Miracle-dz/UniFAR-FTUs huggingface dataset:
Longitudinal Analysis of Risk Factors for Clinical Outcomes of Enterobacteriaceae Meningitis/Encephalitis in Post-Neurosurgical Patients: A Comparative Cohort Study During 2014–2019

Purpose Our study is a retrospective observational study conducted in one of the largest clinical centers of neurosurgery in China. We aimed to investigate the antimicrobial susceptibility patterns of the Enterobacteriaceae isolates responsible for nosocomial meningitis/encephalitis in post-neurosurgical patients. Meanwhile, we tried to evaluate the risk factors for mortality following Enterobacteriaceae meningitis/encephalitis. Patients and Methods Medical data on clinical characteristics, antibiotic susceptibilities, and mortality were reviewed until patients’ discharge or death in the hospital. Data for a total of 164 cerebrospinal fluid (CSF) infection cases due to Enterobacteriaceae after neurosurgery were collected between January 2014 and November 2019 in order to identify risk factors affecting the outcome. Kaplan–Meier survival analysis and multivariable Cox proportional hazard models were applied. Results In this study, a total of 2416 neurosurgical meningitis/encephalitis cases were reported between 2014 and 2019. Enterobacteriaceae accounted for 7.3% (176/2416) of all the bacterial infections. Of them, 164 Enterobacteriaceae isolates were available to divide into two groups according to the final outcome of whether the patient died or survived. In total, 38 patients died (23.2%) and 126 patients survived (76.8%). The most frequent infecting species was Klebsiella pneumoniae (47.0%, 77/164). Fourteen-day and 30-day mortality rates were 7.9% (13/164) and 15.2% (25/164). Kaplan–Meier survival analysis revealed that the risk factors of Enterobacteriaceae meningitis/encephalitis that resulted in poor outcomes included comorbidities, Glasgow Coma Scale (GCS) score, sepsis, intensive care unit (ICU) admission, extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, and ventilation. A GCS score of less than or equal to 8 (P=0.04, HR 2.562) was identified to be a significant risk factor for mortality according to the multivariable Cox proportional hazards model. Conclusion In-hospital mortality caused by Enterobacteriaceae meningitis/encephalitis in neurosurgery was high. A GCS score of ≤8 was an independent risk factor for mortality following Enterobacteriaceae meningitis/encephalitis in post-neurosurgical patients.
The need for renovating patient education in kidney transplantation: A qualitative study

BACKGROUND: Many kidney transplant recipients lack the knowledge, abilities, and support they need for self-care. On the other hand, most kidney transplant centers do not have a well-planned and specific training program for them, and educational interventions for kidney transplant recipients have not been adequately effective. This study aimed to describe strategies for improving patient education in kidney transplantation. MATERIALS AND METHODS: Data were collected through semi-structured individual and group interviews with 24 patients, family members, and health-care staff in one of the main kidney transplant centers in Tehran. Participants were selected purposefully, and qualitative content analysis was used to analyze the data. RESULTS: The main finding emerged from the data was the shift from current patient education program to patient- and family-centered education (PFCE). The strategies to achieve this goal were categorized into four main categories including “continuous patient and family education” (pre- and posttransplant patient education), “facilitating the process” (using new technologies, teamwork education, and patient and family accessibility), “strengthening human resources” (empowerment health-care team, allocation of human resources, promoting staffs' motivation, and updating educational content and materials), and “monitoring and evaluation” (correcting patient education recording, supervising the patient education, and appropriate educational evaluation). CONCLUSIONS: Transforming from the current patient education program to PFCE seems to be essential to increase the effectiveness of patient education in kidney transplant process. To this end, providing continuous patient and family education, facilitating the processes, strengthening human resources, and monitoring and evaluation in health-care organizations conducting the kidney transplantation is necessary.
The IL-33/sST2 Axis in Thromboangiitis Obliterans

