Miracle-dz/UniFAR-FTUs huggingface dataset:
Measuring the effectiveness of laparoscopic antireflux surgery: long-term results.

OBJECTIVE To evaluate long-term results and quality of life of patients undergoing laparoscopic antireflux surgery. DESIGN A validated survey instrument, the Gastroesophageal Reflux Disease-Health-Related Quality-of-Life Scale (GERD-HRQL) was mailed to all patients who underwent laparoscopic fundoplications (LFs) from 1997 to 2006. Additional information was obtained regarding reintervention, satisfaction, and medication use. SETTING Tertiary care referral center. PATIENTS Four hundred five consecutive patients who underwent primary or redo LF from 1997 to 2006. MAIN OUTCOME MEASURES GERD-HRQL score, reoperation rate, and antireflux medication use. RESULTS A 54% response rate was obtained. Median follow-up was 60 months (range, 4-75 months). In patients who underwent primary LF, the mean (SD) GERD-HRQL score was 5.71 (7.99) (range, 0-45, with 0 representing no symptoms). Seventy-one percent of patients were satisfied with long-term results. Forty-three percent of patients took antireflux medications at some point following surgery; half of these patients had no diagnostic testing to document GERD recurrence. Only 3 patients (1.2%) required reoperation. Patients undergoing redo LF had higher GERD-HRQL scores (mean [SD], 14.25 [10.33]), lower satisfaction (35%), and greater probability of requiring antireflux medication (78%). Patients with body mass indexes (BMIs) (calculated as weight in kilograms divided by height in meters squared) between 25 and 35 had lower GERD-HRQL scores than thin (BMI < 25) and morbidly obese (BMI >/= 35) patients. CONCLUSIONS Contrary to the medical literature, our results demonstrate that patients undergoing primary LF by an experienced surgical team have near-normal GERD-HRQL scores at long-term follow-up and low reoperation rates and are satisfied with their decision to undergo surgery. Results following redo LF are not as good, highlighting the importance of proper patient selection and surgical technique when performing primary LF.
Sketch‐Based Editing Tools for Tumour Segmentation in 3D Medical Images

In the past years sophisticated automatic segmentation algorithms for various medical image segmentation problems have been developed. However, there are always cases where automatic algorithms fail to provide an acceptable segmentation. In these cases the user needs efficient segmentation editing tools, a problem which has not received much attention in research. We give a comprehensive overview on segmentation editing for three‐dimensional (3D) medical images. For segmentation editing in two‐dimensional (2D) images, we discuss a sketch‐based approach where the user modifies the segmentation in the contour domain. Based on this 2D interface, we present an image‐based as well as an image‐independent method for intuitive and efficient segmentation editing in 3D in the context of tumour segmentation in computed tomography (CT). Our editing tools have been evaluated on a database containing 1226 representative liver metastases, lung nodules and lymph nodes of different shape, size and image quality. In addition, we have performed a qualitative evaluation with radiologists and technical experts, proving the efficiency of our tools.
Adenosine injection prior to cardioplegia enhances preservation of senescent hearts in rat heterotopic heart transplantation.

OBJECTIVES Advanced donor age is one of the risk factors for graft failure and is the leading cause of early death after heart transplantation. Better myocardial preservation methods should reduce graft failure. The purpose of this study was to determine if adenosine, which is known to enhance cardioplegic protection, enhances myocardial preservation during heart transplantation using older donors. METHODS We used a rat heterotopic heart transplantation model with Lewis rats that were at least 60 weeks old as donors. We injected saline (control) or adenosine (0.1 or 0.2 mg/kg) before cardioplegia, perfused with cold Celsior and stored the hearts in Celsior for 6 h at 4°C. The grafts were transplanted into syngenic, 12-16-week old recipients, and blood and tissue were collected 3 h after reperfusion. RESULTS Bolus injection of adenosine led to faster mechanical arrest after perfusion with Celsior and faster reanimation after reperfusion compared with controls. Adenosine treatment significantly reduced myocardial injury, as indicated by serum troponin I and creatine phosphokinase levels. The mRNAs for inflammatory cytokines were markedly increased in the control grafts, but were less upregulated in the grafts treated with adenosine. The grafts treated with adenosine also exhibited less mitochondrial damage, fewer infiltrating cells and a higher adenosine triphosphate content. CONCLUSIONS Adenosine injection prior to perfusion of cardioplegia significantly reduced cold ischaemia/reperfusion injury in cardiac grafts from older donors and improved the stores of cellular energy after reperfusion. This procurement protocol may be clinically feasible and should be considered in the clinical setting, particularly for older donors.
Functional rescue of mutant Vasopressin V2 Receptors in Nephrogenic Diabetes Insipidus : From molecular cause to restored phenotype

