Miracle-dz/UniFAR-FTUs huggingface dataset:
THE PREVALENCE OF DISSEMINATED SCLEROSIS IN SOUTH AUSTRALIA

As RECENTLY as 15 years ago, undergraduates were taught that disseminated sclerosis was very rare in South Australia, and that when it was seen it occurred only in migrants or in Australians who had made trips abroad. South Australia was first settled in 1836 by migrants from the British Isles, and to a lesser extent from Germany, and the population increased for the next century by further immigration only from these two sources, in addition to the natural increase from childbirth. As late as 1947, 94% of the South Australian population was Australian born, whereas with the vast post-war influx of migrants, the genetic pattern of the population is now greatly changed. It has become increasingly apparent that there is a very significant incidence of disseminated sclerosis in South Australia, and that the disease affects many who have been born and bred within the State, as have been their parents, and in many cases their grandparents. The, present study is an attempt to ascertain the prevalence of disseminated sclerosis in South Australia, with particular reference to the prevalence in those born in South Australia as opposed to those born in various European countries. Prevalence is defined as the number of patients diagnosed as suffering from the disease on a certain date, which in this case has been taken as June 30, 1961, the date of the last Commonwealth census.
Software defined service function chaining with failure consideration for fog computing

Middleboxes have become a vital part of modern networks by providing services such as load balancing, optimization of network traffic, and content filtering. A sequence of middleboxes comprising a logical service is called a Service Function Chain (SFC). In this context, the main issues are to maintain an acceptable level of network path survivability and a fair allocation of the resource between different demands in the event of faults or failures. In this paper, we focus on the problems of traffic engineering, failure recovery, fault prevention, and SFC with reliability and energy consumption constraints in Software Defined Networks (SDN). These types of deployments use Fog computing as an emerging paradigm to manage the distributed small‐size traffic flows passing through the SDN‐enabled switches (possibly Fog Nodes). The main aim of this integration is to support service delivery in real‐time failure recovery in an SFC context. First, we present an architecture for Failure Recovery called FRFP; this is a multi‐tier structure in which the real‐time traffic flows pass through SDN‐enabled switches to jointly decrease the network side‐effects of flow rerouting and energy consumption of the Fog Nodes. We then mathematically formulate an optimization problem called the Optimal Fast Failure Recovery algorithm (OFFR) and propose a near‐optimal heuristic called Heuristic HFFR to solve the corresponding problem in polynomial time. In this way, the reliability of the selected paths are optimized, while the network congestion is minimized.
A study of serum YKL-40 and its correlation with traditional biomarkers in rheumatoid arthritis patients

Background: This study was aimed to measure the serum levels of YKL-40 among early and late rheumatoid arthritis (RA) patients along with other disease activity measures in RA patients. Materials and Methods: It was a cross-sectional study involving 152 RA patients based on the 1987 American College of Rheumatology criteria for the diagnosis of RA and 68 age- and sex-matched healthy controls. The patient group was further subdivided into 75 early (<2 years disease duration) and 77 late (>2 years) RA patients based on the duration of the disease. Clinical examination was performed on RA patients, and traditional markers to measure the disease activity such as Disease Activity Score (DAS)-28, Visual Analog Score (VAS), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), anti-cyclic citrullinated peptide (CCP), and rheumatoid factor (RF) were assessed. Serum YKL-40 level was measured using ELISA method. All the values were expressed as median (25th–75th percentile). Results: In our study, there was a significant increase in serum YKL-40 level in RA patients (200.8 [141.24–282.7] ng/ml) compared to healthy controls (82.2 [49.01–123.78] ng/ml) with P < 0.001. There was no significant difference in serum YKL-40 levels among early and late RA patients. The traditional inflammatory markers such as ESR, CRP, and measures of disease activity such as DAS-28 and VAS were significantly increased in late RA patients than early RA (P < 0.001). Serum YKL-40 levels were not correlated with disease activity measures such as DAS-28, VAS, CRP, and ESR in RA patients. Conclusion: Serum YKL-40 level was significantly higher in RA. However there was no difference between early and late RA. It does not correlate with measures of disease activity.
Lung cancer screening: tell me more about post-test risk.

