Miracle-dz/UniFAR-FTUs huggingface dataset:
Lower limb muscle magnetic resonance imaging in Chinese patients with myotonic dystrophy type 1

ABSTRACT Objectives: Muscle magnetic resonance imaging (MRI) is a reliable noninvasion tool for detecting muscle abnormalities of myopathies. This study aimed to investigate the MRI features of lower limb muscles in Chinese patients with myotonic dystrophy type 1 (DM1) and to evaluate the correlation between clinical factors and muscle MRI. Methods: We retrospectively reviewed the medical records and lower limb muscle MRI in 24 Chinese DM1 patients. Muscular Impairment Rating Scale (MIRS) was used to assess the clinical muscular impairment. Modified Mercuri’s scale was used to assess the degree of fatty infiltration. Spearman rank correlation test was used to analyze the relationship between fatty degeneration score with age, age of onset, disease duration, MIRS grading and creatinine kinase (CK) level. Results: Fatty infiltration was found in 22 of 24 DM1 patients and 8 patients were asymmetrically affected. The medial gastrocnemius was the most affected muscle, followed by soleus and tibialis anterior muscles in lower legs. At thigh level, the anterior compartment was usually the most affected region with the rectus femoris relatively spared. 79.2% of DM1 patients had edema in lower limb muscles. The total mean score of fatty infiltration correlated with MIRS grading, age and disease duration but did not correlate with the age of onset or CK level. Conclusion: Here, we found fatty infiltration present in most Chinese DM1 patients with a selective involvement pattern. There is a correlation between the total mean score of fatty infiltration and MIRS grading, age and disease duration.
Occupational diseases in the automotive industry from medical and geographic viewpoints - comparison between the Czech Republic and the Slovak Republic.

OBJECTIVE The aim of the study was to compare the occurrence of occupational diseases (ODs) in the automotive industry in the Czech Republic and the Slovak Republic and to analyze their determinants. METHODS The aggregated and anonymized data on ODs from the period 2001-2017 were used. A questionnaire survey was conducted in the Czech Republic (response rate 70.6%) and in the Slovak Republic (response rate 57%). The occurrence of ODs according to socioeconomic factors, the size of enterprises and their position in the global production networks was evaluated. The quality and scope of the occupational health services were also taken into consideration. RESULTS Workers older than 40 years were at a significantly higher risk of ODs than the younger ones. In the Czech Republic, it corresponded to OR 2.77 (95% CI 2.41-3.19), in the Slovak Republic to OR 2.01 (95% CI 1.34-3.01). The risk of ODs in women was significantly higher than in men - in the Czech Republic it corresponded to OR 3.20 (95% CI 2.79-3.67), in the Slovak Republic to OR 2.43 (95% CI 2.05-2.87). The difference between the two states did not reach statistical significance in any of the studied factors. In both states, no ODs were reported from the microenterprises. CONCLUSION Given the results of the study, it can be recommended to focus on the ergonomics of assembly work in the automotive industry. Special attention should be given to the provision of occupational health services, especially in microenterprises.
Assessment of time management practice and associated factors among primary hospitals employees in north Gondar, northwest Ethiopia

Background Time management practice can facilitate productivity and success, contributing to work effectiveness, maintaining balance and job satisfaction. Thus, this study aimed to assess time management practices and associated factors among employees of primary hospitals in north Gondar. Methods An Institutional based cross-sectional study among primary hospital employees in north Gondar was conducted from March to April 2018. A structured and pre-tested questionnaire was used to collect the data. Simple random sampling technique was utilized to select 422 employees. Bivariate and multivariate logistic regression model were done to identify factors associated with time management practice. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was ascertained to show the strength and direction of association. Result In this study, the prevalence of time management practice was 56.4% (95%CI: 49.3, 61.7). Being satisfied with organizational policies (AOR = 2.16; 95%CI: 1.02–4.68), performance appraisals (AOR: 2.11; 95%CI: 1.32–4.66), compensation and benefits (AOR: 4.18; 95%CI: 2.18–7.99), and planning (AOR: 2.86; 95% CI: 1.42–5.75) were statistically significant factors associated with time management practice. Conclusion and recommendation The overall time management practice among the primary hospital employees was low. Planning, organizational policy, compensation and benefit, performance appraisal, and residence were factors significantly associated with hospital employee’s time management practice. Thus managers and employees need to carry out interventions on significant factors to improve the employees’ time management practice.
Seasonal effects of ambient PM2.5 on the cardiovascular system of hyperlipidemic mice

