Miracle-dz/UniFAR-FTUs huggingface dataset:
The Influence of Transverse Carpal Ligament Thickness on Treatment Decisions for Idiopathic Mild to Moderate Carpal Tunnel Syndrome.

PURPOSE The main cause of carpal tunnel syndrome (CTS) is pathological changes in the flexor synovium, which is a known cause of pressure elevation in the carpal tunnel. The importance of the transverse carpal ligament (TCL) in the pathogenesis of CTS has hitherto been overlooked. However, the TCL significantly affects carpal biomechanics; the TCL is known to affect the carpal bone to a greater extent when intra carpal tunnel pressure is high. In addition, the effect of TCL properties on the progression course of idiopathic CTS is unknown.Therefore, we hypothesized that TCL thickness, measured using ultrasonography, would influence the results of conservative treatment for CTS patients with mild to moderate symptoms. We aimed to investigate the relationship between the ultrasound-measured TCL thickness and idiopathic carpal tunnel conservative treatment surgery rate. MATERIALS AND METHODS We analyzed the wrists of 127 patients with mild to moderate symptoms of CTS. The patients were diagnosed on the basis of electrophysiological assessment outcomes, median nerve cross-sectional area in the carpal tunnel, and clinical symptoms. The Boston carpal tunnel questionnaire score was also measured. Patients with a TCL thinner than 1.5 mm were classified into group A (n = 62), and those with a TCL thicker than 1.5 mm were classified into group B (n = 65). Patients with severe symptoms or other diseases were excluded. The patients were initially treated with night splinting after diagnosis. If symptoms were not ameliorated, steroid injection and surgical treatment were performed consecutively. The procedures were determined by a single surgeon. RESULTS The mean TCL thickness was 1.51 mm: 0.98 mm in group A and 2.28 mm in group B. The percentages of patients who underwent surgery were 43.0% in group A and 67.7% in group B. Group B was 1.77 times more likely to have surgery, and the interval between diagnosis and surgery and/or steroid injection was shorter. The TCL thickness in group B was also related to cross-sectional area and symptom duration. CONCLUSIONS Transverse carpal ligament thickness affects disease progression and may affect treatment efficacy, depending on the treatment method. Transverse carpal ligament thickness may be a criterion for deciding between surgical and conservative treatments based on a thickness threshold of 1.5 mm.
Sample multiplexing for targeted pathway proteomics in aging mice

Significance A user-friendly workflow, termed Tomahto, enables real-time targeted pathway proteomics assays using two-dimensional multiplexing technology. Hundreds of proteins of interest from a multitude of samples can be targeted and accurately quantified in a remarkably sensitive fashion. We highlight Tomahto’s ease of use, sensitivity, and accuracy and present proof-of-principle utility by targeting 260 metabolism- and inflammation-related proteins across 90 samples (nine tissues from five old and five young mice). Tissue-specific aging effects are presented with specific interest in metabolic and inflammatory pathways of white adipose tissue. We validated our approach through comparison with a global proteome survey across the tissues, work that we also provide as a general resource for the community. Pathway proteomics strategies measure protein expression changes in specific cellular processes that carry out related functions. Using targeted tandem mass tags-based sample multiplexing, hundreds of proteins can be quantified across 10 or more samples simultaneously. To facilitate these highly complex experiments, we introduce a strategy that provides complete control over targeted sample multiplexing experiments, termed Tomahto, and present its implementation on the Orbitrap Tribrid mass spectrometer platform. Importantly, this software monitors via the external desktop computer to the data stream and inserts optimized MS2 and MS3 scans in real time based on an application programming interface with the mass spectrometer. Hundreds of proteins of interest from diverse biological samples can be targeted and accurately quantified in a sensitive and high-throughput fashion. It achieves sensitivity comparable to, if not better than, deep fractionation and requires minimal total sample input (∼10 µg). As a proof-of-principle experiment, we selected four pathways important in metabolism- and inflammation-related processes (260 proteins/520 peptides) and measured their abundance across 90 samples (nine tissues from five old and five young mice) to explore effects of aging. Tissue-specific aging is presented here and we highlight the role of inflammation- and metabolism-related processes in white adipose tissue. We validated our approach through comparison with a global proteome survey across the tissues, work that we also provide as a general resource for the community.
Management of Blunt Splenic Injuries in the Setting of Low Trauma Volume: Challenges and Perspectives