Mutations in G protein-coupled receptors are the cause of many inheritable disorders, including X-linked Nephrogenic Diabebetes Insipidus (NDI). Patients suffering from NDI are unable to concentrate their urine in response to the antidiuretic hormone arginine-vaspressin (AVP), which increases the risk of dehydration in these patients. In this thesis, we describe the molecular causes that underlie X-linked NDI, which is due to mutations in the vasopressin V2 receptor (V2R). These mutations cause misfolding of the V2R, which leads to its entrapment in the endoplasmic reticulum (ER) as it fails the quality control standards of this organelle. However, in overexpression studies in COS cells, we found that several mutants were able to function on the molecular level, i.e. they are able to bind AVP and activate the stimulatory G protein. Since their intracellular retention prevents them to bind AVP at the cell surface, we set out to rescue the localization and/or the function of these receptor mutants in a polarized kidney cell line that mimics the kidney collecting duct. 1)We found that several chemical chaperones were able to rescue the cell surface localization of the V2R-V206D mutant, but not of eight other V2R mutants. 2)Cell-permeable antagonists (or ? pharmacological chaperones? ) of the V2R were able to stabilize of 8 out of 9 V2R mutants in the ER and promote their trafficking to the cell surface, where they could be activated to different extents. This functional rescue was a balance between the ability of the antagonist to restore cell surface expression, and its subsequent displacement by AVP. 3)Cell-permeable agonists did not induce plasma membrane trafficking, but rescued their function by activating the mutant receptors inside the cell. Since cell-permeable agonists and antagonists are available for clinical use, or may become available in the near future, they are promising candidates to relieve NDI in patients.
Illuminant Aware Gamut‐Based Color Transfer

This paper proposes a new approach for color transfer between two images. Our method is unique in its consideration of the scene illumination and the constraint that the mapped image must be within the color gamut of the target image. Specifically, our approach first performs a white‐balance step on both images to remove color casts caused by different illuminations in the source and target image. We then align each image to share the same ‘white axis’ and perform a gradient preserving histogram matching technique along this axis to match the tone distribution between the two images. We show that this illuminant‐aware strategy gives a better result than directly working with the original source and target image's luminance channel as done by many previous methods. Afterwards, our method performs a full gamut‐based mapping technique rather than processing each channel separately. This guarantees that the colors of our transferred image lie within the target gamut. Our experimental results show that this combined illuminant‐aware and gamut‐based strategy produces more compelling results than previous methods. We detail our approach and demonstrate its effectiveness on a number of examples.
Liraglutide Treatment May Affect Renin and Aldosterone Release

Abstract Nowadays, GLP-1 receptor agonists are widely used as effective and safe antidiabetic medications. In addition to glucose-dependent insulin secretion, their effects reach beyond glucose control. Previously, it has been shown that acute administration of GLP-1 receptor agonists increases circulating glucocorticoid and mineralocorticoid levels in both humans and rodents. So far, no studies have reported the effects of chronic administration of GLP-1 receptor agonists on the hypothalamic-pituitary-adrenal axis in humans. The aim of the current study was to examine the effects of acute and chronic treatment with the GLP-1 receptor agonist liraglutide on adrenal function in humans. Ten healthy volunteers were recruited into a single group open-label clinical trial. Each participant was tested for baseline levels, and after acute and chronic treatment with 0.6 mg liraglutide daily. A graded glucose infusion test was performed 3 times. We found that aldosterone tended to be suppressed (albeit not statistically different) after acute administration of liraglutide, and increased after chronic dosing; the difference was statistically significant when compared between acute and chronic dosing. Changes in aldosterone levels followed the changes in renin concentrations and the aldosterone-to-renin ratio remained stable. No statistically significant differences were observed in ACTH or cortisol levels. In conclusion, we have shown that a low dose of GLP-1 receptor agonist may interfere with renin and aldosterone release. Further studies in a larger patient sample and with higher doses of GLP-1 receptor agonists are warranted to corroborate this finding. The study protocol was registered at clinical.trials. gov (NCT02089256) and EU Clinical Trial Register (2014-000238-43).
Autologous blood transfusion during emergency trauma operations.

