Miracle-dz/UniFAR-FTUs huggingface dataset:
Role of Bowel Preparation in Adenoma Detection Rate and Follow-up Recommendations in African American Dominant Patient Population

Introduction: Bowel preparation quality in colonoscopy is one of the most essential components of quality assessment. According to the latest guidelines, inadequate bowel preparation warrants repeat colonoscopy in less than a year. Our aim was to investigate the role of bowel preparation in adenoma detection rate (ADR), its relationship with patients' demographics, and compliance with subsequent surveillance recommendations with guidelines. Methods: This is a retrospective chart review study. Bowel preparation quality was divided into three categories: high, intermediate, and low. ADR and polyp detection rates (PDR) were calculated as the number of patients with adenoma or polyp divided by the total number of patients. Results: Among 1,062 patients (934 African American and 128 non-African American) 81%, 11%, and 8% had high, intermediate, and low-quality bowel preparations, respectively. Race, gender, age, type of endoscopist, and body mass index did not play any role in bowel preparation quality. ADR and PDR were significantly higher in African Americans as compared to non-African Americans. ADR was significantly lower in the low-quality as compared to the high- and intermediate-quality bowel preparations (OR=2.13; p=0.0032). Bowel preparation quality was not correlated with subsequent follow-up recommendations. Academic gastroenterologists and surgeons had the highest and lowest compliance with surveillance guidelines, respectively. Conclusions: Racial and gender disparity appears to have no meaningful effect on the quality of bowel preparation. Only two categories (adequate [high/intermediate] or inadequate [low-quality]) may be used for follow-up recommendations. Non-compliance with surveillance guidelines is concerning and may inadvertently increase the interval risk of colorectal cancer.
Pathomorphologial investigation of spondylolisthesis leaded to spondylosis in commercial broiler chicken with posterior paralysis: A case study

Spondylolisthesis known as kinky back syndrome is a deformity of the free sixth thoracic vertebra including enlargement and rotation resulting in posterior paralysis in broiler chicken. Genotype, feeding regimes and environment are involved in occurrence of this congenital anomaly. Spondylolisthesis may result in or happen simultaneously with two other major axial skeleton pathologies including spondylosis and spondylitis as a result of occurrence of degenerative necrobiotic lesions and inflammation of the vertebrae, respectively. This report deals with a male broiler chicken with posterior paralysis in the second week of rearing. After euthanasia, the specimen was evaluated at macroscopic and microscopic levels. Macroscopic findings showed the unilateral enlargement of body and transverse process of sixth thoracic vertebra and downward rotation of the body. The histopathological studies revealed the focal chondronecrosis and degenerative changes in articular facets and cranial process of the vertebra. In conclusion, a diagnosis of spondylolisthesis followed by spondylosis was made based on macroscopic and histopathological findings that to the authors’ best knowledge, is the first report in a broiler farm in Iran.
In vitro evaluation of binding capacity of different binders to adsorb aflatoxin

This study was conducted to compare the efficacy of different feed additives as mycotoxin binders in vitro. Four prevalent aflatoxin-sequestering agents (SAs) including two bentonite clays (common and acid activated bentonite), a yeast cell wall product and an activated charcoal product were evaluated in vitro to verify their capacity for binding aflatoxin B1 (AFB1). The SAs were individually mixed at two different ratios with AFB1 (1:70,000, 1:120,000) and their binding capacity indices were determined. Experimental bentonites showed high adsorption abilities, binding more than 70.00% of the available AFB1. At the 1:70,000 and 1:120,000 aflatoxin binder (AF:B) ratios, acid activated bentonite were sequestered over 87.00 and 99.00% of the AFB1, respectively. Yeast cell wall showed moderate adsorption ability at the 1:120,000 AF:B ratio, adsorbing 47.00 of AFB1. The adsorption ability of activated carbon at two AF:B ratio and yeast cell wall at 1:70,000 AF:B ratio were significantly lower than other binders. The ratio of chemisorption and binding equivalency factor were higher for acid activated bentonite compared to other sequestering agents. Based on the result of this study, it seems that acid activated bentonite could be considered efficient at sequestering the available AFB1, resulting as promising agents for use in animals diet.
Experimental Pharmacological Management of Psoriasis

