Miracle-dz/UniFAR-FTUs huggingface dataset:
ARRHYTHMIA IN THE COURSE OF GENERALISED EPILEPSY OF UNKNOWN ETIOLOGY - A CASE STUDY.

OBJECTIVE The aim: To draw attention to the need for careful analysis of patients with epilepsy in terms of the possibility of co-occurring arrhythmia. PATIENTS AND METHODS Material and methods: Analysis of video-EEG registration in the inter-seizure period in a patient with diagnosed epilepsy. RESULTS Case study: The authors present a 33-year-old patient with generalised epilepsy of unknown etiology diagnosed in childhood. In this subject, generalised seizure discharges without clinical manifestation of epileptic seizure and with concomitant cardiac arrhythmias in the form of atrial fibrillation were recorded during video-EEG registration. This was carried out during the patient's of hospitalisation at the neurology ward. CONCLUSION Conclusions: The case study presented is as an example of existing complex and not fully understood interactions between epilepsy and arrhythmia. A mutation within the SCN1B encoding genes, which is responsible for channelopathy within the voltage-dependent Nav sodium channels, may be considered as a potential cause for this state. However, further analysis and research is needed that would eventually allow to find out the reason for these relationships.
A large-scale study exploring understanding of the national premarital screening program among Jordanians: Is an at-risk marriage a valid option for Jordanians?

Detecting carrier couples through premarital screening implementation is an effective way of controlling thalassaemia. The aim of this study was to investigate the knowledge of university students towards premarital screening and their possible involvement in an at-risk marriage. Students (n = 976) were chosen randomly from Jordanian universities. The questionnaire consisted of three sections: socio-demographical data, the students’ knowledge about the screening programme, and finally their beliefs and future decisions related to it. Most (90%) participants were aware of the premarital screening availability. Females had significantly better understanding of premarital screening compared to males. Despite the majority of the participants not wanting to go ahead with at-risk marriages, 23% would not be deterred from marrying their anticipated partner and believed engaging in at-risk marriage was a valid idea. We suggest providing more effective educational programmes, genetic counselling and free prenatal diagnosis for at-risk couples.
Acetabular impaction grafting with mesh for acetabular bone defects: a systematic review

Introduction: In conjunction with impaction bone grafting (IBG), metal meshes have been proposed to minimise defects of the medial and superolateral walls in order to convert combined complex uncontained segmental defects into contained cavitary defects to facilitate IBG. Methods: The US National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews were queried for publications from January 1980 to March 2019 utilising keywords pertinent to total hip arthroplasty (THA), acetabular impaction bone grafting, clinical or functional outcomes, revision THA, or postoperative complications. Results: 7 articles were found to be suitable for inclusion in the present study. The mean modified Coleman methodology score for methodological deficiencies of the studies was 45.3 (range 38–59). Severe acetabular bone loss was present in 56% of cases having moderate bone loss in 18%, and mild in 26%. The all-cause reoperation rate was 7.4%, while the all-cause revision rate of the acetabular component was 6.2%. Conclusions: IBG with mesh is effective for selected patients with acetabular bone defects. Most patients with moderate bone loss as well as selected patients with large superolateral defects can be successfully treated with IBG combined with mesh. There is limited data to show that IBG with mesh might be associated with decreased survival rates in patients with severe lateral defects (Paprosky IIIA) combined with ischial or medial wall osteolysis who require combined medial and lateral meshes. In addition, patients with severe superomedial migration of the cup (Paprosky IIIB) should not be treated with IBG and mesh.
Oceanic dispersal barriers in a holoplanktonic gastropod

