Miracle-dz/UniFAR-FTUs huggingface dataset:
A Quantitative Study of the Emotional Outcome of People Caring for Stroke Survivors

Background and Purpose—Although the physical and, to a lesser extent, emotional outcome of stroke survivors has been well documented, there are far fewer data relating to the outcomes of those who care for them. We aimed to describe the outcome of those caring for stroke patients and to identify both patient and caregiver factors that are associated with poor caregiver outcomes. Methods—As part of a randomized trial to evaluate a stroke family care worker, we identified 417 patients (67% of all referrals to our institution). We followed up 376 survivors of whom 246 identified a caregiver at a 6-month follow-up interview. The patients and caregivers were asked to complete 2 measures of emotional distress (30-item General Health Questionnaire [GHQ-30] and Hospital Anxiety and Depression [HAD] Scale). A regression analysis was used to identify factors that were independently associated with poor caregiver outcomes. Results—Fifty-five percent of responding caregivers scored more than 4 on the GHQ-30, indicati.
Cadmium Intake as a Prognostic Factor in Endometrial Cancer: A Swedish Cohort-Based Study

Abstract Metalloendocrinology is a new interdisciplinary field, which was established due to the importance of connections between inorganic chemicals and hormonal mechanisms. The role of cadmium in hormone-related tumors is an excellent example of this connection, as cadmium mimics estrogen in the human body. Since endometrial cancer (EC) is hormone-related, it is well-suited for assessing the estrogenic effects of cadmium. Therefore, the present study aims to explore the role of dietary cadmium intake in the progression-free survival (PFS) and overall survival (OS) in women with EC. Dietary cadmium intake was estimated based on a large cohort of Swedish women (n = 416) with EC. Median dietary cadmium intake was then analyzed in relation to different tumor characteristics and clinical outcomes. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Median daily dietary cadmium intake in the cohort was 13.1 μg (interquartile range 25%-75%=6.4). High dietary cadmium intake (μg/day) was associated with significantly decreased OS in the study cohort (HR = 0.956, 95% CI = 0.914-1.001, p = 0.05). Dietary cadmium intake was not associated with PFS (HR = 0.975, 95% CI = 0.924-1.028, p = 0.348). Therefore, our results indicate that high dietary cadmium intake could be associated with poor outcome in women with EC.
A COMPARATIVE ANALYSIS OF MANUAL LIQUID BASED CYTOLOGY VERSUS CONVENTIONAL SMEAR

Introduction: Pap smear is the conventional screening procedure for cervical cancer. MLBC (Manual Liquid Based Cytology) has been developed as a cost effective alternative as it has a short screening time, better morphology and background while also providing residual material to test for HPV DNA. Aim: To evaluate the diagnostic efficacy of MLBC and compare the morphological parameters with conventional PAP smear. Materials and Methods: This is a prospective study comparing 50 cervical smears using Pap smear and MLBC by the split sample method. The smears were stained by Rapid Pap stain and reported using Bethesda System. Results: In MLBC 18 (36%) cases were reported as inadequate smear but none of the smears were inadequate in CS. By MLBC method 10(20%) cases showed inflammatory cells while CS showed inflammatory background in 31(62%) cases. MLBC preparations showed 2 (4%) cases of LSIL while CS showed 2(4%) HSIL and 4(8%) LSIL. The interpretation of results revealed that there was a statistically significant difference between the two methods (P<0.001). Conclusion: MLBC is better than CS in that it has uniform distribution, reduced cellular overlapping and a cleanbackground but it was inferior in detecting epithelial lesions. So, by improving the MLBC technique, its efficiency can be increased for use in low resource settings.
Functional Outcomes in Endoscopic Endonasal Surgery of the Skull Base, A rising challenge