Abstract Psoriasis is a chronic, relapsing, immune-mediated systemic disease. Its pathogenesis is complex and not fully understood yet. Genetic and epigenetic factors interact with molecular pathways involving TNF-α, IL-23/IL-17 axis, and peculiar cytokines, as IL-36 or phosphodiesterase 4. This review discusses the mechanisms involved in the development of the disease, as well as the therapeutic options proposed following the investigation of the inflammatory psoriatic pathways. We performed a comprehensive search using the words “psoriasis” and the newest molecules currently under investigation and approval. From these data, a new scenario in psoriasis is occurring to personalize the therapies - especially systemic ones and those using small molecules – and avoid topical and injectable drugs. We reported the newest therapeutic opportunities, including the inhibitors of Janus kinase/tyrosine kinase 2, phosphodiesterase-4 and IL-36 receptor. Today, more than 20 molecules are under investigation for the treatment of cutaneous psoriasis. Most of them are constituted by small molecules or biologic therapies. This underlines how psoriasis needs systemic therapies, due to its complex pathogenesis and multisystemic involvement.
Rare incidence of tension pneumocephalus 2 months after repeat microvascular decompression

Background: Tension pneumocephalus is a rare complication after intracranial procedures and craniotomy. We report a rare case of intraventricular and subdural tension pneumocephalus occurring 2 months after repeat right-sided microvascular decompression (MVD) for recurrent trigeminal neuralgia. Case Description: The patient in this case was a 79-year-old woman who presented with acute-onset confusion, headaches, nausea, and vomiting. On computed tomography, substantial volumes of pneumocephalus in the fourth ventricle and subdural space at the site of the retrosigmoid exposure for the previous MVD were seen. She underwent emergent wound exploration, and no obvious dural defect or exposed mastoid air cells were identified. The dura was reopened, and the surgical site was copiously irrigated. Mastoid air cells were covered with ample amounts of bone wax, and the wound was closed. The patient recovered well postoperatively with complete resolution of the pneumocephalus by her 3-month follow-up evaluation. Conclusion: It is important to assess for cerebrospinal fluid leakage and that air cells are sealed off before wound closure to prevent a pathway for air to egress into the surgical cavity and corridor.
The complete chloroplast genome and phylogenetic analysis of Piptanthus concolor Craib (Leguminosae)

Abstract In this study, we used high-throughput sequencing technology to sequence and functionally annotate the chloroplast genome of Piptanthus concolor. The total length of P. concolor chloroplast genome is 152,115 bp with the typical quadripartite structure. It contains two inverted repeats (IRa and IRb) of 26,233 bp each, which are separated by a large single-copy (LSC) region of 82,024 bp and a small single-copy (SSC) region of 17,625 bp. The cp genome contained 111 genes, including 77 protein-coding genes, 30 tRNA genes, and 4 rRNA genes. Phylogenetic analysis based on the whole chloroplast genome showed that P. concolor was closely related to Ammopiptanthus.
Clinical Characteristics, Cardiac Magnetic Resonance Features, and Outcomes of Patients with Dilated Cardiomyopathy – An Experience from a South Asian Country