The management of Blunt Splenic Injury (BSI) has changed overtime and Non Operative Management (NOM) is the standard of care. This study reports the experience of the American University of Beirut Medical Center (AUBMC) in the management of (BSI) since the establishment of a trauma team in 2010.
Treatment of Blepharospasm and Oromandibular Dystonia with Botulinum Toxins

Blepharospasm and oromandibular dystonia are focal dystonias characterized by involuntary and often patterned, repetitive muscle contractions. There is a long history of medical and surgical therapies, with the current first-line therapy, botulinum neurotoxin (BoNT), becoming standard of care in 1989. This comprehensive review utilized MEDLINE and PubMed and provides an overview of the history of these focal dystonias, BoNT, and the use of toxin to treat them. We present the levels of clinical evidence for each toxin for both, focal dystonias and offer guidance for muscle and site selection as well as dosing.
Amino-Functionalized Nitrogen-Doped Graphene-Quantum-Dot-Based Nanomaterials with Nitrogen and Amino-Functionalized Group Content Dependence for Highly Efficient Two-Photon Bioimaging

We fabricated nanomaterials comprising amino-functionalized and nitrogen-doped graphene quantum dots (amino-N-GQDs) and investigated their photostability and intrinsic luminescence in the near-infrared spectrum to determine their suitability as contrast agents in two-photon imaging (TPI). We observed that amino-N-GQDs with a higher amount of bonded nitrogen and amino-functionalized groups (6.2%) exhibited superior two-photon properties to those with a lower amount of such nitrogen and groups (4.9%). These materials were conjugated with polymers containing sulfur (polystyrene sulfonate, PSS) and nitrogen atoms (polyethylenimine, PEI), forming amino-N-GQD–PSS–PEI specimens (amino-N-GQD-polymers). The polymers exhibited a high quantum yield, remarkable stability, and notable two-photon properties and generated no reactive oxygen species, rendering them excellent two-photon contrast agents for bioimaging. An antiepidermal growth factor receptor (AbEGFR) was used for labeling to increase specificity. Two-photon imaging (TPI) of amino-N-GQD (6.2%)-polymer-AbEGFR-treated A431 cancer cells revealed remarkable brightness, intensity, and signal-to-noise ratios for each observation at a two-photon excitation power of 16.9 nJ pixel−1 under 30 scans and a three-dimensional (3D) depth of 105 µm, indicating that amino-N-GQD (6.2%)-polymer-AbEGFR-treated cells can achieve two-photon luminescence with 71 times less power required for two-photon autofluorescence (1322.8 nJ pixel−1 with 500 scans) of similar intensity. This economy can minimize photodamage to cells, rendering amino-N-GQD-polymers suitable for noninvasive 3D bioimaging.
Effects of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on all-cause mortality, cardiovascular death, and cardiovascular events among peritoneal dialysis patients