Pteropods, a group of holoplanktonic gastropods, are regarded as bioindicators of the effects of ocean acidification on open ocean ecosystems, because their thin aragonitic shells are susceptible to dissolution. While there have been recent efforts to address their capacity for physiological acclimation, it is also important to gain predictive understanding of their ability to adapt to future ocean conditions. However, little is known about the levels of genetic variation and large‐scale population structuring of pteropods, key characteristics enabling local adaptation. We examined the spatial distribution of genetic diversity in the mitochondrial cytochrome c oxidase I (COI) and nuclear 28S gene fragments, as well as shell shape variation, across a latitudinal transect in the Atlantic Ocean (35°N–36°S) for the pteropod Limacina bulimoides. We observed high levels of genetic variability (COI π = 0.034, 28S π = 0.0021) and strong spatial structuring (COI ΦST = 0.230, 28S ΦST = 0.255) across this transect. Based on the congruence of mitochondrial and nuclear differentiation, as well as differences in shell shape, we identified a primary dispersal barrier in the southern Atlantic subtropical gyre (15–18°S). This barrier is maintained despite the presence of expatriates, a gyral current system, and in the absence of any distinct oceanographic gradients in this region, suggesting that reproductive isolation between these populations must be strong. A secondary dispersal barrier supported only by 28S pairwise ΦST comparisons was identified in the equatorial upwelling region (between 15°N and 4°S), which is concordant with barriers observed in other zooplankton species. Both oceanic dispersal barriers were congruent with regions of low abundance reported for a similar basin‐scale transect that was sampled 2 years later. Our finding supports the hypothesis that low abundance indicates areas of suboptimal habitat that result in barriers to gene flow in widely distributed zooplankton species. Such species may in fact consist of several populations or (sub)species that are adapted to local environmental conditions, limiting their potential for adaptive responses to ocean changes. Future analyses of genome‐wide diversity in pteropods could provide further insight into the strength, formation and maintenance of oceanic dispersal barriers.
The Association of Dexmedetomidine with Firing Properties in Pallidal Neurons

Abstract: Background: Microelectrode recordings (MERs) are used during deep brain stimulation surgery (DBS) to optimize patient outcomes and provide a unique method of collecting data regarding neurological conditions. However, MERs can be affected by anesthetics such as dexmedetomidine. Little is known about the effects of dexmedetomidine (DEX) on the globus pallidus interna (GPi), a common target for DBS. The primary aim of this study is to investigate the hypothesis that DEX is associated with alterations in GPi MERs. Methods: We conducted a retrospective analysis comparing MERs from patients with Parkinson’s disease (PD) and dystonia who underwent insertion of DBS of the GPi under DEX sedation with those who went through the same procedure without DEX (No DEX). Results: Firing rates for GPi neurons in the DEX group were lower (57.44 ± 2.04; mean ± SEM, n = 163 cells) than the No DEX group (69.53 ± 2.06, n = 112 cells, P < 0.0001). Overall, DEX was associated with a greater proportion of GPi cells classified as firing in bursty pattern compared to our No DEX group. (29.41%, n = 153 vs 14.81%, n = 108, P = 0.008). This effect was present for both PD and dystonia patients who underwent the procedure. High doses of DEX were associated with lower firing rates than low doses. Conclusions: Our results suggest that DEX is associated with a decrease in GPi firing rates and are associated with an increase in burstiness. Furthermore, these effects are similar between dystonia and PD patients. Lastly, the effects of DEX may differ between high doses and low doses.
The impact of chest radiography and Xpert MTB/RIF testing among household contacts in Chennai, India

Tuberculosis prevalence surveys have demonstrated the benefit of screening with chest x-ray (CXR) and sensitive diagnostic tests compared to symptoms and smear microscopy. However, in programmatic practice there is little evidence on the yield of different algorithms. We implemented contact tracing in Chennai, India for adult sputum-positive TB patients registered from January 2015 to March 2016. Patients with symptoms or abnormal X-ray findings further underwent testing using Xpert MTB/RIF (Xpert) and smear microscopy. A retrospective cohort study was done to summarize the key findings. We verbally screened 5553 contacts for symptoms, CXR through private sector collaboration, Xpert, and smear microscopy. Overall, 1312 (23.6%) contacts screened positive. CXR alone identified 531 (40.5%) of them, 679 (51.8%) were symptom-positive only, while 102 (7.8%) were positive on both the symptom and CXR screen. Overall, 35 bacteriologically positive cases were identified (0.7%). A standard approach of symptoms screening followed by microscopy identified only 9 (25.7%) of the total number of bacteriologically positive cases, whereas the combination of a CRX screening followed by microscopy identified 13 (37.1%) of the cases. The algorithm of symptoms screening followed by Xpert testing, detected 20 cases, whereas the combination of symptoms and CXR followed by Xpert increased this number to 35 (75% increase compared to symptoms and Xpert). Optimal use of more sensitive screening tests, better diagnostic tests, and novel private sector engagement can improve diagnostic yield in a programmatic setting.
Real‐world effectiveness of direct‐acting antiviral agents for chronic hepatitis C patients with genotype‐2 infection after completed treatment

