Miracle-dz/UniFAR-FTUs huggingface dataset:
Global trends of chronic non-communicable diseases risk factors

One of the global targets for non-communicable diseases is to reduce, by 2025, the rise in global trends of major non-communicable diseases (NCDs). We aimed to estimate worldwide trends in NCD risk factors. Data from the NCD Risk Factor Collaboration (NCD-RisC) allowed the analysis of over 128 million children, adolescents, and adults with available information on height and weight, 4.4 million participants with data on diabetes through measurement of its biomarkers, and 19 million adults that had measured the blood pressures. No changes in age-standardised mean BMI in girls and boys from 1975 to 2016 were registered in eastern Europe, while an increase of up to 1.00 kg/m2 per decade was reported in central Latin America (for girls) and in Polynesia and Micronesia (for boys). Global prevalence of obesity increased from less than 1% in 1975 to 5.6% and 7.8% in 2016 in girls and boys, respectively. In adults, prevalence of obesity increased from 3.2% in 1975 to 10.8% in 2014 in men, and from 6.4% to 14.9% in women. Global diabetes prevalence increased from 4.3% in 1980 to 9.0% in 2014 in men, and from 5.0% to 7.9% in women; the lowest prevalence in 2014 has been recorded in northwestern Europe. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014. Estimation from current trends shows that only a minority of countries (mostly in western Europe) have a 50% or higher probability of halting the rise of diabetes by 2025. Global prevalence of raised blood pressure was more than 20% in both men and women in 2015. Globally, the number of adults with raised blood pressure increased from 594 million in 1975 to 1.13 billion in 2015, with the increase largely in low-income and middle-income countries. The burden of NCD risk factors is partially due to population growth and ageing. However, lifestyle factors play a crucial role in NCD prevention.
Optimization of Sumatriptan Succinate Transdermal Emulgel For Treatment of Migraine

Purpose: Sumatriptan succinate is a BCS class III drug. Oral administration of drug suffers from poor bioavailability problem due to pre-systemic metabolism. Bioavailability for oral route is 15%, for nasal route is 17% and for parenteral route is 97%. Substantial proportion of patients suffers from severe nausea or vomiting during their migraine attack, which make oral treatment unsatisfactory. Transdermal delivery will overcome the problems of the drug giving better results to patients suffering from migraine. Methods: Oleic acid, labrafil M 1994 and transcutol P was used as oil, surfactant and cosurfactant respectively. Both the oily and aqueous phases were heated separately. Oily phase were added to the aqueous phase. Mixing of gel and emulsion in ratio of 1:1 gave emulgel. Emulsion was evaluated for globule size, zeta potential, drug content, stability etc. Carbopol 934 and Xanthan gum was used as a gelling agent. Optimization was carried by factorial design. Emulgel was evaluated for physical parameters, viscosity, drug content, bioadhesive strength, spreadability, in-vitro and ex-vivo diffusion study. Results: FE-SEM image shown spherical globules in shape with size 51.40 µm. Zeta potential showed good stability of the emulsion. FTIR and DSC studies revealed that drug and all excipients were compatible. Factorial design gave batch F7 as optimized one. ANOVA results shown that drug release and gel viscosity values are strongly dependent on concentration of carbopol 934 and xanthan gum respectively. Ex-vivo diffusion study for batch F7 through goat skin indicated 88.68±2.52 % drug release. Statistical studies showed that drug release from the optimized formulation (F7) followed First order release kinetics. Conclusion: Sumatriptan succinate emulgel act as depot of drug which releases drug in controlled manner overcoming oral route side effects.
Importance of the Glycated Hemoglobin Assay in Congolese Women with Polycystic Ovary Syndrome: A Case-Control Study in Kinshasa, DR Congo