Lung cancer screening (LCS) by low-dose computed tomography (LDCT) can save lives because LC is detected in its early asymptomatic stage (1). We have come a long way since the first results of the national lung screening trial (NLST) (2), now confirmed in Europe by volumetric LDCT against control arm by the Nederlands Leuvens Longkanker Screenings Onderzoek (NELSON) (3) and the multicentric Italian lung detection (MILD) (4).
Risk Factors of Hypoglycaemia in Elderly Diabetics A Cross–sectional Analytical Study from Western Rajasthan.

Background: Hypoglycaemia is a side effect of strict diabetes control, especially in the geriatric population above sixty, who constitute approximately 100 million of the Indian population. This study was undertaken to explore the risk factors of hypoglycaemia in elderly in patients. Materials and Methods: Ninety patients who were found to have hypoglycaemia either at admission or while admitted were enrolled. Their risk factors were compared with Ninety age and sex matched inpatients admitted to medical wards who did not experience hypoglycaemia. Results: The duration of diabetes was signiﬁcantly longer (13.4 ± 9.2 vs. 8.1 ± 5.7 years; P = 0.012) in the group which experienced hypoglycaemia. The mean glycated haemoglobin was signiﬁcantly lower in the group which experienced hypoglycaemia (6.73 ± 1.12 vs. 7.61 ± 1.17; P = 0.002). Out of the 90 patients who developed hypoglycaemia 27 were asymptomatic. Infection and renal failure were signiﬁcantly higher in the study group. On multivariate analysis, infection was the only signiﬁcant precipitating factor. Conclusion: With strict blood glucose control, elderly patients are at high risk of hypoglycaemia. The risk is higher if the patients have renal failure and infection. Diabetic therapy in elderly people should be adjusted in such a way to prevent hypoglycaemia. is a serious adverse effect of strict diabetes control. Elderly patients have reduced physiological hypoglycaemia due to several precipitating factors. Hypoglycaemia can even cause nocturnal death apart from its disastrous effect on brain are guidelines to keep glycated haemoglobin (HbA1c) levels at a ﬂexible range in elderly diabetics; risk factors predisposing geriatric mellitus to hypoglycaemia, in comparison with age and sex matched controls who hypoglycaemia.
Temporal flexibility in the digital university: full-time, part-time, flexitime

ABSTRACT This article engages with the persistent theme of flexibility in online distance education. It argues that, while a discourse of flexibility promises opportunities for access to online education, it also has the potential to devalue it by paying too little attention to education’s time-consuming practices, often perpetuating a notion of teaching and learning that is depicted as atemporal and free from the constraints of time. The article draws on case study interviews with staff and students engaged in a distance education expansion project in a UK university. A temporal analysis highlights institutional adjustments towards flexibility and draws attention to interview accounts that are indicative of a culture of combined work and study that is beyond full-time, in a wider context in which part-time study is aligned with affordability and made unproblematic as a flexible mode of access. Further research on time and temporality in distance and higher education is recommended.
Sutureless, Glue-free Conjunctival-Limbal Autograft in the Management of Primary Pterygium

INTRODUCTION Pterygium is a degenerative, triangular wedge-shaped growth of conjunctival tissue, located usually on nasal side, but temporal location can also be there. It proliferates as a vascularized granulomatous tissue to invade the corneal surface. It can cause irritation, mild heaviness or recurrent redness in the eye, in addition to the obvious cosmetic concerns. It also decreases vision in the eye by either causing astigmatism, or directly encroaching the pupillary axis, or by causing corneal opacity [1]. It is inuenced by age and solar radiation [2].
Assessment of balance recovery strategies during manipulation of somatosensory, vision, and vestibular system in healthy and blind Women

