Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparative study of tympanoplasty and its outcome in various age groups using the middle ear risk index scale

Introduction: Otitis media is an important and a highly prevalent disease of the middle ear and poses serious health problem world-wide especially in developing countries where large percentage of the population lacks specialized medical care. With a large number of patients frequently undergoing tympanoplasty for chronic suppurative otitis media (CSOM), it is important to assess the severity of the disease and predict the outcome of the surgical management. Aims and Objectives: To study the efficiency of MERI in predicting the outcome of tympanoplasty in all age-groups. Materials and Methods: A prospective study was carried out in the department of Ear Nose and Throat (ENT), Banaras Hindu University (BHU), Varanasi, where all cases of chronic suppurative otitis media in the age-group of 8–40 years were included from September, 2017 to December, 2018. Total 74 patients with unilateral or bilateral perforation of tympanic membrane were included and these were followed-up for 4 months after surgery. Results: Maximum cases fell under MERI 1-3 (mild disease) and these patients had the best prognosis after tympanoplasty. Patients with unilateral perforation had better success rate as compared to patients with bilateral perforation. Conclusion: Our study showed that myringoplasty is a good treatment modality in the paediatric population and MERI scoring can be useful in predicting the outcome of tympanoplasty in all age-groups.
Perioperative risk factors for pulmonary complications after non-cardiac surgery

Background and Aims: Postoperative pulmonary complications (PPCs) lead to increased morbidity, mortality, length of hospital stay, and cost to the patient. This study was conducted to determine the risk factors and assess the incidence of PPC after non-cardiac surgery. Material and Methods: This prospective, observational study was conducted on 1,170 patients undergoing non-cardiac surgery. Details of patient, surgical, and anesthetic factors were collected and patients were followed up for the entire duration of hospital stay for the occurrence of PPC. Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score and the length of hospital stay was noted for all the patients. Regression analysis was used to find the risk factors associated with development of respiratory complications. Results: The incidence of PPC was found to be 59 in 1,170 patients (5%) in our hospital. Multivariate analysis revealed that patients with intermediate and high risk ARISCAT scoring had higher odds of developing PPC. Higher age (>50 years), positive cough test, presence of nasogastric tube, and intraoperative pulmonary complications were identified as independent risk factors associated with the occurrence of PPC. Conclusion: We found 5% incidence of PPC in our study. Recognition of the delineated risk factors and routine use of ARISCAT score for preoperative assessment may help identify patients at a higher risk of developing postoperative pulmonary complications.
Macular microvaculature evaluation using optical coherence tomography angiography in patients with high myopia

Background: Myopia is one of the common refractive error. Optical Coherence Tomography Angiography (OCTA) is a non-invasive investigation of microvasculature of the retina. Aim: To evaluate the OCTA study of the FAZ area and vascular density (VD) at superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC) in myopic patients versus healthy controls and their correlations to axial length (AL), best corrected visual acuity (BCVA) and spherical equivalent (SE). Setting and Design: Prospective cross-sectional comparative study. Methods and material 75 eyes of 54 patients, group A are 50 eyes with high myopia and group B are 25 eyes of age matched healthy controls. OCTA images were obtained, analyzed and compared using SPSS v.12 in both groups. Results: Foveal thickness was significantly increased in the myopic group (259.7±23.9) P=0.025, while the paravfoveal thickness was decreased (305.9±18.5) P < 0.001. Both superficial and deep FAZ area were increased in group A. The foveal VD at SCP was significantly higher in Group A (30.3±5.2) P=0.006. The whole image DCP VD was significantly lower (44.5±5.4) P < 0.001. Regarding CC, there was a significant difference in both foveal and parafoveal VD (66.1±4.9) (66.5±4.6) P=0.006 and 0.017, respectively, with both being higher in group A. The study also showed the importance of the CD at DCP and CC being negatively correlated with LogMAR BCVA and positively with the SE, while foveal thickness was positively correlated with the AL. Conclusion: OCTA is a valid and fast technique that could give insights about microvascular changes in myopia.
3D Rendering System using Data Glove

—In this paper, we introduce 3D motion rendering system based on a data glove. Our glove measures the movement of fingers by using flex sensors. Integrated FPGA gathers the data from sensors and performs pre-processing of the sensor data. The acquired data are forwarded to PC through Bluetooth communication and an application program displays the gesture.
The content and meaning of war experiences: A qualitative study of trauma and resilience among Liberian young refugees in Ghana

