Miracle-dz/UniFAR-FTUs huggingface dataset:
Assessment of Spiritual Care Practices Among Nurses Caring for Cancer Patients in a Tertiary Hospital in Nigeria

Introduction The importance of spirituality in health and wellness has been documented in the literature. While the developed countries have reported robust evidence of spirituality in nursing practices, there is scant evidence in low- and middle-income countries like Nigeria. Objectives This study assessed the spiritual care practices of the nurses attending to cancer patients in a tertiary health institution in Ilorin. It further determined factors associated with spiritual caring practices among nurses. Methods A descriptive cross-sectional study was conducted between November 2021 and December 2021 to assess spiritual care practices among nurses caring for cancer patients. During the study period, 66 nurses were recruited randomly from the hospital's medical and surgical clinics, palliative care department, and Obstetrics and Gynecology department. Twelve items validated Nurses’ spiritual care practices questionnaire was adapted for this study. Data were analyzed using IBM SPSS version 23. Results The mean age of the respondents was 36.5 years ( + 10.1) while female respondents made up 83.3%. About 48% of the nurses had good spiritual caring practices while 52% had poor spiritual caring practices. Nurses with training in oncology (96%) with p = . 001 and those with spirituality training (86.2%) with p = . 017 showed significant association with spiritual care practices. This study concluded that spiritual care practices among nurses are sub-optimal with training as a significantly associated factor with spiritual care practices. Conclusion It is, therefore, suggested that spiritual care practices should be incorporated into all nursing training and curriculum. This will allow them to better support the spiritual needs of the patients, especially those with chronic diseases like cancer.
Hippo pathway activation mediates chemotherapy-induced anti-cancer effect and cardiomyopathy through causing mitochondrial damage and dysfunction

Rationale: Chemotherapy is a common clinical strategy for cancer treatment. However, the accompanied cardiomyopathy renders cancer patients under risk of another life-threatening condition. Whereas Hippo pathway is known to play key roles in both cancerogenesis and heart disease, it remains unclear whether Hippo pathway activation mediates chemotherapy-induced cardiomyopathy. Methods and Results: In human breast cancer cells, doxorubicin (DOX) significantly induced upregulation of Hippo kinase Mst1, inhibitory phosphorylation of YAP, mitochondrial damage, reduced cell viability and increased apoptosis. Hippo pathway inactivation by Mst1-siRNA transfection effectively improved cell survival and mitigated mitochondrial damage and cell apoptosis. Another anti-cancer drug YAP inhibitor verteporfin also induced lower cancer cell viability, apoptosis and mitochondrial injury. Chronic treatment with DOX in vivo (4 mg/kg/week for 6 weeks) caused mitochondrial damage and dysfunction, oxidative stress and cardiac fibrosis, while acute DOX treatment (16 mg/kg single bolus) also induced myocardial oxidative stress and mitochondrial abnormalities. Chronic treatment with verteporfin (2 months) resulted in cardiomyopathy phenotypes comparable to that by chronic DOX regimen. In transgenic mice with cardiac overexpression of kinase-dead mutant Mst1 gene, these adverse cardiac effects of DOX were significantly attenuated relative to wild-type littermates. Conclusions: Anti-cancer action of both DOX and verteporfin is associated with Hippo pathway activation. Such action on cardiac Hippo pathway mediates mitochondrial damage and cardiomyopathy.
Effects of Curative-Intent Treatments on Hepatocellular Carcinoma Survival in Alcohol-Related Cirrhosis: A Nationwide Study

