Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of continuous positive airway pressure (CPAP) on mild-moderate obstructive sleep apnea (OSA) related dreaminess

Abstract Introduction: Dreaminess is one of the common symptoms of sleep disorders and often leads to complaint of poor sleep quality and morning fatigue. Literatures on the relationship between obstructive sleep apnea (OSA) and dreams have been reported with contradictory results. In this case report, we identified a moderate OSA related dreaminess that was successfully treated by continuous positive airway pressure (CPAP). Patient concerns: We present a case of a 47-year-old woman who was bothered by all-night dreaminess for over 20 years. Diagnosis: An overnight polysomnography (PSG) examination showed the apnea-hypopnea index (AHI) was 21.7 events/hour and the rapid eye movement (REM)-AHI was 46.3 events/hour. The patient was diagnosed with moderate OSA. Interventions: The patient received auto CPAP therapy. Outcomes: The symptoms of dreaminess and daytime functioning significantly improved after CPAP treatment. During the 4-month follow up, 3 CPAP titrations showed that OSA events and OSA related REM interruption almost disappeared. On the night of PSG diagnosis, only 1 non-rapid eye movement sleep 3 (N3) episode occurred before the first REM episode. Nevertheless, N3 episodes were observed before the majority of REM episodes on all three nights of CPAP titration. Conclusion: This case suggests that specific REM related OSA could be the main reason for dreaminess symptoms and could be successfully treated by CPAP. The identification of OSA, especially for mild-moderate OSA, has not received enough attention in the management of complaints of dissatisfactory sleep issues. We believe this case has educational value in clinical practice.
A Snu114–GTP–Prp8 module forms a relay station for efficient splicing in yeast

Abstract The single G protein of the spliceosome, Snu114, has been proposed to facilitate splicing as a molecular motor or as a regulatory G protein. However, available structures of spliceosomal complexes show Snu114 in the same GTP-bound state, and presently no Snu114 GTPase-regulatory protein is known. We determined a crystal structure of Snu114 with a Snu114-binding region of the Prp8 protein, in which Snu114 again adopts the same GTP-bound conformation seen in spliceosomes. Snu114 and the Snu114–Prp8 complex co-purified with endogenous GTP. Snu114 exhibited weak, intrinsic GTPase activity that was abolished by the Prp8 Snu114-binding region. Exchange of GTP-contacting residues in Snu114, or of Prp8 residues lining the Snu114 GTP-binding pocket, led to temperature-sensitive yeast growth and affected the same set of splicing events in vivo. Consistent with dynamic Snu114-mediated protein interactions during splicing, our results suggest that the Snu114–GTP–Prp8 module serves as a relay station during spliceosome activation and disassembly, but that GTPase activity may be dispensable for splicing.
Optimization of Simple Sphygmomanometric Blood Pressure Measurement in Routine Prenatal Care

Background: Despite reported early subclinical hypertension of women at risk, blood pressures at threshold 140/90 mm Hg are used today to guide prenatal care. We aim to investigate the most appropriate gestation-specific threshold to measure early gestational blood pressures, allowing for a simple stratification between pregnant women at low/high risk for hypertension. Methods: Singleton pregnancies were selected at Clinic Oost-Limburg, Genk, Belgium. A standard protocol was used to measure systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP) in supine and standing position, by mode of an oscillometric sphygmomanometer around 12 and 20 weeks of gestation. After delivery, outcome was categorized in normotensive or hypertensive pregnancies. In a subgroup, routine blood pressures retrieved from prenatal records were compared to standardized blood pressures. ROC analysis was used to define early gestational blood pressure thresholds with best discriminative performance for hypertension. All analyses were done in SPSS software (α ≤ 0.05). Results: A total of 780 women were measured at 12 weeks, of which 433 pregnant women were re-evaluated around 20 weeks. At both occasions, blood pressures were significantly higher in hypertensive than in normotensive pregnancies (p<0.0001). Analysis showed for DBP in standing position at cut off 79 mmHg a sensitivity, specificity, positive predictive value and negative predictive value of 72%, 64%, 15,5% and 96% at 12 weeks and 86%, 69%, 20% and 98% at 20 weeks at cut off 77 mm Hg. At 20 weeks, Area under the Curve (AUC) for DBP was 83% in standing position and 80% in supine position. For routine versus standardized blood pressure measurement, AUC was 66% versus 72% at 12 weeks and 69% versus 82% at 20 weeks, respectively. Conclusion: Simple blood pressure measurements with gestation-specific thresholds can easily be used worldwide towards improved planning of prenatal care as compared to current protocols.
Management of stress by professional nurses in the hospitals of Vhembe District in Limpopo Province, South Africa

