Miracle-dz/UniFAR-FTUs huggingface dataset:
A new reduced clock-swing flip-flop: NAND-type keeper flip-flop (NDKFF)

A new reduced clock-swing flip-flop, named NAND-type Keeper Flip-Flop (NDKFF) is proposed. Compared with other conventional reduced clock-swing flip-flops such as HSFF and RCSFF, NDKFF features a simple configuration, which does not have additional clock drivers or does not have additional nand/or p-wells. Compared with the hybrid-latch flip-flop, 52% of the flip-flop power and 64% of the clocking power are saved in the case of 0.25 /spl mu/m CMOS technology. Moreover CLK-to-Q delay is comparable to that of conventional C2MOS-type master-slave flip-flop.
Charing Cross Venous Ulcer Questionnaire - Brasil: estudo bicêntrico de confiabilidade

Resumo Objetivo: Verificar a consistência interna e estabilidade do Charing Cross Venous Ulcer Questionnaire - Brasil (CCVUQ-Brasil). Métodos: Trata-se de uma pesquisa metodológica realizada em duas regiões do Brasil (Goiânia e Niterói), no período de junho de 2016 a junho de 2018. A amostra para a consistência interna foi composta por 112 pessoas e para a estabilidade foram avaliados 74 participantes, todos com úlcera venosa atendidas na rede pública de saúde. Para análise da consistência interna foi calculado o alfa de Cronbach. Para estabilidade, o questionário foi aplicado duas vezes com intervalo de 30 minutos e para sua análise foi calculado o coeficiente de correlação intraclasse (CCI). Resultados: O CCVUQ-Brasil apresentou alfa de Cronbach para pontuação total do questionário igual 0,92 e para os domínios (interação social, atividades domésticas, estética e estado emocional) foi acima de 0,70. A estabilidade foi excelente (CCI=0,96) para pontuação total do questionário e para a maioria dos domínios. Conclusão: O CCVUQ - Brasil obteve boa consistência interna considerando os dois cenários estudados e excelente estabilidade no cenário Goiânia.
To study autonomic variability in offsprings of hypertensive parents in Lucknow using cold pressor test

Introduction: Hypertension runs in family, and familial hypertension is one of the most important risk factor for children to become hypertensive in future life. Teenagers comprise very special group that have hypertensive first degree relatives, these should be very closely monitored. Autonomic derangement in the form of increased sympathetic tone has been seen in young offspring’s with a history of hypertension in their parents. Sympathetic nervous system over-activity is reported in hypertension. If we can detect early proneness to hypertension, it may help an individual to lead a healthy life by changing his/her lifestyle and daily activities. Objective: To study sympathetic autonomic variability in offspring’s of hypertensive parents. Materials and Methods: This is a cross sectional study. In this study 52 healthy young subjects (26 study group i.e., offsprings of hypertensive parents and 26 control group i.e., offsprings of non-hypertensive parents) age: 18-25 years both male and female were chosen. The blood pressure of the participants was recorded using a electronic blood pressure instrument (Citizen 432). The participants were asked to immerse their right hand in ice cold water (4 degree Celsius) for 1 minute. At the completion of one minute, blood pressure was measured. Five minutes after the test, the blood pressure was noted again (recovery). Body mass index was also noted of each individual. Results: It is evident from the results that in both study group and controls, a rise in systolic blood pressure occurred as a result of stress induced by cold test but in study group the diastolic blood pressure showed a significant increase whereas in controls it showed no change after stress induced by cold test. In both the study group and controls, the systolic component returned to the baseline value after a duration of 5 minutes of stress (recovery), whereas the diastolic component of controls returned to the baseline value and even below baseline bu
Cervical cytopathological changes in Pap smear test in the city of Santa Cruz do
 Sul, Rio Grande do Sul, Brazil

