Miracle-dz/UniFAR-FTUs huggingface dataset:
Vesicoureteral reflux and recurrent urinary tract infections

Vesicoureteral reflux (VUR) refers to backflow of urine from the bladder into the upper urinary tract. Children with high-grade VUR are at risk of recurrent urinary tract infections (UTIs). It is commonly associated with bladder–bowel dysfunction, necessitating treatment because it further increases the risk of recurrent UTI and results in delayed resolution of VUR. Almost one-third of patients with VUR diagnosed following UTI show renal scarring. It is debated whether scarring in VUR is entirely acquired following UTI or due to dysplasia. The efficacy of antibiotic prophylaxis has been variable for the prevention of UTI in children with VUR. A meta-analysis suggests that it might be of some benefit in preventing UTI, but not renal scarring and at cost of bacterial resistance. Due to questionable efficacy and potential risk, use of antibiotic prophylaxis should be based on risk stratification rather than mere presence of reflux. In view of lack of significant improvement in long-term outcomes with current available interventions, there is ongoing debate on the aggressiveness of algorithms for diagnosing VUR following UTI. Long-term complications of VUR include proteinuria, hypertension, and end-stage renal disease. As opposed to previous assumption, the risk of end-stage renal failure and hypertension is fairly small with scarring following UTI.
Histopathological pattern of prostatic lesions in Kano, Northwestern Nigeria: A 14-year review

Background: Prostatic lesions are major afflictions of the aging men worldwide. High prevalence of prostatic neoplasm among the aged, their high incidence in the instances of obstructive uropathy, and many other complications with ensuing morbidity and mortality earn them a unique urologic placement. The epidemiological appraisals on the histology of prostatic lesions among men in Kano are not conclusive. The aim of this study was to review the spectrum of prostate lesions diagnosed with histopathology in Kano. Methodology: This was a retrospective review of histologically diagnosed prostatic lesions at Aminu Kano Teaching Hospital, Northwestern Nigeria, from 2005 to 2018. The data collated and analyzed were the age of patients and histological diagnoses. Summaries of these results were shown as mean of patients' age, patients' age range, frequency distribution tables, and some photomicrographs of the lesions. Results: A total of 4292 prostatic specimens were histologically diagnosed in the study. Nodular hyperplasia was the most common histological conclusion (75.9%), followed by invasive prostate cancer (23.5%). Many prostate cancer specimens have Gleason's scores of the poorly differentiated tumor (48.0%). The patient's age in both peaked at the age group of 60–69 years. Few specimens had prostatic intraepithelial neoplasia and inflammatory process. Conclusion: Nodular hyperplasia specimens had the highest of histological conclusions. The age profiles of prostate cancer patients were lower than those of the Western world. High-grade tumors weigh heavy among malignancies and hence the need for better biomarkers which may enhance early diagnosis and better treatment outcome.
Antimicrobial resistance pattern of enterococci isolated from stool samples in a tertiary hospital in Nigeria

Background: Enterococci cause infections both in and out of the hospital setting and have demonstrated resistance to almost all classes of drugs. A combination of cell wall acting agents and high-level aminoglycosides is a commonly used regimen for serious infections, but resistance to either renders the synergism ineffective. Vancomycin is the drug of choice for life-threatening infections, but there have been increasing reports of resistance to the drug. Vancomycin-resistant enterococci (VRE) infection is usually preceded by gastrointestinal colonization. Aim: This study was carried out to determine the antimicrobial resistance profile of Enterococcus species isolated from stool and the prevalence of VRE. Materials and Methods: Enterococci were identified from stool samples based on characteristic growth patterns on Bile Esculin Agar and MacConkey agar and growth in 6.5% sodium chloride broth. Speciation was by conventional biochemical identification. Antibiotic susceptibility testing and screening for high-level aminoglycoside resistance (HLAR) were done by modified Kirby–Bauer disk diffusion technique. Susceptibility of isolates to linezolid, penicillin, nitrofurantoin, high-level gentamicin and streptomycin, tetracycline, ciprofloxacin, vancomycin, and teicoplanin was tested. VRE screening was done using a chromogenic agar. The polymerase chain reaction was used for confirmation. Results: Nine species of Enterococcus were identified from 561 isolates. The most common species were Enterococcus faecium (46.0%), Enterococcus faecalis (21.6%), Enterococcus gallinarum (18.5%), and Enterococcus casseliflavus (5.2%). Resistance was highest to ciprofloxacin, tetracycline, and nitrofurantoin. Lowest resistance was to vancomycin, teicoplanin, gentamicin, and linezolid. VRE prevalence rate was 1.1% and that of HLAR was 20.7%. All VRE had vanA gene. Conclusion: Overall, E. faecium was the predominant species. Highest resistance was to ciprofloxacin and tetracycline.
Gross Motor Developmental Delay in Human Immunodeficiency Virus-Infected Children under 2 Years of Age

