Miracle-dz/UniFAR-FTUs huggingface dataset:
STUDY ON STRESS AMONG UNDERGRADUATE STUDENTS OF A MEDICAL COLLEGE IN COASTAL ANDHRA PRADESH

BACKGROUND: Stress is a part of everyone's life. It is normal for everybody to experience stress to some extent, but too much stress may be harmful. Attending college is a rewarding experience but it also can be a time of considerable anxiety and stress for students. Students are subjected to different kinds of experiences which make them vulnerable to undergo a lot of stress. Of late, there is a growing appreciation of stress in medical professionals including medical students, who have very busy and demanding schedule. Sources of stress are classified into two main groups - academic pressures and non-academic sources including financial problems. There are different coping strategies used by students to manage stress. It is important to understand these strategies and encourage the healthy strategies and discourage the others which are potentially harmful. AIM: to determine the sources of stress in undergraduate medical students and the coping strategies used by these students in managing their stress. SETTINGS AND DESIGN: An institutional cross sectional study among undergraduate students of a medical college in coastal Andhra Pradesh. MATERIAL AND METHODS: After the study protocol was given clearance by the Institution Ethics Committee, consent was taken from the undergraduate medical students of Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, and a predesigned and pretested questionnaire was given which captured information related to basic demographic details followed by questions related to stress and its sources and also the coping strategies used by these students to manage stress. STATISTICAL ANALYSIS: The data collected was entered into Microsoft Excel and analyzed using Epi Info 6 software. Chi Square test was done wherever applicable. RESULTS AND CONCLUSIONS: Total 431 out of 550 medical students (78.4 percent) participated in the study. There were 261 females and 170 males. 'Academic work load', 'long hours of academic work', 'performance in examinations', 'competition for marks' and 'frequency of examinations' were the leading academic sources of stress. 'Quality of food', 'lack of entertainment in the institution', 'worry about future', 'being away from home' and 'lack of time for recreation' were the leading non-academic sources of stress in the students. 'Emotional support from family/friends', 'listening to music/dancing', 'going to place of worship', 'playing sports/games/physical exercises', and 'watching a movie' were reported as the leading coping strategies used by the study subjects.
Anti-antioxidant impacts of circZNF609 silence in HaCaT cells through regulating miR-145

Abstract Background CircZNF609 (cZNF609) is previously revealed as an essential mediator in oxidative stress. This paper determined the role of cZNF609 in skin oxidative damage to evaluate its importance in pressure ulcer. Methods HaCaT cells treated by H2O2 were considered as a cell model of pressure ulcer. The role of cZNF609 in the model was checked by conducting CCK-8 assay, FITC-PI double-staining, ROS detection and Western blot. The downstream gene and signalling of cZNF609 were studied by utilizing qRT-PCR and Western blot. Results HaCaT cells were remarkably damaged by H2O2, as evidenced by the viability loss, apoptosis and ROS generation. It was coupled with the elevated expression of p53, p16, Bax and the activated forms of caspase-3 and PARP. Meanwhile, cZNF609 was high-expressed in response to H2O2. The oxidative stress driven by H2O2 was alleviated by transfection with cZNF609 specific siRNA. Further, the anti-antioxidant impacts of cZNF609 silence were impeded by miR-145 silence. The inhibition of JNK and p38MAPK pathways induced by cZNF609 silence was impeded by miR-145 silence. Conclusion The protective function of cZNF609 silence in H2O2-injured HaCaT cells was revealed in vitro. Silence of cZNF609 exhibited its impact possibly through regulating miR-145, and JNK and p38MAPK pathways.
Evaluation of a sentence test in noise in children with hearing impairment.