Chronic hepatitis C (CHC) is a major cause of cirrhosis, hepatocellular carcinoma (HCC), and mortality. Eliminating hepatitis C virus (HCV) can greatly improve long‐term outcomes. Several direct‐acting antiviral agents (DAAs), including sofosbuvir (SOF) plus different NS5A inhibitors, as well as non‐SOF‐based DAAs, including glecaprevir/pibrentasvir (GLE/PIB), have been approved for treating CHC genotype‐2 (GT‐2) patients in Taiwan. However, there is limited real‐world effectiveness data regarding these different regimens. Thus, we aimed to evaluate the real‐world efficacy in CHC GT‐2 patients who underwent these DAA regimens. We retrospectively enrolled CHC GT‐2 patients who were treated with SOF‐based DAAs or GLE/PIB at a single medical center. A total of 704 enrolled patients were treated with either SOF + ribavirin (RBV), SOF/daclatasvir (DCV) ± RBV, SOF/ledipasvir (LDV) ± RBV, SOF/velpatasvir (VEL) ± RBV, or with GLE/PIB. The overall sustained virological response (SVR) rate was 97.9%. The SVR rate was significantly lower in the SOF + RBV group (95.6%) than in the non‐SOF + RBV (98.9%) group, especially compared to the SOF/DCV (100%) and GLE/PIB groups (99.5%). Among patients treated with SOF + RBV, cirrhotic patients had significantly lower SVR rates than noncirrhotic patients (89.4% vs 98.2%). Multivariate analysis showed that patients with a younger age, hepatitis B virus coinfection, baseline cirrhosis, or those who received SOF + RBV were less likely to achieve SVR. In conclusion, for CHC GT‐2 patients, SOF in combination with DCV, LDV, or VEL, as well as GLE/PIB, achieved similar high efficacies, regardless of cirrhosis, treatment experience, or chronic kidney disease status. Therefore, the use of DAA therapy to eradicate HCV should not be delayed in these populations.
Foster children’s attachment representations: the role of type of maltreatment and the relationship with birth family

ABSTRACT Children in foster care are at risk of developing insecure and disorganized attachment, which is problematic for establishing new relationships in foster families. However, most previous studies have focused on attachment behaviors in young children rather than on attachment representations. We compared foster children’s attachment representations with those of a community group, analyzing also the contribution made by different factors to foster children’s attachment representations. We assessed the attachment representations of 109 children aged between 4 and 9 years (51 children in non-kin foster care and 58 community children) in southern Spain, using a narrative story stem measure. Case records information were collected for adversity and child protection variables. Foster children had fewer security and more avoidance indicators than their community counterparts, with those who had suffered more severe maltreatment scoring lower for security and higher for disorganization. Exposure to physical and emotional abuse and birth parents’ opposition to the foster placement predicted more disorganized attachment representations. Interventions with foster children should consider their heterogeneity in terms of attachment outcomes, and foster caregivers of abused children may need guidance in order to provide therapeutic caregiving.
Application of contemporary neuroproteomic techniques in unravelling neurological disorders.

Decades of research have stunned us with the very distinctive anatomy and physiology of our brain and on the other hand, its complexity has always posed a great difficulty in treating its dysfunction or damage. Understanding the brain under normal and, particularly in the diseased state, has always been very challenging and would have been impossible without proteomics. Neuroproteomic techniques have been extensively used for unraveling both dynamics and content of the proteome of our nervous system. This modern-day investigation and quantification of protein concentration and expression has given us a platform which enhances our knowledge on disease-associated processes and pathways modification and also leads to the identification of possible biomarkers that can be therapeutically targeted. With increased interest in identifying and targeting possible biomarkers, this article focuses on describing applications of the much discussed neuroproteomics, with a significant role in the disease pathogenesis of some very common neurological disorders. This article will collectively discuss the use and relevance of neuroproteomics in a range of neurological diseases such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, epilepsy, and psychiatric disorders. We have also attempted to present the current successes and failures of the neuroproteomics approach on the results obtained from different clinical studies that targeted biomarkers associated with any particular neurological disorder.
Elective Care and Health Services Research in the COVID-19 Era.

