Miracle-dz/UniFAR-FTUs huggingface dataset:
Implementation and Compliance with a Goal-Directed Fluid Therapy (GDFT) Protocol for Total Hip Arthroplasties: A Two-Year Review

Background: Historically, goal-directed fluid therapy (GDFT) has been shown to improve patient outcomes when used in the perioperative setting for specific cases (colorectal, etc). When anesthesia providers use GDFT protocols, intraoperative fluid therapy is” patient specific” via the use of dynamic patient-specific physiologic parameters. Objectives: The aim of the study is to assess whether GDFT improved patient-specific fluid administration. A secondary aim was to assess adherence to the instated GDFT protocol. Method: A retrospective chart review was conducted on 201 patients undergoing total hip arthroplasty (THA) procedures following implementation of a GDFT protocol at the University of Illinois at Chicago Hospital. Results: The compliant group consisted of older, heavier, sicker (higher ASA score) patients whom had more EBL during surgery. The compliant group showed a moderate-strong positive correlation between fluid output and fluid administration (r=0.664), while the group that did not utilize the EV-1000TM monitor and GDFT protocol had a weaker linear relationship (r=0.373). When the protocol was used, practitioners were compliant in over 50 percent of cases for over 70 percent of the surgical time. Conclusion: Trends suggest improved patient-specific precision of fluid administration when a GDFT protocol is used. Further evaluations of a GDFT for THA procedures should be conducted for increased protocol validity. Running Head: GDFT: A TWO-YEAR REVIEW 3 TABLE OF CONTENTS Table of
Study the Effect of Folic Acid as A supplement on Selected Oxidative Stress and Biochemical Parameters in First Trimester of Pregnancy

Folic acid modulates several disorders in humans, pregnancy mostly because of the mitochondria-rich placenta, is a condition that favors oxidative stress.Transitional metals, especially iron, which are particularly abundant in the placenta, are important in the production of free radicals. Adenosine deaminase (ADA), an enzyme essential for the differentiation of lymphoid cells, has been used for monitoring diseases with altered immunity. In the present study we investigated the effect of regular and irregular administered folic acid in the first and second trimester of pregnancy to be compared with non-pregnant women ,and also the effect of regular and irregular using of folic acid supplement on oxidative stress parameters and several biochemical features in first trimester pregnant women. Methods :The Hemoglobin ,Random plasma glucose, transferrin, iron, adenosine deaminase in addition to antioxidants(Total antioxidant capacity (TAC), Glutathione (GSH), Glutathione peroxidase (GSH-Px), Glutathione reductase (GSH-R) and Superoxide dismutase (SOD)), had been measured in studied groups[non pregnant women],group B-I[first trimester], group B-II[second trimester who used folic acid supplementation regularly 5 mg daily] and group B-III [second trimester who used folic acid supplementation irregularly]. Results: The level of transferrin, adenosine deaminase (ADA), malondialdehyde (MDA) and uric acid showed significant increase by comparing group B-II and group B-III] ,also when compared to [non pregnant women],group B-I.Iron, Total antioxidant capacity (TAC), Glutathione (GSH), Glutathione peroxidase (GSH-Px), Glutathione reductase (GSH-R) and Superoxide dismutase (SOD) showed significant decrease in group B-II and group B-III when compared to [non pregnant women and group B-I. In conclusion irregular supplementation of folic acid increased indicators of lipid peroxidation in first trimester of pregnancy. Therefore, this regimen of supplemental folic acid may provide excessive amounts of folic acid and appears to increase the risk of oxidative stress. Key words: Folic acid, lipid peroxidation, adenosine deaminase ,antioxidants, transferrin, Iron and pregnancy .
Case series of adults with Moyamoya-related stroke and rehabilitation outcomes.

