Miracle-dz/UniFAR-FTUs huggingface dataset:
A Comparative Study of the Detection of cAMP response element binding protein (CREB) in the Peripheral Blood of Alzheimer's Patients and the Healthy subjects as a Biomarker for the diagnosis of Alzheimer

Introduction: Alzheimer's disease is a neurodegenerative disease, which usually helps some biomarkers, such as amyloid proteins, to diagnose the disease. Therefore, the purpose of this study was to compare the expression of a protein binding protein to the adjuvant responder to circular adenosine monophosphate (CREB) in peripheral blood of patients to Alzheimer's and healthy elderly people as a biomarker for diagnosing Alzheimer. Materials and Methods: In this case-control study, 32 patients with Alzheimer's disease and 32 normal blood samples were taken. Using real time PCR, CREB expression was evaluated. Results: The mean CREB level in the case group was 0.89 ± 0.30 and in the control group was 1.01 ± 0.03. The mean of BDNF level in the case group was significantly higher than the control group (P <0.001). There was no significant relationship between the level of CREB with age, sex, MMSE score and Cornell scale for depression in dementia (P> 0.05). Conclusion: Reducing CREB levels in people with Alzheimer's disease can be a factor in diagnosis in comparison to healthy people.
Pulmonary metastasectomy for sarcoma-survival and prognostic analysis.

Background Pulmonary metastasectomy (PM) has commonly been performed in patients with controlled metastatic sarcoma. We reviewed our single-institution experience with pulmonary resections for sarcoma to analyse clinical outcome and to identify prognostic factors associated with patient survival. Methods All sarcoma patients undergoing curative intent PM between 2008 and 2014 were retrospectively analysed. Factors related to primary tumour, metastases, applied therapy, systematic inflammation and preoperative nutritional condition, associated with survival after PM were evaluated using the univariable Cox proportional hazard model. Cut-off values of continuous variables were determined by a receiver operating characteristic (ROC) analysis. Results In total, 33 patients (19 male and 14 female, median age 55 years) underwent PM for metastatic sarcoma. There were no perioperative deaths; major complications occurred in 5 (15.2%) patients. The median interval between the treatment of primary tumour and PM was 16 months (range, 0-171 months). The median size of the largest pulmonary lesion was 1.3 cm. Mean follow-up was 37 months (range, 1-100 months) and the 5-year overall survival (OS) rate after first PM was 40.4%. Resection was complete (R0) in 31 (93.9%) patients. In univariable analysis, a shorter interoperative interval [<30 months, hazard ratio (HR) 5.05, 95% confidence interval (CI): 1.15-22.19] and grade 3 (G3) sarcoma (HR 3.52, 95% CI: 1.01-12.25) were significant negative prognosticators. Conclusions Despite the lack of randomized controlled trials PM for sarcomatous disease is a reasonable therapeutic option with acceptable survival in a selected patient population. In sarcoma patients with a shorter interoperative interval and G3 tumour, shorter survival after PM can be expected.
Placental SLE like Autoimmunity and Fetal Loss

