Miracle-dz/UniFAR-FTUs huggingface dataset:
Recovery of injured corticospinal tracts after late recanalisation of basilar artery occlusion

In this study, we performed emergency stent angioplasty in a patient with basilar artery occlusion (BAO) at 21 hours after onset. Serial diffusion tensor tract imaging revealed that the ischaemic corticospinal tracts (CSTs), which passed through pontine infarct, rapidly recovered to normal level even after delayed reperfusion. This case provided in vivo evidences that ischaemic white matter was still salvageable even after prolonged ischaemia. It also provided a new method (diffusion tensor tract imaging) and a novel therapeutic target (white matter) in the evaluation and treatment of acute BAO. A 35-year-old man suffered acute onset of dizziness, generalised weakness and mental dullness for 21 hours. Neurological examination revealed consciousness disturbance, drooping eyelids, horizontal gaze-evoked nystagmus, facial weakness, dysarthria, dysphagia, bilateral limb weakness (Medical Research Council grade III) and a NIHSS score of 19. Diffusion weighted imaging after admission revealed acute ischaemic lesions in right dorsolateral medulla, left cerebellum and bilateral pontine base (figure 1A–C). No intracranial haemorrhage was detected (figure 1D–F). On MR angiography, left vertebral artery (VA) and basilar artery (BA) were not patent while right VA was faintly visible (data not shown). Diagnostic cerebral angiography was performed after obtaining informed consent from the next of kin. After intravenous sedation and general anaesthesia, a sheath passage of size 6 Fr was applied by Seldinger technique. Angiography of the aortic arch was performed by a 5F pigtail catheter (Cordis, Miami, Florida, USA). Angiography of left internal carotid artery (ICA) and left VA were performed by a 5F VER catheter (Cordis, Miami, Florida, USA). Complete occlusion of BA beyond the anterior inferior cerebellar artery branch was demonstrated (figure 2A). Posterior cerebral artery (PCA) and superior cerebellar artery were …
Validation of the Korean Version of the Biological Rhythms Interview of Assessment in Neuropsychiatry

Objective The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) is a scale used to clinically evaluate disturbances in biological rhythm. In this study, we aimed to examine the reliability and validity of the Korean version of the BRIAN (K-BRIAN) in a Korean population. Methods A total of 181 participants, including 141 outpatients with bipolar disorder (BD; type I, 62; type II, 79) and 40 controls, were recruited. Construct validity was tested by comparing the mean K-BRIAN scores of the BD patients and control subjects. Concurrent validity was tested by evaluating the association between the K-BRIAN and the Morningness-Eveningness Questionnaire (MEQ). Results The mean K-BRIAN scores of the control subjects and patients with BD differed significantly (p<0.001). Particularly, the mean K-BRIAN score was considerably lower among control subjects (mean±standard deviation=35.00±8.88) than among patients with BD type I (41.19±12.10) and type II (50.18±13.73). The Cronbach’s alpha for the K-BRIAN was 0.914. The K-BRIAN was found to correlate with the MEQ (r=-0.45, p<0.001). Conclusion The findings affirm that the K-BRIAN has good construct validity and internal consistency. This suggests that the K-BRIAN can be used to assess biological rhythms in the Korean population, especially for patients with mood disorder.
Development of a New Pain Assessment Instrument: Pain Assessment and Care for the Extremely Low Gestational Age Infant Focused Instrument (PACEFI)

