Miracle-dz/UniFAR-FTUs huggingface dataset:
ASSESSMENT OF NEURODEVELOPMENTAL OUTCOME OF PRETERM VERY LOW BIRTH WEIGHT BABIES AT THE CORRECTED AGE OF 1 YEAR

Background: Very low birth weight (VLBW) babies born preterm are likelier to experience negative neurodevelopmental outcomes. To recommend patients for early intervention, it is crucial to identify early determinants connected to the outcome. Aim: To assess the neurodevelopmental outcome of preterm VLBW babies registered at DEIC, ICH&RC, Madurai, by examination and followup at serial intervals till the corrected age of one year. Materials and Methods: The study included preterm neonates who were followed up at the corrected ages of 3, 6, 9 and 12 months and had birth weights between 1000 and 1499 g. The Hammersmith method is used for neurological examination during follow-up, and the Denver development screening test is used for developmental assessment. Result: The VLBW infants serially assessed for neurodevelopmental outcome using DDST and HINE revealed that neurodevelopmental outcome at the corrected age of 1 year was influenced largely by neonatal complications such as RDS (60%) and sepsis (54%). Jaundice was also found in 62% of infants. The final neurodevelopmental status of the preterm VLBW infants at the corrected age of 1 year showed a significant delay as per DDST (35%) and HINE (34%)—birth asphyxia, mechanical ventilation, neonatal convulsions, and faulty feeding directly correlated with the significant delay. Conclusion: Birth asphyxia, mechanical ventilation, newborn convulsions, and improper feeding were identified as risk factors for poor neurodevelopmental outcomes in children born preterm. Long-term monitoring and evaluation of these babies is critical and might impact the outcome through quality survival.
POST-OPERATIVE LUNG FUNCTIONS AFTER LOW-FLOW VERSUS HIGH-FLOW ANAESTHESIA: A RANDOMIZED, DOUBLE BLIND COMPARATIVE STUDY

Background: Low-flow anaesthesia is prevalent in modern Anaesthetic practice due to its advantages like less operating room pollution, preservation of heat & humidity of the respiratory system and reduction in the costs. Not many studies have been done to compare the vital capacity (VC), inspiratory reserve volume (IRV) and peak expiratory flow rate (PEFR) measurements in both low-flow & high flow anesthesia. We evaluated the effects in both scenarios on the Pulmonary functions using respirometer, before and after General Anaesthesia (GA). Materials and Methods: A prospective randomized double-blind study was conducted in eighty patients, belonging to American Society of Anesthesiologists physical status class 1 or 2, undergoing elective peripheral surgeries under GA. The patients were divided into two groups, Group 1-Low-flow Anaesthesia with oxygen (O 2 ) (0.5L) + nitrous oxide (N 2 O) (0.5L) + Sevoflurane (2.5%) and Group 2 - High-flow Anaesthesia with O 2 (2L)+ N 2 O (2L) + Sevoflurane (1.5%). The preoperative values of VC, IRV and PEFR were compared with their postoperative values after GA in both the groups. Result: Both groups showed similar differences in VC, IRV and PEFR which were statistically not significant (p - 0.172, 0.98 and 0.212 respectively). The variation in breath holding time, single breath count and respiratory rates was also found to be similar in both the groups (p-0.687, 0.101 and 0.457 respectively). Conclusion: The pulmonary functions in postoperative period remained unchanged with respect to intraoperative flow rates in patients undergoing peripheral surgeries under General Anaesthesia.
DESIGN AND OPTIMISATION OF A STATIONARY CHEST TOMOSYNTHESIS SYSTEM WITH MULTIPLE FLAT PANEL FIELD EMITTER ARRAYS: MONTE CARLO SIMULATIONS AND COMPUTER AIDED DESIGNS*

