Miracle-dz/UniFAR-FTUs huggingface dataset:
Antisickling effect of chrysin is associated with modulation of oxygenated and deoxygenated haemoglobin via alteration of functional chemistry and metabolic pathways of human sickle erythrocytes

Sickle cell disease (SCD) treatment and management remain a challenging puzzle especially among developing Nations. Chrysin’s sickling-suppressive properties in human sickle (SS) erythrocytes in addition to its effect on AA-genotype erythrocytes were evaluated. Sickling was induced (76%) with 2% sodium metabisulphite at 3 h. Chrysin prevented (81.19%) the sickling and reversed same (84.63%) with strong IC50s (0.0257 µM and 0.00275 µM, respectively). The levels of oxygenated haemoglobin in the two groups (before and after induction approaches) were similar but significantly (P < 0.05) higher than that of SS erythrocytes (the ‘induced’ control), with chrysin-treated AA-genotype showing no effects relative to the untreated. The level of deoxygenated haemoglobin in the ‘induced’ control group was significantly (P < 0.05) higher than those of the chrysin-treated SS erythrocytes. Normal and chrysin-untreated erythrocytes (AA-untreated) were significantly more resistant to osmotic fragility than the SS-untreated. However, treatment with chrysin significantly reduced the osmotic fragility of the cells relative to the untreated cells. Furthermore, chrysin treatment significantly lowers the high level of 2,3-diphosphoglycerate (2,3-DPG) observed in the sickle erythrocytes, with no effects on AA-genotype erythrocytes. Based on functional chemistry, chrysin treatment alters the functional groups in favour of its antisickling effects judging from the observed bends and shifts. From metabolomics analysis, it was observed that chrysin treatment favors fatty acid alkyl monoesters (FAMEs) production with concomitant shutting down-effects on selenocompound metabolism. Thus, sickling-suppressive effects of chrysin could potentially be associated with modulation of oxygenated and deoxygenated haemoglobin via alteration of human sickle erythrocyte’s functional chemistry and metabolic pathways implicated in SCD crisis.
Metformin combined with insulin aspart for ameliorating blood glucose levels and maternal and neonatal outcomes in women with gestational diabetes mellitus and chronic hypertension.

OBJECTIVE To investigate the effect of metformin combined with insulin aspart on blood glucose levels and maternal and neonatal outcomes in women with gestational diabetes mellitus (GDM) accompanied by chronic hypertension (CH). METHODS A prospective study was conducted on 112 women with GDM and CH. The patients were divided into the control group and the observation group according to a random number table method, with 56 patients in each group. The control group received injections of insulin aspart based on blood pressure control, and the observation group received injections of insulin aspart combined with oral metformin based on blood pressure control. Besides, blood glucose levels, maternal pregnancy outcomes and neonatal complications before and after intervention were compared between the two groups. RESULTS Before intervention, there was no significant difference in blood glucose and blood pressure levels between the two groups (P > 0.05). After intervention, the observation group showed significantly decreased fasting blood glucose, 2-h postprandial plasma glucose and glycosylated hemoglobin levels than the control group (P < 0.05); the blood pressure in the observation group was significantly lower as compared with that before intervention (P < 0.05). Additionally, the incidences of adverse pregnancy outcomes (e.g., premature rupture of membranes) and neonatal jaundice and macrosomia were significantly lower in the observation group than in the control group after intervention (both P < 0.05). CONCLUSION Metformin combined with insulin aspart for treating GDM and CH can effectively control blood glucose and blood pressure levels and reduce the risk of adverse perinatal and neonatal outcomes, which exerts positive effect in clinical treatment.
Commissioning of and preliminary experience with a new fully integrated computed tomography linac