Abundant research has shown that traumatic war experiences can interfere with the mental health and wellbeing of children and adolescents, but less is known about the subjective experiences and views of war survivors. The present study identified and described the different types of war experiences of young refugees in an African context and analyzed how they perceived the meanings and impact of war on their lives. The participants were 13 Liberian 25–35-year-old male and female refugees living in Ghana who agreed to take part in semi-structured interviews based on the life history approach. The transcripts were analyzed using a phenomenological method to detect themes incorporating multiple subthemes. The results revealed five main themes about war experiences, all negative in nature: pain and humiliation, loss of close relationships, horrific scenes, threats to life, and fleeing for one’s life. Concerning the perceived meanings and impact of war, the results identified six main themes. Three of them were positive in nature: increased awareness of life, compassion for life, and identification with those suffering. The negative main themes incorporated vivid horrific memories, deprivation of age-appropriate opportunities, and self-harm and destructive behavior. Our findings suggest that young war survivors may be highly motivated to participate in nation- and peace-building and should be provided opportunities to contribute to broader political and civic life.
Effect of Hyperoxia on Myocardial Oxygenation and Function in Patients With Stable Multivessel Coronary Artery Disease

Background The impact of hyperoxia, that is, supraphysiological arterial partial pressure of O2, on myocardial oxygen balance and function in stable multivessel coronary artery disease (CAD) is poorly understood. In this observational study, we assessed myocardial effects of inhalational hyperoxia in patients with CAD using a comprehensive cardiovascular magnetic resonance exam. Methods and Results Twenty‐five patients with stable CAD underwent a contrast‐free cardiovascular magnetic resonance exam in the interval between their index coronary angiography and subsequent revascularization. The cardiovascular magnetic resonance exam involved T1 and T2 mapping for tissue characterization (fibrosis, edema) as well as function imaging, from which strain analysis was derived, and oxygenation‐sensitive cardiovascular magnetic resonance imaging. The latter modalities were both acquired at room air and after breathing pure O2 by face mask at 10 L/min for 5 minutes. In 14 of the 25 CAD patients (56%), hyperoxia induced poststenotic myocardial deoxygenation with a subsequent oxygenation discordance across the myocardium. Extent of deoxygenation was correlated to degree of stenosis (r=−0.434, P=0.033). Hyperoxia‐associated poststenotic deoxygenation was accompanied by ipsiregional reduction of diastolic strain rate (1.39±0.57 versus 1.18±0.65; P=0.045) and systolic radial velocity (37.40±17.22 versus 32.88±13.58; P=0.038). Increased T2, as well as lower cardiac index, and defined abnormal strain parameters on room air were predictive for hyperoxia‐induced abnormalities (P<0.05). Furthermore, in patients with prolonged native T1 (>1220 ms), hyperoxia reduced ejection fraction and peak strain. Conclusions Patients with CAD and pre‐existent myocardial injury who respond to hyperoxic challenge with strain abnormalities appear susceptible for hyperoxia‐induced regional deoxygenation and deterioration of myocardial function. Clinical Trial Registration URL: http://www.clinicaltrials. gov. Unique identifier: NCT02233634.
Morphology lies: a case-in-point with a new non-biting midge species from Oriental China (Diptera, Chironomidae)

Abstract Morphological traits are generally indicative of specific taxa, and particularly function as keys in taxonomy and species delimitation. In this study, a non-biting midge species with an Einfeldia-like superior volsella makes it hard to accurately determined based on its morphological characteristics. Molecular genes of two ribosomal genes and three protein-encoding genes were compiled to construct a related genera phylogeny and to address the taxonomic issues. Phylogenetic inference clearly supports the undetermined species as belonging to Kiefferulus. Therefore, a new species classified in the genus Kiefferulus is described and figured as an adult male from Oriental China. The species could be easily distinguished from other species in having an Einfeldia-like superior volsella and a triangular tergite IX.
Dexmedetomidine as adjunct in awake craniotomy – improvement or not?

Background Over the last decade, awake craniotomy for tumor resection has become a standard to maximize tumor resection and minimize the risk of permanent neurological deficits. Different techniques and medication regimes have been tested for this procedure. Until today there is no consensus on the optimal approach. Therefore, we investigated the effect of dexmedetomidine as an adjunct in awake cerebral tumor surgery and evaluated our improved technique. Methods Data of patients who underwent awake craniotomy for tumor resection at our institution between 09/2006 and 05/2018 were retrospectively analyzed. All patients were kept awake after cortical mapping. After changing our standard anesthetic procedure from propofol/remifentanil alone to propofol/remifentanil and dexmedetomidine, we performed an evaluation of time to arousal, drug dosages, patients’ cooperation and the occurrence of periprocedural adverse events. Results Eighty-four patients received propofol/remifentanil alone (SG). A further 17 patients additionally received dexmedetomidine following craniotomy in order to induce rapid arousal (DG). In the dexmedetomidine group a significantly reduced infusion time for propofol (169.2 ± 47.4 vs. 212.9 ± 63.3 minutes; P = 0.008) and non-significantly shorter time to arousal (12.0 [10.0/16.5] vs. 15.0 [10.0/20.0] minutes; P = 0.271) could be identified. In general, the overall procedure was very well tolerated by all patients. Conclusions The asleep-awake technique is a well-accepted and safe procedure. It allows continuous surveillance of the patient’s neurological function during tumor resection and the postoperative phase, minimizing complications. In addition, our data show that the use of dexmedetomidine results in a shorter time to arousal.
Critical consideration of assessment methods for clinically significant changes of mental distress after psycho‐oncological interventions