Introduction: Systemic Lupus Erythematosus (SLE) is a multisystem autoimmune disease of significant female preponderance. It is associated with increased rates of adverse pregnancy outcomes (APOs), including stillbirth. The relationship between SLE and stillbirth is bidirectional, with women who have had a stillbirth at increased risk of developing SLE. The underlying cause of pregnancy pathologies with SLE has not been fully established, but aberrant placental formation and/or maternal maladaptation to pregnancy, at an immune or vascular level, are plausible. This thesis sought to explore the relationship between stillbirth and SLE in pregnancy, with the hypothesis that women who have a stillbirth display similar vascular and maternal immune issues. Methods: A multi-method approach was taken to address this research question, involving both epidemiological and prospective studies. A large scale epidemiological study was undertaken utilising a UK national primary care database (Clinical Practice Research Datalink, CPRD) to ascertain the risk of developing SLE, following an APO. In the prospective studies, three pregnant cohorts were considered: (i) those with SLE, (SLE Pregnant (SP), n=51), (ii) prior stillbirth (Previous Loss (PL), n=29) or (iii) uncomplicated pregnancies (Normal Pregnant (NP, n=44). Maternal vascular changes were assessed by brachial blood pressure (BP), photoplethysmography (stiffness index (SI), and reflection index (RI)), arteriography (pulsewave velocity (PWV)), plasma placental growth factor (PlGF) and soluble FMS-like tyrosine-kinase 1 (sFLT-1), and uterine artery Doppler velocimetry (UtAD). Immune changes were monitored by peripheral blood microparticles (MPs), T helper 17 (Th17) and T regulatory (Treg) cell numbers. Placental assessments of in utero placental biometry were undertaken, along with placental histological examination and complement deposition (complement factor 4d (C4d) and complement factor 3a receptor (C3aR)). A retrospective study of stillbirth placentas was also conducted. Results: The UK epidemiological study identified 20,123 cases of APO and 97,323 livebirths. The overall incidence of SLE was 0.05%. Women with a stillbirth had a relative risk (RR) of developing SLE of 4.10 (95% CI 3.14-5.36)) compared to livebirth outcomes. In the prospective study, the SP group had the lowest gestation at delivery, exaggerated by lupus nephritis. In utero, placental widths were smallest in the SP group and largest in NP. No difference in C4d staining was defined in livebirth placentas, although stillbirth cohorts had exaggerated deposition associated with villitis (V) and maternal vascular malperfusion (MVM). C3aR was also highest in NP and lowest in the SP group. In stillbirth cases, C3aR deposition was higher in those associated with MVM. Mean arterial BP was higher in PL and lower in NP across gestation. No drop in second trimester BP was seen in PL cases in their current pregnancy. PWV increased with gestation and was highest in SP at 17-28 weeksâ€™ gestation. UtAD measures fell…
AKR1C1-3, notably AKR1C3, are distinct biomarkers for liver cancer diagnosis and prognosis: Database mining in malignancies

Aldo-keto reductases, known as AKR1C1-AKR1C4 enzymes, are pivotal to NADPH-dependent reduction, and their expression is highly associated with the progression of malignant cancers. However, the expression and distinct prognostic value of the AKR1C family members in liver cancer are not well established. In the current study, the expression of AKR1C isoforms was studied using the Oncomine online databases. In addition, their expression profiles were analyzed in cancer cell lines using data from the Cancer Cell lines Encyclopedia (CCLE) database. Furthermore, the mRNA expression levels of AKR1C family members between liver cancer and normal liver samples were assessed by the Gene Expression Profiling Interactive Analysis (GEPIA) database. The AKR1C1-3 prognostic value was further investigated by the Kaplan-Meier plotter database in liver cancer patients. It was found that the expression levels of AKR1C3 were elevated significantly in liver cancer tissues and cells as demonstrated by the Oncomine, CCLE and GEPIA databases. The expression levels of AKR1C1 and AKR1C2 in liver cancer tissues did not increase significantly in the Oncomine database while expression was significantly high in CCLE and GEPIA databases. However, the expression levels of the AKR1C4 gene as determined by the CCLE, GEPIA and Oncomine databases were not consistent. Therefore, the Kaplan-Meier survival curves of liver cancer patients with the expression of AKR1C1-3 genes were next analyzed. The data indicated that high expression levels of AKR1C1-3 were correlated with lower overall survival in liver cancer patients. Using the co-expression and PPI network, AKR1C1-3 genes were identified that were involved in the same pathway displaying 44 total unique interactors. These results suggested that the increased AKR1C1-3, notably AKR1C3 expression levels served as possible diagnostic biomarkers and essential prognostic factors for liver cancer patients. The roles of AKR1C4 in liver cancer require further examination.
Comparative Efficacy on Flexible Ureteroscopy Lithotripsy and Miniaturized Percutaneous Nephrolithotomy for the Treatment of Medium-Sized Lower-Pole Renal Calculi.