Background: Human immunodeficiency virus (HIV) infection has significant effects on child development. We report the outcome of gross motor developmental assessment in HIV-infected children <2 years compared with that of uninfected children. Materials and Methods: Every child <2 years of age presenting for the first time to the pediatric outpatient department of the hospital over 3 months was studied. Each child had a physical examination with gross motor milestone assessment, as well as initial double rapid HIV antibody tests with confirmatory tests for those with positive or discordant results. Children with evidence of motor delay were booked for reassessment after 1 month. The milestone performance criteria of the Multicenter Growth Reference Study of the World Health Organization were used as a standard. Results: One hundred and eight children were studied. Male-to-female ratio was 1:1. Fourteen children (13.0%) were HIV infected. Nine children (8.3%) had delayed development of gross motor milestones, of which five were HIV infected and four were uninfected (P = 0.001). Each motor milestone was attained at a significantly later mean age by the HIV-infected children when compared to the uninfected. Evidence of delay in gross motor milestones was apparent by the first 6 months of life. Conclusions: A tendency to poorer motor development is apparent in young children infected by HIV and can manifest as early as the first 6 months of life. Routine HIV screening as well as early developmental assessment of all children should be encouraged.
Acceptance of Mobile Health Applications: Examining Key Determinants and Moderators

Mobile health applications are increasingly numerous and varied. However, despite high expectations and large budgets involved in their development they are often rejected by potential users, and little is known on why this happens. This study aimed to fill this gap by investigating the determinants of technology acceptance and its moderators. Aligned with the Unified Theory of Acceptance and Use of Technology, we examined the moderating roles of age, gender, and smartphone experience in the relationship between technology acceptance determinants (performance expectancy, effort expectancy, social influence, and facilitating conditions) and the intention to use mobile health applications (N = 394, 18–65 years). A stepwise multiple linear regression was conducted. Results showed that the intention to use mobile health applications was determined by performance expectancy moderated by age and smartphone experience, and that the role of the other determinants depended on age and gender (e.g., more intention to use in older men if less effort, and in younger men if better facilitating conditions). These findings show that user characteristics are relevant moderators and should be considered when targeting specific populations to use mobile health applications.
An Assessment of Melatonin’s Therapeutic Value in the Hypoxic-Ischemic Encephalopathy of the Newborn

Hypoxic-ischemic encephalopathy (HIE) is one of the most frequent causes of brain injury in the newborn. From a pathophysiological standpoint, a complex process takes place at the cellular and tissue level during the development of newborn brain damage in the absence of oxygen. Initially, the lesion is triggered by a deficit in the supply of oxygen to cells and tissues, causing a primary energy insufficiency. Subsequently, high energy phosphate levels recover transiently (the latent phase) that is followed by a secondary phase, in which many of the pathophysiological mechanisms involved in the development of neonatal brain damage ensue (i.e., excitotoxicity, massive influx of Ca2+, oxidative and nitrosative stress, inflammation). This leads to cell death by necrosis or apoptosis. Eventually, a tertiary phase occurs, characterized by the persistence of brain damage for months and even years after the HI insult. Hypothermia is the only therapeutic strategy against HIE that has been incorporated into neonatal intensive care units with limited success. Thus, there is an urgent need for agents with the capacity to curtail acute and chronic damage in HIE. Melatonin, a molecule of unusual phylogenetic conservation present in all known aerobic organisms, has a potential role as a neuroprotective agent both acutely and chronically in HIE. Melatonin displays a remarkable antioxidant and anti-inflammatory activity and is capable to cross the blood-brain barrier readily. Moreover, in many animal models of brain degeneration, melatonin was effective to impair chronic mechanisms of neuronal death. In animal models, and in a limited number of clinical studies, melatonin increased the level of protection developed by hypothermia in newborn asphyxia. This review article summarizes briefly the available therapeutic strategies in HIE and assesses the role of melatonin as a potentially relevant therapeutic tool to cover the hypoxia-ischemia phase and the secondary and tertiary phases following a hypoxic-ischemic insult.
Diffusion Kurtosis Imaging for Detection of Early Brain Changes in Parkinson's Disease

