Miracle-dz/UniFAR-FTUs huggingface dataset:
Using Standard Studies to Interpret the Scores from Scales for Assessing the Internal Validity of Randomized Controlled Trials

Objective A large number of tools for assessing the quality of randomized controlled trials are available; however, users have little guidance as to whether a given score represents high or low validity. The purpose of this study is to explore the use of studies identified as having high-internal validity, referred to as the standard studies, to interpret internal validity scores from studies with unknown internal validity. Methods The standard studies were identified by locating 6 candidate studies reporting the findings of randomized controlled trials from the Journal of American Medicine Association or the New England Journal of Medicine and scoring the studies using 2 scales, the Jadad scale (high score = 5; low = 0) and an internal validity information scale (IVI; high score = 70; low = 0). The 2 studies with the highest average rank were chosen as the standard studies. To determine if the standard studies facilitate interpretation of internal validity scores, 11 randomized controlled trials of garlic for the treatment of hypercholesterolemia were scored using both the Jadad and IVI scales and differences in scores resolved by consensus. The total mean scores were compared with the standard-study mean using a 1-sample t test; the interpretation was based on the comparison. Results The mean-internal validity score for the 2 standard studies was 4.5(90%) for the Jadad scale and 64 (91%) for the IVI scale. For the garlic studies, the Jadad scores ranged from 3 to 5 (60% to 80%), the IVI scores from 15 to 59 (21% to 84%); the mean scores were 4 (standard deviation = 0.9; 80%) and 37(53%), respectively. On the IVI scale, the garlic studies had lower internal validity (P < 0.001), a finding substantiated by the low scores for addressing withdrawals, blinding, and adherence. On the Jadad scale, the scores were comparable with the score for the standard studies (P = 0.093). Conclusions The strategy of using the standard studies to interpret the scores for the IVI scale worked well; the comparison indicated that, overall, the garlic studies were of low-internal validity. With the Jadad scale, the strategy resulted in erroneous conclusions that the garlic studies had relatively high-internal validity; however, it did indicate that the Jadad scale is limited and may not identify studies with very low-internal validity. The results of this study suggest that scales used to assess internal validity should be tested on studies with a range of validity, so the functional characteristics of the scale can be identified.
Incidence of solid organ cancers after liver transplantation: comparison with regional cancer incidence rates and risk factors

Increased rates of solid organ cancers post‐liver transplantation have been reported, but the contribution of environmental factors and immunosuppressive therapy is not clear. This study's aims were to compare the incidence of de novo solid organ cancers after liver transplantation; identify risk factors independent of immunosuppressive therapy associated with these cancers; and assess the influence of calcineurin inhibitors on the appearance of these cancers.
Stability of octyl methoxycinnamate and identification of its photo‐degradation product

A stability study of octyl methoxycinnamate (OMC) using C‐18 HPLC indicated that OMC degraded into a new product when exposed to sunlight. When kept in the dark at 4, 20, 32 and 60 °C for one month, no degradation of OMC was detected. Online HPLC‐APCI‐MS revealed similar APCI mass spectra for OMC and its degradation product. Isolation of the photo‐degradation product was done using semi‐preparative HPLC. NMR spectra of OMC and the isolated photo‐degradation product indicated the change from an E‐octyl‐p‐methoxycinnamate into a Z‐octyl‐p‐methoxycinnamate. NMR spectra of the unfractionated‐light‐exposed‐OMC showed that the Z‐OMC was the only product generated.
Human bone marrow mesenchymal stem cell‐derived hepatocytes express tissue inhibitor of metalloproteinases 4 and follistatin

Human bone marrow mesenchymal stem cell (hBMSC) transplantation is expected to become an alternative regenerative technique for liver diseases. However, the mechanism by which hBMSCs differentiate into hepatocytes is still unclear. The aim of this study was to establish the specific characteristics of hBMSC‐derived hepatocytes (hBMSC‐Heps) for future clinical applications.
Multicentre comparison of skin hydration in terms of physical‐, physiological‐ and product‐dependent parameters by the capacitive method (Corneometer CM 825)

