Miracle-dz/UniFAR-FTUs huggingface dataset:
Mid‐Term Outcome and Angiographic Follow‐Up of Endarterectomy of the Left Anterior Descending Artery in Patients Undergoing Coronary Artery Bypass Surgery

With the advancement of percutaneous coronary interventions (PCIs), more patients with diffuse coronary artery disease are referred for coronary artery bypass graft (CABG) surgery. The use of coronary endarterectomy may be useful in such cases. We reviewed our experience with left anterior descending artery endarterectomy as an adjunct to conventional CABG.
Platelet alloantigen frequencies in Caucasians: a serological study

Summary. Alloimmunization against platelet antigens is related to neonatal alloimmune thrombocytopenia and post‐transfusion purpura. Moreover, platelet‐specific alloantibodies, in addition to HLA‐specific antibodies, play a role in the state of refractoriness to platelet transfusions. Most platelet‐specific alloantigens have been assigned to platelet glycoproteins IIb/IIIa, Ib/IX and Ia/IIa. Data on antigen frequencies were first reported for Caucasians, but since then platelet glycoprotein polymorphisms have been reported for other populations, e.g. the Yuk alloantigens in Japanese. As information on the distribution of the recently described alloantigens is incomplete in Caucasians, this study was undertaken to provide reliable data on the PIA, Ko, Bak, Yuk and Br (HPA 1–5) alloantigens, of the ‘low‐frequency’ Sra and Vaa antigens and of the Naka isoantigen. In contrast to the frequencies determined in Oriental populations, all 964 individuals tested in this study were Yuka‐negative and all persons tested (n= 382) had Naka‐isoantigen‐positive platelets. A comparison of typing results shows that the recently described Siba‐alloantigen is identical with the Koa antigen.
Exhaled breath condensate as a potential biomarker tool for idiopathic pulmonary fibrosis—a pilot study

Idiopathic pulmonary fibrosis (IPF) is a devastating lung disease with poor survival. There is an urgent need to better diagnose and monitor IPF patients as new treatments which slow down disease progression are now available. Exhaled breath condensate (EBC) is easily and non-invasively collected, but analysis of potential biomarkers is difficult due to low concentrations and methodological limitations. We used a non-targeted metabolomics approach to identify discriminatory metabolic profiles that distinguish IPF patients from healthy controls. For the pilot study set, we collected EBC from 10 stable IPF patients and 10 lung healthy controls. Samples were analyzed by ultra high-performance liquid chromatography coupled to high-resolution mass spectrometry in positive and negative ion mode. After data processing and statistical analysis, 58 metabolites were found to be discriminative between IPF patients and controls in the positive ion mode. One metabolite candidate m/z = 341.3514 at a retention time of 9.94 min was 2.5-fold up-regulated in IPF patients compared to healthy controls and validated in a second set of eight IPF patients and healthy controls. The identity of this metabolic feature still remains elusive. Our preliminary results identified a distinguished EBC profile of IPF patients compared to controls. Although these results need to be confirmed in additional individuals, EBC sampling for diagnosis and/or monitoring of IPF patients is a promising new method, which should be further explored. The EBC samples have been obtained within the clinical trial NCT02173145 at baseline.
Observation of the Terminal Ileum

The terminal ileum which is too far from both the mouth and the anus to be observed endoscopically, remained the last place to be visualized by gastroenterological endoscopy. It has become possible to observe the entire colon owing to the advance in the fibercolonoscope, but the existence of the ileocecal valve prevented the introduction of the fibercolonoscope into the terminal ileum. Observing many ileocecal valves it was confirmed that the orifice of the valve was not always closed but it opened according to the intestinal movement. So it was thought possible to pass the valve when it opened maximally. Here we report the way of insertion of the scope into the terminal ileum, together with the normal and the pathologic condition of the ileal mucosa.
Ex Situ Limb Perfusion System to Extend Vascularized Composite Tissue Allograft Survival in Swine