We aimed to evaluate microscale changes in the bilateral red nucleus and substantia nigra of patients with Parkinson's disease (PD) using diffusion kurtosis imaging (DKI). Twenty-six patients with PD [mean age, 62.5 ± 8.7 years; Hoehn-Yahr stage, 0–4.0; Unified Parkinson's Disease Rating Scale (UPDRS) scores, 8–43] and 15 healthy controls (mean age, 59.5 ± 9.4 years) underwent DKI of the substantia nigra and red nucleus. Imaging was performed using a General Electric (GE) Signa 3.0-T MRI system. Patients with PD were divided into two groups consisting of 12 patients with UPDRS scores ≥ 30 and 14 patients with UPDRS scores < 30. All DKI data processing operations were performed with commercial workstations (GE, ADW 4.6) using Functool software to generate color-coded and parametric maps of mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD). MK values in the bilateral substantia nigra were significantly lower in patients with early- and advanced-stage PD than in controls. Moreover, MK values in the left substantia nigra were significantly lower in patients with advanced-stage PD than in those with early-stage PD. Patients with advanced-stage PD also exhibited significant decreases in MK values in the bilateral red nucleus relative to controls. No significant differences in FA or MD values were observed between the PD and control groups. There were no significant correlations between MK, FA, or MD values and UPDRS scores. Our findings suggest that decreased MK values in the substantia nigra may aid in determining the severity of PD and help provide early diagnoses.
First-Year Students Background and Academic Achievement: The Mediating Role of Student Engagement

The current study aimed to analyze the relationships between students’ background variables (students’ academic preparation and sociocultural status), students’ cognitive and behavioral engagement, and an outcome variable (academic achievement). One sample of 380 first-year students who were studying in different scientific areas participated in the study. Students answered a questionnaire at the beginning and at the end of their first semester in college. To increase ecological validity, students’ cognitive and behavioral engagement and academic achievement were assessed using a specific curricular subject of the course as a reference. Students’ grades were collected through academic services. Data from both time points were analyzed with a structural equation model (SEM), and data showed a goodness of fit of SEM in both time points. Findings indicate that cognitive and behavioral engagement mediated the relationship between students’ background variables and their academic achievement. The analysis of both SEM allows us to understand that academic achievement at the end of the semester is closely related to what happens at the beginning of the semester (e.g., approach to learning, study time). Thus, promoting students’ engagement at the beginning of the semester should be considered a priority, as the first part of the first semester represents a critical period for students and for their integration in college. Thus, universities should consider improving their mechanisms of collecting information to allow for early identification, support, and monitoring of students at risk of dropping out, showing high level of disengagement and low academic achievement.
Structural Dynamics Behind Clinical Mutants of PncA-Asp12Ala, Pro54Leu, and His57Pro of Mycobacterium tuberculosis Associated With Pyrazinamide Resistance

