Miracle-dz/UniFAR-FTUs huggingface dataset:
Transoral Endoscopic Thyroidectomy: Review of 81 Cases in a Single Institute.

OBJECTIVE To evaluate the clinical efficacy and safety of transoral endoscopic thyroidectomy (TOET). MATERIALS AND METHODS A total of 81 patients with thyroid nodules underwent TOET in our department from November 2011 to September 2015. The surgical outcomes, cosmetic results, and complications were evaluated. RESULTS Seventy-nine patients were performed TOET successfully, and 2 cases were transferred to open thyroidectomy due to intraoperative CO2 embolism. The average operation time was 89.0 ± 38.6 minutes, and intraoperative blood loss was 29.3 ± 27.6 mL. Two cases experienced transient perioral numbness, and 2 cases experienced transient opening mouth pain. Two cases had transient increased saliva when swallowing. Transient anterior cervical region discomfort was found in 3 cases, and postoperative anterior cervical region infection was found in 4 cases. Other complications were not observed in any case. The average postoperative length of stay was 4.77 ± 2.61 days, and the mean follow-up period was 39.1 ± 22.6 months. During the follow-up period, there were no long-term complications or recurrent patient, and all the patients were satisfied with the cosmetic effect. CONCLUSIONS TOET is a safe and effective procedure with a low incidence of complications and perfect cosmetic effect for patients with thyroid diseases.
Cutaneous mycology: a six-year experience in a tertiary hospital in Malaysia

A fungal infection of the skin is one the most common diseases encountered in dermatology. Cutaneous mycoses comprise superficial fungal infection of the skin, scalp and nails, as well as subcutaneous fungal infection. As a tertiary referral center in the state of Pahang, Malaysia, we receive many referrals for the further management of cutaneous mycoses, and as such, we sought to determine the clinic epidemiologic pattern of these patients.
Brazilian nursing dissertations and theses conducted in intensive care units

Objective: to analyze the Brazilian scientific production of nursing dissertations and theses conducted in Adult Intensive Care Unit. Methods: a bibliometric study through electronic access to the Center for Nursing Studies and Research of the Brazilian Nursing Association was carried out, collecting a sample of 123 dissertations and 27 theses. Results: there was an increase in the number of studies over the years; 54.6% were conducted the Southeast and 26.0% from the South regions of the country. As for the type of study, 70.0% were descriptive and 59.3% quantitative. Regarding the theme most frequently researched, 43.3% addressed nursing care, and 38.0% had critical patients as the target population of the scientific research. Conclusion: brazilian nursing theses and dissertations conducted in Adult Intensive Care Unit were predominantly made up of descriptive and quantitative studies carried out in the Southeast and South regions, and addressing the nursing care provided to patients.
Performance of a demand assignment packet switch for terrestrial and satellite networks

The authors consider a packet switch with demand time-slot assignment capability, to be used in terrestrial or satellite networks. The proposed approach attempts to optimize switch performance by scheduling a maximum number of packets within frames of fixed length, while unscheduled packets remain in buffers to be scheduled in subsequent frames. Delay analysis has been carried out under the assumption that an optimum algorithm has been utilized for this purpose. The analysis provides packet delays by finding the average number of schedule attempts before the packet is transmitted. Performance results indicate that this approach offers high throughput and low packet delays when the switch operates at heavy load. The maximum switch throughput approaches 0.9. An algorithm which can be used for the switch operation is also proposed. This algorithm maximizes the number of packets scheduled within the frame of fixed length. This is done by extracting the minimum amount of traffic from the traffic matrix so that the remaining traffic can be scheduled within one frame. <<ETX>>
Stapled Hemorrhoidopexy and Long Term Outcomes - A Single Center Experience of 3130 Cases at Healing Hands Clinic, India