Background Until recently, it remains unknown whether thromboangiitis obliterans (TAO) is a type of systemic vasculitis. A high level of IL-33 and its soluble decoy receptor sST2 in the acute phase of systemic vasculitis has been demonstrated. Methods The serum level of IL-33 and sST2 in 50 TAO patients, 20 age- and smoking habit-matched controls and 19 age-matched non-smoker controls was evaluated. Results The mean level of IL-33 in TAO, smokers and non-smokers was 370.2±61.7ng/mL,132.14±2.6ng/mL and 11.3±0.38ng/mL, respectively. The IL-33 was significantly higher in the TAO than in either control groups (p < 0.001). The IL-33 in the acute phase of TAO was significantly higher than in the patients in the quiescent phase of the disease (p = 0.019). Also, IL-33 in the patients with gangrene was significantly higher than in the patients with non-healing ulcers (p = 0.021). The sST2 in the TAO patients was 49.3±5.58ng/mL, and in smoker and non-smoker controls, it was 45.3±6.3ng/mL and 4.11±0.17ng/mL, respectively. No significant difference was found between the patients and smoker control groups (p = 0.87). The mean ratio of IL-33/sST2 was 27.89±10.44 in the TAO group and, in smokers and non-smokers, it was 2.85±0.48 and 2.84±0.14, respectively. A significantly high level of IL-33/sST2 ratio was observed in TAO patients in both the active and quiescent phases of the disease in comparison to both control groups (p<0.001). Conclusion The regulation pattern of IL-33/sST2 was different in TAO in comparison to autoimmune vasculitis.
Nutrients in the cassava (Manihot esculenta Crantz) leaf meal at three ages of the plant

The high number of cassava cultivars adapted to many different regions provides a wide variation in the chemical composition of cassava leaves meal (CLM). Therefore, the contents of some nutrients in CLM from five cultivars at three ages of the plant were investigated in order to select the cultivars and ages with superior levels of these nutrients. When the plants were 12 months old, the highest levels of crude protein (CP), b-carotene, iron, magnesium, phosphorus and sulfur were observed. The IAC 289-70 cv. showed the highest levels of magnesium, as well as considerable contents of CP, b-carotene, iron, zinc and sulfur, which did not differ statistically from the cultivars showing the highest levels of these nutrients.
Adipose-Derived Stem Cells Can Replace Fibroblasts as Cell Control for Anti-Tumor Screening Assay

Abstract Anti-tumor activity screening is a typical process used in anti-tumor drug discovery. The ideal anti-tumor drug candidates are extracts or compounds that can inhibit the proliferation of cancer cells via apoptosis, while exerting minimal effects on normal somatic cells. For a long time, fibroblasts were used as normal cells for all anti-tumor screening assays. However, the fibroblasts exhibited several limitations as cell controls for anti-tumor screening. This study aimed to compare the usage of dermal fibroblasts (DFs) and adipose-derived stem cells (ADSCs) as normal cell controls in anti-tumor screening protocols. The DFs and ADSCs were prepared per the published protocols. The IC50 values of doxorubicin on hepatocellular carcinoma cells HepG2, breast cancer cells MCF-7, DFs and ADSCs were determined via the Alamar blue assay. The side effect indexes (SEIs) were calculated as the ratio of IC50 values of drugs on cancer cells and IC50 values of drugs on DFs, and on ADSCs. The stability of the anti-tumor assay was investigated when carried out on DFs and ADSCs from different passages. The results showed that the IC50 values, as well as SEI values, were not significantly different between using DFs or ADSCs as normal cell controls when DFs and ADSCs were at passage 3. However, for DFs at passage 6 to 12, the IC50 values of doxorubicin were significantly different between DFs and ADSCs. The IC50 values of doxorubicin on DFs were strongly reduced due to the senescence of DFs, while the values were more constant in ADSCs. The SEI values of doxorubicin on DFs, compared to HepG2 and MCF-7 cells, were also changed during passage 3 to 12 of the DFs. However, these values were only slightly changed for ADSCs from the 3rd to 12th passages. ADSCs can replace DFs as a normal cell control for anti-tumor activity screening.
Enraizaimento de estacas de Bougainvillea spectabilis Willd. com o uso de ácido indolbutírico