Purpose The aim of curative-intent treatment for hepatocellular carcinoma (HCC) is to restore the patients’ survival to what it would have been, had they not developed HCC. We examined the chances of such ‘statistical cure’ from HCC in patients with cirrhosis due to alcohol-related liver disease (ALD cirrhosis). Patients and Methods Using nationwide Danish healthcare registries, all patients with ALD cirrhosis who were treated for HCC in 2004–2018 were identified and included in cohorts based on initial HCC treatment. We used cure fraction analyses to estimate the chance of being statistically cured by each HCC treatment. Results We included 1087 patients with HCC due to ALD cirrhosis, of whom 51 (4.7%) were treated with resection and 215 (19.8%) were treated with ablation. The cure fraction, ie the fraction of patients who experienced no excess mortality from HCC, was 31.8% (95% CI: 0.0−67.5) following resection and 22.9% (95% CI: 2.6−43.2) following ablation. In patients who were still alive five years after the initial HCC treatment, the likelihood of having been statistically cured at that time was 69.0% after resection and 60.2% after ablation. For both treatments, a 90% chance of having been statistically cured was reached after seven years. Conclusion Based on cure fraction analyses, resection for HCC statistically cures 31.8% of patients with HCC and underlying ALD cirrhosis, while ablation statistically cures 22.9% of patients. Seven years after curative-intent treatments for HCC, surviving patients are 90% likely to be statistically cured of HCC. This information is valuable to patients and the clinicians caring for them.
Bone Involvement as a Primary Rare Manifestation of Waldenstrom Macroglobulinemia: A Case Report and Prevalence in a Nationwide Population-Based Cohort Study

Bone involvement is a rare extranodal manifestation in patients with malignant lymphoproliferative diseases and has also been noted as a rare event in patients with Waldenstrom macroglobulinemia (WM). However, the actual prevalence has not been previously reported. We describe an unusual case of a patient with WM who presented with lower back pain and focal bone lesions at initial diagnosis. Magnetic resonance imaging (MRI) revealed multiple vertebral fractures. Positron emission tomography (PET) detected only nodal changes without pathological skeletal-related metabolic activity. Lymph node and bone marrow biopsies combined with an immunoglobulin M (IgM) M component revealed the diagnosis of WM. A next-generation sequencing (NGS) analysis using a targeted lymphoma panel of 59 recurrently mutated genes in lymphoid neoplasms showed mutations in the MYD88 and CD79B genes. After treatment with rituximab and bendamustine, the patient achieved a partial remission and pain relief. After 3 years of stable disease, a spontaneous subcapital fracture at the base of the femoral neck and new vertebral compression fractures occurred. Whole-body low-dose computed tomography (WB-LDCT) and bone density (dual energy X-ray absorptiometry (DEXA)) scan revealed marked osteopenia. After insertion of a hip prosthesis, examination of the removed hip showed infiltration of clonal lymphoplasmacytic cells. Our case confirms that one must be aware that bone involvement in patients with WM can occur as a rare manifestation. Interestingly, the MYD88/CD79B-mutated (MCD) genotype in diffuse large B-cell lymphoma is characterized by extranodal involvement and may also be involved in the pathogenesis of skeletal-related disease in the present case. As a follow-up to this unusual case, we have carried out an analysis based on the Danish Lymphoma Registry (LYFO) covering the entire national population in the period 2000 - 2020. The registry study included a cohort of 2,459 patients with WM and lymphoplasmacytic lymphoma. Our data revealed that primary bone involvement at diagnosis occurs in 1.75% of adults with WM. To the best of our knowledge, this is the first report of the prevalence of skeletal-related disease in a large nationwide cohort and defines bone involvement as an exceedingly rare event in WM.
Data-Driven Identification of Long-Term Glycemia Clusters and Their Individualized Predictors in Finnish Patients with Type 2 Diabetes

Purpose To gain an understanding of the heterogeneous group of type 2 diabetes (T2D) patients, we aimed to identify patients with the homogenous long-term HbA1c trajectories and to predict the trajectory membership for each patient using explainable machine learning methods and different clinical-, treatment-, and socio-economic-related predictors. Patients and Methods Electronic health records data covering primary and specialized healthcare on 9631 patients having T2D diagnosis were extracted from the North Karelia region, Finland. Six-year HbA1c trajectories were examined with growth mixture models. Linear discriminant analysis and neural networks were applied to predict the trajectory membership individually. Results Three HbA1c trajectories were distinguished over six years: “stable, adequate” (86.5%), “improving, but inadequate” (7.3%), and “fluctuating, inadequate” (6.2%) glycemic control. Prior glucose levels, duration of T2D, use of insulin only, use of insulin together with some oral antidiabetic medications, and use of only metformin were the most important predictors for the long-term treatment balance. The prediction model had a balanced accuracy of 85% and a receiving operating characteristic area under the curve of 91%, indicating high performance. Moreover, the results based on SHAP (Shapley additive explanations) values show that it is possible to explain the outcomes of machine learning methods at the population and individual levels. Conclusion Heterogeneity in long-term glycemic control can be predicted with confidence by utilizing information from previous HbA1c levels, fasting plasma glucose, duration of T2D, and use of antidiabetic medications. In future, the expected development of HbA1c could be predicted based on the patient’s unique risk factors offering a practical tool for clinicians to support treatment planning.
The Bone Bridge for Tibial ACL Graft Fixation: A Biomechanical Analysis of Different Tibial Fixation Methods for ACL Reconstruction