Supplemental Digital Content is available in the text Abstract Background: Based on the International Society for peritoneal dialysis (PD) recommendations, blockade of renin-angiotensin systems with an angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) improves residual kidney function in PD patients. However, the long-term effectiveness of ACEI/ARB use in PD patients has not been fully elucidated. We, therefore, intend to perform a systematic review and meta-analysis to summarize the effects of ACEI/ARB use on long-term mortality, cardiovascular outcomes, and adverse events among PD patients. Methods: This systematic review will include both randomized controlled trials and non-randomized studies in adult PD patients. We also plan to incorporate data from our cohort study in Thai PD population into this review. We will search PubMed, Medline, EMBASE, Cochrane Library, Web of Science, Scopus, CINAHL, and grey literature from inception to February 29, 2019, with no language restrictions. The process of study screening, selection, data extraction, risk of bias assessment, and grading the strength of evidence will be performed independently by a pair of reviewers. Any discrepancy will be resolved through a team discussion and/or consultation with the third reviewer. The pooled effects estimate and 95% confidence intervals will be estimated using DerSimonian-Laird random-effects models. Heterogeneity will be assessed by the Cochran Q test, I2 index and tau-squared statistics. The funnel plots along with the Begg and Egger test and trim and fill method will be performed to investigate any evidence of publication bias. Preplanned subgroup analyses and random-effects univariate meta-regressions will be performed to quantify the potential sources of heterogeneity based on studies- and patient-characteristics. Results: This will be the first systematic review and meta-analysis to summarize the long-term effectiveness of renin-angiotensin system inhibitors in PD populations. Conclusion: In summary, this systematic review and meta-analysis will summarize the effectiveness of ACEI/ARB on long-term mortality, cardiovascular outcomes, and adverse events among adult PD patients by integrated all available evidences. Ethics and dissemination: Based on the existing published data, an ethical approval is not required. The findings will be disseminated through scientific meetings and publications in peer-reviewed journals. PROSPERO registration number: CRD42019129492.
How accurate is the medical record? A comparison of the physician's note with a concealed audio recording in unannounced standardized patient encounters

OBJECTIVES Accurate documentation in the medical record is essential for quality care; extensive documentation is required for reimbursement. At times, these 2 imperatives conflict. We explored the concordance of information documented in the medical record with a gold standard measure. MATERIALS AND METHODS We compared 105 encounter notes to audio recordings covertly collected by unannounced standardized patients from 36 physicians, to identify discrepancies and estimate the reimbursement implications of billing the visit based on the note vs the care actually delivered. RESULTS There were 636 documentation errors, including 181 charted findings that did not take place, and 455 findings that were not charted. Ninety percent of notes contained at least 1 error. In 21 instances, the note justified a higher billing level than the gold standard audio recording, and in 4, it underrepresented the level of service (P = .005), resulting in 40 level 4 notes instead of the 23 justified based on the audio, a 74% inflated misrepresentation. DISCUSSION While one cannot generalize about specific error rates based on a relatively small sample of physicians exclusively within the Department of Veterans Affairs Health System, the magnitude of the findings raise fundamental concerns about the integrity of the current medical record documentation process as an actual representation of care, with implications for determining both quality and resource utilization. CONCLUSION The medical record should not be assumed to reflect care delivered. Furthermore, errors of commission-documentation of services not actually provided-may inflate estimates of resource utilization.
Association of Bio-Inflammatory Markers (CRP, IL-6) with Glucose Level In Obese T2DM Pakistani Patients

Inflammation plays extremely critical and vital role in progression of type 2 diabetes mellitus. Relationship of C-reactive protein and interleukin-6 (IL-6) in obese T2DM and healthy subjects has been premeditated epidemiologically. However, experimental data addressing such concern has scarcely been published from Indian sub-continent. The current study was designed to generate baseline data and to verify existing association between C-reactive protein and IL6 with obesity and uncontrolled progression of T2DM of among Pakistani patients. One hundred fifty T2DM patients (Group I) and fifty healthy subjects with normal levels of CRP and IL-6 (Group II) were included in the study Physical and biochemical parameters were calculated to evaluate the link of bio-inflammatory markers (CRP and IL-6) with uncontrolled T2DM. Physical parameters were observed to be high among obese T2DM subjects than healthy subjects. Serum CRP and IL-6 levels appeared positively correlated to physical parameters. The relationship of CRP and IL-6 with glycaemic control was calculated with HbA1c. It is revealed that both C-reactive protein and IL-6 are sensitive markers in uncontrolled T2DM in obese diabetic patients predicting its severity and may be the rapid progression of diabetic complications. To the best of our knowledge and search through available literature, thisappears isthe first report on relationship between inflammatory sensitive markers (CRP and IL-6) and progression of various T2DM complications among obese T2DM patients in Pakistani population. Need of study Present study needs to finds association, within the indigenous papulation, of elevated biochemical levels of both C-reactive protein and IL-6 with polymorphisms of C-reactive protein and IL-6 genes.
Comparative Study of Segmental Thoracic Spinal Versus Thoracic Epidural Anesthesia for Laparoscopic Cholecystectomy

