Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison of Clinical and Radiographic Success of Rotary with Manual Instrumentation Techniques in Primary Teeth: A Systematic Review

Abstract Aim and objective A systematic review was planned to compare the clinical and radiographic success rate of pulpectomy in primary molars using a rotary system and hand files system. Study design The literature search was undertaken in electronic databases from January 2000 to December 2019 using keywords. Four hundred and forty-two studies were identified after applying limits. Three hundred and thirty-one irrelevant articles were eliminated. Among the 111 articles obtained, 90 articles were eliminated after reading the titles and abstracts. After assessing the full text, 18 articles were eliminated. Randomized controlled trials (RCTs) published in the English language on pulpectomy of primary molars, using hand files and rotary files and with a follow-up period of 12 months were included. Results Three RCTs comparing the clinical and radiographic pulpectomy success rates using rotary and hand files instrumentation were finally selected. Qualitative assessment with RoB 2.0 showed one study had a low risk of bias and two studies had a high risk of bias. Conclusion Pulpectomy procedures in primary teeth using rotary and hand files instrumentation techniques were equally effective in terms of success rates. How to cite this article Natchiyar N, Asokan S, Geetha Priya PR, et al. Comparison of Clinical and Radiographic Success of Rotary with Manual Instrumentation Techniques in Primary Teeth: A Systematic Review. Int J Clin Pediatr Dent 2021;14(1):8–13.
Detection of Molecular Residual Disease Using Personalized Circulating Tumor DNA Assay in Patients With Colorectal Cancer Undergoing Resection of Metastases

PURPOSE More than 50% of patients with stage IV colorectal cancer (metastatic colorectal cancer [mCRC]) relapse postresection. The efficacy of postoperative systemic treatment is limited in this setting. Thus, these patients would greatly benefit from the use of a reliable prognostic biomarker, such as circulating tumor DNA (ctDNA) to identify minimal or molecular residual disease (MRD). PATIENTS AND METHODS We analyzed a cohort of 112 patients with mCRC who had undergone metastatic resection with curative intent as part of the PREDATOR clinical trial. The study evaluated the prognostic value of ctDNA, correlating MRD status postsurgery with clinical outcomes by using a personalized and tumor-informed ctDNA assay (bespoke multiple PCR, next-generation sequencing assay). Postresection, systemic therapy was given to 39.2% of the patients at the discretion of the treating physician. RESULTS Postsurgical, MRD positivity was observed in 54.4% (61 of 112) of patients, of which 96.7% (59 of 61) progressed at the time of data cutoff (hazard ratio [HR]: 5.8; 95% CI, 3.5 to 9.7; P < .001). MRD-positive status was also associated with an inferior overall survival: HR: 16.0; 95% CI, 3.9 to 68.0; P < . 001. At the time of analyses, 96% (49 of 51) of patients were alive in the MRD-negative arm compared with 52.4% (32 of 61) in the MRD-positive arm. Patients who did not receive systemic therapy and were MRD-negative in the combined ctDNA analysis at two time points had an overall survival of 100%. In the multivariate analysis, ctDNA-based MRD status was the most significant prognostic factor associated with disease-free survival (HR: 5.78; 95% CI, 3.34 to 10.0; P < .001). CONCLUSION This study confirms that in mCRC undergoing resection of metastases, postoperative MRD analysis is a strong prognostic biomarker. It holds promises for being implemented in clinical decision making, informing clinical trial design, and further translational research.
Genus Viburnum: Therapeutic Potentialities and Agro-Food-Pharma Applications