Pyrazinamide (PZA) is one of the main FDA approved drugs to be used as the first line of defense against Mycobacterium Tuberculosis (MTB). It is activated into pyrazinoic acid (POA) via MTB's pncA gene-encoded pyrazinamidase (PZase). Mutations are most commonly responsible for PZA-resistance in nearly 70% of the resistant samples. In the present work, MTB positive samples were chosen for PZA drug susceptibility testing (DST) against critical concentration (100 ug/ml) of PZA. The resistant samples were subjected to pncA sequencing. As a result, 36 various mutations have been observed in the PZA resistant samples, uploaded to the NCBI (GeneBank accession no. MH461111). Here we report the mechanism of PZA resistance behind the three mutants (MTs), Asp12Ala, Pro54Leu, and His57Pro in comparison with the wild type (WT) through molecular dynamics simulation to unveil how these mutations affect the overall conformational stability. The post-simulation analyses revealed notable deviations as compared to the WT structure. Molecular docking studies of PZA with MTs and WT, pocket volume inspection and overall shape complementarity analysis confirmed the deleterious nature of these mutations and gave an insight into the mechanism behind PZA-resistance. These analyses provide vital information regarding MTB drug resistance and could be extremely useful in therapy management and overcoming its global burden.
A randomized, controlled study to compare the effectiveness of two foam dressings in the management of lower leg ulcers

Foam dressings are commonly used in the treatment of chronic wounds, including lower leg ulcers. A prospective, randomized, controlled clinical study was conducted to compare the use of two nonadhesive polyurethane foam dressings - a polyurethane foam and a hydrocellular dressing -in the management of patients with moderately to highly exuding venous or venous/arterial lower leg ulcers. One hundred, eighteen patients were recruited and 99 (64 men, 35 women) were treated until healing or for a maximum of 8 weeks. In the polyurethane group, 34% of ulcers healed during a mean study time of 7 (+ 1.7) weeks. In the hydrocellular dressing group, 39% of ulcers healed (mean study time 6.9 [+1.6] weeks). The number of dressing changes per week was significantly lower in the polyurethane foam (mean 2.14) than in the hydrocelluar group (mean 3.34)(P < 0.005). Dressing absorbency was rated excellent in 124 of 163 polyurethane foam, compared to 12 of 170 dressing changes in the hydrocellular dressing group (P < 0.005). Both dressings were comfortable to wear, the level of pain during dressing changes was low, and the level of odor was similar in the two patient groups. Results of this study suggest that foam dressings possess varying levels of absorbency which may affect wear time, dressing leakage, and cost.
The Essential Role Played by B Cells in Supporting Protective Immunity Against Trichuris muris Infection Is by Controlling the Th1/Th2 Balance in the Mesenteric Lymph Nodes and Depends on Host Genetic Background

How B cells contribute to protective immunity against parasitic nematodes remains unclear, with their importance as accessory cells underexplored. In this study, anti-CD20 monoclonal antibody (α-CD20 mAb)-mediated depletion of B cells from C57BL/6 mice revealed an important role for B cells in supporting Th2 immune responses and thus expulsion of Trichuris muris (T. muris). C57BL/6 mice normally mount mixed Th1/Th2 immune responses to T. muris and expel the parasite by the third week post infection. However, B cell-depleted C57BL/6 had significantly reduced Th2-type cytokines post infection and failed to expel the parasite. IFN-γ production in the MLN of C57BL/6 mice receiving α-CD20 mAb treatment was not affected, collectively resulting in an overall change in Th1/Th2 balance in favor of Th1. Further, the expression of IFN-γ and IFN-γ-induced genes at the effector site, the gut, was significantly increased in the absence of B cells. Interestingly, and in complete contrast, BALB/c mice, which mount strongly polarized Th2 immune responses, rather than mixed Th1/Th2 immune responses, were still able to expel T. muris in the absence of B cells. We thus hypothesized that the B cell plays a critical role in enabling strong Th2 responses in the context of mixed Th1/Th2 settings, with the role becoming redundant in highly Th2 polarized environments. In support of this, neutralization of IFN-γ in B cell depleted C57BL/6 restored resistance against T. muris infection. Thus, our data suggest an important role of B cells in supporting Th2-type immune responses in mixed IFN-γ-rich Th1/Th2 settings.
Prospective Evaluation of Cardiopulmonary Resuscitation Performed in Dogs and Cats According to the RECOVER Guidelines. Part 2: Patient Outcomes and CPR Practice Since Guideline Implementation