Background: Laparoscopic cholecystectomy the standard surgery for gallstone disease have been successfully performed under regional anesthetic techniques.In our study we compared thoracic epidural anaesthesia versus segmental thoracic spinal anaesthesia in healthy patients regarding safety, efficacy and complication. Aim and objective: This study was designed to compare and evaluate safety, efficacy ,benefits and complications of conducting laparoscopic cholecystectomy under segmental thoracic spinal versus thoracic epidural anesthesia. Method: Seventy ASA I or II patients undergoing laparoscopic cholecystectomy were randomized into two groups, one group received segmental thoracic spinal anesthesia (TSA) T8-T9 level using 7.5 mg isobaric bupivacaine 0.5% and 25 μg fentanyl with total volume 2ml, other group received thoracic epidural anesthesia (TEA) T8-T9 10 ml of 0.5% isobaric bupivacaine and 25μg fentanyl. Results: Segmental thoracic spinal technique was less technical difficulty (p value 0.017), less shoulder pain (p value0.017 ) more abdominal relaxation ( p value 0.015) than epidural technique (two cases were converted to general anaesthesia in epidural group and one patient in spinal group duo to uncontrollable patient discomfort. The two blocks were effective for surgery with better patient and surgical satisfaction in spinal group recovery. Conclusion: Both segmental thoracic spinal and thoracic epidural anaethesia were safe and effective anaethetic technique for laparoscopic cholecystectomy with less technical difficulty and better abdominal relaxation in spinal group.
Improving Nutrition of Lactating Mothers in a Peri-urban Using Traditional Vegetables. A Case of Mwanamukia in Nairobi

Food production and utilization using urban agriculture goes a long way in fulfilling the human right to food and freedom from hunger as advocated in the International agenda as far back as 1948 that” Everyone has the right to a standard of living adequate for the well-being and health of himself and his family; including food. Food production in lactating mothers household guarantees household food security for all populations. Adequate nutritional status of women is important for good health and increased work capacity of themselves as well as the health of their offspring. Lactating mothers and other vulnerable populations are the ones who suffer most from inequalities in food distribution. This is why household food production becomes the most viable solution especially in lactating mothers’ households. This improves greatly the equation of food availability and accessibility in lactating mothers households. The concept of adequate food is fulfilled by crop production in terms of quantitative terms (i.e caloric sufficiency) and qualitative in terms of (variety, safety and acceptability). Stability of lactating mothers constant food supply is sufficient income, production and transfers of adequate food supplies on continuing basis. Majority of people who cannot meet their nutritional needs live in urban areas especially in the slums. World’s resources are adequate to produce enough food for their populations in the higher-income developed countries. The scale of food production should never be underestimated especially in African urban cities. Conservative estimates suggest that 40% of the African cities are involved in urban agriculture. Studies show that urban farmers consume more vegetables than non-urban farmers. Local food production can be an important source of supply of fresh vegetables for urban populations. Food production can greately improve access to food and dietary diversity thus improving the nutritional status of lactating mothers. The aim of this study was to assess the foods produced and proportion
Maternal Mortality: An Eco-Social Phenomenon that Calls for Systemic Action

the phases commonly associated with joy and hope. though it be an unplanned event for many women, pregnancy usually develops without complications most of the times: mother start together — and well a new phase of their lives. This does not mean that the good outcome was achieved without a signi ﬁ cant number of women experiencing discomfort, stress, anxiety, fear, or even some sadness. These are conditions that, although not desirable, tend to be present during pregnancy, childbirth, and the postpartum period. However, for some women, this is a period of great anguish,suffering,and risk.Riskof intimatepartner violence, of mistreatment in health facilities, of developing physical or psychological sequelae, and risk of dying. of the re ﬂ
Optimization of group size in pool testing strategy for SARS‐CoV‐2: A simple mathematical model

