Miracle-dz/UniFAR-FTUs huggingface dataset:
Outcomes of Primary Arteriovenous Fistula for Hemodialysis in Elderly Patients (>65 Years) with End Stage Renal Disease: A Study on Indian Population

Introduction: The outcome of arteriovenous fistula (AVF) for hemodialysis (HD) in elderly population remains an issue. The aim of our study was to evaluate the outcomes of arteriovenous fistulas created at our institute in patients older than 65 years. Methods: All chronic HD patients with age >65 years who had an AVF created between January 1, 2010 and January 1, 2017 were included retrospectively. Baseline demographic information including age, gender, etiology of renal failure and comorbidities were recorded. Access characteristics including access type and anatomic location were recorded. The end point of study was primary and secondary patency. Minimum follow up period of study was 1 year. Results: A total of 422 AVF were created within the study period. The mean age was 69.3 years. The anatomical site of AVF creation was radiocephalic (RCF) in 74.8% (n = 316), brachiocephalic (BCF) in 18.9% (n = 80) and brachiobasilic (BBF) in 6.1% (n = 26). At one year after creation, cumulative survival of the AVF was 64.7%. At 36 months the primary and secondary patency of RCF, BCF and BBF was 43.6%, 58.6%, 42.6% and 47.3%, 62.5%, 56.9% respectively. The overall median survival did not differ between RCF and BBF fistulas. However, when both were compared with BCF (median survival 1034 days), BBF (median survival 741 days) and RCF (median survival 592 days) had significantly poorer survival (P = 0.004). The most common reason for access failure was thrombosis (28.4%) followed by failure to mature (9%) and aneurysm related complications (9%). Conclusions: Age should not be a limiting factor when choosing AVF as the preferred HD access. Brachiocephalic AVF has better primary and secondary patency with higher overall median survival. However RCF also provides reasonably good survival rates with acceptable complications in elderly population. Thrombosis and fistulas that fail to mature present as a primary concern to patients in elderly population, and demand further study.
Synergistic Neovascularization by Mixed Transplantation of Early Endothelial Progenitor Cells and Late Outgrowth Endothelial Cells

Background— Two types of cells are cultured from the human peripheral blood, early endothelial progenitor cells (EPCs) and outgrowth endothelial cells (OECs), as previously reported. Here, we further characterize these cells, especially with respect to their different origins and functions both in vitro and in vivo. We also investigated whether the combination of these different cell types shows synergism during neovascularization. Methods and Results— Early EPCs were heterogeneously made up of both CD14+ monocyte-derived cells, which secrete cytokines, and CD14−-derived cells, which contain high levels of CD34+KDR+ cells. OECs were cultured almost exclusively from CD14− cells, not CD14+ cells, and were distinct from mature endothelial cells in terms of proliferation potential, KDR+ expression level, and telomerase activity. A portion of cells from CD14− cells and early EPCs produced rapidly proliferating, capillary-forming cells in both the Matrigel plug and the ischemic hind limb similar to OECs. Early .
Urodynamic findings of multiple sclerosis patients at a single institution

Murat Akgül1, Cenk Yazıcı1, Arzu Malak2, Bengü Altunan3, Ersan Arda4, Nilda Turgut3 1Department of Urology, Tekirdağ Namık Kemal University, Faculty of Medicine, Tekirdağ, 2School of Health, Tekirdağ Namık Kemal University, Tekirdağ, 3Department of Neurology, Tekirdağ Namık Kemal University, Faculty of Medicine, Tekirdağ, 4Department of Urology, Trakya University, Faculty of Medicine, Edirne, Turkey Urodynamic findings of MS Urodynamic findings of multiple sclerosis patients at a single institution
Enabling Automated Device Size Selection for Transcatheter Aortic Valve Implantation

