Miracle-dz/UniFAR-FTUs huggingface dataset:
Characteristics of craniofacial morphology and factors affecting them in patients with isolated cleft palate

Background Myriad maxillo-mandibular occlusal relationships are observed in patients with isolated cleft palate (ICP), unlike in patients with other cleft types, such as cleft lip and palate. Objectives This study aimed to categorise the characteristics of craniofacial morphology in patients with ICP, and investigate the clinical factors affecting these categorised morphological characteristics. Methods Thirty-six girls with ICP (age (mean ± SD): 5.36 ± 0.36 years) underwent cephalometric measurement. Their craniofacial morphology was categorised using cluster analysis. Profilograms were created and superimposed onto the standard Japanese profilograms to visualise the morphological characteristics of each group (cluster). The mean values and variations in the linear and angular measurements of each group were compared with the Japanese standards and statistically analysed using Dunnett’s test after the analysis of variance. Fisher’s exact test was used to analyse the differences between the cleft types (cleft in the hard and/or soft palate) and skills of the operating surgeons in the groups. Results Cluster analysis of craniofacial morphologies in patients with ICP resulted in the formation of three categories: the first cluster exhibited a relatively harmonious anteroposterior relationship between the maxilla and the mandible (22.2%); the second cluster exhibited crossbite owing to a significantly smaller maxilla (33.3%); and the third cluster exhibited a smaller mandible with posterior rotation showing skeletal class II malocclusion (44.4%). Differences in cleft types and surgeons were not associated with the distribution of patients in each cluster. Conclusions Patients with ICP exhibited characteristic morphological patterns, such as bimaxillary retrusion or severe mandibular retrusion, besides the anterior crossbite frequently found in patients with cleft lip and palate . Understanding the typical morphological characteristics could enable better diagnostic categorisation of patients with ICP, which may eventually improve orthodontic treatment planning.
Reply to Wolowich and Kwon

concentrations as these data are not presented in tabular form in the manuscript. Yao reported the predicted lungto-plasma ratio of HCQ was 400 to 1; using a blood-to-plasma ratio of 7.2, this is a lung-to-blood ratio of 56 to 1. This figure is misleading as our simulation demonstrates that 98% of the drug in the lung is sequestered in the lung lysosomes after the first dose of the regimen (Table 1). Our simulation also predicts lysosomal concentrations in the lung to be >20 000 μM for the majority of the 5-day dosage regimen and the 5-day postregimen period. The lack of lysosomal binding in a model used to predict the concentration profile of a drug known to be highly lysomotropic overestimates drug in the lung tissue, as a significant amount of the drug is sequestered in the lysosomes. Whether the drug in the lysosomes retains antiviral activity is unknown. We also examined the model used by Yao et al available on the Simcyp website [2]. Several discrepancies were noted. Bioavailability (F) in the Tett et al [4] study used to calibrate the model was 0.75; Yao used F = 1 in the simulations. The Tett et al study absorption rate constant ka was 0.5 h-1; Yao used 0.8 h-1. Yao et al admits the use of a “high” lungto-plasma tissue partition coefficient (Kp) derived from animal studies. The actual value used was 108 with a scalar of 2.45, meaning the Kp was 265. As has been documented several times in the literature, Kp derived from animal tissue homogenate should not be used in PTA analysis [5–8]. They also employed an additional organ with a Kp of 547; when the scalar of 2.45 is applied, the Kp is 1340. The net result of these discrepancies will underestimate drug in the blood, overestimate drug in the lungs, and moreover place the drug in the lung tissue and not the lung lysosomes. These findings suggest that the model predictions published by Yao et al are suspect and could mislead practitioners to use the drug in COVID patients with little evidence of efficacy.
A Validation Study of the Rainbow Model of Integrated Care-Measurement Tool for Patients in China

