Miracle-dz/UniFAR-FTUs huggingface dataset:
Incidence of Thyroid Cancer in Long Standing Multinodular Goiter: Prospective Study

Introduction: Multi-nodular goiter is a common presentation of many thyroid diseases. Thyroid nodules are present in 4%- 7% of the people on neck palpation. Multi-nodular goiter was thought to be at a low risk for malignant changes, as compared to its single nodule, but many studies showed a significant risk. Aim: To determine the incidence of thyroid cancer in longstanding multinodular goiter after histopathological examination of thyroid specimens following near total or total thyroidectomy. Patients and Methods: This prospective, observational study was done in the surgical Department of Baghdad Teaching Hospital, by our team in the first surgical unit-second floor, over a period of twenty five months from December 2014 to January 2017. All the patients with multinodular goiter were evaluated and they were offered surgery by near total or total thyroidectomy. The specimens were sent for histopathological examination to assess the incidence and the types of various types of thyroid cancer in Multi-nodular goiter. Results: Among the 147 Multi-nodular goiter cases which were studied, 19 (12.9%) cases had a thyroid malignancy. Papillary carcinoma constitutes 74% of the cases and it was the most common type of malignancy observed. Conclusions: Multinodular goiter could be assign of different types of thyroid malignancy. The most common type was papillary carcinoma.
The heat-shock response and heat sensitivity of Bombyx mori

Lorsqu'ils sont exposes a une temperature elevee, de nombreux organismes repondent au choc thermique par une synthese nouvelle des proteines de choc thermique. Nous demontrons ici que la reaction au choc thermique de Bombyx mori est similaire a celle d'autres insectes en cela qu'elle induit la production de trois groupes de proteines de choc thermique. La reaction au choc thermique de Bombyx mory differe de celle de Drosophila car la repression de la synthese des proteines non liees au choc thermique ne constitue pas la caracteristique principale de la reaction. A cet egard, la reaction au choc thermique de Bombyx mori ressemble a celle de Manduca. Cette difference de synthese des proteines non liees au choc thermique pourrait correspondre soit a des differences phylogenetiques entre les ordres d'insectes, soit a la tolerance particuliere de ces deux genres aux temperatures relativement elevees
AWARENESS OF VİTAMİN D DEFİCİENCY AMONG TRIPOLI UNIVERSITY STUDENTS IN LIBYA

Introduction: Vitamin D deficiency considered to be the most popular, widespread problem and undiagnosed medical conditions around the world. It appears to be related to many of health consequences. Aim: This study is conducted to assess level of knowledge and create good awareness about vitamin D among Tripoli university students. Method: A Cross sectional study was conducted between May and June of 2016 among male and female students of Tripoli University they were of different ages, classes and faculties. Results: The majority have good knowledge about vitamin D, it appears that the education was commonest source of knowledge, most of them (87%) are taking vitamin D rich foods, about (28%) did not expose their bodies to the sun, while most of the others exposed to the sun in period less than 15 minutes, additionally only 17% tested 25(OH) D level in their body, 25% have a family member suffering from vitamin D deficiency. Conclusion: The results of this study show students level regarding the knowledge and attitude toward main sources of vitamin D, nevertheless and based on results of laboratories data, we still require more awareness about this problem. Key words: Tripoli University; 25-hydroxyvitamin D; Awareness; vitamin D deficiency.
Perspectives of medical students and teaching faculty on teaching medicine in their native language.

