Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of the Use of Shared Decision Making in Breast Cancer: International Survey

Objectives: To assess shared decision-making (SDM) knowledge, attitude and application among health professionals involved in breast cancer (BC) treatment. Materials and Methods: A cross-sectional study based on an online questionnaire, sent by several professional societies to health professionals involved in BC management. There were 26 questions which combined demographic and professional data with some items measured on a Likert-type scale. Results: The participation (459/541; 84.84%) and completion (443/459; 96.51%) rates were high. Participants strongly agreed or agreed in 69.57% (16/23) of their responses. The majority stated that they knew of SDM (mean 4.43 (4.36–4.55)) and were in favour of its implementation (mean 4.58 (4.51–4.64)). They highlighted that SDM practice was not adequate due to lack of resources (3.46 (3.37–3.55)) and agreed on policies that improved its implementation (3.96 (3.88–4.04)). The main advantage of SDM for participants was patient satisfaction (38%), and the main disadvantage was the patients’ paucity of knowledge to understand their disease (24%). The main obstacle indicated was the lack of time and resources (40%). Conclusions: New policies must be designed for adequate training of professionals in integrating SDM in clinical practice, preparing them to use SDM with adequate resources and time provided.
Impact of In Vitro Gastrointestinal Digestion on the Bioaccessibility of Phytochemical Compounds from Eight Fruit Juices

Fruits contain a number of useful substances including antioxidants. Their bio-accessibility after passing through the digestive tract is of primary importance when considering their benefits. In this respect, we investigated the effect of in vitro digestion on the phytochemicals of eight fruit juices. Freshly prepared juices from pomegranate, orange and grapefruit were used as well as commercially available juices from cherry, black grapes and aloe vera, blackberry and chokeberry, and two types of chokeberry and raspberries. Spectrophotometric and HPLC methods were used in order to analyse the sugar content, the total phenolic (TPC) and flavonoid contents (TFC), anthocyanins, phenolic acids and antioxidant activity. Principle component analysis was used to explain the differentiation among the types of fruit juice. Sugar recovery variation was between 4–41%. The bio-accessibility of TPC ranged from 13.52–26.49% and of flavonoids between 24.25–67.00%. The pomegranate juice and the juice of black grapes and aloe vera kept 58.12 and 50.36% of their initial anthocyanins content, while for the other samples less than 1.10% was established. As a result, a maximum of 30% remaining antioxidant activity was measured for some of the samples, but for most this was less than 10%. In conclusion, fruit juices are a rich source of biologically active substances, but a more detailed analysis of food transformation during digestion is needed.
Maximal Isometric or Eccentric Hamstring Strength—Which Test Modality Might Be More Suitable for Assessments in Youth Alpine Ski Racers?

Background: Physical fitness is an important component in the development of youth alpine ski racers. To write systematically planned and age-appropriate fitness programs athletes need to be physically tested at regular intervals at an early age. Although well-developed hamstring muscle strength is important for alpine ski racing performance and the prevention of serious knee injuries, it has not been well investigated, especially in youth athletes. Accordingly, the first aim of the present study was to assess the test-retest reliability of the maximum bilateral eccentric (MBEHS) and unilateral isometric (MUIHS) hamstring tests. The second aim of the present study was to assess whether the results of these two methods correlate and if it is possible to commit to one of the two methods to provide an economic test procedure. Methods: The first study included 26 (14 females/12 males) youth alpine ski racers aged between 12 and 13 years. All athletes performed two MBEHS and two MUIHS tests, 7 days apart. The intraclass correlation coefficient (ICC 3,1) and their 95% confidence intervals based on a consistency two-way mixed model were used to estimate the reliability of the two different test modalities. The second study included 61 (27 females/34 males) youth alpine ski racers aged between 10 and 13 years. All athletes performed one MBEHS and one MUIHS test. Bland-Altman plots and the 95% limits of agreement as well as correlations by Pearson (r) between the different test modalities were assessed. Results: In study 1 “poor” to “moderate” (MBEHS right leg 0.79 (0.58–0.90); left leg 0.83 (0.66–0.92); MUIHS right leg 0.78 (0.56–0.89); left leg 0.66 (0.37–0.83)) ICC values and 95% confident intervals were obtained. Standard error of measurement (SEM) between trails was between 18.3 and 25.1 N. Smallest detectable difference (SDD) was between 50.8 and 69.5 N. In study 2 mean differences between MBEHS and MUIHS was around 20 N with higher values for MBEHS. Significant moderate-to-strong correlations were found between the test modalities (r = 0.74–0.84, p <0.001). Conclusions: The MBEHS test has higher ICC values, lower CV values, higher SEM values and lower SDD values than the MUIHS test. All this suggests that the MBEHS test is more suitable than the MUIHS test to determine the maximum hamstring force in young alpine ski racers.
The Effect of Supplementary LED Lighting on the Morphological and Physiological Traits of Miniature Rosa × Hybrida ‘Aga’ and the Development of Powdery Mildew (Podosphaera pannosa) under Greenhouse Conditions

