Miracle-dz/UniFAR-FTUs huggingface dataset:
Development and Primary Evaluation of a Smartphone Application for Blood Glucose Control in Hospitalized Patients

Background: Diabetes is one of the major causes of morbidity and mortality. Diabetes and hyperglycemia are leading causes for cardiovascular diseases, chronic infections, and other serious problems. The use of smartphone is dramatically increasing, and as such, it is sensible to use an application for management of hospitalized patients with diabetes or hyperglycemia. We designed a software for physicians by use of which they educate to take appropriate decisions in management of patients with diabetes and evaluated the quality of the application using a questionnaire. Materials and Methods: Application is designed in a cascade framework to help in management of patients with diabetes and hyperglycemia. The treatment protocols presented in the program were extracted from diabetes management guidelines and valid review articles. Furthermore, we developed a questionnaire to assess the quality of the program. Physicians (n = 36) used this program for 1 week after which they completed the questionnaire. Results: The physicians described the application to be useful and understandable. Conclusion: A high percentage of physicians and health providers are aware of the problems when it comes to hospitalized patients with diabetes and our application was designed to resolve the associated difficulties.
Stationkeeping in the Space Shuttle middeck, preliminary design for the dice bus module

The Space Shuttle middeck is an unlikeIy place to h d a fieefioating satellite. That, however, is just what DICE proposes to be: an untethered free-flyer under astronaut supervision. In support of the DICE project , this thesis examines the disturbance forces to which that free-flyer would fa11 prey, proposes a design for an actuation system which would counter those disturbances, and simulates the control of this actuation system. From a survey of middeck disturbance forces, five significant ones are examined: middeck air circulation, solar radiation pressure, atmospheric drag, graviiy gradient torque, and orbital offset between Shuttle Orbiter and DICE mass centers. A simulation of these forces is created in XMath. Middeck air circulation proves to be the greatest disturbance, exerting forces up to 10-~ N and torques up to IOy4 Nm. In reply to these disturbances, an actuation system is proposed. It re-circulates middeck cabin air through the DICE bus and ejects it through 3 nozzle clusters in order to produce a net thrust. The airflow created by such an actuation system is characterised, while mock-up condit ions, t hruster location, and valve position are varied. The force output of one nozzle on the mock-up most faithful to curent design is measured to be 10-2 N.
STRASS (EORTC 62092): A phase III randomized study of preoperative radiotherapy plus surgery versus surgery alone for patients with retroperitoneal sarcoma.

11001 Background: The predominant pattern of failure of retroperitoneal sarcoma (RPS), frequently associated with subsequent death, is locoregional recurrence. Unlike in limbs, the efficacy of radiotherapy (RT) combined with surgery is not established. Methods: STRASS is a randomized, multicentre, international trial. Eligible patients had histologically-proven localized primary RPS, operable and suitable for radiotherapy. Patients were randomized 1:1 to preoperative RT (3D-CRT or IMRT) 50.4 Gy followed by surgery (RT/S group) or surgery alone (S group), stratified by hospital and performance status (0-1 vs 2). Primary endpoint is abdominal recurrence-free survival (ARFS; local relapse after complete resection, peritoneal sarcomatosis, R2 surgery, progressive disease during RT or unresectable disease). IDMC recommended a sensitivity analysis in which local progression on RT is not regarded as an event for patients who subsequently achieve complete surgical resection. Secondary endpoints were recurrence-free survival, overall survival, acute toxicity profile of RT, perioperative and late complications, and QoL. The study was designed to provide 90% power to show an increase of 20% in the 5-year ARFS rate, from 50% to 70% (corresponding to a HR of 0.52) at 2-sided 5% significance level. Results: 266 patients from Europe, USA and Canada were randomized between January 2012 and April 2017; 198 patients (74.5 %) had liposarcoma (LPS). Eighteen patients were designated ineligible. Overall rate of re-operation for any complication was 10.1%: 13 (10.9%) and 12 (9.4%) patients in RT/S versus S groups. 19 pts (14%) progressed during RT, 4 of whom did not undergo surgery. 3-year ARFS was 60.4% (95% Confidence interval (CI) 51.4-68.2%) and 58.7% (49.5- 66.7%) (HR = 1.01, 95%CI 0.71-1.44, p=0.954) in RT/S versus S groups. In the sensitivity analysis, 3-year ARFS was 66.0% (57.1-73.5%) and 58.7% (49.5-66.7%) in RT/S versus S groups (HR = 0.84, 95% CI 0.58-1.21, p=0.340). In the LPS subgroup, 3-year ARFS (sensitivity analysis) was 71.6% (61.3-79.6%) and 60.4% (49.8-69.5%) in RT/S versus S groups (HR = 0.64, 95%CI 0.40-1.01, p =0.049). Conclusion: STRASS failed to demonstrate a benefit of pre-operative RT for RPS. In the exploratory analysis, preoperative RT may benefit the LPS subgroup. Funding Source: EORTC and EUROSARC FP7 278472. Clinical trial information: EORTC 62092.
Lymphatic Surgery