Objectives: The objectives of the study were to evaluate the clinical presentation, cardiac magnetic resonance (CMR) features, and outcomes of patients with dilated cardiomyopathy (DCM). Material and Methods: A retrospective study was conducted at a tertiary care center of Pakistan. All patients who underwent CMR for further evaluation of DCM during the period of 2011–2019 and in whom CMR confirmed the diagnosis of DCM, were included in the study. Patients were followed up in the year 2020 for all-cause mortality and cardiovascular hospitalizations. Results: A total of 75 patients were included in the study. The mean age was 38.7 ± 13 with the majority (n = 57, 76%) being male. Dyspnea was the most common presenting symptom (n = 68, 90.7%). The mean left ventricle ejection fraction (LVEF) by CMR was 29.3 ± 12 and mean left ventricle stroke volume (LVSV) was 66.5 ± 31. Late gadolinium enhanced (LGE) was present in 28 (37.3%) patients. Follow-up was available in 61 patients with the mean follow-up duration of 39.7 ± 27 months. Most patients (40, 65.6%) experienced all-cause major adverse cardiovascular events (MACE) during the follow-up and mortality was observed in 10 (16.4%) patients. LVSV by CMR (P = 0.03), LVEF by CMR (P = 0.02), and presence of pericardial effusion (PE) (P = 0.01) were significantly associated with all-cause MACE. On multiregression analysis, SV by CMR was associated with all cause MACE (P = 0.048). The presence of LGE was associated with higher mortality (P = 0.03). Conclusion: LVSV, LVEF by CMR, and PE were significantly associated with all-cause MACE. LGE was associated with higher mortality. Our cohort had a relatively younger age of presentation and diagnosis, and a greater mortality on follow-up, when compared with other regions of the world.
The Level of Knowledge about Toxoplasmosis among University Students in Rabat in Morocco

The aim of this descriptive cross-sectional study is to evaluate the knowledge of toxoplasmosis among medical, biology, and veterinary students in Rabat in Morocco. The data was collected by using a questionnaire which includes demographic characteristics, epidemiology, diagnosis, and clinical issues related to knowledge of toxoplasmosis. During analysis, the study groups were divided based upon their specialty of students who were medical, biology, and veterinary students. Out of 230 students, 55.2% were female and 44.8% were male. The average age of the study population is 21.7 ± 02 years. Less than half (42.6%) have heard of the disease; most of them have heard from faculty during studies in classrooms with 75.8%, and 3.2% were from the internet. Only 36.5% knew the correct causative agent of toxoplasmosis, and 32.1% were aware of the definitive host. The current study documented that there are gaps in the knowledge of the students regarding toxoplasmosis. Therefore, the present study puts the basis for future studies highlighting the importance of educating students to improve knowledge and attitudes towards toxoplasmosis.
Bioinformatics Study of Sea Cucumber Peptides as Antibreast Cancer Through Inhibiting the Activity of Overexpressed Protein (EGFR, PI3K, AKT1, and CDK4)

Breast cancer is the most common type of cancer in women globally. The overexpressed proteins, including EGFR, PI3K, AKT1, and CDK4, have a role in the growth of breast cancer cells. The 3D peptide structure of sea cucumber Cucumaria frondosa was modeled and then docked with EGFR, PI3K, AKT1, and CDK4 proteins using AutoDock Vina software. The docking result, which has the best binding affinity value, is continued with molecular dynamics simulation. The docking results showed that all peptides bind to the active sites of the four proteins. WPPNYQW and YDWRF peptides bind to proteins with lower binding affinity values than positive controls. The four proteins were in a stable state when complexed with the WPPNYQW peptide, which was seen from the RMSD and RMSF value. PI3K-YDWRF and AKT1-YDWRF complexes are stable, characterized by high RMSD values and increased volatility in several amino acids. WPPNYQW peptide has high potential as an antibreast cancer agent because it binds to the active sites of the four proteins with low binding affinity values and stable interactions. Meanwhile, the YDWRF peptide interacts with the four proteins with low binding affinity values, but the interaction is only stable on PI3K and AKT1 proteins.
Effect of high cut-off dialysis for acute kidney injury secondary to cast nephropathy in patients with multiple myeloma: a systematic review and meta-analysis