Background: The tibial fixation site is considered the weak link in anterior cruciate ligament (ACL) reconstruction, and conflicting results regarding the biomechanical properties of various fixation methods have been reported. Purpose: To examine knots tied over a bone bridge and its biomechanical properties as a suitable tibial fixation method in ACL reconstruction. Study Design: Controlled laboratory study. Methods: We divided 40 fresh-frozen porcine tibiae into 4 equal groups to evaluate flexor tendon grafts set with standard tibial fixation techniques: (1) bone bridge (BB group), (2) suspension button (SB group), (3) combined interference screw and bone bridge (IFS/BB group), and (4) combined interference screw and suspension button (IFS/SB group). Each construct was subjected to cyclic loading (1500 cycles, 50-250 N, 1 Hz) with a servohydraulic materials testing machine to measure elongation; load-to-failure testing (displacement rate: 25 mm/s) was then performed. Load to failure, stiffness, and yield load were compared between constructs using 1-way analysis of variance. Results: The hybrid fixation constructs (IFS/BB and IFS/SB groups) showed significantly better biomechanical properties than the isolated extracortical fixation constructs (BB and SB groups) (P < .05 for all). There were no differences between the isolated extracortical fixation constructs or between the hybrid fixation constructs in elongation or load to failure; however, stiffness of the IFS/BB group was significantly higher than that of the IFS/SB group (175.3 ± 16.6 vs 144.9 ± 20.1 N/mm, respectively; P < .05). Stiffness between the SB and BB groups was not significantly different. Conclusion: Hybrid fixation had superior biomechanical performance compared with isolated extracortical fixation. However, tibial graft fixation using a bone bridge either as isolated extracortical fixation or combined with an interference screw for hybrid fixation showed equivalent biomechanical properties compared with suspension button–based graft fixation. Clinical Relevance: The clinical use of a bone bridge for tibial graft fixation could reduce the cost for ACL reconstruction and lower the rate of implant-associated issues.
Nomograms Based on Non-High-Density Lipoprotein to Predict Outcomes in Patients with Prior Coronary Artery Bypass Grafting with Acute Coronary Syndrome: A Single-Center Retrospective Study

Introduction Non-high-density-lipoprotein cholesterol (non-HDL-C) is a secondary therapeutic target in cardiovascular diseases and is used for residual risk assessment in patients with coronary artery syndrome (ACS). This study was designed to determine the association between non-HDL-C in patients with prior coronary artery bypass graft (CABG) with ACS and clinical outcomes. Methods We retrospectively analyzed 468 patients with prior CABG with ACS and categorized them into two groups based on the median non-HDL-C level. The primary endpoints were major adverse cardiovascular events (MACEs), including cardiovascular death and recurrent myocardial infarction. Kaplan–Meier curves, Cox proportional-hazard regressions, and restricted cubic splines were used to determine the association between non-HDL-C and MACEs. The discrimination and reclassification of the nomogram based on non-HDL-C were assessed using time-dependent receiver operating characteristic (ROC) curves and net reclassification improvement (NRI). Results During the average follow-up time of 744.5 days, non-HDL-C was independently associated with the occurrence of MACEs (hazard ratio [HR] = 5.01, 95% confidence interval [CI] = 1.65–15.24; p = 0.005) after adjusting for other lipid parameters. The spline curves indicated a linear relationship between non-HDL-C and MACEs (p-nonlinear: 0.863). The time-dependent areas under the ROC curves of prior-CABG-ACS nomograms containing non-HDL regarding MACEs in two consecutive years were 91.7 (95% CI: 85.5–97.9) and 91.5 (95% CI: 87.3–95.7), respectively. The NRI analysis indicated that the prior-CABG-ACS model improved the reclassification ability for 1- and 2-year MACEs (22.4% and 7%, p < 0.05, respectively). Discussion Non-HDL is independently associated with the risk of MACEs in patients with prior CABG with ACS. The prior-CABG-ACS nomogram based on non-HDL-C and five convenient variables generates valid and stable predictions of MACE occurrence.
Pathogenesis and Therapy of Coagulation Disorders in Severe Acute Pancreatitis