HYPOTHESIS Intraoperative cell salvage (CS) of shed blood during emergency surgical procedures provides an effective and cost-efficient resuscitation alternative to allogeneic blood transfusion, which is associated with increased morbidity and mortality in trauma patients. DESIGN Retrospective matched cohort study. SETTING Level I trauma center. PATIENTS All adult trauma patients who underwent an emergency operation and received CS as part of their intraoperative resuscitation. The CS group was matched to a no-CS group for age, sex, Injury Severity Score, mechanism of injury, and operation performed. MAIN OUTCOME MEASURES Amount and cost of allogeneic transfusion of packed red blood cells and plasma. RESULTS The 47 patients in the CS group were similar to the 47 in the no-CS group for all matched variables. Patients in the CS group received an average of 819 mL of autologous CS blood. The CS group received fewer intraoperative (2 vs 4 U; P = .002) and total (4 vs 8 U; P < .001) units of allogeneic packed red blood cells. The CS group also received fewer total units of plasma (3 vs 5 U; P = .03). The cost of blood product transfusion (including the total cost of CS) was less in the CS group ($1616 vs $2584 per patient; P = .004). CONCLUSION Intraoperative CS provides an effective and cost-efficient resuscitation strategy as an alternative to allogeneic blood transfusion in trauma patients undergoing emergency operative procedures.
Effect of blood products transfusion on the development of postinjury multiple organ failure.

HYPOTHESIS Transfusion of fresh frozen plasma (FFP) and platelets is independently associated with the development of multiple organ failure (MOF) in critically injured patients. DESIGN Prospective cohort study. SETTING Academic regional level I trauma center. PATIENTS From 1992 to 2004, a total of 1440 critically injured patients were admitted to our surgical intensive care unit and survived at least 48 hours. Of these, 1415 had complete data on age, Injury Severity Score (ISS), and units of FFP, platelets, and packed red blood cells (PRBCs) transfused. Multiple organ failure was defined using the Denver MOF score. Multiple logistic regression analysis was used to adjust transfusion of FFP, platelets, and PRBCs for known MOF risk factors. MAIN OUTCOME MEASURE Multiple organ failure. RESULTS The mean (SD) ISS was 29.3 (11.3), and the mean (SD) patient age was 37.4 (16.6) years. Among 1440 patients, 346 (24.0%) developed MOF, and 118 (8.2%) died. Multiple logistic regression analysis detected a significant interaction between units of FFP and PRBCs transfused (P < .001). Regardless of the units of PRBCs transfused, FFP transfusion was independently associated with the development of MOF. However, the deleterious effect associated with FFP transfusion was more prominent among patients receiving fewer than 6 U of PRBCs. Platelet transfusion was unassociated with MOF after adjustment for age, ISS, and FFP and PRBC transfusion. CONCLUSIONS Early transfusion of FFP is associated with an increased risk of postinjury MOF, even after adjusting for age, ISS, and PRBC transfusion. Caution is warranted in developing protocols for empirical FFP transfusion. Specifically, transfusion triggers for FFP should be reexamined, as well as the practice of delivering FFP in fixed ratios to the units of PRBCs transfused.
Reevaluating Reconstruction Filters for Path‐Searching Tasks in 3D

In this paper, we present an experiment on stereoscopic direct volume rendering, aiming at understanding the relationship between the choice of reconstruction filter and participant performance on tasks requiring spatial understanding such as 3D path‐searching. The focus of our study is on the impact on task performance of the post‐aliasing and smoothing produced by the reconstruction filters. We evaluated five reconstruction filters, each under two different transfer functions and two different displays with a wide range of behaviours in terms of post‐aliasing and smoothing. We found that path‐searching tasks commonly found in the literature, and as the one we employed here, elicit bias in the responses which should be taken into account when analysing the results. Our analysis, which employed both standard statistical tests and techniques from signal detection theory, indicates that the choice of reconstruction filter affects some aspects of the spatial understanding of the scene.
Mesh Statistics for Robust Curvature Estimation

