Miracle-dz/UniFAR-FTUs huggingface dataset:
The Role of Cardiopulmonary Exercise Testing in Hypertrophic Cardiomyopathy

This review emphasizes the importance of cardiopulmonary exercise testing (CPET) in patients diagnosed with hypertrophic cardiomyopathy (HCM). In contrast to standard exercise testing and stress echoes, which are limited due to the ECG changes and wall motion abnormalities that characterize this condition, CPET allows for the assessment of the complex pathophysiology and severity of the disease, its mechanisms of functional limitation, and its risk stratification. It is useful tool to evaluate the risk for sudden cardiac death and select patients for cardiac resynchronization therapy (CRT), cardiac transplantation, or mechanical circulatory support, especially when symptomatology and functional status are uncertain. It may help in differentiating HCM from other forms of cardiac hypertrophy, such as athletes’ heart. Finally, it is used to guide and monitor therapy as well as for exercise prescription. It may be considered every 2 years in clinically stable patients or every year in patients with worsening symptoms. Although performed only in specialized centers, CPET combined with echocardiography (i.e., CPET imaging) and invasive CPET are more informative and provide a better assessment of cardiac functional status, left ventricular outflow tract obstruction, and diastolic dysfunction during exercise in patients with HCM.
COVID-19 and sexual reproductive health service utilisation among women of reproductive age in Zambia

ABSTRACT Zambia has made improvements in addressing maternal and child health in the past two decades. The COVID-19 pandemic outbreak, which could put a strain on the healthcare systems and alter how access to sexual and reproductive health services is provided, could, however, have a negative impact on the gains. Data from a recent nationally representative COVID-19 survey, conducted in April 2021, was used to examine the utilisation of antenatal care services among pregnant women during the pandemic in Zambia. Overall, 10 per cent (95% CI: 8.0–11.4) of pregnant women missed antenatal care during the COVID-19 period, signifying an increase when compared to the time before the outbreak of COVID-19. Age of a woman and level of education were associated with the risk of missing antenatal care services. The study highlights the need to improve communication to women on availability and access to sexual reproductive health services to stimulate demand and use among women during this period.
On non-primitive Weierstrass points

We give an upper bound on the codimension in $M_{g,1}$ of the variety $M^S_{g,1}$ of marked curves $(C,p)$ with a given Weierstrass semigroup. The bound is a combinatorial quantity which we call the effective weight of the semigroup; it is a refinement of the weight of the semigroup, and differs from it precisely when the semigroup is not primitive. We prove that whenever the effective weight is less than g, the variety $M^S_{g,1}$ is nonempty and has a component of the predicted codimension. These results extend previous results of Eisenbud, Harris, and Komeda to the case of non-primitive semigroups. We also survey other cases where the codimension of $M^S_{g,1}$ is known, as evidence that the effective weight estimate is correct in much wider circumstances.
Assessment of Anteroposterior Diameter, Interpedicular Distance and Cross-Sectional Area of the Lubar Spine in Patients Undergoing CT Scan in a Tertiary Care Center

Introduction: Lumbar spinal stenosis is a frequent cause of low back pain. Decreased lumbar spinal canal parameters are major risk factors for canal stenosis. This study was done to assess anteroposterior diameter, interpedicular distance and cross-sectional area of the lumbar spinal canal on a CT scan. Methods: It was a cross-sectional descriptive study conducted at Nepal Medical College Teaching Hospital. Anteroposterior diameter, interpedicular distance and cross-sectional area of the lumbar spinal canal were measured. Results: A total of 171 subjects were selected. The mean of anteroposterior diameter from L1-L5 was 16.46 mm, 16.05 mm, 15.04 mm, 15.08 mm and 15.23 mm respectively. The means of interpedicular distance from L1-L5 were 22.71 mm, 23.20 mm, 24.52 mm, 26.29 mm and 29.90 mm respectively. The means of cross sectional area from L1-L5 were 288.79 mm2, 2773.15 mm2, 266.84 mm2, 282.89 mm2 and 317.04 mm2 respectively. A statistically significant difference between sex and anteroposterior diameter was noted at L2 and the interpedicular distance was at L4 and L5 levels. The cross-sectional area has increased with increased age in all five vertebral levels but it showed statistically significant variation only at L1. Conclusion: Anteroposterior diameter, interpedicular distance and cross-sectional area varies at each level on the lumbar vertebra and may vary according to age and sex.
A Cross-Sectional Study of the Dermatological Manifestations of Patients with Fabry Disease and the Assessment of Angiokeratomas with Multimodal Imaging