The number of transcatheter aortic valve implantation (TAVI) procedures is expected to increase significantly in the coming years. Improving efficiency will become essential for experienced operators performing large TAVI volumes, while new operators will require training and may benefit from accurate support. In this work, we present a fast deep learning method that can predict aortic annulus perimeter and area automatically from aortic annular plane images. We propose a method combining two deep convolutional neural networks followed by a postprocessing step. The models were trained with 355 patients using modern deep learning techniques, and the method was evaluated on another 118 patients. The method was validated against an interoperator variability study of the same 118 patients. The differences between the manually obtained aortic annulus measurements and the automatic predictions were similar to the differences between two independent observers (paired diff. of 3.3 ± 16.8 mm2 vs. 1.3 ± 21.1 mm2 for the area and a paired diff. of 0.6 ± 1.7 mm vs. 0.2 ± 2.5 mm for the perimeter). The area and perimeter were used to retrieve the suggested prosthesis sizes for the Edwards Sapien 3 and the Medtronic Evolut device retrospectively. The automatically obtained device size selections accorded well with the device sizes selected by operator 1. The total analysis time from aortic annular plane to prosthesis size was below one second. This study showed that automated TAVI device size selection using the proposed method is fast, accurate, and reproducible. Comparison with the interobserver variability has shown the reliability of the strategy, and embedding this tool based on deep learning in the preoperative planning routine has the potential to increase the efficiency while ensuring accuracy.
Allogeneic mesenchymal stem cell therapy: A regenerative medicine approach to geroscience

Extraordinary advances in medicine and public health have contributed to increasing life expectancy worldwide. However, health span—“healthy aging”—has paradoxically lagged to parallel this increase. Consequently, aging‐associated illnesses, such as Alzheimer's disease and aging frailty, are having a growing impact on patients, their families, and entire health‐care systems. Typically, such disorders have been treated as isolated disease entities. However, the inextricable links between aging‐associated disorders and the aging process itself have become increasingly recognized, leading to formation of the field of geroscience. The geroscience concept is that treating the aging process itself should lead to treatment and prevention of aging‐related disorders. However, the aging process is complex, dictated by highly interrelated pleiotropic processes. As such, therapeutics with pleiotropic mechanisms of action (either alone, or as part of combinatorial strategies) will be required for preventing and treating both aging and related disorders. Mesenchymal stem cells (MSCs) have multiple mechanisms of action that make these highly promising geroscience therapeutic candidates. These cells have a high safety profile for clinical use, are amenable to allogeneic use since tissue‐type matching is not required, and can have sustained activity after transplantation. Herein, we review preclinical and clinical data supporting the utility of allogeneic MSCs as a geroscience therapeutic candidate.
Comparative Cytological Techniques in the Diagnosis of Non Neoplastic and Neoplastic Bronchopulmonary Lesions

1 Consultant pathologist, 2 Associate Professor, 3 Professor Department of Pathology, NKP Salve Institute of Medical Science and Research Centre, Nagpur, India *Corresponding Author Dr Pragati Karmarkar Department of Pathology, NKP Salve Institute of Medical Science and Research Centre, Nagpur, India Abstract Objective: Diagnostic cytology is one of the suitable modality for both non-neoplastic and neoplastic conditions of the lung. The aim is to use different cytological methods in the diagnosis of lesions of the respiratory tract. It has been generally acclaimed as one of the most successful application in the evaluation of patient with suspected lung malignancy. Materials and Method: It was a prospective study of 127 cases. The present study was conducted in the department of pathology at a tertiary care hospital. It is a crosssectional study, carried out on all patients who were admitted with lung diseases during a period of two years . Both male and female patients of all age group with the specified respiratory tract complaints like cough, breathlessness, hemoptysis, fever and chest pain were subjected to bronchoscopic examination. Results: There were 81 males and 46 females. Male : female ratio was 1.76 : 1. The mean age was 50±16.14 years. The lowest age was 14 years and the oldest age was 85 years. It was included in both the nonneoplastic and neoplastic study groups. Sensitivity of BB was 91.8%; while that of BAL was only 59.2%. specificity of BB was 87.5% and that of BAL was 75%. Accuracy of BB was 90.7% while that of BAL was 63.1%. Conclusions: Bronchial brushing is a much superior technique in the diagnosis of bronchopulmonary lesions. It demonstrates far better sensitivity, specificity and accuracy. Combination of various cytohistological techniques complements each other and enhances the diagnostic efficacy of various nonneoplastic and neoplastic lung diseases.
Dilated cardiomyopathy in spider-monkey (Ateles chamek, Humboldt, 1812): case report

