Miracle-dz/UniFAR-FTUs huggingface dataset:
Improving shared decision-making in pharmacist-led haematology clinics: a ‘Plan Do Study Act’ approach

Introduction The concept of person-centred care is regarded as an essential approach to healthcare. A core component of person-centred care is the shared decision-making process. There is evidence that effective shared decision-making can improve people's satisfaction with their care. This quality improvement project used the ‘Plan Do Study Act’ (PDSA) cycles to test the small changes made and to assess their impact on shared decision-making in clinic consultations. Objective To enhance patient satisfaction in pharmacist-led haematology clinics by improving shared decision-making. Methods Patients from a haematology clinic participated in a survey based on the validated ‘Benefit, Risk, Alternatives, do Nothing’ (BRAN) questions, which encourage patients’ involvement in shared decision-making conversations with clinicians. Data were collected from 142 consultations over 3 months, using three PDSA cycles, which provided the structure to implement changes, evaluate their impact, and build on the learning from previous cycles. The first cycle analysed the shared decision-making in the clinic. The second cycle involved shared decision-making training for pharmacists. On the third cycle, decision-making aid leaflets were implemented. Results First cycle results showed patients were mostly satisfied with the ‘Benefit’ statement. The second cycle revealed satisfaction improvements on ‘Risk’. On the third cycle, satisfaction increased on the ‘do Nothing’ statement. The baseline mean of the patient satisfaction score increased from 3.25/5 at the start to 3.75/5 by the end of the study. Conclusions The results show that each cycle had a positive effect, suggesting that training specialist pharmacists in person-centred care and shared decision-making led to an improvement in patient satisfaction. Encouraging patients to be involved in shared decision-making enabled them to ask questions in consultations and led to improved satisfaction. The project highlighted the importance of developing the skills and knowledge of the pharmacy workforce to support the needs of an expanding and ageing cancer population.
CRED9: a differentially expressed elncRNA regulates expression of transcription factor CEBPA

Enhancer RNAs (eRNA) are noncoding transcripts produced from active enhancers and have potential gene regulatory function. CCAAT enhancer-binding protein alpha (CEBPA) is a transcription factor generally involved in metabolism, cell cycle inhibition, hematopoiesis, adipogenesis, hepatogenesis, and is associated with tumorigenesis. In this study, we demonstrate that an enhancer-associated long noncoding RNA (elncRNA), transcribed from an enhancer located 9 kb downstream from the transcriptional start site (TSS) of CEBPA, positively regulates the expression of CEBPA. As a result, we named this elncRNA “CEBPA regulatory elncRNA downstream 9 kb” or “CRED9. ” CRED9 expression level positively correlates with CEBPA mRNA expression across multiple cell lines as detected by RT droplet digital PCR. Knockdown of CRED9 resulted in a reduction of CEBPA mRNA expression in Hep3B cells. Additionally, CRED9 knockdown in Hep3B and HepG2 cells resulted in lower CEBPA protein expression. We also found that knockdown of CRED9 in Hep3B cells caused a 57.8% reduction in H3K27ac levels at the +9 kb CEBPA enhancer. H3K27ac has previously been described as a marker of active enhancers. Taken together, the evidence presented here supports a previously proposed model whereby, in some contexts, eRNA transcripts are necessary to amplify and maintain H3K27ac levels at a given enhancer. Ultimately, this study adds to the growing body of evidence that elncRNA transcripts have important roles in enhancer function and gene regulation.
Effectiveness of powered exoskeleton use on gait in individuals with cerebral palsy: A systematic review