Abstract Ischemia superimposed upon pancreatic edema leads to acute necrotizing pancreatitis. One possible mechanism contributing to ischemia is intravascular thrombogenesis since fibrin deposits have been detected in pancreatic capillaries by electron microscope. Current experimental and clinical data provided compelling evidence that the disorders in the blood coagulation system play a critical role in the pathogenesis of severe acute pancreatitis (SAP). This leads to microcirculatory failure of intra- and extrapancreatic organs and multiple organ failure and increases the case fatality rate. However, the mechanism of coagulopathy underlying SAP is not yet clear, although some anticoagulant drugs have entered clinical practice showing improvement in prognosis. Thus, enhanced understanding of the process might improve the treatment strategies with safety and high efficacy. Herein, the pathogenesis of the coagulation system of SAP was reviewed with a focus on the coagulation pathway, intercellular interactions, and complement system, thereby illustrating some anticoagulant therapies and potential therapeutic targets.
Binary Nanodrug-Delivery System Designed for Leukemia Therapy: Aptamer- and Transferrin-Codecorated Daunorubicin- and Luteolin-Coloaded Nanoparticles

Objective This study aimed to develop a binary nanodrug-delivery system decorated with aptamers (APs) and transferrin (Tf) and loaded with daunorubicin (Drn) and luteolin (Lut) for the treatment of leukemia. Methods Oligonucleotide AP- and Tf-contaiing ligands were designed and synthesized separately. AP-decorated Drn-loaded nanoparticles (AP-Drn NPs) and Tf-Lut NPs were prepared by self-assembly. An AP- and Tf-codecorated Drn- and Lut-coloaded nanodrug-delivery system (AP/Tf-Drn/Lut NPs) was prepared by self-assembly of AP-Drn NPs and Tf-Lut NPs. In vitro and in vivo efficiency of the system was evaluated on leukemia cell line and cell-bearing mouse model in comparison with single ligand–decorated, single drug–loaded and free-drug formulations. Results AP/Tf-Drn/Lut NPs were spherical and nanosized (187.3±5.3 nm) and loaded with about 85% of drugs. In vitro cytotoxicity of AP/Tf-Drn/Lut NPs was remarkably higher than single ligand–decorated ones. Double drug–loaded AP/Tf-Drn/Lut NPs exhibited higher tumor-cell inhibition than single drug–loaded ones, which showed a synergic effect of the two drugs. AP/Tf-Drn/Lut NPs achieved the most efficient antileukemic activity and absence of toxicity in vivo. Conclusion The present study showed that AP/Tf-Drn/Lut NPs are a promising drug-delivery system for targeted treatment of leukemia, due to the synergic effect of the two drugs in this system. The limitations of this system include stability during large-scale production and application from bench to bedside.
Lumbar vertebral pattern variation in the common opossum (Didelphis marsupialis Linnaeus, 1758): implication on lumbar nerve distribution