O uso de acido indolbutirico (IBA) como estimulador do enraizamento em estacas de Bougainvillea spectabilis Willd. pode propiciar aumento de raizes para a formacao de mudas comercializaveis. Objetivou-se avaliar o enraizamento, a formacao de brotos e a sobrevivencia de estacas herbaceas, lenhosas e semi-lenhosas de Bougainvillea com o uso de acido indolbutirico (IBA). As estacas foram coletadas e tratadas com o IBA (1000 e 2000 mg/lt). Aos 56 dias avaliaram-se a porcentagem de estacas vivas, enraizadas e com brotos; o numero de brotos e de raizes por estaca e o comprimento da maior raiz e maior broto. As menores porcentagens de enraizamento foram verificadas nas estacas sem o uso de IBA. Maiores diferencas foram verificadas para as estacas lenhosas. O uso do IBA favorece o enraizamento de estacas de Bougainvillea, com melhor desempenho para as estacas lenhosas e na concentracao de 2000 mg/lt de IBA.
Correlates of Uptake of Antiretroviral Therapy in HIV-Positive Orphans and Vulnerable Children Aged 0–14 Years in Tanzania

Background In 2018, only 65% of Tanzanian children aged 0–14 years living with human immunodeficiency virus (HIV) were on treatment, suggesting that challenges exist. This study explores factors associated with uptake of antiretroviral therapy (ART) among HIV-positive orphans and vulnerable children (OVC). Methods Data are from the USAID Kizazi Kipya project that aims to increase the uptake of HIV/AIDS and other health and social services by OVC and their caregivers. HIV-positive OVC aged 0–14 years who were enrolled in the project from January 2017 to September 2018 were analyzed. ART status (off ART or on ART) was the outcome variable. Multivariate analysis was performed using multilevel logistic regression. Results Of the 10,047 HIV-positive OVC aged 0–14 years analyzed, 93.5% were currently on ART at enrollment. In the multivariate analysis, OVC with male caregivers were 4-times more likely than those with female caregivers to be on ART (OR=4.03, 95% CI=1.49–10.90). OVC with HIV-positive caregivers were 12-times more likely than those with HIV-negative caregivers to be on ART (OR=12.0, 95% CI=3.81–37.70). OVC with caregivers who did not disclose their HIV status were 74% less likely to be on ART than OVC of HIV-negative caregivers (OR=0.26, 95% CI=0.08–0.90). OVC living in urban areas were more than 5-times as likely as their rural counterparts to be on ART (OR=5.55, 95% CI=2.21–14.0). Conclusion The majority of the OVCLHIV in the current study were currently on ART (93.5%) at enrollment. However, uptake of ART by the OVC was dependent on factors external to themselves. Advancing ART uptake may require targeting OVC of female caregivers, OVC of HIV-negative caregivers, as well as OVC of caregivers of undisclosed HIV statu, and rural areas.
Policies vs Practice of Medical Error Disclosure at a Teaching Hospital in Saudi Arabia

Background Medical errors are unavoidable in health care institutions. Errors can occur due to multiple reasons, yet communication between health care providers has proven to be the highest. However, policies and programs of medical error disclosure were established to ensure that patients and their family members get the necessary closure. Hence, it is vital to recognize physicians’ awareness of policies and programs related to disclosure practice. Objective The objective of this study was to examine factors impacting the awareness of hospital policies and programs and their impact on the actual disclosure of medical errors. Methods This was a quantitative cross-sectional study, using a self-administered survey given to 206 physicians from numerous departments at King Fahd Hospital of the University. Results The majority of participants were not aware of policies and programs related to disclosure, nor had they disclosed a medical error to patients. There was no statistical significance between policies and programs and the practice of disclosure, yet position level and gender were statistically significantly related to awareness. Conclusion Physicians of King Fahd Hospital of the University demonstrated a low awareness rate of the hospital policies and programs regarding disclosure practice. Advanced efforts of hospital leaders need to be made to communicate, train and educate providers about their policies to promote disclosure practice.
Regenerative Endodontic Therapy in the Management of Immature Necrotic Permanent Dentition: A Systematic Review

Materials and Methods The electronic databases PubMed and Google Scholar were used to search the literature for relevant studies after applying specific inclusion and exclusion criteria. Studies that fulfilled both the inclusion and exclusion criteria were included in this systematic review. The search was conducted by two independent reviewers following the PRISMA guidelines. Results Only 46 studies that fulfilled both the inclusion and exclusion criteria, which were conducted within the last 10 years, were included in this systematic review. These studies investigated different aspects of regenerative endodontic therapy including different types of scaffolds, intracanal medications, pulpal space/barriers, root maturation stage, follow-up duration, and updated studies on their use in the management of immature necrotic permanent teeth. Conclusions This review concluded the compiled data observed that endodontic regenerative therapy was more efficient in treating immature necrotic permanent teeth and offered a greater advantage that should lead to wider acceptance among endodontists for effective results compared to different treatment options. However, more clinical trials with a standardized protocol and defined clinical, radiographic, and histopathological outcomes with longer follow-up periods are warranted.
Impact of Modality and Intensity of Early Exercise Training on Ventricular Remodeling after Myocardial Infarction

