Miracle-dz/UniFAR-FTUs huggingface dataset:
Perioperative Hyperglycemia Increases Risk for Deep Wound Infection after Major Orthopedic Surgery

Total hip and knee replacement surgery are one of the most frequent major surgeries performed in USA. In 2002, the number of primary hip and knee arthroplasty was 119,000 and 381,000, respectively. (1) By year 2030 the number is projected to increase to 572,000 and 3,481,000, respectively. (2) Deep wound infection after major orthopedic surgery is one of the most serious complications causing increase in morbidity and mortality and health care costs. (3) Various risk factors for developing infection after hip and knee replacement surgery were described including age, ASA PS status, obesity, patients’ comorbidities and surgical technique factors. (4,5,6,7) Perioperative hyperglycemia may increase the risk for infection after the surgery,(8) but it is unknown if increases the risk after major orthopedic surgery. We investigated whether high blood glucose increases a risk for periprosthetic joint infection (PJI) after total hip and knee arthroplasty.
Multidrug resistance mechanism in colorectal cancer therapy: Study progress

Colorectal cancer is one of the most common malignant tumors in the digestive tract and the morbidity increase annually. Surgery is still the main method for treating colorectal cancer, supplemented by chemotherapy. However, chemotherapy resistance is the predominant cause for failed chemotherapy treatment against colorectal cancer. Exploring the resistance mechanisms against existing chemotherapy may be a key step for getting more effective chemotherapies against malignancies. The underlying mechanisms of resistance are complicated and interfered by numerous factors. This paper summarized the previous studies focusing on drug resistance mechanism, with the emphasize factors including mediation of membrane transporter proteins, abnormal changes in the activity of drug resistance-related transferase, apoptosis-related regulation, DNA repair, changes in microenvironment, and signal transduction pathways and activating transcription factors. DOI: 10.11855/j.issn. 0577-7402.2019. 07.16
Brain-Computer Interface Channel-Selection Strategy Based on Analysis of Event-Related Desynchronization Topography in Stroke Patients

In the last decade, technology-assisted stroke rehabilitation has been the focus of research. Electroencephalogram- (EEG-) based brain-computer interface (BCI) has a great potential for motor rehabilitation in stroke patients since the closed loop between motor intention and the actual movement established by BCI can stimulate the neural pathways of motor control. Due to the deficits in the brain, motor intention expression may shift to other brain regions during and even after neural reorganization. The objective of this paper was to study the event-related desynchronization (ERD) topography during motor attempt tasks of the paretic hand in stroke patients and compare the classification performance using different channel-selection strategies in EEG-based BCI. Fifteen stroke patients were recruited in this study. A cue-based experimental paradigm was applied in the experiment, in which each patient was required to open the palm of the paretic or the unaffected hand. EEG was recorded and analyzed to measure the motor intention and indicate the activated brain regions. Support vector machine (SVM) combined with common spatial pattern (CSP) algorithm was used to calculate the offline classification accuracy between the motor attempt of the paretic hand and the resting state applying different channel-selection strategies. Results showed individualized ERD topography during the motor attempt of the paretic hand due to the deficits caused by stroke. Statistical analysis showed a significant increase in the classification accuracy by analyzing the channels showing ERD than analyzing the channels from the contralateral sensorimotor cortex (SM1). The results indicated that for stroke patients whose affected motor cortex is extensively damaged, the compensated brain regions should be considered for implementing EEG-based BCI for motor rehabilitation as the closed loop between the altered activated brain regions and the paretic hand can be stimulated more accurately using the individualized channel-selection strategy.
Long-term outcomes of mediastinoscopic esophagectomy in early esophageal squamous cell carcinoma: 269 cases study

