Miracle-dz/UniFAR-FTUs huggingface dataset:
Analysis of blood parameters in relation to the risk of cardiovascular disease for older population in Kelantan

Cardiovascular disease (CVD) is known to be the leading cause of morbidity and mortality worldwide and its complication is increasing among older people. Blood parameters including blood pressure (BP), glucose (BG), cholesterol (CHL) and uric acid (UA) are important aspects in maintaining a good condition of the cardiovascular system. The aim of this study is to determine the reference values of blood parameters among older population as well as to assess the association of CVD risk factors with the factors of age, gender and body mass index (BMI). Blood samples were collected from 400 older respondents (≥50 years) in Kota Bharu, Kelantan. The findings showed that respondents aged ≥60 years had significantly higher levels of BP and UA, but lower CHL than 50-59 years respondents (p<0.05). The males had significantly higher BP and lower CHL than the females (p<0.05). The respondents with BMI of ≥25 kgm-2 had significantly higher BP and BG than the respondents with BMI of <25 kgm-2 (p<0.05). There were significant associations between BP-BG, BG-UA and CHL-UA. It can be concluded that the levels of blood parameters are affected by the factors of age, gender and BMI.
Cancer of Unknown Primary: A Review on Clinical Guidelines in the Development and Targeted Management of Patients with the Unknown Primary Site

Cancer of unknown primary (CUP) is a malignant widespread metastatic disease without an identifiable primary site after extensive clinical investigation. Recently, a decline is observed in the diagnosis of CUP, mainly due to improvement in detection of the primary tumors, thus decreasing the unknown primaries. Worldwide, CUP is the sixth to eighth most common malignancy, accounting for 2.3% to 5% of a new cancer diagnosis. CUP is third to fourth most common cause of death due to cancer-related mortality. The prognosis of CUP is depressing with the median survival of three to six months in the previous studies, but according to recent studies, median survival is less than one year. High risk for developing CUP is seen in heavy smokers (26 or more cigarettes/day) and individuals with the lowest quartiles of waist circumference. A weak association is observed with the use of alcohol consumption and low level of education. Human papillomavirus DNA plays a role in those with squamous cell carcinoma of unknown primaries in head and neck regions. In the diagnosis of CUP, comprehensive medical history, complete physical examination (including genitourinary, rectal exam, and breast examination in women) and necessary laboratory tests are crucial. Whole-body positron emission tomography-computed tomography (PET/CT) is the investigation of choice to assess the entire body for CUP. Multiparametric 3T-MRI (MP-MRI) is used to examine the local soft tissue status, helps in the staging of the tumor, and to determine the extent of involvement of tissue for medical as well as prognostic purposes. Immunohistochemistry outlines the specific markers, including caudal-related homeobox protein (CDX2), homeobox protein Nkx-3.1 (NKX3-1), paired box gene 8 (PAX8), special AT-rich sequence-binding protein 2 (SATB2), thyroid transcription factor 1 (TTF-1), and splicing factor 1 (SF1) with the focus on the effectiveness of lineage-restricted transcription factors. Patients response to treatment can be evaluated by the gene expression profiling (GEP) test that also predicts tissue of origin (TOO). Tumor identified through gene profiling is sensitive to platinum/taxane therapy, others that are not TOO tumors are resistant to platinum/taxane. The new therapeutic method based on molecular profiling is associated with higher treatment response. In comprehensive genomic profiling, it is observed that there is at least one clinically appropriate genomic alteration in CUP that can influence the targeted therapy. The targeted therapeutic approach will not only improve the disease outcome but will also be cost-effective and save time from finding the primary site.
Vaginal spermicides: some current concerns.