Background: Individuals with vision loss are at an increased risk of falls. Understanding what factors contribute to postural instability within this population is a necessary step towards the development of training programs and rehabilitation targeted at reduction of falls in this population. The aim of this study was to assess the balance recovery during manipulation of somatosensory, vision, and vestibular system in healthy and blind persons. Methods: This causal-comparative study, thirty healthy (28.18±0.47 years) and blind (29.22±0.24 years) subjects were selected as samples. Balance recovery strategies in various situations were recorded by six high-speed cameras after sudden movement of a treadmill. Independent T-test test was used for data analysis. Results: The results of this study indicated that the mean of hip and ankle swings in different conditions was significantly higher in the blind group than in the healthy group, both in the anterior-posterior and posterior-anterior disturbances. There was also a significant difference between the ratio of hip/ankle ROM (the dominant strategy for balance recovery) in all situations (p <0.05). Conclusion: The findings of this study revealed that both healthy and blind groups had different mechanisms and responses for balance recovery after anterior-posterior and posterior-anterior perturbation (the dominant strategy investigated in each position separately). Also, the results showed that blind individuals more resort to hip strategies to maintain their postural stability and prefer to rely on somatosensory information to restore balance as the dominant sensory system.
Effect of Preventive Bundle Guidelines on Nurses’ Knowledge and Compliance Regarding Pressure Ulcer Among Critically Ill Children at Pediatric Intensive Care Unit

Pressure ulcers are a common and highly relevant professional care issues in pediatric intensive care units. The aim of this study was to evaluate the effect of preventive bundle guidelines on nurses’ knowledge and compliance regarding pressure ulcer among critically ill children at Pediatric intensive care unit. Research design: A quasi-experimental design was used. Settings: This study was conducted at the pediatric intensive care unit in Benha Specialized Pediatric Hospital. Sample: A Convenient sample of nurses (n=43) and purposive sample of critically ill children (n=70) were included from the above mentioned setting. Those children were divided equally into two groups (study and control). Tools of data collection: Three tools were used namely; a structured interviewing questionnaire format, pressure ulcer preventive bundle compliance checklist and Braden Q Risk Assessment Scale. Results: Most children in the study group were not at risk of pressure ulcer in the first and second week of admission as well as before discharge than children in the control group. Moreover, the results revealed that there was significant improvement in nurses’ knowledge regarding pressure ulcer as well as their compliance with preventive bundle guideline after bundle implementation. Conclusion: The implementation of preventive bundle guidelines proved to be effective in improving nurses' knowledge and their compliance, with a positive impact on the incidence of pressure ulcer among critically ill children. Recommendation: Preventive bundle guidelines should be implemented in pediatric intensive care units to reduce the harm associated with hospital-acquired pressure ulcer.
Influence of Taillight Brightness on the Ability to Recognize Closing Speed, Closing Distance, and Closing vs. Separating

Rear-end crashes contribute to a large percentage of fatal collisions in the United States. However, every rear-end collision cannot be classified as a single type of crash. Some crashes may be caused due to human error while some crashes may be attributed to a human inability to recognize closing speed well. Observers were shown two 4-second video clips of a commercial vehicle closing on a slow-moving vehicle on an unlit highway. The lead vehicle was depicted at distances of 91m (300 ft), 128m (420 ft) and 152m (500 ft). Closing speeds of 40 km/h (25 mph) and 105 km/h (65 mph) were depicted. The taillights on the lead vehicle were randomly shown as bright, or 80% dimmer which is typical of older taillights or aged retroreflective materials. Results showed that observers’ ability to recognize closing from separating worsened with increased distance, dimmer taillights and lower closing speeds. Observers perceived brighter taillights to be closer. Also, at greater distances, observers did not recognize closing speeds as well.
Laboratory Investigation of Human Rhinovirus Infection in Cheonan, Korea

Annually, millions of children die from respiratory virus infections. Human rhinovirus (HRV) is a causative agent of severe respiratory infections in young, elderly, and asthmatic patients with weak immunity. In this study, 9,010 respiratory virus specimens were collected from January 2012 to December 2018 at Dankook University Hospital, Cheonan and examined by real-time reverse transcription polymerase chain reaction. Twelve respiratory viruses were detected. The mean detection rate was 21.3% (N=1,920/9,010), and the mean age of HRV-positive patients was 6.5 years (median age: 1.6 years, range: 0.0 ∼ 96.0). The detection rate was the highest in July (32.4%) and the lowest in February (8.3%). When the detection rate was analyzed by age group, the detection rate was the second highest in patients aged 10 ∼ 19 years. The co-infection rate of HRV was 35.3%, and the most common combination was with Adenovirus. Respiratory virus infections are known to occur in children and elderly people with weak immunity. However, in this study, the detection rate was second highest in patients aged 10 ∼ 19 years. Indeed, the detection rate in this age group was more than 15%, except in January and February. These results suggested that steady-state studies on the infection patterns of HRV are required.
Dynamic changes in prescription opioids from 2006 to 2017 in Texas