Background Cerebral palsy (CP) is a leading cause of childhood disability. The motor impairments of individuals with CP significantly affect the kinematics of an efficient gait pattern. Robotic therapies have become increasingly popular as an intervention to address this. Powered lower limb exoskeletons (PoLLE) are a novel form of robotic therapy that allow the individual to perform over-ground gait training and yet its effectiveness for CP is unknown. Purpose To determine the effectiveness of PoLLE use on gait in individuals with CP. Method A systematic search of eight electronic databases was conducted in March 2020. Studies included children (0–18 years) and or adults (18+ years) diagnosed with CP who used a PoLLE for gait training. This review was conducted and reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement, with the methodology registered with PROSPERO (CRD42020177160). A modified version of the McMaster critical review form for quantitative studies was used to assess the methodological quality. Due to the heterogeneity of the included studies, a descriptive synthesis using the National Health & Medical Research Council (NHMRC) FORM framework was undertaken. Results Of the 2089 studies screened, ten case series and three case studies met the inclusion criteria highlighting the current evidence base is emerging and low level. A range of PoLLEs were investigated with effectiveness measured by using a number of outcome measures. Collectively, the body of evidence indicates there is some consistent positive evidence on the effectiveness of PoLLE in improving gait in individuals with CP, with minimal adverse effects. While this is a positive and encouraging finding for an emerging technology, methodological concerns also need to be acknowledged. Conclusion With rapidly evolving technology, PoLLEs could play a transformative role in the lives of people impacted by CP. Ongoing research is required to further strengthen the evidence base and address current methodological concerns.
RHEB/mTOR hyperactivity causes cortical malformations and epileptic seizures through increased axonal connectivity

Hyperactivation of the mammalian target of rapamycin (mTOR) pathway can cause malformation of cortical development (MCD) with associated epilepsy and intellectual disability (ID) through a yet unknown mechanism. Here, we made use of the recently identified dominant-active mutation in Ras Homolog Enriched in Brain 1 (RHEB), RHEBp.P37L, to gain insight in the mechanism underlying the epilepsy caused by hyperactivation of the mTOR pathway. Focal expression of RHEBp.P37L in mouse somatosensory cortex (SScx) results in an MCD-like phenotype, with increased mTOR signaling, ectopic localization of neurons, and reliable generalized seizures. We show that in this model, the mTOR-dependent seizures are caused by enhanced axonal connectivity, causing hyperexcitability of distally connected neurons. Indeed, blocking axonal vesicle release from the RHEBp.P37L neurons alone completely stopped the seizures and normalized the hyperexcitability of the distally connected neurons. These results provide new evidence of the extent of anatomical and physiological abnormalities caused by mTOR hyperactivity, beyond local malformations, which can lead to generalized epilepsy.
Mobile Remote Presence Robots for Medical Consultation and Social Connectedness

We demonstrate that Mobile Remote Presence systems (MRP) aka telepresence robots can be successfully used in certain types of medical consultation such as consultation from a distance with residents of nursing homes. We argue that MRP afforded media richness also allows for supporting social connectedness during medically recommended isolation regimes similar to the ones that are implemented in residential care homes around the world during the SARS-CoVID-2 pandemic. Specifically, our research found that MRP are perceived as a more natural medium compared to typical telephones or videoconferencing via computers or tablets. MRP allow conversations to become more dynamic and engaging since remote participants are able to adjust their remote position and perspective during a conversation. Participants in our experiments reported they would be willing to engage even in difficult or emotional topics when using MRP however there are also certain types of situations that would still ask for face-to-face conversations.
Fatigue profile among petrochemical firefighters and its relationship with safety behavior: the moderating and mediating roles of perceived safety climate

The present study aimed to investigate fatigue among firefighters and its relationship with their safety behavior. The moderation and mediation effects of perceived safety climate on this relationship were also investigated. Firefighters from 10 petrochemical companies in Iran were investigated. Moderation analysis was performed based on hierarchical regression analyses and mediation effects were studied using structural equation modeling. A total number of 261 firefighters participated in this study. The mean scores of general fatigue, physical fatigue, reduced activity, reduced motivation and mental fatigue were 10.5, 9.0, 8.2, 7.6 and 8.7, respectively. Fatigue had a negative significant effect on firefighters’ safety behavior. Perceived safety climate had a mediation but not moderation effect on the relationship between fatigue and safety behavior of firefighters. Generally, the fatigue level among firefighters was fairly low, but had a significant negative effect on firefighter’s safety behavior. Perceived safety climate can mediate such a negative effect.
Characteristics and conflicts of interest at Food and Drug Administration Gastrointestinal Drug Advisory Committee meetings