Extended endonasal endoscopic approaches (EEEA) for skull base lesions have been increasing over the last decade. Determinants for this development are the enhanced understanding of the endoscopic anatomy, improvement of imaging systems and specific instruments, and the use of vascularized flaps for reconstruction [1]. This EEEA can cause postoperative morbidity related to the reconstruction, like crusting and posterior rhinorrhea, especially in those cases requiring an endonasal flap [2,3]. The healing process start the first week with a reepithelization by stratified epithelium, then hair cells appear in the third week and complete recovery of the sinus epithelium occurs within 6-8 weeks [4]. Given this, [5] conclude that one must wait at least three months to assess the clinical and postoperative symptoms. Regarding quality of life (QOL) after EEEA evidence have shown that the morbidity is related to the extension of the approach. [6] reported a negative impact in QOL after the use of nasoseptal flap which is commonly associated to extended approaches. The latter was mainly due to an increased tendency to headaches and reduced smell; however, recovery occurs over time especially in those patients with secreting pituitary tumors. Since the use of endoscopic skull base surgery, there have been great efforts to develop specific QOL questionnaires for EEEA and pituitary surgery (Table 1) Until now, the following tests have been applied in English literature; Quality of Life-Assessment of Growth Hormone Deficiency in Adults [7], Hypopituitarism Quality of Life Satisfaction (QLS-H) [8], Previous Skull Base Quality of Life (ASB-QOL) [9], Hormone Deficiency-Dependent Quality of Life ( HDQOL) [10], Acromegaly Quality of Life (ACROQOL) [11], Pituitary Adenoma Quality of Life (PA-QOL) [12], Cushing Quality of Life [13], Addison Quality of Life (AddiQOL) [14], or ASK nasal inventory [15]. Handicaps for these tests are that they do not include specific areas about quality of life and cancer, visual defects, hormonal deficiency or sinonasal symptoms. Here, we will discuss the impact of EEEA regarding the following topics:
Accidental Head Injuries in Children: Experience of Suez Canal Teaching Hospital

Background: Accidental head injuries in children represent a significant public health problem. However, there is a paucity of data regarding rates, modes and age-related risks of these injuries especially in developing countries. Aim: To define the etiology, clinical aspects, interventions, and the clinical outcome of accidental head injuries in children presented to Suez Canal teaching hospital. Patients and Methods: Prospective analysis was conducted on children admitted to emergency department/Suez Canal teaching hospital for treatment of accidental head injuries. Data included patient`s demographics, etiology & mechanism of injury, severity of injury using pediatric Glasgow coma scale, clinical aspects, treatment received, and the final functional outcome using King’s Outcome Scale for Childhood Head Injury. Results: Two hundred and six injured children aged 18 years or less were admitted to hospital in the period from January 2014 to June 2015. Male/Female ratio was 1.3/1. Falls were the commonest mode of injury (61%), followed by Road traffic accidents (18%), and home injuries (14%). Most injuries were of mild severity (83%). CT brain revealed skull fracture in 11%, and intracranial bleeds in 7%. Fourteen patients were operated upon. The mean length of hospital stay was 4.3 days. Final assessment revealed good recovery in 89% of children, moderate to severe disability in 8.5%, and a mortality rate of 2.4%. Conclusion: Children aged 2-5 years were more frequently present with an accidental head injury. Most injuries were mild, and falls were the commonest mode of injury. Most children required simple management without need for surgical intervention. Good recovery was the rule in most children with low disability and mortality rates.
miR-21 facilitates the diagnostic value of miR-138 for papillary thyroid cancer in formalin-fixed paraffin-embedded tissues

Background miR-138 was thought to be anti-tumor miRNA for its ability of suppressing tumor growth. The objective of this study was to evaluate the potential predictive value of miR-138 and its combination with miR-21 in formalin-fixed paraffin-embedded (FFPE) tissues of papillary thyroid cancers (PTCs). Methods miR-138/miR-21 expression was tested in 101 PTC and 51 benign thyroid nodule (control) patients using quantitative real-time PCR. Clinical and pathological characteristics of enrolled subjects were obtained from medical records. Results miR-138 was significantly down-regulated in PTC compared with controls (median 0.0122 vs. 0.0943), and miR-138 exhibited capability of discriminating PTC from controls, with a diagnostic accuracy of 71.1% (sensitivity 84.3%, specificity 49.5%). A combination of miR-138 and miR-21 increased the diagnostic accuracy to 79.1% (sensitivity 73.3%, specificity 76.5%). Multivariate logistic regression confirmed the association between miR-138/miR-21 expression and PTC diagnosis. Moreover, miR-138 expression was further down-regulated in PTC with capsule invasion compared with PTC tissues without capsule invasion (median 0.0043 vs. 0.0373, P=0.003). Conclusions MiR-138 expression was not only associated with onset of PTC, but also the aggressiveness of PTC. A combination of miR-138 and miR-21 enhanced the diagnostic value of individual biomarkers.
The Patient Selection Criteria for Veno-arterial Extracorporeal Mechanical Oxygenation