Our own results are consistent with the work of Sterling and Myant. It will be seen that in the dog extracellular fluid appears to contain total proteins that are 30-45 % of those of serum and these are fairly constant for any one individual. It is known that albumin leaks from the circulation to be returned by the lymphatic system, and Wasserman & Mayerson (1951) estimated the rate in resting dogs to be 0.1 % per min. They noted that the rate of loss of globulin was lower, for globulin has a larger molecule which is longer than that of albumin (Cohn et al. 1944). There is also little doubt that the levels of potassium and chloride in serum differ significantly from those in tissue cage fluid; so we must believe that these highly significant differences in concentrations are distinguishing features of the extracellular tissue fluid. This may be an example of the Gibbs-Donnan effect (Fruton & Simmonds 1958) due to the net electric charge of proteins causing an unequal distribution of diffusible ions between blood and tissue fluid and it does infer that there may be a pH difference between the two fluids. In a limited series of estimations in our dogs, such differences have been noted. Fruton & Simmonds (1958) also pointed out that, although the Gibbs-Donnan effect may play some part, it should be stressed that living cells represent dynamic systems in which the energy for the maintenance of a concentration gradient is derived from intracellular chemical reactions. The dynamic state of tissue cage fluid is further demonstrated by the movement of sodium and albumin. When radioactive sodium is injected intravenously it can be recovered from tissue cages within 30 minutes. Indeed, the concentration of sodium in tissue fluid rises steadily and may exceed that of blood because sodium in the latter fluid is presumably being excreted by the kidney and there may be some pooling in the tissue cage. When sodium is injected into a tissue cage it can be recovered from blood and from other tissue cages also within 30 minutes. This is perhaps what one would expect from a molecule of such small size (24). But when a larger molecule (of 75 000) such as albumin is used the results are similar but the rate of transfer is slower. Again there appears to be a dynamic relationship between blood and tissue cage fluid, indicating that the latter is in continuity with the body extracellular fluid space. The experiments with inulin, also a large molecule, would seem to confirm this.
Community Clinic-based Approach to Address Pediatric Obesity among a Predominantly Latino Sample of Youth Enrolled in a State Health Plan

