Miracle-dz/UniFAR-FTUs huggingface dataset:
The Role of Fear-Avoidance Beliefs on Low Back Pain-Related Disability in a Developing Socioeconomic and Conservative Culture: A Cross-Sectional Study of a Pakistani Population

Background The relationship of low back pain, the world’s top disabling condition, with functional disability is often explained by the mediation effect of fear, catastrophizing, and psychological distress. These relationships have not been explored within chronic back pain patients from a low socio-economic, predominantly Muslim country. Thus, it was unclear whether previously established pathways would be consistent in Pakistani pain patients to help guide Pakistani clinicians caring for back pain patients. This cross-sectional study translated English versions of questionnaires within the fear-avoidance model into Urdu, tested the clinimetric properties of the Urdu versions for people with chronic low back pain (CLBP) in Pakistan, and performed mediation analysis to investigate pathways of the fear-avoidance model. Methods Translation of questionnaires was completed in 4 steps using the forward-backward technique, with subsequent analyses for internal consistency (Cronbach’s α), construct validity (Pearson’s r-value), and test–retest reliability (ICC r-value). Multiple mediation analysis with bootstrapping was performed to analyze pathways within the fear-avoidance model from the Urdu translated questionnaires. Results A total of 151 people from Pakistan with CLBP completed the questionnaires, with good results for internal consistency (r > 0.85), convergent validity (r > 0.59), and test–retest reliability (ICC r > 0.85). The association of pain with disability was significant (B=2.36, r2 = 0.19, p<0.001), and the indirect effect of the mediators explained 81% of pain intensity’s total effect on disability. All mediators, apart from physical activity-related fear-avoidance beliefs, were significant mediators of the effect of pain intensity on disability. Conclusion The Urdu versions of the fear-avoidance questionnaires show good clinimetric properties for use in clinical settings and research in Pakistan. These analyses support existing data for the mediation effect of catastrophizing, psychological distress, and self-efficacy on pain-related disability, and extends these findings to suggest that fear about work may be more important in a relatively lower socioeconomic sample of pain patients.
Synergistic Cytotoxic Effect from Combination of Wedelolactone and Cisplatin in HeLa Cell Line: A Novel Finding

Context and Objective Cisplatin is a platinum drug in current clinical use for the treatment of cervical cancer. However, drug toxicity and resistance are its two major limitations. The aim of this investigation was to test the cytotoxic activity of potential phytochemicals alone and in combination with cisplatin in cervical cancer cells. Methods In this study, cytotoxicity of phytochemicals including wedelolactone (WDL), betulinic acid (BA) and epigallocatechin gallate (EGCG) was investigated in human cervical cancer cell line HeLa through 3-(4, 5-Dimethyl-2-thiazolyl)-2, 5-diphenyl-2H-tetrazolium bromide (MTT) reduction assay. Combined drug action resulting from the combination of cisplatin with WDL and BA was investigated in the same cell line through median effect principle. The combination index (CI) was taken as a measure of combined drug action. Results BA resulted in synergistic outcome when co-administered with cisplatin at 0/0 time; (bolus administration) while administration of either drug (cisplatin or BA) four hours before the other (0/4 or 4/0) resulted in antagonistic action. WDL, on the other hand, was found out to be synergistic at any of the applied sequence of drug administration (0/0, 0/4 or 4/0). Discussion and Conclusion This is the first study reporting cytotoxic activity of WDL in HeLa cells either as single agent or in combination with cisplatin. These results support the idea that sequential combination of cisplatin with WDL and BA may work effectively in cervical cancer cells.
Effect of Social Distancing on COVID-19 Incidence and Mortality in Iran Since February 20 to May 13, 2020: An Interrupted Time Series Analysis

Background and Objective Numerous actions have been taken to control the COVID-19 pandemic and reduce their morbidity and mortality. One of the most important measures in this regard is social distancing. However, there is limited evidence on the effectiveness of social distancing on COVID-19 incidence and mortality. Thus, the current study aimed to assess the effectiveness of social distancing measures on the COVID-19 incidence and mortality in Iran. Materials and Methods In the current quasi-experimental study, we evaluated the daily incidence cases and the number of deaths of COVID-19 in Iran before and after the implementation of social distancing measures. The segmented regression model was used to analyze the data. We also performed the interrupted time series (ITS) analysis using Newey ordinary least squares (OLS) regression-based methods. Results After the implementation of social distancing, the trend of both daily new cases and deaths due to COVID-19 was decreasing [(ß = −1.70 (95% CI = [−2.30 – −1.10; P < 0.001])) and (ß = −0.07 (95% CI = [−0.10 − −0.05; P < 0.001], respectively))]. Conclusion Social distancing along with other public health interventions could reduce the morbidity and mortality of COVID-19 to some degrees, and it seems to be crucial to control the pandemic.
RAPD analysis of the genetic polymorphism in European wheat genotypes.