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) plays a crucial role in the management of patients with refractory cardiac and pulmonary dysfunction by providing temporary mechanical hemodynamic and respiratory support. However, the paucity of guidelines on indications for administering it and the failure to timely initiate VA-ECMO often result in a high in-hospital mortality rate and poor six-month outcomes after VA-ECMO deployment. Due to ethical issues, randomized controlled studies with VA-ECMO have not been conducted so that no recommended evidence-based guidelines exist for VA-ECMO patient-selection criteria. Therefore, the indication for administering the device depends solely on expert opinion after reviewing the literature. We conducted a review of the current literature to better understand and classify the need for proper patient selection, including proven indications for VA-ECMO.
EFFECT OF AN IN SERVICE TRAINING PROGRAM FOR INTENSIVE CARE NURSING STAFF IN THEIR PRACTICE - KHARTOUM STATE 2014-2017

Background: Cardiopulmonary resuscitation is the emergency procedure used to salvage victims of cardiac and respiratory arrest. It should be carried out with great urgency to avoid permanent brain damage or even death that would result if the victim stays from 4 to 6 minutes without oxygen. The aim of study: To assess the effectiveness of structured teaching program on the skills of cardio pulmonary resuscitation among the nursing staff in the Khartoum Teaching, Ahmed Gasim, Omdurman Teaching, and the Khartoum North Teaching hospitals. Methods: A quasi experimental design pretest/posttest for the same group. The study was conducted in the intensive care units in Khartoum hospitals. The study sample consisted of 100 nurses. Data was collected by a questionnaire and an observational checklist. The intervention program was in a form of lectures guidelines book. Data were analyzed using Statistical Packages for Social Sciences (SPSS). Results: the study showed the Nurses' skills before implementation program poor (57%) good (31%) very good (12%). Nurses' skills after implementation program poor (4%) good (18%) very good (78%), (P value 0.002). Conclusion: The study concluded that educational program had a significant impact related to the improvement of the nurses' practice post application of the program. Key words: Training program, Practice, Nurses, Intensive Care Unit.
The ethics of care and justice in primary nursing of older patients

While the ethic of care has generally been regarded as an appropriate attitude for nurses, it has not received equal attention as a mode of ethical problem solving. The primary nursing model is expected to be aligned with the ethic of care because it emphases the nurse–patient relationship and enables more independent role for nurses in decision-making. The aim of this study was to examine nurses’ ethical decision-making in the context of primary nursing. Participants were seven nurses, and one physiotherapist from a geriatric rehabilitation unit of a public hospital in Finland. Data were collected through focus group interviews and qualitatively analyzed through Lyons’ coding scheme for moral orientations. The results showed that primary nurses employ empathic understanding and particularistic thinking when building relationships with patients and their families, and when assessing their needs for coping at home after discharge. Most ethical conflicts were related to discharge and were solved through balancing the ethics of care and justice considerations. It is concluded that care and justice are integrated in nurses’ everyday ethical decision-making. The ethic of care nurtures good patient–nurse relationships, while the ethic of justice is needed to address the fair delivery of care in the context of an aging population and diminishing public resources. Both ethics should be acknowledged in clinical practices and included in ethics education.
Pregnancy Outcome in Elderly Primigravidae: A 5-year Review in a Tertiary Health Care Institution in Abakaliki, Southeast, Nigeria