ABSTRACT Background Acute kidney injury (AKI) caused by cast nephropathy is associated with increased morbidity and mortality among patients with multiple myeloma (MM). High cut-off haemodialysis (HCO-HD) has proven to be effective in the removal of serum light chains but the effect on clinical outcomes, especially renal recovery, remains uncertain. Methods A systematic review and meta-analysis were performed examining all randomized controlled trials (RCTs) and observational studies (OBSs) assessing the effect of HCO-HD on clinical outcomes of patients with MM complicated by cast nephropathy–induced severe AKI. The primary outcome was all-cause mortality at the end of the study. The secondary outcomes included all-cause mortality at 12 months, HD independence and serum kappa and lambda light chain reduction. Pooled analysis was performed using random effects models. Results We identified five studies, comprising two RCTs and three retrospective cohort studies, including 276 patients with a mean follow-up of 18.7 months. The majority of the studies were of suboptimal quality and underpowered. Compared with patients treated with conventional HD, HCO-HD was not associated with a survival benefit at 12 months {five studies, 276 patients, relative risk [RR] 1.02 [95% confidence interval (CI) 0.76–1.35], I2 = 33.9%} or at the end of the studies at an average of 34 months [five studies, 276 patients, RR 1.32 (95% CI 0.71–2.45), I2 = 62.0%]. There was no difference in HD independence at 90 days [two trials, 78 patients, RR 2.23 (95% CI 1.09–4.55)], 6 months [two studies, 188 patients, RR 1.19 (95% CI 0.68–2.06)] or 12 months [two studies, 188 patients, RR 1.14 (95% CI 0.58–2.26)]. Patients receiving HCO dialysis, however, had a greater reduction in serum kappa [two studies, 188 patients, weighted mean difference (WMD) 46.7 (95% CI 38.6–54.7), I2 = 52.0%] and lambda [two studies, 188 patients, WMD 50.3 (95% CI 21.4–79.3), I2 = 95.1%] light chain levels. Conclusion Current evidence from RCTs and OBSs suggests HCO dialysis is able to reduce serum free light chains but makes no significant improvement in all-cause mortality and renal outcomes compared with conventional HD for patients with myeloma cast nephropathy. However, there is a trend towards better renal outcomes with the use of HCO dialysis. The lack of long-term data and the small sample sizes of the included studies limit this analysis. Therefore further large-scale RCTs with longer follow-up are needed to assess the effect of HCO dialysis on clinical outcomes in patients with myeloma cast nephropathy.
Resistance patterns and clinical outcomes of Klebsiella pneumoniae and invasive Klebsiella variicola in trauma patients

Recent reclassification of the Klebsiella genus to include Klebsiella variicola, and its association with bacteremia and mortality, has raised concerns. We examined Klebsiella spp. infections among battlefield trauma patients, including occurrence of invasive K. variicola disease. Klebsiella isolates collected from 51 wounded military personnel (2009–2014) through the Trauma Infectious Disease Outcomes Study were examined using polymerase chain reaction (PCR) and pulsed-field gel electrophoresis. K. variicola isolates were evaluated for hypermucoviscosity phenotype by the string test. Patients were severely injured, largely from blast injuries, and all received antibiotics prior to Klebsiella isolation. Multidrug-resistant Klebsiella isolates were identified in 23 (45%) patients; however, there were no significant differences when patients with and without multidrug-resistant Klebsiella were compared. A total of 237 isolates initially identified as K. pneumoniae were analyzed, with 141 clinical isolates associated with infections (remaining were colonizing isolates collected through surveillance groin swabs). Using PCR sequencing, 221 (93%) isolates were confirmed as K. pneumoniae, 10 (4%) were K. variicola, and 6 (3%) were K. quasipneumoniae. Five K. variicola isolates were associated with infections. Compared to K. pneumoniae, infecting K. variicola isolates were more likely to be from blood (4/5 versus 24/134, p = 0.04), and less likely to be multidrug-resistant (0/5 versus 99/134, p<0.01). No K. variicola isolates demonstrated the hypermucoviscosity phenotype. Although K. variicola isolates were frequently isolated from bloodstream infections, they were less likely to be multidrug-resistant. Further work is needed to facilitate diagnosis of K. variicola and clarify its clinical significance in larger prospective studies.
Management of recurrent schwannoma of the cauda equina: A case report