Background One of the basic policy questions to be decided at the inception of medical education institutes is the language of instruction. Aims This study explored the perspectives of medical faculty and students at a college in Saudi Arabia on the language of instruction in medical education. Methods A cross-sectional survey of undergraduate medical students and full-time faculty members at a medical college in Riyadh, Saudi Arabia, was conducted in 2016. Each participant completed a self-administered, validated 28-item questionnaire. Results The total number of students and faculty who responded were 468 (76%) and 37 (93%) respectively. Most students and faculty members agreed that studying in English enables a better access to medical information (n=457, 91%) and more job opportunities (n=419, 83%). Less than 15% of the students preferred to be taught in Arabic in most of the curriculum aspects except for communication skills (n=131, 28%) and the Objective Structured Clinical Examination (OSCE) (n=119, 26%). Conclusions Most medical students and faculty members preferred English as the language of instruction for medical education and did not believe that teaching medicine in Arabic should be sought as a future goal.
A Systematic Review of Proton Pump Inhibitors for the Prevention and Treatment of Preeclampsia and Gestational Hypertension

Background: Preeclampsia is a hypertensive disorder of pregnancy with a high rate of neonatal and maternal morbidity and mortality. The only definitive treatment is delivery. Through pre-clinical studies, proton pump inhibitors (PPIs), which are commonly and safely used in pregnancy, have been identified as potential therapeutic agents. Objective: To undertake a systematic review evaluating PPIs in the prevention and/or treatment of preeclampsia and gestational hypertension. Search strategy: Electronic databases were searched from inception to 2018. Search terms included preeclampsia, proton-pump inhibitors, pregnancy-induced hypertension, lansoprazole, rabeprazole, esomeprazole and omeprazole. Selection criteria: Studies were included if they were randomized control trials, case-control or cohort studies on human subjects. Case reports, review articles, opinion pieces and conference abstracts were excluded as well as studies with no or inappropriate control arms. Data collection and analysis: Only one eligible study was identified, so no analyses were able to be performed. Main results: There was only one clinical trial eligible for inclusion. This was a randomized clinical trial investigating the role of PPIs in the treatment of preterm preeclampsia in a high-risk, inpatient setting. This was a negative finding, with no change in the primary outcome of prolongation of gestation between the PPI group and placebo control. Conclusion: There is a scarcity of clinical trials published investigating the therapeutic potential of PPIs for preeclampsia and gestational hypertension. Of the one available study, PPIs were not found to prolong gestation among preterm preeclamptic patients compared to placebo control. In order to further elucidate the clinical potential of PPIs to prevent or treat preeclampsia, further trials are required.
Antemortem CSF Aβ42/Aβ40 ratio predicts Alzheimer's disease pathology better than Aβ42 in rapidly progressive dementias

Despite the critical importance of pathologically confirmed samples for biomarker validation, only a few studies have correlated CSF Aβ42 values in vivo with postmortem Alzheimer's disease (AD) pathology, while none evaluated the CSF Aβ42/Aβ40 ratio. We compared CSF Aβ42 and Aβ42/Aβ40 ratio as biomarkers predicting AD neuropathological changes in patients with a short interval between lumbar puncture and death.
Individualized Health Intervention: Behavioral Change and Quality of Life in an Older Rural Chinese Population

A randomized cluster trial was conducted to assess the impact of individualized health intervention guided by the transtheoretical model (TTM) theory on behavior change and quality of life (QoL) among the older rural population of China. A total of 2441 persons aged 60 years and over participated in the study. After a nine-month intervention, brined vegetable intake, salt intake, and smoking decreased (p < .001) while fresh vegetable and fresh fruit intake increased within the intervention group (p < .01) after adjusting for sociodemographic characteristics. The intervention group improved significantly in role-physical, role-emotional, mental health, and mental component summary scale scores (p < .05) after adjusting for sociodemographic characteristics, health behavior, and chronic disease status. The study shows that individualized health interventions are a feasible method of changing the health behaviors and improving the QoL in the older rural population of China.
Assessment of serum vitamin D level before and after narrowband therapy in vitiligo