Moyamoya disease is a rare cerebrovascular syndrome characterized by progressive stenosis and occlusion of the internal carotid arteries and other circle of Willis blood vessels. There is a growing body of research on Moyamoya, but very little describing clinical and functional outcome post rehabilitation treatment. This case series describes two individuals with Moyamoya who were in their 30’s, college education, high functioning, and healthy and without any neurological history until they suffered acute intraventricular hemorrhages in physical and cognitive impairments. Both individuals showed impairments in short-term memory and higher level attention including alternating attention. Both received transdisciplinary treatment for 3 to 4 months, showed cognitive and physical recovery, and were able to return to successfully their careers. Based on these cases it appears reasonable to assume that despite the anomalous blood vessel development, some individual with this disorder may have very good stroke recoveries, though it may need follow up due to possible risk of needing a surgical intervention.
Germline polymorphisms (SNPs) to predict toxicity and efficacy in FLOT-treated patients with locally advanced gastroesophageal junction or gastric adenocarcinoma—data from the NeoFLOT study

Background: Perioperative treatment is standard of care in Western Europe for locally advanced gastroesophageal cancer (GEC) [gastric and gastroesophageal junction (GEJ) adenocarcinoma]. Predictive markers for toxicity and efficacy prior to start with chemotherapy are desirable, particularly when applying a prolonged neoadjuvant treatment. Here we analyse the impact of previously published SNPs involved in drug metabolism and DNA repair. Methods: Genomic DNA was isolated from 48 tumor samples of patients treated within the NeoFLOT-study. In this trial, FLOT (5-FU, leucovorin, oxaliplatin, docetaxel) was administered every two weeks for 6 cycles chemotherapy prior to surgery. Direct DNA sequencing was carried out for rs25487 [Excision Repair Cross-Complementation Group 1 (XRCC1)], rs1805087 [5-methyltetrahydrofolate-homocysteine methyltransferase (MTR)], rs11615 and rs3212986 (both ERCC1), rs1799793 and rs13181 (both ERCC2), rs1801019 [Orotate Phosphoribosyl Transferase (OPRT)] and rs16430del [thymidylate synthase: 6-bp-deletion in the in the 3' untranslated regulatory region (TS3utrdel)]. Furthermore, thymidylate synthase: 28-bp-tandem repeats in the 5' untranslated region (TS5utr tandem repeat) polymorphism was analysed by Restriction Fragment Length Polymorphism (RFLA). Toxicity was stated according to NCI-CTC version 4.0. For efficacy analysis overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and recurrence-free survival (RFS) were used. Results: ERCC2 rs1799793 was significantly associated with thrombocytopenia ≥ grade 3 (P=0.04) and overall hematotoxicity ≥ grade 3 (P=0.04) while rs13181 was significantly associated with leukopenia ≥ grade 3 (P=0.03). Rs11615 of ERCC1 had a predictive value for leukopenia (P=0.04) and thrombocytopenia (P=0.008). Rs1805087 of MTR and TS5utr tandem repeat polymorphism were both associated with anemia (P=0.04 and 0.04, respectively). Concerning non-hematological toxicity, rs1805087 of MTR was associated with diarrhea (P=0.004). Regarding treatment efficacy, patients harbouring the minor allele of C of OPRT rs1801019 obtained a higher ORR and showed a better but statically non-significant prolonged PFS and OS while rs3212986 of ERCC1 was associated with pCR rate (P=0.006). Conclusions: For single nucleotide polymorphism (SNPs) of ERCC1/2, MTR and TS tandem repeat we could demonstrate the predictive value for toxicity of FLOT in GEC. Furthermore, OPRT rs1801019 might be useful to predict response for neoadjuvant treatment.
Diagnosis and treatment challenges of Sheehan's Syndrome

Sheehan’s Syndrome is a chronic health condition specific to women who have experienced postpartum hemorrhage. It is characterized by varying degrees of pituitary hormone imbalance related to the pathological process of pituitary gland necrosis after hemorrhage has occurred. Though the syndrome is a rare complication of hemorrhage, diagnosis is often substantially delayed due to the circumstances surrounding delivery and the broad spectrum of clinical presentation. The aim of this paper is to explore the complexities of the syndrome in an effort to help practitioners provide early diagnosis and appropriate treatment to women with the condition. This is achieved by synthesizing relevant and recent literature about immediate and delayed presentations of the condition via the frame of a clinical vignette. *Correspondence to: Brittany E. Gaspar, School of Nursing, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, FL 32205, USA, Tel: (352) 2835690, E-mail: brittanygasparbsn@gmail.com
Ambulatory Blood Pressure Monitoring in The TRU Sleep Clinic: Should High Blood Pressure and Sleep Apnea Be Tested For And Treated Simultaneously?