Fabry disease (FD) is a multisystemic X-linked lysosomal storage disease that presents with angiokeratomas (AKs). Our objective was to investigate the clinical and morphologic features of AKs and to present two experimental techniques, multispectral imaging (MSI) and non-linear microscopy (NLM). A thorough dermatological examination was carried out in our 26 FD patients and dermoscopic images (n = 136) were evaluated for specific structures. MSI was used for the evaluation of AKs in seven patients. NLM was carried out to obtain histology samples of two AKs and two hemangiomas. Although AKs were the most common manifestation, the majority of patients presented an atypical distribution and appearance, which could cause a diagnostic challenge. Dermoscopy revealed lacunae (65%) and dotted vessels (56%) as the most common structures, with a whitish veil present in only 25%. Autofluorescence (405 nm) and diffuse reflectance (526 nm) images showed the underlying vasculature more prominently compared to dermoscopy. Using NLM, AKs and hemangiomas could be distinguished based on morphologic features. The clinical heterogeneity of FD can result in a diagnostic delay. Although AKs are often the first sign of FD, their presentation is diverse. A thorough dermatological examination and the evaluation of other cutaneous signs are essential for the early diagnosis of FD.
Personalized Medicine in Medullary Thyroid Carcinoma: A Broad Review of Emerging Treatments

Medullary thyroid carcinoma (MTC) arises from parafollicular cells in the thyroid gland, and although rare, it represents an aggressive type of thyroid cancer. MTC is recognized for its low mutational burden, with point mutations in RET or RAS genes being the most common oncogenic events. MTC can be resistant to cytotoxic chemotherapy, and multitarget kinase inhibitors (MKIs) have been considered a treatment option. They act by inhibiting the activities of specific tyrosine kinase receptors involved in tumor growth and angiogenesis. Several tyrosine kinase inhibitors are approved in the treatment of advanced MTC, including vandetanib and cabozantinib. However, due to the significant number of adverse events, debatable efficiency and resistance, there is a need for novel RET-specific TKIs. Newer RET-specific TKIs are expected to overcome previous limitations and improve patient outcomes. Herein, we aim to review MTC signaling pathways, the most recent options for treatment and the applications for personalized medicine.
A Moment's Thought: Centers of Mass and Combinatorial Identities

Summary We provide proofs of well-known formulae using physical arguments. Specifically, we locate the center of mass of a configuration of masses two different ways, and then equate the results. Most notably, we show how this idea leads to a new proof without words for the sum of squares of consecutive natural numbers. We also demonstrate how the method can be profitably applied to certain combinatorial identities, and Fibonacci summations.
Biologically inspired de novo protein structure prediction