Non-human primates are routinely studied and managed in zoos, conservation breeding centers, and research centers, but there is currently limited information regarding diseases that can affect these animals. Dilated cardiomyopathy is one of the most common cardiovascular diseases in small animal clinical practice. However, there are few reports of this condition occurring in non-human primates. Here, in a spider monkey (Ateles chamek) housed in the Rio de Janeiro Zoo, we report the occurrence of dilated cardiomyopathy, its etiology, pathophysiology, clinical presentation, diagnosis through clinical examination, and the use of complementary exams (radiographic, electrocardiographic, and echocardiographic), as well as the protocol, used in the treatment. In this case, it is assumed that the occurrence of the disease was related to the peripartum period due to the hormonal and metabolic changes that occurred, and the physiological interactions of gestation and puerperium
Neck-specific strengthening exercises and cognitive therapy for chronic neck pain: a systematic review

Abstract Background: Neck pain has been estimated to affect one in two people. Cognitive therapy and neck-specific strengthening exercises are two interventions that target different factors related to chronic neck pain in order to decrease pain and disability. Objectives: To critically appraise the effect of a combination of neck-specific strengthening exercises and cognitive therapy compared to the individual therapies on pain and disability in patients with non-specific chronic neck pain. Methods: A systematic search of the five following online databases was undertaken from inception up to April 2017: Ovid MEDLINE, PsycINFO, EMBASE + EMBASE Classic, CINAHL, and PEDro. Key inclusion criteria were as follows: randomized control trials published in English, participants with chronic neck pain (greater than three months), an intervention of cognitive therapy and neck-specific strengthening exercise, and an outcome measure of pain and/or disability. Results: Seven randomized control trials met inclusion criteria, and five were included in meta-analysis. The studies were of a low-to-moderate methodological quality. Evidence was found for the effectiveness of neck-specific strengthening exercises (SMD 0.30, 95%CI 0.09 to 0.52, p = .005) and a combination of cognitive therapy and neck-specific strengthening exercise (SMD 0.50, 95%CI 0.29 to 0.71, p < .0001) in reducing pain and disability compared to a control of prescribed physical activity. The combination of cognitive therapy and neck-specific strengthening exercises was not found to be more effective at reducing pain and disability than neck-specific strengthening exercises alone (SMD 0.22, 95%CI −0.01 to 0.45, p = .06) or cognitive therapy alone (SMD 0.26, 95%CI −0.33 to 0.86, p = .39). Conclusions: The effects of both neck-specific exercises and cognitive therapy observed in this review are statistically significant; however, it is questionable whether they are clinically significant based on the measures used.
Yaşlılarda Bası Yaraları ve Beslenme Tedavisi

Basi yaralari, baski veya sikistirma sonucu genelde kemik cikintisinin uzerinde bulunan deri ve/veya dokunun hasaridir. Yaslilar basi yarasi gelisim riski bakimindan en riskli gruptur. Basi yaralari; istenmeyen agirlik kaybi, besin ogelerinin yetersiz alimi ve dusuk beden kutle indeksi (<18.5 kg/m 2 ) ile iliskilendirilmektedir. Yaslilarda basi yarasi olusum riskini en aza indirmek icin gunluk 30-35 kkal/kg enerji, 1.2-1.5 g/kg protein ve 1 mL/kkal sivi alinmasi onemlidir. Arjinin ve glutamin gibi spesifik aminoasit suplemantasyonlarinin basi yarasinin iyilesmesini hizlandirabilecegi dusunulmektedir. Yaslilarda basi yararlarinin onlenmesinde ve tedavisinde sadece diyetle alimi az olan veya besin ogesi yetersizligi olan vitamin ve mineral suplemantasyonu onerilmelidir. Basi yarasi iyilesmeyen bireyin besin ogesi gereksinimleri oral olarak karsilanamiyorsa, enteral veya paranteral beslenme destegi dusunulmelidir. Ancak, tuple beslenme uygulanacagi durumlarda, riskler ve bireyde ulasilmasi dusunulen hedefler iyi degerlendirilmelidir.
Evaluation of a program of physical exercise on blood markers and sleep quality in elderly

