Miracle-dz/UniFAR-FTUs huggingface dataset:
Copeptin Level in Isolated Coronary Artery Ectasia

Introduction: The level of copeptin was investigated in patients who underwent coronary angiography for suspected coronary artery disease and diagnosed with isolated coronary artery ectasia (CAE). Patients and Methods: A total of 308 patients were diagnosed as having coronary ectasia out of 3412 patients who underwent coronary angiography between May 2015 and July 2016. The evaluations were performed by two experienced physicians who were aware of the study design. Among these patients, 41 patients who did not have severe coronary artery disease (CAD) and who were diagnosed as having isolated CAE were included in the study. The control group comprised 33 ageand gender-matched individuals diagnosed as having normal coronary arteries following coronary angiography for suspected CAD. Patients with a previous coronary revascularization for severe CAD, known congestive heart disease and severe cardiac valve disease, and a left ventricular ejection fraction below 50% were excluded from the study. Blood samples were obtained from both groups and the serum copeptin levels were compared with each other. Results: Among patients with CAE, the frequency of isolated CAE was 14.9%. Among the total coronary angiography series, the frequency of isolated CAE was 1.34%. Most patients with isolated CAE were men (70%; women: 30%), and the mean age of the patients was 58 ± 9.2 years. In patients with isolated CAE, the frequencies of type I, type II, type III, and type IV CAE were found to be 4.3%, 17.4%, 32.6%, and 45.6%, respectively, according to Markis classification. The level of copeptin was found to be 7.8 ± 0.9 pmol/L in patients with normal coronary arteries and 9.7 ± 1.6 pmol/L in patients with isolated CAE (p< 0.028). Conclusion: The level of copeptin is increased in patients with isolated CAE. However, our results have to be supported by long-term randomized studies on isolated CAE patients with and high copeptin levels.
Comparison of clinical outcomes according to the history of previous gastrectomy in patients undergoing pancreatoduodenectomy: a propensity score matching analysis

Purpose Although pancreatoduodenectomy (PD) in patients who have previously undergone gastrectomy is challenging, little is known about the clinical outcomes and the differences compared to those with conventional PD. We collected cases and conducted studies in retrospective review. Methods Of the 1,722 patients who underwent PD at Seoul National University Hospital between 2000 and 2014, 49 (2.8%) underwent previous gastrectomy. Clinical outcomes including operation-related factors and postoperative morbidities were analyzed. Results Among the 49 patients with curative surgery, 25 patients were male (51.0%) and the mean age was 64.7 years. Gastric cancer was the most frequent cause of previous gastrectomy (93.8%). With one-to-one propensity score matching analysis, lower preoperative body mass index (22.6 kg/m2 vs. 20.8 kg/m2, P = 0.002), higher EBL (390.0 mL vs. 729.5 mL, P = 0.027), and higher transfusion rates (10.2% vs. 36.7%, P = 0.002) were shown in the gastrectomy group. Operation time, postoperative hospital stay, and rate of clinically relevant pancreatic fistula were comparable. Conclusion Secondary PD after prior gastrectomy remains challenging, with higher EBL and rate of transfusion. However, when performed by experienced surgeons, the patients with or without previous gastrectomy show comparable postoperative clinical outcomes, such as similar duration of postoperative hospital stay and rate of postoperative pancreatic fistula.
From Apoptosis to Regulated Necrosis: An Evolving Understanding of Acute Kidney Injury

Acute kidney injury (AKI) is a prevailing health threat around the world with high mor- talities and heavy economic burdens. In the past, apoptosis was recognized as the main contributor to the pathogenesis of AKI. However, recent evidence has suggested that regulated necrosis also plays an important role in the pathologic process of various types of renal damages, improving our limited understanding of the complex mechanisms underlying AKI. Regulated necrosis is a newly identified type of “programed cell death” with morphologic features of necrosis, which includes necroptosis, ferroptosis, parthan- atos, pyroptosis, etc. In this chapter, we summarized the molecular pathways of both apoptosis and regulated necrosis, and reviewed the potential roles and corresponding mechanisms of various cell deaths in AKI based on recent advances. We also discussed the therapeutic potentials and clinical implications based on manipulating regulated cell death. Taken together, the progress in this field lays the ground for better prevention and management of AKI in the future.
Rural and Urban Differences in Nebraskans’ Access to Marijuana, Methamphetamine, Heroin, and Prescription Pills