The genus Viburnum (Adoxaceae, Dipsacales) is of scientific interest due to the chemical components and diverse biological activities found across species of the genus, which includes more than 230 species of evergreen, semievergreen, or deciduous shrubs and small trees. Although frequently used as an ornament, the Viburnum species show biological properties with health-promoting effects. Fruits, flowers, and barks of certain species are used for pharmaceutical purposes or as cooking ingredients, hence containing biochemical compounds with health-promoting activity such are carotenoids, polyphenols, and flavonoids. However, its taxonomical determination is difficult, due to its wide distribution and frequent hybridizations; therefore, an objective classification would allow us to understand its biological activity based on its phytochemical components. More than sixty phytochemical compounds have been reported, where vibsanin-type diterpenes and their derivatives are the most prevalent. Leaves and twigs of V. dilatatum contain the largest number of phytochemicals among the genus. Through preclinical evidence, this study provides insight regarding antioxidant, antibacterial, anti-inflammatory, cytotoxic, and anticancer activities of genus Viburnum.
Association Between Smoking and COVID-19 Severity: Evidence from Bangladesh

Purpose Previous studies have explored several risk factors for coronavirus disease 2019 (COVID-19) severity, but there is still a lack of association with smoking. Our study aims to find out the association between smoking and COVID-19 severity. Subjects and Methods This comparative study was conducted among hospitalized severely and critically ill COVID-19 patients, as well as asymptomatic, mild, and moderate patients from the list of the city corporation (Dhaka, Bangladesh), as confirmed by reverse-transcription polymerase chain reaction (RT-PCR). A total of 2022 adults aged ≥18 years were enrolled in this study. Results The mean age of the patients was 41.17 years; 66.96% of the patients were male, 57.02% were aged above 35 years, and 81.50% of the patients had ever been married; and 33.09% cases were mild and 14.99% were severe. Among the patients, 29.4% were ever-smokers. Smoking status, duration, and frequency, and the presence of comorbidities were significantly associated with COVID-19 severity (p<0.001). Ever-smokers were 1.35 times (95% CI: 0.74–2.45), 1.30 times (95% CI: 0.58–2.87), and 2.45 times (95% CI: 1.07–5.61) more likely to be mild, severe, and critical cases in comparison to non-smokers. Conclusion This study revealed a strong association between smoking and COVID-19 severity that calls for mass awareness and cessation campaigns from governments and voluntary organizations.
Screening of Depression in Elderly Population Using a Geriatric Depression Scale in the Field Practice Area of Urban Health Training Centre Attached to SMS Medical College, Jaipur

Background and objective: Depression is one of the most common illnesses worldwide, with more than 264 million people affected. Various studies in the elderly population have estimated the prevalence of depression across India, with results ranging from 6% to 62%. The objectives of this study were to estimate the prevalence of depression among the elderly population using a Geriatric Depression Scale (GDS) and to find out the association between various sociodemographic parameters and depression among elderly people. Materials and methods: This cross-sectional study was conducted in the field practice area of Urban Health Training Centre (UHTC), attached to Sawai Man Singh (SMS) Medical College, Jaipur from September 2019 to July 2020 among elderly people. Some 250 participants were interviewed. Results: Depression was present in 41.6% of the study participants. Age group, gender, marital status, educational qualification, type of family, financial dependence, socioeconomic status, and presence of morbidity were significantly associated with the presence of depression among study participants (p<0.05). Conclusion: The prevalence of depression in the urban elderly population was high (41.6%). By identifying risk factors for depression among the elderly population and screening them on time, we can reduce the severity and burden of the disease to a greater extent.
Gig Health vs eHealth: Future Prospects in Saudi Arabian Health-Care System

Introduction The number of gig workers has been rising across the world, reflecting the growing trend toward the gig economy, which is already functioning in various sectors, such as transport(eg, Uber), technology (eg, Appen), and others (eg, Upwork). However, application of gig economy in health care is underresearched, especially in areas of eHealth that can facilitate various online activities and be outsourced. Purpose The purpose of this study was to investigate the gig economy and eHealth in terms of prospects for future health care in Saudi Arabia. Methods Analysis of data collected using online semistructured interviews with 19 experts, including executives from ministries of health and information and communications, physicians, and health-care administrative managers was conducted and new empirical insights are offered. Results A lack of legal and regulatory frameworks and integrating gig culture into the eHealth system were identified to be the major challenges. Improved operational efficiency of health care, reduced costs, and positive societal impact were identified to be the opportunities and benefits of using the gig economy and eHealth in Saudi Arabia. A strategic framework and an effective regulatory framework are essential for integrating the gig economy into the eHealth system in Saudi Arabia and improving future health care by adopting innovative artificial intelligence and machine-learning technologies. Conclusion eHealth has major scope for future health-care operations in Saudi Arabia and use of the gig economy in eHealth may lead to effective management of eHealth operations. More studies are required to evaluate the idea of integrating the gig economy and eHealth and analyze its impact.
Artificial Neural Networks Analysis of polysomnographic and clinical features in Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): from sleep alteration to “Brain Fog”

