Miracle-dz/UniFAR-FTUs huggingface dataset:
Nkx2.5 insufficiency leads to atrial electrical remodeling through Wnt signaling in HL-1 cells

Homeobox protein Nxk-2.5 (Nkx2.5) is a homeobox transcription factor that promotes chamber-like myocardial gene expression. Data from a previous genome-wide association study suggested that Nkx2.5 may be associated with the genetic variation that underlies atrial fibrillation (AF). Nkx2.5 loss of function has been demonstrated to be associated with an increasing susceptibility of familial AF. Therefore, the aim of the present study was to investigate the effect of Nkx2.5 loss of function on electrophysiological substrates in HL-1 cells. To the best of our knowledge, the results demonstrated for the first time that Nkx2.5 expression was significantly decreased in a rat model exhibiting AF. The effect of silencing Nkx2.5 was assessed following transfection with adenoviral vectors with specific NKX2.5-shRNA. The effect of Nkx2.5 silencing on potassium/sodium hyperpolarization-activated cyclic nucleotide-gated channel 4 (HCN4), gap junction alpha-5 protein (Cx40), calcium handling proteins and protein Wnt-11 (Wnt11) expression levels was also assessed in HL-1 cells. The results revealed that Nkx2.5 silencing increased HCN4 expression, decreased Cx40 expression and disrupted the expression of calcium handling proteins. Additionally, Wnt11 signal protein expression was decreased following Nkx2.5 silencing. The results of the present study demonstrated that Nkx2.5 served as a transcriptional regulator of the electrophysiological substrates associated with AF.
Primary motor cortex has independent representations for ipsilateral and contralateral arm movements but correlated representations for grasping

Motor commands for the arms and hands generally originate in contralateral motor cortex anatomically. However, ipsilateral primary motor cortex shows activity related to arm movement despite the lack of direct connections. The extent to which the activity related to ipsilateral movement is independent from that related to contralateral movement is unclear based on conflicting conclusions in prior work. Here we present the results of bilateral arm and hand movement tasks completed by two human subjects with intracortical microelectrode arrays implanted in left primary motor cortex for a clinical brain-computer interface study. Neural activity was recorded while they attempted to perform arm and hand movements in a virtual environment. This enabled us to quantify the strength and independence of motor cortical activity related to continuous movements of each arm. We also investigated the subjects’ ability to control both arms through a brain-computer interface system. Through a number of experiments, we found that ipsilateral arm movement was represented independently of, but more weakly than, contralateral arm movement. However, the representation of grasping was correlated between the two hands. This difference between hand and arm representation was unexpected, and poses new questions about the different ways primary motor cortex controls hands and arms.
Determinants of the utilisation of sexual and reproductive healthcare services by male adolescents in the Tshwane Metropolitan Municipality in South Africa

Background Male adolescent sexual and reproductive health is one of the essential healthcare programmes in the world. However, male adolescents still face numerous challenges in this area. Determinants of the utilisation of these services need to be known to develop strategies to improve utilisation of the available services by male adolescents. Aim The aim of this study was to identify the determinants of the utilisation of sexual and reproductive healthcare services by male adolescents in the Tshwane Metropolitan Municipality in South Africa. Setting The study was conducted in the Tshwane Metropolitan Municipality in South Africa. Methods An explorative, descriptive and qualitative approach was employed. The study was contextual in nature, and purposive sampling was used. The population of the study consisted of male adolescents (aged 18–24 years) living in the Tshwane metropolitan Municipality. Twenty male adolescents participated in the study. Data collected using semistructured individual interviews were analysed using Tesch’s method of data analysis, and measures to ensure trustworthiness and ethical consideration pertaining to the study were established. Results The perception of existing services was found to be a significant individual factor influencing them negatively in utilising the services. This was linked to the violation of their rights as human beings by healthcare providers, their unmet expressed needs and the ineffectiveness as well as inefficiency of the support structures. Conclusion These results suggest that utilisation of these services by male adolescents can be improved by changing their perception of the existing services through support from different structures of the society.
a coping strategies intervention makes a difference on coping social support and quality of life of people living with hiv aids plwh

