Miracle-dz/UniFAR-FTUs huggingface dataset:
ECG feature extraction using principal component analysis for studying the effect of diabetes

Abstract The condition of cardiac health is given by Electrocardiogram (ECG). ECG analysis is one of the most important aspects of research in the field of Biomedical and healthcare. The precision in the identification of various parameters in ECG is of great importance. Many algorithms have been developed in the last few years for this purpose. Since diabetes is the major chronic illness prevailing today, recently there has been increasing interest in the study of the relationship between diabetes and cardiac health. This paper presents an algorithm based on Principal Component Analysis (PCA) for 12 lead ECG feature extraction and the estimation of diabetes-related ECG parameters. The data used for our purpose is acquired by XBio Aqulyser unit from TMI systems. The baseline wander is removed from the acquired data using the FFT approach and the signal is de-noised using wavelet transform and then the PCA method is employed to extract the R-wave. The other waves are then extracted using the window method. Later, using these primary features, the diabetes mellitus (DM)-related features like corrected QT interval (QTc), QT dispersion (QTd), P wave dispersion (PD) and ST depression (STd) are estimated. This study has taken 25 diabetic patients data for study.
Electrical characterization of conductive textile materials and its evaluation as electrodes for venous occlusion plethysmography

Abstract The ambulatory monitoring of biosignals involves the use of sensors, electrodes, actuators, processing tools and wireless communication modules. When a garment includes these elements with the purpose of recording vital signs and responding to specific situations it is call a ‘Smart Wearable System’. Over the last years several authors have suggested that conductive textile material (e-textiles) could perform as electrode for these systems. This work aims at implementing an electrical characterization of e-textiles and an evaluation of their ability to act as textile electrodes for lower extremity venous occlusion plethysmography (LEVOP). The e-textile electrical characterization is carried out using two experimental set-ups (in vitro evaluation). Besides, LEVOP records are obtained from healthy volunteers (in vivo evaluation). Standard Ag/AgCl electrodes are used for comparison in all tests. Results shown that the proposed e-textiles are suitable for LEVOP recording and a good agreement between evaluations (in vivo and in vitro) is found.
Artificial neural network-based classification of body movements in ambulatory ECG signal

Abstract Ambulatory ECG monitoring provides electrical activity of the heart when a person is involved in doing normal routine activities. Thus, the recorded ECG signal consists of cardiac signal along with motion artifacts introduced due to a person’s body movements during routine activities. Detection of motion artifacts due to different physical activities might help in further cardiac diagnosis. Ambulatory ECG signal analysis for detection of various motion artifacts using adaptive filtering approach is addressed in this paper. We have used BIOPAC MP 36 system for acquiring ECG signal. The ECG signals of five healthy subjects (aged between 22–30 years) were recorded while the person performed various body movements like up and down movement of the left hand, up and down movement of the right hand, waist twisting movement while standing and change from sitting down on a chair to standing up movement in lead I configuration. An adaptive filter-based approach has been used to extract the motion artifact component from the ambulatory ECG signal. The features of motion artifact signal, extracted using Gabor transform, have been used to train the artificial neural network (ANN) for classifying body movements.
Avaliação da qualidade de vida em pacientes idosos um ano após o tratamento cirúrgico de fraturas transtrocanterianas do fêmur