Pain in extremely low gestational age (ELGA) infants remains under-assessed and poorly managed despite the fact that pain may have profound consequences with regard to infants’ neuro-development (Als, 1982). Pain prevention is a critical goal of pain assessment, yet barriers exist. Most critical is the lack of valid, reliable, and clinically useful pain tools. This observational descriptive study focused on the development of a gestational age appropriate instrument for 24–29 6/7 week infants and evaluation of the new instrument, Pain Assessment and Care for the Extremely Low Gestational Age Infant Focused Instrument (PACEFI). Additionally, differences in behavioral cues and physiologic indicators were evaluated for ELGA infants and very low gestational age (VLGA) infants for non-invasive and invasive procedures. Nurse raters used the PACEFI to rate these infants during both procedures at baseline, during, and recovery to assess variation in expected pain. The PACEFI demonstrated a high internal consistency (.879) and appeared to be contributing to the measurement of pain. A RANOVA found a significant difference in rating scores ( p < .001) for both procedures. Baseline and recovery scores were lower than during scores. ELGA infants demonstrated a dampened response (p < .023) as compared to the VLGA infants during the invasive procedure. Alternatively, ELGA infants demonstrated a more vigorous response for noninvasive procedure and dropped below baseline scores at recovery. The whole care experience during the non-invasive procedure may have led to sensitization for the VLGA infant and overwhelming energy expenditure for the ELGA infant. Furthermore, physiologic indicators and behavioral cues were inconsistent arguing for independent assessment of these parameters. Knowledge gained from this study: 1) provides information regarding gestational age differences in pain behaviors; and (2) clarifies if the measurement of these behaviors addresses the immediate need for pain assessment for this vulnerable population. Running head: PAIN ASSESSMENT FOR ELGA INFANTS i
Needle Entry Angle to Prevent Carotid Sheath Injury for Fluoroscopy-Guided Cervical Transforaminal Epidural Steroid Injection

Objective To suggest rotation angles of fluoroscopy that can bypass the carotid sheath according to vertebral levels for cervical transforaminal epidural steroid injection (TFESI). Methods Patients who underwent cervical spine magnetic resonance imaging (MRI) from January 2009 to October 2017 were analyzed. In axial sections of cervical spine MRI, three angles to the vertical line (α, angle not to insult carotid sheath; β, angle for the conventional TFESI; γ, angle not to penetrate carotid artery) were measured. Results Alpha (α) angles tended to increase for upper cervical levels (53.3° in C6-7, 65.2° in C5-6, 75.3° in C4-5, 82.3° in C3-4). Beta (β) angles for conventional TFESI showed a constant value of 45° to 47° (47.5° in C6-7, 47.4° in C5-6, 45.7° in C4-5, 45.0° in C3-4). Gamma (γ) angles increased at higher cervical levels as did α angles (25.2° in C6-7, 33.6° in C5-6, 43.0° in C4-5, 56.2° in C3-4). Conclusion The risk of causing injury by penetrating major vessels in the carotid sheath tends to increase at upper cervical levels. Therefore, prior to cervical TFESI, measuring the angle is necessary to avoid carotid vessels in the axial section of CT or MRI, thus contributing to a safer procedure.
Stage 5 retinopathy of prematurity: An update

Retinopathy of prematurity (ROP) is one of the most common causes of preventable blindness in children. In spite of the availability of various treatment options, and favorable results with timely intervention, many infants present to the ophthalmologists in the advanced end stage of the disease due to lack of awareness especially in the developing nations. This blinding or Stage 5 of ROP presents with total retinal detachment and has to be managed surgically. The surgical techniques for Stage 5 ROP are unique and demanding. The successful anatomical results after surgery are only seen in 20%–50% of cases. In spite of a successful anatomical result, the visual outcome may be slow and limited. The use of newer pharmacological adjuncts has shown promising results. Because of heterogeneity of presentation of the disease severity, a genetic predisposition has also been proposed. A concerted effort from the pediatricians, ophthalmologists, and healthcare workers is required to establish effective screening and treatment guidelines to prevent blindness due to ROP. Till then surgical management has to be done. Parents must be educated regarding the limited visual benefits of surgery and the need for prolonged follow-up. This review gives a comprehensive overview of the pathogenesis, clinical aspects, surgical interventions, and their outcomes and future prospects of Stage 5 ROP.
An observational prospective study of performance of acromioaxillosuprasternal notch index in predicting difficult visualisation of the larynx