Background: Most patients with HIV confront a range of psychological challenges, including the prospect of loss of social support, worsening quality of life, and coping with uncertainty. Objective: This study aimed to assess the coping, social support and quality of life of PLWH and to determine effect of coping strategies intervention on coping, social support and quality of life of PLWH. Methods: A pre-experimental-one group pre-test post-test time series design was used on 200 PLWH who were seropositive for last six months and were recruited for the study from ART clinic of a tertiary care hospital in Northern India. BREF COPE, MOS Social support and WHOQOL-BREF HIV questionnaires were administered to assess the coping, social support and quality of life of PLWH respectively at baseline, posttest-1 (after one month) and posttest 2(after three months). Results: The most commonly used coping styles were acceptance and religion. The social supports mostly used by PLWH were tangible support and affectionate support, and least used support was positive social interaction. The lowest quality of life was seen in social relations, followed by physical quality of life. There was statistically significant increase in coping, social support and quality of life after the administration of coping strategies intervention. The structured coping intervention was found effective in improving coping, social support and quality of life. Conclusion: The findings of this study suggest that coping strategies intervention improved coping,QOL and social support in People living with HIV.
Can lactate clearance used to as a determinant of survival in mechanical ventilation follow up of critically ill patients?

Aim: Serum lactate level is known to have prognostic value in critical patients. Tissue hypoxia is a cause of an increase in lactate levels. A decrease in excretion and metabolism of lactate can increase lactate levels. In this study, we have investigated whether clearance of serum lactate could be a predictor of mortality in critically ill intubated patients at the emergency room. Materials and Methods: Study Groups. Data of 205 critically ill patients requiring intubation, admitted to the emergency department of Haydarpasa Numune Training and Research Hospital between January 2011 and December 2015 have been scanned retrospectively. The intubations were performed according to the latest rapid sequence intubation protocols. Results: There were 100 (48.8%) male and 105 (51.2%) female patients. Median, minimum, and maximum age were 76,19, and 104, respectively. The number of patients who could not survive was 157 (76.6%). The median, maximum, and minimum age in the non-survivor group were 78,31, and 104, while they were 70,19, and 90 in the survivor group, respectively. The difference was statistically significant (p
The Psychometric Properties and Clinical Use of the Turkish Version of the Functional Assessment of Cancer Therapy–Lung (FACT-L) Scale

Objectives:psychometric properties of the Turkish version of the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale and the sensitivity to changes in clinical indicators. Patients and Methods:This study was conducted within the framework of a national multicentre project. Patients with either stage IIIB or IV primary lung cancer diagnosed after April 2010were included in thisstudy. A classical confirmatory approach was used for both the reliability and validity analyses. Internal consistency was tested using Cronbach’s α value, and the validity analysis was performed using construct validity and clinical validity. Results:276 (92.3%) patients were male and the average age was 60.8 ± 9.4 years. The most frequently observed histological type was squamous cell carcinoma (36.8%), and 61.5% of these stage IV tumours. Cronbachs α values for the subscales ranged from 0.60 to 0.84. The majority of the FACT-L subscales revealed inter-scale correlation coefficients greater than 0.35. All sub-dimensions, except that of the social/family well-being scale, are able to significantly discriminate between stages IIIB and IV. Significantly lower scale scores were detected in patients with stage IV than stage IIIB. The comparative fit index was 0.917, and the root mean square error of approximation was 0.091. Dyspnoea, haemoptysis, chest pain, weight loss, anorexia, localised pain, and fever symptoms had a significant correlation with the FACT-L, trial outcome index, and lung cancer subscale. Conclusion:Turkish version of the psychometric properties of the original FACT-L scale is regarded as a valid and reliable tool and can be used safely in a clinical context when managing patients with lung cancer in Turkey.
Comparison between weekly versus 3-weekly paclitaxel in combination with carboplatin as neoadjuvant chemotherapy in advanced ovarian cancer