Objective: To determine the cytopathologic alterations in women who undergo the Papanicolaou exam by the single health system in a laboratory in the city of Santa Cruz do Sul, Rio Grande do Sul, Brazil. Methodology: Data were collected from cytopathological reports of the year 2015 by the cancer information system. The variables referring to age and cytopathologic alteration were selected. The analyzes were performed by descriptive statistics, including frequency, mean, standard deviation. The associations between the categorical variables were evaluated by the Qui Quadrado test in SPSS software version 22.0. Results: In the year 2015, 2346 women underwent cytopathological examination, where 34.7% were within the limits of normality, 62.6% presented benign cellular alteration, of which 47.5% were inflammatory. Of the alterations, 1.8% were atypical squamous cells of undetermined significance (ASC-US); 0.6% were low-grad squamous intraepithelial lesion (LSIL); 0.2% were atypical squamous cells and it was not possible to exclude high grade squamous intraepithelial lesion (ASC-H); and 0.1% were high-grade intraepithelial lesions (HSIL). Regarding the age of the women, a higher frequency was observed in the age group above 55 years and an average of 46.5 years. Conclusion: The benign cellular alterations were the most frequent, with the prevalence of inflammation. The most common precursor lesions of cervical cancer were ASC-US and LSIL.
A mixed methods study of chronic pain in Qatar

Background: Many studies have shown that chronic pain has negative impacts on a person's health-related quality of life (HRQOL) depending on the pain intensity, location and dysfunction in daily activities. Moreover, chronic pain is influenced by many factors, such as perception, belief and experience. Aim: The aim of this study is to identify the relationship between chronic pain intensity, location and dysfunction with HRQOL, as well as understanding an individual's life experience of living with chronic pain. Methods: We applied a sequential explanatory mixed methods design that first began with a quantitative phase (Cross-Sectional Survey) to measure chronic pain intensity, location and dysfunction and its impact on an individual's quality of life. This was then followed by a qualitative phase (Descriptive Qualitative), in which some of the quantitative findings were explored in more depth. Setting: Chronic pain clinic at Hamad General Hospital in Doha, Qatar with 142 chronic non-malignant pain patients referred from urban and rural areas. Results: Over half reported pain in the back and had pain in more than one site. Multiple linear regression analysis revealed that increasing chronic pain severity and location had a significant negative effect on daily functioning (p 0.05). In contrast, there was a significant impact on MH and SF (P ≤ 0.05) with older age. Two major key elements emerged to account for a person's ability to live and cope with chronic pain: (1) social context and (2) religious beliefs. These two themes were usually interwoven with subthemes that contributed to our understanding of pain. Subthemes included feeling disabled, the meaning of having and coping with chronic pain, perceptions of health, the future and pain, and alternative therapy. The subthemes were influenced positively by social context and religious beliefs; therefore, socially connected, religiously oriented and observant people with chronic pain were able to maintain or enhance some domains of their HRQOL. Conclusion: Chronic pain does not necessarily have a significant negative impact on all domains of quality of life. How sufferers perceive their pain and the personal resources they have to deal with its consequences, based on their background, religion and culture, can influence how they cope with their condition. Exploring the life experiences of living with chronic pain from those in other cultures might contribute to our understanding and lead to the development of social support initiatives, thus enhancing or maintaining some aspects of HRQOL. %%%%Contexte: De nombreuses etudes ont montre que la douleur chronique a des repercussions negatives sur la qualite de vie liee a la sante d'une personne (QVRS) en fonction de l'intensite de la douleur, de l'emplacement et du…
Deep Learning-Based Proarrhythmia Analysis Using Field Potentials Recorded From Human Pluripotent Stem Cells Derived Cardiomyocytes

An early characterization of drug-induced cardiotoxicity may be possible by combining comprehensive in vitro proarrhythmia assay and deep learning techniques. We aimed to develop a method to automatically detect irregular beating rhythm of field potentials recorded from human pluripotent stem cells (hPSC) derived cardiomyocytes (hPSC-CM) by multi-electrode array (MEA) system. We included field potentials from 380 experiments, which were labeled as normal or arrhythmic by electrophysiology experts. Convolutional and recurrent neural networks (CNN and RNN) were employed for automatic classification of field potential recordings. A preparation phase was initially applied to split 60-s long recordings into a series of 5-s windows. Subsequently, the classification phase comprising of two main steps was designed and applied. The first step included the classification of 5-s windows by using a designated CNN. While, the results of 5-s window assessments were used as the input sequence to an RNN that aggregates these results in the second step. The output was then compared to electrophysiologist-level arrhythmia detection, resulting in 0.83 accuracy, 0.93 sensitivity, 0.70 specificity, and 0.80 precision. In summary, this paper introduces a novel method for automated analysis of “irregularity” in an in vitro model of cardiotoxicity experiments. Thus, our method may overcome the drawbacks of using predesigned features that restricts the classification performance to the comprehensiveness and the quality of the designed features. Furthermore, automated analysis may facilitate the quality control experiments through the procedure of drug development with respect to cardiotoxicity and avoid late drug attrition from market.
A Case Report of Recurrent Endometrial Stromal Sarcoma to the Breast, Lung and Pelvis after 15 years of Subtotal Hysterectomy