Nonoxynol-9 is the active ingredient in most vaginal spermicides in the UK. Spermicides separate the head and midpiece regions of spermatozoa rendering them immobile. Yet nonoxynol-9 does not diffuse into cervical mucus thus not retaining its spermicidal activity. For example when a concentration of nonoxynol-9 that kills 100% of the sperm in semen is in mucus only 50% of the sperm are killed. This may explain the high contraception failure rate (4-25%) for vaginal contraception when not used with barrier methods. On the other hand chlorhexidine represents the 2nd generation of spermicides. It disperses well in mucus and retains spermicidal activity. It also stays in the vagina longer than nonoxynol-9 which lengthen spermicidal activity time. In vitro studies show that nonoxynol-9 in concentrations present in the vagina after spermicide insertion inactivates HIV and infected lymphocytes. Yet in vivo studies do not demonstrate this same HIV destroying ability. For example prostitutes in Nairobi Kenya who used spermicides experienced HIV seroconversion. Some researchers surmise that high frequency use of spermicides irritate the vagina. It may be the detergent action of spermicides that break down the epithelium or make it difficult for women to notice asymptomatic lesions. Lesions do facilitate entry of HIV. Another possible explanation is that nonoxynol-9 changes vaginal flora causing an increase in growth of pathogens such as Candida. Any infection related inflammation facilitate HIV passage across the epithelium. Despite these negative results of in vivo studies and since the UK spermicide market is presently dependent on nonoxynol-9 confidence in nonoxynol-9 should not be eroded however. Carefully controlled studies in women who do not use it frequently are needed. Chlorhexidine also has anti-HIV properties and does not irritate the vagina.
Technology-enabled assessments to enhance multiple sclerosis clinical care and research.

Background Comprehensive and efficient assessments are necessary for clinical care and research in chronic diseases. Our objective was to assess the implementation of a technology-enabled tool in MS practice. Method We analyzed prospectively collected longitudinal data from routine multiple sclerosis (MS) visits between September 2015 and May 2018. The MS Performance Test, comprising patient-reported outcome measures (PROMs) and neuroperformance tests (NPTs) self-administered using a tablet, was integrated into routine care. Descriptive statistics, Spearman correlations, and linear mixed-effect models were used to examine the implementation process and relationship between patient characteristics and completion of assessments. Results A total of 8022 follow-up visits from 4199 patients (median age 49.9 [40.2-58.8] years, 32.1% progressive course, and median disease duration 13.6 [5.9-22.3] years) were analyzed. By the end of integration, the tablet version of the Timed 25-Foot Walk was obtained in 89.0% of patients and the 9-Hole Peg Test in 94.8% compared with 74.2% and 64.3%, respectively before implementation. The greatest increase in data capture occurred in processing speed and low-contrast acuity assessments (0% prior vs 78.4% and 36.7%, respectively, following implementation). Four PROMs were administered in 41%-98% of patients compared with a single depression questionnaire with a previous capture rate of 70.6%. Completion rates and time required to complete each NPT improved with subsequent visits. Younger age and lower disability scores were associated with shorter completion time and higher completion rates. Conclusions Integration of technology-enabled data capture in routine clinical practice allows acquisition of comprehensive standardized data for use in patient care and clinical research.
Measuring insulin sensitivity and the effect of alternative dietary interventions and exercise on metabolic control

The metabolic syndrome is highly prevalent in western society, and the numbers affected by obesity and diabetes continue to rise. This thesis reviews the mechanisms at play and the gaps in the literature that, if filled, may increase knowledge of treatment regimes for affected individuals. Experimentally, it was demonstrated that the oral glucose tolerance test can be a reliable tool to measure insulin sensitivity following adequate dietary and exercise control. Acute and chronic cinnamon ingestion was shown to improve insulin sensitivity. Feeding frequency was found to alter insulin and ghrelin responses and relationships following mixed-meal ingestion. And finally, postprandial lipaemia was found to be attenuated for up to 24 hours following moderate-intensity exercise, illustrating the requirement of daily exercise. In summary, oral glucose tolerance tests are suitable for experimental interventions; and the clinical management of factors associated with the metabolic syndrome should perhaps consider dietary supplements, meal frequency, and exercise timing in addition to the traditional dietary and physical activity guidelines currently in practice.
Review of Spinal Pedicle Screws

Background: Pedicle screws are medical implants which are implanted posteriorly into the vertebrae of the spine and longitudinally connected to a rod to form a construct which corrects spinal alignment or promotes stabilization. Pedicle screw fixation is considered to be the gold standard of spinal internal fixation due to its many benefits in a variety of debilitating spinal conditions. Objective: The aim of the work is to evaluate the use of spinal pedicle screws for different lesions in the past, in the present and in the future. Conclusion: Some successful applications of pedicle screws include surgical treatment of scoliosis reduction and stabilization of spondylolisthesis, stabilization of unstable spinal fractures, simple lumbar degenerative disc disease, primary or metastatic tumors of the lumbar spine, and surgical revision of symptomatic pseudoarthrodesis of the lumbar region.
The effect of time on apoptosis changes following ischemia-reperfusion in isolated heart of rats