Background Studies in larger populations and long-term outcomes of Mediastinoscopic esophagectomy (ME) were needed. The aim of this study was to report the long-term survival and surgical process for reducing the postoperative complications after ME. Methods From December 2005 to March 2018, 269 patients diagnosed with esophageal squamous cell carcinoma were participated for ME in our center, while we improved the surgical process in November 1st 2014, clinical data was collected and analyzed. Results The overall survival rate after ME was 60.3% at 10-year and 69.2% at 5-year, and the survival curve was markedly associated with T and N stages. N2–3 stage resulted in lower survival time, while the median survival was 36 months. After Nov. 2014, the positive rate of lymph nodes around left recurrent laryngeal nerve (LRLN) was increased from 6.7% to 14.5% (P<0.05), and the morbidity of vocal cord paralysis decreased from 9.8% to 3.9% (P<0.05), while the incidence of anastomotic fistula decreased from 15% to 5.3% in ME (P<0.05), compared with the data before Nov. 2014. Conclusions ME was an effective surgical method for esophageal cancer. The processes of isolating and marking the LRLN and reinforcing the posterior wall of anastomosis were proved valuable for improvement of postoperative complications.
Mental Health Promotion: Paradigms and Practice

Part One - Defining the Field: 1 Mental Health. 2 Health Promotion. 3 Mental Health Promotion. 4 Community. 5 Community Mental Health Promotion. Part Two - Developing the Field: 6 Mental Health Policy. 7 Mental Health Assessment. 8 Mental Health Consultation. 9 Mental Health Education and Training. Part Three - Breaking Out of the Field: 10 Beyond Mental Health Promotion. Appendices: Notes on Community Organizing Mental Health Promotion Targets A Job Description for Community Mental Health Promotion Mental Health Promotion Courses.
Temporary remission of advanced hepatocellular carcinoma in a patient treated with sorafenib therapy alone - A case report and literature review

Hepatocellular carcinoma (HCC) is a primary liver tumor which has been increasing in incidence over the past several years [1], and is the second leading cause of cancer death in the world [2]. Advanced HCC usually carries a poor prognosis. Over the past decade, systemic therapy for HCC has been evolving rapidly offering more therapeutic options and longer survival for those with incurable HCC. Here, we report a case of advanced HCC treated with single agent sorafenib and achieved complete radiographic response. In this article, we also provide a summary of current status of systemic therapy for HCC. *Correspondence to: Yixing Jiang, Marlene and Stewart Greenebaum Cancer Center, University of Maryland Medical Center, Baltimore, USA, E-mail: yjiang@umm.edu
c-Met overexpression in breast cancer with positive axillary lymph node

Background: Breast cancer is the second most common cancer in the world and is the most epidemic cancer in women, with approximately 1.67 million cases. Metastasis of tumor cells to other organs is a major cause of the increasing trend of mortality in breast cancer. This study aims to analyze the expression of c-Met associated with metastasis to axillary lymph nodes in invasive breast cancer.Method: The research was conducted at the Laboratory of Anatomical Pathology of Hasanuddin University Hospital. Stratified sampling was performed from January 2014 - January 2019. Immunohistochemical staining technique was applied upon 66 collected samples, followed by evaluating the c-Met expression score in invasive breast cancer group with positive and negative lymph node status.Result: c-Met overexpression was found among the invasive breast cancer incidence with lymph node metastasis. Among 50 cases with c-Met overexpression (c-Met positive), 40 cases (80%) of invasive breast cancer with lymph node metastasis were identified, while 10 cases (20%) were found in invasive breast cancer without metastasis to lymph nodes. On 16 cases with negative c-Met, 3 cases (18.8%) were found in invasive breast cancer with lymph node metastasis, and 13 cases (81.3%) in invasive breast cancer without metastasis to the lymph nodes. The statistical test results indicated a significant correlation between c-Met expression scores and metastasis to axillary lymph nodes in invasive breast cancer (p <0.001). Conclusion: As one of biomarkers, c-Met overexpression plays a vital role in the treatment of patients with invasive breast cancer to predict patient outcomes and to determine modalities. It is possible to apply c-Met overexpression to investigate aggressiveness of metastatic tumor cells in the future.
Study of histopathological and biochemical effect of Punica granatum L. extract on streptozotocin -induced diabetes in rabbits