Introduction: The original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care (RMIC), which provides a comprehensive theoretical framework for integrated care. The aim of this paper is to modify the original patient version of the RMIC-MT for the Chinese primary care context and validate its psychometric properties. Methods: The translation and adaptation processes were performed in four steps, forward and back-translation, experts review and pre-testing. We conducted a cross-sectional study with 386 patients with diabetes attending one of 20 community health stations in the Nanshan district. We analyzed the distribution of responses to each item to study the psychometric sensitivity. Exploratory factor analysis with principal axis extraction method was used to assess the construct validity. Confirmation factor analysis was used to evaluate model fit of the modified version. Cronbach’s alpha was used to ascertain the internal consistency reliability. Results: During the translation and adaptation process, all 24 items were retained with some detailed modifications. No item was found to have psychometric sensitivity problems. Five factors (person-centeredness, clinical integration, professional integration, team-based coordination, organizational integration) with 15 items were determined by exploratory factor analysis, accounting for 53.51% of the total variance. Good internal consistency was achieved with each item correlated the highest on an assigned subscale and Cronbach’s alpha score of 0.890. Moderately positive associations (r≥ 0.4, p<0.01) between the score of the scale and these correlations indicate good construct validity. Conclusions: The results showed initial satisfactory psychometric properties for the validation of the Chinese RMIC-MT patient version. Its application in China will promote the development of people-centered integrated primary care. However, future studies with diverse samples crossing regions would be needed to test its psychometric properties for the various Chinese primary care contexts.
Treatment of COPD with Long-Acting Bronchodilators: Association Between Early and Longer-Term Clinically Important Improvement

Introduction This post hoc analysis of the “Early MAXimization of bronchodilation for improving COPD stability” (EMAX) trial investigated whether patients achieving early clinically important improvement (CII) sustained longer-term improvements and lower risk of clinically important deterioration (CID). Methods Patients were randomized to umeclidinium/vilanterol, umeclidinium, or salmeterol for 24 weeks. The patient-reported outcomes (PROs) Transition Dyspnea Index (TDI), Evaluating Respiratory Symptoms, St George’s Respiratory Questionnaire (SGRQ) and COPD Assessment Test (CAT) were assessed. CII, defined as attaining minimum clinically important differences (MCID) in ≥2 PROs, was assessed at Weeks 4, 12 and 24. CID was defined as a deterioration in CAT, SGRQ, TDI by the MCID and/or a moderate/severe exacerbation from Day 30. Results Of 2425 patients, 50%, 53% and 51% achieved a CII at Weeks 4, 12 and 24, respectively. Patients with a CII at Week 4 versus those without had significantly greater odds of achieving a CII at Weeks 12 and 24 (odds ratio: 5.57 [95% CI: 4.66, 6.66]; 4.09 [95% CI: 3.44, 4.86]). The risk of a CID was higher in patients who did not achieve a CII at Week 4 compared with patients who did (hazard ratio [95% CI]: 2.09 [1.86, 2.34]). Patients treated with umeclidinium/vilanterol versus either monotherapy had significantly greater odds of achieving CII at Weeks 4, 12 and 24. Conclusion Achieving a CII at Week 4 was associated with longer-term improvement in PROs and a reduced risk of deterioration. Further research is required to investigate the importance of an early response to treatment on the long-term disease course.
Effects of Tai Chi on Patients with Mild Cognitive Impairment: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Design Randomized controlled trials (RCTs) from multiple databases from inception to December 2020 published in English were searched. Two researchers independently performed eligible study screening and data extraction. The methodological quality was assessed with the Jadad score. Meta-analysis of RCTs on TC in the treatment of MCI was performed with RevMan Version 5.4. 1. Results Seven RCTs with 1265 participants were included. For most RCTs, the overall reporting of methodological quality was high. Results of the meta-analysis indicate that TC improved MCI patients' cognitive function significantly, including overall cognitive function (MD = −2.24, 95% CI -3.51 to -0.97, P = 0.0005), memory and learning (SMD = 0.83, 95% CI 0.22 to 1.45, P = 0.008), visuospatial ability (MD = 3.15, 95% CI 0.74 to 5.56, P = 0.01), executive functions (MD = 0.32, 95% CI 0.03 to 0.61, P = 0.03), and physical activity (MD = 18.78, 95% CI 10.80 to 26.76, P < 0.00001). However, no significant benefit was found for TC on psychological activity (MD = 0.17, 95% CI -0.62 to 0.96, P = 0.36) and biomarker improvement. Conclusion The meta-analysis confirmed the clinical therapeutic effect of TC for MCI. More rigorous and long-term follow-up RCTs should be conducted in the future.
How do Americans want elections to be run during the COVID-19 crisis?