Hemorrhoids are one of the commonly reported anorectal disorders and a worldwide problem. It has prevalence rate of 4.4% in the United States [1]. However; no epidemiological data is available for India, but considered to be higher in Indian population. Most of the patients who turned up late to the hospitals, presented with advanced disease (Grade III or IV). The treatment options for hemorrhoids are conservative (medical), nonsurgical (office based) and surgical treatments. A surgical option would be considered in patients with grade III & grade IV hemorrhoids and concomitant anorectal pathology [2].
Reply: problematic use of prescribed opioids for chronic noncancer pain-no scarcity of data outside the United States

Letter to Editor: We readwith interest the study byMorley et al. in the recent issue of PAIN. We agree with the authors that “America is first” in the number of studies on the problematic use of prescribed opioids and the magnitude thereof, as compared to many other countries. However, there is no scarcity of data on the problematic use of opioid analgesics outside the United States as stated by the authors. There are well-conducted studies with signals of an “opioid epidemic” in both Australia and Canada. To the best of our knowledge, all U.S. studies on abuse and misuse of prescribed opioids have been conducted in selected populations, for example, veterans or commercial, Medicare Advantage, and Medicaid health plan members, and not with samples representative of the general population. By contrast, studies with representative population samples have been conducted in Europe. A longitudinal population-based Danish study with a random sample of 25,000 adults in 2010 identified at least 2 of 6 addictive behaviours in 22.6% of long-term opioid users (defined by at least 1 prescription per month for 6 months in the previous year) with chronic pain compared with 11.5% of the nonopioid users with chronic pain and 8.9% of the individuals without chronic pain. In a cohort of new opioid users (17,248 persons) in a nationwide Norwegian prescription database who initiated treatment with weak opioids in 2005, only 0.08% developed prescription patterns, indicating problematic opioid use within 3 years. In a study conducted in Germany, the pooled 1-year prevalence of abuse/addiction of prescribed opioids for chronic noncancer pain (defined by hospital stays because of mental and behavioural disorders due to alcohol, opioids, tranquilizers, multiple substances, and intoxications by narcotic agents) was 0.56% in 870,000 persons of a large medical health insurance organization during the fiscal year 2012. This sample was largely representative of the general German population in terms of age. It is interesting to note that both in the highly selected sample of Morley et al. and in the largely representative German population sample some predictors of problematic use of prescribed opioids such as younger age, male sex, and prescription of tranquilizers were identical. We therefore agree with the authors that problematic use of prescribed opioids, especially in young men for chronic noncancer pain without an established nociceptive or neuropathic cause, warrants attention on an international scale. However, U.S. data on the prevalence rates of problematic use of opioids for chronic noncancer pain should not be extrapolated to other countries. We contend that due attention should be given to national guidelines on opioids for chronic noncancer pain and studies conducted outside the Unites States to understand the global perspective of this issue. Conflict of interest statement
Injeção intravítrea de polissorbato 80: estudo funcional e morfológico

Objective: to determine the functional and morphological effects at rabbits retina of PS80 concentration used in the preparation of intravitreal drugs. Methods: eleven New Zealand rabbits received a intravitreal injection of 0.1ml of PS80. As control, the contralateral eye of each rabbit received the same volume of saline. Electroretinography was performed according to a modified protocol, as well as biomicroscopy and retina mapping before injection and seven and ten days after. Animals were euthanized in the 30th day and the retinas were analyzed by light microscopy. Results: eyes injected with PS80 did not present clinical signs of intraocular inflammation. Electroretinography did not show any alteration of extent and implicit time of a and b waves at scotopic and photopic conditions. There were no morphological alterations of retinas at light microscopy. Conclusion: intravitreal injection of PS80 in the used concentration for intravitreal drug preparations do not cause any functional or morphological alterations of rabbit retinas. These results suggest that PS80 is not toxic to rabbit retinas and may be safely used in the preparation of new lipophilic drugs for intravitreal injection.
Primary Cleft Lip Repair of Unusual Bilateral Cleft