Background and Purpose: Comprehensive weight management interventions with family involvement are effective in reducing obesity among children and youth. This prospective cohort study examined whether youth who participated in a clinic-based, culturally-sensitive pediatric weight management intervention experienced reductions in BMI percentile, percent body fat, and waist circumference, from baseline to the end of the program. Methods: Participants included 240 children and youth (61.3% male) between ages 5 to 18 years (Mean age= 12.8 + 3.7 years), and nearly all of them were of Latino race/ethnicity. All participants were clinically diagnosed as overweight or obese and were referred to participate in the eight-week intervention, which included standard medical consultations, psychological counseling, and physical activity sessions for the youth participants, and nutrition education for their parents. Participants completed baseline and end-of-the-program assessments. Results: Participants experienced significant decreases in BMI percentile and body fat percentage after adjusting for growth in height. Older children were more likely to experience decreases in waist circumference relative to younger children. Conclusion: This study suggests that a clinic-based, culturally sensitive intervention may effectively reduce indicators of obesity among youth in predominantly Latino communities, beyond changes in these indicators due to normal growth.
Knowledge, Attitude and Practice for Prevention and Treatment of Swine Flu in Population of Udaipur City

Background Swine flu has become a very common seasonal respiratory disease having larger number of morbidities and mortalities. It has created panic situation among general public and health care workers just because of lack of awareness regarding the same. Aims & Objectives This study was carried out to reach general public of every class for their perception for this pandemic disease. Knowledge regarding measures for prevention and treatments available if it occurs was the objective of this study. Also to find out myths prevalent in them and to create awareness in proper direction was the objective of this study. Material and Method This study was carried out on 500 people chosen randomly from different places of Udaipur having different class and strata. Study was done by making pre-formed questionnaires. Data was analyzed by using SPSS. Findings Major part of study population gain information from news papers and TV channels. 76% of study population had heard about swine flu by different resources. Myths are prevalent in 37% of populations regarding causes and mode of occurring of swine flu. Only 23% of study population knows importance of hand-washing as measure for preventing swine flu. Conclusion Though large campaign carried out by government and media, people needs to be made aware for every aspects of swine flu through ground level awareness programmes.
Reproducibility crisis. Impact on uncontrolled release of nutraceutical preparations

In the last decade, natural integrative treatments of Polycystic Ovary Syndrome (PCOS) – a complex ovarian syndrome characterized by anovulation/androgenism/ cystic ovaries – gained momentum, given that a plethora of nutraceuticals flooded into the market. Namely, two inositol isomers myo-inositol (myo-Ins) and D-chiroinositol (D-Chiro-Ins) have been proven to be effective in PCOS treatment, by improving insulin resistance, serum androgen levels and many features of the metabolic syndrome. However, DCI alone, mostly when it is administered at high dosage, negatively affects oocyte quality. On the contrary, the association myo-Ins/DChiro-Ins in a combination reproducing the plasma physiological ratio (40:1) – as claimed by a Consensus Conference (Bevilacqua et al., 2015) and confirmed by a recent clinical pilot study (Nordio, 2019) represents, up to now, the most promising alternative in achieving better clinical results, by counteracting PCOS at both systemic and ovary level. Honestly, we still lacking a compelling clinical vindication of that assumption, the outstanding experimental results performed in animals notwithstanding (Bevilacqua et al., 2019). However, data gathered suggest that the two inositol should be administered according to a physiological ratio, which would mirror the concentrations found in the blood (Bizzarri et al., 2016), or in the ovarian follicle (Chiu et al., 2002). However, only few, pivotal studies based on these correct physiological premises have been performed so far. It is staggering. As a result, a good opportunity – treatment of a complex syndrome through natural and safe compounds – risks to be wasted.
Real World Response to Direct Acting Antivirals DAA in African
Americans Treated in a Non-Gastroenterology Setting