INTRODUCTION: Stress management is a major challenge in South Africa, as well as other countries. Job stress has negative effect on professional nurses ’rendering of patient care. They should thus be able to manage their stress successfully in order to render quality nursing care to the customers. The purpose of the study was to identify and describe factors contributing to stressors among professional nurses, the effects of stressors on the wellbeing of professional nurses and the management of stress by professional nurses. METHOD: A quantitative, exploratory, descriptive design was utilised. The target population of this research study comprised of all professional nurses who were at work the day the researcher visited the sampled hospitals. The questionnaires were used to collect data from the sampled professional nurses, and descriptive statistic was used to analyse the data. RESULTS: The findings revealed that 45% of the professional nurses experienced pressure of work without rest, whereas 75% viewed changes at work as challenging and 15% mostly experienced accidents while on duty. Most of them indicated that they had previously
Ps19, a novel chitin binding protein from Pteria sterna capable to mineralize aragonite plates in vitro

Mollusk shell is composed of two CaCO3 polymorphs (calcite and aragonite) and an organic matrix that consists of acetic acid- or ethylenediaminetetraacetic acid (EDTA)-soluble and insoluble proteins and other biomolecules (polysaccharides, β-chitin). However, the shell matrix proteins involved in nacre formation are not fully known. Thus, the aim of this study was to identify and characterize a novel protein from the acetic acid-insoluble fraction from the shell of Pteria sterna, named in this study as Ps19, to have a better understanding of the biomineralization process. Ps19 biochemical characterization showed that it is a glycoprotein that exhibits calcium- and chitin-binding capabilities. Additionally, it is capable of inducing aragonite plate crystallization in vitro. Ps19 partial peptide sequence showed similarity with other known shell matrix proteins, but it displayed similarity with proteins from Crassostrea gigas, Mizuhopecten yessoensis, Biomphalaria glabrata, Alpysia californica, Lottia gigantea and Elysia chlorotica. The results obtained indicated that Ps19 might play an important role in nacre growth of mollusk shells.
Global Trends and Forecast of the Burden of Adverse Effects of Medical Treatment: Epidemiological Analysis Based on the Global Burden of Disease Study

Aim To quantify and update the years of life lost (YLL), years lived with disability (YLD) and disability-adjusted life years (DALY) due to the adverse effects of medical treatment (AEMT) between 1990 and 2017. Subject and methods We analyzed the latest dataset from the Global Burden of Disease (GBD) 2017 study. We described the burden of AEMT based on the number of DALY. We additionally evaluated the global age and sex-specific DALY and compared the age-standardized rates of DALY across the World Health Organization (WHO) regions from 1990 to 2017. Results Worldwide, the total DALYs due to AEMT were 84.93 [95% uncertainty interval (UI), 62.52 to 102.21] in 1990 and 62.79 (52.09 to 75.45) in 2017 per 100,000 population. The global percentage of change in DALY showed a negative trend of −26.06 % (−41.52 to −10.59) across all WHO regions between 1990 and 2017. The YLD has increased during the period from 1997 to 2017 by 29.47% (17.87 to 41.06). In 2017, men were affected more than women with a DALY of 66.78 in comparison to 58.91 DALY in women. DALY rates per 100,000 were highest across all the WHO regions in the first years of life. The predicted DALY rates were 59.92 (57.52 to 62.32) in the year 2020, 50.36 (32.03 to 68.70) in 2030, and 40.8 (−1.33 to 82.93) in 2040. Conclusion Using the GBD 2017 study data, we found a decrease in the DALY rate due to AEMT between 1990 and 2017 with a varying range of DALY between different WHO regions. DALY also differed by age and sex. The forecasting analyses showed a decrease in DALY due to AEMTs with a significant drop in the European region when compared to the African and American regions. However, the increasing trend for YLD signifies an increasing burden of people living with poor health due to AEMT. Our study proposes to identify disability due to AEMT as a significant public health crisis and calls for policymakers to create a robust revised policy.
Dosimetric comparison of simultaneous integrated boost versus concomitant electron boost in radiotherapy treatment of breast cancer