Objective: To demonstrate the safety and efficacy of flexible ureteroscopy lithotripsy (FURL) and miniaturized percutaneous nephrolithotomy (MPCNL) through the comparative studies in treating medium-sized lower-pole renal calculi. Methods: Two hundred and twenty eligible patients with lower-pole renal calculi (1-2 cm) were enrolled and further randomly assigned into FURL group and MPCNL group. Patients' demographics, preoperative characteristics, intraoperative and postoperative complications, stone-free rate, and comfort and pain indicated by Bruggrmann Comfort Scale (BCS) and visual analog scale (VAS) were evaluated and recorded. Trauma index such as white blood cells, C-reactive protein (CRP), and interleukin (IL)-6 were also detected. Results: The stone-free rate and the operating time were comparable in FURL and MPCNL groups. Intraoperative and postoperative complication analysis showed that blood loss and hospital stay were significantly lower in the FURL group compared with MPCNL group. No significant difference in minor pelvic perforation, false passage, hemoglobin drop, persistent hematuria, ureteral perforation, moderate fever, urosepsis, and postoperative serum creatinine level was observed. However, as to comfort and pain indicated by BCS and VAS and stress indicated by CRP and IL-6, FURL was superior to MPCNL. Conclusion: FURL could be a better alternative surgical method to MPCNL with similar curative effect and less blood loss and hospital stay.
A study on tracheostomy

Background: Last two decades tracheostomy is assumed its rightful place as a safe simple procedure with a wide range of usefulness. Laryngeal obstruction became recognized as the chief indication for tracheostomy. Now a day, this is performed in head and chest injuries and other conditions where in normal respiratory efficiency is impaired. The present study was done to analyze the various indications and study the prevalence of tracheostomy and compare it between emergency and planned tracheostomy.Methods: This study includes patients who are intubated, that are referred from ICU with prolonged ventilation and those admitted into ENT ward with various indications. In this institute tracheostomy is done between 5th and 10th day for patients on mechanical ventilation. Results: Out of 80 total tracheostomies horizontal procedure done in 42 cases and 38 cases are vertical procedures. Horizontal procedure has more advantages than vertical procedure. Among 80 total procedures 48 cases are done under general anaesthesia and 32 cases under local anaesthesia. Most of the cases are elective done under general anaesthesia because patients are already intubated. Out of 80 cases 5 cases developed sudden apnea, 5 cases developed haemorrhage, 6 cases developed surgical emphysema and subglottic stenosis is developed in 1 case.Conclusions: It is evident from this study that prolonged mechanical ventilation is more common indication for tracheostomy. Majority of the tracheostomies are done in malignant conditions either carcinoma larynx or carcinoma hypopharynx with stridor and dyspnoea. This indicates not only the prevalence of malignancy in this region but also the dreaded ness of this disease causing air way.
Is aerobic exercise training during hemodialysis a reliable intervention for autonomic dysfunction in individuals with chronic kidney disease? A prospective longitudinal clinical trial

Introduction Physical exercises help in the rehabilitation and recovery of various diseases. Cardiovascular and hypertension problems are the main causes of people being affected by kidney problems, which as a consequence, affects the heart rate variability (HRV) of the individual. Physical activity developed in a well-planned and thorough way can be a component in the treatment of this problem. Objective We aimed to evaluate the effects of aerobic exercise intervention during hemodialysis on autonomic heart rate regulation in individuals with chronic kidney disease (CKD). Methods This was a longitudinal trial conducted in 19 CKD patients. The patients underwent three weekly sessions of aerobic exercise during hemodialysis for 30 mins for 12 weeks (three months). Results HRV was analyzed before and after the protocol training. Linear indices of HRV were not different between before and after the protocol training. Nonlinear HRV analysis indicated reduced values of determinism (p=0008, Cohen’s d=0.82) and entropy (p=003, Cohen’s d=0.84) after the training protocol. Conclusion In conclusion, aerobic exercise training during hemodialysis did not improve autonomic control of heart rate in CKD patients.
Beyond brain death : the case against brain based criteria for human death

Preface and Acknowledgments. Introduction: Beyond Brain Death M. Potts, et al. Brain Death - The Patient, the Physician, and Society P.A. Byrne, et al. Metaphysical Misgivings about 'Brain Death' D.A. Jones, O.P. Pro-Life Support of the Whole Brain Death Criteria: A Problem of Consistency M. Potts. The Demise of 'Brain Death' in Britain D.W. Evans. Brain Stem Death: A United Kingdom Anaesthetist's View D.J. Hill. Brain Death and Cardiac Transplantation: Historical Background and Unsettled Controversies in Japan Y. Watanabe. Philosophical and Cultural Attitudes Against Brain Death and Organ Transplantation in Japan T. Abe. Brain Death and Euthanasia J. Seifert. The Moment of Death and the Morally Safer Path M. Haverland. A Narrative Case Against Brain Death M. Evans, M. Potts. Organ Transplantation, Brain Death, and the Slippery Slope: A Neurosurgeon's Perspective. Notes on Contributors. Index of Subjects. Index of Names.
Comparison of Complication and Reoperation Rates for Minimally Invasive Versus Open Cheilectomy of the First Metatarsophalangeal Joint