A multicentre study for measuring skin hydration with 349 volunteers was carried out in six different laboratories. The purpose of the study was to investigate physical‐, physiological‐ and product‐dependent parameters of three test emulsions (base, base + moisturizer and base + moisturizer + lipids) in a double‐blind study. A comparison between analogous and digital sensor technology of the Corneometer CM825 was examined. Here, a clear relationship between both sensor types could be highlighted. A vital point of the study was the division of the test subjects according to their skin type. To get more objective limits for three different skin types – very dry, dry and normal skin – visual expert evaluation, self‐assessment and hydration measurements were analysed by means of statistical methods. The moisture‐related skin types were determined as follows: very dry skin was characterized with corneometer units below 30, dry skin between 30 and 40 and normal skin higher than 40 a.u. (arbitrary units). The efficacy of the three test emulsions was examined in relation to the mentioned skin types. Analysing the measured data of all test centres, a clear dependency of skin physiology (skin type) and product efficacy became evident. The drier the skin, the higher the increase of hydration. The product performance of the three test emulsions compared to the untreated control resulted in a significant increase of skin hydration in all measuring centres. The evaluation of a product ranking showed a good differentiation between the basic emulsion and the two other products. An increase of efficacy by adding lipids could be observed in four of six centres. The important influence of the skin type of the volunteers on the degree of product performance, as demonstrated in this study, should be especially considered when drawing up guidelines for efficacy testing.
Comparison of shockwave lithotripsy and flexible ureteroscopy for the treatment of kidney stones in patients with a solitary kidney.

INTRODUCTION AND OBJECTIVES To compare the outcomes of these minimally invasive procedures in this patient population. PATIENTS AND METHODS The database of our institution has been retrospectively reviewed, and medical records of urolithiasis patients with a solitary kidney who underwent flexible ureteroscopy (F-URS) or extracorporeal shock wave lithotripsy (SWL) between January 2009 and December 2012 were examined. Retreatment rates, complications, changes in estimated glomerular filtration rates (eGFRs), chronic kidney disease (CKD) stages, and stone-free rates were compared between the two groups. RESULTS Stones of 48 patients (mean age: 48.8±15.4, range: 14-76) with solitary kidneys were treated with SWL (n=30, 62.5%) or F-URS (n=18, 37.5%). Patient demographics and stone related parameters were similar. The most common stone location was the pelvis in the SWL group (36.6%), whereas it was the pelvis and a calix in the F-URS group (38.8%). Complications and success rates were similar in both groups, however, patients in the SWL group needed more sessions to achieve stone clearance (2.2±0.89 vs 1.06±0.24, p=0.0001). Preoperative and postoperative eGFR and CKD stage changes were also similar. CONCLUSION Both SWL and F-URS are effective and safe techniques, which can be used for the treatment of stones in patients with solitary kidneys. However, patients treated with SWL need more sessions to achieve stone clearance.
Evaluation of the analgesic properties of acepromazine maleate, oxymorphone, medetomidine and a combination of acepromazine-oxymorphone.

OBJECTIVE To determine the presence and duration of analgesia after oxymorphone, acepromazine maleate, acepromazine-oxymorphone combination and medetomidine administration in dogs. STUDY DESIGN Blinded, controlled study. ANIMALS Six adult beagle dogs. METHODS Each dog participated in five trials receiving acepromazine maleate (0.2 mg kg-1 IM), oxymorphone (0.2 mg kg-1 IM), acepromazine-oxymorphone drug combination (0.2 mg kg-1 each IM), medetomidine (20 μg kg-1 IM) and sterile saline (control). Two specially designed instruments were used for analgesia determination: a heat device (HD) utilized a linear ramped intensity incandescent bulb and a pressure device (PD) consisted of a pneumatic cylinder that protruded a 2.5-cm bolt. The minimum pressure and heat necessary to produce an avoidance response were determined. Analgesia testing was performed prior to and at 30-minute intervals for six hours after drug administration. RESULTS Oxymorphone, acepromazine-oxymorphone and medetomidine significantly elevated both pressure and heat response thresholds compared to controls and acepromazine. Both medetomidine and acepromazine-oxymorphone provided a significantly longer duration of analgesia than oxymorphone. No adverse effects were observed at any of the thermal or pressure application sites. CONCLUSIONS Oxymorphone, medetomidine and acepromazine-oxymorphone produced significant analgesia with medetomidine and acepromazine-oxymorphone providing the longest duration of analgesia.
Modest advances in survival for patients with colorectal‐associated peritoneal carcinomatosis in the era of modern chemotherapy

The treatment of metastatic colorectal cancer (CRC) has evolved rapidly over the last decade, with combination chemotherapy and targeted biologic agents leading to significant improvements in survival. Despite these advances, little is known about their effectiveness in CRC‐associated peritoneal carcinomatosis. The purpose of this study was to evaluate outcomes in patients with CRC‐associated PC treated in the era of modern chemotherapy.
Shewanella arctica sp. nov., an iron-reducing bacterium isolated from Arctic marine sediment.