INTRODUCTION School-aged children with hearing impairment (HI) listen and learn in noisy environments. On-going monitoring of speech understanding in noise is essential to adjust clinical interventions accordingly. METHODS The aim of this study was to assess Dantale II in a paediatric population. The secondary aims were identification of differences and similarities between groups of children with HI and normal hearing and between different hearing technologies; investigation of possible associations between Dantale II and verbal working memory. This was a longitudinal, prospective study comparing groups of children (n = 70) using the Dantale II with five-word sentences and verbal working memory with the Clinical Evaluation of Language Functioning-4. RESULTS Dantale II seems clinically feasible from the age of six years. Children with NH outperformed children with HI both on completion of the tests and dB signal-to-noise ratio (SNR) scores. Children with hearing aids outperformed children with cochlear implants on dB SNR scores. A significant and moderately strong association between speech understanding in noise and verbal working memory was identified. CONCLUSIONS Our study produced knowledge about a new generation of children with HI, who showed potentials not previously described. Future research on cognitive development of paediatric populations with HI is essential, as knowledge from adult populations cannot be transferred directly to paediatric populations. FUNDING The project received funding from the Innovation Foundation, the Oticon Foundation, Decibel and The Capital Region of Denmark. TRIAL REGISTRATION not relevant.
Fourier Transform Infrared Spectroscopy as a Cancer Screening and Diagnostic Tool: A Review and Prospects

Infrared spectroscopy has long been used to characterize chemical compounds, but the applicability of this technique to the analysis of biological materials containing highly complex chemical components is arguable. However, recent advances in the development of infrared spectroscopy have significantly enhanced the capacity of this technique in analyzing various types of biological specimens. Consequently, there is an increased number of studies investigating the application of infrared spectroscopy in screening and diagnosis of various diseases. The lack of highly sensitive and specific methods for early detection of cancer has warranted the search for novel approaches. Being more simple, rapid, accurate, inexpensive, non-destructive and suitable for automation compared to existing screening, diagnosis, management and monitoring methods, Fourier transform infrared spectroscopy can potentially improve clinical decision-making and patient outcomes by detecting biochemical changes in cancer patients at the molecular level. Besides the commonly analyzed blood and tissue samples, extracellular vesicle-based method has been gaining popularity as a non-invasive approach. Therefore, infrared spectroscopic analysis of extracellular vesicles could be a useful technique in the future for biomedical applications. In this review, we discuss the potential clinical applications of Fourier transform infrared spectroscopic analysis using various types of biological materials for cancer. Additionally, the rationale and advantages of using extracellular vesicles in the spectroscopic analysis for cancer diagnostics are discussed. Furthermore, we highlight the challenges and future directions of clinical translation of the technique for cancer.
F-DCS: FMI-Based Distributed CPS Simulation Framework with a Redundancy Reduction Algorithm

A cyber physical system (CPS) is a distributed control system in which the cyber part and physical part are tightly interconnected. A representative CPS is an electric vehicle (EV) composed of a complex system and information and communication technology (ICT), preliminary verified through simulations for performance prediction and a quantitative analysis is essential because an EV comprises a complex CPS. This paper proposes an FMI-based distributed CPS simulation framework (F-DCS) adopting a redundancy reduction algorithm (RRA) for the validation of EV simulation. Furthermore, the proposed algorithm was enhanced to ensure an efficient simulation time and accuracy by predicting and reducing repetition patterns involved during the simulation progress through advances in the distributed CPS simulation. The proposed RRA improves the simulation speed and efficiency by avoiding the repeated portions of a given driving cycle while still maintaining accuracy. To evaluate the performance of the proposed F-DCS, an EV model was simulated by adopting the RRA. The results confirm that the F-DCS with RRA efficiently reduced the simulation time (over 30%) while maintaining a conventional accuracy. Furthermore, the proposed F-DCS was applied to the RRA, which provided results reflecting real-time sensor information.
Trends, Patient and Prescriber Characteristics in Gabapentinoid Use in a Sample of United States Ambulatory Care Visits from 2003 to 2016