Background: Vitiligo is an acquired, progressive, multifactorial, depigmenting disorder characterized by the appearance of circumscribed white macules in the skin due to chronic progressive loss of functional melanocytes in the epidermis. The etiology of vitiligo is not clear, although various hypotheses have been proposed. Objective: To evaluate the serum levels and the possible role of 25 OH vit D in vitiligo and to detect whether its level is modulated by Narrowband ultraviolet (B NB-UVB) therapy. Patients and Methods: The current study included 30 patients with vitiligo. In addition, 30 healthy subjects who were age and gender matched, served as a control group. All persons were recruited from the outpatient clinic of Al-Azhar University hospital (Damitta) and from Dermatology, Leprosy and Venereology Mansoura Hospital, from March 2018 to June 2018. Results: Vitamin D levels were lower in patients with vitiligo as compared to the control subjects. Levels of vitamin D increased significantly after NB-UVB therapy. Also, VASI scores showed improvement after NB-UVB therapy. The mean VASI score in both groups showed highly significant decrease after treatment by NB-UVB. Comparison and correlation between VASI before NB- UVB therapy and 25(OH) D showed good negative correlation. Conclusion: Decreased vitamin D serum level was found in vitiligo patients, indicating its possible involvement in the pathogenesis of the disease. This level was increased significantly after NB-UVB therapy. In addition, vitamin D serum level correlated negatively with the severity of the disease.
To Use or Not to Use Opioid Analgesia for Acute Abdominal Pain Before Definitive Surgical Diagnosis? A Systematic Review and Network Meta-Analysis

Background Despite the existing evidence, many physicians are reluctant to use opioid analgesia for acute abdominal pain. Methods We performed updated conventional and network meta-analyses. For the first time to our knowledge, direct and indirect evidence of any type of opioid analgesia was estimated and compared using network meta-analysis. Results There was no significant difference in the intensity of pain between the two cohorts (mean difference (MD) = 0.43 (-0.05 to 0.91), P = 0.08). In addition, no significant difference was detected in the rate of incorrect diagnoses between the opioid analgesia and the placebo cohorts (odds ratio (OR) = 0.79 (0.54 to 1.17), P = 0.24). Network meta-analysis demonstrated that the results of direct evidence of head-to-head comparisons of opioid analgesics with placebo were in accordance with the results of conventional meta-analysis. Moreover, estimation and comparison of the indirect evidence on the four opioid analgesics did not demonstrate significant differences in effect size. Conclusions Any type of opioid analgesic can be used safely for acute abdominal pain without risk of impairment of diagnostic accuracy.
The Universal Transport System: An Adaptive End-to-End Protocol Analysis and Design

This thesis presents a study that investigates the operation of end-to-end protocols and shows the bene ts of a general purpose adaptive approach. The application of this work includes protocols for high speed networks, multimedia networks and mobile networks where the QoS of the underlying data links and/or the requirements of the application are variable. The study is composed of a number of steps. Firstly several end-to-end protocols are decomposed into their atomic protocol functions. Compound protocol functions are then synthesised by combining the atomic ones. A mapping from the various application classes into a set of protocol functions is also developed. Experiments are then performed that quantify the processing overheads of TCP that are associated with the error control and ow control protocol functions. Two platforms are compared, a 486 and a Dec 5000/240. Both platforms use Mach 3.0. The results show that protocol customisation resulted in improved performance. The need for an adaptive protocol is then outlined. The implementation of adaptivity is then investigated by modifying TCP so that various protocol functions can be selected during a data transfer. This modi cation uses dynamic linking (DLD) to allow the protocol to be very exible. The results show that adaptivity introduces only a small overhead. xx Abstract xxi A generic adaptive framework is then presented that uses the atomic protocol functions to implement a general purpose protocol. This framework supports protocol implementation concepts such as ILP and ALF.xxi A generic adaptive framework is then presented that uses the atomic protocol functions to implement a general purpose protocol. This framework supports protocol implementation concepts such as ILP and ALF. Chapter
Extracorporeal membrane oxygenation after lung transplantation: risk factors and outcomes analysis.