The coronavirus disease 2019 (COVID-19) pandemic has upended health care delivery systems around the globe and generated a massive amount of research, most of which has focused on public health measures to contain the pandemic and the provision of acute care to patients with serious infections. However, lurking in the background are the less visible and more insidious changes resulting from the sudden reduction in elective, non–COVID-19–related care. A glaring example has been a 25% reduction in outpatient services, with a concomitant skyrocketing number of telemedicine encounters. 1 Evidence of the potential harms from the curtailments in face-to-face care has included a precipitous drop in the delivery of preventive care, including reductions of 90% or more in screenings for breast, colon, and cervical cancers. 2 As is often the case in the US health care system, these failings have disproportionately affected individuals who belong to racial and ethnic minority groups and individuals with socioeconomic disadvantage.
Desmoid-type fibromatosis difficult to distinguish from GIST : A case report.

Background : Desmoid-type fibromatosis is a very rare disease that has no characteristic image findings, so it is often difficult to differentiate from gastrointestinal stromal tumor (GIST). A case of desmoid-type fibromatosis that was difficult to differentiate from GIST is reported. The decisive factor in the diagnosis was positive nuclear immunostaining for β-catenin nucleus. Case presentation : A man is his 30s had no significant past medical history, including no abdominal surgery. A medical check-up found a large tumor in the right lateral abdomen. After some examinations, a preoperative diagnosis of GIST was made, and open ileocecal resection was performed. However, the final diagnosis based on the pathological findings was desmoid-type fibromatosis. Conclusions : We should consider desmoid-type fibromatosis when we find a large abdominal mass, but it may be difficult to diagnose based only on imaging findings. Immunohistochemical examination of the specimen may make the diagnosis. J. Med. Invest. 67 : 375-377, August, 2020.
Culturally Sensitive Care: Definitions, Perceptions, and Practices of Health Care Professionals

Introduction Research highlights that patients from ethnic minority groups often receive lower quality of care. This study contributes to the knowledge and understanding of culturally sensitive care and explores health care professionals’ definitions and perceptions of this concept and how they deliver this in practice. Method This qualitative study conducted a total of six focus groups (n = 34) and four in-depth interviews with six categories of health care professionals in Belgium. Thematic content analysis was used. Results The results indicate that the concept of culturally sensitive care is perceived quite narrowly. Professionals are likely to portray their own frame of reference and find it challenging to show empathy with patients with a different background. Othering (micro-racism by defining “the other”) is a powerful example. Discussion The discussion reveals the significance of increasing cultural awareness and understanding, sensitizing about current narrow perceptions, and enhancing culturally sensitive care in the Belgian health care setting.
Cancer Stem Cells in Head and Neck Metastatic Malignant Melanoma Express Components of the Renin-Angiotensin System

Components of the renin-angiotensin system (RAS) are expressed by cancer stem cells (CSCs) in many cancer types. We here investigated expression of the RAS by the CSC subpopulations in human head and neck metastatic malignant melanoma (HNmMM) tissue samples and HNmMM-derived primary cell lines. Immunohistochemical staining demonstrated expression of pro-renin receptor (PRR), angiotensin-converting enzyme (ACE), and angiotensin II receptor 2 (AT2R) in all; renin in one; and ACE2 in none of the 20 HNmMM tissue samples. PRR was localized to cells within the tumor nests (TNs), while AT2R was expressed by cells within the TNs and the peritumoral stroma (PTS). ACE was localized to the endothelium of the tumor microvessels within the PTS. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) detected transcripts for PRR, ACE, ACE2, and AT1R, in all the five HNmMM tissue samples and four HNmMM-derived primary cell lines; renin in one tissue sample and one cell line, and AT2R in none of the five HNmMM tissue samples and cell lines. Western blotting showed variable expression of ACE, PRR, and AT2R, but not ACE2, in six HNmMM tissue samples and two HNmMM-derived primary cell lines. Immunofluorescence staining of two HNmMM tissue samples demonstrated expression of PRR and AT2R by the SOX2+ CSCs within the TNs and the OCT4+ CSCs within the PTS, with ACE localized to the endothelium of the tumor microvessels within the PTS.
Tacrolimus Bayesian Dose Adjustment in Pediatric Renal Transplant Recipients