This study was undertaken to determine the antidiabetic effects of oral administration of Punica granatum L. extract on serum and tissues of streptozotocin induced diabetic rabbits at 100 mg/kg. The present study was carried out at the Faculty of veterinary Medicine, Tikrit University, from February to August 2017 for 10 weeks. For this purpose, 30 rabbits were randomly separated into three groups, each containing 10 animals: Group 1, healthy control rabbits; Group 2, diabetic rabbits received streptozotocin (STZ, 65 mg/kg); Group 3, diabetic rabbits treated with PS extract (the 100 mg PS+1 ml DW) for 21 days. At the end of experiment, blood samples were taken for measuring serum biochemical parameters. For histopathological evaluation, sections of kidneys were fixed in 10% buffered formalin and 5micron thick sections with H&E stain were prepared using routine histopathological techniques. The treatment revealed that PSE extract significant decreased serum glucose thrombospondin-1, nitric oxide, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase alkaline phosphatase, and C-reactive protein in diabetic treated rabbits as compared to diabetic rabbits. Histopathology of kidney showed lesions similar to human glomeruloscleroses, glomerular membrane thickening, arteriolar hyalinization and tubular necrosis. From the above one can conclude that PSE extract possess nephroprotective effect in experimentally induced diabetic rabbits.
Clinical significance of MET gene amplification in metastatic or locally advanced gastric cancer treated with first-line fluoropyrimidine and platinum combination chemotherapy

Objective To investigate the clinical significance of MET gene amplification in patients with gastric cancer in the palliative setting. Methods MET amplification was assessed using fluorescence in situ hybridization (FISH) in 50 patients and quantitative polymerase chain reaction (qPCR) in 326 patients; 259 patients treated with first-line fluoropyrimidine and platinum were included for survival analysis. Results The results of FISH and qPCR indicated that the c-MET/CEP7 ratio was correlated with gene copy number. The optimal cutoff value for the copy number using qPCR to detect MET gene amplification with FISH was 5 (κ=0.778, P<0.001). Twenty-one out of 326 patients (6.4%) were identified asMET amplification with a copy number of >5 detected by qPCR. MET-amplified gastric cancer was associated with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) score of ≥2 (33.3% vs. 10.5% P=0.007), peritoneal metastasis (76.2% vs. 46.2%, P=0.008), and elevated bilirubin levels (28.6% vs. 7.3%, P=0.006). The median overall survival (OS) and progression-free survival (PFS) were 11.9 and 5.6 months, respectively. MET-amplified gastric cancer was not associated with survival outcomes [hazard ratio (HR)=0.68, 95% confidence interval (95% CI): 0.35−1.32, P=0.254 for PFS; HR=0.68, 95% CI: 0.35−1.32, P=0.251 for OS]. Conclusions qPCR can be used to detect MET gene amplification. MET amplification was not a predictor of poor prognosis in patients with metastatic or unresectable gastric cancer.
The Effect of Sulpiride and Food Restriction on Depression and Anxiety Control in Adult Male Rats

Published online: 18 August 2019 Background and Aim: Food restriction (FR) affects on depression and anxiety behavior. Previous studies have pointed to the role of sulpiride in the treatment of depression and anxiety. The purpose of this study was to determine the role of dopaminergic system and food restriction on depression and anxiety. Materials and Methods: Forty two adult male Wistar rats (180-220g) were divided into 7 groups including: control, sham, 25%, 50%, 75% FR, 75% FR with sulpiride and sulpiride(50μg/rat). The treatment period was 21 days. Day 19 surgery and cannulation was performed and Sulpiride was injected intracrebroventricularly (icv) on the 21st day. Depression and anxiety tests (Tail suspension test and Elevated Plus Maze), was taken from the rats on the 21st day. Data were analyzed by ANOVA test. Ethical Considerations: Ethical points were observed according to the declaration of Helsinki and acts of Bioethics Committee at Urmia University (Ref No: AECVU-180-2018). Findings: Mobility time in FR groups and sulpiride compared to control and in 75% with sulpiride compared to 75% had significant increase. immobility time in FR and sulpiride had significant decrease compared to control. Open arm entry in 75% FR had significantly decreased compared to control and in 75% FR with sulpiride had significantly increased compared to 75%. Open arm spend time in 75% FR with sulpiride had significant increase compared to 75%. Motor activity was reduced in FR groups and injection sulpiride. Conclusion: It seems that sulpride and FR play a role in improving semi-depression circumstances. Sulpiride also play a role in controlling the anxiety behavior induced by FR. Keywords
Advances of FDA Approved Drugs that Target PD-1 and PD-L1 for Cancer Immunotherapy