We investigated the growth traits, flower bud formation, photosynthetic performance, and powdery mildew development in miniature Rosa × hybrida ‘Aga’ plants grown in the greenhouse under different light-emitting diode (LED) light spectra. Fluorescence-based sensors that detect the maximum photochemical efficiency of photosystem II (PS II) as well as chlorophyll and flavonol indices were used in this study. Five different LED light treatments as a supplement to natural sunlight with red (R), blue (B), white (W), RBW+FR (far-red) (high R:FR), and RBW+FR (low R:FR) were used. Control plants were illuminated only by natural sunlight. Plants were grown under different spectra of LED lighting and the same photosynthetic photon flux density (PPFD) (200 µmol m−2 s−1) at a photoperiod of 18 h. Plants grown under both RBW+FR lights were the highest, and had the greatest total shoot length, irrespective of R:FR. These plants also showed the highest maximum quantum yield of PS II (average 0.805) among the light treatments. Red monochromatic light and RBW+FR at high R:FR stimulated flower bud formation. Moreover, plants grown under red LEDs were more resistant to Podosphaera pannosa than those grown under other light treatments. The increased flavonol index in plants exposed to monochromatic blue light, compared to the W and control plants, did not inhibit powdery mildew development.
A Comparison of Nutritional Status, Knowledge and Type 2 Diabetes Risk Among Malaysian Young Adults With and Without Family History of Diabetes

Background Genetic factors increase the risk of type 2 diabetes mellitus (T2DM). Thus, family history status may be a useful public health tool for disease prevention. This study compared the nutritional status, knowledge level, and T2DM risk among young adults with and without a family history of diabetes in Malaysia. Methods A total of 288 university students aged 18 to 29 years participated in this comparative cross-sectional study. We assessed dietary intake, level of physical activity, knowledge of diabetes and T2DM risk. Results Respondents with a family history of diabetes had significantly higher weight (P = 0.003), body mass index (P < 0.001), waist circumference (P < 0.001), diabetes knowledge level (P < 0.005) and T2DM risk (P < 0.001). Ethnicity, fibre intake, T2DM risk score and knowledge about diabetes were significant contributors toward family history of diabetes (P = 0.025, 0.034, < 0.001 and 0.004, respectively). Conclusion Young adults with a family history of diabetes had suboptimal nutritional status. Despite being more knowledgeable about diabetes, they did not practice a healthy lifestyle. Family history status can be used to screen young adults at the risk of developing T2DM for primary disease prevention.
Treatment-Resistant Depression Revisited: A Glimmer of Hope