Digital tomosynthesis (DT) allows 3D imaging by using a ~30° range of projections instead of a full circle as in computed tomography (CT). Patient doses can be ~10 times lower than CT and similar to 2D radiography but diagnostic ability is significantly better than 2D radiography and can approach that of CT. Moreover, cold-cathode field emission technology allows the integration of 10s of X-ray sources into source arrays that are smaller and lighter than conventional X-ray tubes. The distributed source positions avoid the need for source movements and Adaptix Ltd has demonstrated stationary 3D imaging with this technology in dentistry, orthopaedics, veterinary medicine and non-destructive testing. In this work we present Monte Carlo simulations of an upgrade to the Adaptix technology to specifications suited for chest DT and we show computer aided designs for a system with various populations of these source arrays. We conclude that stationary arrays of cold-cathode X-ray sources could replace movable X-ray tubes for 3D imaging and different arrangements of many such arrays could be used to tailor the X-ray fields to different patient size and diagnostic objective.
Sex Differences in Giant Cell Arteritis

patients with stable findings had a higher mean age, longer duration of SSc with shorter duration of pulmonary symptoms, a lower skin score, greater impairment of FVC and DLCO (p <0.05), a higher chest radiograph score, and a higher HRCT score (p < 0.05). Only 11 of 18 (55%) patients completed the therapy in our study. Two patients were lost to followup after first and fourth pulses. CYC had to be permanently discontinued due to severe intolerance in one and hematuria in another patient. Other side effects were cytopenias in 3 patients and infections such as oral candidiasis with recurrent pyoderma, pulmonary tuberculosis, Pneumocystitis carinii , herpes zoster, amoebiasis, and infection of toe ulcer in one patient each, oligo/amenorrhea in 2, alopecia in 2, intermittent erythematous pruritic facial rash in 3, oral ulcers in 2, and musculoskeletal pains in one patient. Mild nausea lasting 1–2 days was seen in almost all patients, although severe nausea and vomiting with giddiness necessitating emergency room observation was seen in only one patient. Our study suggests that CYC pulse combined with moderate dose prednisolone is effective in clinical, functional, and radiological stabilization in the treatment of alveolitis in SSc, but is not without side effects and a high rate of discontinuation.
A SYSTEMATIC REVIEW OF THE PROSPECTIVE STUDIES ON ADVERSE DRUG REACTIONS REPORTED WITH ANTI-MICROBIALS AMONG INDIAN PATIENTS

Background: Adverse Drug Reactions (ADRs) are an added economic burden on the healthcare system and thus a well-recognized public health problem affecting the quality of life of patients. Evidence-based systematic reviews on ADRs from India are sparse. A comprehensive systematic review and meta-analysis was undertaken from the literature with prospective monitoring for identifying ADRs related to anti-microbial drugs in Indian patients according to the PRISMA guidelines. Materials and Methods: MEDLINE and EMBASE databases from January 2001 until July 2018 were searched for identification of literature and information pertaining to the characteristics of pharmacovigilance studies such as occurrence, class of drug, age, gender, structure of hospital was collated. ADR occurrence was calculated using random-effects model meta-analysis with their 95% confidence intervals and heterogeneity evaluation. Result: For systematic review and meta-analysis, 115 and 61 prospective studies respectively were included. There is a substantial difference observed among the types of reported ADRs, seriousness and types of medicines due to variations in study methodology. The pooled ADR incidence was 4.92% [CI 95% 2.77 – 7.63] among the included 61 studies published over 18-year period, however, the results should be considered cautiously owing to high heterogeneity (I2 = 99.97% [95% CI: 99.96 – 99.98]). The most frequently associated ADRs against antimicrobial drugs were attributed to skin and sub-cutaneous tissue disorders (30.33%), followed by gastrointestinal disorders (22.83%). Most of the ADRs are attributed to the beta-lactam antibiotics (including penicillin and cephalosporins) followed by aminoglycosides. Conclusion: The incidence for anti-microbials observed was lower in comparison to the global studies. The study highlights variations among the studies and the need to standardize the reporting criteria among the reported studies across country.
COMPARATIVE STUDY OF ANTIOXIDANTS VITAMINS AND ENZYMES IN ALCOHOLIC LIVER DISEASES IN KARNATAKA POPULATION