Background and Aims: Bedside screening test for predicting difficult intubation is an accepted practice, even though its clinical value remains limited. This study aimed to study the predicting value of acromioaxillosuprasternal notch index (AASI) for difficult visualisation of the larynx (DVL). Methods: After Hospital Ethical Committee approval, 440 consecutive consenting adult non-obstetric patients were included in this study. AASI, modified Mallampati class (MMT), sternomental distance (SMD), thyromental distance (TMD) and inter incisor distance (IID) were evaluated preoperatively by trained personnel. Visualisation of larynx was graded according to Cormack–Lehane grading, with grade III and IV being considered as DVL. The cut-off values for prediction of DVL were defined a priori. Direct laryngoscopy was carried out by qualified anaesthesiologists blinded to the results of the airway predictors under evaluation. Primary outcome variable was AASI as a predictor of DVL. Comparing DVL with MMT, SMD, TMD and IID were secondary objectives. Results: DVL was observed in 3.6% [95% confidence interval (1.9–5.4%)] patients. We observed that sensitivity, specificity and Area Under Curve i.e., AUC (95% confidence interval) of ROC of AASI was 81.25 (53.69-95.03), 96.7 (94.39-98.11) and 0.890 (0.777-1.000) respectively. AUC of AASI was found to better than MMT, SMD, TMD and IID. Conclusion: AASI (≥0.5) is a good predictor of difficult visualisation of the larynx at direct laryngoscopy.
A retrospective analysis of reporting of adverse drug reactions to oncology drugs: An experience from a national center of clinical excellence

INTRODUCTION: Adverse drug reaction (ADR) is a public health problem which constitutes one of the leading causes of morbidity and mortality worldwide. In India, only a few studies reported cancer chemotherapy-induced ADRs. The objectives of the present study were to assess the organ system involved, frequency, severity, and preventability of the ADRs occurred. MATERIALS AND METHODS: Data on ADRs of retrospective cohorts were extracted from the filled ADR forms received from the department of radiation oncology. Descriptive statistic was used to summarize and analyze the available data, namely patient demography, causality, severity, and preventability of the event. RESULTS: A total of 191 chemotherapy-induced ADR reports were received from 164 patients during the period March 2015 to August 2017. Almost three-fourth of the ADRs occurred in patients who were receiving regimens involving multiple drugs. Taxanes, alkylating agents, and platinum compounds were the common drug groups involved. The skin (n = 90) was the most frequently involved organ with alopecia and hyperpigmentation as most common manifestations. The severity (Hartwig and Siegel) and preventability scales (Modified Schumock and Thornton) indicated that most reactions were mild (54.45%) in nature and the majority of them were preventable. More than two-third (69%) of the reactions were related “possible” to the suspected drug as determined by the World Health Organization causality assessment. CONCLUSION: Chemotherapy-related ADRs among cancer patients are worrisome. It has a negative impact on patient quality of life and in addition increases cost of therapy. It is found that timely reporting of chemotherapy-related ADRs and having an effective ADR monitoring system in place ensure preventability of the ADRs in many cases. Oncologists, Radiotherapists and Onco-surgeons should be actively involved in ADR reporting (Onco-Pharmacovigilance) and exchange constructive information, update and educate each other about appropriate use of anticancer drugs. Onco-pharmacovigilance is the need of the hour and could be of immense value in reducing morbidity and mortality if practiced with utmost importance.
A revised simulated annealing algorithm for obtaining the minimum total tardiness in job shop scheduling problems

This paper applies a revised configuration generation mechanism of the Simulated Annealing (SA) algorithm to obtain the minimum total tardiness in job shop scheduling problems. In addition to always generating feasible configurations, this revised mechanism can also exclude some cost non-decreasing configurations in advance. The revised SA method is also compared with a more tailored algorithm (MEHA) and two other SA approaches. Computational results indicate that the solution quality of the SA approaches outperform MEHA. Among the three SA approaches, the revised SA has the best performance. Moreover, the SA approaches differ insignificantly in terms of computational time.
Putting out the blaze: The neural mechanisms underlying sexual inhibition