The ability of a user to access a given type of drug is related to the configuration of the market for that drug, and a range of economic and criminal justice concerns. This study focuses on Nebraskan’s “ready access” to four types of drugs (marijuana, methamphetamine, heroin, and prescription pills) in 2016, using a statewide survey of housed Nebraskan adults. Ready access is defined as a participant knowing at least one person from whom they could obtain a given type of drug if they wanted to. We found that 35% of adult Nebraskans knew at least one person from whom they could obtain marijuana, 8.9% for methamphetamine, 4.5% for heroin, and 17.8% knew at least one source for prescription pills. Relationships between knowing a source for each type of drug and rurality, sex, race, religious attendance, mental health symptoms, and education are explored.
Foetal hepatorenal toxicity and intrauterine growth retardation in pregnant Wistar rats treated with artemether

Objectives: Foetal hepatorenal toxicity and foetal morphology were evaluated following artemether administration to pregnant Wistar albino rats. Methods: Twenty pregnant Wistar rats weighing between 180–200 g were divided into four groups (n=5, each) with Group 1 serving as the control. Groups 2, 3 and 4 received 1.1 mg, 2.2 mg and 3.3 mg per kilogram body weight artemether, respectively orally, twice daily for three days on day 7, 8 and 9 of pregnancy. The animals were sacrificed on day 20 of pregnancy and foetuses were harvested and evaluated for morphological changes. Foetal body weight and crown-rump length (CRL) were measured; alpha-fetoprotein (AFP) was assayed using amniotic fluid, and foetal kidney and liver were evaluated histologically for toxicity. Results: There was a significant decrease in body weight, CRL and AFP of the treated groups compared to the control. The foetal liver of the treated groups revealed distorted cytoarchitecture, marked hepatocyte inflammation and hepatic necrosis. The foetal kidney of artemether-treated groups also showed disorganised renal structure, atrophic and degenerated glomeruli with acute tubular necrosis. Conclusion: Artemether administration to pregnant albino rats causes intrauterine growth retardation or stunted growth, as well as foetal hepatorenal toxicity.
Cilostazol Protects Against Brain White Matter Damage and Cognitive Impairment in a Rat Model of Chronic Cerebral Hypoperfusion

Background and Purpose— White matter lesions contribute to cognitive impairment in poststroke patients. The present study was designed to assess the neuroprotective mechanisms of cilostazol, a potent inhibitor of type III phosphodiesterase, through signaling pathways that lead to activation of transcription factor cAMP-responsive element binding protein (CREB) phosphorylation using rat chronic cerebral hypoperfusion model. Methods— Rats underwent bilateral common carotid artery ligation. They were divided into the cilostazol group (n=80) and the vehicle (control) group (n=80). Performance at the Morris water maze task and immunohistochemistry for 4-hydroxy-2-nonenal (HNE), glutathione-S-transferase-pi (GST-pi), ionized calcium-binding adaptor molecule 1, phosphorylated CREB (p-CREB), Bcl-2, and cyclooxygenase-2 (COX-2) were analyzed at baseline and at 3, 7, 14, 21, and 28 days after hypoperfusion. Result— Cilostazol significantly improved spatial learning memory (6.8±2.3 seconds; P<0.05) at 7 days after h.
Efficacy and safety of extracorporeal shock wave on low back pain: A systematic review and meta-analysis

