Miracle-dz/UniFAR-FTUs huggingface dataset:
Urinary Metabolite Signatures for Predicting Elderly Stroke Survivors with Depression

Background Post-stroke depression (PSD) is a major complication in stroke survivors, especially in elderly stroke survivors. But there are still no objective methods to diagnose depression in elderly stroke survivors. Thus, this study was conducted to identify potential biomarkers for diagnosing elderly PSD subjects. Methods Elderly (60 years or older) stroke survivors with depression were assigned into the PSD group, and elderly stroke survivors without depression and elderly healthy controls (HCs) were assigned into the non-depressed group. Urinary metabolite signatures obtained from gas chromatography-mass spectrometry (GC-MS)-based metabolomic platform were collected. Both univariate and multivariate statistical analysis were used to find the differential urinary metabolites between the two groups. Results The 78 elderly HCs, 122 elderly stroke survivors without depression and 124 elderly PSD subjects were included. A set of 13 differential urinary metabolites responsible for distinguishing PSD subjects from non-depressed subjects were found. The Phenylalanine, tyrosine and tryptophan biosynthesis, Phenylalanine metabolism and Galactose metabolism were found to be significantly changed in elderly PSD subjects. The phenylalanine was significantly negatively correlated with age and depressive symptoms. Meanwhile, a biomarker panel consisting of 3-hydroxyphenylacetic acid, tyrosine, phenylalanine, sucrose, palmitic acid, glyceric acid, azelaic acid and α-aminobutyric acid was identified. Conclusion These results provided candidate molecules for developing objective methods to diagnose depression in elderly stroke survivors, suggested that taking supplements of phenylalanine might be an effective method to prevent depression in elderly stroke survivors, and would be helpful for future revealing the pathophysiological mechanism of PSD.
Keep Calm and Stay Safe: The Relationship between Anxiety and Other Psychological Factors, Media Exposure and Compliance with COVID-19 Regulations

The COVID-19 pandemic has led many countries to employ public health regulations to achieve behavioral change and stop the transmission of the virus. The factors influencing compliance with these regulations may differ from “classic” predictors for medical compliance. This study attempted to assess the effect of social communication and psychological factors on intention to comply. A cross-sectional online survey was conducted on healthy adults living in Israel (n = 697). The survey assessed the intention to comply with the state COVID-19 regulations and explored possible correlations with demographic and psychosocial factors. Data were collected during May 2020 using a Qualtrics online survey. Data were analyzed to find correlations between anxiety, uncertainty, media exposure and other variables and the level of intention to comply as self-reported. Moderation and mediation effects were studied by an integrative model of influencing factors. We found that media exposure change, trust in responsible agencies and anxiety were positively correlated with compliance, while uncertainty was correlated with noncompliance. The effect of media exposure on compliance had two components. First, media exposure was positively correlated with compliance. On the other hand, media exposure was positively correlated with uncertainty, and uncertainty was negatively correlated with compliance. Interestingly, anxiety, which was positively correlated with media exposure, also moderated the negative correlation between uncertainty and compliance. Our results highlight the important role of uncertainty and anxiety as moderators between media exposure and compliance. To increase public compliance with COVID-19 regulations, efforts should be directed at decreasing uncertainty and anxiety.
Influence of Geographic Origin and Plant Source on Physicochemical Properties, Mineral Content, and Antioxidant and Antibacterial Activities of Moroccan Propolis

This research is aimed at determining the physicochemical properties (resin, wax, balsams, pH, moisture, ash, and mineral contents) of propolis samples collected from different geographical areas in Morocco, as well as evaluating the antioxidant and antibacterial activities of these samples. The results showed the following values for physicochemical analysis: resin (17.42-58.01%), wax (21.31-70.12%), balsam (0.27-2.12%), pH (3.7-5.3), moisture (1.02-3.65%), and ash (0.72-5.01%). The phenolic and flavone/flavonol contents of samples were ranged between 6.74 mg FAE/g and 149.13 mg FAE/g and between 1.19 mg QE/g and 108.11 mg QE/g, respectively. The sample P3 presented also the strongest radical scavenging activity toward DPPH, ABTS free radicals, and FRAP assay with IC50 values of 0.021, 0.026, and 0.042 mg/mL, respectively. All propolis samples showed significant inhibitory effects against all tested microorganisms with MICs ranging from 0.28 mg/mL to 1.12 mg/mL for Gram-negative strains and from 0.002 mg/mL to 1.12 mg/mL for Gram-positive strains. A strong correlation was found between resin, total phenolic compounds, flavones/flavonols, and antioxidant activity. Linear discriminant analysis revealed that the samples studied were divided into two groups which were differentiated by the data of antioxidant activity, mineral contents, and antibacterial activity. It can be concluded that the physicochemical properties, mineral content, and biological activities of Moroccan propolis depend on their geographical and botanical origin.
Development of a predictive model of growth hormone deficiency and idiopathic short stature in children