Background Lung transplantation is the treatment of choice for end-stage pulmonary disease in selected patients. However, severe primary graft dysfunction is a significant complication of transplant and requires the implantation of an extracorporeal support. The aim of the study is to evaluate the impact of extracorporeal membrane oxygenation (ECMO) after transplant in our center. Methods From January 2008 till June 2018, 195 consecutive unselected patients receiving a lung transplant were considered. Mean age was 49±15 years. Main indications for transplant were idiopathic pulmonary fibrosis in 72 patients, chronic obstructive pulmonary disease in 60 patients, and cystic fibrosis in 40 patients. Prior to transplant, 18 patients were on mechanical ventilation and 14 were on ECMO. Results Twenty-five patients required venous-venous ECMO after transplant. Vascular disease as cause of transplant [relative risk (RR) 7.8, 95% CI: 1.5-41, P=0.02], donor age (RR 1.6, 95% CI: 1.03-2.3, P=0.03) and need for cardiopulmonary by-pass during transplant (RR 3.1, 95% CI: 1.02-9, P=0.04) were associated with ECMO implantation. Patients requiring post-transplant ECMO received more transfusions (P<0.01), had a longer mechanical ventilation (P<0.01) and ICU stay (P<0.01) and had a higher hospital mortality (P<0.01). Post-transplant ECMO significantly influenced one- and five-year survival [hazard ratio (HR) 5.5, 95% CI: 3-10, P<0.001 and HR 3.5, 95% CI: 2-6, P<0.001, respectively]. However, conditional survival after t months is similar for patients with or without post-transplant ECMO. Conclusions In our experience, although ECMO is a reliable and effective strategy to support pulmonary function, severe graft dysfunction after lung transplantation still has a significant impact on early and late results.
Induction of Labor in Obese Women -What Should We Know?

Obesity prevalence has been increasing dramatically in the last decades, affecting women in reproductive years and altering obstetric and prenatal outcomes [1] . The World Health Organization (WHO) stratifies obesity into three classes: class I (body mass index (BMI) 30-34.9), class II (BMI 35-39.9), and class III (BMI ≥40) [2]. Worldwide, approximately 300 million females above the age of 20years are categorized as overweight (BMI 25-29.9kg/m2) or obese (BMI ≥30kg/m2).
Reliability and Validity of Fall Efficacy Scale-International in People with Parkinson's Disease during On- and Off-Drug Phases

Purpose Since fear of falling may be one of the main problems in people with Parkinson's disease (PD), its assessment with valid tools is necessary in both drug phases. This study was carried out to investigate the psychometric attributes of the Fall Efficacy Scale-International (FES-I) in people with PD, both in On and Off phases. Methods One hundred twenty-four patients with PD (mean age ± standard deviation, 60.33 ± 12.59 years) were assessed with the FES-I, both in On- and Off-drug phases. Dimensionality, internal consistency, and test-retest reliability were, respectively, explored by means of factor analysis, Cronbach's alpha, and Intraclass Correlation Coefficient. Convergent validity of FES-I was established with Visual Analog Scale-Fear of Falling, Berg Balance Scale, and Functional Reach Test. Parkinson's Disease Questionnaire-39 and Unified Parkinson Disease Rating Scale-Activities of Daily Living were also applied. Discriminative validity was tested between patients with and without a history of falling. Results Factor analysis showed two factors for On- and one factor for Off-drug phase. Internal consistency (α = 0.96, On phase; 0.98, Off phase) and test-retest reliability (0.94; 0.91) were satisfactory in both drug phases. There was a moderate/high correlation (rS = |0.50–0.70|) between FES-I and Visual Analog Scale-Fear of Falling, Berg Balance Scale, and Functional Reach Test. Parkinson's Disease Questionnaire-39 and Unified Parkinson Disease Rating Scale-Activities of Daily Living were achieved in both drug phases too. The sensitivity of FES-I to discriminate Parkinson's disease with and without falls showed moderate effect size in both phases. Conclusion This study verified that FES-I is unidimensional, reliable, and valid to measure the Fear of Falling during On- and Off-drug phases in people with PD.
Principles of Internal Medicine.