Endometrial stromal sarcoma (ESS) is an extremely rare malignant tumor of the endometrium accounting for only 0.2% of all uterine malignancies and for 15-26% of primary uterine sarcomas. The annual incidence of ESS is 1-2 per million women [1].
Prevalence and determinants of adherence to antiretroviral treatment among HIV patients on first-line regimen: a cross-sectional study in Dakar, Senegal

Introduction Successful and long-term positive impact of antiretroviral treatment requires high rates of adherence (> 90%). In Senegal, there is a lack of data regarding adherence to antiretroviral treatment and only a few studies have looked at the determinants. The aim of this study is to assess the prevalence and determinants contributing to antiretroviral (ARV) adherence among Human Immunodeficiency Virus (HIV) infected outpatients receiving care at four public hospitals in Dakar, Senegal. Methods A cross-sectional based study was carried out among HIV-positive ART adults in Dakar, Senegal. Patients were systematically sampled during either their clinical visits or visit to collect ARV drugs from six public hospitals and data collected with a questionnaire. The study outcome was adherence to antiretroviral treatment assessed by a multiple approach method which combined three self-reported adherence tools: self-reporting, Visual Analog Scale (VAS), and the Simplified Medication Adherence Questionnaire (SMAQ). Data were entered with an Excel spreadsheet and transferred to STATA for descriptive, bivariate and multivariate analysis. All the statistical tests were done at the threshold level of 0.05. Results A total of 150 HIV-positive patients on first line ART regimen at six public health facilities were enrolled into the study. The mean age of patients was 43.1 years with a sex ratio of 0.3. Most of the patients were prescribed Tenofovir-based regimen. Of these patients, 26.67% were found to be highly adherent. After adjusting for health-related variables, demographic and socio-economic variables, better adherence was associated with participating actively within an association of persons living with HIV (AoR=2.89; 95% CI: 1.04 - 7.99; p value 0.041) while being widowed patient was associated with lower adherence (AoR=0.17; 95% CI: 0.03 - 0.94; p value 0.043). Conclusion Our study findings imply that adherence should be routinely assessed during medical visits. Ongoing strategies to improve adherence such as out-of-clinic group-based models or psychological support should be directed toward outpatients' clinics to assist in improving adherence and long term virologic suppression in Senegal.
Tumor microenvironment immune types in gastric cancer are associated with mismatch repair however, not HER2 status

The treatment of patients with human epidermal growth factor receptor 2 (HER2)-negative gastric cancer is a major challenge. Immunotherapy using immune checkpoint inhibitors is a rapidly growing field. In a number of malignancy types it has been demonstrated that patients with mismatch repair deficiency efficiently respond to programmed death-ligand 1 (PD-L1) blockade therapy. Recent studies have evaluated tumor microenvironment immune types to predict which patients may clinically benefit from immunotherapy. The present study aimed to evaluate the immunohistochemical expression of PD-L1 in 70 gastric cancer tissue samples. Potential associations between PD-L1 expression and mismatch repair deficiency, HER2 and Epstein Barr virus (EBV) status were then investigated in the context of the tumor microenvironment. A positive association was identified for PD-L1 expression with mismatch repair deficiency and EBV status; however, no association was revealed with HER2 status. Immunohistochemistry was then used to classify the microenvironment immune types. This demonstrated that the majority of the gastric cancer samples (73%) belonged to the tumor microenvironment immune type II [PD-L1−/cluster of differentiation 8 (CD8)+ low], which involves an immune ignorant state and has a low sensitivity to immunotherapy. However, 7% of the gastric cancer cases were identified to belong to the tumor microenvironment immune type I (PD-L1+/CD8+ high), which exhibits adaptive immune escape responses and a high chance of reversion with immune checkpoint blockade therapy. In conclusion, the present study emphasized the importance of evaluating tumor microenvironment immune types, mismatch repair deficiency status and EBV status, rather than PD-L1 expression alone, when evaluating the eligibility of a patient for immunotherapy with anti-programmed cell death protein-1/PD-L1 antibodies.
Real-World Experience of a Standalone Robotic Device for Batch Compounding of Small-Volume Parenteral Preparations