ABSTRACT People in polluted communities are often exposed to both PM and ozone (O3), albeit not always simultaneously; an important question is whether exposure to particles with seasonal compositional differences can influence biological outcomes. We addressed this question using a mouse model of cardiovascular disease by contrasting the health outcomes of exposures to particles formed or aged during periods of relatively high photochemical activity (i.e. spring/summer), which has increased ambient O3 concentrations, with outcomes of exposures to fall/winter particles which are associated with lower O3 concentrations. Electrocardiographs (ECGs) and blood pressures (BPs) were acquired following exposures to concentrated ambient particles (CAPs). ECGs were analyzed to changes in specific waveform parameters and changes in heart rate variability (HRV). Exposures elicited several types of waveform abnormalities that were associated with seasonal differences in particle constituents. Alterations in R-R interval and P-R interval were seen following exposure to summer CAPs but not fall CAPs and differential responses were seen in the corrected Q-T interval following the two seasonal exposures. Measures of HRV increased after exposure to summer CAPs compared to air-exposed controls but not following the winter CAPs exposure. There were chemical differences with respect to the organic constituents in ambient particles between summer and fall aerosol. The oxygen to carbon ratios (O:C) were generally higher in the spring and summer than in the fall, consistent with seasonal differences in atmospheric photochemical activity. Seasonal differences in atmospheric photochemical activity can modify ambient aerosol composition and can alter biological responses in the cardiovascular system. The results from this study confirm that ambient photochemical activity can alter the toxicity of ambient PM. Regional and seasonal differences in PM2.5 composition should be important considerations when evaluating the effects of PM exposure on cardiovascular health. Implications: Particles formed during periods of high photochemical activity (e.g. spring/summer) elicit more adverse cardiovascular health effects than particles formed during periods of low photochemical activity (e.g. fall/winter). Seasonal differences in atmospheric photochemical activity modified ambient aerosol composition and worsened cardiovascular responses. These results can inform regulatory agencies and may help design air quality regulations for PM2.5 that consider seasonal and regional variations.
International Multi-institutional Experience with the Transoral Endoscopic Thyroidectomy Vestibular Approach.

Background: Surgical approaches to thyroidectomies have undergone a rapid evolution over the past three decades. Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is currently the latest remote access procedure for the treatment of benign and malignant thyroid disease. The purpose of this article is to present the results of TOETVA from five different international institutions. Materials and Methods: From 2016 to 2019, 152 TOETVA procedures were performed on 149 patients at five separate international institutions. Outcomes were analyzed from a prospectively maintained database. There were 12 (8%) men and 137 (92%) women with mean ages of 41.5 ± 10.3 (27-69) and 46.9 ± 1.8 (17-78), respectively. Results: There were 3 (2%) cases that required conversion from the endoscopic approach to an open procedure. A thyroid lobectomy was performed in 111 (73.0%) cases, total thyroidectomy in 38 (25.0%) cases whereas a completion thyroidectomy in 3 (2.0%) cases. Mean operative times were 161.8 ± 42.4 (83-304) minutes for the lobectomy, 213.4 ± 71.7 (120-430) minutes for the total thyroidectomy, and 136.7 ± 109.8 (64-263) minutes for the completion thyroidectomy. The final pathology report revealed 107 (70.4%) benign nodules, 44 (28.9%) nodules with underlying papillary thyroid carcinoma, and 1 (0.7%) case with Hurthle cell carcinoma. Of the 152 cases, 7 (4.7%) patients developed temporary hypoparathyroidism. There were 5 (3.3%) patients who developed transient recurrent laryngeal nerve (RLN) injury and 3 (2.0%) with persistent injury of the RLN. Temporary lower lip numbness was noted in 51 (33.6%) patients whereas 1 (0.7%) patient was noted to have persistent numbness. We reported 57 (38.5%) patients with temporary chin numbness, 9 (5.9%) patients with skin injuries, and 2 (1.3%) with tracheal perforation. Conclusion: To date, the literature and the outcomes from these 5 international institutions have determined that, in select patients, TOETVA can be as safe and efficacious as the traditional trans-cervical technique for the treatment of specific thyroid pathologies.
PreS1 Mutations Alter the Large HBsAg Antigenicity of a Hepatitis B Virus Strain Isolated in Bangladesh