Introduction The United States Food and Drug Administration (FDA) Gastrointestinal Drug Advisory Committee (GIDAC) is involved in gastrointestinal drug application reviews. Characteristics and conflicts of interest (COI) in GIDAC meetings are not well described. This study analyzed FDA GIDAC meetings and characteristics that predict recommendations. Methods In this cross-sectional study, all publicly available GIDAC meetings where proposed medications were voted on were included. Data were collected regarding indications, medication sponsor, primary efficacy studies, and voting member characteristics (e.g. committee membership, COI). Univariate analyses were conducted at per-meeting and per-vote levels to assess for predictors of committee recommendation and individual votes respectively. Results Thirty-four meetings with 476 individual votes from 1998–2018 were included. Twenty-three (68%) proposals were recommended for approval and 25 (74%) received FDA approval. Most proposals involved >1 primary study (n = 27, 79%). At least one voting member had a COI in 24 (71%) of 34 meetings. Twelve (35%) meetings had at least one sponsor COI. Among 476 individual votes, 74 (15.5%) involved a COI, with 33 (6.9%) sponsor COI. COI decreased significantly over time, with fewer COI in 2006–2010, 2011–2015, and 2016–2020 compared to 1996–2000 and 2001–2005 (p<0.01). There were no significant associations between pre-defined predictors, including COI, and committee level recommendations or individual votes (p>0.05 for all univariate analyses). Conclusions The GIDAC reviewed 34 proposals from 1998–2018. The majority were recommended for approval and later approved by the FDA, highlighting the GIDAC’s prominence in the regulatory process. COI are present among GIDAC panelists but decreasing over time and not associated with recommendations.
Gene expression profiles of peripheral blood mononuclear cells from patients with atopic dermatitis stimulated with Malassezia globosa

To the Editor: Malassezia located in the skin of patients with atopic dermatitis (AD) might be related to its pathogenesis, consisting of Malassezia globosa and Malassezia restricta as the dominant species. However, the specific molecular mechanisms of Malassezia on host immune cells from AD patients are still unclear. In our study, the Affymetrix Human Prime View array was used to detect the effect ofM. globosa on the gene expression of peripheral blood mononuclear cells (PBMCs) from AD patients, which was favorable to further understand the role of Malassezia colonization in the pathogenesis of AD.
Belief in an Afterlife Influences Altruistic Helping Intentions in Alignment With Adaptive Tendencies

Evolutionary definitions of altruism are only concerned with reproductive consequences and not motives or other psychological mechanisms, making them ideal for generalization to all forms of organisms. Hamilton’s inclusive fitness theory explains altruistic behavior toward genetic relatives and has generated extensive empirical support. Trivers’ theory of reciprocal altruism helps explain patterns of helping among non-kin, and other research has demonstrated that human helping intentions follow fitness consequences from age-based reproductive value on altruism. The current study examines a novel psychological factor, belief in the afterlife, which may influence altruistic helping intentions. Belief in the afterlife was incorporated into a previous study design assessing the effects of a target’s genetic relatedness and age-based reproductive value. The influences of inclusive fitness and target age were reproduced in a non-Western sample of participants (N = 300) in Iran. Belief in the afterlife predicted the overall confidence of risking one’s life to save another across all targets, and also moderated the effects of genetic relatedness and target age. Rather than promoting altruism equitably or advantaging those favored by adaptive tendencies, higher belief in an afterlife aligned with these tendencies in promoting further favoritism toward close kin and younger targets with higher reproductive value.
BRD4 methylation by the methyltransferase SETD6 regulates selective transcription to control mRNA translation