Fragment-based approaches are the current standard for de novo protein structure prediction. These approaches rely on accurate and reliable fragment libraries to generate good structural models. We demonstrate that fragments presenting different predominant predicted secondary structures should be treated differently during fragment library generation. Using this information, we developed Flib and shown that it generates fragment libraries with higher precision and coverage than two other methods. We explored co-evolution to identify pairs of residues that are in contact, which were then used to improve model generation. We performed a comparative analysis of nine methods in terms of their precision and their usefulness to de novo structure prediction. Our results show that metaPSICOV stage 2 produces the most accurate predictions and that metaPSICOV stage 1 generates the best modelling results. In general, contact predictors are good at identifying contacts between β-strands and bad at identifying contacts between α-helices. We also show that the ratio of satisfied predicted contacts can be used to assess whether correct models were generated for a given target. We also investigated whether the biological process of cotranslational protein folding, the notion that proteins fold as they are being synthesized, can be used to improve de novo protein structure prediction. Our tool for this investigation is SAINT2. SAINT2 differs from conventional fragment-assembly approaches as it is able to perform predictions sequentially from N to C-terminus, starting with a small peptide that is extended as the simulation progresses (SAINT2 Cotranslational). SAINT2 is also able to generate decoys in a standard non-sequential fashion (SAINT2 In Vitro). We compared SAINT2 Cotranslational to SAINT2 In Vitro and shown that SAINT2 Cotranslational generally produces better answers, generating an individual decoy between 1.5 to 2.5 times faster than SAINT2 In Vitro. Our results suggest that biologically inspired structure prediction can improve search heuristics and final model quality.
Diet Plus Inositols, α-Lactalbumin and Gymnema sylvestre: The Successful Combo to Restore Body Weight and Metabolic Profile in Obese and Dysmetabolic Patients

The primary control of dysmetabolic patients is extremely challenging worldwide, with inadequate dietary habits and sporadic physical activity among the key risk factors for metabolic syndrome onset. Nowadays, there is no exclusive treatment for this condition, and considering that preventive measures usually fail, new therapeutic approaches need to be proposed and investigated. This present pilot study compared the effects of diet alone and in association with a combination of myo-inositol and d-chiro-inositol in their 40:1 ratio, α-lactalbumin, and Gymnema sylvestre on different metabolic parameters in obese dysmetabolic patients. To this purpose, 37 patients with BMI between 30 and 40 and fasting blood glucose between 100 and 125 mg/dL were divided into two groups: (i) the control group followed a hypocaloric Mediterranean diet, (ii) while the study group was also supplemented with a daily dosage of two sachets, each one containing 1950 mg myo-inositol, 50 mg d-chiro-inositol, 50 mg α-lactalbumin, and 250 mg Gymnema Sylvestre. After a 6-month treatment, all parameters improved in both groups. Nevertheless, the treated group experienced a greater improvement, especially concerning the variation from the baseline of HOMA index, triglycerides, BMI, body weight, and waist circumference. These findings support the supplementation with myo-inositol and d-chiro-inositol in the 40:1 ratio, α-lactalbumin, and Gymnema sylvestre as a therapeutical strategy to potentiate the beneficial effects induced via dietary programs in dysmetabolic patients.
Diversity and Co-Occurrence Pattern Analysis of Cecal and Jejunal Microbiota in Two Rabbit Breeds

Simple Summary A large population of bacteria, protozoa, fungi, and algae colonizes an animal’s body surface. The complex community of microbes that occupies a specific area of the organism and develops symbiotic relationships with the host is referred to as the microbiota. In this context, the gut microbiota plays an important physiological role as it influences the digestion and absorption of nutrients, the development and maturation of the immune system, and thus the growth, resistance to disease, and welfare of the animal. For these reasons, it is important to know the role of the microbiota in these specific functions, as well as which factors can impact the composition of bacterial populations, because changes in the microbiota can result in both beneficial and detrimental effects (dysbiosis) on the host. This study, in addition to providing information on the composition of the microbiota in the jejunum and cecum of rabbits, also evaluates the effect of breed and different growth rates using a modern methodological approach. Since the effect of these factors on the modulation of the gut microbiota has been little studied, this research could be the starting point for new experimental investigations aimed at enhancing rabbit productivity and welfare. Abstract This study aimed to evaluate the productive performance and microbiota variation in the jejunum and cecum of two rabbit breeds with different growth rates. This study was carried out on Native Middle-Egypt Breed (NMER) and Giant Flanders (GF) rabbits from 5 weeks to 12 weeks of age. Twenty NMER (NM) and GF male rabbits were slaughtered, and the jejunum and cecum tracts were collected to assay gut microbiota composition via 16S ribosomal RNA (rRNA) gene sequencing and histology examination. At 12 weeks of age, daily weight gain, villus height in the jejunum, total protein, and albumin were higher in GF rabbits than in NMER rabbits. Also, the jejunal villi of GF were well arranged in their dense borders. The microbiota between the jejunum and cecum was significantly different in terms of Beta-diversity. A significant correlation between Enterococcus (jejunum NM samples) and Lactobacillus (cecum GF samples) with body weight and weight gain was found (p < 0.05). Moreover, Escherichia-Shigella in the cecum of NM was significantly correlated with weight gain (p < 0.05). The most abundant genera identified in the jejunal and cecal contents of GF were generally beneficial microbiota. They may also play a role in reducing the pathogenic effects of Escherichia coli in these rabbits.
Cardiovascular Effects of Weight Loss in Obese Patients with Diabetes: Is Bariatric Surgery the Additional Arrow in the Quiver?