Wheat (Triticum aestivum L.) is one of the main crops for human nutrition. The genetic variability of grown wheat has been reduced by modern agronomic practices, which inturn prompted the importance of search for species that could be useful as a genepool for the improving of flour quality for human consumption or for other industrial uses. Therefore, the aim of this study was to analyze the genetic diversity among 24 European wheat genotypes based on Random Amplified Polymorphism (RAPD) markers. A total of 29 DNA fragments were amplified with an average 4.83 polymorphic fragments per primer. The primer producing the most polymorphic fragments was SIGMA-D-P, where 7 polymorphic amplification products were detected. The lowest number of amplified fragments (3) was detected by using the primer OPB-08. The size of amplified products varied between 300 bp (OPE-07) to 3000 bp (SIGMA-D-P). The diversity index (DI) of the applied RAPD markers ranged from 0.528 (OPB-07) to 0.809 (SIGMA-D-P) with an average of 0.721. The polymorphism information content (PIC) of the markers varied from 0.469 (OPB-07) to 0.798 (SIGMA-D-P) with an average 0.692. Probability of identity (PI) was low ranged from 0.009 (SIGMA-D-P) to 0.165 (OPB-07) with an avarage 0.043. The dendrogram based on hierarchical cluster analysis using UPGMA algorithm was prepared. Within the dendrogram was separated the unique genotype Insegrain (FRA) from the rest of 23 genotypes which were further subdivided into two subclusters. In the first subclaster were grouped 13 genotypes and the second subcluster involved 10 genotypes. The first subcluster also included the genotype Bagou from France, in which were detected novel high - molecular - weight glutenin subunits using SDS-PAGE. Using 6 RAPD markers only two wheat genotypes have not been distinguished. Through that the information about genetic similarity and differences will be helpful to avoid any possibility of elite germplasm becoming genetically uniform.
Exploring the Relational Intervention of Storytelling: A Qualitative Study of the Patient Stories Project in a Single ICU

Objectives: Our study objective was to explore nurses’ experiences of how the Patient Stories Project, an intervention consisting of garnering and sharing ICU survivor stories with the ICU team, influenced their perceptions of the value of their work and their nurse-patient relationships. Design: This was a qualitative descriptive case study that used thematic analysis. Setting: This study was conducted in a single, 34-bed adult ICU in a Canadian tertiary care teaching hospital, serving a mixed medical and surgical patient population and employing over 200 nurses. Subjects: Semistructured focus groups with 12 ICU nurses were conducted between June 2019 and July 2019. Intervention: The Patient Stories Project is a systematic process for collecting and sharing former patients’ stories. On a regular basis, former ICU patients return to the ICU to say, “thank you,” share their experiences, and tell their stories to staff. Measurements and Main Results: Storytelling through the Patient Stories Project gives meaning to nurses’ work and provides avenues for nurses to think about their work more positively. Key themes were as follows: 1) perspective taking, 2) emphasizing the value in caring, 3) providing positive closure, 4) engendering team belonging, and 5) building a sense of hope. Conclusions: This study addresses the Critical Care Societies Collaboratives “call to action” to create a healthy work environment. Nurse focus group participants articulated how an initiative such as the Patient Stories Project may augment the relational aspects of work that are important to nurses, as well as their patients and families. Our study results have implications for the importance of using storytelling as a relational strategy to protect against depersonalization and cynicism, elements of burnout.
MicroRNA-34b expression enhances chemosensitivity of endometrial cancer cells to paclitaxel