Abstract Purpose A new medical linear accelerator (linac) platform integrated with helical computed tomography (CT), the uRT‐linac 506c, was introduced into clinical application in 2019 by United Imaging Healthcare (UIH) Co., Ltd. (Shanghai, China). It combines a Carm linac with a diagnostic‐quality 16‐slice CT imager, providing seamless workflow from simulation to treatment. The aim of this report is to assess the technical characteristics, commissioning results and preliminary experiences stemming from clinical usage. Methods The mechanical and imaging test procedures, commissioning data collection and TPS validation were summarized. CTIGRT accuracy was investigated with different loads and couch extensions. A series of end‐to‐end cases for different treatment sites and delivery techniques were tested preclinically to estimate the overall accuracy for the entire treatment scheme. The results of patient‐specific QA and machine stability during a one‐year operation are also reported. Results Gantry/couch/collimator isocentricity was measured as 0.63 mm in radius. The TPS models were in agreement with the beam commissioning data within a deviation of 2%. An overall submillimeter accuracy was demonstrated for the CT‐IGRT process under all conditions. The absolute point dose difference for all the preclinical end‐to‐end tests was within 3%, and the gamma passing rate of the 2D dose distribution measured by EBT3 film was better than 90% (3% DD, 3 mm DTA and 10% threshold). Pretreatment QA of clinical cases resulted with better than 3% point dose difference and more than 99% gamma passing rate (3% DD/2 mm DTA/10% threshold) tested with Delta4. The output of the linac was mostly within 1% of variation in a one‐year operation. Conclusion The commissioning results and clinical QA results show that the uRT‐linac 506c platform exhibits good and stable performance in mechanical and dosimetric accuracy. The integrated CT system provides an efficient workflow for image guidance with submillimeter localization precision, and will be a good starting point to proceed advanced adaptive radiotherapy.
Biomarkers for differentiating grade II meningiomas from grade I: a systematic review

Abstract Introduction There are a number of prognostic markers (methylation, CDKN2A/B) described to be useful for the stratification of meningiomas. However, there are currently no clinically validated biomarkers for the preoperative prediction of meningioma grade, which is determined by the histological analysis of tissue obtained from surgery. Accurate preoperative biomarkers would inform the pre-surgical assessment of these tumours, their grade and prognosis and refine the decision-making process for treatment. This review is focused on the more controversial grade II tumours, where debate still surrounds the need for adjuvant therapy, repeat surgery and frequency of follow up. Methods We evaluated current literature for potential grade II meningioma clinical biomarkers, focusing on radiological, biochemical (blood assays) and immunohistochemical markers for diagnosis and prognosis, and how they can be used to differentiate them from grade I meningiomas using the post-2016 WHO classification. To do this, we conducted a PUBMED, SCOPUS, OVID SP, SciELO, and INFORMA search using the keywords; ‘biomarker', ‘diagnosis’, ‘atypical’, ‘meningioma’, ‘prognosis’, ‘grade I’, ‘grade 1’, ‘grade II’ and ‘grade 2’. Results We identified 1779 papers, 20 of which were eligible for systematic review according to the defined inclusion and exclusion criteria. From the review, we identified radiological characteristics (irregular tumour shape, tumour growth rate faster than 3cm3/year, high peri-tumoural blood flow), blood markers (low serum TIMP1/2, high serum HER2, high plasma Fibulin-2) and histological markers (low H3K27me3, low SMARCE1, low AKAP12, high ARIDB4) that may aid in differentiating grade II from grade I meningiomas Conclusion Being able to predict meningioma grade at presentation using the radiological and blood markers described may influence management as the likely grade II tumours will be followed up or treated more aggressively, while the histological markers may prognosticate progression or post-treatment recurrence. This to an extent offers a more personalised treatment approach for patients.
Molecular characterization and histo-physiological alterations induced by concurrent helminthosis in the liver of urban commensal rodents in Punjab, India.