Background: Dorsal cheilectomy of the first metatarsophalangeal joint is an accepted treatment to alleviate dorsal impingement, pain, and reduced dorsiflexion in hallux rigidus. Traditionally performed via an open incision, this procedure has more recently been performed using minimally invasive techniques despite limited supportive published evidence. Methods: From December 2012 through December 2017, a retrospective analysis of all cheilectomies performed in our institution was done. The surgical technique was recorded along with any subsequent procedures performed for either persistent or recurrent pain, and complications were also noted. A comparison between open and minimally invasive outcomes was performed. In total, 171 cheilectomies were performed during this period. There were 38 open and 133 minimally invasive procedures. Results: At a mean 3-year follow-up, the reoperation rates of the 2 groups were different with only 1 (2.6%) of the open group requiring a fusion, while 17 (12.8%) of the minimally invasive surgical (MIS) group required further surgery (relative risk, 4.86; P = .059). In the open group, there was 1 (2.6%) complication, compared with 15 (11.3%) in the minimally invasive group (relative risk, 4.29; P = .076). Conclusion: While patients may opt for MIS cheilectomy with a proposed faster recovery time and better cosmesis, they should be counseled about the risks and benefits of both methods, and that the technique of MIS cheilectomy utilized in this study appears to have an increased relative risk of requiring a further procedure. Level of Evidence: Level III, retrospective comparative series.
Perceptions and Practices of Providing Physical Activity Counselling and Exercise Prescriptions among Physiotherapists in Nova Scotia.

Purpose: We assessed the perceptions and practices of physical activity counselling and exercise prescription of physiotherapists in Nova Scotia. Method: A total of 146 physiotherapists in Nova Scotia completed an online self-reflection survey regarding their current practice of, confidence in, barriers to, and facilitators of providing physical activity and exercise (PAE) counselling to their patients. Results: Physiotherapists included physical activity counselling and exercise content in 85% of patient counselling appointments. They reported a high level of confidence (> 90%) in providing PAE information and answering patients' PAE questions and moderate confidence in their patients' abilities to maintain PAE over the long term (73%) and to follow through on their PAE recommendations (66%). Patients' interest in PAE was the greatest barrier to providing PAE counselling. The physiotherapists reported being most comfortable when prescribing exercise for patients with musculoskeletal conditions and least comfortable with patients with cancer, insulin-dependent diabetes, and respiratory conditions. Most physiotherapists (71%) reported being interested in pursuing further education or training in PAE counselling and prescription. Conclusions: The physiotherapists frequently recommended PAE to their patients, had moderate confidence in their patients' ability to follow through on their advice, and experienced patients' disinterest in PAE as the greatest barrier to providing PAE counselling. The results of this study suggest a desire by physiotherapists for educational training opportunities, which we recommend be focused on providing behavioural strategies and further information to help overcome patient-focused barriers; this will help patients adopt and maintain physically active lifestyles.
Evaluation of depression and anxiety levels in patients with a complaint of a breast mass: a prospective study

Giris : Meme kanseri dunyada ve ulkemizde kadinlarda en sik gorulen kanserdir. Erken tani ve gelisen tedavi olanaklarina ragmen meme kanseri, kabul edilmesi zor, onemli bir kaygi kaynagi olarak cesitli psikososyal sorunlari gundeme getirmektedir. Biz bu calismamizda memede kitle yakinmasiyla poliklinige basvuran hastalardaki depresyon ve anksiyeteyi degerlendirerek, kitlenin kadinlarin ruh sagliginda olusturdugu etkiyi tespit etmeyi amacladik. Yontem : Bu calisma analitik tipte bir vaka kontrol calismasidir. Calismaya katilanlarin %100’u kadindi (n=200). Hastalar Beck Depresyon Olcegi (BDO), Beck Anksiyete Olcegi (BAO) ve sosyodemografik verileri iceren anket formunu doldurdu. Bulgular : Vaka ve kontrol gruplari arasinda medeni durum, kimlerle yasadigi, aylik gelir duzeyi, yasadigi yer, meslek ve egitim duzeyi acisindan istatistiksel olarak anlamli farklilik saptanmadi (p>0,05). Vaka ve kontrol gruplarinin BDO skor ortalamasi arasinda anlamli fark vardi (19,6±1,05, 8,92±0,62, sirasiyla, p<0,001). Iki grup arasinda BAO skor ortalamalari arasinda da istatistiksel olarak anlamli fark saptandi (20,34±1,23, 7,88±0,71, sirasiyla, p<0,001). Sonuc : Calismamizda memede kitle yakinmasi ile basvuran kadinlarda depresyon ve anksiyete skorlari saglikli kadinlara gore anlamli yuksekti.
The role of primary care physicians and nurses in convincing patients to participate in a colorectal cancer screening program in a Polish coordinated care organization: a questionnaire-based study