When this book arrived my first thought was, "Good Heavens! What a weight! " I carried it to the kitchen and put it on the scales. It weighs eight and a half pounds. It can be bought in two volumes, and it would be worth paying the higher price to get it in that form; when I tried to read it in bed I found the pressure on my abdomen was intolerable. The arrangement of the beginning part of the book is very good. Instead of plunging straight into details of any particular disease, the first part contains chapters on "The Approach to the Patient" and "The Physician's Responsibility," and the second part consists of forty-five chapters on the "Cardinal Manifestations of Disease": chest pain, abdominal pain, fever, changes in weight, and so on. I looked in the chapter on changes in weight to see if the myth of there being
Profil Berpikir Analitis Masalah Aljabar Siswa Ditinjau dari Gaya Kognitif Visualizer dan Verbalizer

This research aimed to describe the profile of the visualizer and verbalizer students to think analytically in solving mathematical problems. The subjects were 3 visualizer students and 3 verbalizer students obtained by VVQ questionnaire. The research data are the form of analytical thinking tests and interviews were then analyzed based on the indicators of analytical thinking in solving mathematical problems based on the stage Polya. The results obtained by the visualizer students mention known and asked by picture, modelize problem by picture, use any different strategies, and conclude by picture. In other hand, verbalizer students mention known and asked by words, modelize problem by word (symbol or alphabet), use same strategy, and conclude by words. In the final result, there is no difference ability between the visualizer and verbalizer students' cognitive style to think analytically in solving the problem because both are quite good.
If the Gear Fits, Spin It Again!

To understand how students learn while engaged in active and embodied science games, two gears games were created. Would students' gear switching skills during the game be correlated with pre- and post-knowledge tests? Twenty-three seventh graders, playing as dyads, used gestures to manipulate virtual gears in the games. The Microsoft Kinect sensor tracked arm-spinning movements. Paper and pencil gear knowledge tests were administered before and after. In Game 1 (the easier one), the in-game switching data was significantly negatively correlated with only pretest gear knowledge. In Game 2 (the harder one), switching was negatively associated with both pre- and posttests. Negative correlations mean that fewer switches were used and that demonstrated better knowledge of mechanical advantage. In-game process data can provide a window onto learner's knowledge. However, the games need to have appropriate sensitivity and map to the learner's ZPD. In ludo (or in-process) data from videogames with high sensitivity may attenuate the need for repetitive traditional knowledge tests.
Preservice Teachers’ Confidence and Preferred Teaching Strategies using TeachLivE ™ Virtual Learning Environment: A Two-Step Cluster Analysis

TeachLivETM, a mixed reality learning environment originating from University of Central Florida (2011), has recently been introduced to the Australian preservice teaching context by Murdoch University (2016) and the University of Newcastle (2017). This paper, the first of a program of research mapping the implementation of TeachLivETM within the Australian context, captures preservice teachers’ (PSTs) reflections on their initial interactions with the mixed reality learning environment. The study highlights preferred teaching strategies and teaching confidences during initial interactions in the simulation laboratory and introduces a quality measure within the reflective practice process. A Two-Step Cluster analysis of 322 PSTs was conducted. Results showed a positive impact of reflective practice and revealed that most preservice teachers preferred ‘Questioning’ and ‘Direct Instruction’ methods of delivering micro-teaching lessons. The authors offer a typology of teaching strategies, confidences and a quality measure for teacher educators.
Intentional Retention and Restoration of Mesiodens Highlighting the Importance of Patient Treatment Needs in Treatment Planning

Early diagnosis and extraction is the best treatment option for the mesiodens to prevent further complications. But in most cases, mesiodens is not diagnosed at correct time and leads to various complications such as ectopic eruption of permanent central incisor. In such cases also, treatment is extraction of mesiodens and orthodontic alignment of ectopically erupted tooth. Treatment should always be planned taking various factors into consideration such as main objective for the treatment, radiographic and clinical evaluation, treatment outcome, financial condition of the patient and patient’s preferences. We should think of all treatment alternatives while planning treatment and must take final decision with patient’s involvement. This case report presents a case of intentional retention of fully erupted mesiodens as an esthetic substitute for malpostioned maxillary central incisor emphasizing the importance of patient preferences and treatment needs in treatment planning.