Obesity is an increasingly widespread disease worldwide because of lifestyle changes. It is associated with an increased risk of cardiovascular disease, primarily type 2 diabetes mellitus, with an increase in major cardiovascular adverse events. Bariatric surgery has been shown to be able to reduce the incidence of obesity-related cardiovascular disease and thus overall mortality. This result has been shown to be the result of hormonal and metabolic effects induced by post-surgical anatomical changes, with important effects on multiple hormonal and molecular axes that make this treatment more effective than conservative therapy in determining a marked improvement in the patient’s cardiovascular risk profile. This review, therefore, aimed to examine the surgical techniques currently available and how these might be responsible not only for weight loss but also for metabolic improvement and cardiovascular benefits in patients undergoing such procedures.
Knowledge Level of the Anganwadi Workers on Integrated Child Development Service: A Study in Manipur, India

Integrated Child Development Service (ICDS) is a Government program in India that mainly focuses on child and maternal health to address the health, nutrition, and development needs of children, pregnant women, nursing mothers, and adolescent girls. The Anganwadi workers are the front-line workers who are responsible for transferring the services of ICDS to children and mothers. As the ICDS program is designed for vulnerable section of the society like women and children it is important not only from health point of view but also from the point of socio economic as well as for a better future generation. Success of any program depends on the knowledge of stakeholders about the concept, objective, functions of the program. Anganwadi workers are grass-root level functionaries who are implementing the program at ground level. Their knowledge level has impact on implementation and output of the programme. This paper attempts to explore the knowledge level of AWWs regarding not only the activities of ICDS but also their knowledge on different nutrients its source and importance which will act as a guide to policy makers, planners, extension functionaries, scientist, researchers, students and health personnel. For this purpose 150 respondents from Imphal East, Manipur were selected randomly and interviewed with a structured schedule. The data were analyzed using appropriate statistical methods. The finding of the study revealed that majority of the AWWs had medium level of knowledge regarding the objectives and functions of ICDS. Further it was found that only 16 per cent of the respondents had high knowledge level regarding Vitamin A, 4.67 per cent regarding Iron, 0 per cent for Calcium and 15.33 per cent for Vitamin C respectively. Moreover, it was found that age and experience of the respondents had a negatively significant relationship with their knowledge while their educational qualification was correlated positively. Thus, the present study strongly felt the need of improving the quality of knowledge and awareness among Anganwadi workers about the various activities of ICDS and the nutritional requirements of mother and children which needs regular training, awareness and orientation programs along with group discussion and observations.
Participation in School Committees in Monitoring Primary School Projects in the Nyang’hwale District in Tanzania

School committees hold a central role in decision making on various issues about the development and delivery of primary education, including the monitoring of school projects. This study examined the participation of school committees in monitoring primary school projects in selected schools in Nyang’hwale District in the Geita Region. Specifically, the study determined the extent of school committee members’ participation in monitoring school projects and examined factors influencing the school committee’s participation in monitoring primary school projects. A purposive sampling technique was used to select 17 primary schools and 136 school committee members and key informants involved in the study. Data were collected through structured interviews using a structured questionnaire, key informant interviews and documentary review, and were analyzed for descriptive statistics, chi-square test and binary logistic regression. Results showed that most of the school committee members participated in project identification and planning, but less in budgeting activities. The main factors that influenced the participation of school committees were their perceived ability to speak up in meetings, their willingness to participate and their source of information. It was concluded that school committees’ participation in monitoring school projects was limited and constrained by gender imbalance. Thus, there is a need for capacity building for school committees to enhance their capacity for their roles and responsibilities.
Pulmonary Alveolar Proteinosis: An Overview and Emerging Therapeutics