Objective: Analyze the effects of a physical exercise program on blood markers and sleep quality in the elderly. Method: A total of 112 elderly people with metabolic diseases controlled by hypocholesterolemic and hypoglycemic medications participated in the study. The participants were divided into two groups, an exercise group composed of 54 individuals with a mean age of 62 years and control group of 58 individuals with a mean age of 63 years. Results: Blood glucose, total cholesterol, and triglyceride levels showed a mean reduction of 27.47, 18.13, and 23.48 mg/dl, respectively, and an increase of 8.98 mg/dl in the high-density lipoprotein level was seen. A significant change was seen in the low-density lipoprotein, very-low-density lipoprotein, and calcium levels on comparing the exercise group post-test values with that of the control group pre-test. The Pittsburgh Sleep Quality Index score showed a significant reduction of 3.15 (p < 0.001, μp2=0.78) on comparing the exercise group with the control group. Conclusion: It can be concluded that the physical exercise program, consisting of supervised walking and gymnastics with localized quadriceps muscle strengthening exercises, performed for 16 weeks at a frequency of three times a week for 60 min, was effective in improving the low-density lipoprotein and very-low-density lipoprotein levels and sleep quality of the elderly.
Appraisal of Periodontal Condition amongst Leather Manufacturing Plant Workers in Central India: A Prevalence Survey

Objective To assess the periodontal status among the leather factory workers in Dewas and to provide a baseline data for the oral health care and promotion programs. Materials and Methods A total of 850 study population was considered for examination, and the age ranged from 20 to 60 years. All those factory workers with low socioeconomic status and poor background were considered. The data were collected by means modified World Health Organization (WHO) Oral Health Assessment 1997 Performa and clinical examination with the use of the Community Periodontal Index (CPI). Statistical analyses were used: chi-squared test, Mann–Whitney U test, and Kruskal–Wallis test. Results The sociodemographic characteristics were found to be significantly associated with the periodontal status in the study population (p ≤ 0.05). Mean number of loss of attachment (LOA) 0 sextants was 3.55 ± 2.35, LOA 1 was 0.935 ± 1.3, LOA 2 was 0.414 ± 0.8, LOA 3 was 0.529 ± 0.94, and LOA 4 was 1.24 ± 0.04; all the parameters showed statistically significant difference (p=0.001) except LOA 1 and LOA 2. Conclusion The periodontal health status of the factory workers is poor. Factors associated with high prevalence of periodontal disease could be the following: a high rate of tobacco consumption and not cleaning their teeth at all along with other associated factors like stress, poor oral hygiene, etc.
Artificial Intelligence Inspired Transmission Scheduling in Cognitive Vehicular Communications and Networks

The Internet of Things (IoT) platform has played a significant role in improving road transport safety and efficiency by ubiquitously connecting intelligent vehicles through wireless communications. Such an IoT paradigm however, brings in considerable strain on limited spectrum resources due to the need of continuous communication and monitoring. Cognitive radio (CR) is a potential approach to alleviate the spectrum scarcity problem through opportunistic exploitation of the underutilized spectrum. However, highly dynamic topology and time-varying spectrum states in CR-based vehicular networks introduce quite a few challenges to be addressed. Moreover, a variety of vehicular communication modes, such as vehicle-to-infrastructure and vehicle-to-vehicle, as well as data QoS requirements pose critical issues on efficient transmission scheduling. Based on this motivation, in this paper, we adopt a deep ${Q}$ -learning approach for designing an optimal data transmission scheduling scheme in cognitive vehicular networks to minimize transmission costs while also fully utilizing various communication modes and resources. Furthermore, we investigate the characteristics of communication modes and spectrum resources chosen by vehicles in different network states, and propose an efficient learning algorithm for obtaining the optimal scheduling strategies. Numerical results are presented to illustrate the performance of the proposed scheduling schemes.
Ultrasound assessment in psoriatic arthritis (PsA) and psoriasis vulgaris (non-PsA): which sites are most commonly involved and what features are more important in PsA?

