Miracle-dz/UniFAR-FTUs huggingface dataset:
COMPARISON OF GROUP AND INDIVIDUAL TRAINING ON THE PATIENTS’ COMPLIANCE AND INCIDENCE OF WARFARIN SIDE EFFECTS AFTER CARDIAC VALVE REPLACEMENT

Introduction: Oral anticoagulant therapies are intended for prevention of thrombotic adverse effects and to maintain the level of drug without bleeding. The probability of risk highly depends on the patient compliance after discharge from hospital. This study was designed to compare the effect of group and individual education on patients’ compliance and incidence of adverse effects of warfarin after cardiac valve replacement surgery. Methods: In this quasi experimental study, 76 inpatients older than 18 years, undergone valve replacement surgery in cardiovascular ward of ShaheedRajaei Heart Center who met the inclusion criteria were selected randomly. After informed consent, they were randomly allocated to intervention or control groups. The patients in control group received individual education (the regular method) and intervention group was instructed in groups for three sessions each having one week interval. Up to six months, the results of the lab tests (PT, PTT, INR), the number of carried out lab tests, time interval between tests, and the incidence of complications were recorded, and finally compared statistically between the groups. Results: Comparing the compliance to therapy for two groups after six months, a significant difference was noticed (p=0.03). As 88.2% of intervention group vs. 61.2% in control groups had carried out their lab tests completely (p=0.02). Result of lab tests reported abnormal PT and INR in only 2 cases (5.9%) among patients of intervention group while 59.1% of patients in control group had the experience of once or more abnormal results (P=0.00). Three cases of deaths, two cases of hospitalization, and two cases of blood transfusions were reported in control group while none of the above was observed in the intervention group. Conclusion : Group education leads to the improvement of adherence to therapy which results in reduction of mortality among warfarin consumers after valve replacement surgery. Therefore it is highly recommended to nursing administrators to establish education units in hospital and conduct group education sessions for patients to reduce their problems. Simultaneously this leads to the reduction of hospital charges as well as financial and emotional loads on patients.
SXGBsite: Prediction of Protein–Ligand Binding Sites Using Sequence Information and Extreme Gradient Boosting

The prediction of protein–ligand binding sites is important in drug discovery and drug design. Protein–ligand binding site prediction computational methods are inexpensive and fast compared with experimental methods. This paper proposes a new computational method, SXGBsite, which includes the synthetic minority over-sampling technique (SMOTE) and the Extreme Gradient Boosting (XGBoost). SXGBsite uses the position-specific scoring matrix discrete cosine transform (PSSM-DCT) and predicted solvent accessibility (PSA) to extract features containing sequence information. A new balanced dataset was generated by SMOTE to improve classifier performance, and a prediction model was constructed using XGBoost. The parallel computing and regularization techniques enabled high-quality and fast predictions and mitigated overfitting caused by SMOTE. An evaluation using 12 different types of ligand binding site independent test sets showed that SXGBsite performs similarly to the existing methods on eight of the independent test sets with a faster computation time. SXGBsite may be applied as a complement to biological experiments.
Is Roux-en-Y or Billroth-II reconstruction the preferred choice for gastric cancer patients undergoing distal gastrectomy when Billroth I reconstruction is not applicable? A meta-analysis

