (n=1,277) subjects were enrolled and the eight SNPs in CDKAL1 and HHEX genes associated with insulin secretion were genotyped in a Chinese population using MassARRAY. Then, the association of these SNPs with T2DM was analyzed. Results Our results revealed that four SNPs (rs4712524, rs10946398, rs7754840 in CDKAL1, and rs5015480 in HHEX) showed significantly different distributions between the T2DM and NDM groups (P<0.00625). The G allele of rs4712524 (P=0.004, OR=1.184; 95% CI=1.057–1.327), C allele of rs10946398 (P<0.001, OR=1.247; 95% CI=1.112–1.398), and C allele of rs775480 in CDKAL1 (P<0.001, OR=1.229; 95% CI=1.096–1.387) functioned as risk alleles of T2DM. The C allele of rs5015480 in HHEX (P<0.001, OR=1.295; 95% CI=1.124–1.493) was also the risk factor for T2DM. The haplotype analysis revealed that CDKAL1 haplotype rs4712524G-rs10946398C-rs7754840C-rs9460546G (P=0.001, OR=1.210; 95% CI=1.076–1.360) and HHEX haplotype rs1111875C-rs5015480C (P<0.001, OR=1.364; 95% CI=1.180–1.576) were the risk factors of T2DM. Conclusion Our results revealed that genetic variations in CDKAL1 and HHEX were associated with T2DM susceptibility in Chinese population.
Assessing the Clinical Utility of Point of Care HbA1c in the Ophthalmology Outpatient Setting

Background/Aims Effective management of diabetic retinopathy requires multidisciplinary input. We aimed to evaluate the impact of point of care (POC) HbA1c testing as a tool to identify patients most in need of specialist diabetologist input and assess the accuracy and determinants of patients’ insight into their glycaemic and blood pressure control. Methods Forty-nine patients with diabetic retinopathy were recruited from the eye clinic at Great Western Hospital. Patients completed a questionnaire and POC HbA1c and blood pressure values were measured. Statistical analysis was completed with SPSS v23. Results Mean age was 64.4 years, median interval since the last formal HbA1c reading was 10.2 months and the mean POC HbA1c was 64.1 mmol/mol. HbA1c significantly correlated with the degree of retinopathy. Of the patients, 81.6% had POC readings above the levels recommended by the National Institute for Health and Care Excellence, with only 16.3% having insight into this. Insight to HbA1c levels was predicted by age but not by duration of disease. Fourteen patients (33.3%) identified with high HbA1c readings were referred to secondary diabetic services and 88.8% of patients felt that the test was useful and likely to improve their diabetic control. Conclusion The majority of patients had poor insight into their diabetes control, with sub-optimal treatment and follow-up. Poor insight is high in younger patients, suggesting that POC HbA1c testing is particularly important in educating younger patients who may be Type 1 diabetics with more severe disease. POC HbA1c represents a cost-effective, reproducible and clinically significant tool for the management of diabetes in an outpatient ophthalmology setting, allowing the rapid recognition of high-risk patients and appropriate referral to secondary diabetic services.
Within-session test-retest reliability of pressure pain threshold and mechanical temporal summation in healthy subjects

Objective To determine the absolute and relative intra-rater within-session test-retest reliability of pressure pain threshold (PPT) and mechanical temporal summation of pain (TSP) at the low back and the forearm in healthy participants and to test the influence of the number and sequence of measurements on reliability metrics. Methods In 24 participants, three PPT and TSP measures were assessed at four sites (2 at the low back, 2 at the forearm) in two blocks of measurements separated by 20 minutes. The standard error of measurement, the minimal detectable change (MDC) and the intraclass correlation coefficient (ICC) were investigated for five different sequences of measurements (e.g. measurement 1, 1–2, 1-2-3). Results The MDC for the group (MDCgr) for PPT ranged from 28.71 to 50.56 kPa across the sites tested, whereas MDCgr for TSP varied from 0.33 to 0.57 out of 10 (numeric scale). Almost all ICC showed an excellent relative reliability (between 0.80 and 0.97), except when only the first measurement was considered (moderate). Although minimal differences in absolute PPT reliability were present between the different sequences, in general, using only the first measurement increase measurement error. Three TSP measures reduced the measurement error. Discussion We established that two measurements of PPT and three of TSP reduced the measurement error and demonstrated an excellent relative reliability. Our results could be used in future pain research to confirm the presence of true hypo/hyperalgesia for paradigms such as conditioned pain modulation or exercise-induced hypoalgesia, indicated by a change exceeding the measurement variability.
The effect of temperature on limiting current density and mass transfer in electrodialysis