Increasing gabapentinoid use has raised concerns of misuse and abuse in the United States (US). Little is known about the characteristics of gabapentinoid use in general clinical practice over time. This cross-sectional study used data from the National Ambulatory Medical Care Survey. We examined the trends of patient and prescriber characteristics and the diagnoses associated with US ambulatory care visits involving gabapentinoids for adult visits from 2003 to 2016. Using multivariable logistic regression, we estimated the adjusted proportion of gabapentinoid-involved visits among all visits and tested for trend significance. Among the weighted estimate of 260.1 million gabapentinoid-involved visits (aged 18–64 years: 61.8%; female: 61.9%; white: 85.5%), the adjusted annual proportion of gabapentinoid-involved visits nearly quadrupled from 2003 to 2016 (9.1 to 34.9 per 1000 visits; Ptrend < 0.0001), driven mainly by gabapentin. Nearly half had concurrent use with opioids (32.9%) or benzodiazepines (15.3%). Primary care physicians (45.8%), neurologists (8.2%), surgeons (6.2%), and psychiatrists (4.8%) prescribed two-thirds of the gabapentinoids. Most (96.6%) of the gabapentinoid visits did not have an approved indication for gabapentinoids among the first three diagnoses. Among US ambulatory care visits from 2003 to 2016, gabapentinoid use increased substantially, commonly prescribed by primary care physicians.
Using Clinical Characteristics and Patient‐Reported Outcome Measures to Categorize Systemic Lupus Erythematosus Subtypes

The type 1 and type 2 systemic lupus erythematosus (SLE) categorization system was recently proposed to validate the patients’ perspective of disease and to capture a more comprehensive spectrum of symptoms. The objective of this study was to characterize the clinical manifestations of SLE subtypes and to determine the correlation between the patient‐ and physician‐reported measures used in the model.
HCV genotype profile in Brazil of mono-infected and HIV co-infected individuals: A survey representative of an entire country

Introduction To be eligible for government-provided treatment in Brazil, all HCV-infected individuals are required to be genotyped shortly after diagnosis. We describe the HCV genotype (G) profiles by geographic region, gender, age and HIV co-infection. Methods We assessed 29,071 genotypes collected from HCV-infected individuals from March 2016 to March 2018 (Abbott Real-Time HCV Genotype). We randomly selected 12,336 samples for HIV co-infection testing using an EIA rapid test kit (TR DPP HIV 1/2 Bio-Manguinhos). Descriptive statistical analyses were performed using R. Results Overall, HCV genotype distribution was 40.9% G1A, 30.2% G1B, 23.8% G3, 3.8% G2, 0.7% G4, 0.1% G5 and 0.6% with multiples genotypes. G1A prevalence was 44.4% among males and 35.8% among females. G1B and G2 were more prevalent in older individuals than G1A and G3. G3 was more prevalent in the South region. Of samples tested for HIV co-infection, 15% were HIV+. Median age among HCV/HIV co-infected individuals was 50 years old compared to 57 years old among mono-infected individuals. Distinct HCV genotype prevalence between HCV/HIV co-infected and HCV mono-infected individuals were respectively: G1A 60.6% versus 37.8%, G1B 15.2% versus 32.9%, and G3 18.9% versus 24.7%. G4 was detected among co-infected young men (3.5% versus 0.2% among mono-infected). Conclusion The increasing prevalence of G3, as inferred by the younger ages of the HCV-infected individuals, poses an extra challenge with regards to disease progression. Distinct genotypical profiles between HCV mono-infection and HCV/HIV co-infection warrant future research in order to better understand and help mitigate HCV chains of transmission.
The Role of the Cervicovaginal Microbiome on the Genesis and as a Biomarker of Premalignant Cervical Intraepithelial Neoplasia and Invasive Cervical Cancer

The microbiome is able to modulate immune responses, alter the physiology of the human organism, and increase the risk of viral infections and development of diseases such as cancer. In this review, we address changes in the cervical microbiota as potential biomarkers to identify the risk of cervical intraepithelial neoplasia (CIN) development and invasive cervical cancer in the context of human papillomavirus (HPV) infection. Current approaches for clinical diagnostics and the manipulation of microbiota with the use of probiotics and through microbiota transplantation are also discussed.
ICare Pro: Age Dependent Effect of Central Corneal Thickness on Intraocular Pressure in Glaucoma and Ocular Hypertension Patients

