Miracle-dz/UniFAR-FTUs huggingface dataset:
Osteoprotegerin and Osteopontin Are Expressed at High Concentrations Within Symptomatic Carotid Atherosclerosis

Background and Purpose— The aim of this study was to compare the concentration of osteoprotegerin (OPG), receptor activator of nuclear factor κB ligand (RANKL), and osteopontin (OPN) in stable (asymptomatic) and unstable (symptomatic) carotid atherosclerosis. In addition, we were interested in the effect of angiotensin II blockade on the secretion of these proteins by unstable atherosclerosis. Methods— Endarterectomy samples removed from patients with recent (within 6 weeks) or no previous focal neurological symptoms were assessed by immunohistochemistry, Western analysis, and explant culture. Concentrations of OPG, RANKL, and OPN were measured by mean optical density (MOD), densitometry of protein bands, and enzyme-linked immunosorbent assay of supernatants from explant culture, and compared between symptomatic and asymptomatic patients. Results— The concentration of OPG and OPN within the proximal internal carotid (PIC) part of the endarterectomy specimen removed from symptomatic patients was elevated 2.
Is prone sleeping dangerous for neonates? Polysomnographic characteristics and NDN gene analysis

Objective: Prone sleep is an identified risk factor for sudden infant death syndrome, possibly due to reduced blood pressure, cerebral oxygenation, and impaired cerebral vascular control. Cardiac and respiratory responses in neonates during supine and prone sleep have not been reported. Materials and Methods: In this study, daytime polysomnography (PSG) data from 17 neonates aged 2–3 days during supine and prone sleep were reported and the NDN gene, an important gene for neonatal respiratory control, was sequenced for correlation with neonatal respiratory parameters. Heart rate (HR), oxygen saturation, carbon dioxide concentration, sleep stages, central apnea index (CAI), obstructive apnea/hypopnea index (OAHI), and oxygen nadir were compared between supine and prone sleep and between participants with different single-nucleotide polymorphisms (SNPs) in the NDN gene. Results: During prone sleep, neonates had a faster HR, decreased oxygen saturation, and a longer duration of oxygen saturation <90% than during supine sleep, suggesting that cardiopulmonary responsiveness was impaired. Sleep efficiency, sleep stages, oxygen nadir, and carbon dioxide tension were not different during supine and prone sleep. Central apnea occurred more significantly than obstructive apnea. During supine and prone sleep, the CAI was 3.3 ± 2.9/h and 2.3 ± 2.6/h and the OAHI was 0.6 ± 0.7/h and 0.6 ± 0.8/h, respectively. We found one SNP rs3743340 in the NDN gene that had no effect on the sleep and respiratory parameters of PSG. Conclusion: Tachycardia and respiratory instability were recorded in neonates during prone sleep, suggesting that neonates are vulnerable to cardiopulmonary events during prone sleep. Therefore, young neonates should be kept in the supine sleep position unless there are contraindications.
Effects of Task Goal and Personal Preference on Seated Reaching Kinematics After Stroke

Background and Purpose—Current theories of motor control in rehabilitation focus on how the nervous system responds to many types of external and internal constraints to execute motor behavior to accomplish a task. However, the dynamic interplay between these 2 constraints remains unclear. This study examined the impact of some aspects of internal and external constraints on motor performance in persons with stroke. Methods—Twenty-seven persons with stroke used the uninvolved arms to perform an upper-extremity reaching task under 4 experimental conditions, formed by the crossing of functional goals and personal preferences. For the higher level of a functional goal, subjects took a drink from a can of beverage. For the lower level of a functional goal, subjects brought the can to the mouth without drinking. The level of personal preferences was determined, by interview, by the degree of predilection for particular beverages. Results—Significant and large effects of functional goals and personal preference.
The relationship between perceived family support and adherence to highly active anti-retroviral therapy among people living with human immuno-defficiency virus in a tertiary health facility in Nigeria