Background Organ perfusion systems have successfully been applied in solid organ transplantations. Their use in limb transplantation and replantation has not been widely investigated. In this study, we tested the potential for ex situ perfusion system to prolong limb allograft viability in a swine forelimb amputation/replantation model. Methods Fourteen swine were used. In group 1 (n = 4), we perfused 4 amputated limbs for 12 hours using warm (27°C–32°C) autologous blood. Group 2 (n = 3) served as a cold preservation control group, preserving limbs for 6 hours at 4°C. All limbs were transplanted into healthy swine (n = 7) and observed for another 12 hours. Hemodynamic variables of circulation, as well as perfusate gases and electrolytes (pH, pCO2, pO2, O2 saturation, Na+, K+, Cl−, Ca2+, HCO3−, glucose, lactate) were measured. Muscle samples were used to measure single-muscle fiber contractility. Results In the control group, no microcirculation was observed after 6 hours of cold storage. In the pump perfusion group, all limbs displayed a gradual increase in lactate levels (P < 0.05) during ex situ perfusion that returned to normal after transplantation and reperfusion (P = 0.05). The pH and potassium remained stable throughout the experiment. Single-muscle fiber contractility testing showed near normal contractility at the end of the reperfusion period (P > 0.05). Limb weight did not increase significantly between the end of pump perfusion and reperfusion (P > 0.05). Conclusions We demonstrated the potential to preserve limb allograft using ex vivo circulation. This approach promises to extend the narrow time frame for revascularization of procured extremities in limb transplantation.
Urinary Concentrating Mechanism: Structure and Function

This book, written jointly by an American physiologist and a German anatomist, presents a detailed account of the structure and function of the renal medulla, with particular emphasis on the manner in which the kidney elaborates a concentrated urine. It is a scholarly book, and the authors introduce their complicated subject by likening it to a Gothic cathedral. They remind us that what, in its completed, seemingly superhuman form, fills us with wonder and admiration was in fact built over many years, section by section, by the toil of ordinary, and often profane, human laborers. Our knowledge of the countercurrent mechanism is likewise being advanced by scientists erecting an elaborate scaffolding of new information and ingenious hypotheses without being able to visualize clearly what the cathedral will look like in its complete form. But John Ruskin, by no means a stranger to cathedrals, might have also compared this book to
Human adipose stem cells maintain proliferative, synthetic and multipotential properties when suspension cultured as self-assembling spheroids

Adipose-derived stromal/stem cells (ASCs) have been gaining recognition as an extremely versatile cell source for tissue engineering. The usefulness of ASCs in biofabrication is further enhanced by our demonstration of the unique properties of these cells when they are cultured as three-dimensional cellular aggregates or spheroids. As described herein, three-dimensional formulations, or self-assembling ASC spheroids develop their own extracellular matrix that serves to increase the robustness of the cells to mechanical stresses. The composition of the extracellular matrix can be altered based on the external environment of the spheroids and these constructs can be grown in a reproducible manner and to a consistent size. The spheroid formulation helps preserve the viability and developmental plasticity of ASCs even under defined, serum-free media conditions. For the first time, we show that multiple generations of adherent ASCs produced from these spheroids retain their ability to differentiate into multiple cell/tissue types. These demonstrated properties support the idea that culture-expanded ASCs are an excellent candidate cellular material for ‘organ printing’—the approach of developing complex tissue structures from a standardized cell ‘ink’ or cell formulation.
Impact of lifestyle on tuberculosis

Abstract: Tuberculosis (TB) is well known to be associated with poverty and multiple social factors. However, relatively little attention has been paid to the behavioural factors, apart from those associated with drug abuse, alcoholism and HIV infection. In recent years, the roles of other lifestyle‐related factors have been increasingly recognized. In particular, smoking has been associated with excess risks of TB infection, disease and mortality. Only limited evidence is available for the association between TB disease and passive smoking or the use of biomass fuels. Nutrition status also plays an important role. Malnutrition or underweight is associated with increased risk of TB disease, and obesity appears to be protective. On the other hand, diabetes mellitus increases the risk of TB disease, but mainly among those with poor diabetic control. Although the increase in TB risk is only modest for most lifestyle factors, their prevalences are increasing rapidly in some Asian communities. Furthermore, as much as one‐third of the world population is thought to be latently infected with the tubercle bacillus. The successful introduction of directly observed therapy—short course (DOTS) might have rapidly reduced the ongoing risk of transmission in many parts of Asia. However DOTS alone is unlikely to eliminate the continuing emergence of infectious tuberculosis cases through endogenous reactivation among the large pool of latently infected subjects in the Asia–Pacific region. With the close interaction between lifestyle, aging population and aging TB epidemic, promotion of healthy lifestyle may help to complement the DOTS strategy in the control of TB.
Electrospun polyurethane-core and gelatin-shell coaxial fibre coatings for miniature implantable biosensors