ABSTRACT Purpose: Measurement of the exact intraocular pressure (IOP) is essential in glaucoma diagnosis and follow-up, thus all therapeutic options affect IOP in order to win sighted lifetime. As it is known that corneal properties of glaucoma patients differ from normal subjects, the present study aimed to investigate the influence of CCT on rebound tonometry (ICT, ICare Pro) in glaucoma and ocular hypertension patients in dependency of age additionally considering different times of day. Methods: Three hundred sixty-two eyes of 190 subjects were included: 339 open-angle glaucoma and 23 ocular hypertension. IOP was measured at 5 different times of day (6 a.m., 12 a.m., 4 p.m., 9 p.m., and 0 p.m.) by Goldmann applanation tonometry (GAT) and Icare Pro rebound tonometry in a sitting position. Central corneal thickness was measured by central ultrasonic pachymetry (Pachymeter SP-100). Δ ICT was calculated as the difference of GAT, corrected according to age and CCT, and ICT, respectively at each time point. Results: All different GAT time points data correlated significantly (p < .05) with ICT time points. An age effect was observed on overall ICT (p = .02). A decrease of ICT was observed with increasing age. The within differences among ICT repeated measurements were significant as well. Additionally, repeated means of Δ ICT correlated significantly with age and CCT. Intercepts and coefficients were offered for each time point, respectively. GLM model yielded a relation between MD (dependent variable) and age together with CCT (age: p < .0001) and (CCT: p = .043). Conclusions: IOP measurements with ICare Pro were shown to be dependent on age, CCT and time of day in glaucoma and ocular hypertension patients. Thus, aging, corneal biomechanical properties and circadian rhythms should be taken into consideration when adjusting IOP.
Prevalence and factors influencing anaemia among pregnant women in rural Mysuru, India

Background: Anaemia in pregnancy is one of the major causes of maternal morbidity and mortality in India and the world. Determining the status and factors influencing anaemia among pregnant women in rural areas is essential to treat as well as prevent the same. The objective was to estimate the prevalence of anaemia among pregnant women of rural areas of Mysuru, India and to determine the factors influencing anaemia among the study participants. Methods: A cross-sectional study was conducted in the villages under PHCs of Hadinaru and Suttur of Nanjangud Taluk, Mysuru district, India for a period of 18 months. A total of 300 pregnant women residing in these villages, and consenting to participate were included in the study. A structured proforma was used to collect sociodemographic details. Haemoglobin was estimated using Sahli’s haemoglobinometer and type of anaemia was determined by peripheral blood smear. The data was entered using Epi Data v3.1 software, and analyzed using R statistical Software v3.0. 2. Results: The prevalence of anaemia was 51%, majority had mild anaemia (37%). 79% of the study participants were aged 20-29 years, 85% studied upto High school, 83% belonged to lower Socioeconomic class and 66% lived in joint families. The important factors influencing anaemia were poor nutrition (49%), low socioeconomic status (39%) and open defecation (51%). Conclusions: More than half of the pregnant women were anaemic. Also, majority of the anaemic women had mild anaemia, which showed the positive impact of MCH services. The factors influencing anaemia which have been identified in this study need to be addressed to reduce the burden of anaemia among pregnant women in our country.
Outcomes of Robotic Hysterectomy for Treatment of Benign Conditions: Influence of Patient Complexity.

INTRODUCTION Robotic hysterectomy may offer advantages for complex cases over the conventional laparoscopic approach. OBJECTIVE To assess the association of surgical approach (robotic vs conventional) with blood loss, risks of readmission, reoperation, complications, and average operative time. METHODS In a retrospective cohort study, we used the electronic medical records of Kaiser Permanente Northern California, 2011 to 2015, to estimate outcomes of robotic and conventional laparoscopic hysterectomy among women with complex or noncomplex benign disease. Mixed-effects regression models accounted for patient characteristics and surgeon volume. RESULTS The study included 560 robotic and 6785 conventional laparoscopic cases. Overall, 1836 patients (25%) met criteria for being complex. The average operative time was 152 minutes for robotic hysterectomy and 157 minutes for conventional laparoscopic hysterectomy (p < 0.0001). Complex surgical cases averaged 190 minutes and noncomplex cases averaged 144 minutes. The difference in operative time for high-volume surgeons treating complex patients with robotic hysterectomy vs conventional hysterectomy was 21 minutes faster (p < 0.05). After adjustment, the risk of blood loss at least 51 mL was lower for robotic surgery than for conventional surgery for complex and noncomplex patients. Other than risk of urinary tract complications, we observed no differences in the risks of complications or risk of reoperation between robotic and conventional laparoscopy for complex and noncomplex patients. CONCLUSION For women with complex disease, the robotic approach, when used by a higher-volume surgeon, may be associated with shorter operative time and slightly less blood loss, but not with lower risk of complications.
Effects of Probiotics on Metabolic Syndrome: A Systematic Review of Randomized Clinical Trials