Abstract Background and objective: To study the time-dependent effects of ischemia – reperfusion on myocardium cells. Methodology: Male SD rats (270-330gr) were randomly grouped in four groups of 10 in an experimental study. After anesthesia using pentobarbital sodium (50-60 IP-kg/mg) the rats’ hearts in the treatment groups were isolated immediately and connected to langendorff apparatus with krebs solution at 37oC and a fixed pressure. During stabilization, 30m ischemia and 60, 90, and 120min reperfusion was carried out on the hearts. Hearts of the control group remained intact. Immunhistochemistry of apoptotic cells was performed using TUNEL POD Kit and positive TUNEL myocardium cells of each group, in five microscopic view fields, was counted. The results were represented as mean ± SD. Findings: Apoptotic cell counts in control group was 1±0.4, and this figure in the treatment groups T/60min, T/90min, and T/120min was 2.0±0.5, 3.0±0.3, and 6.0±0.3 respectively. Comparison between the treatment groups and control group was carried out using one-way ANOVA and the results showed no significant difference between the groups T/90min and T/120min and the groups T/60 and control (p>0.05). However, the differences between the groups T/120min and T/60min (p<0.001) and groups T/120min and T/90min (p<0.01) was significant. Conclusion: The study showed that ischemia-reperfusion time can be effective on apoptotic changes of myocardium cells of heart.
Classification of Leukemia Detection in Human Blood Sample Based on Microscopic Images

Copyright © 2019 by author(s) and International Journal of Trend in Scientific Research and Development Journal. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) (http://creativecommons.org/licenses/ by/4.0) ABSTRACT Nowadays, the automatic specific tests such as Cytogenetics, Immunophenotyping and morphological cell classification can identify the leukemia disease by making experienced operators observing blood or bone marrow microscopic images. The early identification of Acute Lymphoblastic Leukemia (ALL) symptoms in patients can greatly increase the probability of recovery. When typical symptoms appear in normal blood analysis, those methods are not included into large screening programs and are applied only. The method of blood cell observation using Cytogenetics and Immunophenotyping diagnostic methods are currently preferred for their great accuracy with respect to present undesirable drawbacks: slowness and it presents a not standardized accuracy since it depends on the operator’s capabilities and tiredness. The detection of leukemia in human blood sample using microscopic images is suitable for low costs and remote diagnosis systems. In this paper presents an implementation of detection and classification of leukemia. The system will use features in microscopic images and examine changes on texture, shape and color analysis. Support Vector Machines (SVM) is used as a classifier, which classifies into cancerous or not. The detection and classification of ALL is implemented with MATLAB programming language.
Major histocompatibility complex class II molecule in non-small cell lung cancer diagnosis, prognosis and treatment

Abstract Lung cancer is one of the commonest cancers in the world. More than 70% of lung cancer patients are diagnosed with non-small cell lung cancer (NSCLC). Major histocompatibility complex class II (MHC class II), an important component in antigen presenting process, usually expresses on professional antigen presenting cells (APCs), and it can be induced by interferon-γ (IFN-γ). MHC class II can be expressed by NSCLC cells. In NSCLC patients, the expression of MHC class II can be correlated with the outcome of anti-programmed death-1 (anti-PD-1) therapy. This review summarizes MHC class II expression in NSCLC and the correlation between MHC class II and NSCLC diagnosis, prognosis and therapy.
Diabetes 4.0 - Untersuchung der Usability moderner Blutzuckermessgeräte

Kurzfassung: Im Rahmen dieser Studie wurde die Usability des ersten an ein Smartphone anschließbaren Blutzuckermessgeräts durch Diabetespatienten unterschiedlichen Alters und unterschiedlicher Technikerfahrung partizipativ untersucht. Gemäß DIN ISO 20282-1 wurden den Probanden gezielte Usabilityaufgaben gestellt, die unter Einsatz der Think-aloudMethode bearbeitet wurden. Zusätzlich wurde für jede gestellte Aufgabe einzeln die mentale Beanspruchung erfasst. Als Kontrollvariablen wurden das Alter, das Geschlecht sowie die Technikaffinität und die Health Literacy erfragt. Insgesamt nahmen an dieser Studie N = 10 Probanden (Durchschnittsalter = 59,6 Jahre) teil. Durch diese Studie können konkrete Gestaltungshinweise und Empfehlungen zur Aufzeichnung und Verwaltung diabetesbezogener Gesundheitsdaten gegeben werden.
The Effect of Nitroglycerine Infusion on Postoperative Pain in Lower Limb Surgery: A Clinical Double-Blind Study

