Miracle-dz/UniFAR-FTUs huggingface dataset:
Mesiodistal Angulation of Each Whole Tooth in Patients With Nonsyndromic Unilateral Cleft Lip and Palate: Is it Symmetrical?

Objective: To assess the symmetry of the mesiodistal angulations of maxillary and mandibular teeth in patients with unilateral cleft lip and palate (UCLP) and compare with the class I control group without cleft lip and palate (CLP). Design: A retrospective study. Setting: University department. Patients, Participants: The panoramic radiographs of 45 orthodontically untreated individuals with nonsyndromic UCLP (mean age 14.13 ± 0.75 years) and 45 skeletal class I individuals without CLP (mean age 14.01 ± 0.74 years). Interventions: The line passing through the most superior points of the condyles was taken as the reference. The angle between the long axes of the maxillary and mandibular teeth and reference line was measured digitally. With the purpose of determining condylar symmetry, mandibular asymmetry index measurements were utilized. Independent samples t test and paired samples t test were used for the statistical analyses. Main Outcome Measure(s): The mesiodistal angulation of the maxillary and mandibular teeth in patients with UCLP was measured. The differences between the contralateral sides were determined and compared to class I individuals without CLP. Results: No statistically significant difference was found among the condylar asymmetry in both groups (P > .05). The significant differences between the cleft and noncleft sides in the UCLP group was observed in the maxillary central, canine, first premolar and second molar teeth (P < .001, P = .002, P = .013, P = .012, respectively). The mean differences were found to be higher in the central and lateral incisors, canines and first premolars in the UCLP group (P < .001, P = .006, P = .001, respectively). Conclusions: Although the cleft-side maxillary central incisors tipped in a distal direction in patients with UCLP, the canine and first premolar showed more inclinations toward the mesial direction.
Using Cognitive Behavioral Therapy for Insomnia in People with Type 2 Diabetes, Pilot RCT Part I: Sleep and Concomitant Symptom

ABSTRACT Objective/Background The primary aim of this study was to examine the effect of Cognitive Behavioral Therapy for Insomnia (CBT-I) on the severity of insomnia in people with Type 2 diabetes (T2D) compared to a health education (HE) control group. The secondary aim was to explore the effect of CBT-I on other sleep outcomes and concomitant symptoms. Participants Twenty-eight participants with T2D were randomly assigned to CBT-I (n = 14) or HE (n = 14). Methods Validated assessments were used at baseline and post intervention to assess sleep outcomes and concomitant symptoms. In addition, actigraph and sleep diaries were used to measure sleep parameters. Independent sample t tests and Mann-Whitney U tests were utilized to measure between-group differences in the mean change scores. Results Participants in the CBT-I group showed higher improvements in the following mean change scores compared to the HE group: insomnia symptoms (d = 1.78; p < .001), sleep quality (d = 1.53; p =.001), sleep self-efficacy (d = 1.67; p < .001). Both actigraph and sleep diary showed improvements in sleep latency and sleep efficiency in the CBT-I group as compared to the HE group. In addition, participants in the CBT-I group showed greater improvement in the mean change scores of depression symptoms (d = 1.49; p = .002) and anxiety symptoms (d = 0.88; p = .04) compared to the HE group. Conclusion This study identified a clinically meaningful effect of CBT-I on sleep outcomes and concomitant symptoms in people with T2D and insomnia symptoms. Further work is needed to investigate the long-term effects of CBT-I in people with T2D and insomnia symptoms.
Systematic characterisation of temporal and fate asymmetries and its regulation during Caenorhabditis elegans Embryogensis /Ho Vincy Wing Sze.