Background: Consumption of alcohol causes liver damage by several patho-physiological mechanisms which alter the ROS (Rich Oxygen Spices) which has high anti-oxidant vitamins and enzymes. Their values are altered due to excess amount of ethanol. Hence parameters of anti-oxidant indicate the severity of alcohol liver disease. Materials and Methods: 35 alcoholic liver disease patients were compared with same number of healthy (controlled) group. Clinical and laboratory investigations were carried out by venous blood plasma vit. E levels by Baker Hatal method, Ascorbic acid by Teitz method and SVD by Beers and seizer method. Result: The comparison of non-enzymatic oxidants parameters. Ascorbic acid, vitamin E and comparison of anti-oxidant enzymes SOD, GPX in both groups were statistically highly significant (p<0.00). Conclusion: Increased oxidant enzymes SOD, GPX except catalase and decreased non-enzymatic oxidants values observed in alcohol liver patients. This pragmatic study will help the physician to treat such alcoholic liver patients treat efficiently to avoid morbidity and mortality because treating alcoholic liver patients is a challenge for clinician globally.
A STUDY OF ARRHYTHMIAS DURING THE FIRST 48 HOURS OF HOSPITALIZATION IN ACUTE CORONARY SYNDROME AND ITS CORRELATION WITH SERUM URIC ACID AND CRP

Background: The acute coronary syndrome causes significant metabolic and electrophysiological alterations, including life-threatening arrhythmias. The C-reactive protein (CRP) and serum uric acid have been reported as predictors of arrhythmias. Hence, the present study was performed to study arrhythmias during the first 48 hours of hospitalization in acute coronary syndrome and its correlation with serum uric acid and CRP. Materials and Methods: This prospective observational study was conducted in the Department of general medicine at Thoothukudi medical college from January 2020 to January 2021. The detailed history and physical examination of all patients were noted. Each patient was subjected to 12 lead ECGs with serial monitoring. Each patient was put on Cardiac Monitor for 48 hours following admission to ICCU and monitored serially. All routine blood investigations were tested, including cardiac markers, serum uric acid and CRP. Result: Male predominance was reported (59.5%) in the study. Maximum patients were reported in the age group of 51 to 60 (45%). Smoking was a major risk factor (65%), followed by caffeine (34.5%). In our study, anterior wall MI was found with the highest incidence of 27%. 62% of the patients were presented with STEMI, whereas 38% of patients were found with NSTEMI. The arrhythmia was reported in 61% of patients, and the VPC type was observed highest (31.1%). Increased CRP level and serum acid levels are associated with cardiac arrhythmias risk. Conclusion: High incidences of arrhythmia were observed in the present study. The increased level of CRP and uric acid were reported with high incidences of cardiac arrhythmias.
Evolving Agent Behavior In Multiobjective Domains Using FitnessBased FitnessBased FitnessBased Shaping

Multiobjective evolutionary algorithms have long been applied to engineering problems. Lately they have also been used to evolve behaviors for intelligent agents. In such applications, it is often necessary to “shape” the behavior via increasingly difficult tasks. Such shaping requires extensive domain knowledge. An alternative is fitness-based shaping through changing selection pressures, which requires little to no domain knowledge. Two such methods are evaluated in this paper. The first approach, Targeting Unachieved Goals, dynamically chooses when an objective should be used for selection based on how well the population is performing in that objective. The second method, Behavioral Diversity, adds a behavioral diversity objective to the objective set. These approaches are implemented in the popular multiobjective evolutionary algorithm NSGA-II and evaluated in a multiobjective battle domain. Both methods outperform plain NSGA-II in evolution time and final performance, but differ in the profiles of final solution populations. Therefore, both methods should allow multiobjective evolution to be more extensively applied to various agent control problems in the future.
The oceanic crust : from accretion to mantle recycling

Preface Oceans, continents, and the fundamental cycle of the oceanic lithosphere Magma series from oceanic domains Surveying and sampling the oceanic crust The worldwide oceanic ridge. Geographic extension, morphology and segmentation Structure and lithology of the oceanic crust of the present-day oceans Structure and lithology of fossic oceanic crust in ophiolites Shallow processes: volcanic and tectonic activity of oceanic ridges Deep processes: mantle diapirs, magma extraction and models of accretion magma chambers Basalt-seawater interaction: metamorphic and hydrothermal processes Intraplate oceanic magmatism The fate of the oceanic crust: from subduction to recycline Conclusion: the oceanic crust cycle References Index.
Hesitancy for Vaccines against Corona Virus Disease in Northern India: A Cross-Sectional Study