Objective To compare the efficacy and toxicity of dose-dense weekly paclitaxel and 3-weekly carboplatin (ddPC) as neoadjuvant chemotherapy (NAC) with the standard 3-weekly regimen. Methods A retrospective study of patients diagnosed with stage IIIc and IV ovarian cancer who received at least one cycle of NAC followed by interval debulking surgery between August 2015 and January 2018 was conducted. Patient characteristics, clinical and pathological response to NAC, surgical and survival outcome, and adverse event were compared. Results A total of 23 patients in the ddPC group and 50 patients in the standard group received a median of 3 cycles of NAC. Rate of grade ≥3 neutropenia was significantly higher in the ddPC group than the standard (82.6% vs. 22.0%, p<0.001). Patients in the ddPC group underwent dose-reduction more frequently (34.8% vs. 4.00%, p=0.001). Normalization of cancer antigen-125 post-NAC occurred more frequently in the ddPC group (73.9% vs. 46.0%, p=0.030). No residual disease rate (43.5% vs. 60.0%, p=0.188) and chemotherapy response score of 3 (34.8% vs. 26.0%, p=0.441) were not statistically different between two groups. There was no statistical difference in progression free survival (PFS) at 2 years (36.3% vs. 28.4%, p=0.454). Cox proportional hazard model showed that ddPC was not a significant determinant of PFS (p=0.816). Conclusion There was no difference between both regimens in terms of NAC response and survival outcomes. However, ddPC group showed higher hematologic toxicity requiring dose reduction.
Cardiovascular and metabolic risk factors of shift workers within the automotive industry

Background Previous research highlighted the importance of identifying the modifiable risk factors among shift workers in specific industries to take effective preventative and therapeutic steps to decrease the risks associated with non-communicable chronic diseases. Aim The aim of this study was to investigate the prevalence of cardiovascular and metabolic disease risk factors among shift workers within the automotive industry. Setting This study was conducted at a car manufacturing company in the Eastern Cape Province of South Africa. Methods The study employed a cross-sectional quantitative design. Body mass index was calculated, and the American College for Sports Medicine classification for normal weight, overweight and obesity was used to assess the weight status of the workers. Fasting blood glucose and cholesterol as well as blood pressure (BP) were also measured. Results Seventy-five automotive shift workers participated in the research. Twenty-three per cent of the participants had no risk factors, 30.6% had one risk factor, 34.7% had two risk factors and only 5.3% exhibited four risk factors. Sixty-six percent of participants were classified as either pre-obese or obese, while 55% were hypertensive. Systolic BP (r = 0.258; p < 0.05), diastolic BP (r = 0.342; p < 0.01), cholesterol (r = 0.258; p < 0.05) and age (r = 0.271; p < 0.05) significantly correlated with body mass index. Conclusion This study highlights the prevalence of risk factors for cardiovascular diseases among employees in the automotive industry. However, it does not show any risk factors for metabolic diseases.
USE ASSESSMENT AND COST ANALYSIS OF PARENTERAL NUTRITION FOR ADULTS IN A PUBLIC HOSPITAL