Context: Polycystic ovary syndrome (PCOS) is considered a syndrome related to the metabolic syndrome with a high risk for developing diabetes mellitus. The evaluation of the glycated hemoglobin (HbA1c) seems to be an interesting tool to detect states of hyperglycemia that may be associated with this syndrome and to understand her pathophysiology. Aims: The purposes of this study are to determine the profile of HbA1c in Congolese women with PCOS, to determine the frequency of states of hyperglycemia and to assess the impact of this marker on clinical signs on this syndrome. Material and methods: This is a case-control study of 130 Congolese subfertile women; 65 with a diagnosis of PCOS and 65 others without PCOS. This is conducted from June 2016 to June 2019 among Congolese women of childbearing age. All these women were recruited at the subfertility outpatient clinic of the University Hospital of UNIKIN as well of the YANGA medical centers in Kinshasa, Democratic Republic of Congo. Sickle cell disease was excluded as also the cases of anemia. HbA1c was assayed via the immunoturbidimetric method and the results interpreted according to the ADA recommendations with a pathological cut-off point ≥ 6.5%. Results: Mean hemoglobin was 11.6 ± 1.2 g/dl (11.5 ± 1.1 g/dl vs. 11.8 ± 1.4 g/dl, P = 0.568). The proportion of diabetics was 1.6% (1.6% vs. 1.5%, P = 0.74). Higher HbA1c values were noted in the PCOS group compared to the control group (7.3% ± 2.1% vs. 5.6% ± 0.6%, P 0.001). The multivariate analysis showed a strong correlation between elevated HbA1c levels and PCOS (OR 14.79 (CI 5.43 - 40.32), P 0.001). In the PCOS group, higher HbA1c values were significantly correlated with a higher socio-economic status (OR 3.38 (1.67 - 8.47), P = 0.018) and with obesity (OR 3.48 IC (1.31 - 7.13) P = 0.029). A perfect, positive and significant linear correlation was found between HbA1c and fasting blood glucose (r = 0.807). 60% of women in the PCOS group had pathological values of HbA1c (≥6.5%) co
Effect of indoor air pollution on infant and child-mortality in Myanmar: Evidence from the first Demographic and Health Survey

Indoor air pollution (IAP) from solid fuels for cooking has been considered as a public health threat, particularly for women and children in low- and lower-middle-income countries (LMICs). We investigated the effects of solid fuel use (SFU) on neonatal, infant and under-five child mortality in Myanmar.We used data from Myanmar’s first Demographic and Health Survey conducted in 2016. The sample consists of ever-married mothers with under-five children in the household (n=3249). We calculated the adjusted odds ratio (aOR) to investigate the effects of SFU on neonatal, infant, and under-five mortality using multivariable logistic regression model accounting for survey weight and clustering. Additional analysis was conducted using an augmented measure of the exposure to IAP accounting for both SFU and the location of cooking (high exposure, moderate, and unexposed). The prevalence of SFU was 79.0%, and the neonatal, infant and the under-five mortality rates were 26, 45 and 49 per 1,000 live births, respectively. The odds of infant (aOR 2.17, 95% CI: 1.21, 3.88) and under-five child mortality (aOR 2.22, 95% CI: 1.24, 3.95) were higher in households with SFU compared with households with clean fuel use. When applying an augmented measure of exposure to IAP by incorporating both SFU and the kitchen’s location, the likelihood of infant and under-five mortality was higher among moderately and highly exposed children compared to unexposed children with similar trends. Neonatal mortality was not associated with both SFU and levels of exposure to IAP.Infants and under-five children are at higher risk of mortality from exposure to IAP. The findings suggest that the risk of infants and under-five child mortality may be reduced by increasing access to clean cookstoves and clean fuels in LMICs, especially in Myanmar.
Effect of Patah Tulang Latex (Euphorbia tirucalli L.) on Wound Healing in Wistar Rat

Injure healing process occured on four phases such as hemostatis, inflammation, and maturation. Latex of Patah Tulang (Euphorbia tirucalli L.) can heal the wound because of its component active. Aim of this research was to find out the effect of ointment topical of E. tirucalli L. to wound healing process based on macroscopic and microscopic examination and cellular reaction of CD4+ lymphocyte. Male Wistar Rat, 2 month old, 150-200 Gram of body weight, as much as 36 rats. Rats were divided into 4 groups, and were anesthesized before punctioned on the 2 sides of lateral vertebrae. Group one was used as a control, group two was given with the ointment 9% of E. tirucalli L. , group three was given with 23% of E. tirucalli L. , and group four was given madecassol®. Treatment was given once a day for 15 days. Macroscopical and microscopical changes were observed at the fifth, tenth, and fifteenth day. Macroscopical observation was the diameter of injure. Microscopical observation consisted of epidermal thicness, number of fibroblast, using Haematoxylin and Eosin staining, and cellular reaction of CD4+ lymphocyte using imunohistochemistry. The results showed that topical administration of E. tirucalli ointment 9% and 23% potential to accelerate wistar skin wound healing puncture wounds. There was no difference between E. tirucalli ointment 9% and 23% application to observed parameters.Keywords: Euphorbia tirucalli L. , injure healing, macroscopic, microscopic, lymphocyte CD4+
A novel CpG-based signature for survival prediction of lung adenocarcinoma patients