Study Objectives PANS (pediatric acute onset neuropsychiatric syndrome) is thought to be the result of several mechanisms and multiple etiologies, ranging from endocrine/metabolic causes to postinfectious autoimmune and neuroinflammatory disorders. Sleep disorders represent one of the most frequent manifestations of PANS, involving around 80% of patients. The present study describes the clinical and polysomnographic features in a group of PANS children identifying the relationships between sleep disorders and other PANS symptoms. Methods All participants underwent a clinical evaluation including comprehensive sleep history, polysomnography, cognitive assessment and blood chemistry examination. A data mining approach with fourth-generation artiﬁcial neural networks has been used in order to discover subtle trends and associations among variables. Results Polysomnography showed abnormality in 17 out of 23 recruited subjects (73.9%). In particular, 8/17 children (47%) had ineffective sleep, 10/17 (58.8%) fragmented sleep, 8/17 (47.1%) periodic limb movement disorder (PLMD) and 11/17 (64.7%) REM-sleep without atonia (RSWA). Most subjects presented more than one sleep disturbances. Notably, among the 19/23 patients diagnosed with Tic/Tourette disorder, 8/19 (42.1%) show PLMD and 10/19 (52.6%) RSWA. Artificial neural network methodology and the auto-contractive map exploited the links among the full spectrum of variables revealing the simultaneous connections among them, facing the complexity of PANS phenotype. Conclusion Disordered sleep represents, for prevalence and impact on quality of life, a cardinal symptom in patients with PANS. Thus, considering the weight of sleep disturbances on diagnosis and prognosis of PANS, we could consider the possibility of including them among the major diagnostic criteria.
TaiChi and Qigong for Depressive Symptoms in Patients with Chronic Heart Failure: A Systematic Review with Meta-Analysis

Background Depression is a debilitating comorbidity of heart failure (HF) that needs assessment and management. Along with mind-body exercise to deal with HF with depression, the use of TaiChi and/or Qigong practices (TQPs) has increased. Therefore, this systematic review assesses the effects of TQPs on depression among patients with HF. Methods Randomized controlled trials (RCTs) that examined the effect of TQPs on depression in patients with HF were searched by five databases (PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, CINAHL, and China National Knowledge Infrastructure (CNKI)). With standardized mean difference (SMD) and 95% confidence intervals (95% CI), random-effects meta-analyses of the effect of TQPs on depressive symptoms were performed. Results Of eight included RCTs, seven (481 patients) provided data for the meta-analysis. The pooling revealed that TQPs contribute to depression remission in HF (SMD −0.66; 95% CI −0.98 to −0.33, P < 0.0001; I2 = 64%). Its antidepressive effect was not influenced by intervention duration or exercise setting, but rather by ejection fraction subtype, depressive severity, and depression instruments. The beneficial effects were preserved when the study with the largest effect was removed. Conclusion This study suggests that TQPs might be a good strategy for alleviating depressive symptoms in patients with HF. And rigorous-design RCTs, which focus on the identified research gaps, are needed to further establish the therapeutic effects of TQPs for depression in HF.
Evaluation of the Prognostic Value of Lactate and Acid-Base Status in Patients Presenting to the Emergency Department