Major Depressive Disorder (MDD) is a highly prevalent psychiatric disorder worldwide. It causes individual suffering, loss of productivity, increased health care costs and high suicide risk. Current pharmacologic interventions fail to produce at least partial response to approximately one third of these patients, and remission is obtained in approximately 30% of patients. This is known as Treatment-Resistant Depression (TRD). The burden of TRD exponentially increases the longer it persists, with a higher risk of impaired functional and social functioning, vast losses in quality of life and significant risk of somatic morbidity and suicidality. Different approaches have been suggested and utilized, but the results have not been encouraging. In this review article, we present new approaches to identify and correct potential causes of TRD, thereby reducing its prevalence and with it the overall burden of this disease entity. We will address potential contributory factors to TRD, most of which can be investigated in many laboratories as routine tests. We discuss endocrinological aberrations, notably, hypothalamic-pituitary-adrenal (HPA) axis dysregulation and thyroid and gonadal dysfunction. We address the role of Vitamin D in contributing to depression. Pharmacogenomic testing is being increasingly used to determine Single Nucleotide Polymorphisms in Cytochrome P450, Serotonin Transporter, COMT, folic acid conversion (MTHFR). As the role of immune system dysregulation is being recognized as potentially a major contributory factor to TRD, the measurement of C-reactive protein (CRP) and select immune biomarkers, where testing is available, can guide combination treatments with anti-inflammatory agents (e.g., selective COX-2 inhibitors) reversing treatment resistance. We focus on established and emerging test procedures, potential biomarkers and non-biologic assessments and interventions to apply personalized medicine to effectively manage treatment resistance in general and TRD specifically.
Synthesis,Characterization, and Antibacterial Activity of Quaternized of N-Aromatic Chitosan Derivatives

The quaternized of N-aryl chitosan (CTS) derivatives containing different aromatic moieties were synthesized by two steps, N-aromatic Schiff and the quaternization. The chemical structures of all chitosan derivatives, N-vanillin Schiff’s base chitosan (NVCh), N-cinnamaldehyde Schiff’s base chitosan (NCCh), N-benzaldehyde Schiff’s base CTS (NBCh), and their quaternized of N-aromatic CTS derivatives were characterized by ATR-FTIR. The water solubility of the N-aromatic Schiff’s base CTS derivatives had very poor water solubility. But after quaternized, the water solubility of CTS derivatives was obviously improved. The antibacterial studies of these CTS derivatives were carried out by the inhibition zone diameters methods against E.coli (Gram-negative), S.aurueus and P.aeruginosa (Gram-positive) bacteria, and against V.Aspergillus niger (fungal). It was found that the quaternized NVSCTS showed higher antibacterial activity than quaternized NCCh and quaternized NVBCh at the almost same DQ and ES level. In comparison to each of the chemical structure, it was found that the phenol hydroxyl group effect on antibacterial activity was even higher than that of positive charge density of CTS.
Gynura divaricata Water Extract Presented the Possibility to Enhance Neuronal Regeneration

Gynura divaricata (GD) is an Asian herb widely used as an alternative medicine and functional food for type 2 diabetes. Diabetic neuropathy is considered as an important complication of diabetic patients. This study focused on neuroregenerative effects of GD for use in the prevention of diabetic neuropathy. GD leaves were cut and boiled in water to mimic real-life cooking. The boiled content was filtered through white gauze and lyophilized to preserve as dried powder. Antioxidant assay was performed using DPPH assays. UHPLC-QTOF-MS/MS was employed to test for important compounds in the extract of these herbs. MTT assay was used to test for cell viability. The extracts at concentration of 250 μg/mL were tested with human gingival cell to observe the change of gene expression. The DPPH assay showed that GD water extract at the concentration of 5000 μg/mL could inhibit DPPH radical for 39.2%. The results showed that 5000 µg of GD water extract contained total phenolic content equivalent to 310.9 µg standard gallic acid. UHPLC-QTOF-MS/MS result found phenolic acids and flavonoids as the main components. Human gingival cells treated with 250 μg/mL of GD water extract for 10 days showed upregulation of some neuronal differentiation markers. Staining with Cdr3 dye confirmed the presentation of neuronal progenitors. The extract at the concentration of 250 μg/mL was also tested with apical papilla cells to screen for change of gene expression by RNA sequencing. The result also showed significant upregulation of alpha-internexin (INA). These results indicated that GD water extract might have an inductive effect for neural regeneration and could be used as functional food and supplementation for the prevention or treatment of diabetic neuropathy. This work provided the basic knowledge for further investigations into the benefits of GD for diabetic neuropathy.
Oxytocin in Schizophrenia: Pathophysiology and Implications for Future Treatment