Introduction: The approval of highly effective direct acting antiviral agents such as sofosbuvir/ledipasvir (Harvoni) for the treatment of hepatitis C, provided an oral, tolerable and effective regimen with fixed dosing and treatment period. Given the large numbers of patients to be treated, it is anticipated that non-GI physicians will be treating more patients than in previous years. The goal of this study was to compare the response to Harvoni of patients treated in a Gastroenterology (GI) clinic to that of an Infectious Disease (ID) clinic. Methods: The study collected and analyzed data for HCV patients treated with Harvoni between June 2015 and December 2016 using a university physicians’ practice EMR. There were 389 patients with 294 treated by GI and 95 treated by ID. Results: The protocol viral clearance responses were similar for hepatitis C virus infection (HCV) patients treated in GI (93%) and ID (94%) as well as for HIV co-infected patients treated in ID (100%). The responses were similar for naive (92%) and experienced (95%) and for both AA (93%) and non-AA (96%). Significant numbers of patients did not complete therapy (8%) or did not show up for their SVR visit (13%), thus lowering the intent to treat response compared to the protocol adherence response (97% vs 79%). The primary factor for not achieving an SVR was cirrhosis (99% vs 92%). Conclusions: ID treated significant numbers of both HIV and non-HIV HCV patients and response to treatment with Harvoni was similar to the SVR rate in the GI clinics. Our data also reflects the real-world results of Harvoni treatment where, intent to treat and per protocol are significantly different. We conclude from our study that treatment of hepatitis C with Harvoni has a high SVR without regard to physician specialty, race, HIV co-infection or previous treatment status.
Midazolam Administration Reduces Leptomeningeal Enhancement in Patients Treated with Flow Diverting Stents

Objective: Imaging findings of cerebrovascular dysfunction following endovascular therapy have been increasingly reported. Special attention has been given to leptomeningeal abnormalities seen on post-contrast FLAIR (pcFLAIR) imaging as its presence is associated with poorer prognosis following endovascular therapy. The aim of this study is to investigate the relationship of various clinical variables on the presence and extent of pcFLAIR abnormalities in patients undergoing elective flow diversion of intracranial aneurysms. Patients and Methods: In a single center retrospective cohort, 80 consecutive patients treated with flow diverting stents who subsequently underwent post-operative MR-imaging within 24 hours of the procedure between July 2012 and November 2017 were identified and included in the study. Patient, aneurysm, and imaging characteristics were collected for review. Analysis of clinical variables on the presence and extent of leptomeningeal abnormalities seen on pcFLAIR imaging was performed. Results: We identified 69 of 80 patients (86%) with leptomeningeal enhancement (LME) on pcFLAIR imaging. In all instances, the distribution of LME matched the ipsilateral side of endovascular intervention. Of the 20 patients who had both pre and pcFLAIR imaging, LME was absent on precontrast imaging and seen exclusively on pcFLAIR in all cases. Complete resolution of LME was seen in 31 of 35 (89%) patients with available followup imaging. No significant association was found between LME and the extent of DWI abnormalities, dose of intra-arterial contrast administration, anesthetic or opioid use, procedural time, time until post-operative MR imaging, renal function, age, or number of stents used during embolization. There is a significant inverse relationship between the presence and extent of LME and the dose of intra-operative midazolam administration used during anesthesia (p=0.018). Conclusion: The majority of patients undergoing flow diversion therapy will develop LME on pcFLAIR imaging. LME is absent on pre-contrast imaging and seen exclusively on pcFLAIR in all cases. LME appears to be a transient finding affecting the vascular territory of intervention but in some cases may take months to completely resolve. There is no direct relationship of LME with lesions on DWI or the timing of MR imaging but there is a statistically significant inverse association of midazolam administration and presence and extent of LME. This study provides new evidence suggesting that midazolam may reduce the presence and extent of LME following neuroendovascular surgery and could have neuroprotective effects.
Predictors of Stress in Caregivers of Family Members with Multiple Sclerosis