Coordination of cell division timing is crucial for proper cell fate specification and tissue growth. However, the differential regulation of cell division timing across or within cell types during metazoan development remains poorly understood. To elucidate the systems-level genetic architecture coordinating division timing, we performed a high-content screening for genes whose depletion produced a significant reduction in the asynchrony of division between sister cells (ADS) compared to that of wild-type during Caenorhabditis elegans embryogenesis. We quantified division timing using 3D time-lapse imaging followed by computer-aided lineage analysis. A total of 822 genes were selected for perturbation based on their conservation and known roles in development. Surprisingly, we find that cell fate determinants are not only essential for establishing fate asymmetry, but also are imperative for setting the ADS regardless of cellular context, indicating a common genetic architecture used by both cellular processes. The fate determinants demonstrate either coupled or separate regulation between the two processes. The temporal coordination appears to facilitate cell migration during fate specification or tissue growth. Our quantitative dataset with cellular resolution provides a resource for future analyses of the genetic control of spatial and temporal coordination during metazoan development.
Reinfection of COVID‐19 after 3 months with a distinct and more aggressive clinical presentation: Case report

The sudden pandemic caused by SARS-CoV-2 exposed healthcare professionals worldwide to high viral loads, in an early epidemiological moment, often without the recommended personal protective equipment. We report the case of a Brazilian doctor who, after presenting a mild clinical episode of COVID-19 with molecular confirmation by RT-PCR in March 2020, appeared with a new acute infection by SARS-CoV-2 three months later. In middle of June, she had significant and very specific symptoms of COVID-19 with tomographic and serological confirmation of reinfection. There is a strong probability that these two episodes of infection were caused by different viral strains and that each genetic variation is related to specific clinical manifestations. We observed that, in addition to the different symptoms presented in the reinfections' episode, there was a more intense organic inflammatory response to the virus, with clinical repercussion. This clinical case should be an alert regarding the maintenance of individual protection among health cares, even in individuals who have already had COVID-19, since there is still no guarantee of prolonged immunity. This article is protected by copyright. All rights reserved.
Temperature increase and its effects on fish stress physiology in the context of global warming.

The capacity of fishes to cope with environmental variation is considered to be a main determinant of their fitness and is partly determined by their stress physiology. By 2100, global ocean temperature is expected to rise by 1-4°C, with potential consequences for stress physiology. Global warming is affecting animal populations worldwide, through chronic temperature increases and an increase in the frequency of extreme heatwave events. As ectotherms, fishes are expected to be particularly vulnerable to global warming. Although little information is available about the effects of global warming on stress physiology in nature, multiple studies describe the consequences of temperature increases on stress physiology in controlled laboratory conditions, providing insight into what can be expected in the wild. Chronic temperature increase constitutes a physiological load than can alter the ability of fishes to cope with additional stressors, which might compromise their fitness. Besides, rapid temperature increases are known to induce acute stress responses in fishes and might be of ecological relevance in particular situations. This review summarizes knowledge about effects of temperature increases on the stress physiology of fishes, and discusses these in a context of global warming. This article is protected by copyright. All rights reserved.
Update on ACR TI-RADS: Successes, Challenges and Future Directions, From the AJR Special Series on Radiology Reporting and Data Systems.

The American College of Radiology (ACR) TI-RADS is an ultrasound-based risk stratification system (RSS) for thyroid nodules that was released in 2017. Since publication, research has shown that ACR TI-RADS has a higher specificity compared to other RSSs and reduces the number of unnecessary biopsies of benign nodules compared to other systems by 19.9% to 46.5%. The risk of missing significant cancers using ACR TI-RADS is mitigated by the follow-up recommendations for nodules that do not meet criteria for biopsy. In practice, after a nodule's ultrasound features have been enumerated, ACR TI-RADS' points-based approach leads to clear management recommendations. Practices seeking to implement ACR TI-RADS must engage their radiologists in understanding how the system addresses the problems of thyroid cancer overdiagnosis and unnecessary surgeries by reducing unnecessary biopsies. This review article compares ACR TI-RADS to other RSSs and explores key clinical questions faced by practices considering its implementation. We also address the challenge of reducing interobserver variability in assigning ultrasound features. Finally, we highlight emerging imaging techniques and recognize the ongoing international effort to develop a system that harmonizes multiple RSSs, including ACR TI-RADS.
Covered stent placement for treatment of coarctation of the aorta: immediate and long-term results

