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753, P less then .05. The average discrimination power = 47.27, average Item Difficulty Index = 0.557. The fit indices were acceptable in a range that established its factorial validity and average factor loading was ≥0.7 which established convergent validity. A significant association (χ2 = 33.074, P less then .01) between score interpretation and previous counseling by pharmacists established its construct validity. A significant association (χ2 = 19.113, P less then .05) between score interpretation and patient occupation established known group validity. Conclusion The English version of RAKAS was deemed a reliable and validated tool to measure knowledge about disease in Pakistani patients with RA.Aims Sarcolipin (SLN) is a key regulator of sarcoplasmic reticulum calcium-ATPase (SERCA)2a, which handles intracellular calcium re-uptake. This study was aimed to investigate the involvement of SLN in post-myocardial infarction (MI) heart failure (HF) in diabetes. Methods and results Diabetes/MI rat models were established. Altered SLN expression in diabetic hearts was screened out by microarray. A myocardiotropic viral vector was used to deliver siRNA to silence SLN. DNA methylation was evaluated by bisulfite sequencing. Cardiac functions were evaluated by invasive haemodynamic examinations. The SERCA2a activity, cytoplasmic calcium concentration ([Ca2+ ]i ), calcium spark, and myocyte contraction were detected. Correlation between HF and diabetes was analysed in a cohort consisted of 101 ST-segment elevated myocardial infarction (STEMI) patients between 2017 and 2019 [53.54 ± 4.64 years old; 61.4% male gender; HbA1c% 6.15 ± 2.00; and left ventricular ejection fraction (LVEF%) 40.64 ± 3.20%]. SLN expressionhen 0.01). 3-deazaneplanocin A cell line HbA1c% and LVEF% was related (r = -0.218, P = 0.028). Increased HbA1c% was correlated with reduced LVEF% after adjustment for age, sex, body mass index, cigarette smoking, creatinine, UA, low density lipoprotein, K+ , Na+ , and troponin I (adjusted odds ration = 0.75, 95% confidence interval 0.62-0.90, P = 0.002). Conclusions Diabetes increases the vulnerability of STEMI patients to post-MI HF by down-regulating SLN promoter methylation, which further regulates SERCA2a activity via increasing cardiac SLN expression.Aim To assess the exosomal miR-21/Let-7a ratio, a noninvasive method, in distinguishing non-small cell lung cancer (NSCLC) from benign pulmonary diseases. Methods The exosomes were extracted from the peripheral blood serum using serum exosomal extraction kit. miR-21 and Let-7a levels were evaluated by quantitative reverse transcription polymerase chain reaction. Results We found that miR-21/Let-7a ratio of NSCLC patients was significantly higher than that of healthy people, patients with pulmonary inflammation diseases, and benign pulmonary nodules, respectively. Receiver-operating characteristic analysis revealed that as compared with healthy controls, miR-21/Let-7a produced the area under the curve (AUC) at 0.8029 in patients with NSCLC, which helped to distinguish NSCLC from healthy controls with 81.33% sensitivity and 69.57% specificity. In addition, the AUC of miR-21/Let-7a in NSCLC patients was 0.8196 in comparison to patients with pulmonary inflammation diseases. Meanwhile, the sensitivity and specificity were 56.00% and 100%, respectively. Furthermore, compared with patients with benign pulmonary nodules, the AUC of miR-21/Let-7a in NSCLC patients was 0.7539. The sensitivity and specificity were 56.00% and 82.61%, respectively. Conclusion In the present study, our findings revealed that exosomal miR-21/Let-7a ratio holds considerable promise as a noninvasive biomarker for the diagnosis of NSCLC from benign pulmonary diseases.Anaerobic digesters produce biogas, a mixture of predominantly CH4 and CO2 , which is typically incinerated to recover electrical and/or thermal energy. In a context of circular economy, the CH4 and CO2 could be used as chemical feedstock in combination with ammonium from the digestate. Their combination into protein-rich bacterial, used as animal feed additive, could contribute to the ever growing global demand for nutritive protein sources and improve the overall nitrogen efficiency of the current agro- feed/food chain. In this concept, renewable CH4 and H2 can serve as carbon-neutral energy sources for the production of protein-rich cellular biomass, while assimilating and upgrading recovered ammonia from the digestate. This study evaluated the potential of producing sustainable high-quality protein additives in a decentralized way through coupling anaerobic digestion and microbial protein production using methanotrophic and hydrogenotrophic bacteria in an on-farm bioreactor. We show that a practical case onsideration.Introduction Speech disorder is a common clinical manifestation in patients with Parkinson's disease and atypical parkinsonian syndromes and tends to occur before the onset of the axial parkinsonian symptoms. Due to parkinsonian features that overlap those of Parkinson's disease, the differentiation of voice and a speech disorder is a challenge for clinicians primarily in the early stage of the disease. Methods Speech samples were obtained from 116 subjects including 30 cases of Parkinson's disease, 30 cases of progressive supranuclear palsy, 30 cases of multiple system atrophy, and control group consisted of 26 subjects. Differential diagnosis of dysarthria subtypes was based on the quantitative, acoustic analysis of particular speech components. Additionally, Voice Handicap Index questionnaire was taken into account to differentiate the severity of voice impairment in the study groups. Results Our results showed significant differences in the distribution of acoustic parameters between Parkinson's disease and atypical parkinsonian syndromes. A mixed type of dysarthria with a combination of hypokinetic, spastic, and atactic features has been found in patients with atypical parkinsonism. In patients with the clinical diagnosis of the parkinsonian variant of multiple system atrophy, ataxic components of dysarthria were observed. Patients with PD presented pure hypokinetic dysarthria. Some parameters may be used as a marker for the diagnosis of the initial stage of PD. Voice impartment was significantly more frequent and severe in atypical parkinsonism than in Parkinson's disease. Conclusion Acoustic voice analysis is a very sensitive and noninvasive tool, provides objective information for the assessment of different speech components, has the specific potential to provide quantitative data essential for the improvement of the diagnostic process, and maybe a useful instrument in the differential diagnosis of parkinsonian syndromes.