The aim of the present study was to develop predictive models using clinical features and MRI texture features for distinguishing between growth hormone deficiency (GHD) and idiopathic short stature (ISS) in children with short stature. This retrospective study included 362 children with short stature from Children's Hospital of Hebei Province. GHD and ISS were identified via the GH stimulation test using arginine. Overall, there were 190 children with GHD and 172 with ISS. A total of 57 MRI texture features were extracted from the pituitary gland region of interest using C++ language and Matlab software. In addition, the laboratory examination data were collected. Receiver operating characteristic (ROC) regression curves were generated for the predictive performance of clinical features and MRI texture features. Logistic regression models based on clinical and texture features were established for discriminating children with GHD and ISS. Two clinical features [IGF-1 (insulin growth factor-1) and IGFBP-3 (IGF binding protein-3) levels] were used to build the clinical predictive model, whereas the three best MRI textures were used to establish the MRI texture predictive model. The ROC analysis of the two models revealed predictive performance for distinguishing GHD from ISS. The accuracy of predicting ISS from GHD was 64.5% in ROC analysis [area under the curve (AUC), 0.607; sensitivity, 57.6%; specificity, 72.1%] of the clinical model. The accuracy of predicting ISS from GHD was 80.4% in ROC analysis (AUC, 0.852; sensitivity, 93.6%; specificity, 65.8%) of the MRI texture predictive model. In conclusion, these findings indicated that a texture predictive model using MRI texture features was superior for distinguishing children with GHD from those with ISS compared with the model developed using clinical features.
Impact of the Lockdown due to COVID-19 Pandemic on the Spectrum and Outcome of Trauma in India

Abstract Background: As a pre-emptive measure against the rampaging severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), the Government of India ordered an unprecedented but imperative step of a nationwide lockdown on 22nd March, 2020. The entire month of April 2020 remained in a complete national lockdown. Methodology: We conducted this retrospective study to compare the spectrum and outcome of trauma victims who presented to our emergency department (ED) from April 2020 (lockdown period) to a similar season matched control arm of April 2018 (non-lockdown period). Results: Our study groups included 403 trauma victims (trauma prevalence: 9.7%) from April 2020 as compared to 667 trauma victims (trauma prevalence: 10.8%) from April 2018 with an absolute decrease of −39.6% during the lockdown month. The intense lockdown resulted in an absolute decrease in the number of road traffic accidents (RTA) (−75.1%), sports-related injuries (−81.8%), bull gore injuries (−64.3%), workplace-related injuries (−50.0%), and fall from height (−3.5%). However, an absolute increase in the number of falls on level ground (FLG) (+95.7%), domestic trauma (+91.4%), and burn (+37.5%) patients were noted during the lockdown period. The proportion of trauma victims under the influence of alcohol, as determined by a positive blood alcohol content, was significantly lower in the lockdown period [adjusted OR: 0.34 (95% CI: 0.17–0.67); p-value: 0.002] as were RTAs [adjusted OR: 0.44 (95% CI: 0.31–0.62); p-value: <0.001], FLG [adjusted OR: 1.87 (95% CI: 1.14–3.06); p-value: 0.0], and head injuries [adjusted OR: 0.21 (95% CI: 0.13–0.3); p-value: <0.001]. Conclusion: During the stringent lockdown period of April 2020, there was a significant absolute decrease in the number of trauma victims, especially RTAs. The intense lockdown resulted in a significant decrease in the proportion of trauma victims under the influence of alcohol, head injuries, fractures, and dislocations. How to cite this article: Hazra D, Jindal A, Fernandes JP, Abhilash KPP. Impact of the Lockdown due to COVID-19 Pandemic on the Spectrum and Outcome of Trauma in India. Indian J Crit Care Med 2021;25(3): 273–278.
Transitioning Competency-Based Communication Assessments to the Online Platform: Examples and Student Outcomes