Schizophrenia is a form of mental disorder that is behaviorally characterized by abnormal behavior, such as social function deficits or other behaviors that are disconnected from reality. Dysregulation of oxytocin may play a role in regulating the expression of schizophrenia. Given oxytocin’s role in social cognition and behavior, a variety of studies have examined the potential clinical benefits of oxytocin in improving the psychopathology of patients with schizophrenia. In this review, we highlight the evidence for the role of endogenous oxytocin in schizophrenia, from animal models to human studies. We further discuss the potential of oxytocin as a therapeutic agent for schizophrenia and its implication in future treatment.
The Challenges to Promoting Attachment for Hospitalised Infants with NAS

The postnatal period is crucial for infants in establishing a connection with and security in primary caregivers and can have enduring effects on attachment patterns. However, due to the need for symptom management, many infants diagnosed with neonatal abstinence syndrome (NAS) may be separated from primary caregivers and cared for in a neonatal intensive care unit (NICU) or special care nursery (SCN) soon after birth. Research has shown that substance-exposed infants are more likely to experience insecure attachment patterns with their primary caregivers and that mothers with a history of substance abuse are less sensitive to their infants’ cues. Therefore, the aim of this research was to explore nurses’ and midwives’ experiences in promoting the attachment relationship for infants admitted to an NICU/SCN with NAS. A qualitative research design was used to gather data on the experiences of nine nurses/midwives from various NICU and SCN settings in Australia. Individual, semi-structured interviews were conducted, and transcribed interviews were coded using thematic analysis. While nurses/midwives valued the attachment relationship for infants with NAS, facilitation of the attachment relationship was mainly promoted when the mother was present. However, parents were often reported to be absent from the nursery. Difficulties in promoting an attachment relationship were also identified when an infant had child protection involvement. This research identifies areas in need of innovative change regarding the approach taken to promote the attachment relationship for infants with NAS when they are admitted to an NICU/SCN.
A Muscular and Cerebral Physiological Indices Assessment for Stress Measuring during Virtual Wheelchair Guidance

The work presented in this manuscript has the purpose to assess the relationship between human factors and physiological indices. We discuss the relationship between stress as human factor and cerebral and muscular signals as features. Ten male paraplegic, right-handed subjects were volunteers for the experiment (mean age 34 ±6). They drove a virtual wheelchair in an indoor environment. They filled five missions where, in each one, an environmental parameter was changed. Meanwhile, they were equipped with Electromyography (EMG) sensors and Electroencephalography (EEG). Frequency and temporal features were filtered and extracted. Principal component analysis (PCA), Fisher’s tests, repeated measure Anova and post hoc Tukey test (α = 0.05) were implemented for statistics. Environmental modifications are subject to induce stress, which impacts muscular and cerebral activities. While the time pressure parameter was the most influent, the transition from static to moving obstacles (avatars), tends to have a significant impact on stress levels. However, adding more moving obstacles did not show any impact. A synchronization factor was noticed between cerebral and muscular features in higher stress levels. Further examination is needed to assess EEG reliability in these situations.
Cold and hot water–extractable organic matter as indicators of litter decomposition in forest soils