Coronavirus disease (Covid‐19) has reached unprecedented pandemic levels and is affecting almost every country in the world. Ramping up the testing capacity of a country supposes an essential public health response to this new outbreak. A pool testing strategy where multiple samples are tested in a single reverse transcriptase‐polymerase chain reaction (RT‐PCR) kit could potentially increase a country's testing capacity. The aim of this study is to propose a simple mathematical model to estimate the optimum number of pooled samples according to the relative prevalence of positive tests in a particular healthcare context, assuming that if a group tests negative, no further testing is done whereas if a group tests positive, all the subjects of the group are retested individually. The model predicts group sizes that range from 11 to 3 subjects. For a prevalence of 10% of positive tests, 40.6% of tests can be saved using testing groups of four subjects. For a 20% prevalence, 17.9% of tests can be saved using groups of three subjects. For higher prevalences, the strategy flattens and loses effectiveness. Pool testing individuals for severe acute respiratory syndrome coronavirus 2 is a valuable strategy that could considerably boost a country's testing capacity. However, further studies are needed to address how large these groups can be, without losing sensitivity on the RT‐PCR. The strategy best works in settings with a low prevalence of positive tests. It is best implemented in subgroups with low clinical suspicion. The model can be adapted to specific prevalences, generating a tailored to the context implementation of the pool testing strategy.
Uncertainty-Aware Visual Perception System for Outdoor Navigation of the Visually Challenged

Every day, visually challenged people (VCP) face mobility restrictions and accessibility limitations. A short walk to a nearby destination, which for other individuals is taken for granted, becomes a challenge. To tackle this problem, we propose a novel visual perception system for outdoor navigation that can be evolved into an everyday visual aid for VCP. The proposed methodology is integrated in a wearable visual perception system (VPS). The proposed approach efficiently incorporates deep learning, object recognition models, along with an obstacle detection methodology based on human eye fixation prediction using Generative Adversarial Networks. An uncertainty-aware modeling of the obstacle risk assessment and spatial localization has been employed, following a fuzzy logic approach, for robust obstacle detection. The above combination can translate the position and the type of detected obstacles into descriptive linguistic expressions, allowing the users to easily understand their location in the environment and avoid them. The performance and capabilities of the proposed method are investigated in the context of safe navigation of VCP in outdoor environments of cultural interest through obstacle recognition and detection. Additionally, a comparison between the proposed system and relevant state-of-the-art systems for the safe navigation of VCP, focused on design and user-requirements satisfaction, is performed.
Conjunctivitis and COVID‐19: A meta‐analysis

There are sparse data in literature regarding conjunctivitis incidence in COVID-19 and its relationship with disease severity. The objective of this metanalysis was to assess the association between conjunctivitis and the severity of COVID-19 disease. METHODS We performed a meta-analysis with studies that included patients with severe vs non-severe form of COVID-19 infection. Severe COVID-19 infection was defined as severe pneumonia, mortality, acute respiratory distress syndrome (ARDS), use of mechanical ventilation or Intensive Care Unit (ICU) treatment. RESULTS Three studies, including 1167 patients, reported the incidence of conjunctivitis at admission to the hospital. The overall rate of conjunctivitis was 1.1%; it was 3% and 0.7% in severe and non-severe COVID-19 patients, respectively. Patients with severe COVID-19 had an increased incidence of conjunctivitis (O.R.:3.4; 95% C.I.:1.1-10.2; p=0.030). CONCLUSIONS Conjunctivitis is more frequent in severe COVID and may be a warning sign of poor outcomes. This article is protected by copyright. All rights reserved.