OBJETIVO: Avaliar o impacto que as fraturas transtrocanterianas produzem sobre a qualidade de vida de pacientes idosos, tratados cirurgicamente, durante o periodo de um ano de acompanhamento. MATERIAL E METODO: Foram selecionados 73 idosos com fratura transtrocanterina, com idade igual ou superior a 65 anos de ambos os sexos. Foi aplicado questionario padronizado, para se obter informacoes quanto aos habitos de vida, atividade fisica, funcionalidade, deambulacao e estado cognitivo. Foram excluidos os obitos ocorridos durante o estudo, pacientes que nao deambulavam, com doencas neurologicas ou fraturas patologicas. RESULTADOS: A media de idade foi 80,17 ± 7,2, sendo 75% do sexo feminino. Ao comparar as somatorias das atividades de vida diaria (p=0,04) e instrumentais da vida diaria (p=0,004), obtidas na pre e pos-fratura, os pacientes tornaram-se mais dependentes pos-fratura. Atividades de vida diaria que apresentaram piora pos-fratura foram: tomar banho (p=0,04), ir ao banheiro (p=0,02) e vestir-se (p=0,04). Todas as atividades instrumentais da vida diaria apresentaram diferenca significativa, apresentando maior dependencia funcional pos-fratura, assim como aumento da necessidade de auxilio a deambulacao (p=0,00002), idade avancada (p=0,01) e nao realizar atividades domesticas (p=0,01). A baixa pontuacao no teste Minimental estava associada com uma maior dependencia para realizar as atividades da vida diaria na pre-fratura (p=0,00002) e pos-fratura (p=0,01). CONCLUSAO: Apos um ano, as atividades de vida diaria que dependiam dos membros inferiores pioraram significativamente, todas as atividades instrumentais de vida diaria apresentaram piora significativa em mais de 50% dos pacientes e mais da metade dos pacientes que andavam sem apoio perderam esta capacidade.
An alternative method to reduce anaphylaxis by moxibustion

Epinephrine is a critical drug for patients at risk for anaphylaxis. Here, we suggest moxibustion as an alternative method to reduce anaphylaxis. Moxibustion was applied to the Shimen (CV5) acupoint and found to attenuate compound 48/80-induced mortality. Capsazepine, a transient receptor potential vanilloid (TRPV) 1 antagonist, significantly improved overall survival rates compared to groups treated with moxibustion or 2-aminoethoxydiphenyl borate (an activator of TRPV1, 2, and 3). Probenecid (a TRPV2 agonist) also increased survival rate and reduced histamine levels. Survival rates increased by moxibustion and probenecid were completely inhibited by ruthenium red (a TRPV2 and 3 antagonist) and gadolinium chloride (general TRPV antagonist), respectively. Passive cutaneous anaphylaxis and ear swelling were significantly reduced by moxibustion and probenecid (p < 0.05). In cardiomyocytes, TRPV2 was over-expressed by compound 48/80 and histamine but this increased TRPV2 expression decreased to baseline with moxibustion and probenecid treatment. In addition, intracellular calcium levels increased by compound 48/80 were reduced by probenecid. Overall, these findings suggest that the reduction of anaphylaxis caused by moxibustion could represent a new mechanism of moxibustion related to the regulation of TRPV2 activation and promotion of epinephrine secretion.
Insights on membrane topology and structure/function of UDP-glucuronosyltransferases

The main characteristic of uridine diphosphate (UDP)-glucuronosyltransferases is their potency to glucuronidate a large array of structurally unrelated substances with various nucleophilic groups. The activity of these enzymes strongly depends on their tight association to the membrane of the endoplasmic reticulum. In light of recent data, this review is focused on the membrane-assembly process, which is a prerequisite for activity, and on the amino acids that govern substrate recognition and catalysis at the active site. The major implication of the highly variable N-terminal domain of UDP-glucuronosyltransferases in the substrate specificity of these enzymes is highlighted. In the absence of crystal data of the N-terminal domain, multidisciplinary approaches of genetic-/protein-engineering techniques, homology modeling with glycosyltransferases, and quantitative structure-activity relationships allowed us to point out crucial amino acids. On the basis of these results, possible reaction mechanisms for the glucuronidation of xenobiotics, involving histidine and aspartic acid residues, have been built and are discussed.
Structure, function, regulation and polymorphism and the clinical significance of human cytochrome P450 1A2