Two strains of dissimilatory iron-reducing bacteria, which could couple lactate oxidation to iron reduction for energy conservation, were isolated from Arctic marine sediment. The strains, IR12(T) and IR26, were both Gram-staining-negative, catalase- and oxidase-positive and facultative anaerobes. Their cells were rod-shaped and motile by means of a polar flagellum. Both strains grew in the presence of 0.5-3.5 % (w/v) NaCl, with an absolute requirement for Na(+). Both were psychrotolerant since they could grow at 4-28 °C but had an optimum growth temperature of 20 °C. Both grew at pH 4.5-9.0 (optimum, pH 7.5). The major fatty acids of strains IR12(T) and IR26 were summed feature 3 (C(16 : 1)ω6c and/or C(16 : 1)ω7c) and C(16 : 0). Phylogenetic analyses based on 16S rRNA gene sequences indicated that strains IR12(T) and IR26 belonged to the class Gammaproteobacteria and were most closely related to Shewanella vesiculosa M7(T), Shewanella livingstonensis NF22(T) and Shewanella frigidimarina ACAM 591(T) (with 98.5 and 98.8 %, 98.5 and 98.8 %, and 98.5 and 98.8 % sequence similarities, respectively). The genomic DNA G+C contents of strains IR12(T) and IR26 were 40.0 and 40.3 mol%, respectively. DNA-DNA relatedness data indicated that the two novel strains represented a single species that was distinct from S. vesiculosa M7(T), S. livingstonensis NF22(T) and S. frigidimarina ACAM 591(T). Based on the phylogenetic, phenotypic and DNA-DNA relatedness data, the two new strains represent a single novel species of the genus Shewanella, for which the name Shewanella arctica sp. nov. is proposed. The type strain is IR12(T) ( = KCTC 23109(T) = JCM 16723(T)).
Postoperative Lower Urinary Tract Storage Symptoms: Does Prostate Enucleation Differ from Prostate Vaporization for Treatment of Symptomatic Benign Prostatic Hyperplasia?

PURPOSE To assess the degree of postoperative storage symptoms after GreenLight™ laser photoselective vaporization of the prostate (PVP) and Holmium laser enucleation of the prostate (HoLEP) for management of benign prostatic hyperplasia (BPH) and its predictors. METHODS A retrospective review was performed for patients who underwent HoLEP or PVP for non catheter-dependent patients with BPH. Patients were followed up at 1, 3, 6, and 12 months and then annually by International Prostate Symptoms Score (IPSS), quality of life index, peak flow rate, residual urine volume, and prostate-specific antigen (PSA) level. Moderate or severe storage symptoms were defined as IPSS storage subscore ≥ 9. RESULTS Of 1673 laser procedures, a total of 1100 procedures met the inclusion criteria including 809 HoLEPs and 291 PVPs. The HoLEP group had significantly larger preoperative prostates and longer operative time. In the HoLEP group, postoperative IPSS was significantly better than in the PVP group at all follow-up points (P<0.05). Storage subscore was significantly higher after PVP and did not improve until 6 months postoperatively when it became comparable with that of the HoLEP group. The number of patients with IPSS-storage score ≥ 9 were significantly higher in the PVP group at 1 and 3 months follow-up (37.3% vs 15.1%, P<0.001) and (26.4% vs 17.5%, P=0.004), respectively. XPS-180W was associated with the lowest storage symptoms among the three GreenLight generations at all follow-up visits. In multivariate analysis, baseline IPSS-storage subscore ≥ 9, prolonged operative time >100 minutes, and lower percent of postoperative PSA level reduction significantly predicted less improvement of postoperative storage symptoms regardless of the laser procedure. CONCLUSION Storage urinary symptoms significantly improved more after HoLEP compared with PVP, irrespective of the generation of GreenLight laser used. Recovery from bothersome storage urinary symptoms after prostate vaporization is time dependent, and baseline degree of storage symptoms, prolonged operative time, and lower percent of postoperative PSA level reduction negatively predicts postoperative improvement of storage symptoms regardless of the laser procedure.
Molecular changes in the phosphatidylinositide 3‐kinase (PI3K) pathway are common in gastric cancer