Background Lactate levels predict mortality in a wide range of patients presenting to the Emergency Department (ED); however, the effect of co-existing acidosis is unknown. Here, we investigated the effect of acidosis on in-hospital mortality for patients with hyperlactataemia. Methodology This is a retrospective cohort study of adults cared for in the resuscitation area of one ED who received a metabolic panel on arrival. The primary outcome was in-hospital mortality for patients with normal lactate (0.0-2.0 mmol/L), intermediate lactate (2.1-4.0 mmol/L), or high lactate (>4.0 mmol/L), with and without acidosis. Odds ratios (ORs) were calculated to assess the differences in mortality rates between groups stratified by lactate and acid-base status. Results A total of 4,107 metabolic panels were collected and 3,238 were assessed. In total, 510 (15.8%) and 784 (24.2%) patients had a normal lactate and acidosis/no acidosis; 587 (18.1%) and 842 (26.0%) had intermediate lactate and acidosis/no acidosis; and 388 (12.0%) and 127 (3.9%) had high lactate and acidosis/no acidosis, respectively. The overall mortality was 5%. Mortality was 4.3%/0.6% in the normal lactate, 5.6%/2.6% in the intermediate lactate, and 19.3%/3.9% in the high lactate groups, with and without acidosis, respectively. Combining base excess <-6 and lactate >4 mmol/L had a sensitivity of 39%, specificity of 96%, positive predictive value of 32%, and negative predictive value of 98% for in-hospital mortality (OR: 14.0; 95% confidence interval: 9.77-20.11). Conclusions In an undifferentiated cohort of ED patients presenting to the resuscitation area lactaemia associated with acidosis is a more accurate predictor of in-hospital mortality than hyperlactataemia.
Evaluation of Nutrients Intake for a Group of Jordanian Older Adults with Sarcopenia Syndrome in Amman: An Explorative and Pilot Study

Aim Sarcopenia is an age-related syndrome that is characterized by a progressive loss of muscle mass, strength, and function. This study was performed in order to evaluate nutrients intake and physical activity level and to investigate the effect of sarcopenia syndrome on food intake for a group of Jordanian older adults with sarcopenia syndrome in Amman. Methodology. The study sample consisted of 25 nonsarcopenic people and 25 sarcopenic patients aged over 60 years old with a male to female ratio of 1 : 1. A special questionnaire was used to collect demographic data, health data, data about syndrome characteristics, nutritional assessment, and physical activity level. A 24-hour recall was also used to collect food intake data. Body weight, height, and skinfold thicknesses were measured. Results The mean of the sarcopenic patients' age was 77.5 ± 6.9 years, and the mean of the weight was significantly lower in sarcopenic patients than the nonsarcopenic people. In this study, all macronutrients and micronutrients from dietary intake information were analyzed. Vitamin intake (water- and fat-soluble), as well as minerals (major and trace), amino acids, and essential fatty acids, was assessed. The mean intake of energy and carbohydrates, fat, and dietary fiber was lower than their recommendations, while the mean intake of protein was within the range of its recommendations in the sarcopenia group. The mean of the intake of omega 3 and omega 6 was below their recommendations. Conclusion It could be concluded that sarcopenic older patients in Jordan have similar characteristics with patients studied worldwide with regard to age of patients, female to male ratio, and main symptoms. Sarcopenic older patients in Jordan generally have lower weight and BF% than nonsarcopenic adults and have inadequate dietary intake compared to their recommendations and compared to nonsarcopenic older adults. Therefore, the diet of sarcopenic patients needs modification and follow-up. The level of physical activity and daily living activities for sarcopenic older patients is lower than that of nonsarcopenic older adults.
Nonablative, Noncoagulative Multipolar Radiofrequency and Pulsed Electromagnetic Field Treatment Improves Vaginal Laxity and Sexual Function