Cardiopulmonary resuscitation (CPR) outcomes have not been prospectively described since implementation of the Reassessment Campaign on Veterinary Resuscitation (RECOVER) guidelines. This study aimed to prospectively describe CPR outcomes and document arrest variables in dogs and cats at a U.S. veterinary teaching hospital since implementation of the RECOVER guidelines using the 2016 veterinary Utstein-style CPR reporting guidelines. One-hundred and seventy-two dogs and 47 cats that experienced cardiopulmonary arrest (CPA) underwent CPR following implementation of the RECOVER guidelines and were prospectively included. Supervising clinicians completed a data form for CPR events immediately following completion of CPR from December 2013 to June 2018. Seventy-five (44%) dogs and 26 (55%) cats attained return of spontaneous circulation (ROSC), 45 dogs (26%) and 16 cats (34%) had ROSC ≥ 20 min, 13 dogs (8%) and 10 cats (21%) were alive 24 h after CPR, and 12 dogs (7%) and 9 cats (19%) survived to hospital discharge. The most common cause of death in animals with ROSC ≥ 20 min was euthanasia. Patient outcomes were not significantly different since publication of the RECOVER guidelines except for a higher feline survival to hospital discharge rate. Dogs (p = 0.02) but not cats with initial shockable rhythms had increased rates of ROSC while the development of a shockable rhythm during CPR efforts was not associated with ROSC (p = 0.30). In closed chest CPR an end-tidal carbon dioxide (EtCO2) value of >16.5 mmHg was associated with a 75% sensitivity and 64% specificity for achieving ROSC. Since publication of the RECOVER guidelines, CPR practice did not clinically significantly change at our institution and no improvement of already high ROSC rates was noted. The percentage of cats surviving to hospital discharge was higher than previously reported and the reason for this improvement is not evident with these results. Euthanasia remains a major confounding factor in assessing intermediate and long-term CPR outcomes in dogs and cats.
Synergetic Effects of Combined Treatment of Colistin With Meropenem or Amikacin on Carbapenem-Resistant Klebsiella pneumoniae in vitro

The purpose of this study was to investigate the synergistic and bactericidal effects of combinations of colistin with meropenem or amikacin in vitro and provide laboratory data needed for development of therapeutic strategies for the treatment of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection. We found that minimum inhibitory concentration (MIC) of colistin, meropenem and amikacin were 2~32, 4~256, and 1~16384 μg/ml, respectively. The minimum bactericidal concentration of the antibiotics was either 1× or 2×MIC. Treatments of 6 CRKP isolates at 1 μg/ml colistin completely killed 2 of them and suppressed 4 others growth. 4 CRKP isolates at 16 μg/ml meropenem or amikacin completely killed and suppressed 2 others growth. 2 CRKP isolates showed synergic effects in all colistin combination and 3 CRKP isolates showed synergic effects in part of colistin combination. Our data suggest that colistin in combination with either meropenem or amikacin could be a valid therapeutic option against colistin-resistant CRKP isolates. Moreover, the combination of colistin-amikacin is less expensive to treat CRKP infections in Eastern Heilongjiang Province.
Synthesis, Functionalization, and Bioapplications of Two-Dimensional Boron Nitride Nanomaterials

Two-dimensional boron nitride nanostructures (2D-BNNs) have been increasingly investigated for their applications in several scientific and technological areas. This considerable interest is due to their unique physicochemical properties, which include high hydrophobicity, heat and electrical insulation, resistance to oxidation, antioxidation capacity, thermal conductivity, high chemical stability, mechanical strength, and hydrogen storage capacity. They are also used as fillers, antibacterial agents, protective coating agents, lubricants, boron neutron capture therapy agents, nanocarriers for drug delivery, and for the receptor phase in chemosensors. The investigations for their use in medicine and biomedicine are very promising, including cancer therapy and wound healing. In this review, 2D-BNNs synthesis and their surface modification strategies, biocompatibility, and bioapplication studies are discussed. Finally, a perspective for the future use of these novel nanomaterials in the biomedical field is provided.