In light of the COVID-19 pandemic, pharmacy education has shifted from in-person teaching and assessments to the virtual environment. Many education programs had previously adopted objective structured clinical examinations (OSCEs) to assess communication abilities in-person with standardized patients (SPs). However, comparative student outcome data between virtual and in-person methods as well as guidance on how to conduct communication-based OSCEs in the virtual environment is lacking. The University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences (SSPPS) describes its methods of conducting two types of communication-based OSCEs (patient counseling and gathering a medical history). Student performance data from the two virtual OSCEs in 2020 was compared to results from two 2019 in-person OSCEs using Mann Whitney U Tests. The 2020 cohort scored significantly higher than the 2019 cohort in all variables (i.e., using effective verbal and non-verbal communication, using patient friendly education, organizing the encounter, demonstrating empathy, establishing trust, professionalism) and in overall score. However, the effect size for these findings indicate the differences between performances are generally small and more likely due to changes in grading patterns due to the pandemic.
Spatio-Temporal Patterns of Dengue Incidence in Medan City, North Sumatera, Indonesia

Dengue has been a perennial public health problem in Medan city, North Sumatera, despite the widespread implementation of dengue control. Understanding the spatial and temporal pattern of dengue is critical for effective implementation of dengue control strategies. This study aimed to characterize the epidemiology and spatio-temporal patterns of dengue in Medan City, Indonesia. Data on dengue incidence were obtained from January 2016 to December 2019. Kulldorff’s space-time scan statistic was used to identify dengue clusters. The Getis-Ord Gi* and Anselin Local Moran’s I statistics were used for further characterisation of dengue hotspots and cold spots. Results: A total of 5556 cases were reported from 151 villages across 21 districts in Medan City. Annual incidence in villages varied from zero to 439.32 per 100,000 inhabitants. According to Kulldorf’s space-time scan statistic, the most likely cluster was located in 27 villages in the south-west of Medan between January 2016 and February 2017, with a relative risk (RR) of 2.47. Getis-Ord Gi* and LISA statistics also identified these villages as hotpot areas. Significant space-time dengue clusters were identified during the study period. These clusters could be prioritized for resource allocation for more efficient prevention and control of dengue.
Pegylated Recombinant Human Arginase 1 Induces Autophagy and Apoptosis via the ROS-Activated AKT/mTOR Pathway in Bladder Cancer Cells

Bladder cancer is one of the most commonly diagnosed cancers worldwide, especially in males. Current therapeutic interventions, including surgery, radiation therapy, chemotherapy, and immunotherapy, have not been able to improve the clinical outcome of bladder cancer patients with satisfaction. Recombinant human arginase (rhArg, BCT-100) is a novel agent with great anticancer effects on arginine-auxotrophic tumors. However, the effects of BCT-100 on bladder cancer remain unclear. In this study, the in vitro anticancer effects of BCT-100 were assessed using four bladder cancer cell lines (J82, SCaBER, T24, and 5637), while the in vivo effects were evaluated by establishing T24 nude mice xenograft models. Intracellular arginine level was observed to be sharply decreased followed by the onset of apoptotic events. Furthermore, BCT-100 was found to induce H2O2 production and mitochondrial membrane depolarization, leading to the release of mitochondrial cytochrome c and Smac to the cytosol. Treatment with BCT was observed to upregulate the expression of LC3B and Becllin-1, but downregulate the expression of p62 in a time-dependent manner. Autophagic flux was also observed upon BCT-100 treatment. Besides, the phosphorylation of the AKT/mTOR pathway was suppressed in a time-dependent fashion in BCT-100-treated T24 cells. While N-acetyl-L-cysteine was shown to alleviate BCT-100-induced apoptosis and autophagy, chloroquine, MK-2206, and rapamycin were found to potentiate BCT-100-triggered apoptosis. Finally, BCT-100 was demonstrated to induce autophagy and apoptosis via the ROS-mediated AKT/mTOR signaling pathway in bladder cancer cells.
The Safety of Medicinal Plants Used in the Treatment of Vitiligo and Hypermelanosis: A Systematic Review of Use and Reports of Harm