Abstract Background The aim of this study was to compare the dosimetric parameters and effects of simultaneous integrated boost (SIB) and traditional sequential electron boost, after helical tomotherapy, because of the lack of studies in this field in the current literature. Methods Computed tomographic data of 14 patients who received SIB in 2012–2015 were collected from Hong Kong Sanatorium & Hospital. New tomotherapy with SIB plans and tomotherapy with sequential boost plans were generated for each patient, and results were compared. Results Conformation number, mean dose, dose received by 95% volume (both sides), ipsilateral lung volume receiving 20 Gy (V20) and skin dose (right side) were found to be significantly better for SIB (p<0·05), however coverage index and gross target volume dose showed no significant difference, and heart dose was significantly higher for SIB on the right side. Conclusion Tomotherapy with SIB may be able to offer less organ at risk dose (except for the heart), while maintaining the ability to deliver adequate dose coverage.
Associations Between the Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Metabolic Syndrome, Insulin Resistance, and Lifestyle Habits in Healthy Japanese.

Background: The triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio is related to insulin resistance (IR). However, little information is available on whether TG/HDL-C is associated with IR and components of metabolic syndrome (MetS) and how lifestyle habits affect TG/HDL-C in the healthy Japanese population. Methods: In total, 1068 Japanese subjects who had undergone an annual health examination and who were not receiving medication were recruited. Determinants for TG/HDL-C ratio were investigated using multiple regression analyses. The subjects were divided into three groups by lifestyle habits (i.e., smoking, exercise, and physical activity), homeostasis model assessment of IR (HOMA-IR), and fasting plasma glucose, four groups by alcohol intake, and five groups by numbers of MetS components to compare TG/HDL-C values. All analyses were done separately by sex. Results: Multiple regression analyses revealed that waist circumference and smoking were positively associated with TG/HDL-C in both men and women, whereas physical activity was negatively associated with TG/HDL-C ratio in women. TG/HDL-C increased with increasing number of MetS in both men and women. TG/HDL-C increased as HOMA-IR increased in both men and women, when subjects were stratified according to HOMA-IR. TG/HDL-C values were lower in both men and women who exercised regularly, had high physical activity, or were nonsmokers. Independent of exercise and physical activity, TG/HDL-C was higher in smokers than in nonsmokers for both men and women. The relationship between TG/HDL-C and alcohol intake was not statistically significant in both men and women. Conclusions: The TG/HDL-C ratio is associated with IR, components of MetS, exercise, physical activity, and smoking, but not alcohol intake, in healthy Japanese subjects.
Comparison of Night, Day and 24 h Motor Activity Data for the Classification of Depressive Episodes

Major Depression Disease has been increasing in the last few years, affecting around 7 percent of the world population, but nowadays techniques to diagnose it are outdated and inefficient. Motor activity data in the last decade is presented as a better way to diagnose, treat and monitor patients suffering from this illness, this is achieved through the use of machine learning algorithms. Disturbances in the circadian rhythm of mental illness patients increase the effectiveness of the data mining process. In this paper, a comparison of motor activity data from the night, day and full day is carried out through a data mining process using the Random Forest classifier to identified depressive and non-depressive episodes. Data from Depressjon dataset is split into three different subsets and 24 features in time and frequency domain are extracted to select the best model to be used in the classification of depression episodes. The results showed that the best dataset and model to realize the classification of depressive episodes is the night motor activity data with 99.37% of sensitivity and 99.91% of specificity.
An expert update on novel therapeutic targets for hyperphosphatemia in chronic kidney disease: preclinical and clinical innovations