Submit Manuscript | http://medcraveonline.com most common craniofacial malformation, with an incidence of approximately one in every 650 newborns [3]. The Primary treatment for CLP is surgical. Corrective surgery for cleft lip is recommended until the third month of life and cleft palate repair is recommended until 9 or 12 months of life, because chronology of procedures might vary among specialized centers. Proper nutrition is also fundamental so the child is able to be submitted to cleft corrective surgery; in other words, presenting a stable weight gain, no health alterations and in proper conditions to tolerate anesthetics [1-4]. Bilateral cleft lip (BCL) has a wide variability. The most common type is symmetrical complete cleft lip associated with an anterior maxillary protrusion. In such cases the surgeon must aim for esthetic and functional restoration so that patients’ symmetry is the main goal [5].
Axillary lymph node surgical treatment

Nowadays, the overall attention is focused on de-escalating treatments for breast cancer (BC) including surgery, radiotherapy and chemotherapy. The introduction of sentinel lymph node biopsy (SLNB) has led to less invasive surgical approaches for accurately staging the axilla, with axillary lymph node dissection (ALND) progressively confined to a limited group of patients. One of the goal of surgery in de-escalating approaches is to reduce surgical morbidity by restricting or avoiding axillary surgery with no effect on survival. In this context the importance of imaging study for preoperative identification of axillary metastasis, in order to reduce axillary surgery, is gradually improving while the role of intraoperative assessment of sentinel nodes is progressively becoming limited to restricted groups of patients. According to the results of the ACOSOG Z0011 and following the most important guidelines, ALND can be safely omitted in selected patients treated with breast conserving surgery (BCS) with one or two positive SLNB while the adoption of SLNB positive alone in patients undergoing mastectomy is not yet defined. The increased employment of neoadjuvant chemotherapy (NAC) and the use of SLNB in patients after NAC plays an important role in de-escalation of axillary surgery in this group of patients. However current studies on this topic are still controversial, mainly about clinically positive lymph nodes (cN+) pre NAC patients or how to manage positive SLNB in post NAC patients. Some authors have collected predictive factors of positive non sentinel lymph nodes (NSLNs) in nomograms, considered an useful tool to avoid unnecessary further surgery. Elderly women represent specific group of patients where the axillary approach needs to be properly resized. The management of axilla in BC is in continuous evolution and ongoing studies could make even SLNB useless in the next future.
Limb Salvage Treatment of Large Multicentric Extra-Abdominal Desmoid Tumor of Lower Extremity

Aggressive fibromatoses or desmoid tumor (DT) is a very rare soft tissue neoplasms with incidence 2 – 4 cases per billion every year [1]. Fibromatoses is fibroblast origin benign tumor lesion, locally invasive but never metastatic and with high recurrence rate [2]. There are two types of DT – superficial and the deep group. The deep group is divided into extra abdominal, intra-abdominal and abdominal type and all of them are histologically similar [1]. Extra abdominal presentation is the rarest type and usually tumor is located on head and neck [3], chest wall [4] and spinal cord [5]. Limb localization is most often found in the upper extremity shoulder and arm region, and in lower extremity buttocks, back of the thigh and knee joint [6-8]. So far, the literature describes only several cases of anterior lower limb presentation of desmoid tumor, one case presentation in bilateral lower limbs and there are no literature findings of ipsilateral knee and ankle joint presentation (Table 1) [7-10]. Volume 8 Issue 6 2017
Arranging Queues in Series: A Simulation Experiment

For given external arrival process and given service-time distributions, the object is to determine the order of infinite-capacity single-server queues in series that minimizes the long-run average sojourn time per customer. We gain additional insight into this queueing design problem, and congestion in non-Markov open queueing networks more generally, by performing simulations for the case of two queues. For this design problem, we conclude that the key issue is variability: The order tends to matter more when the service-time distributions have significantly different variability, and less otherwise. Arranging the queues in order of increasing service-time variability, using the squared coefficient of variation as a partial characterization of variability, seems to be an effective simple design heuristic. Parametric-decomposition approximations seem to provide relatively good quantitative estimates of how much the order matters.
Rare Case of Recurrent Fetal Familial Uretrocele