The Parenteral Nutrition (PN) is a high-alert medication, with high-cost, indicated for patients in which oral or enteral nutrition is not possible, is insufficient or contraindicated. There are two PN systems currently available, the custom system, prepared in hospital pharmacies or outsourced to specialized clinics, and the standardized compartmentalized bag system. Currently, it is fundamental that the application of financial resources in health be performed efficiently, considering effectiveness, safety and economy. The aim of this study was to evaluate the effectiveness of industrialized NP in the supply of energy and to perform a pharmacoeconomic analysis of cost minimization comparing standardized and custom bags. For this, was determined the total energy expenditure of patient and then determined the adequacy of the prescriptions of PN. For cost analysis was used the values of the standardized bags used for the patient in relation with the hypothetical cost if the same formulation were custom manipulated. 28 patients and 296 PN prescriptions were identified in the study period. The rates of adequacy to the energy expenditure were 39.3% on the 1st day, 34.6% on the 2nd day, 44.65% on the remaining days of treatment, and 33.33% on the last day. As for the analysis cost, the cost of standardized bags was lower in relation to manipulated bags (p <0.05). It was therefore verified that this was a high level of the inadequacy of the prescriptions of industrialized PN bags and that the same is more cost effective for the hospital in question.
The Presence of Wnt Signaling Mutations in Patients With Diabetic Retinopathy

Purpose: The relationship between poor hemoglobin A1c (HbA1c) control and risk of proliferative diabetic retinopathy (PDR) is well known. Nevertheless, some patients have discordant disease (controlled HbA1c and severe PDR or vice versa). One potential explanation for this discrepancy is the presence of underlying genetic mutations in the Wingless-related integration site (Wnt) signaling pathway. However, minimal clinical data exist on the presence of Wnt signaling mutations in patients with diabetes mellitus (DM) and the correlation with diabetic retinopathy. Methods: Retrospective, nonconsecutive case review of patients with type 1 or 2 DM who underwent genetic testing for at least 1 recognized Wnt signaling pathway mutation from 2011 to 2016. The clinical course and retinal images were reviewed for patients with identifiable mutations. Results: Thirty-six patients, ages 13 to 79 years, consented for genetic analysis. Three patients (8.3%) exhibited at least 1 recognized genetic mutation in the Wnt signaling pathway. Case 1 was a 65-year-old female with type 1 diabetes for > 20 years, HbA1c <7.0%, and no findings of diabetic retinopathy (Tetraspanin 12). Case 2 was a 13-year-old male with type 1 diabetes for 8 years, moderate HbA1c control (7.6-8.3%), and absence of diabetic retinopathy (Norrin). Case 3 was a 48-year-old male with severe PDR requiring multiple laser and antivascular endothelial growth factor (anti-VEGF) treatments despite well-controlled HbA1c (6.0%) (Frizzled-4). Conclusion: Wnt signaling pathway mutations exist in patients with DM. Further studies investigating the prevalence and clinical significance of these mutations in a larger diabetic population are warranted. Identification of these patients with genetic testing may enable earlier medical intervention.
Hypoxia modifies the polarization of macrophages and their inflammatory microenvironment, and inhibits malignant behavior in cancer cells

Macrophages are a heterogeneous group of phagocytes that play critical roles in inflammation, infection and tumor growth. Macrophages respond to different environmental factors and are thereby polarized into specialized functional subsets. Although hypoxia is an important environmental factor, its impact on human macrophage polarization and subsequent modification of the inflammatory microenvironment have not been fully established. The present study aimed to elucidate the effect of hypoxia exposure on the ability of human macrophages to polarize into the classically activated (pro-inflammatory) M1, and the alternatively activated (anti-inflammatory) M2 phenotypes. The effect on the inflammatory microenvironment and the subsequent modification of A549 lung carcinoma cells was also investigated. The presented data show that hypoxia promoted macrophage polarization towards the M2 phenotype, and modified the inflammatory microenvironment by decreasing the release of proinflammatory cytokines. Modification of the microenvironment by proinflammatory M1 macrophages under hypoxia reversed the inhibition of malignant behaviors within the proinflammatory microenvironment. Furthermore, it was identified p38 signaling (a major contributor to the response to reactive oxygen species generated by hypoxic stress), but not hypoxia-induced factor, as a key regulator of macrophages under hypoxia. Taken together, the data suggest that hypoxia affects the inflammatory microenvironment by modifying the polarization of macrophages, and thus, reversing the inhibitory effects of a proinflammatory microenvironment on the malignant behaviors of several types of cancer cell.
Metabolic Alterations Present in Obesity and Correlation with
Non-Alcoholic Fatty Liver Disease (NAFLD)