Aberrant DNA methylation is widely observed in various types of cancer, and expression of microRNAs (miRNAs/miRs) is suppressed by DNA methylation. The present study explored tumor suppressor miRNAs downregulated by DNA methylation in endometrial cancer cells, as the basis of a novel therapeutic approach for endometrial cancer. Among 821 candidate miRNAs, miR-34b was identified as an upregulated miRNA after demethylation treatment in all four endometrial cancer cell lines (HEC-108, SNG-II, Ishikawa and HHUA) examined. miR-34b expression with or without demethylation treatment in cancer cells was confirmed by TaqMan quantitative PCR. MYC and MET, the predicted target genes of miR-34b, were downregulated at both the RNA and protein levels following miR-34b overexpression. Following miR-34b treatment, inhibition of cell growth and invasion, and cell cycle arrest were observed in HEC-108 cells. Sensitivity to paclitaxel was increased in cancer cells with miR-34b overexpression, compared with untreated cancer cells, but this difference was not identified for cisplatin or doxorubicin. In vivo, combination treatment with miR-34b and paclitaxel markedly reduced tumor growth compared with treatment with negative control miRNA and paclitaxel. These data suggest that miR-34b enhances paclitaxel sensitivity in endometrial cancer cells, and that miR-34b and MET are key targets for treatment of endometrial cancer. The present results may contribute to the development of combination treatment with a demethylation agent, miR-34b mimic or MET inhibitor and an anticancer drug.
The Impact of Virologic Parameters and Liver Fibrosis on Health-Related Quality of Life in Black African Patients with Chronic Hepatitis B: Results from a High Endemic Area

Background The effects of virologic parameters, liver fibrosis, and treatment on the HRQoL in black African patients with CHB are unknown. Objective To determine the magnitude and the effects of hepatitis B e antigen (HBeAg), hepatitis B surface antigenemia (HBs antigenemia), viral load, liver fibrosis and treatment on HRQoL impairment in black African patients with CHB using the SF36 (SF36) and chronic liver disease questionnaires (CLDQ). Materials and Methods HRQoL comparison was determined in a case–control study and enrolled 214 patients with CHB (mean age: 42 years, male: 65.9%) and 210 healthy controls subjects (mean age: 37.8 years; male: 63.8%). Control subjects were younger than those with CHB (p=0.01). Analysis of covariance, Welch test and linear regression were used to compare HRQoL between subgroups. Results Adjusted to age and gender, patients with CHB elicited low mean scores on the subscales of role-physical (66.9 vs 78, p=0.001), role-emotional (64 vs 77.5, p=0.01), bodily pain (70.8 vs 96.2, p=0.001), social functioning (74.6 vs 84.5, p=0.003) and general health (64.6 vs 74.4, p=0.03) in comparison with control subjects. Multivariate analysis showed that CHB impaired HRQoL on physical (β= −16.7 (1.8), p<0.0001) and mental component summaries (β= −5.1 (2.0), p=0.01) adjusted to others variables. Patients with HBeAg negative CHB elicited low scores on physical (p=0.004) and mental (p=0.05) component summaries and low CLDQ’s average score (p=0.002) in comparison with those positive. Patients with low (≤1000 IU/mL) HBs antigenemia (p=0.03) or viral load (p=0.03) scored less on physical component summary and those with significant fibrosis or cirrhosis scored less (p=0.003) on mental component summary. Conclusion Black African patients with CHB expressed poor HRQoL, particularly those with HBeAg negative CHB, low viral load, or HBs Antigenemia.
Convalescent Plasma Therapy in Four Critically Ill Pediatric Patients With Coronavirus Disease 2019: A Case Series

Background: Coronavirus disease 2019 is a pandemic with no specific therapeutic agents or vaccination. Small published case series on critically ill adults suggest improvements in clinical status with minimal adverse events when patients receive coronavirus disease 2019 convalescent plasma, but data on critically ill pediatric patients are lacking. We report a series of four critically ill pediatric patients with acute respiratory failure who received coronavirus disease 2019 convalescent plasma as a treatment strategy for severe disease. Case Summary: Patients ranged in age from 5 to 16 years old. All patients received coronavirus disease 2019 convalescent plasma within the first 26 hours of hospitalization. Additional disease modifying agents were also used. All patients made a full recovery and were discharged home off of oxygen support. No adverse events occurred from the coronavirus disease 2019 convalescent plasma transfusions. Conclusion: Coronavirus disease 2019 convalescent plasma is a feasible therapy for critically ill pediatric patients infected with severe acute respiratory syndrome coronavirus 2. Well-designed clinical trials are necessary to determine overall safety and efficacy of coronavirus disease 2019 convalescent plasma and additional treatment modalities in pediatric patients.
The Relationship Between Lateral Femoral Anatomic Structures and the Femoral Tunnel Outlet in Anterior Cruciate Ligament Reconstruction Using the Transportal Technique: A 3-Dimensional Simulation Analysis