Due to the discovery of HAART, HIV is now considered a chronic infection. Near-perfect adherence to HAART is required to achieve sufficient viral suppression. Perceived family support is one of the factors that has been reported to be associated with adherence to medication. The objective of this study was to determine the relationship between family support and adherence to HAART in order to make relevant recommendations as guided by the outcome. The study was a cross-sectional descriptive study involving 297 HIV positive people on HAART who were attending the HIV Clinic of the Federal Medical Centre, Asaba, Nigeria. Respondents were selected using systematic random sampling. Questionnaires were administered to obtain data on socio-demographic factors while relevant tools were used to assess family support and drug adherence. The results were analyzed using the Statistical Package for Social Sciences (SPSS), version 17. The adherence rate among the participants was 24%. Eighty-five percent of the respondents had high family support. Low family support was significantly associated with low mean CD4 count. There was a weak but positive relationship between family support and adherence to HAART. In conclusion, the study reported a weak positive relationship between family support and adherence to HAART.
EVALUATION OF NURSING NOTES BEFORE AND AFTER A TRAINING ACTIVITY IN A UNIVERSITY HOSPITAL

Objective: To verify if the nursing notes improved before and after a training of short duration and the factors those determine this change. Method: We analyzed 1551 reports/nursing notes in two inpatient units and two intensive care units. There was used a form in which there were recorded the adequacies or otherwise of the annotations in function of: the course, shift, professional category, and days of hospitalization of the patient. Results: We observed that there was improvement in the records made after the training course, with an increase of the adequacies. The intensive therapy units showed higher scores for appropriateness to the wards. The time of hospitalization of the patient eventually influences the scores of adequacies. The score of appropriateness of annotations was not different between the professional categories. Conclusion: The action of training of short duration was effective in improving the nursing notes, strengthening the role of continuous education in health services.
Psychotropic medication use during pregnancy

Globally, mental health‐related issues are a growing concern. Pregnant women with mental health‐related illnesses present a unique challenge to health professionals. During pregnancy, the decision to withhold, modify or continue psychotropic medication requires consideration of both maternal and infant outcomes. Health professionals must be aware withdrawal of these medications during pregnancy can often lead to symptom relapse. Decisions around medication management during pregnancy can be challenging due to the lack of data and occasionally conflicting data regarding safety. It is essential that women do not receive conflicting information from health professionals because this can lead to confusion and both intentional and unintentional non‐adherence. Recently, it has been suggested that pharmacists may help optimise medication management and patient outcomes in perinatal care. This review outlines the use of psychotropic medications in pregnancy and discusses key considerations for those involved in providing clinical care to pregnant women with mental illness.
Community health workers in pediatric asthma education programs in the United States: A systematic literature review

ABSTRACT The involvement of community health workers (CHWs) has been shown to be effective at improving health outcomes for those who suffer from chronic diseases. This systematic review provides an overview of the current landscape of CHW-delivered asthma education programs for parents/caregivers who have children with asthma in the United States. Findings suggest that the use of CHWs are effective at reducing racial/ethnic as well as health disparities among children with asthma. However, future research is needed to develop evidence-based asthma education programs that can reduce asthma morbidity and disparities faced among all children with asthma in the United States.
Difficulties in the Diagnosis and Management of Nephropathic Cystinosis

Objective: Nephropathic cystinosis is the most severe form of cystinosis and usually leads to end stage renal disease in late childhood. We aimed to investigate the clinical and laboratory findings, therapeutic and diagnostic difficulties and prognosis of patients with nephropathic cystinosis. Material and Methods: The medical records of fifteen patients who were diagnosed as cystinosis between 1996 and 2012 were retrospectively evaluated. Results: The mean age of the patients was 31.8±35.9 months (6-144 months). 11 (73.3 %) had parental consanguinity. Polyuria, polydipsia and failure to thrive were the most common features. Mean glomerular filtration rate (GFR) was 47.6±29.9 ml/min/1.73 m2 (6.30-100) at admission. Corneal cystine crystals were detected in 12 (80 %) of the patients. We measured leukocyte cysteine levels in only three patients and found it above normal limits. During follow up, 10 patients developed chronic kidney disease (CKD) and three of them reached end-stage renal disease (ESRD). Two of the patients were lost to follow up. Conclusion: There are still many technical and financial problems in the diagnosis and management of cystinosis in our country. Efforts should therefore be directed towards the avoidance of consanguineous marriages to decrease the incidence of the disease.
Frequency of Common Clinical Condition amongClient Presented at Habib Physiotherapy Complex