Background Rodents harbour a number of parasites of public health importance, thus, they threaten human health and livestock. Aims The present study aimed to characterize two helminthic species found in commensal rodents and record histo-physiological alterations induced by them. Methods A total of 300 synanthropic rodents of three species: Rattus rattus (n=201), Bandicota bengalensis (n=90), and Mus musculus ( n=09 ) were live trapped and necropsied in different seasons during November 2017 to October 2019 at Ludhiana, Punjab, India. Results Liver of two species B. bengalensis (72.22%) and R. rattus (65.67%) were found infected with two helminthic parasites Taenia taeniaeformis, and Calodium hepaticum. These endoparasites were present either alone (4.33-6.33%) or as mixed infection (65.55%). The level of total proteins and liver marker enzymes including aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were found significantly higher in the liver of rodent species infected with single and mixed infection compared to those with no infection. In histopathological assay, granulomatous liver lesions and necrosis of hepatocytes were seen which were associated with eggs and adults of C. hepaticum and inflammatory reaction in hepatic parenchyma adjoining to cysts of T. taeniaeformis. Based upon scanning electron microscopy (SEM) identification and molecular characterization using mitochondrial cytochrome oxidase I (COI) region, the metacestodes in whitish cysts were confirmed to be of T. taeniaeformis for the first time in Punjab, India. Conclusion The study highlights an alarmingly high infection of rodents with zoonotic parasites and suggests immediate pest (rodent) control to check the dissemination of zoonotic diseases by helminth species under study.
Levelling up: Global examples of reducing health inequalities

There are significant inequalities in health by socio-economic status, race/ethnicity, gender, neighbourhood deprivation and other axes of social inequality. Reducing these health inequalities and improving health equity is arguably the ‘holy grail’ of public health. This article engages with this quest by presenting and analysing historical examples of when sizeable population-level reductions in health inequalities have been achieved. Five global examples are presented ranging from the 1950s to the 2000s: the Nordic social democratic welfare states from the 1950s to the 1970s; the Civil Rights Acts and War on Poverty in 1960s USA; democratisation in Brazil in the 1980s; German reunification in the 1990s; and the English health inequalities strategy in the 2000s. Welfare state expansion, improved health care access, and enhanced political incorporation are identified as three commonly held ‘levellers’ whereby health inequalities can be reduced – at scale. The article concludes by arguing that ‘levelling up’ population health through reducing health inequalities requires the long-term enactment of macro-level policies that aggressively target the social determinants of health.
Association of Changes in Seasonal Respiratory Virus Activity and Ambulatory Antibiotic Prescriptions With the COVID-19 Pandemic.

of viral in-fectionsorantimicrobialprescribing. However,toourknowl-edge, this study is the first to combine respiratory virus activ-ityandantibioticprescriptionsthatwereindexedtothenumber of over a prolonged period that includes the typi-cal respiratory virus season. The data suggest that COVID-19 transmission mitigation strategies may help curb respiratory viral diseases beyond SARS-CoV-2 and, indirectly, decrease antibioticprescribing.Notably,duringCOVID-19surgesinWis-consin (October to December 2020), we did not observe in-creased ambulatory antibiotic prescriptions. Additionally, noninfluenza virus activity demonstrated a stronger correla-tionwithantibioticprescriptionrates.Wehypothesizethatthis may be because of highly accessible, rapid diagnostics for SARS-CoV-2andinfluenzavirusestoavertunnecessaryantibi-otic prescriptions. These findings may have important impli-cations for future stewardship and public health strategies.
A hub-and-spoke nuclear lamina architecture in trypanosomes

ABSTRACT The nuclear lamina supports many functions, including maintaining nuclear structure and gene expression control, and correct spatio-temporal assembly is vital to meet these activities. Recently, multiple lamina systems have been described that, despite independent evolutionary origins, share analogous functions. In trypanosomatids the two known lamina proteins, NUP-1 and NUP-2, have molecular masses of 450 and 170 kDa, respectively, which demands a distinct architecture from the ∼60 kDa lamin-based system of metazoa and other lineages. To uncover organizational principles for the trypanosome lamina we generated NUP-1 deletion mutants to identify domains and their arrangements responsible for oligomerization. We found that both the N- and C-termini act as interaction hubs, and that perturbation of these interactions impacts additional components of the lamina and nuclear envelope. Furthermore, the assembly of NUP-1 terminal domains suggests intrinsic organizational capacity. Remarkably, there is little impact on silencing of telomeric variant surface glycoprotein genes. We suggest that both terminal domains of NUP-1 have roles in assembling the trypanosome lamina and propose a novel architecture based on a hub-and-spoke configuration.
Development of a novel and specialized cultivation method for isolating Helicobacter pullorum from chicken meat.