Cancer is a lethal disease and is one of the leading causes of death in the world. Though there have been enormous leaps in the field of cancer treatment and prolonged patient survival rate, new therapies are still in high demand. Cancer immunotherapy is an emerging field in cancer treatment especially for patients with late stage cancers that had few options previously. Cancer immunotherapy is composed of CAR-T cell therapy, immune checkpoint inhibitors (ICI), and cancer vaccines. ICIs are monoclonal antibodies, which are used to block certain immune checkpoint from binding with tumor cells, preventing the shutdown of the T-cell. As of now, there have been 6 ICIs approved for many different cancer indications that target the proteins, PD-1, PD-L1 and CTLA-4 that have significantly increased patient response rates in recent years. In this review, the concept, history, recent advances in ICIs, and existing commercial drugs and their response rates in different cancer indications were summarised; the advantages and disadvantages of ICI treatment in cancer were also discussed.
Interpregnancy Interval and Neonatal Outcomes

Objectives: Interpregnancy interval (IPI), the time period between the end of one pregnancy and the conception of the next, can have a significant impact on maternal and infant outcomes. This study examines the relationship between interpregnancy interval and neonatal outcomes of low birth weight, preterm birth, and specific neonatal morbidities. Study Design: Retrospective cohort study comparing neonatal outcomes across 6 categories of IPI using data on 202,600 cases identified from Arizona birth certificates and the Newborn Intensive Care Program data. Comparisons between groups were made using odds ratios and 95% confidence intervals, and multivariable logisitic regression analysis. Results: Interpregnancy intervals of < 12 months and ≥ 60 months were associated with low birth weight, preterm birth, and small for gestational age births. The shortest and longest IPI categories were also associated with specific neonatal morbidities, including periventricular leukomalacia, bronchopulmonary dysplasia, intraventricular hemorrhage, apnea bradycardia, respiratory distress syndrome, transient tachypnea of the newborn, and suspected sepsis. Relationships between interpregnancy interval and specific neonatal morbidities did not remain significant when adjusted for birth weight and gestational age. Conclusions: Significant differences in neonatal outcomes (preterm birth, low birth weight, and small for gestational age) were observed between IPI categories. Consistent with previous research, interpregnancy intervals < 12 months and ≥ 60 months appear to be associated with increased risk of poor neonatal outcomes. Any difference in specific neonatal morbidities between IPI groups appears to be mediated through increased risk of low birth weight and preterm birth by IPI. Table of
PTU-114 Learning from adverse events: A study of JAG endoscopy units

Introduction To meet JAG accreditation standards, endoscopy services are expected to have processes to identify, respond to and learn from adverse events (AEs). Units provide evidence to demonstrate they have met the set standard through audits of mortality and readmission after endoscopy. We conducted the first analysis of UK-wide learning outcomes from AEs based on mortality and readmission data. The aims were to understand how evidence is collected, describe relevant learning outcomes and resultant actions and processes used to share learning. Methods A retrospective analysis of JAG 30-day mortality and 8-day readmission evidence from 2013–2018 was undertaken, assessing methods of data collection and documentation of learning outcomes. Data from evidence files were extracted and thematically analysed to identify and categorise learning outcomes and action points. This study was approved by the JAG research committee. Results Complete data was available for 59 units. 42 units (71%) used the JAG audit proforma in providing evidence. Where no JAG proforma was utilised, data was sourced from other audit summaries (14%), PowerPoint slides (8%) or other tabulated data (7%). 35 units (59%) documented learning outcomes following readmission or mortality, with 85% stating that outcomes were discussed in a formalised meeting. Learning outcomes and action points are summarised below:Abstract PTU-114 Table 1 Learning Outcomes Action Points High-risk patients 1. Increasing numbers• Case selection• Clear communication• Clear documentation• Careful planning Pre-assessment • Screening renal function• Screening patients with renal impairment• Clear instruction for bleeding risks Endoscopist factors • Decision-making- Therapy- Procedure cessation• Knowledge• Skills Systems • Updating referral pathways• Updating vetting pathways• Review of bowel preparation protocols• Updating patient information leaflets• Post-procedure safety-netting Training • Guidance updates• Upskilling• Nurse education Improving AE Data • Real time data analysis• Increasing audit frequency Shared Learning & Feedback • Face-to-face feedback• Email feedback• Promoting reflective practice• Unit meetings Conclusions Learning outcomes centre around managing high-risk patients, pre-assessment and endoscopist factors. Developing systems and training are actions in direct response to learning outcomes. Refining data collection methods was identified as a way to improve learning from AEs. There were a variety of methods to disseminate learning and feedback to endoscopists but no discernible mechanisms to share learning between units were identified. There needs to be a more robust way of collecting and collating endoscopy AE data, with a focus on shared learning between services.
Preoperative instructions and postoperative care in the 21 st century