Study Objective: The US is experiencing an epidemic of opioid overdoses which may be at least partially due to an over-reliance on opioid analgesics in the treatment of chronic non-cancer pain and subsequent escalation to heroin or illicit fentanyl. As Texas was reported to be among the lowest in the US for opioid use and misuse, further examination of this state is warranted. Study Design: This study was conducted to quantify prescription opioid use in Texas. Data Source: Data was obtained from the publically available US Drug Enforcement Administration Automation of Reports and Consolidated Orders System (ARCOS) which monitors controlled substances transactions from manufacture to commercial distribution. Results: Data for 2006 to 2017 from Texas for ten prescription opioids including eight primarily used to relieve pain (codeine, fentanyl, hydrocodone, hydromorphone, meperidine, morphine, oxycodone, oxymorphone) and two (buprenorphine and methadone) for the treatment of an Opioid Use Disorder (OUD) were examined. The change in Morphine Mg Equivalent (MME) of all opioids (+23.3%) was only slightly greater than the states population gains (21.1%). Opioids used to treat an OUD showed pronounced gains (+90.8%) which were four-fold faster than population growth. Analysis of individual agents revealed pronounced elevations in codeine (+387.5%), hydromorphone (+106.7%), and oxycodone (+43.6%) and a reduction in meperidine (-80.3%) in 2017 relative to 2006. Methadone in 2017 accounted for a greater portion (39.5%) of the total MME than hydrocodone, oxycodone, morphine, hydromorphone, oxymorphone, and meperidine, combined. There were differences between urban and rural areas in the changes in hydrocodone and buprenorphine. Conclusions: Collectively, these findings indicate that continued vigilance is needed in Texas to appropriately treat pain and an OUD while minimizing the potential for prescription opioid diversion and misuse. Texas may lead the US in a return to pre opioid crisis prescription levels.
Pre-treatment systemic immune-inflammation represents a prognostic factor in patients with advanced non-small cell lung cancer.

Background Inflammation plays an important role in pathogenesis, development and progression of lung cancer. The aim of the study is to assess the prognostic role of Systemic Immune-Inflammation Index (SII), obtained by analyzing the neutrophil, lymphocyte and platelet counts, and to design prognostic models for patients receiving first-line chemo- or targeted therapy for advanced non-small cell lung cancer (NSCLC). Methods We conducted an analysis on 311 patients with advanced NSCLC, treated with first line chemo- or targeted therapy till June 2015 at our Institution. Patients were stratified in two groups with SII ≥1,270 (Group A) vs. SII <1,270 (Group B). Progression free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier method. The best SII cutoff was identified by X-tiles program. A Cox regression model was carried out for univariate and multivariate analyses. Results At baseline, 179 patients had SII ≥1,270 (Group A), whilst 132 had lower SII (Group B). The median OS was 12.4 months in Group A and 21.7 months in Group B (P<0.001), whilst the median PFS was 3.3 and 5.2 months, respectively (P=0.029). At multivariate analysis, male gender, ECOG-PS ≥2 and SII >1,270 were predictors of worst OS, whilst IV tumor stage was only slightly significant (P=0.08). Otherwise, only wild-type EGFR status and SII ≥1,270 were independent prognostic factors for worst PFS. Conclusions Pre-treatment SII is an independent prognostic factor for patients with advanced NSCLC treated with first-line therapies.
Epidemiology of Bacterial Keratitis in Lumbini Eye Institute