ABSTRACT Introduction: The management of hyperphosphatemia in patients with chronic kidney disease (CKD) is complicated, requiring a multidisciplinary approach that includes dietary phosphate restriction, dialysis, and phosphate binders. Areas covered: We describe key players involved in regulating inorganic phosphate homeostasis and their differential role in healthy people and different stages of CKD. The contribution of paracellular and transcellular intestinal absorptive mechanisms are also examined. Finally, we illuminate recent therapeutic approaches for hyperphosphatemia in CKD. We searched PubMed/Medline (up to November 2019) using the following terms: chronic kidney disease, dialysis, diet, hyperphosphatemia, NaPi2b, nicotinamide, phosphate binder, secondary hyperparathyroidism, tenapanor and vascular calcification. Expert opinion: The precise mechanisms regulating intestinal phosphate absorption in humans is not completely understood. However, it is now established that this process involves two independent pathways: a) active transport (i.e. transcellular route, via specific ion transporters) and inactive transport (i.e. paracellular route across tight junctions). Dietary phosphate restriction and phosphate-binder use can lead to an undesirable maladaptive increase in phosphate uptake and promote active phosphate transport by increased expression of the gastrointestinal sodium-dependent phosphate transporter, NaPi2b. Nicotinamide may overcome these limitations through the inhibition of NaPi2b, by improved efficacy and reduced phosphate binder use and better compliance.
Developmental polychlorinated biphenyl exposure influences adult zebra finch reproductive behaviour

Polychlorinated biphenyls (PCBs) are worldwide chemical pollutants that have been linked to disrupted reproduction and altered sexual behaviour in many organisms. However, the effect of developmental PCB-exposure on adult passerine reproductive behaviour remains unknown. A commercial PCB mixture (Aroclor 1242) or an estrogenic congener (PCB 52) were administered in sublethal amounts to nestling zebra finches (Taeniopygia guttata) in the laboratory to identify effects of developmental PCB-exposure on adult zebra finch reproductive parameters. Results indicate that although traditional measures of reproductive success are not altered by this PCB dosage, PCBs do alter sexual behaviours such as male song and nesting behaviour. Males treated with PCB 52 in the nest sang significantly fewer syllables than control males, while females treated with Aroclor 1242 in the nest showed the strongest song preferences. PCB treatment also caused an increase in the number of nesting attempts and abandoned nests in the Aroclor 1242 treatment relative to the PCB 52 treatment, and offspring with control fathers fledged significantly earlier than those with fathers treated with Aroclor 1242. Behavioural differences between males seem to best explain these reproductive effects, most notably aggression. These findings suggest that sublethal PCB-exposure during development can significantly alter key reproductive characteristics of adult zebra finches, likely reducing fitness in the wild.
Prevalence and Risk Factors Associated with Head Louse (Pediculus humanus capitis) among Primary School Girls in Qom Province, Central Iran

Background: Head louse infestation is highly common in collective centers such as schools, garrisons and campuses. This study was done to determine the prevalence and risk factors associated with Pediculus humanus capitis in primary school girls in Qom Provincecentral Iran. Materials and Methods: This descriptive –analytic study was conducted among 1,725 feminine primary students from 89 schools of Qom province, Central Iran were randomly selected during 2015 to 2017. Data collection was done using standard check list that was provided by the Iran Centres for Disease Control and Prevention (CDC), and physical exams of the hairby visual scalp examination. Head examinations were performed by medical entomologist experts. Analysis of data was done using SPSS version 20.0 software. Results: The prevalence rate of infestation was 13.28%. The rate of head lice infestation was 13.73% in the urban areas and 10.22% in the villages. According to the multivariable logistic regression analysis, a significant relationship was observed between Pediculus capitis and each of these factors: family size, water source, family income (per month for each family, in US dollars), father occupation, parental education, access to primary health care services, having previous history of Pediculus capitis infestation, number of comb uses per day (p<0.05). Conclusion: The head lice infestation is a significant public health issue in primary school girls of Qom province. Risk factors associated with head louse among primary school girls were some demographic and socioeconomic factors. Improvement of these status and designing and implementing appropriate educational and preventive programs can be helpful for surveillance of infestation among primary school girls.
External Validation of a Pharmacokinetic Model of Propofol for Target-Controlled Infusion in Children under Two Years Old