Background It has become established that Helicobacter pullorum could be isolated from raw chicken meat. Aims This study was aimed to develop a novel culture method (protocol B) to isolate H. pullorum from chicken meat by adding some modifications to the traditional culture method (protocol A), and as a consequence to compare their sensitivity, specificity, and the accuracy of these methods with polymerase chain reaction (PCR) test. Methods 400 chicken meat samples were collected from various retail markets and supermarkets. Each sample was processed by protocol A, protocol B, and PCR test. Results Out of 400 samples, 77 (19.25%), and 163 (40.75%) were culture-positive by protocol A and protocol B, respectively. Using PCR test as a gold standard, 196 (49%) samples were identified as H. pullorum. The specificity for both protocols was determined 100%, while the sensitivity of protocol B and protocol A was assessed 83% and 39%, respectively. Also, the higher and lower accuracy belonged to protocol B (92%) and protocol A (70%), respectively. Conclusion The methodology designed herein can provide a suitable, approximately sensitive, specific, and accurate method to cultivate H. pullorum from chicken meat.
Primary hepatic neuroendocrine tumor

Summary Primary hepatic neuroendocrine tumor (PHNET) is a rare type of neuroendocrine tumor (NET) that is also a primary hepatic tumor. Patients are present with almost no specific clinical symptoms and typically present with negative test results and atypical imaging characteristics; therefore, the differentiation of PHNET from other types of primary hepatic masses can be very difficult. In this article, we describe a case of PHNET that mimicked a liver helminth infection in a 57-year-old man. The diagnosis of PHNET in this patient was challenging, and the final diagnosis was based on imaging, histopathology features, and long-term follow-up. Learning points An uncommon type of neuroendocrine tumor (NET) is a primary hepatic neuroendocrine tumor (PHNET). Primary hepatic neuroendocrine tumors are rare NET lesions found in the liver, characterized by non-specific clinical and imaging results, which can be easily confused with other liver lesions, including HCC and parasitic lesions. To have a conclusive diagnosis and classification, a mixture of many medical assessment techniques, such as imaging, gastrointestinal endoscopy, nuclear medicine, anatomy, including histopathology, and immunohistochemistry, is essential.
The importance of skin area and gender in ticklishness.

The importance of skin area and gender in ticklishness was explored in the present study. No previous report has been published on stimulation of the body surface exposed when dressed in a swimsuit (supine and prone positions), and the use of a feather has not been reported before. Fifty-seven university students volunteered (female N = 26, age range: 19-25, mean = 22.4; male N = 31, age range: 20-26, mean = 23.1). Sessions were videotaped for scoring of local involuntary muscle contractions (IMC) and laughter. Smiles were not scored because the face was not visible in the prone position. Subjective ticklishness was scored on a visual analogue scale. Areas that gave rise to ticklishness, were hatched onto a figure of the body. A two-factor design (gender of tickler by gender of ticklee) explored effects on dependent measures. Results showed that laughter was most frequent in female ticklees, disregarding the gender of the tickler. Subjective ticklishness and IMC scored high in opposite gender constellations. Ticklish areas included the ankles, knees, medial sides of the thighs and legs, lateral sides of the upper part of the body, elbows, the upper parts of arms, and the neck and shoulders. It was proposed that laughter in response to tickling stimulation might express gender stereotypes of socio-expressive behavior in playful social interaction, whereas IMC and subjective ticklishness may reflect biological components of playfulness in opposite gender constellations when tickled by a feather.
Exploratory Outlier Detection for Acceleromyographic Neuromuscular Monitoring: Machine Learning Approach