While it is usually not difficult to compute principal curvatures of a smooth surface of sufficient differentiability, it is a rather difficult task when only a polygonal approximation of the surface is available, because of the inherent ambiguity of such representation. A number of different approaches has been proposed in the past that tackle this problem using various techniques. Most papers tend to focus on a particular method, while an comprehensive comparison of the different approaches is usually missing.
An Empirical Study on the Reliability of Perceiving Correlation Indices using Scatterplots

Scatterplots have been in use for about two centuries, primarily for observing the relationship between two variables and commonly for supporting correlation analysis. In this paper, we report an empirical study that examines how humans’ perception of correlation using scatterplots relates to the Pearson's product‐moment correlation coefficient (PPMCC) – a commonly used statistical measure of correlation. In particular, we study human participants’ estimation of correlation under different conditions, e.g., different PPMCC values, different densities of data points, different levels of symmetry of data enclosures, and different patterns of data distribution. As the participants were instructed to estimate the PPMCC of each stimulus scatterplot, the difference between the estimated and actual PPMCC is referred to as an offset. The results of the study show that varying PPMCC values, symmetry of data enclosure, or data distribution does have an impact on the average offsets, while only large variations in density cause an impact that is statistically significant. This study indicates that humans’ perception of correlation using scatterplots does not correlate with computed PPMCC in a consistent manner. The magnitude of offsets may be affected not only by the difference between individuals, but also by geometric features of data enclosures. It suggests that visualizing scatterplots does not provide adequate support to the task of retrieving their corresponding PPMCC indicators, while the underlying model of humans’ perception of correlation using scatterplots ought to feature other variables in addition to PPMCC. The paper also includes a theoretical discussion on the cost‐benefit of using scatterplots.
Safety and feasibility of concomitant surgical ablation of atrial fibrillation in patients with severely reduced left ventricular ejection fraction.

OBJECTIVES Concomitant surgical ablation of atrial fibrillation (AF) is a safe and feasible procedure. However, many surgeons are reluctant to perform it in patients with heart failure. We investigated the safety and efficacy of AF ablation in patients with a severely reduced left ventricular ejection fraction (LVEF <35%). METHODS Between July 2003 and August 2011, 59 patients with severely reduced LVEF underwent concomitant surgical AF ablation, by either left atrial (LA) lesion set or bilateral pulmonary vein isolation in patients with paroxysmal AF, and biatrial lesion set in patients with persistent AF. Follow-up echocardiography (ECG) was conducted after 12 months; rhythm monitoring was accomplished by either 24-h Holter echocardiography or event recorder monitoring. RESULTS The patients' mean age was 68 ± 9 years (male patients, 71%). Paroxysmal AF was present in 24 (41%) and persistent AF in 35 (59%) patients. No ablation-related adverse events occurred. The one-year survival rate was 95% without differences in patients with and without restoration of sinus rhythm (SR). The overall rate of SR was 54% after 1 year, showing a superior result in patients with preoperative paroxysmal AF compared with those with preoperative persistent AF (70 vs 41%, P < 0.001). LVEF improved from 29 ± 8% preoperatively to 39 ± 7% after 12 months of follow-up. The improvement in LVEF was significantly higher in patients with restored SR than in those with AF (16 vs 5%; P < 0.001). Only patients with restoration of SR showed a statistically significant reduction in New York Heart Association functional class at the 12-month follow-up (P = 0.0013). CONCLUSIONS Surgical AF ablation was safe and feasible in patients with severely reduced LVEF. The restoration of SR led to a significantly higher improvement in LVEF and alleviation of clinical heart failure symptoms, not observed if AF persisted postoperatively.
Assessment and Therapy for Young Dysfluent Children: Family Interaction

Clinicians continue to be anxious about the assessment and treatment of dysfluency, but all the evidence suggests that early intervention is of primary importance in preventing long-term chronic stuttering. This practical programme aims to provide the means to assess the child's speech and language and the family life-style, to identify the children at risk and to plan appropriate treatment for the child concerned.
Long-term results of the Ross operation: an 18-year single institutional experience.