Submit Manuscript | http://medcraveonline.com performed in the prior visit revealed a single viable female fetus. The follow up ultrasound in the 19th week of gestation showed normal amniotic fluid volume and left-sided unilateral hydroneprosis with a full-distended bladder. Additionally, thinning out of the parenchyma and a dilated left ureter ending in a large left ureterocele. Douplex kidney was suspected. There was no any other abnormal scan findings. The patient was closely monitored. In the 22nd week of gestation an ultrasound scan showed left renal anterior posterior (AP) dilation, which measured 9 mm with normal kidney function indicated by normal liquor and a distended bladder. The dilatation increased to 18 mm in the 26th week seen by ultrasound scan, and no other abnormalities were noted (Figure 1). Subsequent antenatal and ultrasound were showed no marked changes in these findings. Volume 2 Issue 6 2017
Puerperal breast engorgement: a technological intervention

Characterized by pain [1], edema [2] and increase in breast volume [3], breast engorgement is one of the most common problems in lactation. It occurs mainly by increased vascularization and accumulation of milk and, secondarily, by lymphatic and vascular congestion [2]. Painful situations encountered by breastfeeding mothers are one of the main causes for the abandonment of breastfeeding in the first weeks after childbirth [2,3], fact that can be avoided by means of appropriate approach, using technological resources to massage the breasts and extract the milk [4].
Alpha-band Amplitude During Memory Encoding Is an Index of Memory Performance

Alpha-band (8–13 Hz) rhythm during encoding of sequentially presenting memory items was recorded using a 76-channel magnetoencephalograph. In a memory task, seven images each with an arrow pointing up, down, left or right were presented sequentially. Thereafter, a recall number was presented. Each participant memorized the arrow directions in the order of presentation and recalled the direction of the arrow for the recall number, and responded by pressing a button. Each participant also took part in a control task, in which the participant looked at the same images as those in the memory task but pressed the button previously instructed. Ten right-handed male volunteers performed 280 epochs of the memory task and 120 epochs of control task. The amplitudes of alpha-band rhythm during presentation of midterm (3rd–5th) items were compared with those of beginning (1st and 2nd) items. Fifteen sensors showed signi cant differences (midterm > beginning) in the memory task (0.01 < p < 0.05 at 11 sensors, 0.001 < p < 0.01 at 4 sensors), while no sensors showed a signi cant increase in the control task. Using the statistical parametric mapping (SPM) method, the region of increase in alpha-band rhythm from beginning to midterm was estimated to be located in the visual cortex and around bilateral temporal gyri. Additionally, the increase in amplitude from beginning to midterm was signi cantly greater before a correct answer than before a wrong answer (0.01 < p < 0.05 at 7 sensors and p < 0.001 at 1 sensor). Previous works demonstrated that alpha-band rhythm is increased by active inhibition of visual inputs that are irrelevant to memory. The region of increase estimated to be in the visual cortex agrees with previous works. An interpretation of our results is that since irrelevant visual inputs are successfully inhibited before a correct answer, the amplitude of alpha-band rhythm increases more than that before a wrong answer. These results indicate the possibility that alpha-band amplitude during memory encoding can be used as an index of memory performance.
Responses in plants exposed to dust pollution