Background Perioperative quantitative monitoring of neuromuscular function in patients receiving neuromuscular blockers has become internationally recognized as an absolute and core necessity in modern anesthesia care. Because of their kinetic nature, artifactual recordings of acceleromyography-based neuromuscular monitoring devices are not unusual. These generate a great deal of cynicism among anesthesiologists, constituting an obstacle toward their widespread adoption. Through outlier analysis techniques, monitoring devices can learn to detect and flag signal abnormalities. Outlier analysis (or anomaly detection) refers to the problem of finding patterns in data that do not conform to expected behavior. Objective This study was motivated by the development of a smartphone app intended for neuromuscular monitoring based on combined accelerometric and angular hand movement data. During the paired comparison stage of this app against existing acceleromyography monitoring devices, it was noted that the results from both devices did not always concur. This study aims to engineer a set of features that enable the detection of outliers in the form of erroneous train-of-four (TOF) measurements from an acceleromyographic-based device. These features are tested for their potential in the detection of erroneous TOF measurements by developing an outlier detection algorithm. Methods A data set encompassing 533 high-sensitivity TOF measurements from 35 patients was created based on a multicentric open label trial of a purpose-built accelero- and gyroscopic-based neuromuscular monitoring app. A basic set of features was extracted based on raw data while a second set of features was purpose engineered based on TOF pattern characteristics. Two cost-sensitive logistic regression (CSLR) models were deployed to evaluate the performance of these features. The final output of the developed models was a binary classification, indicating if a TOF measurement was an outlier or not. Results A total of 7 basic features were extracted based on raw data, while another 8 features were engineered based on TOF pattern characteristics. The model training and testing were based on separate data sets: one with 319 measurements (18 outliers) and a second with 214 measurements (12 outliers). The F1 score (95% CI) was 0.86 (0.48-0.97) for the CSLR model with engineered features, significantly larger than the CSLR model with the basic features (0.29 [0.17-0.53]; P<.001). Conclusions The set of engineered features and their corresponding incorporation in an outlier detection algorithm have the potential to increase overall neuromuscular monitoring data consistency. Integrating outlier flagging algorithms within neuromuscular monitors could potentially reduce overall acceleromyography-based reliability issues. Trial Registration ClinicalTrials.gov NCT03605225; https://clinicaltrials.gov/ct2/show/NCT03605225
Tuberculosis control within Indonesia’s hospital accreditation

Background: Tuberculosis (TB) is an infectious disease that is a major problem in Indonesia, placing Indonesia among the three major countries with the highest TB cases in the world. In addition, reporting of TB data from health service facilities, especially hospitals, is still weak. Since the implementation of Directly Observed Treatment Shortcourse (DOTS) in hospitals in 1995, the number of new TB case reports from hospitals is still low. In order to increase hospital participation in TB control, the government has made a breakthrough strategy, which is the integration of the DOTS strategy in hospital accreditation. Design and methods: This study conducted a literature review and document analysis related TB control standards in hospital accreditation and the implication for the involvement of hospitals in national TB program. This study analyzed regulations, policies, and procedures, including hospital accreditation instruments and annual reports of TB. Results:Accreditation standards related to TB control include: i) Hospital must implement a tuberculosis control program in the hospital, including monitoring and evaluation through activities such as health promotion, tuberculosis surveillance, controlling risk factors, detection and treatment of tuberculosis cases, providing immunity and preventive drugs; ii) Hospital prepares resources for service delivery and tuberculosis control; iii) hospital provides facilities and infrastructures for tuberculosis services in accordance with regulations; and iv) hospital conducts tuberculosis services and efforts to control tuberculosis risk factors in accordance with regulations. Conclusions: Standards and elements of the assessment of TB control components in accreditation are adjusted to the national TB control guidelines. Significance for public health Accreditation is an essential element to assess the quality of the hospital handling health problems in the clinical setting. Implementing the hospital accreditation in Indonesia especially for the DOTS strategy requires several standards according to the national TB control guidelines. As a result, achieving optimal TB control through the hospital accreditation and ensuring the quality of care for a patient can be reached. The health worker and public health system take responsibility to ensure implementing the standards of accreditation to control TB cases and achieve effective management.