Background: Physiotherapy is multi-dimensional and can treat a vast variety of conditions, ranging from musculoskeletal aches, arthritis, joints problems, paraplegia, hemiplegic, sports injuries and frozen shoulder etc. Apart from culture competency and core medical knowledge a physiotherapist must be competent enough in all physiotherapist medical conditions where physical therapy plays a vital role. This study aims to identify the frequency of common clinical conditions among client presented at Habib Physiotherapy Complex (HPC), Hayatabad during 2010. Methodology: This was a descriptive study; the data were retrieved from record register of HPC (Indoor and Outdoor patients) recording their presenting complaints and known diagnoses. Data was collected on a structure grid. Data was analyzed using SPSS version 15 and presented in term of frequency and percentages. Result: joint cerebrovascular accidents frozen shoulder, pelvic inflammation, cerebral palsy, polio and paraplegia. of Osteoarthritis (Low Back, Cervical Pain, and Knee Joints Pain) were the most common condition which deteriorated the performance of common individuals in our society.
Hospitalized older adults: functional trajectory in Portuguese hospital

Background: The functional trajectory (FT) of hospitalized older adults (HOA) is an important and underestimated prognostic concept. Objective: To analyze the FT of HOA between baseline and 3-month follow-up. Methodology: Prospective cohort study with 101 HOA admitted to departments of internal medicine. Functionality was assessed using the Katz Index at 3 moments: baseline, discharge, and follow-up. Functional decline (FD) was defined as the loss of at least one point on the Katz Index, compared to baseline score. Results: A FD of 54.5% occurred between baseline and hospital discharge. In the follow-up, 41.6% of the older adults did not recover baseline functional status. Four main trajectories were identified: improvement (7.53%), stability (30.11%), recovery (25.81%), and decline (36.55%). Conclusion: FD is very significant. Functional recovery occurs mainly after hospital discharge. Hospitals and practitioners should adopt care interventions or models focused on maintaining or restoring functionality during hospitalization and enhancing post-discharge rehabilitation
Vitamin D, bone alkaline phosphatase and parathyroid hormone in healthy subjects and haemodialysed patients from West Africa: impact of reference ranges and parathyroid hormone generation assays on the KDIGO guidelines

Abstract Background The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend targets based on multiples of the upper limit of normal (ULN) of parathyroid hormone (PTH) concentration. However, the ULN has not always been correctly established by manufacturers. While it is known that the ULN is supposed to be higher in African Americans than in Caucasians, it is largely unknown in Africans. Methods We established the ULN of PTH concentration in a population of 240 healthy Ivorians using second- and third-generation PTH assays before and after supplementation with 100 000 IU of cholecalferol. We measured the levels of PTH, bone alkaline phosphatase, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D in 100 haemodialysed Ivorian patients. Results The prevalence of vitamin D deficiency in Ivory Coast is low. The ULN obtained using the third-generation PTH assay was similar to that obtained in Caucasians but was higher when PTH was measured using the second-generation PTH assay. According to the KDIGO guidelines, ∼20% of the haemodialysed patients were below twice the ULN and 30% were above nine times the ULN. Approximately 25% of the patients were even >12 times the ULN. We observed a discrepancy in the results between the two PTH assays (14%) that was relatively more important than what we observed from previous studies in Caucasians using the same strategy. Conclusions We found a low prevalence of vitamin D deficiency in a tropical country like Ivory Coast. We also established the PTH reference range, which could prove useful for the follow-up of haemodialysed patients, particularly for the large number of patients suffering from secondary hyperparathyroidism who are at high risk of adverse bone events.
Correlation of liver X receptor and abnormal metabolism in school-age children with obesity