Extensive research has demonstrated a strong correlation between obstructive sleep apnea (OSA) and high blood pressure (hypertension). Furthermore, studies have shown that treating OSA can lead to an improvement in blood pressure levels. Despite this knowledge, many sleep clinics still do not test their patients for hypertension and have yet to develop comprehensive treatment plans that aim to target both OSA and hypertension. The TRU Sleep Clinic currently sees patients referred by local physicians for overnight ambulatory blood pressure (ABP) monitoring; upon their first visit, the patients are questioned regarding their sleep habits and complete questionnaires designed to reveal the level of risk for OSA. Despite this effort, patients are not returning to the clinic for further screening and treatment for OSA. The purpose of this study was to identify ABP patients whose files had been archived, but who should have been tested for OSA, invite those patients back to the clinic for further testing, and determine how to ensure that people do return to the clinic in the future if they are identified as at risk for OSA. To do so, I reviewed 182 archived ABP patient files to identify those patients who demonstrated a risk of OSA during the initial screening process. Then, I contacted those patients and invited them back to the clinic for overnight pulse-oximetry, partly to determine how willing patients were to return to the clinic for OSA testing. I designed a script for contacting patients that emphasized the connection between hypertension and OSA and the possible benefits of treating OSA for their overall health. Finally, I developed an improved ABP patient archive form in order to ensure that when a patient demonstrates a risk of OSA, their file would not be prematurely archived. Based on their Epworth Sleepiness Scale and STOP-BANG questionnaire scores, and their self-reported sleep issues, 48 of the 182 patients should have been invited back to the clinic for overnight pulse-oximetry to test for OSA. Of those, 20 were contacted successfully and 10 agreed to return to the clinic for pulse-ox. The conclusions from this study were that more than a quarter of the patients who initially visited the clinic for overnight ABP monitoring should have returned for pulse oximetry, a substantial proportion of patients were willing to return to the clinic for further testing, and that a new “Request to Archive ABP Patient File” form was necessary in the clinic to ensure that ABP patients demonstrating a risk for OSA were being identified and not archived.
Ungewöhnliche TIPS-Rekanalisation – ab durch die Maschen

Die Anlage eines transjugulären intrahepatischen portosystemischen Shunts ist ein etabliertes therapeutisches Vorgehen bei Patienten mit symptomatischer portaler Hypertension. Hierbei wird ein Kurzschluss zwischen portalvenösem und hepatovenösem System durch den Leberparenchymtrakt mittels Stent erzeugt. Shuntdysfunktionen sind ein bekanntes Problem nach TIPS-Anlage bei bis zu 50% der Patienten (Haskal Z et al. Am J Roentgenol 1994; 163: 439–144; Sterling K et al. Am J Roentgenol 1997; 168: 239– 244), bei denen ein nicht ummantelter sogenannter Bare Metal Stent implantiert wurde sowie bis zu 13–20% bei Patienten mit implantierten ummantelten Stents. Eine besondere Herausforderung stellt daher die interventionelle Wiedereröffnung verschlossener transjugulärer intrahepatischer portosystemischer Shunts dar. Fallberichte !
Comparing Grids With Vertical and Horizontal Item-by-Item Formats for PCs and Smartphones

Much research has been done comparing grids and item-by-item formats. However, the results are mixed, and more research is needed especially when a significant proportion of respondents answer using smartphones. In this study, we implemented an experiment with seven groups (n = 1,476), varying the device used (PC or smartphone), the presentation of the questions (grids, item-by-item vertical, item-by-item horizontal), and, in the case of smartphones only, the visibility of the “next” button (always visible or only visible at the end of the page, after scrolling down). The survey was conducted by the Netquest online fieldwork company in Spain in 2016. We examined several outcomes for three sets of questions, which are related to respondent behavior (completion time, lost focus, answer changes, and screen orientation) and data quality (item missing data, nonsubstantive responses, instructional manipulation check failure, and nondifferentiation). The most striking difference found is for the placement of the next button in the smartphone item-by-item conditions: When the button is always visible, item missing data are substantially higher.
Quality of life of chronic renal patients undergoing hemodialysis