Abstract Objectives This study aimed to describe the safety and efficacy of covered stents in patients with coarctation of aorta (CoA) for immediate and long-term follow-up. Background Covered stents are increasingly being used in (re)CoA, mainly to reduce the risk of aortic wall injuries (AWI). However, limited data are available on intermediate and long-term outcome. Methods In 89 patients (67.4% male) with a mean age of 23.9 ± 15.8 (min max range 5.1–71.6) years were 102 covered stents implanted (January 2003 – December 2017). Short-term pre/post-implant hemodynamics and angiographic data were reported. Changes in blood pressure, the use of antihypertensive drugs and complications were recorded during follow-up. Results The procedural success rate was 100%. The mean invasive ascending-to-descending aorta systolic gradient under general anaesthesia decreased from 25 ± 16 mmHg to 4 ± 7 mmHg (p < 0.001). After a mean follow-up time of 6.6 ± 3.7 years, there was a persistent improvement of the mean systolic blood pressure gradient between right arm and leg (−7 ± 18 vs 38 ± 24 mmHg; p < 0.001). A larger proportion of patients required antihypertensive medication (33.7% vs 50.0%, p = 0.017) and needed ≥ 2 drugs (20.2% vs 27.4%, p = 0.066) to control blood pressure. Long-term adverse events were found in 4.5% of patients [covered stent fracture (n = 3), aneurysm formation (n = 2)]. Conclusions Covered stent implantation for CoA is highly successful, safe and results in a persistent hemodynamic improvement in the immediate and long-term outcome. Lifelong follow-up with additional antihypertensive drug treatment is mandatory to maintain favourable hemodynamic results after stenting. CONDENSED ABSTRACT Long-term follow-up data on covered stents in patients with coarctation of the aorta are scarce. A cohort of 89 patients was reviewed. The procedural implantation success rate was 100%. The invasive gradient decreased from 25 ± 16 mmHg to 4 ± 7 mmHg (p < 0.001). After follow-up of 6.6 ± 3.7 years, there was a persistent improvement of the clinical systolic blood pressure gradient (−7 ± 18 vs 38 ± 24 mmHg; p < 0.001). However, a larger proportion of patients required antihypertensive medication (33.7% vs 50.0%, p = 0.017). Covered stent implantation results in favourable hemodynamic effects, but lifelong follow-up with additional antihypertensive drug treatment is mandatory to maintain these results.
Lumbar Spinal Fixation Removal by a Minimal Invasive Microscope-Assisted Technique. Case Report with Technical Description

The concept of minimally invasive spine surgery (MISS) has gained increasing popularity in the last decades. While MISS holds promise for faster patient recovery, and shorter hospital stays, the removal of the surgical fixation, when required, is still performed by an extensive approach often resulting in disabling pain and discomfort. We describe a novel minimal invasive microscope-assisted technique for lumbar spinal fixation removal. This technique has been successfully applied in a 35-year-old man, affected by back pain despite a previous posterior dynamic MISS L4–S1 fixation. The previous skin incisions were opened and under microscopic vision, the screws and the roads were dissected from the scars and removed. The patient was discharged on postoperative day-1. He reported a progressive improvement of the symptoms with a satisfactory cosmetic result. Minimal invasive microscope-assisted technique for spinal fixation removal offers a simple and effective surgical alternative to the traditional open surgery.
Diagnostic performance of the STOP-Bang questionnaire as a screening tool for obstructive sleep apnea in different ethnic groups.

STUDY OBJECTIVES The STOP-Bang questionnaire is a concise and easy screening tool for obstructive sleep apnea (OSA). Using modified body mass index (BMI), we assessed the diagnostic performance of the STOP-Bang questionnaire in predicting OSA in different ethnic groups undergoing surgery. METHODS This was a multicentre prospective cohort study involving patients with cardiovascular risk factors undergoing major non-cardiac surgery. Patients underwent home sleep apnea testing. All patients completed the STOP-Bang questionnaire. The predictive parameters of STOP-Bang scores were calculated against apnea-hypopnea index (AHI). RESULTS 1,205 patients from four ethnic groups (666 Chinese, 161 Indian, 195 Malay, and 183 Caucasian) were included in the study. The mean BMI ranged from 25 ± 4 to 30 ± 6 kg/m² and mean age ranged from 64 ±8 to 71 ±10 years. For the Chinese and Indian, diagnostic parameters were presented using BMI threshold of 27.5 kg/m² with the area under curve (AUC) to predict moderate-to-severe OSA were 0.709 (0.665-0.753) and 0.722 (0.635-0.808) respectively. For the Malay and Caucasian, diagnostic parameters were presented using BMI threshold of 35 kg/m² with the AUC for predicting moderate-to-severe OSA were 0.645 (0.572-0.720) and 0.657 (0.578-0.736) respectively. Balancing the sensitivity and specificity, the optimal STOP-Bang threshold for the Chinese, Indian, Malay and Caucasian were determined to be 4 or greater. CONCLUSIONS For predicting moderate-to-severe OSA, we recommend BMI threshold of 27.5 kg/m² for Chinese and Indian, and 35 kg/m² for Malay and Caucasian. The optimal STOP-Bang threshold for the Chinese, Indian, Malay and Caucasian is 4 or greater. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov, title: Postoperative Vascular Events in Unrecognised Obstructive Sleep Apnea, identifier: NCT01494181, URL: https://clinicaltrials.gov/ct2/show/study/NCT01494181.
Dennettia tripetala seeds inhibit ferrous sulphate-induced oxidative stress in rat tissues in vitro