Mutations in the hepatitis B virus (HBV) genome can potentially lead to vaccination failure, diagnostic escape, and disease progression. However, there are no reports on viral gene expression and large hepatitis B surface antigen (HBsAg) antigenicity alterations due to mutations in HBV isolated from a Bangladeshi population. Here, we sequenced the full genome of the HBV isolated from a clinically infected patient in Bangladesh. The open reading frames (ORFs) (P, S, C, and X) of the isolated HBV strain were successfully amplified and cloned into a mammalian expression vector. The HBV isolate was identified as genotype C (sub-genotype C2), serotype adr, and evolutionarily related to strains isolated in Indonesia, Malaysia, and China. Clinically significant mutations, such as preS1 C2964A, reverse transcriptase domain I91L, and small HBsAg N3S, were identified. The viral P, S, C, and X genes were expressed in HEK-293T and HepG2 cells by transient transfection with a native subcellular distribution pattern analyzed by immunofluorescence assay. Western blotting of large HBsAg using preS1 antibody showed no staining, and preS1 ELISA showed a significant reduction in reactivity due to amino acid mutations. This mutated preS1 sequence has been identified in several Asian countries. To our knowledge, this is the first report investigating changes in large HBsAg antigenicity due to preS1 mutations.
Pharmacokinetic and pharmacodynamic of the cognitive enhancer modafinil: Relevant clinical and forensic aspects

Abstract Modafinil is a nonamphetamine nootropic drug with an increasingly therapeutic interest due to its different sites of action and behavioral effects in comparison to cocaine or amphetamine. A review of modafinil (and of its prodrug adrafinil and its R-enantiomer armodafinil) chemical, pharmacokinetic, pharmacodynamic, toxicological, clinical and forensic aspects was performed, aiming to better understand possible health problems associated to its unconscious and unruled use. Modafinil is a racemate metabolized mainly in the liver into its inactive acid and sulfone metabolites, which undergo primarily renal excretion. Although not fully clarified, major effects seem to be associated to inhibition of dopamine reuptake and modulation of several other neurochemical pathways, namely noradrenergic, serotoninergic, orexinergic, histaminergic, glutamatergic and GABAergic. Due its wake-promoting effects, modafinil is used for the treatment of daily sleepiness associated to narcolepsy, obstructive sleep apnea and shift work sleep disorder. Its psychotropic and cognitive effects are also attractive in several other pathologies and conditions that affect sleep structure, induce fatigue and lethargy, and impair cognitive abilities. Additionally, in health subjects, including students, modafinil is being used off-label to overcome sleepiness, increase concentration and improve cognitive potential. The most common adverse effects associated to modafinil intake are headache, insomnia, anxiety, diarrhea, dry mouth and raise in blood pressure and heart rate. Infrequently, severe dermatologic effects in children, including maculopapular and morbilliform rash, erythema multiforme and Stevens-Johnson Syndrome have been reported. Intoxication and dependence associated to modafinil are uncommon. Further research on effects and health implications of modafinil and its analogs is steel needed to create evidence-based policies.
Identifying Children with Developmental Coordination Disorder via Parental Questionnaires. Spanish Reference Norms for the DCDDaily-Q-ES and Correlation with the DCDQ-ES