Background: Severe acute respiratory syndrome novel Beta-Coronavirus (SARS-CoV-2) re-emerged in November 2019 in Wuhan (Hubei, China) and rapidly affected nearly 220countries across the globe due to its highly infectious nature. The purpose for conducting this study is to estimate current COVID-19vaccination hesitancy amongpeople residing in these Rural areas. Such type of study has not been done in most of the region of India. It has been assumed that one of the most important hindrances in attaining the goal for herd immunization in order to reduce the burden of the pandemicity is hesitancy and doubtful attitude and behavior regarding vaccine safety among majority of the population worldwide. The objectives areto estimate the prevalence of Covid-19 Vaccination hesitancy and to assess the associated factors in such rural areas. Material(s) and Method(s): Cross-sectional study having total participants of 220 were selected by multistage sampling method and interviewed by pretested interview- schedule and collected data were analyzed using SPSS Version 26.0 and Microsoft Excel 2007. Result(s): Out of 220 participants, 72were estimated as hesitant towards vaccination against Covid-19(P- value: 0.003). Conclusion(s): A high prevalence of hesitant population was observed which is 34%. Almost all study parameters were detected to be associated in contributing hesitancy towards vaccination against Covid-19. ©Copyright: the Author(s), 2022 Licensee PAGEPress, Italy.
Technological Innovation, Resource Allocation and Growth

We propose a new measure of the economic importance of each innovation. Our measure uses newly collected data on patents issued to US firms in the 1926 to 2010 period, combined with the stock market response to news about patents. Our patent- level estimates of private economic value are positively related to the scientific value of these patents, as measured by the number of citations that the patent receives in the future. Our new measure is associated with substantial growth, reallocation and creative destruction, consistent with the predictions of Schumpeterian growth models. Aggregating our measure suggests that technological innovation accounts for significant medium-run fluctuations in aggregate economic growth and TFP. Our measure contains additional information relative to citation-weighted patent counts; the relation between our measure and firm growth is considerably stronger. Importantly, the degree of creative destruction that is associated with our measure is higher than previous estimates, confirming that it is a useful proxy for the private valuation of patents.
Last interglacial coral record of enhanced insolation seasonality and seawater 18O enrichment in the Ryukyu Islands, northwest Pacific

We present a calibrated, high‐resolution 18O/16O and 13C/12C record for a well‐preserved Last Interglacial Porites sp. coral (U‐Th age of 127±6 ka) from the sea‐level high‐stand terrace of Yonaguni Island, Japan. Seasonal variations in the δ18O and δ13C values for the fossil coral are greater than those observed in modern coral records from the same reef setting and appear to be driven by the enhanced insolation seasonality in the northern hemisphere during the Last Interglacial maximum. The 18O enrichment of 1.1‰ in the fossil coral compared to the modern analogue cannot be due entirely to a reduction in sea‐surface temperature because corals in this region are already growing at their lower thermal limit. Instead, most of the 18O enrichment must be due to a change in the δ18O of the surface seawater, probably in response to enhanced evaporation of the ocean or a higher volume flux of the Kuroshio Current.
COMPARISON OF THE EFFECT OF ORAL MIDAZOLAM AND ORAL CLONIDINE AS PREMEDICATION IN CHILDREN UNDERGOING SURGERIES UNDER GENERAL ANESTHESIA

Background: To minimize distress in children in the operating room (OR) environment and to facilitate a smooth induction of anesthesia oral premedication is given in paediatric patients before going to OR. This reduces child’s anxiety for parental separation, intravenous cannulation, and mask applicaton before induction . A sedative drug. Midazolam is currently available the most commonly used premedication in children given before transfer to OR. Clonidine an α 2-agonist, can also be given for premedication as effective as midazolam. The beneficial effects of both are anxiolysis, and sedation preoperatively, hemodynamic stability intraopertatively and reduction of emergence phenomenon and other complications as PONV postoperatively. Materials and Methods: 60 children who were in age group of 2-12 years were randomly divided into two groups. In Group I Midazolam 0.5 mg/kg was given orally while in Group II Clonidine 4 µg/kg was given orally one hour before induction of anesthesia. They were evaluated and compared for benefits of preoperative oral midazolam and oral clonidine on sedation scores, parental separation, venipuncture, quality of induction and mask acceptance, perioperative hemodynamic parameters and analgesic requirements. Independent sample t-test was used and p-value < 0.05 was considered significant. Result: We found that oral midazolam tested significantly better efficacy in the preoperative period. As sedative and anxiolytic, midazolam had faster response after premedication. With midazolam (29.5±9.5) than with clonidine (38.2±12.3), better cooperation during venipuncture, facemask application p value (p<0.001). Whereas there were significant (P < 0.05) attenuation of hemodynamic response to intubation, surgical stress response and extubation with clonidine as compared to midazolam. None of the patients desaturated in either group. Opioid requirement (72%) was more in midazolam group as compared to clonidine (28%) group. Recovery in clonidine group took slightly longer time (60.00 ± 13.77 min) as compared to midazolam group (44.40±13.25 min). Conclusion: We conclude that oral midazolam is better premedication than clonidine in children in preoperative period while clonidine is a better premedication for all surgeries to provide more sedation, stable hemodynamics intraoperatively, reduction in stress response, less opioid consumption with no significant side effects.
NOVEL CORONAVIRUS AND PERINATAL WOMEN: A STUDY ON DEMOGRAPHIC PROFILE AND LABORATORY PARAMETERS