Objetivo: analisar a qualidade de vida de pessoas com doenca renal cronica. Metodos: estudo transversal, descritivo com pessoas em hemodialise. A coleta de dados foi realizada com 105 participantes e utilizou-se o instrumento Kidney Disease and Quality-of-Life Short-Form . Os dados foram analisados utilizando-se media, mediana e desvio padrao. Resultados: a amostra foi composta predominantemente pelo sexo masculino, idade acima de 60 anos e que nao exercem atividade laboral. Situacao de trabalho e Funcao Fisica foram as dimensoes de qualidade de vida mais afetadas, com medias de 14,76 e 43,1, respectivamente. A Funcao Cognitiva e Funcao Sexual apresentaram melhores resultados, com media 86,41 e 86,56. Conclusao: a doenca renal cronica e o tratamento hemodialitico interferem na qualidade de vida dos individuos, com maiores prejuizos nas dimensoes de situacao de trabalho e funcao fisica e melhor repercussao nos dominios dor, funcao social, funcao cognitiva e funcao sexual.
Effect of indoor residual spraying on malaria incidence, parasitemia and parasite density among children less than five years of age in northern Benin

The effects of indoor residual spraying (IRS) on malaria transmission have been documented. However, the impact on morbidity has not always been highlighted. The aim of this study was to evaluate the effects of IRS on malaria incidence, parasitemia and parasite density among children less than five years of age in Benin. We conducted a cohort study in sprayed and unsprayed areas during the malaria transmission season in 2017. At inclusion, finger prick blood samples were used to assess baseline parasitemia by microscopy and rapid diagnostic tests (RDT), and children were then followed up over 7 months during which thick blood smear microscopy and RDT were repeated every month. Prevalence of parasitemia at baseline was 40.70% in the sprayed, 25.3% in the unsprayed area and remains high over the entire monitoring period with the exception of month 4. We noticed a decrease in the incidence rate in the sprayed area of 8% over the period of persistence of the insecticide, while in the unsprayed area the incidence increased by 17%. This study demonstrated that IRS can effectively reduce malaria incidence in an area of high endemicity. We recommend a larger scale study to evaluate the effects of IRS on malaria morbidity after several rounds of spraying. Key words: Effects indoor residual spraying, malaria incidence, parasitemia, parasite density, children less than 5 years, Benin.
Estresse oxidativo em pacientes com neuropatia diabética

ISAAC, Etienne, M.Sc., Universidade Federal de Viçosa, February, 2019. Oxidative stress in patients with diabetic neuropathy. Advisor: Luciana Moreira Lima. Co-advisors: Lucas Vilas Boas Magalhães and Silvia Almeida Cardoso. Diabetic polyneuropathy (PD) is one of the most common microvascular complications of type 2 diabetes mellitus (DM2). Evidence indicates oxidative stress as one of the crucial factors for the development of DM and its complications. the objective of this present study was to evaluate the profile of oxidative stress in patients with DM2 and PD, relating them to factors associated with the development of PD. The study included the participation of 42 volunteers, who were distributed into three groups: one group with patients with DM2 without PD (n = 15); a group with DM2 and PD (n = 14); a control group (n = 13). The following parameters were evaluated: body mass index (BMI), life habit, perceived stress, nitric oxide (NO), malondialdehyde (MDA), total antioxidant capacity (FRAP) and glutathione S transferase (GST). No significant differences were found between the three groups studied for the NO and GST markers. For FRAP, the level was significantly higher in the control group compared to the DM2 and DM2 + PD groups. MDA was significantly lower in the DM2 + PD group (0.30 ± 0.08), compared to the DM2 group without PD (1.06 ± 0.16) and control (1.04 ± 0.15), p<0.0001. The volunteers with DM2, with or without diabetic polyneuropathy, present a reduced level of total antioxidant capacity, in relation to the participants in the control group. These results suggest that diabetic patients with or without peripheral polyneuropathy present alterations in the antioxidant defense system and that the reduced MDA observed in the diabetic group with polyneuropathy may be linked to the effect of medications and supplementation of vitamins A and E.
The Factors Associated with the Fatal Outcome of Stroke