Lung adenocarcinoma (LACA) is the leading cause of cancer-associated death worldwide. The present study intended to identify DNA methylation patterns that may serve as diagnostic and prognostic biomarkers for LACA. Data on DNA methylation and the survival data of the patients of LACA were obtained from The Cancer Genome Atlas. Kaplan-Meier curves and receiver operating characteristic curve analysis were utilized to build diagnostic and prognostic models. A total of 13 CpG sites were identified and validated as the optimal diagnostic and prognostic signature for overall survival. It was concluded that the CpG-based signature is a reliable predictor for the diagnosis and prognosis of patients with LACA.
Non-conventional therapies for Peyronie’s disease: what is the evidence for efficacy?

Background In recent years, there has been a surge in non-conventional therapies for Peyronie’s disease (PD). With increasing interest in these novel therapies, we conducted a narrative review to explore the efficacy and safety of these treatments to provide clarity for patients and providers. Methods A literature search was conducted to find studies describing non-conventional treatments of PD. These treatments were defined as those within the standard of care, including intralesional therapies and surgical options. Results A total of 14 studies were found. Non-conventional therapies included platelet-rich plasma (PRP), hyaluronic acid (HA), combination therapy of PRP and HA, extracorporeal shockwave therapy (ESWT), stem cell therapy (SCT), mycophenolate mofetil (MMF), and H-100. Most studies were limited to animal models and reported modest improvements in angulation and erectile function. Complication rates and cost of each treatment were infrequently reported. Conclusions There is limited evidence supporting non-conventional therapies for PD. As such, they are currently not recommended in clinical guidelines.
PNPLA3 and nonalcoholic fatty liver disease: towards personalized medicine for fatty liver.

HepatoBiliary Surg Nutr 2020;9(3):353-356 | http://dx.doi. org/10.21037/hbsn.2019. 10.35 Nonalcoholic fatty l iver disease (NAFLD) affects approximately 25% of the global population and the future clinical and economic consequences are enormous. The rising disease burden from NAFLD reflects increased rates of obesity and its metabolic consequences, but genetic factors clearly determine how individuals respond to excess caloric intake and the resulting metabolic derangements. The review by Barbara and colleagues (1) focuses on key genetic variants of NAFLD from an ever-growing list (2). Of all the genetic variants, patatin-like phospholipase domain-containing protein 3 (PNPLA-3) has emerged as a major common determinant of NAFLD and may be envisioned as part of a future personalized management strategy. The PNPLA3 story begins in 2008, when a genomewide association study of the Dallas Heart Study cohort identified a significant association between rs738409 C>G, encoding Ile148Met (I148M) and NAFLD, independent of BMI, diabetes, and alcohol use (3). In this ethnically diverse North American cohort, the risk allele (*I148M) was most common in Hispanics, intermediate in those of European descent and lowest in African Americans. Fast forward to 2019, with numerous GWAS and candidategene studies having firmly established PNPLA3 I148M as a genetic modifier of hepatic steatosis and a risk factor for steatohepatitis, fibrosis, and hepatocellular carcinoma (HCC) (4). The distribution of risk allele varies globally, with those of Hispanic and Asian ancestry more likely to carry the M variant (5) (Figure 1). The magnitude of genetic influence of PNPLA-3 on liver-related outcomes is noteworthy. A meta-analysis with the total of 14,266 NAFLD subjects, the M-variants (GG and GC) were associated with a 3.24-fold and 2.14-fold higher odds of HCC than those with those homozygous for wild-type (CC) (6). In a well-characterized biopsyproven NAFLD cohort from northern European with matched NAFLD-HCC cases to non-HCC NAFLD cases, the M-variants conferred a 2.26 higher risk of HCC risk than those with wild-type (7). Increasing body mass index amplifies the risk of the 148M-allele, with a study from Copenhagen showing the odds of cirrhosis among persons with BMI >35 kg/m was 5.8 in homozygotes for the M-variant (versus wild-type) and corresponding odds of cirrhosis for those with BMI <25 kg/m was 2.4 (8). In a large Italian cohort, PNPLA3 M-variants were independently associated with a higher risk of decompensation [hazard ratio (HR), 2.04], HCC (HR, 2.66), and liver-related death (HR, 3.64) among biopsy-proven NAFLD patients (9). Thus, epidemiologic data support PNPLA3 I148M as a major genetic modifier of NAFLD. PNPLA3 is a crucial lipid regulator in hepatocytes and stellate cells. PNAPL3 is regulated by TGF-β to release retinol from retinyl esters in stellate cells, involving stellate cell activation and fibrogenesis. Within hepatocytes, PNPLA3 is located in the lipid droplets, hydrolyzing triglycerides (TG) and catalyzing the transfer Editorial
Effect of haemoglobin levels on outcome in intravenous thrombolysis-treated stroke patients