Lysine methylation of BRD4 selectively determines the recruitment of E2F1 to specific target genes to regulate mRNA translation. The transcriptional coactivator BRD4 has a fundamental role in transcription regulation and thus became a promising epigenetic therapeutic candidate to target diverse pathologies. However, the regulation of BRD4 by posttranslational modifications has been largely unexplored. Here, we show that BRD4 is methylated on chromatin at lysine-99 by the protein lysine methyltransferase SETD6. BRD4 methylation negatively regulates the expression of genes that are involved in translation and inhibits total mRNA translation in cells. Mechanistically, we provide evidence that supports a model where BRD4 methylation by SETD6 does not have a direct role in the association with acetylated histone H4 at chromatin. However, this methylation specifically determines the recruitment of the transcription factor E2F1 to selected target genes that are involved in mRNA translation. Together, our findings reveal a previously unknown molecular mechanism for BRD4 methylation–dependent gene-specific targeting, which may serve as a new direction for the development of therapeutic applications.
Screening the effective component of Leontice robustum by cell membrane chromatography

OBJECTIVE To screen the effective component of Leontice robustum with vasodilatation.METHODS The effective component of Leontice robustum was screened by cell membrane chromatography(CMC) and separated by liquid solid column chromatography.Its pharmacological effect was testified by the trial in vitro . RESULTS It was found that the n butanol extracting site of Leontice robustum (HMQ 4) was a effective part and the component(HMQ 44) separated from the part was a active one in vasodilatation.CONCLUSIONS The interaction between the effective component and the membrane or membrane receptor was reflected in the vascular CMC model.The retention characteristics(capacity factor) of component on the model system was found to have a good correlation with its pharmacological activity in vitro .
Assessment of respiratory effort with EMG extracted from ECG recordings during prolonged breath holds: Insights into obstructive apnea and extreme physiology

Breath holding divers display extraordinary voluntary control over involuntary reactions during apneic episodes. After an initial easy phase to the breath hold, this voluntary control is applied against the increasing involuntary effort to inspire. We quantified an electromyographic (EMG) signal associated with respiratory movements derived from broad bandpass ECG recordings taken from experienced breath holding divers during prolonged dry breath holds. We sought to define their relationship to involuntary respiratory movements and compare these signals with what is known to occur in obstructive sleep apnea (OSA) and epileptic seizures. ECG and inductance plethysmography records from 14 competitive apneists (1 female) were analyzed. ECG records were analyzed for intervals and the EMG signal was extracted from a re‐filtered version of the original broad bandpass signal and ultimately enveloped with a Hilbert transform. EMG burst magnitude, quantified as an area measure, increased over the course of the struggle phase, correlated with inductance plethysmography measures, and corresponded to significant variance in heart rate variability. We conclude that an EMG signal extracted from the ECG can complement plethysmography during breath holds and may help quantify involuntary effort, as reported previously for obstructive sleep apnea. Further, given the resemblance between cardiac and respiratory features of the breath hold struggle phase to obstructive apnea that can occur during sleep or in association with epileptic seizure activity, the struggle phase may be a useful simulation of obstructive apnea for controlled experimentation that can help clarify aspects of acute and chronic apnea‐associated physiology.
Altered Knee Laxity and Stiffness in Response to a Soccer Match Simulation in Players Returning to Sport Within 12 Months After Anterior Cruciate Ligament Reconstruction