Objective: To explore the sleeping condition of children and correlated factors among students at primary school, and the expression of liver X receptor (LXR), cholesterol ester transfer protein (CETP) and cyclooxygenase-2 (COX-2), and the relative factors of liver X receptor (LXR) and lipid metabolism in school-age children with obesity. Methods: A questionnaire survey was conducted among the parents of 3283 students at primary school from June 2011 to October 2011, stratified random sampling selected in four urban districts of the city. A total of 80 obese children and 51 normal controls (age and sex matched children with normal BMI) were chosen. Fasting blood were used to detect the expression levels of metabolic indexes, to declutch and culture macrophage, from which RNA was extracted. The metabolic indexes including aspartate transaminase (AST), alanine aminotransferase (ALT), glutamyl transpeptidase (GGT), total cholesterol (CHOL), triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and expression of LXR, CETP and COX-2 were detected in fasting blood. Results: the prevalence of sleeping disorders was 16.24% in the students of primary school with 18.22% in boys and 14.07% in girls. The main risk factors that affected the sleeping conditions were weight, irregular sleep, not enough sleeping time, adenoids, watching nervous TV and acute exercise before 30 min to sleep, the bedroom with TV, sleeping with their parent, anxiety of the father, the parents' bad marriage, etc. The expression levels of LXR, CETP and COX-2 in obese children were significant higher than that in control children. COX-2 and CETP were positively correlated with LXR respectively. There was no statistic difference between boys group and girls group in the expression levels of LXR, CETP and COX-2. Compared to controls, the levels of AST, ALT, GGT, CHOL, TG and LDL-C were higher while the level of HDL-C was lower in obese children. The correlation analysis found that AST, ALT, CHOL, LDL-C and BMI were positively correlated with LXR (r=0.18 similar to 0.26, P = 5.20 mmol/L (OR=2.038), LDL-C=3.36 mmol/L (OR=2.176) and BMI >= 18.9 kg/m(2) (OR=1.131) were risk factors for LXR>1. Conclusion: The main influence factors of the sleeping are the family and social environment, schoolwork burden, habits of children and their parents' high education and anxiety. Obesity on school-age children can upregulate the expression of liver X receptor and cause liver damage and abnormal lipids metabolism.
Response to resistance training following immobilization—Influence of delaying post‐exercise meal

Elderly women are more vulnerable to muscle disuse atrophy than men, due to lower muscle mass. Thus, identification of preventive strategies is of principal interest. We studied effects of training and timing of protein‐rich meals after exercise sessions, on skeletal muscle mass in healthy postmenopausal women. Following 2 weeks of one‐legged immobilization, a protein‐rich meal was ingested either immediately (T0; n = 9, 56 ± 2 years) or 2 hours (T2; n = 8, 57 ± 3 years) after termination of resistance exercise sessions for 6 weeks. Muscle mass, strength, and power were assessed before, after 2 weeks of lower limb immobilization and after 2 and 6 weeks of combined resistance training and diet intervention. Immobilization reduced muscle mass (~10%), strength (~23%), and power (~26%), but was returned to baseline levels after 2 weeks of training. Improvements in muscle mass and strength did not differ between groups. T0, but not T2, increased their total daily protein intake during the training period. In conclusion, only 2 weeks of supervised resistance training counteracted reductions in muscle mass and strength in postmenopausal women after 2 weeks of immobilization. Timing of protein‐rich meals in the hours after resistance exercise did not have any impact on the effects of training.
Adrenomedullin Enhances Therapeutic Potency of Mesenchymal Stem Cells After Experimental Stroke in Rats

Background and Purpose— Adrenomedullin (AM) induces angiogenesis and inhibits cell apoptosis through the phosphatidylinositol 3-kinase/Akt pathway. Transplantation of mesenchymal stem cells (MSCs) has been shown to improve neurological deficits after stroke in rats. We investigated whether AM enhances the therapeutic potency of MSC transplantation. Methods— Male Lewis rats (n=100) were subjected to 2-hour middle cerebral artery occlusion. Immediately after reperfusion, rats were assigned randomly to receive intravenous transplantation of MSCs plus subcutaneous infusion of AM for 7 days (MSC+AM group), AM infusion alone (AM group), MSC transplantation alone (MSC group), or vehicle infusion (control group). Neurological and immunohistological assessments were performed to examine the effects of these treatments. Results— Some engrafted MSCs were positive for neuronal and endothelial cell markers, although the number of differentiated MSCs did not differ significantly between the MSC and MSC+AM groups. The n.
Inhibition of Spinal 15-LOX-1 Attenuates TLR4-Dependent, NSAID-Unresponsive Hyperalgesia in Male Rats.