OBJECTIVES The purpose of the study was to assess the 18-year outcome of the Ross operation (RO), with emphasis on survival, reoperations, and late function of the pulmonary autografts (PAs) and the right-sided pulmonary allografts. METHODS Between May 1995 to July 2013, 414 patients with a mean age (mean ± standard deviation) of 30.8 ± 13.1 years were submitted to an RO with the root replacement (n = 356) or the inclusion (n = 58) technique. The most prevalent aetiology was bicuspid valve (n = 206, 49.8%). Patients were divided in four groups depending on the type of allograft used on the right side. The mean follow-up was 8.2 ± 5.2 years and was 97.7% complete. In addition to longitudinal outcomes determined by means of the Kaplan-Meier analysis, log-rank test and Cox regression analysis were used to identify predictors of valve failure. RESULTS The early mortality rate was 2.7% and the late survival rate was 89.3% at 15 years, similar to an age- and sex-matched population. There were 22 reoperations on the PA (90.7% freedom at 15 years) and 15 on the pulmonary allografts (92.5% freedom at 15 years). The freedom rate from more than mild aortic insufficiency (AI) was 73.1% at 15 years. Thirty-three patients presented with a late root diameter >45 mm, corresponding to a freedom rate of 72.4% at 15 years. Patients with AI and a dilated annulus, especially males, are at greater risk for these complications. Among the right-sided allografts, fresh decellularized allografts showed significantly superior freedom from structural valve dysfunction. CONCLUSIONS The RO was associated with excellent long-term survival and low incidence of reoperations up to 15 years. Male patients with AI and dilated annulus are at increased risk for late insufficiency and root dilatation. Fresh decellularized allografts presented the best results for reconstruction of the right ventricular outflow tract.
Outcome of non-surgical endodontic treatment

This historical cohort study examined the outcome of non-surgical endodontic treatment and the influence of various factors on the outcome. Patients treated by Graduate Endodontics students were re-examined afier 4 to 6 years by an independent investigator. Outcome criteria were dichotomous the pdradicular tissues were classified as "healed" or "diseased". For Initial Treatment, 8 1 % of the teeth wefe healed. The healing rate was 18% higher for teeth without pre-operative Apical Periodontitis than those with Apical Periodontitis @ < 0.01). For Retreatment, 7 1 % of the teeth were healed. The healing rate for teeth with pre-operative perforation was 53% lower than for al1 othcr teeth (p 4 0.001 ). In conclusion, Apical Periodontitis was the major factor that influenced the outcome of Initial Treatment, while a pre-operative perforation was the major factor that influenced the outcome of Retreatment.
Thoracotomy and decortication: impact of culture-positive empyema on the outcome of surgery.

OBJECTIVES This study aimed to assess the efficacy of thoracotomy and decortication (T/D) in achieving lung re-expansion in patients with Stage III empyema and assess the impact of culture-positive empyema on the outcome of decortication. METHODS This is a retrospective observational study of consecutive patients treated with T/D over a 6-year period. RESULTS A total of 107 consecutive patients were identified. The median age was 55 (range 16-86) years; of which, 86% were male. The median length of hospital stay was 9 (range 2-45) days. Full lung re-expansion was achieved in 86% of cases. There were no postoperative deaths. Pleural cultures were positive in 56 (52%) cases. Patients with culture-positive empyema had a longer duration of pleural drainage (median of 11 days, range 3-112 versus median of 5 days, range 3-29 days for negative culture; P = 0.0004), longer length of hospital stay (median of 11 days, range 4-45 versus median of 7 days, range 2-34 days; P = 0.0002) and more complications (P = 0.0008), respectively. There was no statistically significant difference in the outcome of surgery, i.e. lung re-expansion versus trapped lung (P = 0.08) between the two groups. CONCLUSIONS T/D is safe and achieved lung re-expansion in the majority of patients. Culture-positive empyema was associated with worse outcomes.