To inform the vital conversation among the nation’s political leaders, elections administrators, and scholars about how to hold a safe, accessible, and fair election in November 2020, this article reports how a sample of 5612 eligible American voters, surveyed 8–10 April, wanted to see the election run during the COVID-19 crisis. We embedded a randomized experiment presenting respondents with truthful summaries of the projections of two teams of scientists about the pandemic. Our descriptive findings show that in November 2020, four in 10 eligible voters would have preferred to cast their ballot by mail rather than in person and that a majority of respondents favored policies expanding mail voting. Our experimental findings show that respondents who read the scientific projections were more likely to prefer voting by mail, were more likely to trust that a mail ballot would be counted accurately, and were more likely to favor holding the election entirely by mail.
Aerobic fitness and the sleeping brain of adolescents—a pilot study

Abstract Study Objectives Aerobic fitness (AF) and sleep are major determinants of health in adolescents and impact neurocognitive and psychological development. However, little is known about the interactions between AF and sleep during the developmental transition experienced across adolescence. This study aimed to consider the relationships between AF and habitual sleep patterns and sleep neurophysiology in healthy adolescents. Methods Subjects (mean age = 14.6 ± 2.3 years old, range 11–17, 11 females) were evaluated for AF (peak VO2 assessed by ramp-type progressive cycle ergometry in the laboratory), habitual sleep duration and efficiency (7–14 days actigraphy), and topographic patterns of spectral power in slow wave, theta, and sleep spindle frequencies in non-rapid eye movement (NREM) sleep using overnight polysomnography (PSG) with high-density electroencephalography (hdEEG, 128 channels). Results Significant relationships were observed between peak VO2 and habitual bedtime (r = −0.650, p = .009) and wake-up time (r = −0.603, p = .017), with greater fitness associated with going to bed and waking up earlier. Peak VO2 significantly predicted slow oscillations (0.5–1 Hz, p = .018) and theta activity (4.5–7.5 Hz, p = .002) over anterior frontal and central derivations (p < .001 and p = .001, respectively) after adjusting for sex and pubertal development stage. Similar associations were detected for fast sleep spindle activity (13–16 Hz, p = .006), which was greater over temporo-parietal derivations. Conclusions Greater AF was associated with a more mature pattern of topographically-specific features of sleep EEG known to support neuroplasticity and cognitive processes and which are dependent on prefrontal cortex and hippocampal function in adolescents and adults. AF was also correlated with a smaller behavioral sleep phase delay commonly seen during adolescence.
Catamenial haemoptysis in females with cystic fibrosis: a case series with review of management strategies

Catamenial haemoptysis, the expectoration of blood during menses, has not been extensively reported in the cystic fibrosis (CF) literature. We describe four cases (age range: 25–34 years) of catamenial haemoptysis across four CF centres in the United States. These cases may represent thoracic endometriosis versus hormonal fluctuations in airway inflammation or infection resulting in bronchial artery bleeding. We identify common and nuanced management strategies including use of pro‐coagulants, hormone contraceptives, anti‐inflammatories, bronchial artery embolization, and use of the newer cystic fibrosis transmembrane conductance regulator (CFTR) modulators.
Targeting Impaired Antimicrobial Immunity in the Brain for the Treatment of Alzheimer’s Disease

Abstract Alzheimer’s disease (AD) is the most common form of dementia and aging is the most common risk factor for developing the disease. The etiology of AD is not known but AD may be considered as a clinical syndrome with multiple causal pathways contributing to it. The amyloid cascade hypothesis, claiming that excess production or reduced clearance of amyloid-beta (Aβ) and its aggregation into amyloid plaques, was accepted for a long time as the main cause of AD. However, many studies showed that Aβ is a frequent consequence of many challenges/pathologic processes occurring in the brain for decades. A key factor, sustained by experimental data, is that low-grade infection leading to production and deposition of Aβ, which has antimicrobial activity, precedes the development of clinically apparent AD. This infection is chronic, low grade, largely clinically silent for decades because of a nearly efficient antimicrobial immune response in the brain. A chronic inflammatory state is induced that results in neurodegeneration. Interventions that appear to prevent, retard or mitigate the development of AD also appear to modify the disease. In this review, we conceptualize further that the changes in the brain antimicrobial immune response during aging and especially in AD sufferers serve as a foundation that could lead to improved treatment strategies for preventing or decreasing the progression of AD in a disease-modifying treatment.
LBSL