Abstract The aim of this study is to determine the risk factors associated with the fatal outcome of stroke. The research was designed as observational, non-interventional study, conducted by the type of case series, and it included 290 patients hospitalized with a diagnosis of stroke at Neurology Clinic of the Clinical Center Kragujevac during the observed period from 01/02/2013 to 31/01/2014. The data used for the research were: documentation of Neurology Clinic of the Clinical Center Kragujevac, documentation of the Institute of Public Health Kragujevac and patients’ questionnaires. The results of univariate binary logistic regression pointed out a relevant connection between the fatal outcome of stroke and age (p˂ 0.0001), gender (p˂ 0.0001), the severity of the disease (p = 0.002), smoking (p = 0.021), care for the parents’ health (p = 0.018), the concern about business problems (p = 0.018), while the influence of antidepressants was indicative (p = 0.066), whereas using the multivariate binary logistic regression, it was concluded that age (OR=1.096; 95% CI=1.059-1.134; p<0.001), the severity of the disease (OR=4.324; 95% CI=1.256-14.885; p=0.020) and the use of antidepressants (OR=5.578; 95% CI=1.178-26.423; p=0.030) were factors independently associated with the mortality rate. These findings suggest that it would be useful to carry out additional comprehensive research about all potential risk factors for the occurrence of stroke, and also to establish all the steps that can be taken in order to identify and detect risk factors, their elimination or reduction, and, accordingly, to take aggressive measures of primary and secondary prevention.
Effects of desensitizing dentifrices on the reduction of pain sensitivity caused by in-office dental whitening: a double-blind controlled clinical study

Objective: The purpose of this study was to clinically evaluate the influence of desensitizing dentifrices applied through a plastic tray on reducing the pain sensitivity and color variation caused by in-office dental whitening and to evaluate differences among such dentifrices through a controlled double-blind clinical study. Materials and methods: A prospective study was conducted with 48 individuals between 18 and 30 years without gender distinction. For the dental whitening, 35% hydrogen peroxide was used in three clinical sessions. After each whitening session, the volunteers used a plastic tray containing one of the dentifrices (sucralose– S, sodium fluoride – SF, arginine and calcium carbonate – ACC, and 5% potassium nitrate – PN) for 4 hrs during the night. The evaluation of the sensitivity associated with the use of the plastic tray in each whitening session was performed using the analog numerical scale with scores from 0 to 10. The color variation (ΔE) was determined with a spectrophotometer. The pain sensitivity data were submitted to the multivariate analysis of variance with repeated measurements and a Lambda Wilks test (p<0.05). To analyze the color variation, a one-way ANOVA was applied (p<0.05). Results: The ACC and 5% NP groups showed a reduction in sensitivity in relation to the other groups (p<0.05). There was a reduction in sensitivity after placement of the tray with dentifrice. The color evaluation associated with the dentifrice showed no difference (p=0.9186). Conclusion: The use of desensitizing dentifrices with ACC or 5% NP in a plastic tray was effective for the reduction of pain sensitivity, and the use of a desensitizing dentifrice did not decrease the effectiveness of whitening.
Relationship among Some Colostral Immune Parameters and Hepcidin in Neonatal Calves

This study was designed to determine hepcidin, IgG, Lactoferrin, IL-6 and iron levels in blood serum, colostrum, milk of healthy cows and the healthy calves on different days of the neonatal period. The study included 20 pregnant cows and 20 calves born to them. Blood samples were taken from pregnant animals 15 days before the birth and immediately after the birth for measurements. Blood samples were also obtained from the calves at birth before colostrum intake and 1, 3, 7, 14 and 28 days after birth for measurements. Colostrum samples were collected from mothers immediately after birth and milk samples were taken postpartum on days 1, 3 and 7. After parturition, serum hepcidin levels were higher than pregnant cows (P>0.05). Hepcidin levels in colostrum were found significantly higher (P 0.05) but significantly higher than the values of day 7, 14 and 28 days of life in calves (P<0.001). Serum hepcidin levels similar pattern of changes to those of IgG, Lf and IL-6 after colostrum intake in calves. As a result; It was concluded that hepcidin may be an important component in terms of calf health, given that it shows similar changes with the immune parameters.