Multiple sclerosis (MS) is a disease of the central nervous system that typically results in cognitive and physical impairment. Depending upon the severity of symptoms, persons with MS often need assistance from caregivers in their daily lives. Research has shown that when a family member is diagnosed with the disease, household members become a source of caregiver support. The relationships between caregiver burden and chronic illness and between stress and health are well-documented. The impact of caregiving on individuals with MS remains a continued clinical concern, particularly because depression is highly co-occurring in those with the disease. Understanding the predictors of stress will hopefully provide more knowledge on how to best support caregivers and family members living with MS. This study sought to determine which factors increase or mitigate stress in caregivers of family members with MS. These factors were the level of depressive symptoms, perceived social support, level of coping processes, and patient care satisfaction from the caregiver’s perspective. A total of 40 caregiver participants completed an online survey targeting these factors. The results showed that the level of depressive symptoms was the only variable that predicted the level of perceived stress among caregivers. Thus, depression remains an important clinical consideration in the MS population and their caregivers. Future research should specifically explore the types of coping methods and other factors that predict stress in family caregivers in order to support this population.
Diagnostic value of diffusion-weighted imaging-derived apparent diffusion coefficient and its association with histological prognostic factors in breast cancer

Diffusion-weighted imaging (DWI) has been proven to be effective in detecting breast malignancies and has been widely implemented for breast imaging. However, the exact association between certain DWI biomarkers and well-known prognostic factors remains to be fully elucidated. By studying the association between the apparent diffusion coefficient (ADC) and prognostic factors, the present study aimed to explore the diagnostic value and prognostic potential of the ADC in breast lesions. The study included 539 female subjects with histopathologically confirmed breast lesions who underwent DWI of the breast tissue. The diagnoses comprised 307 subjects with malignant breast tumors and 232 with benign breast tumors. The maximum ADC and mean ADC (ADCmean) values of the breast lesions were calculated. For malignant tumors, the association between ADC and major prognostic factors, including histological grade, nuclear grade and lymph node status, as well as estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2) and proliferation marker protein Ki-67. (Ki-67) status, were evaluated. The ADCmean demonstrated the best diagnostic performance in distinguishing between malignant and benign lesions. With the optimum cut-off value at 1.30×10−3 mm2/sec, ADCmean had a sensitivity and specificity of 84.1 and 90.2%, respectively. In those patients with malignant breast lesions, a decreased ADC was associated with breast lesions with high nuclear and histological grades, and lymph node-positive, ER-negative, PR-negative and HER-2-negative status, and Ki-67 ≥14%. In conclusion, the ADC is a useful imaging biomarker for differentiating between benign and malignant breast tumors. The marked association between the ADC and prognostic factors also demonstrated its value in evaluating the malignancy of breast lesions.
Prostaglandins and Thromboxane Status in Patients with Cardiovascular Diseases in Ekiti State, Nigeria

Aims: Prostaglandins and Thromboxane A2 are prostanoids, with platelet aggregator and vasoconstrictor properties. This study was carried out to assess the prostaglandins and thromboxane status of patients with cardiovascular diseases in Ekiti State, Nigeria. Study Design: This is a comparative study. Methodology: Two hundred patients with various cardiovascular diseases (Stroke, Ischemic heart disease, Hypertension, Hypertension with diabetes and Hypertension with Obesity) were recruited from Federal Teaching Hospital, Iddo Ekiti and Ekiti State Teaching Hospital, Ado Ekiti. Thirty subjects without cardiovascular diseases were used as a control. Their age range was between 30 and 90 years. Plasma prostaglandin, PGD-2, PGE-1 and thromboxane TXA2 were evaluated in all groups by the use of Enzyme-Linked immunosorbent assay (ELISA). The data obtained was subjected to student t-test and ANOVA. Results: The results showed a significant increase (P>0.05) in the plasma levels of prostaglandin Original Research Article Asaolu et al.; AJRB, 2(3): 1-4, 2018; Article no.AJRB. 42447 2 (PGD-2, PGE-1) and thromboxane A2 (TXA2) in all the cardiovascular groups when compared with the control. Plasma levels of TXA2 were found to be significantly higher (P>0.05) in stroke patients when compared with the other type of diseased cardiovascular patients. Conclusion: This study shows that the assessment of plasma prostaglandin and thromboxane levels in cardiovascular disease could be an essential tool in the diagnosis of cardiovascular diseases.