The phosphatidylinositide 3‐kinase (PI3K) pathway is an important signalling pathway that is frequently activated in cancer cells. This has led to the emergence of PI3K inhibitors as potential new treatment modalities for many cancers. We have investigated the frequency of molecular changes in the PI3K pathway in gastric cancer.
Impact of virus eradication in patients with compensated hepatitis C virus‐related cirrhosis: competing risks and multistate model

No published study to date has provided a careful analysis of the effects of a sustained viral response (SVR) on the outcomes of patients with compensated hepatitis C virus (HCV)‐related cirrhosis in relation to the degree of portal hypertension. Therefore, we estimated the impact of achieving SVR on disease progression, hepatocellular carcinoma (HCC) development and mortality in a large cohort of HCV patients with cirrhosis with or without oesophageal varices (OVs) at the start of antiviral therapy.
Genetic Predisposition to Severe Sepsis

Explosion of knowledge both in human genomics and in host inflammatory response explains the increasing interest in infectious disease genetics over the last 5 years. However, twin and adoptee studies suggested more than 15 years ago that host genetic factors are major determinants of susceptibility to infectious diseases in humans. Recently, candidate gene studies and human genome-wide analysis have been used to identify infectious disease susceptibility and resistance genes. Rarely, a single gene defect has been directly related to devastating consequences, such as interferon-gamma receptor mutations leading to fatal infections with ubiquitous mycobacteria. For clinical practice, gene polymorphisms of specific immunologic or physiologic mediators seem to be of major importance. These genetic variants, which modify the regulation or function of the mediators, have been associated with susceptibility or outcome of severe sepsis and septic shock. All steps of the host response to bacteria may be affected by genetic factors. Fc gamma receptor, Mannose Binding Lectin, or chemokine receptor mutations have been shown to modify the detection of pathogens leading to encapsulated bacteria infections, Gram-negative bacteria septic shock, and resistance to human immunodeficiency virus, respectively. Polymorphisms of cytokine genes (tumor necrosis factor [TNF], interleukin [IL]-1-ra, and IL-10) may influence the levels of secreted mediators and unbalance the inflammatory cascade. Coagulation response to sepsis may also be affected by gene variants such as the plasminogen activator inhibitor 1 (PAI-1) common functional polymorphism, which increases the risk of death from meningococcal infection and severe trauma. The impact of these findings on the understanding of infectious disease pathogenesis and on the design of future preventive and therapeutic strategies should be considerable. Clin Pulm Med 2002;9(4):229–237
Evaluation of a Novel Single-Use Flexible Ureteroscope.

INTRODUCTION A novel single-use flexible ureteroscope promises the optical characteristics and maneuverability of a reusable fourth-generation flexible ureteroscope. In this study, the LithoVue Single-Use Digital flexible ureteroscope was directly compared with contemporary reusable flexible ureteroscopes, with regard to optics, deflection, and irrigation flow. METHODS Three flexible ureteroscopes such as the LithoVue (Single Use; Boston Scientific), Flex-Xc (Karl Storz, Germany), and Cobra (Richard Wolf, Germany) were assessed in vitro for image resolution, distortion, color representation, grayscale imaging, field of view, and depth of field. Ureteroscope deflection was tested with an empty channel followed by placement of a 200 μm laser fiber and a 1.9F wire basket, a 2.0F nanoelectric pulse lithotripsy (NPL) probe, and a 2.4F NPL probe. Ureteroscope irrigation flow was measured using normal saline at 100 cm, with an empty channel followed by a 200 μm laser fiber, a 1.9F wire basket and a 2.0F NPL probe. RESULTS The LithoVue showed the largest field of view, with excellent resolution, image distortion, and depth of field. No substantial difference was demonstrated in color reproducibility or in the discernment of grayscales between ureteroscopes. The LithoVue maintained full deflection ability with all instruments in the working channel, although the Flex-Xc and Cobra ureteroscopes showed loss of deflection ranging from 2° to 27°, depending on the instrument placed. With an empty channel, the LithoVue showed an absolute flow rate similar to the Flex-Xc ureteroscope (p = 0.003). It maintained better flow with instruments in the channel than the Flex-Xc ureteroscope. The Cobra ureteroscope has a separate 3.3F instrument channel, keeping flow rates the same with instrument insertion. CONCLUSION The LithoVue Single-Use Digital ureteroscope has comparable optical capabilities, deflection, and flow, making it a viable alternative to standard reusable fourth-generation flexible digital and fiberoptic ureteroscopes.
Bacteriology of urinary tract infection in pediatric patients at KIST Medical College Teaching Hospital