Abstract Background: Although Billroth II and Roux-en-Y procedures are the two most commonly performed types of reconstruction techniques following distal stomach resection, there is yet no consensus on which reconstruction is the best choice. This meta-analysis aims to compare the perioperative safety and long-term complications of Billroth-II and Roux-en-Y reconstruction. Method: We searched the databases of the PubMed, the Cochrane Library, Web of Science, EMBASE, and the Chinese Biomedicine Database from January 2000 to January 2018 and included studies that compared Roux-en-Y with Billroth-II reconstruction after distal gastrectomy for gastric cancer. The meta-analyses were performed using RevMan 5.0 software. Result: Four randomized controlled trials (RCTs) and eight non-randomized observational clinical studies (OCS) were included. Billroth-II anastomosis was more beneficial than Roux-en-Y in reducing the operation time (OR = 34.14, 95%CI = 24.19-44.08, P < .00001, I2 = 54%) and intraoperative blood loss (OR = 54.32, 95%CI = 50.29-58.36, P < .00001, I2 = 36%). However, Roux-en-Y anastomosis was more beneficial than Billroth-II in reducing the incidence of remnant gastritis (OR = 0.12; 95% CI = 0.08-0.17; P < .00001; I2 = 8%), reflux esophagitis (OR = 0.26; 95%CI = 0.15-0.44; P < .00001; I2 = 0%), dumping symptoms (OR = 0.31; 95%CI = 0.13-0.73; P = .008; I2 = 0%), reflux symptoms (OR = 0.20; 95% CI = 0.10-0.42; P < .0001; I2 = 0%). No differences were found between the two groups with respect to anastomotic leakage (OR = 1.56, 95%CI = 0.66-3.64, P = .59, I2 = 0%); postoperative mortality (OR = 1.15, 95%CI = 0.38-3.51, P = .80, I2 = 0%); overall postoperative morbidity (OR = 0.92, 95%CI = 0.6-1.42, P = .72, I2 = 0%); and delayed gastric emptying (OR = 0.84, 95%CI = 0.40-1.77, P = .65, I2 = 0%). Conclusion: Roux-en-Y reconstruction does not carry greater postoperative complications than the Billroth II reconstruction. Additionally, it can improve the postoperative quality of life owing to less remnant gastritis, reflux esophagitis, dumping symptoms, and reflux symptoms. Considering the long-term postoperative outcomes, Roux-en-Y reconstruction appears to be a better choice following distal stomach resection.
Comparative Molecular Immunological Activity of Physiological Metal Oxide Nanoparticle and its Anticancer Peptide and RNA Complexes

Currently, there is a great interest in nanoparticle-based vaccine delivery. Recent studies suggest that nanoparticles when introduced into the biological milieu are not simply passive carriers but may also contribute immunological activity themselves or of their own accord. For example there is considerable interest in the biomedical applications of one of the physiologically-based inorganic metal oxide nanoparticle, zinc oxide (ZnO). Indeed zinc oxide (ZnO) NP are now recognized as a nanoscale chemotherapeutic or anticancer nanoparticle (ANP) and several recent reports suggest ZnO NP and/or its complexes with drug and RNA induce a potent antitumor response in immuno-competent mouse models. A variety of cell culture studies have shown that ZnO NP can induce cytokines such as IFN-γ, TNF-α, IL-2, and IL-12 which are known to regulate the tumor microenvironment. Much less work has been done on magnesium oxide (MgO), cobalt oxide (Co3O4), or nickel oxide (NiO); however, despite the fact that these physiologically-based metal oxide NP are reported to functionally load and assemble RNA and protein onto their surface and may thus also be of potential interest as nanovaccine platform. Here we initially compared in vitro immunogenicity of ZnO and Co3O4 NP and their effects on cancer-associated or tolerogenic cytokines. Based on these data we moved ZnO NP forward to testing in the ex vivo splenocyte assay relative to MgO and NiO NP and these data showed significant difference for flow cytometry sorted population for ZnO-NP, relative to NiO and MgO. These data suggesting both molecular and cellular immunogenic activity, a double-stranded anticancer RNA (ACR), polyinosinic:poly cytidylic acid (poly I:C) known to bind ZnO NP; when ZnO-poly I:C was injected into B16F10-BALB/C tumor significantly induced, IL-2 and IL-12 as shown by Cohen’s d test. LL37 is an anticancer peptide (ACP) currently in clinical trials as an intratumoral immuno-therapeutic agent against metastatic melanoma. LL37 is known to bind poly I:C where it is thought to compete for receptor binding on the surface of some immune cells, metastatic melanoma and lung cells. Molecular dynamic simulations revealed association of LL37 onto ZnO NP confirmed by gel shift assay. Thus using the well-characterized model human lung cancer model cell line (BEAS-2B), poly I:C RNA, LL37 peptide, or LL37-poly I:C complexes were loaded onto ZnO NP and delivered to BEAS-2B lung cells, and the effect on the main cancer regulating cytokine, IL-6 determined by ELISA. Surprisingly ZnO-LL37, but not ZnO-poly I:C or the more novel tricomplex (ZnO-LL37-poly I:C) significantly suppressed IL-6 by >98–99%. These data support the further evaluation of physiological metal oxide compositions, so-called physiometacomposite (PMC) materials and their formulation with anticancer peptide (ACP) and/or anticancer RNA (ACR) as a potential new class of immuno-therapeutic against melanoma and potentially lung carcinoma or other cancers.
Novel Convenient Approach to the Solid-Phase Synthesis of Oligonucleotide Conjugates