Background: Pregnancies in women of advanced maternal age have been historically regarded as high risk pregnancies because of the associated increase in risk of maternal and perinatal morbidity and/or mortality. Hence, there is a need to evaluate the pregnancy outcome of elderly primigravidae in our setting. Aim: To determine the pregnancy outcomes in elderly primigravidae compared to the younger primigravidae at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and Method: This was a retrospective case-control study of pregnancy outcomes of 49 elderly primigravidae (case group), who delivered at the hospital over a 5-year period, were compared with those of 98 younger primigravidae (control group) (≤ 34 years old) that delivered during the same period. Data collection was done using a pre-designed proforma; analysis was done using Epi Info 7.2. 1 CDC. Result: During the study period, there were 11703 deliveries. The incidence of elderly primigravidity was 0.42%. The mean age of the study group was 36.5 ± 1.7 years and that of the control group was 24.3 ± 4.2 years. Forty-four (89.8%) patients were booked in the study group, while 71 (72.8%) patients were booked in the control group. Elderly primigravidae were more likely to book before 14 weeks’ gestational age compared with younger primigravidae (χ2=33.29, P0.05)). The caesarean section rate in the case group was higher but of no statistical significance (p=0.51). There was no recorded maternal death in both groups. Conclusion: Elderly primigravidity is not uncommon in our environment. Due to the anxiety associated with such pregnancies they were more likely to book earlier than the younger primigravidae. Although they were more likely to have medical complications, the maternal and perinatal outcomes were not statistically different from younger primigravidae.
NEUROCOGNITIVE DEFICIT IN BIPOLAR I DISORDER PATIENTS CURRENTLY IN EUTHYMIC STATE, THEIR UNAFFECTED FIRST DEGREE RELATIVE AND HEALTHY CONTROL GROUP- A COMPARATIVE STUDY

BACKGROUND Neurocognitive dysfunctions particularly executive functioning, attention, processing speed, verbal learning and declarative memory are key aspects of Bipolar disorder, as they occur in all the phases of the illness, across all neuropsychological domains, even during remission of symptoms. In our study, we compared the frequency and types of neurocognitive deficits and factors influencing them in individuals with Bipolar I disorder, their first-degree unaffected relatives and healthy controls.
Epidemiologic Study of Congenital Heart Diseases and Its Related Factors in Children Referred to the Pediatric Cardiac Clinic of Birjand University of Medical Sciences, Iran

Background: Congenital heart disease is the most common type of maternal abnormality and is the leading cause of mortality in the first year of life. The aim of this study was to determine the epidemiological and related factors of congenital heart disease (CHD) in children referred to the pediatric heart clinic of Vali-e-Asr Hospital of Birjand, Iran. Materials and Methods: In this descriptive-analytical cross-sectional study, the study population included 300 patients with congenital heart disease who referred to the Vali-e-Asr Hospital, Birjand, Iran. A checklist form was used to complete the information contained in the patient records and contact their parents. The collected data were analyzed using SPSS software version 16.0 at a significance level of p≤0.05. Results: The mean age of children with CHD at the time of diagnosis was 1.25 ± 2.92 years. 156 (52%) were male. The most common type of CHD included ventricular septal defect (28.7%), patent ductus arteriosus (18.2%), and atrial septal defect (14.6%). Down syndrome (3.8%) was the most common anomaly. In 57% of cases, there was a familial relationship between parents. There was a significant statistical difference between drug use in pregnancy, maternal age, age of patients, mother's education level, place of residency, and familial relationship of parents and CHD in the children p≤0.05. Conclusion: Based on the results, the most common type of CHD included ventricular septal defect, patent ductus arteriosus, and atrial septal defect, respectively. There was a relationship between baseline and clinical characteristics (maternal age, patient age, familial relationship, and drug use in pregnancy), and CHD in the children.
Methylene Blue for Treating Vasoplegic Syndrome During Liver Transplantation: A Bolus Dose or Continuous Infusion?

Received : December 15, 2018 Accepted : May 11, 2019 Published : June 15, 2019 Abstract Background: Role of methylene blue in vasopressor-resistant hypotension during liver transplantation has limited literature. Case Report: A 60-year-old man who had vasoplegic syndrome during liver transplantation is discussed in this case report. His pre-operative evaluation was normal. While it was expected that arterial blood pressure would be in normal range at 190 min after portal vein reperfusion, severe hypotension recurred under the high dose vasopressor treatment. Observed hypotension along with hemodynamic findings suggested vasoplegic syndrome. Therefore, 2 mg/kg of methylene blue was administered. The arterial blood pressure showed improvement immediately after methylene blue administration. The vasopressors were gradually reduced, and the operation completed uneventfully, the patient was transferred to the intensive care unit. Five minutes after the admission, cardiac arrest was witnessed. The cause of cardiac arrest was assumed that the previously infused methylene blue significantly decayed and per se vasopressor was ineffective in maintaining the hemodynamic stability of this patient. The patient was resuscitated successfully and discharged to the service on postoperative day 4. Conclusion: Infusion of methylene blue following a bolus dose could be beneficial in maintaining hemodynamic stability when vasoplegic syndrome develops in liver transplantation.
OCR with a convolutional neural networks integration model in machine vision