Mild extractions were used as indicators of easily decomposable organic matter (OM). However, the chemical composition of extracted OM often remained unclear. Therefore, the composition of cold and hot water–extractable OM was investigated in the O horizons (Oi, Oe, Oa) of a 170 y old beech stand (Fagus sylvatica) in the Ore Mtns. , SE Germany. To simulate litter decomposition, the O horizon samples were incubated for 1 week under defined conditions. Cold- and hot-water extracts were analyzed and chemically characterized by pyrolysis–field ionization mass spectrometry (Py-FIMS). The C and N concentrations were always lower in the cold-(C: 2.69 to 3.95 g kg–1; N: 0.14 to 0.29 g kg–1) than in the hot-water extracts (C: 13.77 to 15.51 g kg–1; N: 0.34 to 0.83 g kg–1). The C : N ratios of both extracts increased with increasing depth. Incubation increased the concentrations of C and N in all water extracts, while C : N ratios of extracts decreased. The molecular-chemical composition of cold and hot water–extracted OM revealed distinct differences. Generally, cold water–extracted OM was thermally more stable than hot water–extracted OM. The mass spectra of the hot water–extracted organic matter revealed more intensive signals of carbohydrates, phenols, and lignin monomers. Additionally, the n-C28 fatty acid and the n-C38–to–n-C52 alkyl monoesters clearly distinguished the hot- from the cold-water extract. A principle-component analysis visualized (1) alterations in the molecular-chemical composition of cold- and hot-water extracts due to previous incubation of the solid O horizon samples and (2) a decomposition from the Oi to the Oh horizon. This provides evidence that the macromorphological litter decomposition was reflected by the chemical composition of water extracts, and that Py-FIMS is well-suited to explain at the molecular level why OM decomposability is correlated with water-extracted C.
Therapeutic Targeting of MicroRNAs in the Tumor Microenvironment

The tumor-microenvironment (TME) is an amalgamation of various factors derived from malignant cells and infiltrating host cells, including cells of the immune system. One of the important factors of the TME is microRNAs (miRs) that regulate target gene expression at a post transcriptional level. MiRs have been found to be dysregulated in tumor as well as in stromal cells and they emerged as important regulators of tumorigenesis. In fact, miRs regulate almost all hallmarks of cancer, thus making them attractive tools and targets for novel anti-tumoral treatment strategies. Tumor to stroma cell cross-propagation of miRs to regulate protumoral functions has been a salient feature of the TME. MiRs can either act as tumor suppressors or oncogenes (oncomiRs) and both miR mimics as well as miR inhibitors (antimiRs) have been used in preclinical trials to alter cancer and stromal cell phenotypes. Owing to their cascading ability to regulate upstream target genes and their chemical nature, which allows specific pharmacological targeting, miRs are attractive targets for anti-tumor therapy. In this review, we cover a recent update on our understanding of dysregulated miRs in the TME and provide an overview of how these miRs are involved in current cancer-therapeutic approaches from bench to bedside.
Epigenetic Regulation of Processes Related to High Level of Fibroblast Growth Factor 21 in Obese Subjects

We hypothesised that epigenetics may play an important role in mediating fibroblast growth factor 21 (FGF21) resistance in obesity. We aimed to evaluate DNA methylation changes and miRNA pattern in obese subjects associated with high serum FGF21 levels. The study included 136 participants with BMI 27–45 kg/m2. Fasting FGF21, glucose, insulin, GIP, lipids, adipokines, miokines and cytokines were measured and compared in high serum FGF21 (n = 68) group to low FGF21 (n = 68) group. Human DNA Methylation Microarrays were analysed in leukocytes from each group (n = 16). Expression of miRNAs was evaluated using quantitative PCR-TLDA. The study identified differentially methylated genes in pathways related to glucose transport, insulin secretion and signalling, lipid transport and cellular metabolism, response to nutrient levels, thermogenesis, browning of adipose tissue and bone mineralisation. Additionally, it detected transcription factor genes regulating FGF21 and fibroblast growth factor receptor and vascular endothelial growth factor receptor pathways regulation. Increased expression of hsa-miR-875-5p and decreased expression of hsa-miR-133a-3p, hsa-miR-185-5p and hsa-miR-200c-3p were found in the group with high serum FGF21. These changes were associated with high FGF21, VEGF and low adiponectin serum levels. Our results point to a significant role of the epigenetic regulation of genes involved in metabolic pathways related to FGF21 action.