A novel and convenient approach for the solid-phase 5′-functionalization of oligonucleotides is proposed in this article. The approach is based on the activation of free 5′-hydroxyl of polymer support-bound protected oligonucleotides by N,N′-disuccinimidyl carbonate followed by interaction with amino-containing ligands. Novel amino-containing derivatives of closo-dodecaborate, estrone, cholesterol, and α-tocopherol were specially prepared. A wide range of oligonucleotide conjugates bearing closo-dodecaborate, short peptide, pyrene, lipophilic residues (cholesterol, α-tocopherol, folate, estrone), aliphatic diamines, and propargylamine were synthesized and characterized to demonstrate the versatility of the approach. The developed method is suitable for the conjugate synthesis of oligonucleotides of different types (ribo-, deoxyribo-, 2′-O-methylribo-, and others).
Analysis of Time-Course, Dose-Effect, and Influencing Factors of Antidepressants in the Treatment of Acute Adult Patients With Major Depression

Abstract Objective Model-based meta-analysis was used to describe the time-course and dose-effect relationships of antidepressants and also simultaneously investigate the impact of various factors on drug efficacy. Methods This study is a reanalysis of a published network meta-analysis. Only placebo-controlled trials were included in this study. The change rate in depression rating scale scores from baseline was used as an efficacy indicator because a continuous variable is more likely to reflect subtle differences in efficacy between drugs. Results A total 230 studies containing 64 346 patients were included in the analysis. The results showed that the number of study sites (single or multi-center) and the type of setting (inpatient or noninpatient) are important factors affecting the efficacy of antidepressants. After deducting the placebo effect, the maximum pure drug efficacy value of inpatients was 18.4% higher than that of noninpatients, and maximum pure drug efficacy value of single-center trials was 10.2% higher than that of multi-central trials. Amitriptyline showed the highest drug efficacy. The remaining 18 antidepressants were comparable or had little difference. Within the approved dose range, no significant dose-response relationship was observed. However, the time-course relationship is obvious for all antidepressants. In terms of safety, with the exception of amitriptyline, the dropout rate due to adverse events of other drugs was not more than 10% higher than that of the placebo group. Conclusion The number of study sites and the type of setting are significant impact factors for the efficacy of antidepressants. Except for amitriptyline, the other 18 antidepressants have little difference in efficacy and safety.
The Influence of Histologic Inflammation on the Improvement of Liver Stiffness Values Over 1 and 3 Years

Background: Transient elastography is now an indispensable tool for estimating liver fibrosis. Although many clinical factors other than fibrosis itself are known to affect liver stiffness (LS) values, it is still not yet clear what factors are related to improving LS values. The aim of this study was to find out how baseline histologic inflammation influences LS values and how much this inflammation affects improvement in LS values over time, regardless of actual fibrosis content. Methods: This retrospective study included 678 consecutive patients who underwent liver biopsy and sequential LS assessment from 2006 to 2015 at six tertiary hospitals in Korea. Linear regression analysis was used to evaluate how improvement of LS value can be associated with other factors besides fibrosis content. Results: Basal LS values increased with increasing inflammation in the same fibrosis stage. Degree of inflammation influenced the baseline LS value in a proportional manner (beta coefficient (BE), 6.476; 95% confidence interval (CI), 2.24–10.72; p = 0.003). Moreover, histologic inflammation affected the change in LS value significantly. Higher inflammation grade at baseline was a significant predictor for an improvement in LS value, regardless of the fibrosis stage (BE, −8.581; 95% CI, −15.715–−1.447; p = 0.019). In a subgroup analysis of patients who received repeated liver biopsies, the results showed a similar tendency. Conclusions: The LS value is affected by the degree of inflammation even at a low ALT level. Furthermore, baseline histologic inflammation has a significant impact on the improvement of LS values over time. Therefore, baseline inflammation should be taken into consideration when interpreting an improvement in LS value.
CHIRURGIE CARDIAQUE / CARDIAC SURGERY SURGICAL RESULTS FOR RHEUMATIC HEART VALVE DISEASE IN SENEGAL A.G. CISS; P.A. DIENG; P.S. BA; M. GAYE; S. DIATTA; FALL M.L.; M. LEYE; O. DIARRA; KANE O.; M.