Supplemental Digital Content is Available in the Text. Background: Immunosuppressant Bayesian Dose Adjustment (ISBA) is an online expert system that estimates the area under the curve (AUC) of immunosuppressive drugs through pharmacokinetic modelling and Bayesian estimation to propose dose adjustments to reach predefined exposure targets. The ISBA database was retrospectively analyzed to describe tacrolimus pharmacokinetics and exposure, evaluate the efficiency of ISBA dose recommendations, and propose tacrolimus AUC0–12h target ranges for pediatric renal allograft recipients treated with immediate release tacrolimus. Methods: The database included 1935 tacrolimus dose adjustment requests from 419 patients <19 years old who were treated with immediate-release tacrolimus and followed in 21 French hospitals. The tacrolimus exposure evolution with patient age and posttransplantation time, the correlation between trough tacrolimus concentration (C0) and AUC0–12h at different periods posttransplantation, and the efficiency of dose recommendations to avoid underexposure and overexposure and to decrease between-patient AUC variability were investigated. Results: Tacrolimus AUC showed large between-patient variability (CV% = 40%) but moderate within-patient variability (median = 24.3% over a 3-month period). Dose-standardized exposure but not the AUC/C0 ratio significantly decreased with time posttransplantation and patient age. We derived AUC0–12h ranges from the consensual C0 ranges using linear regression equations. When the ISBA recommended dose was applied, the AUC distribution was narrower and a significantly higher proportion was within the targets (P < 0.0001). Conclusions: ISBA efficiently reduced tacrolimus underexposure and overexposure. The AUC0–12h target ranges for pediatric patients derived from the database were similar to those previously reported for adults. Estimating the AUC/C0 ratio could help determine personalized C0 targets.
Role of Adipose-Derived Mesenchymal Stem Cells in the Regeneration of Cardiac Tissue and Improvement of Cardiac Function: a Narrative Review

Recent efforts have made in order to novel therapeutic approaches to reduce the heavy cardiovascular burden. The use of cell therapy and applying stem cell-based therapies has received much attention; of particular interest are adipose-derived mesenchymal stem cells (ADSCs). The present review aimed to review the studies which examined and researched various aspects of ADSCs to improve cardiac function. A comprehensive review of all articles assessed and discussed the application of ADSCs in the improvement of cardiac tissue renewing and cardiomyocytes regeneration was planned and conducted by the two reviewers. The initial literature search revealed a total of 153 articles that, of those, 34 were considered eligible. From the perspective of heart tissue regeneration, the inductive role of ADSCs in sensing mechanical stimulation and produce collagen and elastin scaffolds, vascularizing cardiac tissue, and exosomes (vesicles derived from ADSCs) in ADSCs‐ mediated myocardial protection has indicated. In the process of ADSCs differentiation to cardiomyocytelike cells, the role of various targeted pathways have been identified that can be influenced by different elements such as TGF-beta1, phorbol myristate acetate, Angiotensin II, Rhoassociated kinases, 5-Azaytidine, Sodium valproate, fibrin scaffold and trichostatin A have been highlighted. In the final, from a therapeutic point of view, the effectiveness of ADMSCs differentiation to cardiomyocytes as improving left ventricular functional state has been discussed. Summarizing the studies confirms a significant improvement in cardiac function following direct application of ADSCs or their transformation to cardiomyocytes by stimulating or inhibiting various cellular pathways leading reducing oxidative stress and inflammatory bed, reducing cardiomyocyte apoptosis, attenuating cardiac fibrosis, reducing the infiltration of immune cells and collagen deposition, and enhancing angiogenesis.