The aim of this systematic review is to evaluate whether the use of probiotics has any effect on the components of metabolic syndrome (MetS) before patients develop type 2 diabetes. A qualitative systematic review, following the Cochrane methodology, and a comprehensive literature search of randomized controlled trials (RCTs) were conducted in PubMed and Scopus from inception until 4 July 2019. According to our inclusion criteria, nine clinical studies were finally analyzed, corresponding to six RCTs. Probiotics intake in patients with MetS resulted in improvements in body mass index, blood pressure, glucose metabolism, and lipid profile in some studies. Regarding inflammatory biomarkers, probiotics also positively affected the soluble vascular cell adhesion molecule 1 (sVCAM-1), interleukine-6 (IL-6), tumor necrosis factor α (TNF-α), vascular endothelial growth factor (VEGF), and thrombomodulin. Despite the diversity of the published studies, the intake of probiotics for patients with MetS may offer a discrete improvement in some of the clinical characteristics of the MetS and a decrease in inflammatory biomarkers. Nevertheless, these beneficial effects seem to be marginal compared to drug therapy and a healthy lifestyle and clinically non-relevant.
Pervasive within-host recombination and epistasis as major determinants of the molecular evolution of the foot-and-mouth disease virus capsid

Although recombination is known to occur in FMDV, it is considered only a minor determinant of virus sequence diversity. This is because recombination appears to be highly suppressed at phylogenetic scales; inter-serotypic recombination events are rare; and in those a mosaic structure is present whereby recombination only occurs almost exclusively in non-structural proteins. Here we show that co-inoculation of closely related strains in buffaloes results over time in extensive within-host recombination in the genomic region coding for structural proteins. This enables us to directly estimate recombination rates for the first time. Quite surprisingly, the effective recombination rate in VP1 during the acute infection phase turns out to be about 0.1 per base per year, i.e. comparable to the mutation/substitution rate. Thanks to the features of our experimental setup, we are also able to build a high-resolution map of effective within-host recombination in the capsid-coding region. We find that the linkage disequilibrium pattern inside VP1 points to a mosaic structure with two main genetic blocks. Positive epistatic interactions between co-evolved variants appear to be present both within and between blocks. These interactions are due to intra-host selection both at the RNA and protein level. Overall our findings show that during FMDV co-infections by closely related strains, capsid-coding genes recombine within the host at a much higher rate than expected, despite the presence of strong constraints dictated by the capsid structure. Although those intra-host results are not immediately transportable to a phylogenetic setting, they force us to reconsider the relevance of recombination and epistasis, suggesting that they must play a major and so far underappreciated role in the molecular evolution of the virus at all time scales. Author summary Recombination in the capsid-coding region of the Foot-and-Mouth Disease virus genome is highly suppressed at phylogenetic scales. However, the role of recombination in the intra-host dynamics of the virus is not known. In our experiment, a co-infection of African buffaloes with closely related FMDV strains results in a population structure of the intra-host viral swarm, allowing us to detect recombination events. For structural protein-coding sequences, the swarm dynamics is driven by extensive within-host recombination. During the acute infection phase, we infer intra-host recombination rates of 0.1 per base per year, comparable to the typical mutation rate of the virus. The recombination map reveals two linkage blocks within the VP1 protein-coding sequence. Epistatic interactions between co-evolved mutations in VP1 are caused by intra-host selection at the RNA and protein level and are present both within and between blocks. Our findings support a major role for recombination and epistasis in the intra-host evolution of FMDV.