Objectif : Evaluer les résultats de la chirurgie des valvulopathies rhumatismales au Sénégal en terme de mortalité et de morbidité. Patients et Méthodes : C’est une étude rétrospective sur 10 ans portant sur 250 patients opérés de valvulopathies rhumatismales à Dakar. Nous avions étudié les données cliniques, échographiques, les procédures opératoires ainsi que les complications post-opératoires. L’analyse statistique recherchait les variables liés à la mortalité et à la morbidité. L’âge moyen était de 38 ans et 47% des patients avaient moins de 20 ans. Résultats : La mortalité post-opératoire immédiate était de 7.6% (n=19), elle était dûe à une protection myocardique insuffisante (n=3), à une instabilité hémodynamique (n=7), à une tamponnade cardiaque (n=3), à un accident vasculaire cérébral (n=2) et à une coagulopathie (n=4). La mortalité tardive était de 2% ; elle était dûe à une thrombose sur prothèse mécanique (n=2) et à une endocardite infectieuse (n=2). La mortalité opératoire était 4 fois plus élevée chez les patients qui avaient un temps de circulation extracorporelle supérieur à 180 mn (HR= 6,18 ; p = 0.01). La fibrillation auriculaire était un facteur de mortalité (p < 0,001). Quatre malades (2 %) présentaient une fuite mitrale importante après plastie mitrale. Les résultats de la plastie étaient satisfaisantes dans 44% des cas. Conclusion : La pathologie cardiaque au Sénégal est dominée par les valvulopathies rhumatismales. La mortalité postopératoire importante exige un renforcement des moyens en réanimation.
Specialized concussion clinic referrals are not intended for all acute concussion patients in the emergency department.

The emergency department (ED) is the ﬁ rst point of healthcare contact for most head injured patients. The majority (estimated 85%) of patients suffering a head injury will not have intra-cranial damage requiring neurosurgical consultation but may have symptoms of mild traumatic brain injury, also known as concussion. 1 Early and spontaneous resolution occurs in most patients within 7 days, yet 15% – 30% of patients with concussion will develop post-concussion syndrome. Patients with post-concussion syndrome have persistent symptoms that usually last 2 – 4 months and typically peak 4 – 6 weeks following the injury. However, in a smaller per-centage of patients, symptoms last for a year or longer. Approximately 20% of adults with post-concussion syndrome will not have returned to full-time work 1 year after the initial injury, and some are disabled per-manently. 2 To date, clinical prediction tools do not yet exist to accurately identify adult concussion patients at risk of post-concussion syndrome. with assault-related were more likely to return to the ED. demonstrated by Morrison et al., adults presenting to the ED with concussion have differing demographic and injury-characteristics than previously studied pediat-ric populations, particularly with respect to mechanism of injury. 3,8 It is uncertain whether early exercise interventions will have the same impact on adult recovery as they have in children and adolescents. Results from a randomized controlled trial comparing prescribed light exercise with standard management for adult ED patients with concussion are forthcoming and will also inform ED providers how to counsel patients regarding light exercise. 10 Thus, based on the best available evidence, current guidelines for the management of concussion recommend no more than 2 days of physical rest and a graded return to activities as tolerated. 11 As this study by Morrison and colleagues underscores, adults with concussion are frequent patients in the ED, and a minority of these patients will return with persistent symptoms. Although this is a self-limited condition in the majority of patients, there remains an urgent need for a clinical prognostic tool that accurately identi-ﬁ es adult patients at risk for post-concussion syndrome early in their injury. In addition, forthcoming research on the effectiveness of early interventions in acute concussion will likely shed light on ED interventions, which may mitigate the impact of prolonged symptoms in this patient population.
Yoga Breathing Techniques (YBTs) in Exercise Induced Asthma: A Pilot Study

Yoga Breathing Techniques (YBTs) have been claimed to be beneficial in patients with asthma during acute bronchospasm. This study was undertaken to verify this claim under controlled conditions using objective data. Six adult asthmatics (4 female, 2 male) in the age range of 23 to 48 years (mean age 34 years) volunteered to participate in this study. All the volunteers were taught YBT by a senior Yoga instructor over 2 sessions and were instructed to practice these sessions daily with the help of a prerecorded guiding tape over a period of 2 weeks. Subjects acted as their own controls. During the "control day," their baseline vital signs were measured, including pulse rate (PR), blood pressure (BP), peak flow measurements (PEFR), and spirometry (PFT). They all then underwent exercise testing by climbing up and down 14 steps indoors with controlled temperature and humidity. Serial PFT, BP, and PR were measured and recorded at 1 minute, 7 minutes, and 15 minutes post exercise. On the "control day," subjects.
Estimating the Heritability of Experiencing Child Maltreatment in an Extended Family Design