Developmental Coordination Disorder (DCD) is one of the most prevalent neurodevelopmental disorders in school-aged children, with major consequences in psychosocial and physical health. Adequate identification of this disorder is necessary to prompt effective interventions. The aims of this study were to develop the Spanish adjusted reference norms for the DCDDaily-Q and to test the correlation and agreement between the Spanish versions of the DCDDaily-Q (DCDDaily-Q-ES) and the Developmental Coordination Disorder Questionnaire (DCDQ-ES), two reliable instruments to assess motor performance and DCD. Clinically relevant percentiles were calculated for the DCDDaily-Q-ES using a representative sample of Spanish children aged 5 to 10 years (n = 356; M = 7.3 years, SD = 1.8; boys = 50%). Pearson’s correlation coefficient and intraclass correlation coefficient (ICC) were used to determine correlation and agreement between questionnaires, respectively. A moderate and significant correlation and agreement between DCDDaily-Q-ES and DCDQ-ES was found (r = 0.406; ICC = 0.381; p < 0.001). Differences in daily participation and performance were found between age groups, but not between boys and girls. Spanish age-adjusted percentiles and cutoff scores for DCDDaily-Q-ES are provided. This study offers further validation and relevant information regarding assessment of DCD and has practical implications for clinical practice and research.
Development of frailty subtypes and their associated risk factors among the community-dwelling elderly population

In order to explore frailty subtypes and find their associated risk factors, we conducted cross-sectional surveys of 5,341 seniors aged 60 and over in China using the Frailty Index (FI) scale. We identified four frailty subtypes, namely multi-frail, cognitive and functionally frail, psychologically frail and physiologically frail. Old age and low education level were the common risk factors among the four subtypes. Being widowed, divorced or unmarried was a risk factor for multi-frail, cognitive and functionally frail and psychologically frail, and male sex was a protective factor against cognitive and functionally frail and psychologically frail subtypes. Having a harmonious relationship with family was a protective factor against multi-frail, and fewer visits to the elderly by their children was a risk factor for psychologically frail. Dissatisfaction with their housing was a risk factor for cognitive and functionally frail, psychologically frail and physiologically frail, and a pension being the main source of income was a risk factor for cognitive and functionally frail and psychologically frail. Exercising every day was a protective factor against multi-frail and cognitive and functionally frail, and a lower level of physical activity was a risk factor for all four frailty subtypes. Our findings confirm the heterogeneity of frailty and suggest that different frail elderly individuals need more targeted care interventions.
Maresin 1, a Proresolving Lipid Mediator, Ameliorates Liver Ischemia-Reperfusion Injury and Stimulates Hepatocyte Proliferation in Sprague-Dawley Rats

Maresin-1 (MaR1) is a specialized pro-resolving mediator, derived from omega-3 fatty acids, whose functions are to decrease the pro-inflammatory and oxidative mediators, and also to stimulate cell division. We investigated the hepatoprotective actions of MaR1 in a rat model of liver ischemia-reperfusion (IR) injury. MaR1 (4 ng/gr body weight) was administered prior to ischemia (1 h) and reperfusion (3 h), and controls received isovolumetric vehicle solution. To analyze liver function, transaminases levels and tissue architecture were assayed, and serum cytokines TNF-α, IL-6, and IL-10, mitotic activity index, and differential levels of NF-κB and Nrf-2 transcription factors, were analyzed. Transaminase, TNF-α levels, and cytoarchitecture were normalized with the administration of MaR1 and associated with changes in NF-κB. IL-6, mitotic activity index, and nuclear translocation of Nrf-2 increased in the MaR1-IR group, which would be associated with hepatoprotection and cell proliferation. Taken together, these results suggest that MaR1 alleviated IR liver injury, facilitated by the activation of hepatocyte cell division, increased IL-6 cytokine levels, and the nuclear localization of Nrf-2, with a decrease of NF-κB activity. All of them were related to an improvement of liver injury parameters. These results open the possibility of MaR1 as a potential therapeutic tool in IR and other hepatic pathologies.
Outcomes and Risk Factors of Revision and Replacement Artificial Urinary Sphincter Implantation in Radiated and Non-radiated Patients.