Human CYP1A2 is one of the major CYPs in human liver and metabolizes a number of clinical drugs (e.g., clozapine, tacrine, tizanidine, and theophylline; n > 110), a number of procarcinogens (e.g., benzo[a]pyrene and aromatic amines), and several important endogenous compounds (e.g., steroids). CYP1A2 is subject to reversible and/or irreversible inhibition by a number of drugs, natural substances, and other compounds. The CYP1A gene cluster has been mapped on to chromosome 15q24.1, with close link between CYP1A1 and 1A2 sharing a common 5′-flanking region. The human CYP1A2 gene spans almost 7.8 kb comprising seven exons and six introns and codes a 515-residue protein with a molecular mass of 58,294 Da. The recently resolved CYP1A2 structure has a relatively compact, planar active site cavity that is highly adapted for the size and shape of its substrates. The architecture of the active site of 1A2 is characterized by multiple residues on helices F and I that constitutes two parallel substrate binding platforms on either side of the cavity. A large interindividual variability in the expression and activity of CYP1A2 has been observed, which is largely caused by genetic, epigenetic and environmental factors (e.g., smoking). CYP1A2 is primarily regulated by the aromatic hydrocarbon receptor (AhR) and CYP1A2 is induced through AhR-mediated transactivation following ligand binding and nuclear translocation. Induction or inhibition of CYP1A2 may provide partial explanation for some clinical drug interactions. To date, more than 15 variant alleles and a series of subvariants of the CYP1A2 gene have been identified and some of them have been associated with altered drug clearance and response and disease susceptibility. Further studies are warranted to explore the clinical and toxicological significance of altered CYP1A2 expression and activity caused by genetic, epigenetic, and environmental factors.
CARDIOVASCULAR COMORBIDITIES IN PATIENTS WITH PSORIASIS

Psoriasis is a chronic inflammatory disease that affects approximately 1-3% of the population. Psoriasis is associated with conventional cardiovascular risk factors, including hypertension, diabetes mellitus, obesity, smoking and hyperlipidaemia. Furthermore, psoriasis, like other type 1 helper T-cell-driven inflammatory disorders such as rheumatoid arthritis and systemic lupus erythromatosus, is an independent risk factor for atherothrombotic disease. Because of psoriasis and atherosclerosis are both characterized by T helper 1 and T helper type 17 activation and reduced T regulatory cell function. Therefore, psoriasis is associated with increased risk of adverse cardiovascular events. Young age, severe skin affection and⁄ or psoriatic arthritis carry the most risk. The high-risk group of patients with psoriasis may be candidates for early cardiovascular risk factor modification.
Interactions of dietary phytochemicals with ABC transporters: possible implications for drug disposition and multidrug resistance in cancer

Common foods, such as fruits and vegetables, contain a large variety of secondary metabolites known as phytochemicals, many of which have been associated with health benefits. However, there is a limited knowledge of the processes by which these, mainly charged, phytochemicals (and/or their metabolites) are absorbed into the body, reach their biological target, and how they are eliminated. Recent studies have indicated that some of these phytochemicals are substrates and modulators of specific members of the superfamily of ABC transporting proteins. In this review, we present the reported interactions between the different classes of phytochemicals and ABC transporters and the mechanism by which they modulate the activity of these transporters. We also discuss the implications that such interactions may have on the pharmacokinetics of xenobiotics and the possible role of phytochemicals in the reversal of multidrug resistance in cancer chemotherapy.
Exercise as therapy in chronic diseases