Background: The acute effects of exercise on anterior knee laxity (AKL) and anterior knee stiffness (AKS) have been documented in healthy participants, but only limited evidence has been provided for athletes cleared to return to sports after anterior cruciate ligament (ACL) reconstruction (ACLR). Purpose/Hypothesis: The purpose was to determine if 45 minutes of a soccer match simulation lead to acute changes in AKL and AKS in soccer players returning to sport within 12 months after ACLR. We hypothesized that the reconstructed knee of the ACLR group would exhibit an altered response to sport-specific exercise. Study Design: Controlled laboratory study. Methods: A total of 13 soccer players cleared to return to sport after ACLR and 13 healthy control soccer players matched for age, physical activity level, limb dominance, and anthropometric characteristics were recruited. To assess the effects of a standardized soccer match simulation (Soccer Aerobic Field Test [SAFT45]) on AKL and AKS, an arthrometric evaluation was carried out bilaterally before and immediately after SAFT45. To conduct a comprehensive examination of the force-displacement curve, the absolute and side-to-side difference (SSD) values of both AKL and AKS were extracted at 67, 134, and 200 N. Results: The ACLR and control groups showed similar AKL and AKS at baseline (P > .05). In response to SAFT45, laxity increased bilaterally at all force levels by 14% to 17% only in the control group (P < .025). Similarly, AKS at 134 and 200 N decreased in response to SAFT45 only in the control group (10.5% and 20.5%, respectively; P < .025). After SAFT45, the ACLR group had 1.9 and 2.5 times higher SSDs of AKS at 67 and 134 N compared with the control group, respectively (P < .025), as well as a 1.9 times higher SSD of AKS at 134 N compared with baseline (P = .014). Conclusion: Soccer players at the time of return to sport after ACLR showed an altered mechanical response to a sport-specific match simulation consisting of bilaterally unchanged AKL and AKS. Clinical Relevance: Soccer players showing altered AKL and AKS in response to exercise after ACLR may not be ready to sustain their preinjury levels of sport, thus potentially increasing the risk of second ACL injuries.
Recognition of Neonatal Hospitalization Cost in an Intensive Care Unit in Greece and the Deviation from Its Current Reimbursement System

In this paper efforts have been made to record the actual, real cost of health care services in a Neonatal Intensive Care Unit (N.I.C.U.) of a public hospital. It is well known that, in recent years, the hospitals have been reimbursed with the system of Diagnosis-Related Groups (D.R.G.'s). The purpose of this study is to determine whether the costs according with D.R. G. 's correspond to the actual-real cost, as this is recorded in the N.I.C.U. This cost is called direct cost. Here is a case study of a premature neonate in the intensive care unit (N.I.C.U.). From the outset, the age of pregnancy, the birth weight, the duration of hospitalization in N.I.C.U. and the needs of the newborn in oxygen, medication, as well as nutrition are defined which are very important in shaping the cost. Then, the cost is calculated according to the D.R. G. 's system. By setting three basic diagnoses (I.C.D.-10), we find the D.R. G. which better describes the case, as well as the associated costs. Then, we calculate the direct cost and list all the consumables, exams, staff costs, overheads. Comparing the two results we find that the cost of D.R. G. does not meet the direct cost of hospitalization. There is a significant deviation from the actual real cost, which proves the under-costing of the health services. The D.R. G. 's system leads hospitals to increase their financial deficits and provide degraded quality health services. It is necessary to readjust the D.R. G. 's according to the reality and the redefinition of the hospital's reimbursement system to meet the direct - real cost of the health services offered.
Clinical characteristics, Cryptococcus neoformans genotypes, antifungal susceptibility, and outcomes in human immunodeficiency virus-positive patients in Beijing, China

Cryptococcus neoformans is an environmental fungal pathogen that causes opportunistic infections and severe disseminated meningoencephalitis, mainly in immunocompromised patients such as those with acquired immunodeficiency syndrome (AIDS). In this study, the clinical characteristics, treatment protocols, and outcomes of 70 patients with AIDS and Cryptococcus neoformans infection at Beijing Ditan Hospital were retrospectively analyzed. We performed antimicrobial sensitivity tests and multilocus sequence typing (MLST) on C. neoformans isolates from these patients. The most common symptoms were headache (58.6%), fever (54.3%), and high cerebrospinal fluid pressure (≥200 mm H2O) (71.4%). All patients were positive for C. neoformans antigen in blood or cerebrospinal fluid. The CD4 cell counts of 92.8% (65/70) of patients were <100 cells/µL. In total, 74 C. neoformans isolates were obtained from the 70 patients. The 65 isolates that could be typed fell into 12 sequence types (STs) by MLST: ST5, ST31, ST63, ST202, ST237, ST289, ST295, ST296, ST298, ST324, ST337, and ST359. ST5 was the major type, accounting for 78.5% of isolates (51/65). This study comprehensively assessed the clinical and molecular epidemiology of C. neoformans in patients with AIDS and may inform the development of targeted prevention and treatment strategies for immunocompromised patients with C. neoformans infection.