Background: Extracorporeal shock wave therapy (ESWT) is a relatively new type of treatment for many musculoskeletal disorders. However, ESWT for low back pain remains controversial as the pain relieve benefit is questionable. We performed this systematic review and meta-analysis to explore the effectiveness and safety of ESWT interventions on pain and disability in patients with low back pain (LBP). Methods: In this meta-analysis, we searched electronic databases in the Pubmed, Embase, Cochrane’s library, China National Knowledge Infrastructure, and Wanfang Database to determine the equivalence of ESWT and placebo for the treatment of LBP up to April 4, 2022. A number of other outcomes were measured, including functional status, quality of life, and psychological outcomes measured by the Oswestry Disability Index. Weighted mean differences were calculated for continuous outcomes, while risk ratios were calculated for binary outcomes. Stata 12.0 software was used for statistical analysis. Results: Thirteen randomized controlled trials included for further analysis. Compared with control, the ESWT group showed lower pain intensity at month 1 (P < .05), as well as lower disability score at month 1 (P < .05) and at month 3 (P < .05). There was no statistically significant difference between ESWT and control groups in terms of the pain intensity at month 3 (P > .05). No serious adverse events related to treatment were reported. Sensitivity analysis demonstrates that the conclusions from this analysis were robust. Conclusions: ESWT is effective in alleviating pain and improving the functional outcomes for patients with LBP. However, there remains a lack of high-level evidence to verify their effectiveness and safety and support their clinical application.
Liver Stiffness Measurement Is Useful to Predict Early Recurrence of Hepatocellular Carcinoma after Sustained Virological Responses by Direct Antiviral Agents in Patients with Hepatitis C

Background: Recently, increases in the risk of Hepatocellular carcinoma (HCC) recurrence in patients with hepatitis C virus (HCV) due to the administration of direct antivirals agents (DAA) have been reported. Methods: One hundred and nineteen patients who were treated with DAA and achieved sustained viral response (SVR) were prospectively followed-up for over two years by transient elastography with liver stiffness measurements (LSM). Fourteen out of 119 patients (12%) had a history of being treated for HCC by radiofrequency ablation or resection and achieved complete responses after previous HCC treatments before the initiation of DAA. HCC was diagnosed by contrast-enhanced computed tomography (CT) or enhanced magnetic resonance imaging (MR). CT or MR was performed before the DAA treatment and every 6 months after during the follow-up. LSM was performed at the initiation of DAA (LSM0), at 24 weeks after the start of DAA (LSM24), at 48 weeks after that (LSM48) and at 2 years after that (LSM2y). Results: LSM0, LSM24, LSM48 and LSM2y of 105 patients without HCC were 7.5 (3.027.0), 6.0 (2.5 - 31.6), 4.6 (2.6 - 25.2) and 4.4 (3.1 - 29.9) kPa, respectively, showing significant improvements. Three out of 105 patients (2.9%) subsequently developed HCC and their LSM showed improvements. Eight out of fourteen patients (57%) with a history of HCC treatments subsequently developed HCC recurrence. LSM0 in the eight patients with recurrence increasing from 12.1 to 27.0 kPa, LSM24 from 9.9 to 26.6 kPa and LSM48 from 9.6 to 18.0 kPa. On the other hand, the six other patients without recurrence had LSM values that were less than 12.0 kPa at last. Based on the ROC analysis, LSM0 15.4, LSM24 12.8 and LSM48 9.6 kPa were identified as cut-off values. Conclusion: HCV patients previously treated for HCC with high LSM values before and after DAA have an elevated risk of HCC recurrence, particularly LSM24 >12.8 kPa and LSM48 >9.6 kPa.
Personality Dimensions and Attributional Styles in Individuals with and without Gender Dysphoria

This research investigates personality dimensions and attributional styles among individuals with and without gender dysphoria in relationship to gender, educational level, and ethnicity. Participants were 60 men and women with and without gender dysphoria. A demographic sheet and two inventories were used. Results showed that patients with gender dysphoria had significantly higher neuroticism and lower agreeableness compared with individuals without gender dysphoria. No significance differences in extraversion, openness to experience, and conscientiousness (based on the “big five” personality model) were found between those with and without gender dysphoria. Also, individuals without gender dysphoria had higher positive attributional styles compared to patients with gender dysphoria. Finally, there were significant effects for gender and ethnicity on personality dimensions, but not for gender, ethnicity, or the ethnicity by gender interaction on the attributional styles.
Growth Factor Gene-Modified Mesenchymal Stem Cells in Tissue Regeneration