Background Previously, a linked pharmacokinetic-pharmacodynamic model (the Kim model) of propofol with concurrent infusion of remifentanil was developed for children aged 2–12 years. There are few options for pharmacokinetic-pharmacodynamic model of propofol for children under two years old. We performed an external validation of the Kim model for children under two years old to evaluate whether the model is applicable to this age group. Methods Twenty-four children were enrolled. After routine anesthetic induction, a continuous infusion of 2% propofol and remifentanil was commenced using the Kim model. The target effect-site concentration of propofol was set as 2, 3, 4, and 5 μg/mL, followed by arterial blood sampling after 10 min of each equilibrium. Population estimates of four parameters—pooled bias, inaccuracy, divergence, and wobble—were used to evaluate the performance of the Kim model. Results A total of 95 plasma concentrations were used for evaluation of the Kim model. The population estimate (95% confidence interval) of bias was −0.96% (−8.45%, 6.54%) and that of inaccuracy was 21.0% (15.0%–27.0%) for the plasma concentration of propofol. Conclusion The pooled bias and inaccuracy of the pharmacokinetic predictions are clinically acceptable. Therefore, our external validation of the Kim model indicated that the model can be applicable to target-controlled infusion of propofol in children younger than 2 years, with the recommended use of actual bispectral index monitoring in clinical settings that remifentanil is present. Trial Registration Clinical Research Information Service Identifier: KCT0001752
Radiologic Management of Hepatic Malignancy

Chemical ablation 3 The tumor is too large for chemical ablation. This procedure can be used instead of or in addition to thermal ablation, depending on the tumor location. Thermal ablation 5 Stereotactic body radiotherapy (SBRT) 4 Transarterial embolization (TAE) 6 Transarterial chemoembolization (TACE) 7 This procedure refers to either conventional TACE or DEB-TACE. Selective internal radiation therapy (SIRT) 7 This procedure is especially applicable in portal vein thrombosis or extensive bilobar disease. Transarterial chemoembolization (TACE) combined with thermal ablation 7
Drug and Opioid-Involved Overdose Deaths — United States, 2017–2018

Of the 70,237 drug overdose deaths in the United States in 2017, approximately two thirds (47,600) involved an opioid (1). In recent years, increases in opioid-involved overdose deaths have been driven primarily by deaths involving synthetic opioids other than methadone (hereafter referred to as synthetic opioids) (1). CDC analyzed changes in age-adjusted death rates from 2017 to 2018 involving all opioids and opioid subcategories* by demographic characteristics, county urbanization levels, U.S. Census region, and state. During 2018, a total of 67,367 drug overdose deaths occurred in the United States, a 4.1% decline from 2017; 46,802 (69.5%) involved an opioid (2). From 2017 to 2018, deaths involving all opioids, prescription opioids, and heroin decreased 2%, 13.5%, and 4.1%, respectively. However, deaths involving synthetic opioids increased 10%, likely driven by illicitly manufactured fentanyl (IMF), including fentanyl analogs (1,3). Efforts related to all opioids, particularly deaths involving synthetic opioids, should be strengthened to sustain and accelerate declines in opioid-involved deaths. Comprehensive surveillance and prevention measures are critical to reducing opioid-involved deaths, including continued surveillance of evolving drug use and overdose, polysubstance use, and the changing illicit drug market; naloxone distribution and outreach to groups at risk for IMF exposure; linkage to evidence-based treatment for persons with substance use disorders; and continued partnerships with public safety.
Proactive Environmental Strategy and Environmental Performance: A Resource-based Perspective

This paper reviews the relationship between proactive environmental strategy and environmental performance from the resource-based perspective by providing the recent findings on this relationship. The benefits and meaning of proactive environmental strategy and environmental performance are discussed in this article. We find that the resource-based view theory is important to define the relationship between proactive environmental strategy and environmental performance.