Background Acute postoperative pain causes severe discomfort in patients accompanied by hemodynamic and metabolic instability. Objectives The aim of this study was to evaluate the effects of nitroglycerin addition on the infusion of intravenous analgesia pump in patients with lower limb orthopedic surgery. Methods This study was a double-blind clinical trial conducted on 75 patients with lower limb fracture. Patients were randomly assigned to receive three regimens for postoperative pain control via intravenous analgesia pump, including group A (fentanyl 10mc/kg + 10 mL distilled water), B (fentanyl 10 mc/kg + nitroglycerin 500 mc), and C (fentanyl 10 mc/kg + nitroglycerin 1000 mc). The patients at the beginning of recovery and prior to putting the pain pump at the time of 4, 8, 12, 24, and 48 hours, were assessed with visual analogue scale (VAS) to measure pain and Ramsay scale to measure sedation. Results The results showed that weight, height, and gender distribution were not significantly different in the three groups. The HR, MAP, and VAS mean scores showed a significant difference for intragroup and intergroup differences in the three groups at many times. Conclusions Low dose nitroglycerine, as an adjuvant drug, can be added to intravenous patient-controlled analgesia pump in patients undergoing surgery for better analgesic purposes in patients without underlining disease.
Assessing Certified Registered Nurse Anesthetists’ Attitudes Toward and Barriers to the Use of Evidence-Based Anesthesia Practice

Evidence-based practice is the integration and synthesis of the best research evidence with clinical expertise and patient values. Use of evidence-based practice decreases variability in care and improves patient outcomes. This research project assessed variables that inhibit the adoption of evidence-based practice into individual CRNAs’ practice. Ninety-two CRNAs in Georgia participated in an email survey to assess attitudes and perceived barriers to evidence-based practice. Attitudes toward evidence-based practice were assessed with the Evidence-Based Practice Questionnaire (EBPQ), and perceived barriers to the use of evidence-based practice were assessed with the BARRIERS scale. A Pearson product-moment correlation coefficient was computed to assess the relationship between collected CRNA demographics and each of the instruments. There was a significant and positive correlation between characteristics of the CRNA and CRNA experience (r = .27, n = 69, p = .02), indicating that more experienced CRNAs perceived greater barriers to utilization of EBP. There was also a significant and negative correlation between characteristics of the CRNA and level of education (r =-.34, «=69, p=.005), indicating that as CRNA education increases, perceived barriers to utilization of EBP decrease. No statistical significance was found in relationships between any other CRNA characteristics and perceived barriers.
Association of metabolic syndrome with intravesical prostatic protrusion and international prostatic severity symptoms score in patients with benign prostatic enlargement

Background: Intravesical prostatic protrusion (IPP), a morphological change resulting from enlarged lateral and median lobe of prostate. It could be for assessment of BOO (Bladder outlet obstruction). MetS is one of the causative factors for the development of Benign Prostatic Enlargement (BPE) and associated LUTS. The aim of this study is to assess the association of components of MetS and MetS with IPP, TPV and International Prostatic Severity Symptoms Score (IPSS). Methods: This is a single centre cross-sectional study in Department of Urology, GMCH, Guwahati, Assam, India between March 2016 and May 2018, 114 consecutive men aged >50 years presenting with LUTS suggestive of BPE (PSA 0-4ng/ml). MetS was defined according to International Diabetes Federation criteria. We have analysed IPSS and IPP of these patients. Patients were classified into 3 groups each for IPSS and IPP (IPSS: group I - 0-7, II -8-19, III ->20 and IPP: Group I- <5 mm, II- 5-10 mm, III- >10 mm). Results: We have correlated these groups with each component of MetS and MetS. IPSS group III had significant correlation with hyperglycaemia (HG), hypertriglyceridemia (HTG), hypertension (HTN) and HDL cholesterol (HDL), group II had significant correlation with HG, HTN and HDL and group I had significant correlation with HTN (p<0.001). Similarly, IPP group III had significant correlation with HG, HTG, HTN, obesity and HDL, group II had significant correlation with HG, HTN and obesity and group I had significant correlation with HTN only (p<0.001). Conclusions: We found that patients with higher IPSS and IPP had significant correlation with MetS components.
Rhythmic Masticatory Muscle Activity during Sleep: Etiology and Clinical Perspectives