This study focuses on a high-temperature operation in electrodialysis of salt solutions and studies the effect of temperature on limiting current density and mass transfer. Experiments were conducted under various conditions of temperature (T), varying from 15 to 90°C; of dialysate concentration (Cd), varying from 5 × 10−3 to 3 × 10−2M; and of dialysate velocity (ud), varying from 0.206 to 2.44 cm s−1. A least squares fitting of the experimental data on limiting current density (Ilim) yields an Arrhenius equation as follows: The molar flux N (mol cm−2 s−1), initial concentration (C0; M) and temperature (T; °C) were found to have the following relationship: N/C0 is slightly increased with increasing temperature ranging from 25 to 70°C.
Computational analysis of Cyclin D1 gene SNPs and association with breast cancer

Abstract CCND1 encodes for Cyclin D1 protein and single-nucleotide polymorphisms (SNPs) can modulate its activity. In the present study, the impact of CCND1 SNPs on structure and/or function of Cyclin D1 protein using in silico tools was investigated. Our analysis revealed only one splice site SNP (c.1988+5G<A) can effect CCND1 function. Subsequently, 78 out of 169 missense variants were predicted as pathogenic by Polyphen2, SIFT, PROVEAN, SNPs&GO, and PANTHER, and 4/78 missense SNPs were further evaluated because these four SNPs were found to be reside in highly conserved region of Cyclin D1. However, they did not show any major impact on tertiary structure and domain of Cyclin D1 but overall R15S and A190S has displayed a significant diseased phenotype and an altered molecular mechanism predicted by MutPred, FATHMM, SNPeffect, SNAP2, and PredictSNP. Consistently, A190S, R179L, and R15S may also cause a decrease in stability of Cyclin D1 anticipated by I-Mutant, HOPE and SNP effect. Furthermore, the Kaplan–Meier plotter has explained that high expression of CCND1 is associated with less survival rate of breast cancer patients. Altogether our study suggests that c.1988+5G<A, R15S, R179L, and A190S SNPs could directly or indirectly destabilize Cyclin D1.
Cognitive changes during the menopausal transition: a longitudinal study in women with and without HIV.

OBJECTIVE To assess longitudinal changes in cognitive performance across menopause stages in a sample comprised primarily of low-income women of color, including women with HIV (WWH). METHODS A total of 443 women (291 WWH; 69% African American; 18% Hispanic; median age = 42 y) from the Women's Interagency HIV Study completed tests of verbal learning and memory, attention/working memory, processing speed, verbal fluency, motor skills, and executive function first at an index premenopausal visit and thereafter once every 2 years for up to six visits (mean follow-up = 5.7 y). General linear-mixed effects regression models were run to estimate associations between menopause stages and cognition, in the overall sample and in WWH. We examined both continuous scores and categorical scores of cognitive impairment (yes/no >1 standard deviation below the mean). RESULTS Adjusting for age and relevant covariates, the overall sample and WWH showed longitudinal declines in continuous measures of learning, memory, and attention/working memory domains from the premenopause to the early perimenopause and from the premenopause to the postmenopause, Ps < 0.05 to < 0.001. Effects on those same domains were also evident in categorical scores of cognitive impairment, with the increased odds of impairment ranging from 41% to 215%, Ps < 0.05 to < 0.001. The increase in predicted probability of impairment by menopausal stage (% affected) ranged from 4% to 13%. CONCLUSIONS Menopause stage was a key determinant of cognition in a sample of low-income women of color, including WWH. Many of these changes reached a clinically significant level of cognitive impairment.