There is increasing evidence that exercise can be prescribed as a treatment in chronic diseases that do not primarily affect the musculoskeletal system. In a recent review (1), several of these diseases are highlighted, such as metabolic syndrome-related disorders, including insulin resistance, type 1 diabetes, type 2 diabetes and dyslipidemia, and heart and pulmonary diseases, including chronic obstructive pulmonary disease, asthma, coronary heart disease, chronic heart failure and intermittent claudication. Furthermore, exercise can be used as therapy also in cancer, depression, chronic fatigue syndrome and fibromyalgia. More familiar fields to physiotherapists, where exercise has proven to be useful, are muscle, bone and joint diseases, such as osteoarthritis, rheumatoid arthritis and osteoporosis. Several of these fields need to be investigated and developed in a clinical setting concerning intensity, frequency and duration of the exercise. This is an important task for physiotherapy and related fields because some of the above-mentioned diseases have not traditionally been our target groups. As a consequence, there is a lack of reliable and valid outcome measures for assessing the effects of exercise in these new areas. These are challenges for researchers and clinicians to work with jointly. Outcome measures and instruments are highlighted in this issue of Advances in Physiotherapy, although not within new areas of physiotherapy. Vartiainen and co-workers describe test retest reliability of motor performance measures in physically well-recovered, traumatically injured patients, and Langhammar and co-workers investigate the relationship between gait velocity, static and dynamic balance in first time ever stroke patients during the acute rehabilitation period. Pettersson & Koch present at set of instruments for disability assessments of persons with multiple sclerosis. The incidence of injuries among female football players during practice and game is compared in an epidemiological study by Jacobson & Tegner, and cardiorespiratory responses to aquatic exercise is researched by Kosonen and co-workers, with comparisons between healthy females and females with cardiopulmonary diseases. From Saudi Arabia comes an article by Abdulwahab & Beatti on the effect of prone position and interferential therapy on lumbosacral radiculopathy. Cabri presents a book review on the fifth edition of the classic work by Kendall and coauthors, Muscles Testing and function with posture and pain . Physiotherapists all over the world have used this standard book during their education and are therefore familiar with its content. However, this new edition is not quite what a developing profession would require. Summer is here, at least in the northern hemisphere. Enjoy your summer vacation! Advances in Physiotherapy will appear again in September
Serum α-klotho levels are not informative for the evaluation of growth hormone secretion in short children

Abstract Background: α-Klotho is a transmembrane protein that can be cleaved and act as a circulating hormone (s-klotho). s-Klotho serum levels seem to reflect growth hormone (GH) secretory status. We investigated the role of s-klotho as a reliable marker of GH secretion in short children and the factors influencing its secretion. Methods: We enrolled 40 short Egyptian children (20 GH deficiency [GHD] and 20 idiopathic short stature [ISS]). They underwent a pegvisomant-primed insulin tolerance test (ITT) and were accordingly reclassified as 16 GHD and 24 ISS. The samples obtained before and 3 days after pegvisomant administration, prior to the ITT, were used for assaying insulin-like growth factor (IGF)-I and s-klotho. Results: IGF-I and s-klotho serum levels were not significantly different (p=0.059 and p=0.212, respectively) between GHD and ISS. After pegvisomant, a significant reduction in IGF-I and s-klotho levels was found in both groups. s-Klotho significantly correlated only with IGF-I levels in both groups. Conclusions: s-Klotho mainly reflects the IGF-I status and cannot be considered a reliable biomarker for GH secretion in children.
Hospital-acquired acute kidney injury in medical, surgical, and intensive care unit: A comparative study

Acute kidney injury (AKI) is a common complication in hospitalized patients. There are few comparative studies on hospital-acquired AKI (HAAKI) in medical, surgical, and ICU patients. This study was conducted to compare the epidemiological characteristics, clinical profiles, and outcomes of HAAKI among these three units. All adult patients (>18 years) of either gender who developed AKI based on RIFLE criteria (using serum creatinine), 48 h after hospitalization were included in the study. Patients of acute on chronic renal failure and AKI in pregnancy were excluded. Incidence of HAAKI in medical, surgical, and ICU wards were 0.54%, 0.72%, and 2.2% respectively (P < 0.0001). There was no difference in age distribution among the groups, but onset of HAAKI was earliest in the medical ward (P = 0.001). RIFLE-R was the most common AKI in medical (39.2%) and ICU (50%) wards but in the surgical ward, it was RIFLE-F that was most common (52.6%). Acute tubular necrosis was more common in ICU (P = 0.043). Most common etiology of HAAKI in medical unit was drug induced (39.2%), whereas in surgical and ICU, it was sepsis (34% and 35.2% respectively). Mortality in ICU, surgical and medical units were 73.5%, 43.42%, and 37.2%, respectively (P = 0.003). Length of hospital stay in surgical, ICU and medical units were different (P = 0.007). This study highlights that the characters of HAAKI are different in some aspects among different hospital settings.
Anaesthesia for awake craniotomy