Background The aim of this study was to find out the most commonly involved sites and the most important ultrasonic features in psoriatic arthritis (PsA). Methods In total, 120 PsA patients and 320 psoriasis vulgaris (non-PsA) patients were assessed by grayscale and power Doppler (PD) ultrasound (US). Joints, tendons, enthesis, and bursa changes were observed. Weights of affected anatomical sites of PsA patients (overall weights >90%) were calculated. Affected anatomical sites between PsA and non-PsA patients were compared. Ultrasonic features of joint, tendon, entheses, and bursa changes between PsA and non-PsA patients were also compared. Finally, the test performance of ultrasonic features for the diagnosis of PsA was calculated. Results The anatomical sites with the highest weights were the Achilles tendon, quadriceps tendon, and knee; weights of these anatomical sites were all more than 5%. Among the affected anatomical sites of PsA patients, most of the anatomical sites were more greatly affected in the PsA patients than in the non-PsA patients (all P<0.05). The comparison of the affected Achilles tendon, quadriceps tendon, MTP1, subacromial-subdeltoid bursa, MCP4, and MCP3 showed no significance between PsA and non-PsA patients (all P>0.05). Joint synovial thickening, joint PD signal grades, joint bone erosions, tendon sheath synovial thickening, tendon sheath PD signals, enthesis bone erosions, and enthesis PD signals in PsA patients were higher than in non-PsA patients (all P<0.05). Joint PD signal grades, joint bone erosions, enthesis bone erosions, and enthesis PD signals showed the highest specificities, which were 96.06%, 95.15%, 96.93%, and 94.63% respectively. Conclusions The most common involvement sites of PsA were the Achilles tendon, quadriceps tendon, and knee, and some sites in non-PsA patients were also highly involved. The most important features in PsA included joint PD signal grades, joint bone erosion, entheses bone erosions, and entheses PD signals in US assessment.
Assessment of Some Scoring Systems in Prediction of Mortality in Acute Carbon Monoxide Poisoned Patients

Carbon monoxide (CO) is known as a silent killer. In Egypt, it is one of the most common causes of death-related poisonings. This study aimed to evaluate some scoring systems; Glasgow coma scale (GCS), acute physiology and chronic health evaluation II (APACHE II), simplified acute physiology score II (SAPS II) and rapid emergency medicine score (REMS) for predicting in-hospital mortality of patients with acute CO poisoning. One hundred and eight acutely CO poisoned patients were included in the study. For each patient, socio-demographic and toxicological data were recorded. Clinical examination and calculation of the four scoring systems were performed. Patients were divided into two groups; survivors and non-survivors. Discrimination was evaluated using ROC curve and calculating the area under the curve (AUC). The current study revealed that median age of the studied patients was 25.5 years, 55.6% were males and 61.1% were from rural areas. All cases were intoxicated accidently. Among the studied 108 patients; 20 patients died in hospital and 88 patients survived. Both APACHE II and SAPS II had the best AUC, followed by REMS then GCS. The AUC of GCS was significantly lower than those of APACHE II, SAPS II and REMS scores; while differences between AUC of APACHE II, SAPS, and REMS were not statistically significant. It could be concluded that REMS is more useful in predicting in-hospital mortality in acute CO poisoning as it is a simple, easy and rapid scoring system rather than more complicated scoring systems such as APACHE II and SAPS II.
The THE EXPERIENCE OF TYPE 2 DIABETES MELLITUS MALE PATIENTS WHO UNDERGO SEXUAL DYSFUNCTION

The sexual problem became a sensitive issue and embarrassed among patients, especially among those who are living with diabetes. The study aimed to dig up deeply the experience of male patients with diabetes mellitus type 2 who underwent sexual dysfunction. The qualitative study with phenomenology approach was applied in this study. We collected the data by using an interview method. Fifteen samples were recruited using the purposive sampling technique and selected from Endocrine Polyclinic Martha Friska Hospital. The interview transcriptions were analyzed using the qualitative content analysis approach. Four themes related to the patients’ experience on sexual dysfunction have been analyzed in this study including 1) feeling that the sexual libido was high in the midst of the limitation of sexual dysfunction, 2) inferior feelings toward mates, 3) attempting to adapt to sexual changes, 4) trying to solve sexual problems in different ways. The participant had bad experience wich influence their quality of life with their partner. We suggested to the health care providers, including doctors, nurses, etc. to design the cultural program for addressing the sexual problem and completed the facilities for sexual favors. Keywords: type 2 diabetes mellitus, Experience, sexual dysfunction