Background: The COVID-19 pandemic implicated great threat to human lives irrespective of age, gender and co-morbidities. Amongst them, those who suffered extensively were the elderly, patients with associated co-morbidities and pregnant women. Pregnancy is a major physiological change occurring in a woman’s life. With various hormonal changes manoeuvring, the pandemic also inflicted severe complications. This study was done during the peak wave of the COVID 19 pandemic, which shut the whole country into a state of doom. In this study, we have evaluated the changes in the values of various laboratory parameters in COVID-19 positive pregnant population. This study aims to differentiate the standardized cut off value for pregnant and non-pregnant women. Materials and Methods: We enrolled fifty antenatal COVID-19 positive inpatients admitted for delivery and 139 non-pregnant female inpatients as control cases for the study. Socio-demographic data, clinical details and the laboratory parameters of the study population were collected. Mode of delivery, mean duration of stay in hospital (days) and outcome of pregnancy were also included. The data was analysed with appropriate statistical tests. Result: Total WBC count, mean neutrophil count in pregnant females were significantly higher in pregnant females. Lymphopenia and thrombocytopenia were also seen significantly higher in pregnant females than non-pregnant females (p<0.05). The serum total protein in pregnant females was significantly less than that of non-pregnant females (p<0.05). Significantly higher mean alkaline phosphatase levels and significantly lower mean SGPT levels were seen in pregnant females. Significantly lower serum ferritin levels were seen in pregnant females than in non-pregnant females (p<0.05). Conclusion: COVID-19 continues to be of public health interest despite declining rates. There are very few studies conducted among COVID-19 positive pregnant patients. In our study, most of the COVID-19 pregnant patients had high neutrophil count, lymphopenia, thrombocytopenia and deranged liver function tests.
PD-L1 EXPRESSION IN THYROID CARCINOMA AND ITS ASSOCIATION WITH CLINICOPATHOLOGICAL FINDINGS: A HOSPITAL-BASED STUDY FROM SOUTH INDIA

Background: Thyroid carcinoma comprises 1% of all cancers globally and its incidence rates are rising. Aggressive subtypes, including poorly differentiated and anaplastic carcinomas, present therapeutic challenges. Immunotherapy, particularly PD-1/PD-L1 axis blockade, has shown success in various cancers. PD-L1's role in thyroid carcinoma remains unclear, necessitating a comprehensive investigation to explore its prevalence and clinicopathological associations. Understanding PD-L1's impact
Treatment of Varicose Veins / Venous Insufficiency Policy

Policy Statements Greater or Lesser Saphenous Veins Treatment of the greater or lesser saphenous veins by surgery (ligation and stripping) or endovenous radiofrequency or laser ablation may be considered medically necessary for symptomatic varicose veins/venous insufficiency when the following criteria have been met:  There is demonstrated saphenous reflux; AND  There is documentation of one or more of the following indications: o Ulceration secondary to venous stasis that fails to respond to compressive therapy; OR o Recurrent superficial thrombophlebitis that fails to respond to compressive therapy; OR o Hemorrhage or recurrent bleeding episodes from a ruptured superficial varicosity; OR o Persistent pain, swelling, itching, burning, or other symptoms are associated with saphenous reflux, AND the symptoms significantly interfere with activities of daily living, AND conservative management including compression therapy for at least 3 months has not improved the symptoms*.