The successful inhibition of sexual thoughts, desires, and behaviors represents an essential ability for adequate functioning in our daily life. Evidence derived from lesion studies indicates a link between sexual inhibition and the general ability for behavioral and cognitive control. This is further supported by the high comorbidity of sexual compulsivity with other inhibition-related disorders. Here, we aimed at investigating whether sexual and general inhibition recruit overlapping or distinct neural correlates in the brain. Furthermore, we investigated the specificity of two different kinds of sexual inhibition: inhibition of sexually driven motor responses and inhibition of sexual incoming information. To this end, 22 healthy participants underwent functional Magnetic Resonance Imaging (fMRI) while performing a task requiring general response inhibition (Go/No-go), as well as cognitive and motivational sexual inhibition (Negative Affective Priming and Approach-Avoidance task). Our within-subject within-session design enabled the direct statistical comparison between general and sexual inhibitory mechanisms. The general inhibition task recruited mainly prefrontal and insular regions, replicating previous findings. In contrast, the two types of sexual inhibition activated both common and distinct neural networks. Whereas cognitive sexual inhibition engaged the inferior frontal gyrus, the orbitofrontal cortex and the fusiform gyrus, motivational sexual inhibition was characterized by a hypoactivation in the anterolateral prefrontal cortex. Both types of sexual inhibition recruited the inferior frontal gyrus and the inferotemporal cortex. However, the activity of the inferior frontal gyrus did not correlate with behavioral inhibitory scores. These results support the hypothesis of inhibitory processing being an emergent property of a functional network.
Adherence to diabetes medication among diabetic patients in the Bisha governorate of Saudi Arabia – a cross-sectional survey

Background Patients’ non-adherence to diabetes medication is associated with poor glycemic control and suboptimal benefits from their prescribed medication, which can lead to worsening of medical condition, development of comorbidities, reduced quality of life, elevated health care costs, and increased mortality. Objective This study aimed to assess medication adherence among patients with diabetes and associated factors in Bisha primary health care centers (PHCCs) in Saudi Arabia. Patients and methods A cross-sectional study was conducted with a sample of 375 type 1 and 2 Saudi diabetic patients attending PHCCs under the Health Affairs of the Bisha governorate. The participants were aged 18 years and above, and had been taking diabetes medications for at least 3 months. Pregnant women, patients with mental illnesses, and those who were not willing to participate were excluded. Adherence to diabetes medications was measured using the four-item Morisky Green Levine Medication Adherence Scale (MGLS). All participants completed a self-report questionnaire including sociodemographic and clinical variables. Univariate and multivariate analyses were carried out using SPSS version 22. Results Of all the respondents, 134 (35.7%), 161 (42.9%), and 80 (21.4%), patients had high (MGLS score 0), intermediate (MGLS score 1 or 2), and low adherence (MGLS score ≥3), respectively. Factors associated with the level of adherence in univariate analysis were occupational status (P=0.037), current medication (P<0.001), glycated hemoglobin (A1c) (P<0.001), and number of associated comorbidities (P<0.001). In multivariable analyses, A1c <7 (P<0.001) and no associated comorbidities (P<0.003) variables remained significantly associated with adherence. Conclusion The level of adherence to medication in diabetes mellitus patients in the Bisha PHCCs was found to be suboptimal. The findings point toward the need for better management of primary health care providers’ approaches to individual patients, by taking into account their medication adherence levels. Better identification of patients’ level of adherence remains essential for successful diabetes treatment.
Management plans for populations with normal-to-hypertensive blood pressures: risks and benefits of antihypertensive drug treatment in populations previously defined as having high-normal blood pressure