Child-driven genetic factors can contribute to negative parenting and may increase the risk of being maltreated. Experiencing childhood maltreatment may be partly heritable, but results of twin studies are mixed. In the current study, we used a cross-sectional extended family design to estimate genetic and environmental effects on experiencing child maltreatment. The sample consisted of 395 individuals (225 women; M age = 38.85 years, rangeage = 7–88 years) from 63 families with two or three participating generations. Participants were oversampled for experienced maltreatment. Self-reported experienced child maltreatment was measured using a questionnaire assessing physical and emotional abuse, and physical and emotional neglect. All maltreatment phenotypes were partly heritable with percentages for h 2 ranging from 30% (SE = 13%) for neglect to 62% (SE = 19%) for severe physical abuse. Common environmental effects (c 2) explained a statistically significant proportion of variance for all phenotypes except for the experience of severe physical abuse (c 2 = 9%, SE = 13%, p = .26). The genetic correlation between abuse and neglect was ρg = . 73 (p = .02). Common environmental variance increased as socioeconomic status (SES) decreased (p = .05), but additive genetic and unique environmental variances were constant across different levels of SES.
Exercise, headache, and factors associated with headache in chronic whiplash

Abstract Background: Almost 40% of individuals with chronic whiplash-associated disorders (WAD) report headache after 5 years, making it one of the most common persistent symptoms besides neck pain, but randomized treatment studies are lacking. This study aimed to evaluate the effect of 3 different exercise approaches on headache in chronic WAD grades 2 and 3, and to identify potential factors associated with such headache, and whether they differ depending on 3 different aspects of such headache (current headache, maximum headache, or headache bothersomeness). Methods: This was an analysis of a randomized clinical trial of people with chronic WAD and headache (n = 188), who were randomized to either 12 weeks of neck-specific exercise without (NSE) or with a behavioral approach (NSEB) or physical activity prescription (PPA). Data were collected at baseline and at 3, 6, and 12 months. Physical and psychosocial factors were tested for association with headache. Multivariate regression models and linear mixed models were used. Results: The NSE/NSEB groups reported reduced headache both over time and compared to PPA. Up to 51% (NSE) and 61% (NSEB) reported at least 50% reduction in their headache at 12 months. The PPA group was not improved over time. Neck pain and dizziness were associated with headache regardless of aspect of headache. The only associated psychosocial factor was anxiety, which was associated with headache bothersomeness. Other factors were mainly physical, and up to 51% of the variance was explained. Conclusion: Headache in chronic WAD, may be reduced with neck-specific exercise with or without a behavioral approach. Chronic headache was associated with neck pain and dizziness regardless of aspect tested. Other factors associated with headache in chronic WAD were mainly physical rather than psychosocial. Trial registration number: Clinical Trials.gov, no: NCT015285
NEEDLE STICK INJURY AND INADEQUATE POST EXPOSURE PRACTICES AMONG HEALTH CARE WORKERS OF A TERTIARY CARE CENTRE IN RURAL INDIA

Introduction: Occupational exposure to pathogenic microbes as a result of needles stick injury is associated with significant risk to health care professional’s career, health, families and also the patients. Objective: This study was carried out to find out the incidence of needle stick injury (NSI), probable reasons for getting it and to determine barriers in seeking care after NSI among health care workers (HCWs) of a tertiary care centre in Northern India. It was also planned to assess awareness, acceptability and availability of post exposure prophylaxis (PEP) in the above population. Method: A cross- sectional study was conducted among HCWs of MM Institute of Medical sciences and Research, Mullana. A total of 300 health care workers were selected for the study by simple random sampling method. A self designed, semi- structured interview schedule was used to collect data from the participants by interview method Result: 80.5% of HCWs reported having had one or more NSI in their career, maximum among the nursing staff (94.2%). The average number of NSIs was found to be 1.85 per HCW per year (±2.29 SD). 17.8% of HCWs had a NSI involving a high risk patient. 56.8% of the NSI were from a hollow-bore type of needle. Most of NSIs were while recapping a needle after use (27%) or bending the needle for breaking it before disposal (20%). Majority of the NSI were not