Purpose: Intravenous (IV) drugs prepared by a robotic device offer additional safeguards and advantages, which result in decreased errors and wastage, operational efficiency, and a retrievable electronic audit trail when compared with the traditional method of IV drug compounding. Objectives: To describe the real-world experience of using Robotic IV Automation (RIVA; ARxIUM) from its implementation phase (August-December 2014) through to its operational phase (March 2015-March 2018) for batch compounding of small-volume preparations. Method: The Data Warehouse and Analytics were used extensively to generate reports for batch-prepared small-volume preparations from the implementation phase (August 2014-December 2014) through to the operational phase (March 2015-March 2018). These reports analyzed cleaning history, doses produced by drug and size, waiting times, daily usage and the rejection rate data of RIVA. A self-administered structured questionnaire with open-ended and closed questions was administered to the experienced stakeholders on the performance of RIVA after the evaluation period. The response scales used anchors such as 1 = strongly disagree to 5 = strongly agree. The questionnaire contained a 5-point Likert scale of 16 domains, including demographic data. Results: The number of sterile products prepared by the robot averaged about 5000 per month when it was fully operational (March 2015-April 2018). The highest number of daily preparations was 335 with an average of 262 during our evaluation period; this involved 21 production queues and a run time of 17:42 h/d and an average of 16:33 h/d/wk. We were able to operate the robot at about 45% of its true capacity; this enabled us to prepare a minimum of 30% of the small-volume parenteral preparations required at the time. Responses from the closed questions resulted in the agreeance that the overall impression of RIVA was “very good. ” The safety features of RIVA had a median score of being “very safe. ” The real impact of the automation was felt during the downtime of the IV robot; at this point, staff could evaluate the impact the robot had on the work flow within the IV room. Conclusions: This study demonstrated that it is feasible to replace some of the manual compounding of small-volume parenteral preparations through batch compounding using an IV robotic device. Despite operating the robot at about 45% of its true capacity, we prepared a minimum of 30% of our high-load small-volume parenteral preparations, which was our goal. Having proactive inventory planning would maximize the use of the IV robot and reduce the idle time, thus enabling the robot to function to its maximum potential and increase its efficiency.
Repressed Wnt Signaling Accelerates the Aging Process in Mouse Eyes

Purpose Ocular aging is a natural process of functional decline in vision. When the process reaches a point that compromised vision affects normal daily activity, it manifests as age-related ocular diseases, such as age-related macular degeneration, cataracts, glaucoma, and pseudoexfoliation syndrome. We previously reported that repressed Wnt signaling accelerated the maturation of corneal epithelium during tissue development. Here, we explore the hypothesis that repressed Wnt signaling is associated with accelerated aging in mouse eyes. Methods Wnt ligand antagonist secreted frizzled-related protein 1 (sFRP1) was expressed in the corneal stroma by a tissue-specific, inducible, bitransgenic system. Tissue structure was analyzed for signs of aging. Signal transduction analysis was performed to determine the cellular response to sFRP1. Results Mouse eyes with sFRP1 expression showed signs of accelerated aging, resembling those found in pseudoexfoliation (PEX) syndrome, a known age-related disease. Specific findings include granular deposition on the surface of the anterior lens capsule, pigment loss from the anterior surface of the iris, the presence of fibrillary material in the anterior chamber, and changes in cell size (polymegethism) and shape (pleomorphism) of the corneal endothelial cells. In vitro studies demonstrated that sFRP1 did not inhibit Wnt5a function and that cells responded to sFRP1 and Wnt5a in a very similar manner. Conclusion The expression of sFRP1 accelerates the aging process in mouse eyes and future studies are warranted to elucidate the underlying mechanisms.
HAND-ASSISTED LAPAROSCOPIC SURGERY FOR THE CANCER OF THE LEFT COLON AND RECTUM - AN IDEAL OPTION OF MINIMALLY INVASIVE SURGERY? SINGLE CENTRE EXPERIENCE WITH 459 CASES