The aim of this study was to introduce bioactivity to the electrospun coating for implantable glucose biosensors. Coaxial fibre membranes having polyurethane as the core and gelatin as the shell were produced using a range of polyurethane concentrations (2, 4, 6 and 8% wt/v) while keeping gelatin concentration (10% wt/v) constant in 2,2,2-trifluoroethanol. The gelatin shell was stabilized using glutaraldehyde vapour. The formation of core–shell structure was confirmed using transmission/scanning electron microscopy and FTIR. The coaxial fibre membranes showed uniaxial tensile properties intermediate to that of the pure polyurethane and the gelatin fibre membranes. The gelatin shell increased hydrophilicity and glucose transport flux across the coaxial fibre membranes. The coaxial fibre membranes having small fibre diameter (541 nm) and a thick gelatin shell (52%) did not affect the sensor sensitivity, but decreased sensor's linearity in the long run. In contrast, thicker coaxial fibre membranes (1133 nm) having a thin gelatin shell (34%) maintained both sensitivity and linearity for the 84 days of the study period. To conclude, polyurethane-gelatin coaxial fibre membranes, due to their faster permeability to glucose, tailorable mechanical properties and bioactivity, are potential candidates for coatings to favourably modify the host responses to extend the reliable in vivo lifetime of implantable glucose biosensors.
The development of skin barrier function in the neonate

The skin, one of the largest organs of the body, functions as a protective and regulatory barrier between the body and the external environment. At birth, infants must make the transition from a fluid intrauterine environment to dry, extrauterine life. Full-term infants, born at 40 weeks of gestation, make the transition with a competently formed barrier. However, the skin of the premature neonate comprises as much as 13% of the body weight, compared to only 3% of the body weight of an adult (1). In addition, the surface area to body weight ratio of the neonate is four times that of adults (2). Thus, the immaturity of the skin has numerous ramifications for the neonate, including ineffective thermoregulation (3), fluid imbalance (4), percutaneous absorption of toxins (2), tissue injury (5), infection (6), and delayed healing (7). Within the last decade, new technologies have changed the caretaking practices of the premature neonate; advances in respirator design, monitor technology, reduction of blood volume required for specialized tests, and the sophistication of new diagnostic techniques have all contributed to increasing the chances of survival of the premature neonate (8). Nevertheless, much remains to be learned about the complex extrauterine skin development of these neonates.
Who are the Chronically Homeless? Social Characteristics and Risk Factors Associated with Chronic Homelessness

Abstract This study explored the social characteristics and risk factors associated with chronic homelessness in order to develop a set of indicators as a basis for understanding and treating the chronically homeless. The sample consisted of 140 homeless, recruited from total of six sites. Variables in the analysis included age, gender, educational attainment, physical and sexual abuse, frequency of emergency room visits, history of drug use, alcohol use, and history of residential treatment. Variables were analyzed using independent samples t-tests and chi square test of independence. Results indicated that educational attainment, frequency of emergency room visits, transportation, criminal record, physical abuse, specific acts of sexual abuse, history of drug use, alcohol use, and residential treatment were all related to chronic homelessness. The chronically homeless were also more likely to utilize mental health services and bus passes, have their governmental benefits cutoff, and report paper work too difficult for government subsidies.
Optimization of Perioperative Conditions to Prevent Ischemic Cholangiopathy in Donation After Circulatory Death Donor Liver Transplantation