Recent changes in American and European guidelines on the management of arterial hypertension have caused a considerable shift in the landscape of hypertension management. The 2017 American College of Cardiology/American Heart Association/American Society of Hypertension guideline recommends an office visit blood pressure (BP) > 130/80 mmHg as the new threshold for diagnosis of hypertension, and states that the treatment goal for all hypertensive patients should be lowered to < 130/80 mmHg. In contrast, the 2018 European guideline maintains the diagnostic threshold of hypertension at 140/90 mmHg. However, despite their differences in thresholds for diagnosis of hypertension, both guidelines are in agreement that treatment should be considered in patients with BPs in the range of 130 to 139/80 to 89 mmHg if they have high cardiovascular risk. The results from the Systolic Blood Pressure Intervention Trial (SPRINT) study and recent meta-analyses suggest that BP lowering with antihypertensive treatment may be beneficial in reducing cardiovascular event rates in subjects with high-normal BP or stage 1 hypertension according to the new American guideline. However, intensive BP lowering is associated with increased incidence of treatment-associated adverse events, and evidence suggests that BP lowering below 120/70 mmHg increases the risk of cardiovascular events. In this review, we discuss the evidence supporting antihypertensive treatment in subjects with high-normal BP and discuss the specific subgroup of subjects that might benefit from BP lowering.
Characterization of pharmaceutical medication without a medical prescription in children before hospitalization in a resource-limited setting, Cameroon

Introduction The use of different therapeutic approaches is common among sick children in Cameroon. The main objective of this study was to characterize the use of non-prescription drugs and describe the therapeutic itineraries of sick children before admission to the hospital. Methods A cross-sectional and prospective study was conducted from January to May 2017. A closed-ended questionnaire (CEQ) consisting of one or several response options was administered to the parents/guardians of the children on admission to the hospital in the pediatric ward of the Laquintinie Hospital in Douala (LHD) and the Cité des Palmiers District Hospital (CPDH) of the city of Douala. Inclusion of participants was made consecutively for adolescents who gave their consent and parents or guardians who signed the informed consent for all children. The confidentiality of the data was ensured by the replacement of the names by codes. Results Overall, 295 hospitalized children were included with an average age of 3.1 (SD: 3.3) years in the study. More than half of these children (58.6%) came from LHD. More than 90% of parents had at least one therapeutic recourse (TR). The ratio of boys to girls 3/1. Self-medication (74.1%) and medical consultation (16.9%) were the main therapeutic paths in 1st recourse. The medical consultation (80.2%) and the pharmaceutical advice (16.9%) were used frequently in 2nd recourse. The mean lapse time to see a medical professional was 2.7 days (min-max: 0-14 days). The main symptoms associated with TR were fever (76.6%), vomiting (24.7%) and diarrhea (22.7%). The most frequently used drugs were Analgesics/antipyretics (47.6%), antimalarials (15.0%) and antibiotics (10.2%) and the family medicine box was the highest source of drugs. Conclusion Self medication remains the first therapeutic path, followed by medical consultation as second therapeutic path taken when the disease is perceived as serious.
Anthropomorphic Breast and Head Phantoms for Microwave Imaging

This paper deals with breast and head phantoms fabricated from 3D-printed structures and liquid mixtures whose complex permittivities are close to that of the biological tissues within a large frequency band. The goal is to enable an easy and safe manufacturing of stable-in-time detailed anthropomorphic phantoms dedicated to the test of microwave imaging systems to assess the performances of the latter in realistic configurations before a possible clinical application to breast cancer imaging or brain stroke monitoring. The structure of the breast phantom has already been used by several laboratories to test their measurement systems in the framework of the COST (European Cooperation in Science and Technology) Action TD1301-MiMed. As for the tissue mimicking liquid mixtures, they are based upon Triton X-100 and salted water. It has been proven that such mixtures can dielectrically mimic the various breast tissues. It is shown herein that they can also accurately mimic most of the head tissues and that, given a binary fluid mixture model, the respective concentrations of the various constituents needed to mimic a particular tissue can be predetermined by means of a standard minimization method.