Introduction Vitiligo is disfiguring and devastating condition that can humans feel stigmatic and devalued. Melasma is a general condition of hyperpigmentation particularly involving the face. The pigmentation disorders of vitiligo (hypopigmentation or de-pigmentation) and melasma (Hypermelanosis) are common among the world’s population (around 1% for vitiligo). Objective The identification of medicinal plants used in the treatment of vitiligo and hypermelanosis. A systematic literature review on harms associated with the medicinal plants used in the treatment of vitiligo and hypermelanosis. To review and summarize information on reported adverse drug reactions (ADRs) associated with these medicinal plants contained in (where access is available) national and global individual case safety report databases. Methods A systematic review of the literature with special reference to all types of clinical trial and case reports using biomedical databases including Medline, EMBASE, Scopus, International Pharmaceutical Abstracts and so forth to identify medicinal plants alone or as an adjuvant with other treatments and their safety/tolerability in the treatment of vitiligo and Hypermelanosis. Other sources of this search were medicinal plants text books, pharmacopoeias and authentic websites discussing possible treatments for vitiligo/hypermelanosis. It also included databases such as VigiAccess containing data from spontaneous reporting schemes for ADRs. Results A total of 55 articles (47 clinical trials and 8 case reports) met the inclusion criteria. Some trials did not reported safety information, some did report, but not very well. Reports of blistering, erythema, acute hepatitis and mutagenesis with Psoralea corylifolia. Adverse effects of erythema (mild to severe), phototoxic reactions, mild raise in liver transaminases, gastrointestinal disturbances, burns, itching, scaling, depigmented macules, pruritis, and giddiness with the use of psoralens. Khellin-related erythema, perilesional hyperpigmentation, gastrointestinal disturbances, mild raise in liver transaminases and orthostatic complaints. Infrequent side effects with Ginkgo biloba. Lower grade of erythema and edema reported with the use of Polypodium leucotomos. Conclusion Primarily the retrieved clinical studies were efficacy oriented and safety parameters were secondary in priority whilst the general protocol of clinical trials requires the screening of drugs/medicinal plants on the basis of safety studies before testing the clinical aspects of efficacy. Thereby it is recommended that efficacy studies may be followed once the safety has been established for a particular medicinal plant in treating vitiligo and hypermelanosis.
Total Knee Arthroplasty with Intra-Articular Resection of Bone for Knee Arthritis Secondary to Malunion of a Tibial Shaft Fracture: A Radiological Evaluation of Correction of the Tibial Deformity

This retrospective study was aimed to evaluate the clinical outcome and the extent of correction of the tibial deformity by a radiological evaluation following total knee arthroplasty (TKA) combined with intra-articular bone resection, in patients with knee arthritis and ipsilateral malunited tibial fractures. Fifteen patients (15 knees) with severe arthritis of the knee and extra-articular malunion of the tibia were treated using TKA with intra-articular bone resection. The extra-articular deformities in the coronal plane were 10 tibia vara (mean 15°, range 9°-30°), 4 tibia valgum (mean 12°, range 6°-20°), and one double deformity in the tibial shaft. The follow-up duration was 84 months (24–240). At the last follow-up, the mean Knee Society knee and function scores had improved, respectively (p = 0.001). The mean arc of knee motion improved from 97° preoperatively to 118.3° at the last follow-up (p < 0.001). The mean mechanical axis improved from a preoperative 15.5° to 1.5° of varus (p = 0.013). Excluding the patient with a double tibial malunion, in the 10 patients with varus tibial angulations, the tibia vara had improved from 15° preoperatively to 2.6° (p = 0.005). There were no observed complications except for one with a postoperative deep infection. In conclusion, our results indicated that TKA with intra-articular resection of the bone is an effective procedure for the treatment of severe arthritis of the knee with extra-articular malunion of the tibia in the coronal plane (≤30° of varus; ≤20° of valgus).
Left Ventricular Remodeling Risk Predicted by Two-Dimensional Speckle Tracking Echocardiography in Acute Myocardial Infarction Patients with Midrange or Preserved Ejection Fraction in Western Romania