Background Donation after circulatory death (DCD) donor pool remains underutilized for liver transplantation (LT). We describe optimizing “modifiable risk factors,” such as cold ischemia time (CIT) recipient warm ischemia time (WIT) and the use of thrombolytic flush at the time of procurement to minimize ischemic cholangiopathy (IC). Methods From July 2011 (era II), to improve outcomes after DCD LT, measures were taken to minimize CIT, operative time and recipient WIT along with the use of tissue plasminogen activator (tPA) flush during DCD procurements. Thirty consecutive DCD LTs were performed prospectively in era II. Outcomes were compared with 61 historic controls (era I). Reperfusion biopsies were evaluated for the presence of necrosis and biliary epithelial damage. Results Median CIT (4.9 [3.5-5.9] vs 6.4 [4.3-12]; P < 0.001), hepatectomy time (70 [42-120] vs 81 [58-207]; P = 0.02), and recipient WIT (16 [13-31] vs 24[15-40]; P < 0.001) were significantly shorter in era II. All patients in era II received tPA flushed liver grafts. None of the patients in era II developed IC (0% vs 18%; P = 0.013). There were fewer biliary complications in era II, and there was no increased risk of bleeding associated with the use of tPA. One-year graft survival was slightly better in era II (n = 24 patients with 1 year follow-up) (88% vs 80%; P = 0.14). Conclusions Optimizing peritransplant conditions, such as shortening ischemic times with the use of thrombolytic donor flush, may prevent IC after DCD LT. With this approach, the DCD donor pool may be expanded.
QUALITY OF LIFE, PERCEIVED STIGMA, ACTIVITY AND PARTICIPATION OF PEOPLE WITH LEPROSY-RELATED DISABILITIES IN SOUTH-EAST NEPAL

In Nepal, many people live with leprosy-related disabilities. The objective of this study was to evaluate differences in socio-economic characteristics, quality of life (QOL), perceived stigma, activity and participation among people affected by leprosy as a group and between this group and the general population, and to identify prime determinants of QOL among the leprosy-affected people. People with leprosy-related disabilities (N=100; 54DGI/46DGII) and community controls (N=100) were selected from Morang district, South-East Nepal, using quota sampling. QOL, perceived stigma and participation and activity limitations were measured using the Nepali abbreviated version of the World Health Organisation Quality of Life (WHOQOL) assessment and the Nepali versions of the Jacoby Scale, Participation Scale and Green Pastures Activity Scale (GPAS), respectively. Total QOL, participation and activity levels of people affected by leprosy were worse than those of the general population. Regression analysis showed that the ability to maintain a family, satisfaction with health, vocational training, sex, activity and participation limitations (the latter for QOL only), perceived stigma and living situation (i.e. joint family, type of house) were significantly associated with a deterioration in QOL and higher participation restriction in one or both of the grading groups. There is an urgent need for interventions focused on quick referral of people with leprosy, to minimize the development of visible impairments, and social rehabilitation. The latter can be achieved by creating more public awareness, providing (financial) support for income generating projects and /or vocational training to leprosy- affected people, and by encouraging them to be involved in all community development activities. The current results indicate that such measures would help improve the quality of life of people with leprosy-related disabilities. DOI 10.5463/DCID.v22i1. 15
Bioprinting 3D cell-laden hydrogel microarray for screening human periodontal ligament stem cell response to extracellular matrix

Periodontitis is an inflammatory disease negatively affecting up to 15% of adults worldwide. Periodontal ligament stem cells (PDLSCs) hold great promises for periodontal tissue regeneration, where it is necessary to find proper extracellular matrix (ECM) materials (e.g., composition, concentration). In this study, we proposed a bioprinting-based approach to generate nano-liter sized three-dimensional (3D) cell-laden hydrogel array with gradient of ECM components, through controlling the volume ratio of two hydrogels, such as gelatin methacrylate (GelMA) and poly(ethylene glycol) (PEG) dimethacrylate. The resulting cell-laden array with a gradient of GelMA/PEG composition was used to screen human PDLSC response to ECM. The behavior (e.g., cell viability, spreading) of human PDLSCs in GelMA/PEG array were found to be depended on the volume ratios of GelMA/PEG, with cell viability and spreading area decreased along with increasing the ratio of PEG. The developed approach would be useful for screening cell-biomaterial interaction in 3D and promoting regeneration of functional tissue.
Pattern of Mandibular Fractures in Western Region of Nepal