Pulmonary alveolar proteinosis (PAP) is a rare pulmonary syndrome characterized by surfactant accumulation in the alveoli, which results in impaired gas exchange. There are three types of PAP: primary, secondary and congenital. Autoimmune PAP, which is under the category of primary PAP, is the most common form, and is caused by an impairment in granulocyte–macrophage colony-stimulating factor (GM-CSF) signalling, due to the presence of anti-GM-CSF autoantibodies. While some patients with PAP remain asymptomatic, most present with progressive dyspnoea of insidious onset that, rarely, can progress to respiratory failure and death. Currently, there is no known cure and no approved therapies for PAP. Whole-lung lavage remains the gold-standard treatment; however, several novel and promising targeted therapies are being actively investigated.
Piperine-Loaded In Situ Gel: Formulation, In Vitro Characterization, and Clinical Evaluation against Periodontitis

Periodontitis is an inflammatory disorder associated with dysbiosis and characterized by microbiologically related, host-mediated inflammation that leads to the damage of periodontal tissues including gingiva, connective tissues, and alveolar bone. The aim of this study was to develop an in situ gel consisting of piperine. Eight in situ gel formulations were designed by varying the concentration of deacylated gellan gum cross-linked with sodium tripolyphosphate, and poloxamer-407. The prepared gels were evaluated for gelation temperature, gelation time, viscosity, piperine-loading efficiency, and piperine release. Finally, the optimized formula was evaluated for anti-inflammatory effectiveness among human patients during a 14-day follow-up. The optimized in situ gel formulation exhibited a gelation temperature of 35 ± 1 °C, gelling of 36 ± 1 s, excellent syringeability, and piperine loading of 95.3 ± 2.3%. This formulation efficiently sustained in vitro drug release for up to 72 h. In vivo studies revealed an efficient sol-to-gel transformation of optimized in situ gel formulation at physiological conditions, permitting an efficient residence time of the formulation within a periodontitis pocket. Most importantly, a clinical study revealed that treatment with the optimized formulation elicited a significant reduction in the mean plaque score (p = 0.001), gingival index (p = 0.003), and pocket depth (p = 0.002), and exerted a potent anti-inflammatory potential, compared to the control group. Collectively, piperine-loaded in situ gel might represent a viable therapeutic approach for the management of gingival and periodontal diseases.
Snowflakes in the atmospheric surface layer: observation of particle–turbulence dynamics

We report on optical field measurements of snow settling in atmospheric turbulence at $Re_{\unicode[STIX]{x1D706}}=940$ . It is found that the snowflakes exhibit hallmark features of inertial particles in turbulence. The snow motion is analysed in both Eulerian and Lagrangian frameworks by large-scale particle imaging, while sonic anemometry is used to characterize the flow field. Additionally, the snowflake size and morphology are assessed by digital in-line holography. The low volume fraction and mass loading imply a one-way interaction with the turbulent air. Acceleration probability density functions show wide exponential tails consistent with laboratory and numerical studies of homogeneous isotropic turbulence. Invoking the assumption that the particle acceleration has a stronger dependence on the Stokes number than on the specific features of the turbulence (e.g. precise Reynolds number and large-scale anisotropy), we make inferences on the snowflakes’ aerodynamic response time. In particular, we observe that their acceleration distribution is consistent with that of particles of Stokes number in the range $St=0.1{-}0.4$ based on the Kolmogorov time scale. The still-air terminal velocities estimated for the resulting range of aerodynamic response times are significantly smaller than the measured snow particle fall speed. This is interpreted as a manifestation of settling enhancement by turbulence, which is observed here for the first time in a natural setting.