The objective of this study was to analyze the impact of different modalities and intensities of exercise training on cardiac remodeling started early after experimental myocardial infarction (MI). Male Wistar rats, weighing 200–250 g, were subjected to experimental MI. After 5 days, the animals were allocated into three experimental groups and observed for three months: S (sedentary control animals), C (animals subjected to continuous low-intensity training), and HIT (animals subjected to high-intensity interval training). Low-intensity exercise training was performed at a treadmill speed corresponding to 40% VO2 max, which was kept unchanged throughout the entire session (i.e., continuous low-intensity training). High-intensity interval training was performed in such a way that rats run during 3 min at 60% VO2 max, followed by 4-minute intervals at 85% VO2 max (i.e., high-intensity interval training). After the follow-up period, we studied hypertrophy and ventricular geometry, functional alterations in vivo and in vitro, oxidative stress, apoptosis, and cardiac energetic metabolism. Our data showed that both high-intensity interval and continuous low-intensity modalities improved cardiac energetic metabolism variables in comparison with sedentary infarcted animals. In addition, high-intensity interval training decreased cardiac oxidative stress, associated with improved diastolic function. On the other hand, the continuous low-intensity group showed impairment of cardiac function. Therefore, altogether, our data suggest that high-intensity interval training could be the best modality for early physical exercise after MI and should be better studied in this clinical scenario.
Exosomal miR-638 Inhibits Hepatocellular Carcinoma Progression by Targeting SP1

Purpose Exosomal microRNAs (miRNAs) play essential roles in the development of hepatocellular carcinoma (HCC). Nevertheless, the role and mechanism of exosomal miR-638 in HCC development remain largely unknown. Methods Exosomes were isolated and confirmed via transmission electron microscopy and western blot. The abundances of miR-638 and specificity protein 1 (SP1) were measured via quantitative reverse transcription polymerase chain reaction or western blot. Cell proliferation was investigated by Cell Counting Kit-8, colony formation assay, apoptosis, cell cycle distribution and related protein expression. Cell migration and invasion were detected via transwell assay and western blot. Co-culture experiment was performed to assess exosome transfer from HCC cells to endothelial cells. The target correlation between miR-638 and SP1 was analyzed via dual-luciferase reporter and RNA immunoprecipitation assays. The subcutaneous xenograft experiment was conducted to test the function of miR-638 in vivo. Results The miR-638 level declined in exosomes from serum or HCC cell medium. miR-638 overexpression repressed HCC cell proliferation by decreasing viability and colony formation and inducing apoptosis and cell cycle arrest at G1 phase, and decreased abilities of migration and invasion. Exosomal miR-638 from HCC cells could transfer to human umbilical vein endothelial cells (HUVECs) and suppress HUVEC proliferation, migration and invasion. SP1 was a target of miR-638 and overexpression of SP1 reversed the effect of miR-638 on HCC cells. Overexpression of miR-638 reduced xenograft tumor growth via decreasing SP1. Conclusion Exosomal miR-638 inhibited HCC tumorigenesis by targeting SP1. This study indicated the potential clinical implications of miR-638 in HCC.
Pancreatic Neuroendocrine Tumor-Induced Hyperammonemic Encephalopathy in the Absence of Hepatic Involvement

A 47-year-old Hispanic man with a medical history of depression was sent from a psychiatric facility to the intensive care unit for decreased responsiveness. The family reported that the patient had become increasingly depressed with daily diarrhea and an unintentional 50-poundweight loss over the past 6months. Alcohol level and drug screens were negative. Significant laboratory data revealed aspartate aminotransferase of 43 U/L, alanine aminotransferase of 126 U/L, prothrombin time of 16.1 s, and ammonia level of 163 mmol/L. Hepatitis panel, human immunodeficiency virus screen, autoimmune panel, and tumor markers (cancer antigen 19-9, alpha-fetoprotein) were unremarkable. Computed tomography (CT) and magnetic resonance imaging of the brain were negative. Abdominal CT revealed an intra-abdominal mass in the upper left quadrant, originating from the pancreas (Figure 1). CTguided core needle biopsy with immunohistochemical staining positive for synaptophysin and chromogranin A, both under 4003 magnification (Figure 2), supports the diagnosis of a well-differentiated, grade 1 of 3, pancreatic neuroendocrine tumor (PNET). Distal pancreatectomy with splenectomy followed, with negative pancreatic margins, and splenic and liver tissue negative for metastasis. The patient’s confusion resolved.
Anosmia in the course of COVID-19