Background : Mandible and nasal bones are the most prominent part of the facial skeleton and are commonly fractured. Its fractures result in severe loss of function and disfigurement. This study was conducted to evaluate and analyze the pattern of mandibular fractures in Western region of Nepal. Methods: This hospital based, descriptive, cross sectional study included 120 patients treated in the Department of Dental surgery, Manipal Teaching Hospital, Pokhara, Nepal from 1st August 2008 to1st December2011.These patients were examined both clinically and radiologically for mandibular fractures. Data concerning age, gender, causes of fracture and sites of fracture were analyzed. Results: The age range was 3-80 years (mean26.3±13.43years) and male to female ratio was 1:0.69. Highest frequency was seen in 21-30 years age group. The leading cause of mandibular fracture was road traffic accident (n=56; 46.6%), followed by accidental fall from height or tree (n=28; 23.3%), physical assault (n=18; 15%), sports injuries (n=12; 10%), industrial accidents (n=4; 3.3%) while 2 cases (1.6%) were associated with other causes. The most common site was parasymphysis (n=42; 35%) followed body (n=22; 18.33%), angle (n=20; 16.6%), condyle (n=18;15%) and symphysis (n=10;8.33%). Conclusion: The study reveals that the majority of the patients were young adult male. The most common etiological factor was road traffic accident and commonly fractured site was the parasymphysis. Keywords : Mandible fracture; etiology; road traffic accidents; pattern DOI: http://dx.doi. org/10.3126/njms.v1i1. 5798 Nepal Journal of Medical Sciences. 2012; 1(1): 45-48
Assessment of the prevalence of myths regarding oral health among general population in Maduravoyal, Chennai

Introduction: Myths have a strong influence in seeking treatment during illness. Understanding the myths and misconceptions about the disease is important in providing dental care. Objectives: The purpose of this study was to assess the prevalence of myths regarding oral health, among out-patients attending a dental institute and suggest possible measures in conveying the facts. Settings and Design: Descriptive cross-sectional study carried out in a dental institute. Materials and Methods: A pre-tested questionnaire on most common myths was given to 250 out-patients of which 135 (54%) were males and 115 (46%) were females. About 32% were 60 yrs. Statistical Analysis Used: Chi-square test. Results: The prevalence of myths regarding dental caries was 65.68%, oral hygiene was 55.92%, oral cancer was 58.24%, and general dental aspects was 43.32%. Conclusion: Thus, it can be concluded that various myths regarding dental treatments are highly prevalent among the general population and requires immediate addressing.
Predictive Score for Posttransplantation Outcomes

Background Most current scoring tools to predict allograft and patient survival upon kidney transplantion are based on variables collected posttransplantation. We developed a novel score to predict posttransplant outcomes using pretransplant information including routine laboratory data available before or at the time of transplantation. Methods Linking the 5-year patient data of a large dialysis organization to the Scientific Registry of Transplant Recipients, we identified 15 125 hemodialysis patients who underwent first deceased transplantion. Prediction models were developed using Cox models for (a) mortality, (b) allograft loss (death censored), and (c) combined death or transplant failure. The cohort was randomly divided into a two thirds set (Nd = 10 083) for model development and a one third set (Nv = 5042) for validation. Model predictive discrimination was assessed using the index of concordance, or C statistic, which accounts for censoring in time-to-event models (a-c). We used the bootstrap method to assess model overfitting and calibration using the development dataset. Results Patients were 50 ± 13 years of age and included 39% women, 15% African Americans, and 36% persons with diabetes. For prediction of posttransplant mortality and graft loss, 10 predictors were used (recipients' age, cause and length of end-stage renal disease, hemoglobin, albumin, selected comorbidities, race and type of insurance as well as donor age, diabetes status, extended criterion donor kidney, and number of HLA mismatches). The new model (www.TransplantScore.com) showed the overall best discrimination (C-statistics, 0.70; 95% confidence interval [95% CI], 0.67-0.73 for mortality; 0.63; 95% CI, 0.60-0.66 for graft failure; 0.63; 95% CI, 0.61-0.66 for combined outcome). Conclusions The new prediction tool, using data available before the time of transplantation, predicts relevant clinical outcomes and may perform better to predict patients' graft survival than currently used tools.