Introduction Alterations in haemoglobin levels are frequent in stroke patients. The prognostic meaning of anaemia and polyglobulia on outcomes in patients treated with intravenous thrombolysis is ambiguous. Patients and methods In this prospective multicentre, intravenous thrombolysis register-based study, we compared haemoglobin levels on hospital admission with three-month poor outcome (modified Rankin Scale 3–6), mortality and symptomatic intracranial haemorrhage (European Cooperative Acute Stroke Study II-criteria (ECASS-II-criteria)). Haemoglobin level was used as continuous and categorical variable distinguishing anaemia (female: <12 g/dl; male: <13 g/dl) and polyglobulia (female: >15.5 g/dl; male: >17 g/dl). Anaemia was subdivided into mild and moderate/severe (female/male: <11 g/dl). Normal haemoglobin level (female: 12.0–15.5 g/dl, male: 13.0–17.0 g/dl) served as reference group. Unadjusted and adjusted odds ratios with 95% confidence intervals were calculated with logistic regression models. Results Among 6866 intravenous thrombolysis-treated stroke patients, 5448 (79.3%) had normal haemoglobin level, 1232 (17.9%) anaemia – of those 903 (13.2%) had mild and 329 (4.8%) moderate/severe anaemia – and 186 (2.7%) polyglobulia. Anaemia was associated with poor outcome (ORadjusted 1.25 (1.05–1.48)) and mortality (ORadjusted 1.58 (1.27–1.95)). In anaemia subgroups, both mild and moderate/severe anaemia independently predicted poor outcome (ORadjusted 1.29 (1.07–1.55) and 1.48 (1.09–2.02)) and mortality (ORadjusted 1.45 (1.15–1.84) and ORadjusted 2.00 (1.46–2.75)). Each haemoglobin level decrease by 1 g/dl independently increased the risk of poor outcome (ORadjusted 1.07 (1.02–1.11)) and mortality (ORadjusted 1.08 (1.02–1.15)). Anaemia was not associated with occurrence of symptomatic intracranial haemorrhage. Polyglobulia did not change any outcome. Discussion The more severe the anaemia, the higher the probability of poor outcome and death. Severe anaemia might be a target for interventions in hyperacute stroke. Conclusion Anaemia on admission, but not polyglobulia, is a strong and independent predictor of poor outcome and mortality in intravenous thrombolysis-treated stroke patients.
Associations of muscular strength and cardiorespiratory fitness with bone mineral density in older adults

Purpose: To evaluate the independent and combined associations of muscular strength (MS) and cardiorespiratory fitness (CRF) with bone mineral density (BMD) in older adults. Methods: This cross-sectional study included 353 older adults (189 women and 164 men) aged 65 years or older (mean ages 72 and 71 in women and men, respectively). MS was assessed by grip strength (average of the highest force values after three trials on each hand, Jamar+ digital hand dynamometer, Patterson Medical) and CRF was assessed by the 400-meter walk test (minutes to complete 400-meter walking). Whole-body BMD was measured by dual-energy Xray absorptiometry (DXA, Hologic Horizon W, Hologic). Low BMD was defined as t-score below -1.0, the value that was calculated with BMD (g/cm). Linear regression was used to find the associations of MS and CRF with BMD in women and men, separately. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of having low BMD in BMI-specific tertiles of MS and CRF in women and men, separately. To investigate the combined association of MS and CRF with low BMD, joint analyses were conducted after dichotomizing MS and CRF (upper two thirds and lower one third). Then, study participants were assigned to one of weak and unfit, weak and fit, strong and unfit, and strong and fit groups. Results: In women, only MS was positively associated with t-score after adjusting for age from linear regression. In men, only MS was positively associated with t-score after adjusting for age, current smoking status, heavy alcohol consumption, physical inactivity, supplement/medication for bone health, body mass index, and CRF. In women, MS and CRF appeared to be inversely associated with the prevalence of low BMD, although not significant (all p-trends>0.05) from logistic regression. In men, only MS appeared to be inversely associated with the prevalence of low BMD, although not significant (all p-trends>0.05). In the joint analyses of MS and CRF with
Design, Development and Construct Validation of the Children’s Dietary Inflammatory Index