BACKGROUND/OBJECTIVE. Hand-assisted laparoscopic surgery (HALS) has been introduced into clinical practice almost three decades ago, very soon after the introduction of conventional laparoscopic surgery. It combines the advantages of both laparoscopic (minimally invasive) and open surgery. Despite a good piece of data in the medical literature, the clear place of this kind of laparoscopic surgery today is not easy to delineate. Our study aimed to review single centre experience in treating patients with left colon and rectal cancers using HALS. METHODS. This study was a retrospective analysis of prospectively collected data of 459 patients undergoing hand assisted laparoscopic colorectal surgery for left colon and rectal cancer, in a single tertiary care institution, National Cancer Institute, from January 1, 2006, to December 31, 2016. All consented patient with confirmed invasive cancer of left colon and rectum undergoing HALS were included in the analysis. RESULTS. The patients’ mean age was 64.14 ± 9.75 years. Female and male ratio was similar: 232 (50,5 %) versus 227 (49,5 %). The mean length of postoperative hospital stay was 6.7 (from 2 to 34) days. There were 5 (1,1 %) conversions to open surgery. Histological examination revealed mean lymph node harvest to be 15 ± 12, ranging from 8 to 90. Stage I, II and III cancer was similar in distribution accounting for 133 (28,9 %), 139 (30,3 %), 151 (32,9 %) patients respectively and 36 (7,8 %) patients with stage IV. 244 (53,2) of patients underwent surgery for the cancer of the left colon (sigmoid colectomy or left hemicolectomy), and 215 (46,8 %) patients underwent surgery for rectal cancer. Postoperative complications occurred in 28 (6.1 %) patients, eight of them (1,7 %) needed reintervention (laparotomy) because of anastomotic insufficiency and intraabdominal abscesses. ЛАПАРОСКОПИЧЕСКИЕ ОПЕРАЦИИ С РУЧНОЙ АССИСТЕНЦИЕЙ ПРИ РАКЕ ТОЛСТОЙ КИШКИ – ИДЕАЛЬНЫЙ МИНИИНВАЗИВНЫЙ СПОСОБ ВМЕШАТЕЛЬСТВА? АНАЛИЗ ОПЫТА ЛЕЧЕНИЯ 459 ПАЦИЕНТОВ В ОДНОМ ЛЕЧЕБНОМ УЧРЕЖДЕНИИ
Relation of the incidence of congenital variations and anomalies with intracranial aneurysms in intracranial arteries

Objectives: There exists many embryological steps during the development of intracranial vascular structures. Therefore, the congenital variations and anomalies of these structures are often encountered. For a proper evaluation of cerebrovascular imaging studies it is essential to know the frequencies of these anomalies and variations, their locations and the possible accompanying patologies should be distinguished. We aimed to analyse the frequency of congenital variations and anomalies and their association with intracranial aneurysms by evaluating the cerebral angiographic images. Methods: The cerebral angiograms taken for various reasons in the Radiology Department, Faculty of Medicine, Gaziosmanpasa University, between January 2007 and April 2009, were evaluated in a retrospective fashion. We investigated the association of intracranial aneurysms and congenital variations in addition to the influence of variations on aneurysm formation. A total of 254 cases with intracranial artery variation-anomaly and coexisting intracranial artery aneurysm were included in the study. Results: The most common variation in intracranial arteries was the agenesis or hypoplasia of the A1 segment of anterior cerebral artery. This was followed infundibular dilatation of posterior communicating artery and fetal type posterior cerebral artery. The incidence of aneurysm was 22.5% in patients who had A1 hypoplasia-agenesia and 18.2% in patients who had trifurcation of middle cerebral artery. Conclusion: Flow haemodynamics take an important part in the formation of intracranial saccular aneurysms. The incidence of aneurysm formation increases in congenital anomalies of intracranial vascular structures. It is necessary to explore the relationship between variations and aneurysms in order to understand the haemodynamic factors which take place in the pathogenesis of aneurysms. These ratios lead us to think that the incidence of aneurysms increases in cases which have variations when compared to those which have not.