Background: Schwannomas of the cauda equina are rare intradural primary spinal tumors. Many of these patients initially present with cauda equina syndromes, and only 2.2% demonstrate clinical recurrence. Gross total excision is the procedure of choice. Case Description: A 62-year-old female had undergone resection of a cauda equina schwannoma 5 years previously. She newly presented with cauda equina symptoms attributed to a recurrent schwannoma. Following gross total secondary tumor resection, the patient’s preoperative deficits fully resolved, and the tumor never recurred. Conclusion: Secondary gross total excision of schwannomas of the cauda equina is critical to avoid further tumor recurrence.
Phytochemical Analysis and Investigation of the Antimicrobial and Cytotoxic Activities of Croton dichogamus Pax Crude Root Extracts

Background Increasing antimicrobial resistance has led to an arduous search for new potent drugs from nature. In this search, plants have proved to be rich reservoirs of efficacious medicinal components that manage ailments. The current study is designed to investigate the phytochemical composition, antimicrobial activity, and the cytotoxicity of the crude root extracts of Croton dichogamus, a shrub that is commonly used in the eastern Africa for the management of infectious diseases. Methods The roots of Croton dichogamus were obtained, dried, ground, and extracted using three solvents (acetone, distilled water, and 50% ethanol). The antimicrobial activity was tested using agar well diffusion and microbroth dilution techniques against five human pathogens. The brine shrimp lethality assay was used to assess the toxic effect. Results The phytochemical screening indicated the presence of terpenoids, flavonoids, tannins, phenols, polyuronides, saponins, and anthracenes. The brine shrimp lethality assay indicated that all the extracts were highly cytotoxic with LC50 values below 100 μg/ml. Acetonic extract had an LC50 value of 4.148 μg/ml, hydroethanolic extract had 76.09 μg/ml, and aqueous extract had 42.61 μg/ml. All extracts showed the antibacterial activity against Gram-positive bacteria (B. cereus and S. aureus) and a fungal organism, C. albicans. The extracts showed no antibacterial effect on the Gram-negative bacterial strains (P. aeruginosa and E. coli) at a concentration of 250 mg/ml. The highest antimicrobial activity was demonstrated by the acetonic extract on B. cereus which had an MIC of 10.42 mg/ml and a zone of inhibition of 17.33 ± 0.58 at a concentration of 250 mg/ml. Conclusion In this research work, we report that C. dichogamus had the antimicrobial activity confirming the folklore claim. The results made a strong case for isolation of novel anticancer lead compounds.
Efficacy of Pitolisant on the Treatment of Narcolepsy: A Systematic Review

Narcolepsy is characterized by excessive daytime sleepiness (EDS) and cataplexy. Histamine neurons play an important role in enhancing wakefulness. The objective of our study was to evaluate the efficacy of pitolisant, a histamine 3 (H3)-receptor antagonist/inverse agonist, in patients with a high burden of narcolepsy symptoms. We conducted an advanced PubMed search strategy with inclusion and exclusion criteria. The outcome included the Epworth Sleepiness Scale (ESS) and adverse effects frequency. Our primary outcome included the mean ESS score at the endpoint and showed that pitolisant was superior to the placebo, but not non-inferior to modafinil. Adverse effects were less common and shorter in duration in the pitolisant group compared to the modafinil-treated patients. Pitolisant was efficacious in reducing excessive daytime sleepiness and cataplexy compared with placebo, and it was well-tolerated in patients with severe narcolepsy symptoms as compared with modafinil.