Abstract Awake craniotomy is a neurosurgical procedure during which the patient remains awake as a whole or during some part of the surgery. Although not a new procedure, it has regained its importance since last two decades following the advent of newer drugs along with improvised techniques. The role of anesthesiologist during this procedure is of paramount importance. In this review, we discussed the anesthetic management during awake craniotomy and re-emphasized on the avoidance of intraoperative untoward events with appropriate patient selection.
Nuclear-receptor–mediated regulation of drug– and bile-acid–transporter proteins in gut and liver

Adverse drug events (ADEs) are a common cause of patient morbidity and mortality and are classically thought to result, in part, from variation in expression and activity of hepatic enzymes of drug metabolism. It is now known that alterations in the expression of genes that encode drug- and bile-acid–transporter proteins in both the gut and liver play a previously unrecognized role in determining patient drug response and eventual clinical outcome. Four nuclear receptor (NR) superfamily members, including pregnane X receptor (PXR, NR1I2), constitutive androstane receptor (NR1I3), farnesoid X receptor (NR1H4), and vitamin D receptor (NR1I1), play pivotal roles in drug- and bile-acid–activated programs of gene expression to coordinately regulate drug- and bile-acid transport activity in the intestine and liver. This review focuses on the NR-mediated gene activation of drug and bile-acid transporters in these tissues as well as the possible underlying molecular mechanisms.
Melatonin improves sleep quality in hemodialysis patients

Disturbed sleep is common in end-stage renal disease (ESRD). Exogenous melatonin has somniferous properties in normal subjects and can improve sleep quality (SQ) in several clinical conditions. Recent studies have shown that melatonin may play a role in improving sleep in patients undergoing dialysis. The goal of the present study was to assess the effect of exogenous melatonin administration on SQ improvement in daytime hemodialysis patients. Lipid profile and the required dose of erythropoietin (EPO) are also reported as secondary outcomes. In a 6-week randomized, double-blind cross-over clinical trial, 3 mg melatonin or placebo was administered to 68 patients at bedtime. A 72-h washout preceded the switch from melatonin to placebo, or vice versa. SQ was assessed by the Pittsburgh sleep quality index (PSQI). Sixty-eight patients completed the study protocol and were included in the final analysis. Melatonin treatment significantly improved the global PSQI scores (P < 0.001), particularly subjective SQ (P < 0.001), sleep efficiency (P = 0.005) and sleep duration (P < 0.001). No differences in sleep latency and daytime sleepiness were observed. Melatonin also increased the high-density lipoprotein (HDL) cholesterol (P = 0.003). The need for EPO prescription decreased after melatonin treatment (P < 0.001). We conclude that melatonin can improve sleep in ESRD. The modest increase in HDL cholesterol and decrease in the EPO requirement are other benefits associated with this treatment
Correlation of serum phosphate with carotid intimal-medial thickness in chronic kidney disease patients

While increased serum phosphate concentration is a significant risk factor for vascular calcification, it is unclear whether serum phosphate is also a risk factor for increased arterial wall thickness in chronic kidney disease (CKD) patients. Using B-mode ultrasonography, we examined carotid intimal-medial thickness (CIMT) of CKD patients and analyzed risk factors for increased IMT with regard to the effect of serum phosphate. One hundred patients were enrolled (73 patients without diabetes, 27 patients with diabetes; 57 men, 43 women; age, 46.2 ± 15.3 years). CIMT of patients with diabetes was significantly greater than that of patients without diabetes (0.78 ± 0.250 versus 0.66 ± 0.178 mm; P < 0.0001). For the group of all patients, CIMT correlated strongly and significantly with serum phosphate (r = 0.911; P < 0.001). In multiple regression analysis serum phosphate level (β = 0.356; <0.0001) was found to be a significant independent risk factor for increased CIMT, in addition to other independent risk factors, including advanced age, higher systolic blood pressure, urinary albumin and the presence of diabetes (R2 = 0.956; P < 0.00001). In conclusion, high serum phosphate level is a significant and independent factor associated with advanced arteriosclerosis in CKD patients with and without diabetes in addition to advanced age.