Objectives: This study was designed to investigate the antioxidant activity of pepper fruit (Dennettia tripetala) seed extract. Methods: Phenol content, reducing activity, Fe(II)-chelating ability and 1,1-diphenyl-2 picryl hydrazyl (DPPH) radical-scavenging ability of the extract were consequently examined whereas the antioxidant potentials and inhibitory effect of D.tripetala seed on FeSO4-induced oxidative stress in some rat tissues were evaluated. Results: The seed had a high concentration of total phenol. Incubation of the liver and brain tissue homogenates in the presence of Fe2+ caused a major increase in the malondialdehyde (MDA) contents of the homogenates. However, the aqueous seed extract of D.tripetala caused a significant decrease in the MDA contents of the liver and brain in a dose-dependent manner. The aqueous extract of the seed had a considerably higher inhibitory effect on Fe2+-induced lipid peroxidation in the rat brain than the liver homogenates. Conclusion: The high inhibitory effect of Dennettia tripetala seed is attributable to its high phytochemical content, Fe2+ chelating ability, DPPH scavenging ability and reducing power. These results suggest that the seed extract of D.tripetala possess body antioxidant pool improving potentials which may contribute to the prevention of the incidence of neurodegenerative maladies.
Morphological classification of conspecific birds from closely situated breeding areas – A case study of the Common Nightingale

Abstract In this paper, a complex morphological comparison of four Common Nightingale groups (Luscinia megarhynchos) is demonstrated. In total, 121 territorial nightingales were mist-netted and measured individually on four study areas called ‘Bódva’, ‘Felső-Tisza’, ‘Szatmár-Bereg’ and ‘Bátorliget’ in the North-Eastern part of Hungary in 2006–2013. To distinguish groups by morphology, Classification and Regression Trees (CART), Random Forest (RF) and Linear Discriminant Analysis (LDA) methods were used. Comparison of the four studied Common Nightingale groups shows substantial morphological differences in the length of the second, the third and the fourth primaries (P2, P3, P4), in bill length (BL) and bill width (BW), while other characteristics showed greater similarities. Based on the results of all the applied classification methods, birds originated from Szatmár-Bereg were clearly distinguishable from the others. The differences in morphology can be explained by interspecific competition or phenotypic plasticity resulting from the change of ecological, environmental parameters. Our case study highlights the advantageous differences of the classification methods to distinguish groups with similar morphology and to choose important variables for classification. In conclusion, broad application of the classification methods RF and CART is highly recommended in comparative ecological studies.
H2O2-Responsive Antioxidant Nanoparticle Attenuates Whole Body Ischemia/Reperfusion-Induced Multi-Organ Damages