Objective Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL) is regarded a relatively mild leukodystrophy, diagnosed by characteristic long tract abnormalities on MRI and biallelic variants in DARS2, encoding mitochondrial aspartyl-tRNA synthetase (mtAspRS). DARS2 variants in LBSL are almost invariably compound heterozygous; in 95% of cases, 1 is a leaky splice site variant in intron 2. A few severely affected patients, still fulfilling the MRI criteria, have been described. We noticed highly unusual MRI presentations in 15 cases diagnosed by WES. We examined these cases to determine whether they represent consistent novel LBSL phenotypes. Methods We reviewed clinical features, MRI abnormalities, and gene variants and investigated the variants' impact on mtAspRS structure and mitochondrial function. Results We found 2 MRI phenotypes: early severe cerebral hypoplasia/atrophy (9 patients, group 1) and white matter abnormalities without long tract involvement (6 patients, group 2). With antenatal onset, microcephaly, and arrested development, group 1 patients were most severely affected. DARS2 variants were severer than for classic LBSL and severer for group 1 than group 2. All missense variants hit mtAspRS regions involved in tRNAAsp binding, aspartyl-adenosine-5′-monophosphate binding, and/or homodimerization. Missense variants expressed in the yeast DARS2 ortholog showed severely affected mitochondrial function. Conclusions DARS2 variants are associated with highly heterogeneous phenotypes. New MRI presentations are profound cerebral hypoplasia/atrophy and white matter abnormalities without long tract involvement. Our findings have implications for diagnosis and understanding disease mechanisms, pointing at dominant neuronal/axonal involvement in severe cases. In line with this conclusion, activation of biallelic DARS2 null alleles in conditional transgenic mice leads to massive neuronal apoptosis.
Clinicopathological features and outcome of COVID-19 – Early experiences from three COVID hospitals, Chittagong, Bangladesh

Introduction: COVID 19 is an unknown virus affecting mankind creating a deadly experience to all. It is true for Bangladesh also. So the objectives of the present study are to find the clinicopathological features and outcome of COVID patients admitted to three COVID dedicated hospitals of Chittagong, Bangladesh. Methods: This was an observational study where a total of 209 patients admitted to three COVID dedicated hospital were recruited. Clinicopathological data were recorded and patients were under observation till discharge and thus outcome were recorded. Prior consent was taken from the patients and ethical clearance was also taken. Data were compiled and analyzed by Statistical Package for Social Sciences-20. Results: Among 209 patients most of them were male 139 (66.5%) and male to female ratio was 1.98:1. Age group distribution revealed more were aggregated in the age group of 41–50 years 36 (17.2%), 51–60 years 54 (25.8%), and 61–70 years 57 (27.3%). Among all 92 (44%) patients were reverse transcription-polymerase chain reaction (RT-PCR) positive and 117 (56%) were probable cases. Fever was present in 195 (93.3%) cases, cough in 180 (86.1%), respiratory distress in 105 (50.2%) anosmia in 123 (58.8%), aguesea in 112 (53.58%) and lethargy was present in 143 (68.42%). Chest X-ray findings revealed 73 (34.9%) had bilateral patchy opacities, 20 (9.6%) had unilateral opacities 65 (31.1%) had consolidations, 6 (2.9%) had ground glass opacities, and 2 (1.0%) had pleural effusion. Supplemental O2 was given in 173 (82.8%) patients, Favipiravir in 59 (28.2%), Remdesivir in 111 (53.1%), Methylprednisolone in 87 (41.6%), Dexamethasone in 93 (44.5%), Antibiotics in 204 (97.60%), Toccilizumab in 34 (16.3%), plasma in 18 (8.6%), and low molecular weight heparin (LMWH) in 200 (95.7%) patients. Regarding outcome of the COVID patients admitted, 85 (92.4%) patients improved, 6 (6.5%) died who were RT-PCR positive and 107 (91.15%) improved, 9 (7.7%) died who were probable cases. Total death rate was 7.1%. Conclusion: The present study findings were some early activities among COVID patients in the years 2020. Male were more affected and middle age group people were the most victims.
Periodontal status in long-term orthodontic retention patients up to 10 years after treatment – a cross-sectional study