Currently in the world, thousands of people are somewhat overweight. Obesity, mainly characterized by the accumulation of fat in adipose tissue can cause various damages in the body, incluind Metabolic Syndrome. There is a high correlation between patients with this syndrome and those with Non-Alcoholic Fatty Liver Disease (NAFLD), being defined as the increase of the deposition of lipids in the liver in the absence of excessive consumption of alcohol. Excess intake of saturated fatty acids, increased free fatty acids derived from white adipose tissue lipolysis, reduced β-oxidation along with an increase in de novo lipogenesis and decreased synthesis or secretion of VLDL in hepatocytes contribute to the Hepatic steatosis. The treatment for these pathologies is initially based on diet changes and physical activity practice. In addition, there are still some classes of medicines available to treat the accumulation of fat in the liver as well as decrease insulin resistance. Studies still seek to find specific medicines for the treatment of NAFLD, therefore, the most effective method continues to be prevention, through an improvement in the quality of life, related to a balanced diet and the practice of regular physical activity.
Targeted next generation sequencing identifies a genetic spectrum of DNA variants in patients with hemiplegic migraine

Objective: Hemiplegic migraine in both familial (FHM) and sporadic (SHM) forms is a rare subtype of migraine with aura that can be traced to mutations in the CACNA1A, ATP1A2 and SCN1A genes. It is characterised by severe attacks of typical migraine accompanied by hemiparesis, as well as episodes of complex aura that vary significantly between individuals. Methods: Using a targeted next generation sequencing (NGS) multigene panel, we have sequenced the genomic DNA of 172 suspected hemiplegic migraine cases, in whom no mutation had previously been found by Sanger sequencing (SS) of a limited number of exons with high mutation frequency in FHM genes. Results: Genetic screening identified 29 variants, 10 of which were novel, in 35 cases in the three FHM genes (CACNA1A, ATP1A2 and SCN1A). Interestingly, in this suspected HM cohort, the ATP1A2 gene harboured the highest number of variants with 24/35 cases (68.6%), while CACNA1A ranked the second gene, with 5 variants identified in 7/35 cases (20%). All detected variants were confirmed by SS and were absent in 100 non-migraine healthy control individuals. Assessment of variants with the American College of Medical Genetics and Genomics guidelines classified 8 variants as pathogenic, 3 as likely pathogenic and 18 as variants of unknown significance. Targeted NGS gene panel increased the diagnostic yield by fourfold over iterative SS in our diagnostics facility. Conclusion: We have identified 29 potentially causative variants in an Australian and New Zealand cohort of suspected HM cases and found that the ATP1A2 gene was the most commonly mutated gene. Our results suggest that screening using NGS multigene panels to investigate ATP1A2 alongside CACNA1A and SCN1A is a clinically useful and efficient method.
Characterization of inferior alveolar nerve canal using orthopantomography in Bangalore population

Aims: This study was aimed to localize the mandibular canal (MC) for Bangalore population, using digital orthopantomographs (OPGs). Objectives: The aim was to assess the location of the inferior MC in both sides of the mandible and in both genders and to assess the bone levels in both the genders as age increases. Materials and Methods: This study consisted of 160 OPGs, D1 = Distance between superior border of MC and root apex of 2 nd molar, D2 = Distance between superior border of MC and root apex of 2 nd premolar, D3 = Distance from superior border of MC to alveolar bone crest. D4 = Height of MC, D5 = Distance between MC to the lower border of mandible. Results: Right and left side comparison between males and females were not significant. Right side comparison between males and females was significant for all except D2. Left side comparison between males and females was significant for all except D1. Correlation between age and parameter in males and females showed a positive correlation with all except D3. Conclusion: The results showed all the variables were correlated linearly with the age in both genders. Significant differences between males and females measurements were detected.