Mortality and morbidity after cardiac arrest remain high due to ischemia/reperfusion (I/R) injury causing multi-organ damages, even after successful return of spontaneous circulation. We previously generated H2O2-activatable antioxidant nanoparticles formulated with copolyoxalate containing vanillyl alcohol (PVAX) to prevent I/R injury. In this study, we examined whether PVAX could effectively reduce organ damages in a rat model of whole-body ischemia/reperfusion injury (WBIR). To induce a cardiac arrest, 70µl/100 g body weight of 1 mmol/l potassium chloride was administered via the jugular venous catheter. The animals in both the vehicle and PVAX-treated groups had similar baseline blood pressure. After 5.5 minutes of cardiac arrest, animals were resuscitated via intravenous epinephrine followed by chest compressions. PVAX or vehicle was injected after the spontaneous recovery of blood pressure was noted, followed by the same dose of second injection 10 minutes later. After 24 hours, multiple organs were harvested for pathological, biochemical, molecular analyses. No significant difference on the restoration of spontaneous circulation was observed between vehicle and PVAX groups. Analysis of organs harvested 24 hours post procedure showed that whole body I/R significantly increased reactive oxygen species (ROS) generation, inflammatory markers, and apoptosis in multiple organs (heart, brain, and kidney). PVAX treatment effectively blocked ROS generation, reduced the elevation of pro-inflammatory cytokines, and decreased apoptosis in these organs. Taken together, our results suggest that PVAX has potent protective effect against WBIR induced multi-organ injury, possibly by blocking ROS-mediated cell damage.
Post-traumatic growth in prisoners and its association with the quality of staff-prisoner relationships.

BACKGROUND Being sentenced to imprisonment can be traumatic. This may lead to further negative effects, including reoffending or disorders of mental health. Emerging research, however, has suggested that traumatic events can, at times, also lead to post-traumatic growth, leading us to question whether prisoners could experience this. AIMS Our aims were to explore the prevalence of post-traumatic growth in prisoners and any association between this and prisoners' perceptions of the quality of their relationships with staff. Our primary hypothesis was that there would be a positive association between perceptions of the quality of relationships with staff members and post-traumatic growth. We also hypothesised an interaction between staff-prisoner relationships and the extent to which sentencing was experienced as traumatic. METHOD The Post-traumatic Growth Inventory and the Barrett-Lennard Relationship Inventory were distributed to all 762 prisoners in a high-security prison for adult men in England. First, one-tailed correlations between variables were run, then a hierarchical regression analysis was conducted to test for an interaction between staff-prisoner relationship ratings, trauma of sentencing and post-traumatic growth. RESULTS Just over one fifth of the men (n = 160) returned questionnaires; 76 (48%) had scores indicative of moderate-to-high post-traumatic growth. There was a significant positive association between perceptions of the relationships with staff members and the post-traumatic growth reported. There was no significant interaction between the staff-prisoner relationships and the experience of trauma of imprisonment. CONCLUSIONS Our study extends understanding of prisoners through finding that higher levels of self-rated post-traumatic growth were associated with experiencing empathy, positive regard, acceptance and genuineness from prison staff. This highlights the need for high-quality relationships to be adopted in all aspects of prison setting and culture and offers further direction for research into such relationships and their role in promoting positive psychological outcomes.
Quantitative Estimation of LIMA Blood Flow between Extraluminal Papavarine vs Extraluminal Papavarine Plus Intraluminal Vasodilator Cocktail in CABG Patients

Objective: In this study, we aimed at a comparative quantitative estimation of the difference in LIMA blood flow between LIMAs treated with topical papaverine alone and LIMAs treated with a combination of topical papaverine plus an intraluminal cocktail of papaverine, nitroglycerine, and milrinone. Methods: Nearly 50 consecutive patients with similar demographics undergoing elective on-pump CABG were recruited for the study. After pedicled LIMA harvest, topical papaverine was sprayed on the pedicle and kept enveloped in papaverine soaked gauze. LIMA flow was then estimated. Later, intraluminal vasodilator solution of papaverine, NTG, milrinone, and heparinized blood were instilled in LIMA, and LIMA flows were estimated. Results: The mean LIMA flows with topical papaverine alone was 47.19 mL/min whereas the mean LIMA flows with topical papaverine plus intraluminal cocktail was 104 mL/min. There was a significant difference between the two flows as their mean was 56.815 mL/min and the paired t-test for significance had a P value of 0.0001. Conclusion: There was a significant difference in the LIMA flow when the LIMA had been treated with the intraluminal instillation of the vasodilator cocktail in addition to the topical application of papaverine solution. Therefore, intraluminal vasodilator cocktail of milrinone, NTG, and papaverine mixed with heparinized blood in addition to topical papaverine is a simple and effective method for LIMA preparation in CABG.