Considering the heterogeneity of cancer entities and the associated disease progression, personalized care of patients is increasingly emphasized in psycho‐oncology. This individualization makes the use of measurements of individual clinically significant change important when studying the efficacy and effectiveness of psycho‐oncological care. Two conceptualizations for the measurement of clinical significance are critically contrasted in this study: the Reliable Change Index (RCI) and the Minimal Important Difference (MID) method.
Assessing the Complex Causes of Kidney Allograft Loss

Supplemental Digital Content is available in the text. Background. Although graft loss is a primary endpoint in many studies in kidney transplantation and a broad spectrum of risk factors has been identified, the eventual causes of graft failure in individual cases remain ill studied. Methods. We performed a single-center cohort study in 1000 renal allograft recipients, transplanted between March 2004 and February 2013. Results. In total, 365 graft losses (36.5%) were identified, of which 211 (57.8%) were due to recipient death with a functioning graft and 154 (42.2%) to graft failure defined as return to dialysis or retransplantation. The main causes of recipient death were malignancy, infections, and cardiovascular disease. The main causes of graft failure were distinct for early failures, where structural issues and primary nonfunction prevailed, compared to later failures with a shift towards chronic injury. In contrast to the main focus of current research efforts, pure alloimmune causes accounted for only 17.5% of graft failures and only 7.4% of overall graft losses, although 72.7% of cases with chronic injury as presumed reason for graft failure had prior rejection episodes, potentially suggesting that alloimmune phenomena contributed to the chronic injury. Conclusions. In conclusion, this study provides better insight in the eventual causes of graft failure, and their relative contribution, highlighting the weight of nonimmune causes. Future efforts aimed to improve outcome after kidney transplantation should align with the relative weight and expected impact of targeting these causes.
European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness

Patients with acquired brain injury and acute or prolonged disorders of consciousness (DoC) are challenging. Evidence to support diagnostic decisions on coma and other DoC is limited but accumulating. This guideline provides the state‐of‐the‐art evidence regarding the diagnosis of DoC, summarizing data from bedside examination techniques, functional neuroimaging and electroencephalography (EEG).
Artificial Turf Infill: A Comparative Assessment of Chemical Contents

Concerns have been raised regarding toxic chemicals found in tire crumb used as infill in artificial turf and other play surfaces. A hazard-based analysis was conducted, comparing tire crumb with other materials marketed as alternative infills. These include other synthetic polymers as well as plant- and mineral-based materials. The comparison focused on the presence, absence, number, and concentration of chemicals of concern. No infill material was clearly free of concerns, but several are likely to be somewhat safer than tire crumb. Some alternative materials contain some of the same chemicals of concern as those found in tire crumb; however, they may contain a smaller number of these chemicals, and the chemicals may be present in lower quantities. Communities making choices about playing surfaces are encouraged to examine the full range of options, including the option of organically managed natural grass.
The Clinical and Parasitologic Follow-up of Trypanosoma cruzi–infected Children in a Nonendemic Country

Background: Chagas disease has become a global health problem, with the pediatric population being especially vulnerable. Our aim was to describe the clinical-epidemiologic aspects of disease in this population, as well as tolerance and adherence to treatment and the subsequent evolution of the disease. Methods: A prospective study involving 949 children 0–14 years of age screened from 2007 to 2018. Diagnosis was performed by polymerase chain reaction and/or microhematocrit in <1-year-old children or serology in those ≥1 year of age. After diagnosis, children were examined for the clinical manifestation of Chagas disease and were treated with benznidazole. Treatment response was monitored by polymerase chain reaction and serology. Results: Forty children were infected (4.2% of the population screened). Twelve children were diagnosed during the acute phase (≤1-year-old), 3 of whom were symptomatic, and 28 (4- to 14-year-olds) were in the chronic phase: 18 in the indeterminate phase and 10 presented cardiac and/or digestive involvement. Regarding treatment, 10 (25.6%) children had side effects (6 mild, 2 moderate and 2 severe reactions), leading to treatment interruption in 3 of them. No side effects were detected in ≤1-year-old children (P < 0.05). Cure was confirmed in 29.4% of the children during follow-up, and the age of the children at treatment (≤1 year) was clearly associated with the effectiveness of treatment (P < 0.05). Conclusions: Effectiveness and safety of treatment were optimum in ≤1-year-old children. Increased side effects, cardiac and/or digestive disorder incidence and lower treatment effectiveness were detected in older children, highlighting the need for early screening.
The influence of degree of socialization and age on length of stay of shelter cats