The preoperative and postoperative management of patients undergoing right hemicolectomy for colon cancer has undergone significant change in the 20th century. From a time where a postoperative stay of 10 days was not uncommon, patients are now routinely discharged on postoperative day 2–3, and same day colectomy is also practiced in some centers. Enhanced recovery programs are standard practice and their guidelines are developed from a strong evidence base around perioperative management and recovery. The preoperative visit is increasingly important and is used to identify modifiable risk factors such as malnutrition, anemia, smoking, and alcohol abuse. Detailed counselling and preoperative education should also be undertaken so patients are psychologically prepared for their cancer surgery and have clear expectations and goals for their recovery. Nausea and vomiting postoperatively is a common cause of delayed discharge. Patients at risk should be identified preoperatively and treated prophylactically. Prehabilitation is an exciting field in colorectal surgery but its role in right hemicolectomy for colon cancer is limited due the necessary short interval between diagnosis and surgery. Patients should be fasting for the minimal amount of time preoperatively and should be allowed clear carbohydrate containing fluids up until 2 hours before surgery. The intraoperative use of opioids should be minimized and high risk patients should have goal-directed fluid therapy (GDFT). As the majority of right colectomies are performed laparoscopically, TAP blocks should be used instead of epidural analgesia for postoperative pain relief. The routine use of nasogastric tubes or abdominal drains should be avoided. Patients should be mobilized the evening after surgery and diet advanced early to prevent postoperative ileus. In modern colorectal practice, regular audits should be undertaken in the unit to ensure adherence to enhanced recovery programs and to identify areas for improvement.
Turmeric: The genus Curcuma

Turmeric: the genus Curcumanis the first comprehensive monographic treatment on turmeric. It covers all aspects of turmeric including botany, genetic resources, crop improvement, processing, biotechnology, pharmacology, medicinal and traditional uses, and its use as a spice and flavoring. Bringing together the premier experts in the field from India, Japan, UK, and USA, this book offers the most thorough examination of the cultivation, market trends, processing, and products as well as pharmacokinetic and medicinal properties of this highly regarded spice. While Ayurveda has known for millennia that turmeric cleanses the body, modern science has now discovered that it produces glutathione-s-transferase that detoxifies the body and therefore strengthens the liver, heart, and immune system. By comparing traditional uses with modern scientific discoveries, the text provides a complete view of the medicinal value and health benefits of turmeric. Heavily referenced with an exhaustive bibliography at the end of each chapter, the book collects and collates the currently available data on turmeric. Covering everything from cultivation to medicine, Turmeric: the Genus Curcuma serves as an invaluable reference for those involved with agriculture, marketing, processing or product development, and may function as a catalyst for future research into the health benefits and applications of turmeric.
SOP Prähospitale Schlaganfallversorgung

FandlerIm Gegensatz zu anderen Notfällen ist beim Schlaganfall eine gezielte kausale Therapie nur im Krankenhaus möglich – die bestmögliche prähospitale Behandlung stellt dennoch einen besonders wichtigen Teil der Versorgungskette von Schlaganfallpatienten dar. Vier Punkte haben hierbei eine besondere Relevanz: Stabilisierung der Vitalfunktionen, Erhebung einer kurzen, spezifischen Anamnese, gezielte neurologische Untersuchung und der rasche avisierte Transport in ein geeignetes Krankenhaus mit Stroke Unit.