Abstract Objective To assess periodontal status in long-term orthodontic retention patients and investigate possible risk indicators. Materials and Methods Plaque index (PI), gingival index (GI), probing pocket depth (PPD), gingival recessions (GR) and calculus were recorded in 211 patients with or without fixed retainers. Results Periodontal parameters were within the limits of clinically healthy periodontium. The use of fixed retainers was associated with higher PI in the maxilla (ß = 1.10 [0.37]; p <.05). Older age was associated with higher PI in the mandible (ß = 0.27 [0.11]; p <.05). Smoking was associated with gingival bleeding on both palatal (ß = 0.63 [0.16]; p < .01) and labial sides in the maxilla (ß = 0.46 [0.20]; p <.05). Smoking was also associated with increased prevalence of GR in the mandible (ß = 0.24 [0.07]; p <.01), while use of snuff had similar effect on the labial side in the maxilla (ß = 0.35 [0.08]; p <.01). Higher age (ß = 0.05 [0.02]; p <.05) and the presence of a retainer (ß = 0.23 [0.07]; p < .05) were associated with calculus accumulation on the lingual side in the mandible. Conclusion The present observational study suggest that long-term fixed retainers alone have no detrimental effect on the periodontium. Additional factors may increase the risk of plaque deposits and increased probing pocket depths. Further prosepective studies are needed to confirm the present outcome.
PU.1 interaction with p50 promotes microglial-mediated inflammation in secondary spinal cord injury in SCI rats

Abstract Purpose/aim of the study Secondary spinal cord injury is the inflammatory damage to surrounding tissues caused by activated microglial-mediated neuroinflammatory responses. The nuclear factor-κB (p65/p50) pathway and PU.1 are closely correlated with inflammatory responses; thus, we examined the relationship and function between PU.1 and p50 in secondary spinal cord injury.Materials and methods In this study, we established an adult rat acute spinal cord injury model to simulate the pathological process of spinal cord injury.Results: We found that the expression of PU.1 was significantly increased at three days after spinal cord injury and mainly expressed in activated microglia. Moreover, p-p50 expression was increased in SCI rats and the protein interacted with PU.1. Lipopolysaccharide was used to induce microglia activation in vitro.Conclusions: The results showed that PU.1 and p-p50 expression was significantly increased and PU.1 interacted with p50 in the nucleus. The levels of tumor necrosis factor-α and interleukin-1β secreted by microglia were detected by enzyme-linked immunosorbent assay. The results showed that when both PU.1 and p50 were overexpressed, tumor necrosis factor-α and interleukin-1β secretion was significantly increased to levels higher than in cells overexpressing PU.1 or p50 alone. These results suggest that PU.1 and p50 interact to promote p65 transcription and the expression of inflammatory factors, which is an important mechanism of the microglial-mediated inflammatory response to secondary injury after spinal cord injury.
Anti-obesity properties and mechanism of action of flavonoids: A review

Abstract Obesity is a major public health problem, and there is increasing scientific interest in its mechanisms, as well as a search for new compounds with antioxidant and anti-inflammatory properties that can minimize the metabolic complications associated with its pathology. One potential source of these compounds is natural products; Among these, flavonoids are a promising group of natural substances. Flavonoids are active constituents with diverse biological activities and are widely found in plants kingdom. Numerous studies have shown that flavonoids can effectively inhibit obesity and related metabolic disorders. The review synthesizes recent evidence in respect of progress in the understanding of the anti-obesity effects of flavonoids. Such effects which occurs through the modulation of proteins, genes and transcriptional factors involved in decreasing lipogenesis, increasing lipolysis, expenditure energy, stimulating fatty acids B-oxidation, digestion and metabolism of carbohydrates. In addition to mitigating inflammatory responses and suppress oxidative stress. A better understanding of the modulating effects and mechanisms of flavonoids in relation to obesity will allow us to better use these compounds to treat or even prevent obesity and its associated comorbidities.