Abstract Rationale: A sudden onset of anosmia has been recently recognized as a symptom of coronavirus disease (COVID-19). Patient concerns: Here, we describe a case of complete anosmia in a young male with COVID-19. Although he had fever and odynophagia, no abnormalities were observed in his nasopharyngeal mucosa, suggesting that his anosmia resulted from olfactory neuropathy. Diagnoses: COVID-19 was confirmed by RNA detection in nasopharyngeal swab specimen. Interventions: The patient received olfactory training and B complex vitamins. Outcomes: On day 30, the patient reported complete recovery of his sense of smell. Lessons: As early diagnosis is fundamental to control the spread of COVID-19 infection, we emphasize that anosmia identified in febrile cases during the COVID-19 epidemic may be a symptom indicative of the disease. Moreover, COVID-19-related anosmia can be completely reversible.
Antimicrobial Peptides and Ectosymbiotic Relationships: Involvement of a Novel Type IIa Crustin in the Life Cycle of a Deep-Sea Vent Shrimp

The symbiotic shrimp Rimicaris exoculata dominates the macrofauna inhabiting the active smokers of the deep-sea mid Atlantic ridge vent fields. We investigated the nature of the host mechanisms controlling the vital and highly specialized ectosymbiotic community confined into its cephalothoracic cavity. R. exoculata belongs to the Pleocyemata, crustacean brooding eggs, usually producing Type I crustins. Unexpectedly, a novel anti-Gram-positive type II crustin was molecularly identified in R. exoculata. Re-crustin is mainly produced by the appendages and the inner surfaces of the cephalothoracic cavity, embedding target epibionts. Symbiosis acquisition and regulating mechanisms are still poorly understood. Yet, symbiotic communities were identified at different steps of the life cycle such as brooding stage, juvenile recruitment and molt cycle, all of which may be crucial for symbiotic acquisition and control. Here, we show a spatio-temporal correlation between the production of Re-crustin and the main ectosymbiosis-related life-cycle events. Overall, our results highlight (i) a novel and unusual AMP sequence from an extremophile organism and (ii) the potential role of AMPs in the establishment of vital ectosymbiosis along the life cycle of deep-sea invertebrates.
Curcumin protects bone biomechanical properties and microarchitecture in type 2 diabetic rats with osteoporosis via the TGFβ/Smad2/3 pathway

Type 2 diabetic osteoporosis (T2DOP) has become a common secondary cause of osteoporosis that accelerates bone loss and leads to bone fractures. The aim of the current study was to investigate the association between the anti-osteoporotic effect of curcumin (Cur) and the transforming growth factor (TGF)β/Smads signaling pathway. Male Sprague-Dawley rats were used in the experiments. The type 2 diabetes mellitus (T2DM) animals were treated with Cur for 8 weeks and blood lipid markers, bone microstructure and bone biomechanics were then evaluated. The mRNA expression levels of TGFβ1, type I TGFβ receptor (TβRI), TβRII and Smad2/3 were determined using reverse transcription-quantitative PCR (RT-qPCR) and immunohistochemistry. The body weight of rats with type 2 diabetes-induced osteoporosis increased (P<0.05), while the lipid (total cholesterol, triglyceride and low-density lipoprotein) and fasting blood glucose levels were decreased by Cur (P<0.05). In addition, Cur significantly improved bone biomechanical properties (maximum load, breaking load, elastic load and the bone rigidity coefficient) and preserved bone microarchitecture (P<0.05). The RT-qPCR and IHC results revealed that Cur increased TGFβ1, TβRI, TβRII and Smad2/3 expression levels and promoted Smad2/3 phosphorylation in bones. The present results also indicated that Cur regulated lipid and glucose levels, improved bone biomechanical properties and preserved bone microarchitecture, and that these effects may be mediated via TGFβ/Smad2/3 pathway activation.