Approximately 60% of the general adult population experiences rhythmic masticatory muscle activity (RMMA) during sleep. The etiology of this movement is not yet understood. However, it has been demonstrated that an increased frequency of RMMA may have detrimental consequences on the stomatognathic system. In this case, RMMA is considered the manifestation of a sleep-related motor disorder known as sleep bruxism (SB). According to the definition of the International Classification of Sleep Disorders, SB is the activity of tooth grinding and clenching during sleep. The occurrence of SB-related activity, i.e., RMMA, is associated with rises of sympathetic tone, heart rate, blood pressure, and it is frequently concomitant with larger respiratory breaths. All these events can be described within a sleep arousal. The present thesis includes four research articles aimed to study i) the etiology of RMMA during sleep in relation to sleep arousal; and ii) the clinical perspectives of SB assessment and management. To further investigate the etiology of RMMA and its association with sleep arousal fluctuations we analyzed the cyclic alternating pattern (CAP), a scoring method to assess sleep instability and describe sleep arousal pressure. CAP was scored in SB subjects and controls that participated in two experimental protocols in which sleep architecture and stability were altered by either a medication (i.e., clonidine), or sensory stimulations (i.e., vibratory/auditory). Under these experimental conditions known to increase sleep instability, we were able to show that sleep arousal is not the trigger or cause of RMMA, rather the “permissive window” that facilitates the occurrence of RMMA during sleep. To evaluate the clinical relevance of SB, we conducted a survey on a 7-17 year old orthodontic population to investigate the prevalence and risk factors associated with SB. It appeared that SB is a highly prevalent sleep disorders in children (15% of prevalence), and is a risk factor for tooth wear (odds ratio, OR 8.8), jaw muscle fatigue (OR 10.5), frequent headache (OR 4.3), loud breathing during sleep (OR 3.1), and several sleep complaints, such as daytime sleepiness (OR 7.4). These findings led us to design an experimental trial
The evaluation of oxidative stress parameters in the benign prostatic hyperplasia, prostatitis and prostate cancer

Amac : Son zamanlarda, oksidatif stresin iyi huylu prostat hiperplazisi, prostatit ve prostat kanserinde ozellikle onemli bir rolu oldugu iyi bilinmektedir. Bu calisma benign prostat hiperplazisi, prostatit ve prostat kanseri olan hastalarda oksidatif stres ve antioksidan parametreleri degerlendirmeyi planlamaktadir. Gerec ve Yontem: Bu amacla benign prostat hiperplazisi (n = 14), prostatit (n = 15) ve prostat kanseri (n=11) diger kronik hastaligi olmayan, sigara ve alkol kullanmayan toplamda kirk erkek hasta degerlendirmeye alindi. Venoz kan ornekleri alindi. Prostatit ve prostat kanserli hastalarda tirobarbiturik asit reaksiyonu (TBARS), total oksidan durum (TOS), total antioksidan kapasite (TAC), glutatyon (GSH) duzeyleri ve katalaz (CAT) aktivitesi iyi huylu prostat hiperplazisine gore degerlendirildi. Bulgular: GSH duzeylerinin anlamli derecede dusuk oldugu, TBARS ve TOS duzeylerinin benign prostat hiperplazisine gore prostat kanserli hastalarda anlamli olarak daha yuksek oldugu gorulmustur. Ayrica, GSH ve CAT, BPH ile karsilastirildiginda prostatitde onemli olcude farkli bulunmustur. Oksidatif stres, daha yuksek TBARS seviyeleri ve daha dusuk GSH seviyeleri ile prostat kanseri ve prostatit de gorulebilir. Sonuc: Antioksidan enzimin artan aktivitesi, oksidatif strese yanit olarak telafi edici bir duzenleme olabilir.
Reanimación cardiopulmonar extracorporal en la parada cardíaca pediátrica refractaria

extracorporal en la parada cardiaca pediatrica refractaria Richard T. Fiser, MD , Marilyn C. Morris, MD, MPH Division of Critical Care Medicine, University of Arkansas for Medical Science, 800 Marshall Street Slot 512-12, Little Rock, AR 72202-3591, USA ECMO Program, Arkansas Children’s Hospital, Little Rock, AR, USA Division of Critical Care, Morgan Stanley Children’s Hospital of New York, Columbia University, 3959 Broadway CHN 10-24, New York, NY 10032, USA