Background: Urinary tract infection is common in children and is an important cause of morbidity. Urinary tract infection at young age can lead to renal injury and scarring, and ultimately lead to end stage renal disease in adulthood. Objectives: The purpose of study was to identify the different species of microorganisms, along with their antimicrobial susceptibility pattern, causing urinary tract infection in paediatric patients presenting with urinary tract infection at KIST Medical College, Imadol, Lalitpur, Nepal. Methods: This retrospective study examined microbiological and antimicrobial susceptibility pattern for urine samples collected at KIST Medical College, Imadol, Lalitpur from December 2010 to November 2013. A urine sample was included in our dataset if it demonstrated pure growth of a single organism and accompanying antimicrobial susceptibility and subject demographic data were available. Results: Escherichia coli was the most common organism isolated, followed by Klebsiella species, Staphylococcus species and then by Proteus species , Enterococcus species and Citrobacter species being equal in number. Microorganisms were most susceptible to amikacin and nitrofurantoin and most resistant to ampicillin and nalidixic acid. Conclusion: Though various microorganisms are responsible for urinary tract infection in children, Escherichia coli is the most common causative agent. Antimicrobial resistance has already emerged against many antibiotics, making empiric treatment of these infections challenging. DOI: http://dx.doi. org/10.3126/jkmc.v3i1. 10919 Journal of Kathmandu Medical College Vol. 3, No. 1, Issue 7, Jan.-Mar., 2014, Page: 21-25
Management of postdural puncture headache: greater occipital nerve block technique

Background Although epidural blood patch remains the gold standard for the treatment of postdural puncture headache (PDPH), it may not be successful in severe and persistent cases. Greater occipital nerve block (GONB) is a novel and easy technique that can be performed in an anesthesia clinic. The present study was carried out to evaluate ultrasound-guided GONB as a line of management for patients with PDPH. Materials and Methods We examined 30 patients age range 18-60 years, of both sexes American Society of Anesthesiologists I-II who developed PDPH either after a cesarian section or any operation under spinal anesthesia. Patients were randomized into two groups: the GONB group, which received ultrasound-guided GONB, and the control group, which received medications. Patients were examined for development of PDPH either during hospitalization or within 2 weeks of operation. If headache was not relieved within both groups, epidural blood patch was performed 24-48 h from the start of medical treatment in the control group but from the time of GONB in the study group. We recorded time of improvement or disappearance of headache, amount of analgesic consumption, and any side effects. Results Patients in the GONB group showed a statistically significant lower numerical rating score and greater improvement than the control group (P < 0.0001) during the second 12 h. The headache was completely relieved in the GONB group within a significantly shorter time than in the control group: 29.20 ± 14.67 and 73.60 ± 43.47 h, respectively (P = 0.00). Tramadol and pregabalin were consumed significantly less by the participants in the GONB group compared with those in the control group (P < 0.001). Conclusion GONB is a potentially useful alternative technique for the management of PDPH.
Clinical course and short‐term mortality of cirrhotic patients with infections other than spontaneous bacterial peritonitis

Clinical course and risk factors of death in non‐spontaneous bacterial peritonitis (SBP) infections are poorly known. We assessed the prevalence of acute kidney injury (AKI) and type‐1 hepatorenal syndrome (HRS), hospital, 30‐day and 90‐day mortality and risk factors of death in 441 decompensated patients.
Shear‐wave elastography of the liver and spleen identifies clinically significant portal hypertension: A prospective multicentre study

Clinically significant portal hypertension (CSPH) is associated with severe complications and decompensation of cirrhosis. Liver stiffness measured either by transient elastography (TE) or Shear‐wave elastography (SWE) and spleen stiffness by TE might be helpful in the diagnosis of CSPH. We recently showed the algorithm to rule‐out CSPH using sequential liver‐ (L‐SWE) and spleen‐Shear‐wave elastography (S‐SWE). This study investigated the diagnostic value of S‐SWE for diagnosis of CSPH.