Dust particles form a major part of air pollutants arising due to industrial processes and pose serious threat to the ecosystem. In India 30-35% of air pollutants comprises of dust particles. Activities such as coal mining, quarrying, stone crushing, thermal power plants, cement industries etc., adds huge quantities of dust to the environment. The current scenario of large scale deforestation; destruction of biota and other ecosystem components are being attributed to be the effect of dust pollution [1]. Aerosols being small enough to be suspended in air have an affinity to adhere to the solid surface coming in contact with it. When the air current passes through a tree, some portion of the dust particle adhere to the upper and lower portion of the leaves, some of these are bounced back or deposited elsewhere depending upon the size and character of the particle, wind velocity and the surface area of deposition [2]. After deposition dust particles have a tendency to stick to the leaf surfaces for a definite period of time till they get washed off with rain or shredding of the leaf itself. Particle having size lesser than diameter of stomata apertures directly enters the sub-stomatal cavity and comes in contact with the spongy parenchyma of the leaf tissue, larger particles gets access into the leaf interior by getting dissolved in water and carbonic acid discharged by the stomata itself. Plants grasp the dust and loam of topsoil; the soil-inhabitant tiny plants also reduce air-pollutants and break or degrade many poisonous chemicals those go into the soil [3].
Lumbar Facet Joint Kinematics and Load Effects During Dynamic Lifting

Although extensive efforts have been dedicated to investigating the risk factors of low back pain in the workplace, a clear knowledge of their effects on the facet joint (FJ) mechanics is lacking. In this study, fourteen healthy participants performed dynamic lifting task with varying external load while a dynamic stereo-radiography system captured their lumbar motion continuously. The FJ kinematics in the lumbar spine were ascertained using a volumetric model-based tracking method. The FJ kinematics data from seven participants were processed and analyzed using non-parametric statistical test. The results indicated significant (p<0.05) effects of external load on the FJ flexion and superior-inferior translation at all segments, showing more consistent trends at the L2-L3, L3-L4, and L4-L5 joints during trunk flexion angles of approximately 20° and 40°. Findings of this study provide a preliminary but important foundation in elucidating facet-related injury mechanism due to strenuous exertions in workplaces.
Probabilities of Error for Adaptive Reception of M-Phase Signals

Probabilities of error are derived for 2- and 4-phase signaling over an L -diversity branch, time-invariant, additive Gaussian noise channel and for M -phase signaling over an L diversity branch, Rayleigh fading, additive Gaussian noise channel. Both channels corrupt the signaling waveforms transmitted through them by introducing an additive Gaussian noise and an unknown or random multiplicative gain and phase shift in the transmitted signal. The receiver processing consists of cross correlating the signal plus noise received over each diversity branch by a noisy reference signal, which is derived either from the previously received informationbearing signals or from the transmission and reception of a pilot signal, and adding the outputs from all L -diversity branches to form the decision variable. The novel aspects of this paper are: 1) the result for the phase distribution of the decision variable for M -phase signaling over an L -diversity branch, Rayleigh fading channel, 2) the explicit expressions for the probabilities of error for M -phase signaling systems operating over an L -diversity branch, Rayleigh fading channel, and 3) the expression for the probability of error for 4-phase signaling over a time-invariant channel. Previously published error probabilities for 2- and 4-phase signaling over a Rayleigh fading channel are obtained as special cases.
Multivessel revascularization in non-ST-elevation acute coronary syndrome : Should it become the rule in all patients ? Revascularização multivaso na síndrome coronária aguda sem supradesnivelamento do segmento st : deve ser a regra em todos os doentes ?

An invasive strategy is increasingly used in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS), especially when the risk of events is intermediate or high. In confirmed obstructive coronary artery disease, coronary revascularization reduces both mortality and nonfatal events. Around 50% of patients with NSTE-ACS have multivessel disease, and so the type and form of revascularization may require an individualized decision-making process, including discussion in the heart team. One of the issues facing the care team is whether revascularization of patients with NSTE-ACS and multivessel disease should be incomplete (only the culprit artery) or complete, and in the latter case, whether it should be carried out during the same procedure or in subsequent procedures. There is growing evidence that multivessel revascularization, including of non-culprit lesions, in patients with ST-segment elevation myocardial infarction is safe and reduces the risk of recurrent events. Although it is tempting to extrapolate these results to the NSTE-ACS patient population, it is important to note that there have been no prospective randomized tri-