Background Patients with acute myocardial infarction (AMI) are at high risk for left ventricular (LV) remodeling and heart failure. We aimed to study whether LV strains (S) and strain rates (SR) could predict cardiac remodeling in patients with AMI having a midrange or preserved LV ejection fraction (EF) following a percutaneous coronary intervention (PCI) within the first 12 hours from the onset of symptoms. Patients and Methods This is a case-control observational study including patients admitted for their first AMI, either with ST-segment elevation (STEMI) or without ST elevation (NSTEMI), with an LVEF > 40% after a successful PCI. Echocardiography was repeated after 6 months, and the patients were divided into two groups, according to whether LV remodeling was determined on echocardiography. Results Of the 253 AMI patients (mean 66 aged ± 13 years), including 185 males (73%), 61 (24%) presented signs of LV remodeling. In univariate logistic regression analysis, age, male sex, smoking history, hypertension, hypercholesterolemia, Killip class, renal function, peak creatine phosphokinase - MB level, 2- and 3-vessel coronary artery disease (CAD), and several echocardiographic parameters were significantly associated with LV remodeling (P<0.05). In multivariate logistic regression analysis harmed (H) LS and SR, Killip class, 3-vessel CAD, and LV end-diastolic volume were outlined as independent predictors for LV remodeling. Receiver operating characteristic curve analyses showed that HLS and HLSR were the most powerful independent predictors for LV remodeling (P<0.001), with an area under the curve (AUC) of 0.85 (sensitivity 83%; specificity 84%; p <0.001) and 0.77 (sensitivity 93; specificity 61%; p <0.001), respectively. The identified cut-off values for predictor variables were HLS< −11%, and HLSR< −0.65s−1. Conclusion We concluded that 2D-STE was the best method to evaluate LV remodeling in patients with AMI and midrange or preserved LVEF following myocardial revascularization by a PCI.
Comparison of precursor infiltration into polymer thin films via atomic layer deposition and sequential vapor infiltration using in-situ quartz crystal microgravimetry

Previous research exploring inorganic materials nucleation behavior on polymers via atomic layer deposition indicates the formation of hybrid organic–inorganic materials that form within the subsurface of the polymer. This has inspired adaptations to the process, such as sequential vapor infiltration, which enhances the diffusion of organometallic precursors into the subsurface of the polymer to promote the formation of a hybrid organic–inorganic coating. This work highlights the fundamental difference in mass uptake behavior between atomic layer deposition and sequential vapor infiltration using in-situ methods. In particular, in-situ quartz crystal microgravimetry is used to compare the mass uptake behavior of trimethyl aluminum in poly(butylene terephthalate) and polyamide-6 polymer thin films. The importance of trimethyl aluminum diffusion into the polymer subsurface and the subsequent chemical reactions with polymer functional groups are discussed.
Influence of Lost to Follow Up from Antiretroviral Therapy Among Retroviral Infected Patients at Tuberculosis Centers in Public Hospitals of Benishangul-Gumuz, Ethiopia

Background Broadening access to healthcare (ART) antiretroviral therapy has led to a 19% reduction in the death rate of people infected with the human immunodeficiency virus. This study would also describe the status and deciding factors of ART in (TB) tuberculosis centers in public hospitals of Benishangul-Gumuz, Ethiopia, for (LTFU) lost follow-up among (RVI) retroviral infected patients. Methods Hospital-based, unrivalled analysis of the case management (3:1) design was conducted. A total of 752 study participants (563 controls and 189 cases) Picked by systematic random sampling methodology, and where reviewed their charts from TB Centers. Data were entered and cleaned using Epi data version 3.1. 1 and then exported to SPSS version 22 for analysis. To analyze the statistical relationship between the outcome variable and independent variables, binary logistic regression was used. Relevance was declared at a p-value <0.05. Results A total of 1122 (25.3%) were LTFU. Among index cases with male cases, there were higher odds of lost to follow up (AOR= 1.68, 95% CI; 1.085, 2.609), 15–24 old age group have no formal education, civil servant were also having high comparatively. In index cases with identified parents, the risk of LTFU up had lower HIV status (AOR=0.5; 95% CI; 0.24, 0.997). Rest all variables showed low odds to LTFU. Conclusion A large number of patients enrolled in ARTwere missing from follow-up at TB centers, but unfortunately did not make the next appointment reported. The absence of prophylaxis was accepted as an independent determinant of LTFUfor ART.