Background: Medical assistants/care coordinators play a crucial role in the coordinated care system. The tasks of nurses and some qualified supporting staff have been extended to include this role along with the implementation of the pilot program POZ Plus in Polish primary healthcare. A personalized approach to the patient is especially important during the implementation of large-scale prevention programs. Aim of the study: To assess who has the greatest influence on the patient’s decision to undergo screening colonoscopy and outline the current and potential roles of nurses in this process. Material and methods: This questionnaire-based study was conducted at the coordinated care facility Medical and Diagnostic Center (CMD) in Siedlce, Poland between March 1st and June 15th, 2017. Results: 138 patients participated in the study. The majority (75; 54.4%) reported they were directly convinced to undergo colonoscopy by a primary care physician. 18 (13.0%) were convinced by a nurse, and 22 (15.9%) by another specialist. The remaining (23; 16.7%) patients indicated other factors. The majority of patients (74; 53.6%) responded saying that all necessary information about the entire test course was provided by the nurse, while 35 (25.4%) shared that this information had come from the primary care physician, 8 (5.80%) from the specialist doctor, 3 (2.17%) from the receptionist and 18 (13.0%) from other sources of information, such as the Internet, leaflets and notice boards. Conclusions: We found that primary care physicians at this institution have an important role in convincing patients to undergo preventive colonoscopy, while nurses provide key information to patients on the preparation and the course of this procedure. Although the current model seems to be effective in a coordinated care setting, there may be still a place for nurse care coordinators to take on some tasks previously performed by doctors.
Timing of Elective Cesarean Section and Growth and Psychomotor Developmental Indices in 6-Month-Old Infants.

BACKGROUND In the present study, we evaluated post-natal growth and psychomotor development status of infants at 6 months of age based on their gestational age at elective cesarean sections. METHODS This is a prospective cohort study performed in 2014-2015 in Iran. The study population consisted of 6-month-old infants with gestational ages of 38-40 weeks delivered by elective cesarean section. The subjects were divided into 3 groups: Group A (neonates with gestational age of 380/7 weeks), group B (neonates with gestational age of 390/7 weeks), and group C (neonates with gestational age of 406/7 weeks). At the infant age of 6 months, the mothers were called for follow-up visits. Growth and psychomotor status of all subjects were assessed by expert pediatricians based on the Age and Stage Questionnaires. Recorded data related to outcomes in neonatal period and 6 months later were analyzed to determine associations between groups' variables. RESULTS A total of 952 subjects were found eligible for study participation. The mean birth weight, length and head circumference were significantly higher in group C compared with the other groups (P=0.005). Regarding growth parameters, a significant association was found between gestational age at birth and all other growth indices at 6 months of age (P=0.005). The mean weight at 6 months of age was higher in group B in comparison with group A (P=0.001) and C (P=0.007). Infants born at 380/7 weeks were shorter in comparison with those born at 390/7 (P=0.002) and 406/7 weeks (P=0.005). Head circumference was significantly lower in group A than group B (P=0.02) and C (P=0.05). Regarding psychomotor indices at 6 months, a significant association was found between gestational age at birth and problem-solving skills (P=0.003). Delays in problem-solving skills were more frequent in neonates born at 380/7 weeks compared with those born at 390/7 (P=0.005) or 406/7 weeks (P=0.003). This difference was also significant between the two groups who were born at 390/7 and 406/7 weeks (P=0.01). CONCLUSION The results from this study demonstrated that postponing the time of planned elective cesareans beyond 39 weeks of gestation may improve infant's growth and psychomotor outcomes.