Objective: This study investigated nonablative/noncoagulative multipolar radiofrequency and pulsed electromagnetic field (RF/PEMF) treatment for vaginal laxity (VL) and its impact on sexual function in parous women. Methods: This prospective, open-label single-center study enrolled 34 female subjects, 23–59 years of age, with ≥1 vaginal delivery and self-reported VL. Three monthly intravaginal treatments with RF/PEMF energy were performed. Treatment and follow-up assessments included the vaginal health index (VHI), vaginal pH, female sexual function index (FSFI), and VL/sexual satisfaction (SS) and subject satisfaction scores. Mean score and percent improvement over baseline were reported. Subject discomfort/pain was assessed after each treatment. Results: Total and each individual domain scores of the VHI improved significantly, while vaginal pH levels decreased from baseline to both 1 and 4 months (p < 0.01) after the last treatment. FSFI (<0.001), VL (<0.001), and SS (<0.001), including overall satisfaction scores (<0.01), improved post-treatment, with positive effects further sustained until at least 4 months post-treatment. Pain/discomfort post-treatment was reported as none to mild. No noticeable adverse events (AEs) or unanticipated side effects were reported. Conclusions: Nonablative/noncoagulative multipolar RF/PEMF is safe and is associated with significant 1- and 4-month post-treatment improvements in symptoms associated with VL and sexual dysfunction, as assessed by the VHI, vaginal pH, FSFI, and VL subject satisfaction score. SS and overall satisfaction scores also improved. The treatment was well tolerated with no or little pain, and no adverse events were reported. Clinical Trial Registration number: NCT04607798.
Effect of Traditional Chinese Medicine Therapy on the Trend in CD4+ T-Cell Counts among Patients with HIV/AIDS Treated with Antiretroviral Therapy: A Retrospective Cohort Study

This retrospective cohort study was conducted to explore the effect of traditional Chinese medicine (TCM) therapy on the long-term trends in CD4+ T-cell count among patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) who were treated with combined antiretroviral therapy (cART) over a 14-year period. A total of 721 individuals were treated with cART alone (cART group), and 307 individuals were treated with both cART and TCM (TCM + cART group). Among all enrolled patients with HIV/AIDS, 99.5% were farmers, 71.1% had more than 6 years of education, and 96.8% were infected with HIV via a paid blood donation. For those patients with HIV/AIDS who had a baseline CD4+ T-cell count of <350 cells/mL, the CD4+ T-cell count tended to increase to approximately 350 cells/mL more rapidly in the TCM + cART group than in the cART group, but when the baseline CD4+ T-cell count was ≥350 cells/mL, there was no difference between the cART and TCM + cART groups. For other patients with HIV/AIDS who had a baseline CD4+ T-cell count of 350–500 cells/mL, the CD4+ T-cell counts tended to increase slightly, but there was no difference between the two groups. For patients with HIV/AIDS who had a baseline CD4+ T-cell count of ≥500 cells/mL, the CD4+ T-cell counts tended to be maintained at a particular level, with no difference between the two groups. The results show that the effect of TCM on the CD4+ T-cell counts of patients with HIV/AIDS is related to the CD4+ T-cell level at the time of initial treatment. TCM can increase the CD4+ T-cell count among patients with HIV/AIDS who have a baseline CD4+ T-cell count of <350 cells/mL. Sex and age have a slight influence on the therapeutic effect of TCM.
Via Sapientiae Via Sapientiae

The efficiency and generalizability of a deep learning model is based on the amount and diversity of training data. Although huge amounts of data are being collected, these data are not stored in centralized servers for further data processing. It is often infeasible to collect and share data in centralized servers due to various medical data regulations. This need for diversely distributed data and infeasible storage solutions calls for Federated Learning (FL). FL is a clever way of utilizing privately stored data in model building without the need for data sharing. The idea is to train several different models locally with same architecture, share the model weights between the collaborators, aggregate the model weights and use the resulting global weights in furthering model building. FL is an iterative algorithm which repeats the above steps over defined number of rounds. By doing so, we negate the need for centralized data sharing and avoid several regulations tied to it. In this work, federated learning is applied to gaze recognition, a task to identify where the doctor’s gaze at. A global model is built by repeatedly aggregating local models built from 8 local institutional data using the FL algorithm for 4 federated rounds. The results show increase in the performance of the global model over federated rounds. The study also shows that the global model can be trained one more time locally at the end of FL on each institutional level to fine-tune the model to local data.