OBJECTIVE To design and validate a literature-derived, population-based Children's Dietary Inflammatory Index (C-DII)TM. DESIGN The C-DII was developed based on a review of literature through 2010. Dietary data obtained from children in 16 different countries were used to create a reference database for computing C-DII scores based on consumption of macronutrients, vitamins, minerals, and whole foods. Construct validation was performed using quantile regression to assess the association between C-reactive protein (CRP) concentrations and C-DII scores. DATA SOURCES All data used for construct validation were obtained from children between six and 14 years of age (n = 3300) who participated in the U.S. National Health and Nutrition Examination Survey (NHANES) (2005⁻2010). RESULTS The C-DII was successfully validated with blood CRP concentrations in this heterogeneous sample of 3300 children from NHANES (52% male; 29% African American, 25% Mexican American; mean age 11 years). The final model was adjusted for sex, age, race, asthma, body mass index (BMI), and infections. Children in level 3 (i.e., quartiles 3 and 4 combined) of the C-DII (i.e., children with the most pro-inflammatory diets) had a CRP value 0.097 mg/dL higher than that in level 1 (i.e., quartile 1) for CRP values at the 75th percentile of CRP using quantile regression (p < 0.05). CONCLUSION The C-DII predicted blood CRP concentrations among children 6⁻14 years in the NHANES. Further construct validation with CRP and other inflammatory markers is required to deepen understanding of the relationship between the C-DII and markers of inflammation in children.
Characterization of Uropathogenic Escherichia coli: Distribution of Adhesin-Encoding Genes and O-Serotypes Among Ciprofloxacin Susceptible and Resistant Isolates

Background: Some evidence indicates that there is a potential linkage between ciproﬂoxacin resistance and the prevalence of virulence factors in pathogenic Escherichia coli strains. Objectives: The study was conducted to evaluate the association of eight putative adhesin-encoding genes and 12 O-serotypes among ciproﬂoxacin susceptible/resistant in uropathogenic E. coli (UPEC) isolates. Methods: A total of 100 E. coli isolates collected from symptomatic patients with urinary tract infection were surveyed for antimicrobial susceptibility test and polymerase chain reaction (PCR) to ﬁnd the presence of eight putative adhesin-encoding genes and 12 O-serotype and their association with ciproﬂoxacin susceptibility and resistance. Results: Thehighestandthelowestresistancerateswereobtainedagainstampicillin(92%)andgentamycin(19%),respectively. How-ever, the resistance rate to ciproﬂoxacin was detected in 43% of E. coli isolates. PCR results revealed the frequency of eight putative adhesinmarkersrangedfrom4to95%. Thepresenceof 2genes( ﬁmH and sfa )was>76% amongallscreenedisolates. Of 100UPECiso-lates, 73 were positive for one of the tested O-serotypes. The most common types of O-serotype were O 2 (16%), O 6 (16%), and O 18 (14%). The ﬁmH , sfa , and papC were the most prevalent pattern in the ciproﬂoxacin-susceptible isolates (31 vs. 17). There was no signiﬁcant correlation between the presence of O-serotype, adhesin-encoding genes and susceptibility/resistance to ciproﬂoxacin. Conclusions: The results revealed that UPEC isolates of diﬀerent geographical regions might have various properties. It is worth-whiletoelucidatethediﬀerencesthatmightresultinproducingvaluableevidencebasedonclinicalguidelinesforthemanagement of urinary tract infection.
Vaskulitis: Rehabilitation und sozialmedizinische Leistungsbeurteilung

Zusammenfassung Vaskulitiden sind seltene Erkrankungen mit potentiell lebensbedrohlichem Verlauf. Im Gegensatz zu anderen rheumatischen Erkrankungen konnte in den letzten 10 Jahren bei den Vaskulitiden zwar die Mortalität gesenkt werden, nicht jedoch die Zahl der Erwerbsminderungssrenten und der Arbeitsunfähigkeitstage. Dieser Artikel gibt dem klinisch tätigen Rheumatologen einen Überblick über die Rehabilitation und sozialmedizinische Begutachtung von Patienten mit Vaskulitis. Die Begründung der sozialmedizinischen Einschätzung erfolgt anhand der Internationalen Klassifikation der Funktionsstörungen (ICF). Während einer Rehabilitation auf Kosten der Deutschen Rentenversicherung erfolgt immer eine umfassende sozialmedizinische Begutachtung.