While nonsteroidal inflammatory drugs (NSAIDs) are the first line of therapeutics for the treatment of mild to moderate somatic pain, they are not generally considered to be effective for neuropathic pain. In the current study, direct activation of spinal Toll-like 4 receptors (TLR4) by the intrathecal (IT) administration of KDO 2 lipid A (KLA), the active component of lipopolysaccharide (LPS), elicits a robust tactile allodynia that is unresponsive to cyclooxygenase (COX) inhibition, despite elevated expression of COX metabolites in the spinal cord. IT KLA increases 12-Lipoxygenase-mediated hepoxilin production in the lumbar spinal cord, concurrent with expression of the tactile these findings suggest that spinal TLR4-mediated hyperpathic states are mediated at least in part through activation of microglial 15-LOX-1.
Validation of age-based body mass estimation methods in toddlers and pre-school children

Background: Body mass is commonly used to determine medication dosages and equipment size. In emergency situations (including cases necessitating surgery) weighing paediatric patients can be impractical. Clinicians may use any of several body mass estimation techniques to surmount this obstacle. This study's aim was to compare the actual body mass of children with estimated mass as predicted by several commonly used estimation methods. Methods: This diagnostic cross-sectional study recorded data from patients between one and five years of age in the Tshwane district. Measurement procedures were standardised to ensure consistency. Results: The relationship between anthropometric and demographic variables were determined and applied to different estimation models to assess the models’ applicability to the Tshwane district population. The APLS (Advanced Paediatric Life Support) formula (Body mass (kg) = (Age + 4) × 2) proved the most appropriate. This formula gave a mean underestimation of 0.51 kg. Age proved to be the variable with the strongest correlation to body mass. A formula was developed specifically for the selected population, adding mid upper arm circumference as a second variable. This formula is more complex and offers only a marginal improvement in accuracy of weight estimation. Conclusion: The APLS formula is a reasonable tool to use when estimating the body mass in children between one and five years old in the Tshwane district population. It is a well-known and simple formula, making it well suited to this purpose.
Aldose Reductase–Mediated Phosphorylation of p53 Leads to Mitochondrial Dysfunction and Damage in Diabetic Platelets

Background— Platelet abnormalities are well-recognized complications of diabetes mellitus. Mitochondria play a central role in platelet metabolism and activation. Mitochondrial dysfunction is evident in diabetes mellitus. The molecular pathway for hyperglycemia-induced mitochondrial dysfunction in platelets in diabetes mellitus is unknown. Methods and Results— Using both human and humanized mouse models, we report that hyperglycemia-induced aldose reductase activation and subsequent reactive oxygen species production lead to increased p53 phosphorylation (Ser15), which promotes mitochondrial dysfunction, damage, and rupture by sequestration of the antiapoptotic protein Bcl-xL. In a glucose dose–dependent manner, severe mitochondrial damage leads to loss of mitochondrial membrane potential and platelet apoptosis (cytochrome c release, caspase 3 activation, and phosphatidylserine exposure). Although platelet hyperactivation, mitochondrial dysfunction, aldose reductase activation, reactive oxygen species production, and p53 phosphorylation are all induced by hyperglycemia, we demonstrate that platelet apoptosis and hyperactivation are 2 distinct states that depend on the severity of the hyperglycemia and mitochondrial damage. Combined, both lead to increased thrombus formation in a mouse blood stasis model. Conclusions— Aldose reductase contributes to diabetes-mediated mitochondrial dysfunction and damage through the activation of p53. The degree of mitochondrial dysfunction and damage determines whether hyperactivity (mild damage) or apoptosis (severe damage) will ensue. These signaling components provide novel therapeutic targets for thrombotic complications in diabetes mellitus.