Abstract There have been marked changes in the field of stem cell therapeutics in recent years, with many clinical trials having been conducted to date in an effort to treat myriad diseases. Mesenchymal stem cells (MSCs) are the cell type most frequently utilized in stem cell therapeutic and tissue regenerative strategies, and have been used with excellent safety to date. Unfortunately, these MSCs have limited ability to engraft and survive, reducing their clinical utility. MSCs are able to secrete growth factors that can support the regeneration of tissues, and engineering MSCs to express such growth factors can improve their survival, proliferation, differentiation, and tissue reconstructing abilities. As such, it is likely that such genetically modified MSCs may represent the next stage of regenerative therapy. Indeed, increasing volumes of preclinical research suggests that such modified MSCs expressing growth factors can effectively treat many forms of tissue damage. In the present review, we survey recent approaches to producing and utilizing growth factor gene-modified MSCs in the context of tissue repair and discuss its prospects for clinical application.
Influence of Diabetic Retinopathy on the Relationship Between Body Mass Index and Mortality in Patients with Poorly Controlled Type 2 Diabetes

Purpose An “obesity paradox” has been observed in patients with type 2 diabetes. However, the optimal body mass index (BMI) for survival may be influenced by the stage of diabetes. We examined the relationship between BMI and mortality in patients with type 2 diabetes and the influence of diabetic retinopathy (DR). Patients and Methods This is a retrospective cohort composing patients with type 2 diabetes who were admitted due to poor glucose control. Presence of DR was confirmed by ophthalmologists. The primary outcome was all-cause mortality. The association between BMI and mortality was assessed using a Cox proportional hazards model with adjustment for age, sex, and traditional risk factors. Results A total of 2053 patients were enrolled. Over median follow-up of 6.7 years, there were 1060 deaths. Patients were classified into five categories based on admission BMI (kg/m2): <18.5, 18.5‒23, 23‒25, 25‒27 (reference), 25‒30 and >30. Mortality risk was significantly higher in the <18.5 kg/m2, 18.5–23 kg/m2, and 23–25 kg/m2 categories than in the reference category (P <0.001). The similar obesity paradox was observed in the subgroup of patients without DR. However, in patients with DR, only patients with BMI <18.5 kg/m2 had significantly increased mortality than those in the reference category. The presence of DR significantly modified the shape of the association between BMI and mortality (P = 0.019). Conclusion The obesity paradox exists in patients with poorly controlled type 2 diabetes. The presence of DR appears to significantly influence the shape of the association between BMI and mortality.
Veteran and Provider Satisfaction with a Home-Based Telerehabilitation Assessment for Wheelchair Seating and Mobility

The objective of this project was to measure Veteran and provider satisfaction with a home-based telerehabilitation assessment for wheelchair seating and mobility. Forty-three Veterans were seen remotely at their place of residence by a provider, using a VA Video Connect synchronous videoconferencing system. Veteran and provider satisfaction were collected using the Telerehabilitation Questionnaire (TRQ). Mean individual TRQ scores for both Veterans and providers were significantly higher than the scale midpoint of 3.5. Veterans had higher scores than providers for five individual items on the TRQ. Higher scores by Veterans on the technology and quality and clarity of the video and audio likely correspond to the differences in environmental settings in which the visit occurred for the Veteran compared with the provider. High satisfaction scores with the telerehabilitation assessments are likely attributed to the positive working relationship between the provider and the rehabilitation technician, who provided in-person technical support to the Veteran in the home during the wheeled mobility evaluation. Overall, the results indicate a high level of Veteran and provider satisfaction using telerehabilitation for wheelchair seating and mobility evaluations.
Predictors of Glycaemic Control among Ghanaian Type 2 Diabetic Patients Using Diabetes Self-management Approach