ABSTRACT Surveys indicate that cat behaviors, such as degree of friendliness or playfulness, are important to potential adopters and cat owners. There are few data, however, relating the degree of socialization in cats with length of stay (LOS) in a shelter. Based on provided definitions, staff from 31 shelters in the Northeastern and Mid-Atlantic United States placed cats (n = 645) into one of three behavioral categories: interactive, approachable, and unapproachable. Age and LOS for each cat were also reported. Using a mixed model analysis that controlled for the effect of shelter, the LOS of interactive cats was 37 days, LOS of approachable cats was 51 days, and LOS of unapproachable cats was 119 days. LOS increased four days, on average, for each additional year of age and there was an interaction between age and behavioral categories. Importantly, LOS of interactive cats was not influenced by age. Future research should explore the effectiveness of cat behavioral modification programs on reducing LOS of shelter cats.
Anti-PD-1 immunotherapy leads to tuberculosis reactivation via dysregulation of TNF-α

Previously, we developed a 3-dimensional cell culture model of human tuberculosis (TB) and demonstrated its potential to interrogate the host-pathogen interaction (Tezera et al., 2017a). Here, we use the model to investigate mechanisms whereby immune checkpoint therapy for cancer paradoxically activates TB infection. In patients, PD-1 is expressed in Mycobacterium tuberculosis (Mtb)-infected lung tissue but is absent in areas of immunopathology. In the microsphere model, PD-1 ligands are up-regulated by infection, and the PD-1/PD-L1 axis is further induced by hypoxia. Inhibition of PD-1 signalling increases Mtb growth, and augments cytokine secretion. TNF-α is responsible for accelerated Mtb growth, and TNF-α neutralisation reverses augmented Mtb growth caused by anti-PD-1 treatment. In human TB, pulmonary TNF-α immunoreactivity is increased and circulating PD-1 expression negatively correlates with sputum TNF-α concentrations. Together, our findings demonstrate that PD-1 regulates the immune response in TB, and inhibition of PD-1 accelerates Mtb growth via excessive TNF-α secretion.
Identification of differentially methylated candidate genes and their biological significance in IUGR neonates by methylation EPIC array

Abstract Background Intrauterine growth restriction (IUGR) is a pregnancy-associated disease manifested by decreased growth rate of fetus than the normal genetic growth potential. It is associated with increased susceptibility to metabolic diseases later in life. Although the mechanisms underlying the origin of metabolic diseases are poorly understood, DNA methylation is a crucial investigation for the identification of epigenetic changes. Objectives To assess the degree of change of DNA methylation in IUGR neonates and compare with that of appropriate for gestational age (AGA) neonates and to explore the differentially methylated candidate genes and their biological significance. Methods This cohort study was conducted in the Neonatology Department of JIPMER during the period of November 2017 to December 2018. Forty each of IUGR and gestation matched AGA neonates were recruited. Umbilical cord blood samples were collected at birth. DNA was separated from the blood samples; and, using 5-mC DNA ELISA method, the percentage of genomic DNA methylated in these neonates was established. Data were expressed as mean ± standard deviation. Methylation EPIC array was performed to identify the differentially methylated candidate genes. David analysis was used to find out the functional annotation chart by KEGG pathway. Results Genomic DNA methylation varied significantly between IUGR and AGA neonates (IUGR: 3.12 ± 1.24; AGA: 4.40 ± 2.03; p value: <.01). A global shift toward hypomethylation was seen in IUGR compared with AGA, targeted to regulatory regions of the genome, and specifically promoters. Pathway analysis identified deregulation of pathways involved in metabolic diseases. Altered methylation of PTPRN2 & HLADQB1 genes leads to dysregulation of T-cells and reactive oxygen species (ROS). These changes may lead to complications later among these neonates subjected to IUGR. Conclusion Our findings show significant changes in the methylation pattern of genes among IUGR and AGA babies. Steps for correcting the changes may help in reducing later complications among IUGR babies.