Background: The relationship between the lateral femoral anatomic structures and femoral tunnel outlet according to changes in knee flexion and transverse drill angle during femoral tunnel creation in anterior cruciate ligament (ACL) reconstruction remains unclear. Purpose: To investigate the relationships between the lateral femoral anatomic structures and femoral tunnel outlet according to various knee flexion and transverse drill angles and to determine appropriate angles at which to minimize possible damage to the lateral femoral anatomic structures. Study Design: Controlled laboratory study. Methods: Simulation of ACL reconstruction was conducted using a 3-dimensional reconstructed knee model from the knees of 30 patients. Femoral tunnels were created using combinations of 4 knee flexion and 3 transverse drill angles. Distances between the femoral tunnel outlet and lateral femoral anatomic structures (minimum safe distance, 12 mm), tunnel length, and tunnel wall breakage were assessed. Results: Knee flexion and transverse drill angles independently affected distances between the femoral tunnel outlet and lateral femoral anatomic structures. As knee flexion angle increased, the distance to the lateral collateral ligament, lateral epicondyle, and popliteal tendon decreased, whereas the distance to the lateral head of the gastrocnemius increased (P < .001). As the transverse drill angle decreased, distances to all lateral femoral anatomic structures increased (P < .001). Considering safe distance, 120°, 130°, or 140° of knee flexion and maximum transverse drill angle (MTA) could damage the lateral collateral ligament; 130° or 140° of knee flexion and MTA could damage the lateral epicondyle; and 110° or 120° of knee flexion and MTA could damage the lateral head of the gastrocnemius. Tunnel wall breakage occurred under the conditions of MTA – 10° or MTA – 20° with 110° of knee flexion and MTA – 20° with 120° of knee flexion. Conclusion: Approximately 120° of knee flexion with MTA – 10° and 130° or 140° of knee flexion with MTA – 20° or MTA – 10° could be recommended to prevent damage to the lateral femoral anatomic structures, secure adequate tunnel length, and avoid tunnel wall breakage. Clinical Relevance: Knee flexion angle and transverse drill angle may affect femoral tunnel creation, but thorough studies are lacking. Our findings may help surgeons obtain a stable femoral tunnel while preventing damage to the lateral femoral anatomic structures.
Prevalence and risk factors of secondary traumatic stress in emergency call-takers and dispatchers – a cross-sectional study

ABSTRACT Background: Emergency call-takers and dispatchers (ECDs) field emergency calls and dispatch the appropriate emergency services. Exposure to the callers’ traumatic experiences can lead to psychological stress and even to secondary traumatic stress (STS). In addition, previous studies suggest that ECDs may also suffer from posttraumatic stress disorder (PTSD), depression and anxiety disorders. Objectives: To investigate the prevalence of STS and to screen for PTSD, depression and anxiety disorders in ECDs. We further aimed to identify sociodemographic variables and attachment styles as possible risk factors for higher STS symptom load in ECDs. Methods: STS and PTSD regarding lifetime traumatic events, as well as depression and anxiety disorders, were investigated in N = 71 ECDs. Multiple regression analysis was performed to identify possible risk factors for higher STS symptom load. Results: The analysis determined a prevalence of 8.5% for moderate STS and 2.8% for severe STS. A total of 11.3% of the ECDs screened positive for PTSD, 15.5% for depression and 7.0% for anxiety disorders. A higher number of children and the absence of a secure attachment style were identified to be significantly associated with higher STS symptom load. Conclusions: STS resulting from exposure to traumatic emergency caller content is a common phenomenon among ECDs. Specific sociodemographic variables and the attachment style are significant risk factors of STS symptom load. ECDs should receive regular psychoeducational interventions and supervision to identify and mitigate mental distress at an early stage.
Design and Fabrication of Dual Redox Responsive Nanoparticles with Diselenide Linkage Combined Photodynamically to Effectively Enhance Gene Expression