Aims: Management of a complex metabolic disease like diabetes can be very challenging since it involves a careful combination of medication, exercise, diet and regular monitoring of blood glucose in order to achieve good glucose control. The study aimed at determining predictors of glycaemic control of type 2 diabetic patients using diabetes self-management approach. Study Design: A Cross-sectional study. Place and Duration of study: Diabetes clinic at two selected district hospitals in Ashanti region of Ghana. Methodology: A structured questionnaire was used to collect demographic, medical history and dietary information. A validated Diabetes Self-Management Questionnaire was also used. Serum Original Research Article Apini et al.; IJBCRR, 23(2): 1-18, 2018; Article no.IJBCRR. 42976 2 glycated haemoglobin (HbA1c) was used as the standard for glycaemic control. Results: Mean glycated haemoglobin level for study participants was 7.2%±0.2. Optimal glycaemic control was significantly associated with diabetes self-management (r= -0.428), diabetes-related distress (r= 0.381) and acceptance and action on diabetes (r= 0.316). In. addition to the above associations, diabetes self-management (β= -0.297, p=0.007) and diabetes-related distress (β= 0.219, p=0.028) could significantly predict glycated haemoglobin but not acceptance and action on diabetes (β= 0.046, p=0.665). Conclusions: All the three study variables correlated with glycated haemoglobin of study participants but only diabetes self-management and diabetes-related distress had predictive value. Further, an epidemiological study is needed to ascertain the strength of the effects. Various health stakeholders should encourage diabetic patients to understand the importance of diabetes selfmanagement which may help in better glycaemic control, disease management and better quality of life.
Prediction Model for Risk of Adenoma at Screening Colonoscopy

Aim: To identify risk factors for adenomatous polyps and develop an adenoma prediction model in individuals undergoing screening colonoscopy. Methods: We extracted demographic data, smoking history, current aspirin use and family history of colorectal cancer (CRC) as well as colonoscopy and histopathology results from individuals who underwent screening colonoscopy at the Minneapolis VA Medical Center between 2007 and 2012. Results: 3000 veterans were included. Adenomas were found in 1,063 patients (35%). Advanced adenomas were seen in 248 patients (8%). Risk factors for adenoma: age (OR 1.02, 95% CI 1.01, 1.03), male sex (OR 2.26, 95% CI 1.50, 3.52), and smoking (OR 1.53, 95% CI 1.29, 1.83). Risk factors for advanced adenoma: male sex (OR 3.79, 95% CI 1.18, 23.2) and smoking (OR 1.61, 95% CI 1.10, 2.34). Variables included in the final model were age, sex, BMI, race, use of aspirin, smoking history, and family history of CRC. The adjusted AUROCC for adenoma was 0.532 (95% CI 0.517, 0.554) and for advanced adenoma 0.613 (95% CI 0.564, 0.651). Conclusion: The model can be used to predict the risk of adenoma at screening colonoscopy and identify those patients who will benefit most from screening colonoscopy.
Challenges experienced by healthcare workers in managing patients with hearing impairment at a primary health care setting: a descriptive case study

Background: There has been little research on the experiences of healthcare workers (HCWs) with deaf/hearing impaired (HI) clients. Anecdotal evidence suggests that HCWs experience challenges, but little is reported on how they manage these challenges. Interactions with and care of deaf/Deaf and HI patients by clinicians has yielded several questions around communication and assessment strategies, as well as comparative quality of health care for deaf/Deaf and HI clients. This research was intended to further the understanding and knowledge of these aspects of health care of deaf/Deaf and HI clients. Methods: The study design is a qualitative, descriptive case study. Data were collected using semi-structured interviews with individual HCWs and focus-group discussions with groups of participants. Participants were invited staff members at Retreat Community Health Centre (RCHC) in Cape Town. Convenience sampling was used to select participants, and interviews were conducted until saturation was reached. Data were studied and analysed using the phenomenological method. Results: HCWs reported that they serve very few Deaf or HI clients. However, themes of language barriers, resilience, preconceptions, improvisation and innovation, interpreters and recommendations emerged. Difficulties in communication were acknowledged, but HCWs insisted that these barriers are not insurmountable. Discussion and conclusion: A few preconceptions and gaps in knowledge and awareness were revealed. HCWs also tended to rely on escorts and other interpreters. The dominant recommendations are that HCWs should receive training in sign language (SL) and/or that SL interpreters be available at facilities. Despite using words and phrases such as ‘frustrating’ and ‘more effort’, participants’ concluding remarks reiterate that their experiences are positive, suggesting a notable resilience.