Background: Bacterial keratitis is a common sight threatening condition. Un­treated, it often leads to progressive tissue destruction with corneal perfora­tion or extension of infection to adjacent tissue. The aim of the study was to study the epidemiological characteristics of bacterial keratitis seen at Lumbini eye institute in western part of Nepal. Methods: A retrospective study was done from 1st November 2017 to 30th October 2018 in which records of all culture-positive bacterial keratitis over a 1 year period. Data regarding age of patient, occupation, type of injury, coex­isting ocular disease was recorded. Clinical evaluation corneal scrapings were collected and subjected to culture and microscopy using standard protocols in all patients. Results: Out of 800 corneal ulcer cases, 305(38.12%) were found to be of bac­terial aetiology. A total of 100(32.78%) bacterial pathogens were isolated of which predominant bacterial species Staphylococcus epidermidis 56(56%) fol­lowed by Staphylococcus aureus 21(21%), Pseudomonas aeruginosa 12(12%), Streptococcus viridans 5(5%), Nocardia 4(4%) and Streptococcus pneumonia 2(2%) were isolated. Patients with age >45 years were 71(71%) and < 45 years were 29(29%). Among these, (55)55% of patients were non-agricultural work­ers and (45)45% were farmers; this difference was statistically not significant (p>0.0001). Co-existing ocular diseases predisposing to corneal ulceration were identified only in 19(19%), compared to other predisposing risk factors in 81(81%). Conclusions: The epidemiological characteristic of bacterial keratitis varies geographically. This study describing the features of bacterial keratitis would greatly help the practicing ophthalmologist in the management of their pa­tients.
The Ratio of Calprotectin to Total Protein as A Diagnostic Marker for Spontaneous Bacterial Peritonitis in Patients with Liver Cirrhosis and Ascites

Background: Spontaneous bacterial peritonitis (SBP) is a potentially fatal condition, characterized by infection of ascitic fluid in absence of any intraabdominal surgically treatable source of infection.Diagnosis of SBP is based on a differential ascites leucocytic count. Aim of the Work: to assess the role of ascitic fluid calprotectin in diagnosis of SBP. Patients and Methods: A cross sectional study was conducted on 60 patients with decompensated liver disease were selected. They were divided into: 1) Non SBP Group: included 30 patients with cirrhotic ascites without clinical or laboratory evidence of spontaneous bacterial peritonitis. 2) SBP Group: included 30 patients with cirrhotic ascites and spontaneous bacterial peritonitis. Results:. Ascitic fluid calprotectin level and the ratio of calprotectin to total protein was statistically significant higher in SBP group than non SBP group. There was a significant decrease in total protein and albumin in ascitic fluid in SBP group compared to non SBP group . A significant positive correlation was detected between ascitic fluid calprotectin and ascitic fluid TLC and PNLs among SBP group, A significant positive correlation between the ratio of calprotectin to total protein and ascitic fluid TLC and PNLs among SBP group. Asitic fluid calprotectin at cut-off value 96 ng/ml, had a sensitivity 86.67 % and a specificity 76.67 % in diagnosis of SBP with positive predictive value 85.2 % and negative predictive value 78.8%. The ratio of calprotectin to total protein at cutoff value 9.6, had a sensitivity 96.67 % and a specificity 90 % in diagnosis of SBP with positive predictive value 96.4 % and negative predictive value 90.6%. Conclusion: The ratio of calprotectin to total protein had high sensitivity and specificity in diagnosis of SBP and better than calprotectin alone. The ratio of calprotectin to total protein could be a useful diagnostic test for SBP.
A Soft-switched Pwm Interleaved Boost-flyback Converter With Power Factor Correction

This paper proposes a soft switching interleaved Boost-Flyback converter employed as a preregulator stage providing power factor correction. The use of a soft commutation cell allows the main switches to be turned on and off under null current and null voltage conditions, respectively. Interleaving techniques imply the overall reduction of the Boost inductor size and also the minimization of the switching losses without increasing voltage and current stresses. This topology has the advantages of the Flyback converter, as auxiliary power supplies are not necessary. A theoretical analysis, including the description of the operating stages and relevant expressions is developed. Additionally, simulation and experimental results are presented.