ABSTRACT The lumbar nerve distribution can differ depending on vertebral count variations among individuals of the same species. The variation in the lumbar vertebra formula and the lumbar nerve distribution in twenty adult common opossums (eight female and twelve males) was studied. Radiographs were taken to confirm vertebral identification and count. Two vertebral patterns were recognized: three specimens presented five lumbar vertebrae (5VP) and seventeen individuals presented six lumbar vertebrae (6VP). All the 6VP specimens had the same innervation pattern; however, the 5PV had three different innervation patterns (5PVa, 5VPB, and 5PVc). 5VPa and 6VP differed only in the origin of the lateral femoral cutaneous nerve (L2-L3 and L3, respectively). The differences among 5PVa, 5PVb, and 5VPc were seen in the iliohypogastric nerve, which was formed by L1 in 5VPa and 5VPb, and T13 in 5VPc. The ilioinguinal nerve was formed by L1-L2 in 5VPa and 5VPb, while it was formed by T13-L1 in 5VPc. The genitofemoral nerve was formed by L2-L3 in 5VPa, L2 in 5VPb, and L1-L2 in 5VPc. The cutaneous femoris lateralis was formed by L2-L3 in 5VPa and 5VPc, while it is formed only by L2 in 5VPb. The femoral and obturator nerves were formed by L3-L4 in 5VPa, and L2-L3 in 5VPb and 5VPc. The lumbosacral trunk originated from L4-L5-S1 in 5VP and L5-L6-S1 in 6VP. The data provided in this study may help understand the relationship between the spine and lumbosacral plexus variations and may find application in veterinary spine surgery.
Linkages Between Parenting Practices and Adolescents’ Life Satisfaction: The Mediating Role of Resilience

Background Life satisfaction is a critical antecedent of adolescents’ positive development in many domains. To promote adolescents to feel more satisfied with their lives, it is important to identify the factors influencing life satisfaction and to further investigate the inner mechanisms. The purpose of this research was to examine whether parenting practices were closely associated with life satisfaction among Chinese adolescents and whether these associations were mediated by adolescents’ resilience. Methods In this one-year interval longitudinal study, 353 students (50.7% girls) in Grade 7 and Grade 10 were recruited as participants. At the first wave of assessment, they reported parenting practices and resilience; at the second wave of assessment, they rated the level of life satisfaction. Results The results of this study revealed that parental responsiveness, demandingness, and autonomy granting promoted adolescents’ life satisfaction. Additionally, parental responsiveness and demandingness positively predicted adolescents’ life satisfaction through the mediating effect of adolescents’ resilience; however, resilience did not significantly mediate the relation between autonomy granting and adolescents’ life satisfaction. Conclusion Adolescents’ resilience plays a mediating role in the relations between parental responsiveness and demandingness and adolescents’ life satisfaction. The present study highlights the significance of providing adolescents with positive parenting practices and promoting adolescents’ development of resilience to elevate their life satisfaction.
Multiple pathways of lipid dysregulation in amyotrophic lateral sclerosis

Abstract Amyotrophic lateral sclerosis is a rapidly progressing neurodegenerative disease characterized by the degeneration of motor neurons and loss of various muscular functions. Dyslipidaemia is prevalent in amyotrophic lateral sclerosis with aberrant changes mainly in cholesterol ester and triglyceride. Despite this, little is known about global lipid changes in amyotrophic lateral sclerosis or in relation to disease progression. The present study incorporated a longitudinal lipidomic analysis of amyotrophic lateral sclerosis serum with a comparison with healthy controls using advanced liquid chromatography-mass spectrometry. The results established that diglyceride, the precursor of triglyceride, was enriched the most, while ceramide was depleted the most in amyotrophic lateral sclerosis compared with controls, with the diglyceride species (18:1/18:1) correlating significantly to neurofilament light levels. The prenol lipid CoQ8 was also decreased in amyotrophic lateral sclerosis and correlated to neurofilament light levels. Most interestingly, the phospholipid phosphatidylethanolamine and its three derivatives decreased with disease progression, in contrast to changes with normal ageing. Unsaturated lipids that are prone to lipid peroxidation were elevated with disease progression with increases in the formation of toxic lipid products. Furthermore, in vitro studies revealed that phosphatidylethanolamine synthesis modulated TARDBP expression in SH-SY5Y neuronal cells. Finally, diglyceride, cholesterol ester and ceramide were identified as potential lipid biomarkers for amyotrophic lateral sclerosis diagnosis and monitoring disease progression. In summary, this study represents a longitudinal lipidomics analysis of amyotrophic lateral sclerosis serum and has provided new insights into multiple pathways of lipid dysregulation in amyotrophic lateral sclerosis.