Background PEI is currently the most used non-viral gene carrier and the transfection efficiency is closely related to the molecular weight; however, the prominent problem is that the cytotoxicity increased with the molecular weight. Methods A novel redox responsive biodegradable diselenide cross-linked polymer (dPSP) was designed to enhance gene expression. ICG-pEGFP-TRAIL/dPSP nanoparticles with high drug loading are prepared, which have redox sensitivity and plasmid protection. The transfection efficiency of dPSP nanoparticle was evaluated in vitro. Results The plasmid was compressed by 100% at the N/P ratio of 16, and the particle size was less than 100 nm. When explored onto high concentrations of GSH/H2O2, dPSP4 degraded into small molecular weight cationic substances with low cytotoxicity rapidly. Singlet oxygen (1O2) was produced when indocyanine green (ICG) was irradiated by near-infrared laser irradiation (NIR) to promote oxidative degradation of dPSP4 nanoparticles. Under the stimulation of NIR 808 and redox agent, the particle size and PDI of ICG-pDNA/dPSP nanoparticle increased significantly. Conclusion Compared with gene therapy alone, co-transportation of dPSP4 nanoparticle with ICG and pEGFP-TRAIL had better antitumor effect. Diselenide-crosslinked polyspermine had a promising prospect on gene delivery and preparation of multifunctional anti-tumor carrier.
The POSITIONED Study: Prone Positioning in Nonventilated Coronavirus Disease 2019 Patients—A Retrospective Analysis

Supplemental Digital Content is available in the text. Objectives: Given perceived similarities between coronavirus disease 2019 pneumonia and the acute respiratory distress syndrome, we explored whether awake self-proning improved outcomes in coronavirus disease 2019-infected patients treated in a rural medical center with limited resources during a significant local coronavirus disease 2019 outbreak. Design: Retrospective analysis of prospectively collected clinical data. Setting: Single-center rural community-based medical center in Grand Island, NE. Patients: One hundred five nonintubated, coronavirus disease-infected patients. Interventions: None. Measurements and Main Results: After patients were educated on the benefits of awake self-proning, compliance was voluntary. The primary outcome was need for intubation during the hospital stay; secondary outcomes included serial peripheral capillary oxygen saturation measured by pulse oximetry to the Fio2 ratios, in-hospital mortality, and discharge disposition. Of 105 nonintubated, coronavirus disease-infected patients, 40 tolerated awake self-proning. Patients who were able to prone were younger and had lower disease severity. The risk of intubation was lower in proned patients after adjusting for disease severity using Sequential Organ Failure Assessment scores (adjusted hazard ratio, 0.30; 95% CI, 0.09–0.96; p = 0.043) or Acute Physiology and Chronic Health Evaluation II scores (adjusted hazard ratio, 0.30; 95% CI, 0.10–0.91; p = 0.034). No prone patient died compared with 24.6% of patients who were not prone (p < 0.001; number needed to treat = 5; 95% CI, 3–8). The probability of being discharged alive and peripheral capillary oxygen saturation measured by pulse oximetry to the Fio2 ratios were statistically similar for both groups. Conclusions: Awake self-proning was associated with lower mortality and intubation rates in coronavirus disease 2019-infected patients. Prone positioning appears to be a safe and inexpensive strategy to improve outcomes and spare limited resources. Prospective efforts are needed to better delineate the effect of awake proning on oxygenation and to improve patients’ ability to tolerate this intervention.
Islet Transplantation Imaging in vivo

Abstract Although islet transplantation plays an effective and powerful role in the treatment of diabetes, a large amount of islet grafts are lost at an early stage due to instant blood-mediated inflammatory reactions, immune rejection, and β-cell toxicity resulting from immunosuppressive agents. Timely intervention based on the viability and function of the transplanted islets at an early stage is crucial. Various islet transplantation imaging techniques are available for monitoring the conditions of post-transplanted islets. Due to the development of various imaging modalities and the continuous study of contrast agents, non-invasive islet transplantation imaging in vivo has made great progress. The tracing and functional evaluation of transplanted islets in vivo have thus become possible. However, most studies on contrast agent and imaging modalities are limited to animal experiments, and long-term toxicity and stability need further evaluation. Accordingly, the clinical application of the current achievements still requires a large amount of effort. In this review, we discuss the contrast agents for MRI, SPECT/PET, BLI/FI, US, MPI, PAI, and multimodal imaging. We further summarize the advantages and limitations of various molecular imaging methods.