PURPOSE Risk factors for complications after artificial urinary sphincter surgery include a history of pelvic radiation and prior artificial urinary sphincter complication. The survival of a second artificial urinary sphincter in the setting of prior device complication and radiation is not well described. We report the survival of redo artificial urinary sphincter surgery and identify risk factors for repeat complications. MATERIALS AND METHODS A multi-institutional database was queried for redo artificial urinary sphincter surgeries. The primary outcome was median survival of a second and third artificial urinary sphincter in radiated and non-radiated patients. A Cox proportional hazards survival analysis was performed to identify additional patient and surgery risk factors. RESULTS The median time to explantation of the initial artificial urinary sphincter in radiated (n=150) and non-radiated (n=174) patients was 26.4 and 35.6 months respectively (p=0.043). For a second device the median time to explantation was 30.1 and 38.7 (p = 0.034) and for a third device it was 28.5 and 30.6 months (p=0.020). The 5-year revision free survival for patients undergoing a second AUS with no risk factors, history of radiation, history of urethroplasty, and both a history of radiation and urethroplasty are 83.1%, 72.6%, 63.9%, and 46% respectively. CONCLUSIONS Patients without additional risk factors undergoing 2nd and 3rd AUS surgeries experience similar revision free rates to their initial AUS devices. Patients who have been treated with pelvic radiation have earlier AUS complications. When multiple risk factors exist, revision free rates decrease significantly.
Probiotics Prevent Dysbiosis and the Raise in Blood Pressure in Genetic Hypertension: Role of Short-chain Fatty Acids.

SCOPE The objective of this study was to determine the cardiovascular effects of the probiotics Bifidobacterium breve CECT7263 (BFM) and Lactobacillus fermentum CECT5716 (LC40), and the short chain fatty acids butyrate and acetate in spontaneously hypertensive rats (SHR). METHODS AND RESULTS Ten five-weeks old Wistar Kyoto rats (WKY) and fifty aged-matched SHR were randomly distributed into six groups: control WKY, control SHR, treated SHR-LC40, treated SHR-BMF, treated SHR-butyrate, and treated SHR-acetate. Chronic treatments with LC40 or BFM increased butyrate-producing bacteria and prevented the blood pressure increase in SHR. Oral treatment with butyrate or acetate also prevented the increase in both blood pressure and Firmicutes/Bacteroidetes ratio. All treatments restored the Th17/Treg balance in mesenteric lymph nodes, normalized endotoxemia, and prevented the impairment of endothelium-dependent relaxation to acetylcholine, as a result of reduced NADPH oxidase-driven reactive oxygen species production. These protective effects might be mediated by both the reduction in vascular lipopolysaccharide/toll-like receptor 4 pathway and the increase in Treg infiltration in the vasculature. CONCLUSION The probiotics LC40 and BFM prevent dysbiosis and the development of endothelial dysfunction and high blood pressure in genetic hypertension. These effects seems to be related to endotoxemia reduction and to increase Treg accumulation in the vasculature. This article is protected by copyright. All rights reserved.
Customised Jigs in Primary Total Knee Replacement

Patient-specific surgery employing customising jigs for bone resections is becoming increasingly popular for total knee replacement surgery. Theoretical advantages of this technology include, but are not limited to, more accurate limb alignment and reduced surgical time, blood loss and in-patient hospital stay. In turn, these may result in more cost savings when compared with standard techniques of performing knee replacement surgery. The literature published so far has primarily examined alignment data but has failed to consistently confirm the previously proposed benefits. It appears that longer-term data, focusing on patient function and implant survival, will be required before the clinical and cost utility of these guides can be determined. This article briefly outlines the manufacturing process and surgical technique of patient-specific jigs and presents the clinical evidence pertaining to key elements of this new technology.
Methods of the Analysis of Oxylipins in Biological Samples

Oxylipins are derivatives of polyunsaturated fatty acids and due to their important and diverse functions in the body, they have become a popular subject of studies. The main challenge for researchers is their low stability and often very low concentration in samples. Therefore, in recent years there have been developments in the extraction and analysis methods of oxylipins. New approaches in extraction methods were described in our previous review. In turn, the old analysis methods have been replaced by new approaches based on mass spectrometry (MS) coupled with liquid chromatography (LC) and gas chromatography (GC), and the best of these methods allow hundreds of oxylipins to be quantitatively identified. This review presents comparative and comprehensive information on the progress of various methods used by various authors to achieve the best results in the analysis of oxylipins in biological samples.