Optical character recognition (OCR) in complex scenes, particularly in industry environment, is a challenging problem that has received a significant amount of attention. A unified model for different types of character in different production lines is needed. In this paper, we propose a unified framework to classify characters using convolutional neural network (CNN) to satisfy the two main requirements in industrial OCR, the high recognition rate and less training time by combining the representational power of multi-layer neural networks together with multi-stage features. In the model, there are three CNNs, two with multi-stage features and one with deeper layers, which can be used to extract different fonts and types characters in different complex background. The results in experiments demonstrate the efficiency with high recognition rate and less training time in complex industrial environment.
Prevalence and characterization of urolithiasis in the Western region of Saudi Arabia

Objectives: The main objective of this study is to determine the prevalence and risk factors of urolithiasis among the Saudi population in Makkah region. Methods: A cross-sectional survey was conducted on February 2017 in Makkah region (Makkah, Jeddah, and Taif). Data were obtained through direct interviews with participants, using an 18-questions-self-questionnaire, inquiring about demographic data (age, gender, weight, height, location, and occupation), educational level, history of renal stone disease (symptoms, modality of diagnosis, hospital admission, and previous treatment), and risk factors of stone formation such as family history and daily fluid intake. Results: A total of 1506 individuals were interviewed, including 82% from Makkah, 15.7% from Jeddah, and only 2.3% from Taif. The overall percentage of those diagnosed urolithiasis was 6.2%; including 6.6% males and 5.8% females (P = 0.06). Of those with stones, 5% were medically treated, 1.7% were hospitalized, and 1.2% were surgically managed for stones. There was a positive linear correlation between the prevalence of stones and participants' age group (r = 0.87, P = 0.01). More than 80% of participants were highly educated, which did not impact the prevalence of stones formation (P = 0.14). Urolithiasis was reported by 8.9% obese participants, 5.9% overweight, and 5.4% with normal body mass index (r = 0.68, P = 0.03). When stratified by jobs, stone prevalence significantly increased in retired participants (17.2%) than in workers (8.8%), followed by those without work (7.7%) and finally by students (3.3%) (P < 0.001). There was no significant difference between urolithiasis and type of drinking water (P = 0.62). Conclusion: The prevalence of urolithiasis in the Western region of Saudi Arabia has not changed much since the previous report, which was 30 years ago. It seems that the middle-aged population in their third decade of life, those who are overweight and obese people are at a high risk of developing urolithiasis.
Investigation of Hematological Profiles in the Growth Process of Van Cat Breeds

Bu calismada saglikli Van Kedisi yavrularinda dogumdan bir yasina kadar olan buyume surecinde hematolojik parametrelerin belirlenmesi amaclandi. Bu amacla Van Kedisi Arastirma Merkezinde ayni bakim ve beslenme sartlarinda barindirilan 10 erkek ve 10 disi olmak uzere toplam 20 yavru Van Kedisi kullanildi. Van Kedisi yavrularindan bir yil boyunca her ay duzenli olarak kan ornekleri alindi. Buyume doneminde hematokrit ve hemoglobin degerleri birinci (%29.9±0.9, 10.0±0.3 g/dl) ve ikinci (%29.9 ± 1.9, 10.0 ± 0.7 g/dL) ayda en dusuk seviyede belirlendi. En yuksek seviyesine 10. ayda (%40.4±2.2, 13.0 ± 0.6 g/dL) ulasti. Granulosit yuzdesi ilk ayda en dusuk oranda olculdu, daha sonraki aylarda ise artis goruldu. Lenfosit/Monosit oranlarinin (%), dorduncu ve on ikinci aylar arasinda azaldigi, en dusuk degerin besinci ayda (%18.6 ± 3.2) oldugu belirlendi. Sonuc olarak yavru Van kedilerinde hematolojik parametrelerin yorumlanmasinda buyume donemindeki degisimlerin goz onunde bulundurulmasinin yararli olacagi kanisina varildi.